Evaluation of the absorbed dose in odontological computerized tomography; Avaliacao da dose absorvida em tomografia computadorizada odontologica

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Legnani, Adriano; Schelin, Hugo R.; Rocha, Anna Silvia P.S. da, E-mail: schelin@utfpr.edu.b, E-mail: anna@utfpr.edu.b [Universidade Tecnologica Federal do Parana (UTFPR), Curitiba, PR (Brazil); Khoury, Helen J., E-mail: khoury@ufpe.b [Universidade Federal de Pernambuco (UFPE), Recife, PE (Brazil)

2011-10-26

This paper evaluated the absorbed dose at the surface entry known as 'cone beam computed tomography' (CBCT) in odontological computerized tomography. Examination were simulated with CBCT for measurements of dose. A phantom were filled with water, becoming scatter object of radiation. Thermoluminescent dosemeters were positioned on points correspondent to eyes and salivary glands

Pharmacists' social authority to transform community pharmacy practice

Directory of Open Access Journals (Sweden)

Timothy McPherson

2011-01-01

Full Text Available Leaders in the profession of pharmacy have articulated a vision of pharmacists as providers of patient-centered care (PCC services and the Doctor of Pharmacy was established as the required practice degree to achieve this vision. Pharmacist-provided PCC services have been shown to reduce medication costs and improve patient compliance with therapies. While community pharmacists are capable of, and are ideally placed for, providing PCC services, in fact they devote most of their time to prescription dispensing rather than direct patient care. As professionals, community pharmacists are charged with protecting society by providing expert services to help consumers manage risks associated with drug therapies. Historically pharmacists fulfilled this responsibility by accurately dispensing prescription medications, verifying doses, and allergy checking. This limited view of pharmacy practice is insufficient in light of the modern view of pharmacists as providers of PCC. The consumers' view of community pharmacy as a profession represents a barrier to transforming the basis of community pharmacy from product distribution to providing PCC services. Community pharmacists are conferred with social authority to dictate the manner in which their professional services are provided. Pharmacists can therefore facilitate the transition to PCC as the primary function of community pharmacy by exercising their social authority to engage consumers in their roles in the new patient-pharmacist relationship. Each pharmacist must decide to provide PCC services. Suggestions for initiating PCC services in community pharmacy are offered.   Type: Idea Paper

Public perception of pharmacists: Film and television portrayals from 1970 to 2013.

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Yanicak, Amy; Mohorn, Phillip L; Monterroyo, Philipp; Furgiuele, Gabrielle; Waddington, Lindsay; Bookstaver, P Brandon

2015-01-01

To determine the percentage of pharmacists portrayed in a positive, negative, or neutral light in films and television shows available in the United States from January 1970 to July 2013. Secondary objectives were to evaluate pharmacist characters as heroes, villains, or victims; assess pharmacist characters' demographics; and determine the presence of pharmacist characters in medical-themed television shows. Retrospective, observational, descriptive study. A review of available U.S. film and television from January 1970 to July 2013 at an academic institution. 214 television episodes or films that contained at least one pharmacist portrayal. Electronic inquiries requesting submissions of known pharmacist portrayals were distributed to pharmacy professionals in national and state-affiliated pharmacy organizations and to faculty, staff, and students at the University of South Carolina. Electronic databases and search engines (Internet Movie Database [IMDb], Bing, and Google) were consulted and used to further research possible pharmacist portrayals. The study investigators developed an algorithm incorporating social norms, common pharmacist practices, and viewer perceptions to determine positive, negative, or neutral status for each pharmacist portrayal. Year and genre of media, demographics of identified pharmacist characters, portrayal status of identified pharmacist characters, and number of pharmacist characters and appearances per each television show reviewed. In the films and television shows reviewed, there were 231 pharmacist portrayals, with 160 unique pharmacist characters. Of the 231 portrayals, 145 (63%) were negative, 30 (13%) were positive, and 56 (24%) were neutral. Of the 160 unique characters, 121 (76%) were male, 120 (75%) were Caucasian, and 86 (54%) were younger than 50 years old. The name of the character was provided for 70 (44%) of the pharmacists portrayed. The portrayal of pharmacists in U.S. film and television is primarily negative

Pharmaceutical Role Expansion and Developments in Pharmacist-Physician Communication.

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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.

Ethics and the Computerization of Pharmacy.

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McCarthy, Robert L.; Perrolle, Judith A.

1991-01-01

The current and potential impact of computerization on pharmacy practice is discussed, focusing on ethical dilemmas in the pharmacist-patient relationship, confidentiality of records, and the role of artificial intelligence in decision making about drug therapy. Case studies for use by teachers of pharmaceutical ethics are provided. (Author/MSE)

Implementation of computerized add-on testing for hospitalized patients in a large academic medical center.

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Kim, Ji Yeon; Kamis, Irina K; Singh, Balaji; Batra, Shalini; Dixon, Roberta H; Dighe, Anand S

2011-05-01

Physician requests for additional testing on an existing laboratory specimen (add-ons) are resource intensive and generally require a phone call to the laboratory. Verbal orders such as these have been noted to be associated with errors in accuracy. The aim of this study was to compare a novel computerized system for add-on requests to the prior verbal system. We compare the computerized add-on request system to the verbal system with respect to order completeness and workflow. We demonstrate that the computerized add-on system resulted in the complete in-laboratory documentation of the add-on request 100% of the time, compared to 58% with the verbal add-on system. In addition, we show that documentation of a verbal add-on request in the electronic medical record (EMR) occurred for 4% of requests, while in the computerized system EMR documentation occurred 100% of the time. We further demonstrate that the computerized add-on request process was well accepted by providers and did not significantly change the test mix of the add-on requests. In computerized physician order entry (CPOE) implementations, add-on order functionality should be considered so these orders are documented in the EMR.

Quality assurance of clinical transfusion practice by implementation of the privilege of blood prescription and computerized prospective audit of blood requests.

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Marconi, M; Almini, D; Pizzi, M N; Riccardi, D; Bergamaschi, W; Giovanetti, A M; Rebulla, P; Sirchia, G

1996-03-01

Guidelines, algorithms and recommendations have been issued in the attempt to ensure appropriateness of transfusion practice, but the results are less than satisfactory, mainly due to the difficulty to turn paper procedures into actual practice. In our hospital we have tried to overcome this difficulty through the implementation of a quality assurance programme which includes giving the privilege of nonurgent blood prescription to a limited number of physicians and a computerized prospective audit of blood requests. The latter is performed through verification of the compliance of blood requests, which are designed to include a patient's laboratory and clinical data, with hospital guidelines for the proper use of blood. In the 12 months since implementation of the computerized prospective audit the transfusion service has evaluated 7884 requests. Of these, 63.4% (n = 4998) were for red blood cells, 21.1% (n = 1664) for platelets and 15.5% (n = 1222) for fresh frozen plasma. The prospective audit showed that 96.8% and 98.1% of requests for red units and platelets were appropriate, respectively. Conversely, approximately 27% of plasma requests did not comply with guidelines, mainly because the evidence of coagulopathy was missing. However, inappropriateness of plasma requests for elective general surgery decreased from 39% at the onset of the programme to 14% in the last trimester considered. Moreover, the evaluation by retrospective audit of the proportion of patients transfused with both red blood cells and plasma in the perioperative period out of those transfused with red blood cells only, as an indicator of unwanted reconstitution of whole blood, showed that this proportion decreased from 47.6% (320/672) in the 12 months before implementation of computerized audit to 37.8% (244/646) in the following 12 months (difference = -9.8%, 95% confidence interval of the difference from -4.5% to -15.1%; P audit is a useful tool for assuring the quality of blood requesting.

[Implementation of computerized phisician order entry in a hospital setting: what are the keys to success?].

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Garçous, R; Remy, G; Bary, M; Amant, F; Cauwe, F; De Beusscher, L; Bouzette, A; De Coster, P; Hecq, J-D

2013-06-01

A software of computerized physician order entry [CPOE] was developed by a data-processing company in collaboration with the Mont-Godinne University Hospital By 2006, parallel to the evolution of the software, the progressive implementation of CPOE was carried out, and currently covers 16 wards, the emergency room, the recovery rooms and the center of medical care [day hospital] as well as the day surgical center Complete computerization of the drug supply chain, including the regulation by the physician, the pharmaceutical validation, the delivery and the follow-up of stocks by pharmacy, the validation of the administration by the nurse and the tariffing of the drugs. In 2006, a working group was created in order to validate specifications allowing the development of a software of CPOE, Linked to the computerized medical record. A data-processing company was selected in order to develop this software. Two beds were computerized in the pneumology ward, in order to test and validate the software. From 2007 to 2009, 3 additional wards were computerized [geriatrics, neurosurgery, revalidation]. A steering committee of CPOE, composed of various members (direction, doctors, pharmacists, nurses, data processing specialistsl is created. This committee allows the installation of the means necessary to the deployment of CPOE in the Institution. Structured teams for the deployment are created: medical and nurse coaches. From 2009 to 2012, the deployment of the software is carried out, covering 16 wards, the emergency room, the recovery room and the day-hospitals. The computerization of the drug supply chain is a challenge which concerns the institutional level. The assets of our hospital and our project were: - a strong management committee, making of this project a priority entering the strategical planning of the institution; - a steering committee allowing each type of actor to express his needs, and of prioriser requests; - a closer medical coaching; - teams of nurses

Pharmacists' knowledge and interest in developing counseling skills relating to oral contraceptives.

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Amin, Mohamed E K

2016-04-01

Possessing correct therapeutic information on oral contraceptives is an important prerequisite for the provision of sound advice to women who are using these products. This study examines Egyptian pharmacists' knowledge of pharmacotherapeutic aspects of oral contraceptives as well as interest in developing skills in providing counseling on oral contraceptive pills. Community pharmacies throughout Alexandria, Egypt. A cross-sectional survey was self-administered by a random sample of community pharmacists in Alexandria, Egypt. Five multiple choice questions likely to arise when counseling women on oral contraceptives were constructed. Questions covered compatibility with breastfeeding, precautions, health risks and managing missed pills of oral contraceptives. Using ordered logistic regression, a model was estimated to predict pharmacists' interest in developing skills in providing counseling on oral contraceptives. Pharmacists' aggregate scores for knowledge questions and pharmacists' interest in developing skills in providing counseling on oral contraceptive pills. Of the 181 approached pharmacists, 92 % participated. Twenty one pharmacists (13 %) did not know the correct answer to any question, 122 (73 %) answered one-two correctly, 23 (14 %) answered three-four correctly. No pharmacist answered all five questions correctly. For pharmacists' interest in developing skills in providing counseling on oral contraceptives, the percentage values for answers were: not interested at all (10.2 %), slightly interested (27.0 %), somewhat interested (23.4 %), interested (30.0 %) and extremely interested (9.6 %). Pharmacists' interest in developing skills in providing counseling on oral contraceptives was significantly associated with the number of women who requested advice from the pharmacists on oral contraceptives (OR 1.54, CI 1.24-1.91). In terms of the learning method of preference, percentage values for answers were: attending a workshop (4 %), online course (18

Dose profile study on computerized tomography scanning of skull with simulator object

International Nuclear Information System (INIS)

Mourao, A.P.

2011-01-01

This work presents a comparison among the dose profiles in scanning of computerized tomography of a simulator object of PMMA in its periphery region. To obtain the deposited dose at the PMMA thermoluminescent dosemeters were used positioned at the interior of PMMA simulated object longitudinal to periphery and at the center of cylinder (positions denominated North, South, East, West and Center). Eight scanning were performed of simulator object using the routine protocol for skull in eight different services of radiodiagnostic by TC

Dose profile measurement in computerized axial tomography equipment using thermoluminescent dosemeters

International Nuclear Information System (INIS)

Azorin V, J.C.; Falcony, C.; Azorin N, J.

2000-01-01

In this work are presented the results about measuring the radiation dose profile in two equipment of computerized axial tomography (Tac). Thermoluminescent dosemeters (Dtl) of LiF, Mg, Cu, P + Ptfe in form of disks were used which were developed and made in Mexico. The results showed that Dtl are appropriated for these type of studies. (Author)

[Discuss the relationship between physicians and pharmacists in the context of euthanasia].

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Buijsen, M A J M

2018-01-01

Physicians are regularly confronted with pharmacists who refuse to provide euthanasia drugs. They do not always understand that the provision of euthanasia drugs is not a normal professional activity for pharmacists. It is a lot less clear that pharmacists are also allowed to have fundamental objections. In addition, professional standards lack clarity for pharmacists who do not have such objections to the provision of euthanasia drugs. The relationship between physicians and pharmacists in the context of euthanasia presents problems overlooked by researchers of the third evaluation of the Termination of Life on Request and Assisted Suicide (review procedures) Act (WTL). The professional bodies of physicians and pharmacists should address these as soon as possible.

Patient Awareness and Expectations of Pharmacist Services During Hospital Stay.

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King, Philip K; Martin, Steven J; Betka, Eric M

2017-10-01

There are insufficient data in the United States regarding patient awareness and expectations of hospital pharmacist availability and services. The objective of this research is to assess patient awareness and expectations of hospital pharmacist services and to determine whether a marketing campaign for pharmacist services increases patient awareness and expectations. Eligible inpatients were surveyed before and after implementation of a hospital-wide pharmacist services marketing campaign (12 items; Likert scale of 1 [strongly disagree] to 4 [strongly agree]; maximum total score of 48) regarding awareness of pharmacist services. The primary outcome was the change in median total survey scores from baseline. Other outcomes included the frequency of patient requests for pharmacists. Similar numbers of patients completed the survey before and after the campaign (intervention, n = 140, vs control, n = 147). Awareness of pharmacist availability and services was increased (41 [interquartile ranges, IQRs: 36-46] vs 37 [IQR 31-43]; P marketing campaign implementation. Awareness among inpatients of pharmacist services is low. Marketing pharmacist availability and services to patients in the hospital improves awareness and expectations for pharmacist-provided care and increases the frequency of patient-initiated interaction between pharmacists and patients. This could improve patient outcomes as pharmacists become more integrally involved in direct patient care.

Utilization of simulated patients to assess diabetes and asthma counseling practices among community pharmacists in Qatar.

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Paravattil, Bridget; Kheir, Nadir; Yousif, Adil

2017-08-01

Background Patient counseling is one of the most important services a pharmacist can provide to patients. Studies have shown that counseling provided by pharmacists may prevent medication related problems and improve adherence to medication therapy. Objective To explore counseling practices among community pharmacists using simulated patients and to determine if patient, pharmacist, and pharmacy characteristics influence the counseling provided by community pharmacists. Setting Private community pharmacies within Qatar. Method This is a randomized, cross sectional study where simulated patients visited community pharmacies and presented the pharmacist with a new prescription or requested a refill for either a diabetes or asthma medication. Pharmacists completed a questionnaire at the end of the simulated interaction, which was utilized to determine if patient, pharmacist, or pharmacy characteristics had any influence on the counseling provided to patients. A scoring system was devised to assess the pharmacist's counseling practices. Main outcome measure To evaluate the type of information provided by community pharmacists to the simulated patient regarding diabetes and asthma. Results One hundred and twenty-nine pharmacists were enrolled in the study. Eighty one percent of pharmacists had a score master of pharmacy degree provided significantly better counseling (f = 3.261; p = 0.042). Many pharmacists (65%) provided hypoglycemia management to patients, however, 63% referred the patient to the physician when the patient experienced hypoglycemia from inappropriate medication administration. Only 2 (7%) pharmacists correctly counseled the patient on all 8 inhaler administration steps. Majority of pharmacists (50%) educated on the role of the rescue and controller therapy in asthma, however, 33% referred the patient to the physician when the patient inquired about controller therapy use. Conclusion Patient counseling was substandard with the majority of community

The Hispanic pharmacist: Value beyond a common language.

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Cipriano, Gabriela C; Andrews, Carlota O

2015-01-01

To highlight the added value of bilingual Hispanic pharmacists in the care of Hispanic patients by sharing their patients' language and culture. Inability to speak and/or write in the patients' native language severely impairs our best efforts to deliver good health care. This is a widely recognized cause of non-compliance or less than favorable possible health outcomes in Hispanic patients. What has received less attention, however, is that the ability to speak Spanish alone may not remove completely the barrier for non-compliance among Hispanics. Bilingual Spanish-English pharmacists do not have the language barrier, but if they do not recognize and accept cultural differences, their impact in their patients' response may still be limited. It is time to recognize the added value of Hispanic pharmacists to Hispanic patients' health outcomes. Understanding and sharing a culture allows the pharmacist to make medication education and interventions relevant to the patient and spark interest in their own health care. Thus, in caring for the health of our patients, cultural barriers may be more challenging to conquer than language barriers; deep appreciation and acceptance of our patients' belief system cannot be acquired by just reading about it, having a computerized program, or hiring an interpreter.

The Hispanic pharmacist: Value beyond a common language

Directory of Open Access Journals (Sweden)

Gabriela C Cipriano

2015-04-01

Full Text Available Objective: To highlight the added value of bilingual Hispanic pharmacists in the care of Hispanic patients by sharing their patients’ language and culture. Summary: Inability to speak and/or write in the patients’ native language severely impairs our best efforts to deliver good health care. This is a widely recognized cause of non-compliance or less than favorable possible health outcomes in Hispanic patients. What has received less attention, however, is that the ability to speak Spanish alone may not remove completely the barrier for non-compliance among Hispanics. Bilingual Spanish–English pharmacists do not have the language barrier, but if they do not recognize and accept cultural differences, their impact in their patients’ response may still be limited. Conclusion: It is time to recognize the added value of Hispanic pharmacists to Hispanic patients’ health outcomes. Understanding and sharing a culture allows the pharmacist to make medication education and interventions relevant to the patient and spark interest in their own health care. Thus, in caring for the health of our patients, cultural barriers may be more challenging to conquer than language barriers; deep appreciation and acceptance of our patients’ belief system cannot be acquired by just reading about it, having a computerized program, or hiring an interpreter.

Pharmacists' role in opioid overdose: Kentucky pharmacists' willingness to participate in naloxone dispensing.

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Freeman, Patricia R; Goodin, Amie; Troske, SuZanne; Strahl, Audra; Fallin, Amanda; Green, Traci C

To assess pharmacists' willingness to initiate the dispensing of naloxone. As of 2015, Kentucky law permits certified pharmacists to dispense naloxone under a physician-approved protocol. Electronic survey (e-mail) gauging perception of pharmacists' role in opioid overdose and attitudes toward, and barriers to, naloxone dispensing. All Kentucky pharmacists with active licenses in 2015. Ordinal logistic regression was used to estimate the impact of pharmacist characteristics and attitudes on willingness to initiate naloxone dispensing, where the dependent variable was operationalized as a Likert-type question on a scale of 1 (not at all willing) to 6 (very willing). Of 4699 practicing Kentucky pharmacists, 1282 responded, of which 834 were community practitioners (response rate 27.3%). Pharmacists reported varying willingness to initiate naloxone dispensing, with 37.3% very willing (score 5 or 6) and 27.9% not willing (score 1 or 2). However, a majority of pharmacists reported willingness to dispense naloxone with a valid prescription (54.0%, score 5 or 6). Women pharmacists were 1.3 times more likely than men to be willing to initiate naloxone dispensing (95% confidence interval [CI] 1.0-1.6). Those who reported confidence in identifying individuals at risk for overdose were 1.2 times more likely to initiate dispensing, and those who reported confidence in ability to educate patients about overdose were 1.6 times more likely to express willingness to initiate naloxone dispensing (95% CIs, respectively, 1.0-1.3 and 1.4-1.8). Community pharmacists reported barriers to naloxone access at higher rates than pharmacists from other practice settings. Kentucky pharmacists are divided in their willingness to initiate naloxone dispensing; however, those who are confident in their ability to identify overdose risks are more willing. Increasing pharmacist confidence through appropriately designed education programs could facilitate pharmacist participation in naloxone

Opportunities for Pharmacists and Student Pharmacists to Provide Clinical Preventive Services

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Natalie A. DiPietro Mager

2017-01-01

Full Text Available Pharmacists and student pharmacists can play an important role in providing clinical preventive services as specified by the United States Preventive Services Task Force (USPSTF. The USPSTF guidelines provide evidence-based recommendations about clinical preventive services for the general population. The purpose of this paper is to provide information to pharmacists and student pharmacists developing and implementing preventive health care services. Examples of successful pharmacy-based programs are also provided. Pharmacists and student pharmacists can provide preventive health care interventions by conducting screenings, providing education, and making referrals. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties   Type: Idea Paper

Pharmacists as immunizers: a survey of community pharmacists' willingness to administer adult immunizations.

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Edwards, Nicholas; Gorman Corsten, Erin; Kiberd, Mathew; Bowles, Susan; Isenor, Jennifer; Slayter, Kathryn; McNeil, Shelly

2015-04-01

Adult immunization rates worldwide fall below desired targets. Pharmacists are highly accessible healthcare providers with the potential to increase immunization rates among adults by administering vaccines in their practice setting. To determine the attitudes of community-based Canadian pharmacists with respect to expanding their scope of practice to include administration of immunizations. An internet-based survey was emailed to community pharmacists across Canada. The survey was piloted through focus groups for qualitative feedback, tested for content validity, and test-retest reliability prior to dissemination. There were 495 responses to the survey. The majority (88 %) agreed that pharmacists as immunizers would increase public access, improve rates (84 %), and be acceptable to the public (72 %). However, only 68 % agreed that pharmacists should be permitted to immunize. The majority of respondents (90 %) agreed that certification in vaccine administration should be required for pharmacists to administer vaccines. Pharmacists identified education, reimbursement, and negative interactions with other providers as barriers to pharmacists administering vaccines. Canadian pharmacists are willing to expand their scope of practice to include immunization. However, implementation requires professional development and certification in vaccine administration.

Implementation of a pharmacist-managed heart failure medication titration clinic.

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Martinez, Amanda S; Saef, Jerold; Paszczuk, Anna; Bhatt-Chugani, Hetal

2013-06-15

The development, implementation, and initial results of a pharmacist-managed heart failure (HF) medication titration clinic are described. In a quality-improvement initiative at a Veterans Affairs health care system, clinical pharmacists were incorporated into the hospital system's interprofessional outpatient HF clinic. In addition, a separate pharmacist-managed HF medication titration clinic was established, in which pharmacists were granted an advanced scope of practice and prescribing privileges, enabling them to initiate and adjust medication dosages under specific protocols jointly established by cardiology and pharmacy staff. Pharmacists involved in the titration clinic tracked patients' daily body weight, vital signs, and volume status using telephone-monitoring technology and via patient interviews. A retrospective chart review comparing achievement of target doses of angiotensin-converting enzyme inhibitor (ACEI), angiotensin-receptor blocker (ARB), and β-blocker therapies in a group of patients (n = 28) whose dosage titrations were carried out by nurses or physicians prior to implementation of the pharmacist-managed HF medication titration clinic and a group of patients (n = 27) enrolled in the medication titration clinic during its first six months of operation indicated that target ACEI and ARB doses were achieved in a significantly higher percentage of pharmacist-managed titration clinic enrollees (52.9% versus 31%, p = 0.007). Patients enrolled in the pharmacist-managed HF medication titration clinic also had a significantly higher rate of attainment of optimal β-blocker doses (49% versus 24.7%, p = 0.012). Implementation of a pharmacist-managed HF medication titration clinic increased the percentage of patients achieving optimal ACEI, ARB, and β-blocker dosages.

Statistical evaluation of the dose-distribution charts of the National Computerized Irradiation Planning Network

International Nuclear Information System (INIS)

Varjas, Geza; Jozsef, Gabor; Gyenes, Gyoergy; Petranyi, Julia; Bozoky, Laszlo; Pataki, Gezane

1985-01-01

The establishment of the National Computerized Irradiation Planning Network allowed to perform the statistical evaluation presented in this report. During the first 5 years 13389 dose-distribution charts were calculated for the treatment of 5320 patients, i.e. in average, 2,5 dose-distribution chart-variants per patient. This number practically did not change in the last 4 years. The irradiation plan of certain tumour localizations was performed on the basis of the calculation of, in average, 1.6-3.0 dose-distribution charts. Recently, radiation procedures assuring optimal dose-distribution, such as the use of moving fields, and two- or three-irradiation fields, are gaining grounds. (author)

[Pharmacists' interventions conducted by hospital pharmacists on psychotropic drugs pharmacotherapy].

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Parent, G; Rose, F-X; Bedouch, P; Conort, O; Charpiat, B; Juste, M; Roubille, R; Allenet, B

2015-09-01

The French Society of Clinical Pharmacy (SFPC) through the special interest group "standardization and optimization of clinical pharmacy activities" stated that the study of pharmacists' interventions (PIs) conducted during prescription analysis was a priority. The SFPC developed an internet website named Act-IP(®) (http://www.sfpc.eu/fr/) where French speaking pharmacists were able to document PIs using a normalized codification. The objective of this study was to analyze medication-related problems linked to psychotropic drugs in hospital and to investigate PIs performed during prescription analysis. This is a multicenter, retrospective, observational study using PIs involving psychotropic medications recorded between September 2006 and February 2009 on the Act-IP(®) website. Four thousand six hundred and twenty PIs recorded by 165 pharmacists in 57 hospitals were related to psychotropic drugs. Patients concerned by these drug-related problems were 64 years old on average. Seven categories of medication-related problems represented more than 69% of PIs (1.1-Non Conformity of the drug choice compared to the formulary; 4.1 Supratherapeutic dose; 5.3 Therapeutic redundancy; 6.2 Drug interaction (all levels of severity); 7.0 Adverse drug reaction; 8.3 Inappropriate drug form; 8.5 Inappropriate timing of administration). The PIs related to 9.2 Patient's non compliance, 2.0 Untreated indication and 3.2 Length of the treatment too short were infrequent (less than 1%). The most common type of intervention was the dose adjustment. Almost 45% of these PIs involved Zopiclone or Zolpidem prescription in elderly patients. Seven hundred and nine drug interactions were identified by pharmacists. The most common type of drug interaction considered the risk of cardiac arrhythmias due to antipsychotic medications. One hundred and thirty-three PIs concerned adverse drug reaction. The most frequent adverse drug reactions were a fall (36 PIs), hemorrhage/bleeding (32 PIs

How can pharmacist remuneration systems in Europe contribute to generic medicine dispensing?

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Dylst P

2012-03-01

Full Text Available Generic medicines can generate larger savings to health care budgets when their use is supported by incentives on both the supply-side and the demand-side. Pharmacists’ remuneration is one factor influencing the dispensing of generic medicines.Objective: The aim of this article is to provide an overview of different pharmacist remuneration systems for generic medicines in Europe, with a view to exploring how pharmacist remuneration systems can contribute to generic medicine dispensing.Methods: Data were obtained from a literature review, a Master thesis in Pharmaceutical Care at the Catholic University of Leuven and a mailing sent to all members of the Pharmaceutical Group of the European Union with a request for information about the local remuneration systems of community pharmacists and the possible existence of reports on discounting practices.Results: Pharmacists remuneration in most European countries consists of the combination of a fixed fee per item and a certain percentage of the acquisition cost or the delivery price of the medicines. This percentage component can be fixed, regressive or capped for very high-cost medicines and acts as a disincentive for dispensing generic medicines. Discounting for generic medicines is common practice in several European countries but information on this practice tends to be confidential. Nevertheless, data for Belgium, France, the Netherlands and United Kingdom indicated that discounting percentages varied from 10% to 70% of the wholesale selling price.Conclusion: Pharmacists can play an important role in the development of a generic medicines market. Pharmacists should not be financially penalized for dispensing generic medicines. Therefore, their remuneration should move towards a fee-for-performance remuneration instead of a price-dependent reimbursement which is currently used in many European countries. Such a fee-for-performance remuneration system provides a stimulus for generic medicines

[Study impacto: Descriptive analyzis of pharmacist's clinical practice in onco-hematology].

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Le Guen, R; Madelaine, I; Tournamille, J-F; Bellanger, A; Astier, A; Braguer, D; Ollivier, C; Bardin, C; Lemare, F; Daouphars, M; Pinguet, F; Latour, J-F; Vigneron, J; Tilleul, P

2015-05-01

Pharmaceutical analyses of chemotherapy prescriptions by hospital pharmacists are activities codified by regulation and rules (bon usage). The involvement of the pharmacists in clinical pharmacy activities in the oncology setting is not clearly identified, justifying the development of a mapping of these activities from a questionnaire addressed to the professionals. One hundred and seven centers have participated to this study at the national level (overall participation rate of 32.4%). More than 95% of them used a computerized ordering system and three quarter of them submit the introduction of new compounds to an analysis by the drug therapeutic committee. Prescription analysis allowed detecting around 2% of errors from the current prescription. Clinical pharmacist participates to tumor boards of onco-hematology (RCP) at a level of 46% for senior pharmacist and 42% for junior pharmacist. This involvement in the RCP allowed anticipating protocol's modification and temporary used authorization. Ninety-two percent of the senior pharmacists estimate that they highlight the risk of no reimbursement for prescription out of the guideline during RCP, resulting to a modification of the prescription for 40% of them. This level of intervention is lower with respectively 64% and 10% for the juniors. This study underlines the expert value of the clinical pharmacist dedicated to oncology setting in pre and post analysis prescriptions. It could be targeted by a prospective analysis of both clinical and pharmacoeconomics impact of these interventions. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

The Impact of AUC-Based Monitoring on Pharmacist-Directed Vancomycin Dose Adjustments in Complicated Methicillin-Resistant Staphylococcus aureus Infection.

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Stoessel, Andrew M; Hale, Cory M; Seabury, Robert W; Miller, Christopher D; Steele, Jeffrey M

2018-01-01

This study aimed to assess the impact of area under the curve (AUC)-based vancomycin monitoring on pharmacist-initiated dose adjustments after transitioning from a trough-only to an AUC-based monitoring method at our institution. A retrospective cohort study of patients treated with vancomycin for complicated methicillin-resistant Staphylococcus aureus (MRSA) infection between November 2013 and December 2016 was conducted. The frequency of pharmacist-initiated dose adjustments was assessed for patients monitored via trough-only and AUC-based approaches for trough ranges: 10 to 14.9 mg/L and 15 to 20 mg/L. Fifty patients were included: 36 in the trough-based monitoring and 14 in the AUC-based-monitoring group. The vancomycin dose was increased in 71.4% of patients when troughs were 10 to 14.9 mg/L when a trough-only approach was used and in only 25% of patients when using AUC estimation ( P = .048). In the AUC group, the dose was increased only when AUC/minimum inhibitory concentration (MIC) AUC/MIC ≥400. The AUC-based monitoring did not significantly increase the frequency of dose reductions when trough concentrations were 15 to 20 mg/L (AUC: 33.3% vs trough: 4.6%; P = .107). The AUC-based monitoring resulted in fewer patients with dose adjustments when trough levels were 10 to 14.9 mg/L. The AUC-based monitoring has the potential to reduce unnecessary vancomycin exposure and warrants further investigation.

Evaluation of Pharmacists' Work in a Physician-Pharmacist Collaborative Model for the Management of Hypertension.

Science.gov (United States)

Isetts, Brian J; Buffington, Daniel E; Carter, Barry L; Smith, Marie; Polgreen, Linnea A; James, Paul A

2016-04-01

Physician-pharmacist collaborative models have been shown to improve the care of patients with numerous chronic medical conditions. Team-based health care using integrated clinical pharmacists provides one opportunity to improve quality in health care systems that use population-based financing. In November 2015, the Centers for Medicare and Medicaid Services (CMS) requested that the relative value of pharmacists' work in team-based care needs to be established. Thus the objective of this study was to describe the components of pharmacists' work in the management of hypertension with a physician-pharmacist collaborative model. Descriptive analysis of the components of pharmacists' work in the Collaboration Among Pharmacists and Physicians to Improve Outcomes Now (CAPTION) study, a prospective, cluster randomized trial. This analysis was intended to provide policymakers with data and information, using the CAPTION study model, on the time and intensity of pharmacists' work to understand pharmacists' relative value contributions in the context of CMS financing and population management aims. The CAPTION trial was conducted in 32 community-based medical offices in 15 U.S. states and included 390 patients with multiple cardiovascular risk factors. Blood pressure was measured by trained study coordinators in each office, and patients were included in the study if they had uncontrolled blood pressure. Included patients were randomized to a 9-month intervention, a 24-month intervention, or usual care. The goal of the pharmacist intervention was to improve blood pressure control and resolve drug therapy problems impeding progress toward blood pressure goals. This intervention included medical record review, a structured assessment with the patient, collaboration to achieve goals of therapy, and patient follow-up. The two intervention arms (9 and 24 mo) were identical the first 9 months, and that time frame is the focus of this workload evaluation. Pharmacists completed

Attitudes and practices of pharmacists towards emergency contraception in Durban, South Africa.

Science.gov (United States)

Hariparsad, N

2001-06-01

Emergency contraception, which is used to prevent pregnancy following unprotected intercourse, could prove invaluable to a country like South Africa which has high fertility and pregnancy rates. However, the success of emergency contraception is dependent on the awareness, knowledge, attitudes and practices amongst health-care providers and the public towards it. The aim of this study was to assess the attitudes and practices of community pharmacists towards emergency contraception. The study was conducted in North and South Central Durban, South Africa. This questionnaire-based study sought from pharmacists the frequency of demand and supply of emergency contraception, as well as their attitudes and practices towards it. The sample included all 182 pharmacies located in the study area. A total of 96% of pharmacists had received requests for emergency contraception within the last year. On average, each pharmacist received 177 requests for emergency contraception. Sixty-nine per cent of pharmacists were in favor of making emergency contraceptive pills available without a prescription, 62% were already supplying emergency contraceptive pills without a prescription and 67% felt that it was important to increase public awareness regarding emergency contraception. Ninety-one per cent of pharmacists did not have any literature regarding emergency contraception to hand to clients, 68% had a private area in their pharmacy to counsel patients and 86% of pharmacists indicated that they discussed long-term contraception with clients. This study is the first in South Africa aimed at determining the utilization of emergency contraception. However, further studies are required in order to ascertain information that will assist in changing current health policies to improve those in reproductive health care.

Dose evaluation in diagnostic for computerized tomography; Evaluacion de dosis en diagnostico por tomografia computarizada

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Flores, W.; Borges, J.C.; Mota, H. [Universidad Federal de Rio de Janeiro, PEN/COPPE/UFRJ. Caixa Postal 68509. 21945-970 Rio de Janeiro (Brazil)

1998-12-31

The patients which are subjected to computerized tomography tests are exposed to relatively high doses given as result doses on organs that are not matter to test. It was realized a dose levels raising in patients subjected to tests by T C, utilizing to measure this magnitude, TLD-100 thermoluminescent dosemeters which were put directly on the patient, in eye regions, thyroid, breast and navel; founding doses fluctuating between 29.10-49.39 mGy in organs examined and dose values between 0.21-29.10 mGy for organs that no matter to test. The applications of ionizing radiations in medicine do not have dose limits, but paying attention to the radiological protection optimization principle, it is recommended the use of clothes to anti-rays protection for zones not examined, getting with this to reduce the level doses as low as possible, without this to diminish the test quality. (Author)

Collaborative Care in Ambulatory Psychiatry: Content Analysis of Consultations to a Psychiatric Pharmacist

Science.gov (United States)

Gotlib, Dorothy; Bostwick, Jolene R.; Calip, Seema; Perelstein, Elizabeth; Kurlander, Jacob E.; Fluent, Thomas

2017-01-01

Objectives To determine the volume and nature (or topic) of consultations submitted to a psychiatric pharmacist embedded in an ambulatory psychiatry clinic, within a tertiary care academic medical center and to increase our understanding about the ways in which providers consult with an available psychiatric pharmacist. Experimental Design Authors analyze and describe the ambulatory psychiatric pharmacist consultation log at an academic ambulatory clinic. All consultation questions were submitted between July 2012 and October 2014. Principal Observations Psychiatry residents, attending physicians, and advanced practice nurse practitioners submitted 280 primary questions. The most common consultation questions from providers consulted were related to drug-drug interactions (n =70), drug formulations/dosing (n =48), adverse effects (n =43), and pharmacokinetics/lab monitoring/cross-tapering (n =36). Conclusions This is a preliminary analysis that provides information about how psychiatry residents, attending physicians, and advanced practice nurse practitioners at our health system utilize a psychiatric pharmacist. This collaborative relationship may have implications for the future of psychiatric care delivery. PMID:28936009

Collaborative Care in Ambulatory Psychiatry: Content Analysis of Consultations to a Psychiatric Pharmacist.

Science.gov (United States)

Gotlib, Dorothy; Bostwick, Jolene R; Calip, Seema; Perelstein, Elizabeth; Kurlander, Jacob E; Fluent, Thomas

2017-09-15

To determine the volume and nature (or topic) of consultations submitted to a psychiatric pharmacist embedded in an ambulatory psychiatry clinic, within a tertiary care academic medical center and to increase our understanding about the ways in which providers consult with an available psychiatric pharmacist. Authors analyze and describe the ambulatory psychiatric pharmacist consultation log at an academic ambulatory clinic. All consultation questions were submitted between July 2012 and October 2014. Psychiatry residents, attending physicians, and advanced practice nurse practitioners submitted 280 primary questions. The most common consultation questions from providers consulted were related to drug-drug interactions (n =70), drug formulations/dosing (n =48), adverse effects (n =43), and pharmacokinetics/lab monitoring/cross-tapering (n =36). This is a preliminary analysis that provides information about how psychiatry residents, attending physicians, and advanced practice nurse practitioners at our health system utilize a psychiatric pharmacist. This collaborative relationship may have implications for the future of psychiatric care delivery.

Computerized management of plant intervention tasks

International Nuclear Information System (INIS)

Quoidbach, G.

2004-01-01

The main objective of the 'Computerized Management of Plant Intervention Tasks' is to help the staff of a nuclear or a conventional power plant or of any other complex industrial facility (chemical industries, refineries, and so on) in planning, organizing, and carrying out any (preventive or corrective) maintenance task. This 'Computerized Management of Plant Intervention Tasks' is organized around a data base of all plant components in the facility that might be subjected to maintenance or tagout. It allows to manage, by means of intelligent and configurable 'mail service', the course of the intervention requests as well as various treatments of those requests, in a safe and efficient way, adapted to each particular organization. The concept of 'Computerized Management' of plant intervention tasks was developed by BELGATOM in 1983 for the Belgian nuclear power plants of ELECTRABEL. A first implementation of this concept was made at that time for the Doel NPP under the name POPIT (Programming Of Plant Intervention Tasks). In 1988, it was decided to proceed to a functional upgrade of the application, using advanced software and hardware techniques and products, and to realize a second implementation in the Tihange NPP under the name ACM (Application Consignation Maintenance). (author)

Who are the opinion leaders? The physicians, pharmacists, patients, and direct-to-consumer prescription drug advertising.

Science.gov (United States)

Lee, Annisa Lai

2010-09-01

A popular perception holds that physicians prescribe requested drugs to patients influenced by mass mediated direct-to-consumer prescription drug advertising. The phenomenon poses a serious challenge to the two-step flow model, which emphasizes the influence of opinion leaders on their followers and their legitimating power over the informing power of the mass media. This study investigates a 2002 Food and Drug Administration (FDA) survey and finds that patients searching for drug information through mass and hybrid media in newspapers and magazines' small print, the Internet, and toll-free numbers are more likely to seek information through interpersonal communication channels like health care providers. Patients using small print, toll-free numbers, one's own physician, and other physicians are associated with influencing their physicians with various drug-requesting behaviors. But physicians only prescribe requested drugs to patients who are influenced by other health care providers, such as pharmacists and other physicians, not the mass media. The influence of expert opinion leaders of drugs is so strong that the patients even would switch from their own unyielding physicians who do not prescribe drugs as advised by the pharmacists. Physicians and patients all are influenced more by other expert opinion leaders of drugs than by the mass media and therefore still uphold the basic tenet of the two-step model.

Effective radiation dose of ProMax 3D cone-beam computerized tomography scanner with different dental protocols.

Science.gov (United States)

Qu, Xing-min; Li, Gang; Ludlow, John B; Zhang, Zu-yan; Ma, Xu-chen

2010-12-01

The aim of this study was to compare effective doses resulting from different scan protocols for cone-beam computerized tomography (CBCT) using International Commission on Radiological Protection (ICRP) 1990 and 2007 calculations of dose. Average tissue-absorbed dose, equivalent dose, and effective dose for a ProMax 3D CBCT with different dental protocols were calculated using thermoluminescent dosimeter chips in a human equivalent phantom. Effective doses were derived using ICRP 1990 and the superseding 2007 recommendations. Effective doses (ICRP 2007) for default patient sizes from small to large ranged from 102 to 298 μSv. The coefficient of determination (R(2)) between tube current and effective dose (ICRP 2007) was 0.90. When scanning with lower resolution settings, the effective doses were reduced significantly (P radiation dose levels. Reduction in radiation dose can be achieved when using lower settings of exposure parameters. Copyright © 2010 Mosby, Inc. All rights reserved.

An evaluation of adherence to society of pharmacists' standards care in pharmacy information systems in Iran.

Science.gov (United States)

Saghaeiannejad-Isfahani, Sakineh; Sharifi-Rad, Javad; Raeisi, Ahmadreza; Ehteshami, Asghar; Mirzaeian, Razieh

2015-01-01

Pharmacy information system (PIS) is a complex computerized system used for collecting, storing, and managing the medication therapy data in the course of patients' care. The purpose of this study was to evaluate the level of adherence to the standards established by the societies of pharmacists in the PISs employed in the hospitals in Isfahan, Iran. The present study was an applied, descriptive-analytical study conducted on the PISs of 19 teaching, private and social insurance hospitals in Isfahan in 2011. Study population consisted of the PISs available in the hospitals under study. Study sample was the same as the study population. The data collection instrument was a self-developed checklist based on the guidelines of the American Society of Health-System Pharmacists and Pharmaceutical Society of Australia, whose validity was assessed and confirmed by expert professors' views. Having been collected by observation and interview methods, data were analyzed by SPSS 18 software using Mann-Whitney statistical test. The findings of the study revealed that the highest rank in adherence to the standards of societies of pharmacists was obtained by social services hospitals (32.75%), while the private hospitals obtained the lowest rank (23.32%). Based on the findings, in the PISs in the hospitals under study, some standards of the society of pharmacists were ignored. Hence, prior to designing and implementing PIS, a needs analysis is required to increase its users' motivation to identify the system potentialities and to allow the system development in compliance with the world technology advancement.

Injudicious Provision of Subtherapeutic Doses of Antibiotics in Community Pharmacies

OpenAIRE

Mohamed E Amin; Amira Amine; Mohammad Shoukry Newegy

2017-01-01

Background: Egyptian pharmacists routinely provide antibiotics without a prescription. A few pills of common cold products are offered under the name “cold group”. A cold group may contain one or more pills of antibiotics. This study aimed to estimate the proportion of pharmacies that provide subtherapeutic doses of antibiotics in community pharmacies as part of a CG or upon direct request from a simulated client. Methods: A probability sample of community pharmacies in Alexandria, Egypt ...

A prototype for evidence-based pharmaceutical opinions to promote physician-pharmacist communication around deprescribing

Science.gov (United States)

Tannenbaum, Cara

2018-01-01

Context: Interprofessional communication is an effective mechanism for reducing inappropriate prescriptions among older adults. Physicians’ views about which elements are essential for pharmacists to include in an evidence-based pharmaceutical opinion for deprescribing remain unknown. Objective: To develop a prototype for an evidence-based pharmaceutical opinion that promotes physician-pharmacist communication around deprescribing. Methods: A standardized template for an evidence-based pharmaceutical opinion was developed with input from a convenience sample of 32 primary care physicians and 61 primary care pharmacists, recruited from conferences and community settings in Montreal, Canada. Participants were asked to comment on the need for clarifying treatment goals, including personalized patient data and biomarkers, highlighting evidence about drug harms, listing the credibility and source of the recommendations, providing therapeutic alternatives and formalizing official documentation of decision making. The content and format of the prototype underwent revision by community physicians and pharmacists until consensus was reached on a final recommended template. Results: The majority of physicians (84%-97%) requested that the source of the deprescribing recommendations be cited, that alternative management options be provided and that the information be tailored to the patient. Sixteen percent of physicians expressed concern about the information in the opinions being too dense. Pharmacists also questioned the length of the opinion and asked that additional space be provided for the physician’s response. A statement was added making the opinion a valid prescription upon receipt of a signature from physicians. Compared to a nonstandardized opinion, the majority of pharmacists believed the template was easier to use, more evidence based, more time efficient and more likely to lead to deprescribing. Conclusion: Physicians and pharmacists endorsed a standardized

Pharmacist home visits: A 1-year experience from a community pharmacy.

Science.gov (United States)

Monte, Scott V; Passafiume, Sarah N; Kufel, Wesley D; Comerford, Patrick; Trzewieczynski, Dean P; Andrus, Kenneth; Brody, Peter M

2016-01-01

To provide experience on the methods and costs for delivering a large-scale community pharmacist home visit service. Independent urban community pharmacy, Buffalo, NY. Mobile Pharmacy Solutions provides traditional community pharmacy walk-in service and a suite of clinically oriented services, including outbound adherence calls linked to home delivery, payment planning, medication refill synchronization, adherence packaging, and pharmacist home visits. Pharmacist daily staffing included three dispensing pharmacists, one residency-trained pharmacist, and two postgraduate year 1 community pharmacy residents. A large-scale community pharmacy home visit service delivered over a 1-year period. Pharmacist time and cost to administer the home visit service as well as home visit request sources and description of patient demographics. A total of 172 visits were conducted (137 initial, 35 follow-up). Patients who received a home visit averaged 9.8 ± 5.2 medications and 3.0 ± 1.6 chronic disease states. On average, a home visit required 2.0 ± 0.8 hours, which included travel time. The percentages of visits completed by pharmacists and residents were 60% and 40%, respectively. The amounts of time to complete a visit were similar. Average home visit cost including pharmacist time and travel was $119 ($147 for a pharmacist, $77 for a resident). In this community pharmacy-based home visit service, costs are an important factor, with each pharmacist visit requiring 2 hours to complete. This experience provides a blueprint and real-world perspective for community pharmacies endeavoring to implement a home visit service and sets a foundation for future prospective trials to evaluate the impact of the service on important indicators of health and cost. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

X-ray exposure dose for the gonadal gland by the examination of computerized tomography and its protection

International Nuclear Information System (INIS)

Moriuchi, Iwao; Kaiya, Hisanori; Hirata, Toshifumi; Asada, Shuichi

1978-01-01

Computerized tomography (CT) is very useful for neuroradiological examination, and so it may possibly be used for screening tests. But x-ray exposure dose by a examination of CT is considerable, especially for the male gonadal gland. This study showed that the dose from a complete CT examination of 10 - 15 scans for a male gonadal gland was about 1,800 times more than a single plain neuroradiography. But by only a 0.07 mm lead equivalent protecter, the exposure dose resulting from CT for a gonadal gland could be reduced to 0.0 mrad. (auth.)

Computerization of effluent management and external dose calculation using the 'ODCM' methodology applied to Almaraz-NPP

International Nuclear Information System (INIS)

Garcia Gutierrez, M.E.; Sustacha Duo, D.

1993-01-01

The ODCM (Offsite Dose Calculation Manual), the official operational document for all nuclear power plants develops the details for the technical specifications for discharges and governs their practical application. The use of ODCM methodology for managing and controlling data associated with radioactive discharges, as well as the subsequent processing of this data to assess the radiological impact, requires and generates a large volume of data, which demands the frequent application of laborious and complex calculation processes, making computerization necessary. The computer application created for Almaraz NPP has the capacity to store and manage data on all discharges, evaluate their effects, presents reports and copies the information to be sent periodically to the CSN (Spanish Nuclear Regulatory Commission) on a magnetic tape. The radiological impact of an actual or possible discharge can be evaluated at anytime and, furthermore, general or particular reports and graphs on the discharges and doses over time can be readily obtained. The application is run on a personal computer under a relational database management system. This interactive application is based on menus and windows. (author)

Evaluation of brain scintigraphy and computerized tomography

International Nuclear Information System (INIS)

Cavailloles, F.; Dairou, R.; Desbleds, M.T.; Benoit, C.; Larmande, P.; Bok, B.; Alperovitch, A.

1983-01-01

In order to assess the clinical usefulness of brain computerized tomography and radionuclide scan, a prospective study was performed on a series of 554 patients. The detection rate was assessed as well as the identification rate of lesions. In addition, the usefulness of both tests was appreciated subjectively by two neurologists reviewing the patients' files. Both give reasonably similar results: computerized tomography is superior to radionuclide scan in the diagnosis of tumors and intracerebral hematomas, the radionuclide scan being slightly superior in the diagnosis of purely ischemic CVA and subdural hematomas. The superiority which was subjectively conceded to computerized tomography was greater than that objectively demonstrated. However, clinical usefulness of computerized tomography was judged important in only 50% of the cases. Moreover, to request both computerized tomography and radionuclide scan appeared as having no interest in 83% of the cases. In that series, the diagnostic hypotheses were in agreement with the final diagnosis in 88% of the cases. Bias encountered in this type of studies are discussed [fr

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

Science.gov (United States)

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

2015-07-01

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

Computerized data base of the fundamental constants of nature

International Nuclear Information System (INIS)

Henry, E.A.; Hampel, V.E.

1975-01-01

Fifty-seven fundamental constants of nature were computerized from the up-to-date evaluations of E. R. Cohen and B. N. Taylor. The constants are annotated with regard to symbol, value, uncertainty, and scaling factor. This computerization is part of the scientific data base project of the Information Research Group at Lawrence Livermore Laboratory. The MASTER CONTROL data base management system is used. The computerized fundamental constants can be requested from the ERDA Computer Program Exchange and Information Center of the Argonne National Laboratory or from the National Technical Information Service of the U. S. Department of Commerce. This is the first of a series of releases on preparation of computerized scientific and technological data banks. The next release is a data bank of conversion factors for different units of measurements. 3 figures

Computerized surveillance of opioid-related adverse drug events in perioperative care: a cross-sectional study

Directory of Open Access Journals (Sweden)

Gattis Katherine G

2009-08-01

Full Text Available Abstract Background Given the complexity of surgical care, perioperative patients are at high risk of opioid-related adverse drug events. Existing methods of detection, such as trigger tools and manual chart review, are time-intensive which makes sustainability challenging. Using strategic rule design, computerized surveillance may be an efficient, pharmacist-driven model for event detection that leverages existing staff resources. Methods Computerized adverse drug event surveillance uses a logic-based rules engine to identify potential adverse drug events or evolving unsafe clinical conditions. We extended an inpatient rule (administration of naloxone to detect opioid-related oversedation and respiratory depression to perioperative care at a large academic medical center. Our primary endpoint was the adverse drug event rate. For all patients with a naloxone alert, manual chart review was performed by a perioperative clinical pharmacist to assess patient harm. In patients with confirmed oversedation, other patient safety event databases were queried to determine if they could detect duplicate, prior, or subsequent opioid-related events. Results We identified 419 cases of perioperative naloxone administration. Of these, 101 were given postoperatively and 69 were confirmed as adverse drug events after chart review yielding a rate of 1.89 adverse drug events/1000 surgical encounters across both the inpatient and ambulatory settings. Our ability to detect inpatient opioid adverse drug events increased 22.7% by expanding surveillance into perioperative care. Analysis of historical surveillance data as well as a voluntary reporting database revealed that 11 of our perioperative patients had prior or subsequent harmful oversedation. Nine of these cases received intraoperative naloxone, and 2 had received naloxone in the post-anesthesia care unit. Pharmacist effort was approximately 3 hours per week to evaluate naloxone alerts and confirm adverse drug

Dose profile study on computerized tomography scanning of skull with simulator object; Estudo do perfil de dose em varreduras de TC de cranio com objeto simulador

Energy Technology Data Exchange (ETDEWEB)

Mourao, A.P., E-mail: aprata@des.cefetmg.b [Centro Federal de Educacao Tecnologica de Minas Gerais (CEFET/MG), Belo Horizonte, MG (Brazil). Nucleo de Engenharia Hospitalar; Alonso, Thessa C.; Silva, Teogenes A. da, E-mail: alonso@cdtn.b, E-mail: silvata@@cdtn.b [Centro de Desenvolvimento da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

2011-10-26

This work presents a comparison among the dose profiles in scanning of computerized tomography of a simulator object of PMMA in its periphery region. To obtain the deposited dose at the PMMA thermoluminescent dosemeters were used positioned at the interior of PMMA simulated object longitudinal to periphery and at the center of cylinder (positions denominated North, South, East, West and Center). Eight scanning were performed of simulator object using the routine protocol for skull in eight different services of radiodiagnostic by TC

Contrast Dose and Radiation Dose Reduction in Abdominal Enhanced Computerized Tomography Scans with Single-phase Dual-energy Spectral Computerized Tomography Mode for Children with Solid Tumors.

Science.gov (United States)

Yu, Tong; Gao, Jun; Liu, Zhi-Min; Zhang, Qi-Feng; Liu, Yong; Jiang, Ling; Peng, Yun

2017-04-05

Contrast dose and radiation dose reduction in computerized tomography (CT) scan for adult has been explored successfully, but there have been few studies on the application of low-concentration contrast in pediatric abdominal CT examinations. This was a feasibility study on the use of dual-energy spectral imaging and adaptive statistical iterative reconstruction (ASiR) for the reduction of radiation dose and iodine contrast dose in pediatric abdominal CT patients with solid tumors. Forty-five patients with solid tumors who had initial CT (Group B) and follow-up CT (Group A) after chemotherapy were enrolled. The initial diagnostic CT scan (Group B) was performed using the standard two-phase enhanced CT with 320 mgI/ml concentration contrast, and the follow-up scan (Group A) was performed using a single-phase enhanced CT at 45 s after the beginning of the 270 mgI/ml contrast injection using spectral mode. Forty percent ASiR was used for the images in Group B and monochromatic images with energy levels ≥60 keV in Group A. In addition, filtered back-projection (FBP) reconstruction was used for monochromatic images hounsfield unit (HU). The abdominal organs of Groups A and B had similar degrees of absolute and relative enhancement (t = 0.36 and -1.716 for liver, -0.153 and -1.546 for pancreas, and 2.427 and 0.866 for renal cortex, all P> 0.05). Signal-to-noise ratio of the abdominal organs was significantly lower in Group A than in Group B (t = -8.11 for liver, -7.83 for pancreas, and -5.38 for renal cortex, all P 3, indicating clinically acceptable image quality. Single-phase, dual-energy spectral CT used for children with solid abdominal tumors can reduce contrast dose and radiation dose and can also maintain clinically acceptable image quality.

Perpetuating stigma or reducing risk? Perspectives from naloxone consumers and pharmacists on pharmacy-based naloxone in 2 states.

Science.gov (United States)

Green, Traci C; Case, Patricia; Fiske, Haley; Baird, Janette; Cabral, Shachan; Burstein, Dina; Schwartz, Victoriana; Potter, Nathan; Walley, Alexander Y; Bratberg, Jeffrey

Little is known about attitudes of pharmacists and consumers to pharmacy naloxone. We examined perceptions and experiences of pharmacy naloxone from people with opioid use disorder, patients taking chronic opioids for pain, caregivers of opioid users, and pharmacists from 2 early pharmacy naloxone adopter states: Massachusetts and Rhode Island. Eight focus groups (4 per state) were held in October to December 2015. Participants were recruited from pharmacies, health clinics, and community organizations; pharmacists were recruited from professional organizations and pharmacy colleges. Focus groups were led by trained qualitative researchers using a topic guide, and recorded and transcribed for analysis. Five analysts developed and applied a coding scheme to transcripts. Thematic analysis involved synthesis of coded data and connections between key themes, with comparisons across the groups. Sixty-one participants included patients with chronic pain (n = 15), people with opioid use disorders (n = 19), caregivers (n = 16), and pharmacists (n = 11). A majority of pharmacists had dispensed naloxone to patients; a minority of all consumer participants had obtained pharmacy naloxone. Four themes emerged: consumer fear of future consequences if requesting naloxone; pharmacists' concerns about practice logistics related to naloxone; differing perceptions of how opioid safety is addressed in the pharmacy; and solutions to addressing these barriers. Whereas consumer groups differed in awareness of naloxone and availability at pharmacies, all groups expressed support for the pharmacist's role and preferences for a universal offer of naloxone based on clear criteria. Pharmacies complement community naloxone provision to patients and caregivers. To overcome stigma of naloxone receipt, increased public awareness of naloxone and pharmacist training about naloxone and addiction are required. Pharmacists should offer naloxone via universal opt-out strategies-where all patients

Increasing access to emergency contraception through online prescription requests.

Science.gov (United States)

Averbach, Sarah; Wendt, Jacqueline Moro; Levine, Deborah K; Philip, Susan S; Klausner, Jeffrey D

2010-01-01

To describe a pilot program, Plan B Online Prescription Access, to provide easy access to prescriptions for emergency contraception via the Internet. We measured electronic prescriptions for Plan B (Duramed Pharmaceuticals, Cincinnati, Ohio) by month over time. Pharmacists faxed patient-generated prescriptions back to the Department of Public Health for confirmation. Despite no marketing, within the first 18 months of the program, 152 electronic prescriptions for Plan B were requested by 128 female San Francisco residents. Seventy-eight prescriptions were filled (51%) by pharmacists. If correctly marketed, online prescriptions for Plan B have the potential to be an effective means of increasing emergency contraception access in both urban and rural settings across the United States. Further user-acceptability studies are warranted.

Medication management in Minnesota schools: The need for school nurse-pharmacist partnerships.

Science.gov (United States)

Little, Meg M; Eischens, Sara; Martin, Mary Jo; Nokleby, Susan; Palombi, Laura C; Van Kirk, Cynthia; van Risseghem, Jayme; Wen, Ya-Feng; Wozniak, Jennifer Koziol; Yoney, Erika; Seifert, Randall

Pharmacist participation in school medication management (MM) is minimal. School nurses are responsible for increasingly complex medication administration and management in schools. The purpose of this study was to 1) assess the MM needs of school nurses in Minnesota, and 2) determine if and how interprofessional partnerships between nurses and pharmacists might optimize MM for students. Researchers from the University of Minnesota College of Pharmacy, School Nurse Organization of Minnesota, and Minnesota Department of Health conducted a 32-item online survey of school nurses. Nurses administered the majority of medications at their school (69.9%) compared with unlicensed assistive personnel (29%). Stimulants (37.7%), asthma medications (25.7%), over-the-counter analgesics (17.8%), and insulin (6.6%) were the most commonly administered drug therapies. A clear majority of school nurses were interested in partnering with pharmacists: 90.3% thought that a pharmacist could assist with MM, 80% would consult with a pharmacist, and 12.3% reported that they already have informal access to a pharmacist. Topics that nurses would discuss with a pharmacist included new medications (71.6%), drug-drug interactions (67.1%), proper administration (52%), and storage (39.4%). The top MM concerns included 1) availability of students' medications and required documentation, 2) health literacy, 3) pharmacist consultations, 4) lack of time available for nurses to follow up with and evaluate students, 5) family-centered care, 6) delegation, 7) communication, and 8) professional development. Although the majority of school nurses surveyed indicated that partnerships with pharmacists would improve school MM, few had a formal relationship. Interprofessional partnerships focused on MM and education are high on the list of services that school nurses would request of a consultant pharmacist. Study results suggest that there are opportunities for pharmacists to collaborate with school nurses

Clinical pharmacist interventions to support adherence to thrombopreventive therapy

DEFF Research Database (Denmark)

Hedegaard, Ulla

The three papers in the thesis were based on two randomised controlled trials (RCTs) on in-hospital clinical pharmacist interventions for improvement of adherence to thrombopreventive therapy in two different populations: outpatients with hypertension and patients with acute stroke/transient isch......The three papers in the thesis were based on two randomised controlled trials (RCTs) on in-hospital clinical pharmacist interventions for improvement of adherence to thrombopreventive therapy in two different populations: outpatients with hypertension and patients with acute stroke...... 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...... targeted patients with hypertension or stroke in a hospital care setting. Thus, the aim of this thesis was to develop and evaluate in-hospital pharmacist interventions including MI to improve adherence to primary and secondary thrombopreventive therapy. The first study was a RCT, which investigated...

Obtaining patient test results from clinical laboratories: a survey of state law for pharmacists.

Science.gov (United States)

Witry, Matthew J; Doucette, William R

2009-01-01

To identify states with laws that restrict to whom clinical laboratories may release copies of laboratory test results and to describe how these laws may affect pharmacists' ability to obtain patient laboratory test results. Researchers examined state statutes and administrative codes for all 50 states and the District of Columbia at the University of Iowa Law Library between June and July 2007. Researchers also consulted with lawyers, state Clinical Laboratory Improvement Amendments officers, and law librarians. Laws relating to the study objective were analyzed. 34 jurisdictions do not restrict the release of laboratory test results, while 17 states have laws that restrict to whom clinical laboratories can send copies of test results. In these states, pharmacists will have to use alternative sources, such as physician offices, to obtain test results. Pharmacists must consider state law before requesting copies of laboratory test results from clinical laboratories. This may be an issue that state pharmacy associations can address to increase pharmacist access to important patient information.

Important Aspects of Pharmacist-led Medication Reviews in an Acute Medical Ward

DEFF Research Database (Denmark)

Bülow, Cille; Faerch, Kirstine Ullitz; Armandi, Helle

2018-01-01

In some hospitals, clinical pharmacists review the medication to find drug-related problems (DRPs) in acutely admitted patients. We aimed to identify the nature of identified DRPs and investigate factors of potential importance for the clinical implementation of pharmacist suggestions. In 100.......05). The most frequently implemented suggestions were based on DRPs concerning 'indication for drug treatment not noticed', 'inappropriate drug form' and 'drug dose too low', with implementation rates of 83%, 67% and 63%, respectively. In our sample, the pharmacist's MR suggestions were only implemented...

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.

Pharmacist-industry relationships.

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Saavedra, Keene; O'Connor, Bonnie; Fugh-Berman, Adriane

2017-12-01

The purpose of this study was to document, in their own words, beliefs and attitudes that American pharmacists have towards the pharmaceutical industry and pharmacists' interactions with industry. An ethnographic-style qualitative study was conducted utilizing open-ended interviews with four hospital pharmacists, two independent pharmacists, two retail pharmacists and one administrative pharmacist in the Washington, DC, metropolitan area to elicit descriptions of and attitudes towards pharmacists' relationships with industry. Analysis of the qualitative material followed established ethnographic conventions of narrative thematic analysis. All pharmacists reported interactions with pharmaceutical company representatives. Most had received free resources or services from industry, including educational courses. Respondents uniformly believed that industry promotional efforts are primarily directed towards physicians. Although respondents felt strongly that drug prices were excessive and that 'me-too' drugs were of limited use, they generally had a neutral-to-positive view of industry-funded adherence/compliance programmes, coupons, vouchers, and copay payment programmes. Interviewees viewed direct-to-consumer advertising negatively, but had a generally positive view of industry-funded drug information. Pharmacists may represent a hitherto under-identified cohort of health professionals who are targeted for industry influence; expanding roles for pharmacists may make them even more attractive targets for future industry attention. Pharmacy schools should ensure that students learn to rely on unbiased information sources and should teach students about conflicts of interest and the risks of interacting with industry. Further research should be conducted on the extent to which pharmacists' attitudes towards their duties and towards drug assessment and recommendation are influenced by the pharmaceutical industry. © 2017 Royal Pharmaceutical Society.

Pharmacists subjected to disciplinary action: characteristics and risk factors.

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

2011-10-01

OBJECTIVE To establish whether there are any characteristics of pharmacists that predict their likelihood of being subjected to disciplinary action. METHODS  The setting was the Royal Pharmaceutical Society of Great Britain's Disciplinary Committee. One hundred and seventeen pharmacists, all of whom had been referred to the Disciplinary Committee, were matched with a quota sample of 580 pharmacists who had not been subjected to disciplinary action but that matched the disciplined pharmacists on a set of demographic factors (gender, country of residence, year of registration). Frequency analysis and regression analysis were used to compare the two groups of pharmacists in terms of sector of work, ethnicity, age and country of training. Descriptive statistics were also obtained from the disciplined pharmacists to further explore characteristics of disciplinary cases and those pharmacists who undergo them. KEY FINDINGS  While a number of characteristics appeared to increase the likelihood of a pharmacist being referred to the disciplinary committee, only one of these - working in a community pharmacy - was statistically significant. Professional misconduct accounted for a greater proportion of referrals than did clinical malpractice, and approximately one-fifth of pharmacists who went before the Disciplinary Committee had previously been disciplined by the Society. CONCLUSIONS  This study provides initial evidence of pharmacist characteristics that are associated with an increased risk of being disciplined, based upon the data currently available. It is recommended that follow-up work is carried out using a more extensive dataset in order to confirm the statistical trends identified here. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

Community pharmacists' knowledge of diabetes management during Ramadan in Egypt.

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Amin, Mohamed E K; Chewning, Betty

2014-12-01

Although Muslim diabetic patients may be aware of their religious exemption from fasting, many still fast and adjust their medication regimens accordingly. Pharmacists have a significant potential to identify and prevent harm from medication misuse in Ramadan. This study examines Egyptian pharmacists' knowledge regarding management of diabetes during Ramadan. It also explores pharmacists' willingness to attend a 1 day workshop on medication regimen adjustment during Ramadan. Community pharmacies throughout Alexandria, Egypt. A cross-sectional study using a pretested self-administered survey was conducted among a random sample of community pharmacists. The survey included three knowledge questions relevant to counseling diabetic patients during Ramadan. Questions covered the recommended timing and dosing for metformin and insulin as well as the safe blood glucose range required for diabetic patients to safely continue their fast. Using logistic regression, a model was estimated to predict pharmacists' willingness to attend a workshop on the adjustment of medication regimens during Ramadan. Content analysis was used to analyze pharmacists' answers to the question concerning what they would like the workshop to cover. Pharmacists' aggregate scores for all three diabetes management knowledge questions and pharmacists' willingness to attend a workshop on the adjustment of medication regimens during Ramadan. Ninety three percent of the 298 approached pharmacists agreed to participate. Forty three pharmacists (15.9%) did not know the correct answer to any question, 118(43.7%) 24 answered one correctly, 86 (31.9%) answered two correctly and only 23 (8.5%) answered all 25 three correctly. Confidence in therapeutic knowledge regarding medication regimen 26 adjustment during Ramadan was not associated with the pharmacists' knowledge of diabetes management during Ramadan. One hundred seventy five (63.6%) pharmacists wanted to attend a workshop on adjusting medication regimens

Emergency supply of prescription-only medicines to patients by community pharmacists: a mixed methods evaluation incorporating patient, pharmacist and GP perspectives.

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Morecroft, Charles W; Mackridge, Adam J; Stokes, Elizabeth C; Gray, Nicola J; Wilson, Sarah E; Ashcroft, Darren M; Mensah, Noah; Pickup, Graham B

2015-07-10

To evaluate and inform emergency supply of prescription-only medicines by community pharmacists (CPs), including how the service could form an integral component of established healthcare provision to maximise adherence. Mixed methods. 4 phases: prospective audit of emergency supply requests for prescribed medicines (October-November 2012 and April 2013); interviews with CPs (February-April 2013); follow-up interviews with patients (April-May 2013); interactive feedback sessions with general practice teams (October-November 2013). 22 community pharmacies and 6 general practices in Northwest England. 27 CPs with experience of dealing with requests for emergency supplies; 25 patients who received an emergency supply of a prescribed medicine; 58 staff at 6 general practices. Clinical audit in 22 pharmacies over two 4-week periods reported that 526 medicines were requested by 450 patients. Requests peaked over a bank holiday and around weekends. A significant number of supplies were made during practice opening hours. Most requests were for older patients and for medicines used in long-term conditions. Difficulty in renewing repeat medication (forgetting to order, or prescription delays) was the major reason for requests. The majority of medicines were 'loaned' in advance of a National Health Service (NHS) prescription. Interviews with CPs and patients indicated that continuous supply had a positive impact on medicines adherence, removing the need to access urgent care. General practice staff were surprised and concerned by the extent of emergency supply episodes. CPs regularly provide emergency supplies to patients who run out of their repeat medication, including during practice opening hours. This may aid adherence. There is currently no feedback loop, however, to general practice. Patient care and interprofessional communication may be better served by the introduction of a formally structured and funded NHS emergency supply service from community pharmacies, with

Reducing drug–herb interaction risk with a computerized reminder system

Science.gov (United States)

Lin, Sheng-Shing; Tsai, Chiu-Lin; Tu, Ching-Yeh; Hsieh, Ching-Liang

2015-01-01

Background Traditional Chinese medicine (TCM) and Western medicine are both popular in Taiwan. Approximately 14.1% of Taiwanese residents use Western drugs and Chinese herbs concurrently; therefore, drug–herb interaction is critical to patient safety. This paper presents a new procedure for reducing the risk of drug interactions. Methods Hospital computer systems are modified to ensure that drug–herb interactions are automatically detected when a TCM practitioner is writing a prescription. A pop-up reminder appears, warning of interactions, and the practitioner may adjust doses, delete herbs, or leave the prescription unchanged. A pharmacist will receive interaction information through the system and provide health education to the patient. Results During the 2011–2013 study period, 256 patients received 891 herbal prescriptions with potential drug–herb interactions. Three of the 50 patients who concurrently used ginseng and antidiabetic drugs manifested hypoglycemia (fasting blood sugar level ≤70 mg/dL). Conclusion Drug–herb interactions can cause adverse reactions. A computerized reminder system can enable TCM practitioners to reduce the risk of drug–herb interactions. In addition, health education for patients is crucial in avoiding adverse reaction by the interactions. PMID:25733840

[Patients' reaction to pharmacists wearing a mask during their consultations].

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Tamura, Eri; Kishimoto, Keiko; Fukushima, Noriko

2013-01-01

  This study sought to determine the effect of pharmacists wearing a mask on the consultation intention of patients who do not have a trusting relationship with the pharmacists. We conducted a questionnaire survey of customers at a Tokyo drugstore in August 2012. Subjects answered a questionnaire after watching two medical teaching videos, one in which the pharmacist was wearing a mask and the other in which the pharmacist was not wearing a mask. Data analysis was performed using a paired t-test and multiple logistic regression. The paired t-test revealed a significant difference in 'Maintenance Problem' between the two pharmacist situations. After excluding factors not associated with wearing a mask, multiple logistic regression analysis identified three independent variables with a significant effect on participants not wanting to consult with a pharmacist wearing a mask. Positive factors were 'active-inactive' and 'frequency mask use', a negative factor was 'age'. Our study has shown that pharmacists wearing a mask may be a factor that prevents patients from consulting with pharmacist. Those patients whose intention to consult might be affected by the pharmacists wearing a mask tended to be younger, to have no habit of wearing masks preventively themselves, and to form a negative opinion of such pharmacists. Therefore, it was estimated that pharmacists who wear masks need to provide medical education by asking questions more positively than when they do not wear a mask in order to prevent the patient worrying about oneself.

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

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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.

Are community pharmacists equipped to ensure the safe use of oral anticancer therapy in the community setting? Results of a cross-country survey of community pharmacists in Canada.

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Abbott, Rick; Edwards, Scott; Whelan, Maria; Edwards, Jonathan; Dranitsaris, George

2014-02-01

Oral anticancer agents offer significant benefits over parenteral anticancer therapy in terms of patient convenience and reduced intrusiveness. Oral anticancer agents give many cancer patients freedom from numerous hospital visits, allowing them to obtain their medications from their local community pharmacy. However, a major concern with increased use of oral anticancer agents is shift of responsibility in ensuring the proper use of anticancer agents from the hospital/clinical oncology team to the patient/caregiver and other healthcare providers such as the community pharmacists who may not be appropriately trained for this. This study assessed the readiness of community pharmacists across Canada to play this increased role with respect to oral anticancer agents. Using a structured electronic mailing strategy, a standardized survey was mailed to practicing pharmacists in five provinces where community pharmacists were dispensing the majority of oral anticancer agents. In addition to collecting basic demographic and their practice setting, the survey assessed the pharmacists' knowledge regarding cancer therapy and oral anticancer agents in particular, their education needs and access to resources on oral anticancer agents, the quality of prescriptions for oral anticancer agents received by them in terms of the required elements, their role in patient education, and steps to enhance patient and personal safety. There were 352 responses to the survey. Only 13.6% of respondents felt that they had received adequate oncology education at the undergraduate level and approximately 19% had attended a continuing education event related to oncology in the past 2 years. Only 24% of the pharmacists who responded were familiar with the common doses of oral anticancer agents and only 9% felt comfortable educating patients on these medications. A substantial portion of community pharmacists in Canada lack a solid understanding of oral anticancer agents and thus are poorly

Hospital pharmacists' and patients' views about what constitutes effective communication between pharmacists and patients.

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Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William N

2017-12-06

The study's objective was to explore hospital pharmacists' and patients' views about what constitutes effective communication exchanges between pharmacists and patients. This was a novel theory-based qualitative study using semi-structured interviews to elicit patients' and pharmacists' perspectives. Pharmacists providing clinical pharmacy services in either inpatient or outpatient settings were recruited first. Eligible patients had been admitted to a study pharmacist's practice area and were prescribed three or more medications to manage a chronic disease(s). Following each pharmacist-patient medication counselling session, semi-structured interviews were held separately with patients and pharmacists. Participants were asked questions intended to explore their views about what constitutes an effective pharmacist-patient conversation. Audio recordings were transcribed verbatim, analysed using a process of inductive thematic analysis and then mapped to Communication Accommodation Theory strategies. Observational notes and reflexive note taking were conducted throughout. Twelve pharmacists each engaged four individual patients for a total of 48 pharmacist-patient conversations (resulting in 48 separate interviews with pharmacists and patients). An overall shared goal was the assurance of patients' confidence in managing their medications at home. Themes included shared colloquialisms/slang, well-explained information, engagement, established rapport and empowerment. Participants provided rich exemplars for each of the themes. Pharmacists and patients provided valuable insights about what makes pharmacist-patient interactions effective. Patient-identified preferences for pharmacist-patient exchanges may help guide pharmacy students and practitioners to engage patients in effective conversations. © 2017 Royal Pharmaceutical Society.

Compilation of requests for nuclear data

International Nuclear Information System (INIS)

1981-03-01

A request list for nuclear data which was produced from a computerized data file by the National Nuclear Data Center is presented. The request list is given by target nucleus (isotope) and then reaction type. The purpose of the compilation is to summarize the current needs of US Nuclear Energy programs and other applied technologies for nuclear data. Requesters are identified by laboratory, last name, and sponsoring US government agency

Physicians and pharmacists: collaboration to improve the quality of prescriptions in primary care in Mexico.

Science.gov (United States)

Mino-León, Dolores; Reyes-Morales, Hortensia; Jasso, Luis; Douvoba, Svetlana Vladislavovna

2012-06-01

Inappropriate prescription is a relevant problem in primary health care settings in Mexico, with potentially harmful consequences for patients. To evaluate the effectiveness of incorporating a pharmacist into primary care health team to reduce prescription errors for patients with diabetes and/or hypertension. One Family Medicine Clinic from the Mexican Institute of Social Security in Mexico City. A "pharmacotherapy intervention" provided by pharmacists through a quasi experimental (before-after) design was carried out. Physicians who allowed access to their diabetes and/or hypertensive patients' medical records and prescriptions were included in the study. Prescription errors were classified as "filling", "clinical" or "both". Descriptive analysis, identification of potential drug-drug interactions (pD-DI), and comparison of the proportion of patients with prescriptions with errors detected "before" and "after" intervention were performed. Decrease in the proportion of patients who received prescriptions with errors after the intervention. Pharmacists detected at least one type of error in 79 out of 160 patients. Errors were "clinical", "both" and "filling" in 47, 21 and 11 of these patient's prescriptions respectively. Predominant errors were, in the subgroup of patient's prescriptions with "clinical" errors, pD-DI; in the subgroup of "both" errors, lack of information on dosing interval and pD-DI; and in the "filling" subgroup, lack of information on dosing interval. The pD-DI caused 50 % of the errors detected, from which 19 % were of major severity. The impact of the correction of errors post-intervention was observed in 19 % of patients who had erroneous prescriptions before the intervention of the pharmacist (49.3-30.3 %, p health services in Mexico. The implementation of early warning systems of the most widely prescribed drugs is an alternative for reducing prescription errors and consequently the risks they may cause.

Community pharmacists' perceptions of barriers to communication with migrants.

Science.gov (United States)

Cleland, Jennifer A; Watson, Margaret C; Walker, Leighton; Denison, Alan; Vanes, Neil; Moffat, Mandy

2012-06-01

Effective communication by pharmacists is essential to ensure patient safety in terms of provision and use of medications by patients. Global migration trends mean community pharmacists increasingly encounter patients with a variety of first languages. The aim of this study was to explore community pharmacists' perceptions of communication barriers during the provision of care to A8 (nationals from central/Eastern European states) migrants. A qualitative face-to-face interview study of purposively sampled community pharmacists, North East Scotland. Participants (n = 14) identified a number of barriers to providing optimal care to A8 migrants including: communication (information gathering and giving); confidentiality when using family/friends as translators; the impact of patient healthcare expectations on communication and the length of the consultation; and frustration with the process of the consultation. Several barriers were specific to A8 migrants but most seemed pertinent to any group with limited English proficiency and reflect those found in studies of healthcare professionals caring for more traditional UK migrant populations. Further research is needed using objective outcome measures, such as consultation recordings, to measure the impact of these perceived barriers on pharmacist-patient consultations. Language and cultural barriers impact on the quality of pharmacist-patient communication and thus may have patient safety and pharmacist training implications. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

Using a computerized provider order entry system to meet the unique prescribing needs of children: description of an advanced dosing model

Directory of Open Access Journals (Sweden)

Schellenberger Patricia

2011-02-01

Full Text Available Abstract Background It is well known that the information requirements necessary to safely treat children with therapeutic medications cannot be met with the same approaches used in adults. Over a 1-year period, Duke University Hospital engaged in the challenging task of enhancing an established computerized provider order entry (CPOE system to address the unique medication dosing needs of pediatric patients. Methods An advanced dosing model (ADM was designed to interact with our existing CPOE application to provide decision support enabling complex pediatric dose calculations based on chronological age, gestational age, weight, care area in the hospital, indication, and level of renal impairment. Given that weight is a critical component of medication dosing that may change over time, alerting logic was added to guard against erroneous entry or outdated weight information. Results Pediatric CPOE was deployed in a staggered fashion across 6 care areas over a 14-month period. Safeguards to prevent miskeyed values became important in allowing providers the flexibility to override the ADM logic if desired. Methods to guard against over- and under-dosing were added. The modular nature of our model allows us to easily add new dosing scenarios for specialized populations as the pediatric population and formulary change over time. Conclusions The medical needs of pediatric patients vary greatly from those of adults, and the information systems that support those needs require tailored approaches to design and implementation. When a single CPOE system is used for both adults and pediatrics, safeguards such as redirection and suppression must be used to protect children from inappropriate adult medication dosing content. Unlike other pediatric dosing systems, our model provides active dosing assistance and dosing process management, not just static dosing advice.

Physician Acceptance of Pharmacist Recommendations about Medication Prescribing Errors in Iraqi Hospitals

Directory of Open Access Journals (Sweden)

ALI AZEEZ ALI AL-JUMAILI

2016-08-01

Full Text Available The objectives of this study were to measure the incidence and types of medication prescribing errors (MPEs in Iraqi hospitals, to calculate for the first time the percentage of physician agreement with pharmacist medication regimen review (MRR recommendations regarding MPEs, and to identify the factors influencing the physician agreement rate with these recommendations. Methods: Fourteen pharmacists (10 females and 4 males reviewed each hand-written physician order for 1506 patients who were admitted to two public hospitals in Al-Najaf, Iraq during August 2015. The pharmacists identified medication prescribing errors using the Medscape WebMD, LCC phone application as a reference. The pharmacists contacted the physicians (2 females and 34 males in-person to address MPEs that were identified. Results: The pharmacists identified 78 physician orders containing 99 MPEs with an incidence of 6.57 percent of all the physician orders reviewed. The patients with MPEs were taking 4.8 medications on average. The MPEs included drug-drug interactions (65.7%, incorrect doses (16.2%, unnecessary medications (8.1%, contra-indications (7.1%, incorrect drug duration (2%, and untreated conditions (1%. The physicians implemented 37 (37.4% pharmacist recommendations. Three factors were significantly related to physician acceptance of pharmacist recommendations. These were physician specialty, pharmacist gender, and patient gender. Pediatricians were less likely (OR= 0.1 to accept pharmacist recommendations compared to internal medicine physicians. Male pharmacists received more positive responses from physicians (OR=7.11 than female pharmacists. Lastly, the recommendations were significantly more likely to be accepted (OR= 3.72 when the patients were females. Conclusions: The incidence of MPEs is higher in Iraqi hospitalized patients than in the U.S. and U.K, but lower than in Brazil, Ethiopia, India, and Croatia. Drug-drug interactions were the most common type of

Attitudes and self-reported behavior of patients, doctors, and pharmacists in New Zealand and Belgium toward direct-to-consumer advertising of medication.

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Dens, Nathalie; Eagle, Lynne C; De Pelsmacker, Patrick

2008-01-01

Patients', doctors', and pharmacists' attitudes toward direct-to-consumer advertising (DTCA) for medication and their perceptions of its impact on patient self-reported behavior in terms of request for, and consumption of, advertised medication were investigated. Data were obtained in New Zealand, 1 of only 2 countries that allow mass-media DTCA for prescription medication, and in Belgium, which does not. Attitudes were relatively negative in both countries, but significantly more positive in New Zealand than in Belgium. The impact of DTCA (both in a positive and a negative sense) on self-reported patient behavior and patient interaction with doctors and pharmacists was limited in both countries. Although -- as already established in previous work -- the informativeness and reliability of DTCA can be much improved, and the attitude of medical professionals toward DTCA is negative in both countries, from the point of view of medical professionals and patients, DTCA does not harm the self-reported relationship between doctors, pharmacists, and patients.

Do pharmacists have a right to refuse to fill prescriptions for abortifacient drugs?

Science.gov (United States)

Weinstein, B D

1992-01-01

Some pharmacists opposed to abortion on moral ground are concerned by having to fill prescriptions for abortifacient drugs like mifepristone (RU-486). The issue of the right of pharmacists to refuse to fill such prescriptions depends on the model of the physician-pharmacist-patient relationship. The libertarian model of pharmacy practice holds that physicians, pharmacists, and patients are bound only by the contract that they freely negotiate with one another, thus the pharmacist has no moral obligation to fill a prescription for mifepristone unless he or she has expressly contracted to do so. The American Pharmaceutical Association's 1981 Code of Ethics does not specify what a pharmacist ought to do in particular circumstances. The right to refuse is strongly supported by the principles of nonmaleficence and respect for autonomy. These are principles of the libertarian model of the pharmacist-patient relationship but are also present in the guild or societal models stressing the duty to avoid harming others. Justification for pharmacists right of refusal appeals to their autonomy rights as members of the moral community rather than the profession of pharmacy. Since the professional right to autonomy is not absolute, moral consideration circumscribe it: it is difficult to argue that a pharmacist who believes that homosexuality is immoral has the right to refuse to fill a prescription for AZT. Even if a person who presents such a prescription is homosexual there is no causal relationship between filling a prescription for AZT and participating in a homosexual act. At the opposite end the libertarians reject the notion of even a basic right to health care. A woman in the above situation would not have a right to the abortifacient drug, so a pharmacist has no duty to dispense it. According to the technician model of professionalism, the pharmacist's personal values do not matter, so a pharmacist has a duty to provide the service.

Attitudes of pharmacists and physicians to antibiotic policies in hospitals.

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Adu, A; Simpson, J M; Armour, C L

1999-06-01

Antibiotic therapy in hospitals has substantial impact on patient outcome and the pharmacy drug budget. Antibiotic policies have been implemented by some hospitals to improve the quality of patient outcome and cost of antibiotic therapy. Antibiotic policies impose certain requirements on pharmacists and physicians. Pharmacists' and physicians' attitudes to and opinions about antibiotic policies are likely to affect the usefulness of such policies. To determine the attitudes of pharmacists and physicians to antibiotic policies in New South Wales (NSW) hospitals. Pharmacists and physicians in NSW public hospitals were surveyed to determine their attitudes to and opinions on antibiotic policies. A simple one-stage cluster sample of 241 pharmacists and a two-stage cluster sample of 701 physicians were obtained. Factor analysis was used to identify the attitudinal dimensions. General linear modelling was used to investigate the effects of predictor variables on outcome variables. The response rates were 91% and 77% for pharmacists and physicians, respectively. Factor analysis identified three dimensions of attitude to antibiotic policies: that they encourage rational antibiotic use; that they improve the quality of antibiotic prescribing and that they are associated with some problems. The reliability of these factors (Cronbach's alpha) ranged from 0.71 to 0.74, and was 0.90 for the overall attitude scale. Pharmacists and physicians had a positive overall attitude to antibiotic policies. Whereas physicians recognize that antibiotic policies improve the quality of prescribing, this was highly correlated with identification of problems (alpha = 0.71). In urban hospitals, pharmacists were more likely than physicians to associate antibiotics with problems. There was a positive overall attitude to hospital antibiotic policies expressed by pharmacists and physicians.

Thermolabile drugs: pharmacist intevention as a guarantee of cold chain maintenance

Directory of Open Access Journals (Sweden)

I. Ricote-Lobera

2014-05-01

Full Text Available Objective: To determine whether pharmacist is able to guaranteecold chain maintenance of thermolabile drugs during transportusing the available information in the reception processand to compare these results with those obtained in a subsequentintervention phase, in which the manufacturing laboratorieswere contacted. Methods: Intervention study, prospective and comparative“before-after”. It was analyzed the storage conditions duringtransport of all thermolabile drugs received in a 400-bed hospitalfor 3 months, excluding those from clinical trials. Results: The intervention allowed to ensure cold chain maintenancein 76,5% (n = 488 of received drugs, representing anincrease of 41,8% (IC 95% 36,7-46,6%; p < 0,001 comparedwith the percentage obtained before the intervention. Conclusions: The pharmacist isn’t able to ensure the cold chainmaintenance of received thermolabile drugs without temperaturemonitoring device (64,6%. Reports requested from laboratoriesallowed to increase significantly that percentage.

Job stress: its relationship to hospital pharmacists' insomnia and work outcomes.

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Yeh, Ying-Chen; Lin, Blossom Yen-Ju; Lin, Wen-Hung; Wan, Thomas T H

2010-06-01

Research must examine the nature of the work environment in order to achieve insight into the causes and effects of factors relevant to reducing job-related stress and improving the quality of work. This study aims to describe the job stressors of hospital pharmacists and to explore their effects on hospital pharmacists' insomnia and work-related outcomes. The study employed a cross-sectional, mailed survey. Structured questionnaires were distributed by postal mail to hospital pharmacists between February and April 2005. The individual hospital pharmacist is the unit of analysis. Descriptive analyses and structural equation modeling were performed on the survey responses from the 247 hospital pharmacists who responded. The top ten stress burdens occur in the areas of dispensing, pharmacy management, and hospital rules. The study findings confirmed the proposed hypotheses: that a hospital pharmacist's job stressors are related to his or her insomnia, intention to reduce working hours, intention to change job content, and intention to quit employment. The study also found associations between hospital pharmacists' social supports, gender, age, and monthly income and their insomnia and work outcomes. Hygienic job stressors based on Herzberg's two-factor motivation theory were examined in this study. These stressors were verified to be related to hospital pharmacists' insomnia and work outcomes. Hospital administrators could consider ways to improve the influences on hospital pharmacists' health.

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.

[Is the ICU staff satisfied with the computerized physician order entry? A cross-sectional survey study].

Science.gov (United States)

Fumis, Renata Rego Lins; Costa, Eduardo Leite Vieira; Martins, Paulo Sergio; Pizzo, Vladimir; Souza, Ivens Augusto; Schettino, Guilherme de Paula Pinto

2014-01-01

To evaluate the satisfaction of the intensive care unit staff with a computerized physician order entry and to compare the concept of the computerized physician order entry relevance among intensive care unit healthcare workers. We performed a cross-sectional survey to assess the satisfaction of the intensive care unit staff with the computerized physician order entry in a 30-bed medical/surgical adult intensive care unit using a self-administered questionnaire. The questions used for grading satisfaction levels were answered according to a numerical scale that ranged from 1 point (low satisfaction) to 10 points (high satisfaction). The majority of the respondents (n=250) were female (66%) between the ages of 30 and 35 years of age (69%). The overall satisfaction with the computerized physician order entry scored 5.74±2.14 points. The satisfaction was lower among physicians (n=42) than among nurses, nurse technicians, respiratory therapists, clinical pharmacists and diet specialists (4.62±1.79 versus 5.97±2.14, phealthcare workers were satisfied, albeit not entirely, with the computerized physician order entry. The overall users' satisfaction with computerized physician order entry was lower among physicians compared to other healthcare professionals. The factors associated with satisfaction included the belief that digitalization decreased the workload and contributed to the intensive care unit quality with a user-friendly and accurate system and that digitalization provided concise information within a reasonable time frame.

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

OpenAIRE

Hanna, Tamer; Bajorek, Beata; Lemay, Kate; Armour, Carol L.

2014-01-01

Objective: To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists' confidence, and appropriateness, in the context of asthma management. Methods: Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios) modelled on information from real patients. Pharmacist interventions w...

Knowledge of folic acid and counseling practices among Ohio community pharmacists

Directory of Open Access Journals (Sweden)

Rodrigues CR

2012-09-01

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

Pharmacist Advancement of Transitions of Care to Home (PATCH) Service.

Science.gov (United States)

Trang, Joseph; Martinez, Amanda; Aslam, Sadaf; Duong, Minh-Tri

2015-11-01

There is a paucity of literature on a well-defined role of a pharmacist in different aspects of transition of care service (TCS). Although health care institutions have specific details on the discharge process, there is a need for a sustainable TCS with a well-defined role of pharmacists. To describe the impact of a pharmacist-led TCS on acute health care utilization, clinic quality indicators, and identification and resolution of medication-related problems (MRPs). A pharmacist-managed TCS service, referred to as the Pharmacist Advancement of Transitions of Care to Home (PATCH) service, was established at an academic medical center, where high-risk patients received a postdischarge phone call from a pharmacist followed by a face-to-face meeting with the pharmacist and the patient's primary care provider (PCP). In a prospective transitions of care group (n = 74), outcomes of patients such as acute health care utilization (an emergency department visit or an inpatient readmission, within 30 days post discharge), clinic quality indicators, and identification and resolution of MRPs were compared to a retrospective control group (n = 87) who received the standard of care. Utilization of acute health care services was significantly lower in the prospective group compared to the retrospective control group (23% vs 41.4%; P = .013). A total of 49 MRPs were discovered in patients who received the TCS. Pharmacists play an integral role in improving the transitions of care to reduce acute health care utilization. In addition, they may improve care transitions by optimizing clinic quality indicators and by identifying and resolving MRPs.

OTC polyethylene glycol 3350 and pharmacists' role in managing constipation.

Science.gov (United States)

Horn, John R; Mantione, Maria Marzella; Johanson, John F

2012-01-01

To define constipation, assess the pharmacist's role in identifying and treating constipation, and review clinical evidence for the efficacy, safety, and tolerability of polyethylene glycol (PEG) 3350 (MiraLAX-Merck Consumer Care), an osmotic laxative now available over the counter (OTC), across a variety of patient populations routinely encountered in pharmacy settings. Systematic PubMed search of the primary literature for constipation treatment guidelines and clinical trial results for PEG 3350. Pharmacists have a unique role in assisting patients with identifying and managing constipation. Multiple controlled clinical trials have established the efficacy, safety, and tolerability of PEG 3350 at its recommended dose of 17 g once daily. On the basis of this evidence, various professional groups have recommended PEG 3350 for use in improving stool frequency and consistency in patients with constipation. PEG 3350 is approved for short-term use, including treatment of constipation caused by medications. Pharmacists can play an important role in managing constipation with OTC agents. Compared with other available OTC agents, PEG 3350 can be recommended to patients suffering from constipation on the basis of a large body of clinical evidence supporting its efficacy and safety, as well as the high patient acceptance shown for its palatability and once-daily dosing.

Stakeholders' views on granting prescribing authority to pharmacists in Nigeria: a qualitative study.

Science.gov (United States)

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

2016-08-01

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

Method of evaluation of diagnostics reference levels in computerized tomography

International Nuclear Information System (INIS)

Vega, Walter Flores

1999-04-01

Computerized tomography is a complex technique with several selectable exposition parameters delivering high doses to the patient. In this work it was developed a simple methodology to evaluate diagnostic reference levels in computerized tomography, using the concept of Multiple Scan Average Dose (MSAD), recently adopted by the Health Ministry. For evaluation of the MSAD, a dose distribution was obtained through a measured dose profile on the axial axis of a water phantom with thermoluminescence dosemeters, TLD-100, for different exam technique. The MSAD was evaluated hrough two distinct methods. First, it was evaluated by the integration of the dose profile of a single slice and, second, obtained by the integration on central slice of the profile of several slices. The latter is in of accordance with the ionization chamber method, suggesting to be the most practical method of dose evaluation to be applied in the diagnostic reference level assessment routine for CT, using TLDs. (author)

Generating demand for pharmacist-provided medication therapy management: identifying patient-preferred marketing strategies.

Science.gov (United States)

Garcia, Gladys M; Snyder, Margie E; McGrath, Stephanie Harriman; Smith, Randall B; McGivney, Melissa Somma

2009-01-01

To identify effective strategies for marketing pharmacist-provided medication therapy management (MTM) services to patients in a self-insured employer setting. Qualitative study. University of Pittsburgh during March through May 2008. 26 university employees taking at least one chronic medication. Three focus group sessions were conducted using a semistructured topic guide to facilitate the discussion. Employees' perceived medication-related needs, perceived benefits of pharmacist-provided MTM, potential barriers for employee participation in MTM, and effective strategies for marketing MTM. Participants reported concerns with timing of doses, medication costs, access, and ensuring adherence. Participants generally felt positively toward pharmacists; however, the level of reported patient contact with pharmacists varied among participants. Some participants questioned pharmacists' education and qualifications for this enhanced role in patient care. Perceived benefits of MTM noted by participants included the opportunity to obtain personalized information about their medications and the potential for improved communication among their health providers. Barriers to patient participation were out-of-pocket costs and lack of time for MTM visits. Participants suggested use of alternative words to describe MTM and marketing approaches that involve personal contact. Pharmacists should emphasize parts of MTM that patients feel are most beneficial (i.e., provision of a personal medication record) and use patient-friendly language to describe MTM when marketing their practice. Patients will need greater exposure to the concept of MTM and the pharmacists' role in order to correctly describe and assign value to this type of pharmacist patient care practice.

Provider and pharmacist responses to warfarin drug–drug interaction alerts: a study of healthcare downstream of CPOE alerts

Science.gov (United States)

Boro, Maureen S; Korman, Nancy E; Davoren, J Ben

2011-01-01

Objective To categorize the appropriateness of provider and pharmacist responses to warfarin critical drug–drug interaction (cDDI) alerts, assess responses and actions to the cDDI, and determine the occurrence of warfarin adverse drug events (ADE) after alerts. Design An 18-month, retrospective study of acute care admissions at a single Veterans Affairs medical center using computerized provider order entry (CPOE). Measurements Patients included had at least one warfarin cDDI alert. Chart reviews included baseline laboratory values and demographics, provider actions, patient outcomes, and associated factors, including other interacting medications and number of simultaneously processed alerts. Results 137 admissions were included (133 unique patients). Amiodarone, vitamin E in a multivitamin, sulfamethoxazole, and levothyroxine accounted for 75% of warfarin cDDI. Provider responses were clinically appropriate in 19.7% of admissions and pharmacist responses were appropriate in 9.5% of admissions. There were 50 ADE (36.6% of admissions) with warfarin; 80% were rated as having no or mild clinical effect. An increased number of non-critical alerts at the time of the reference cDDI alert was the only variable associated with an inappropriate provider response (p=0.01). Limitations This study was limited by being a retrospective review and the possibility of confounding variables, such as other interacting medications. Conclusion The large number of CPOE alerts may lead to inappropriate responses by providers and pharmacists. The high rate of ADE suggests a need for improved medication management systems for patients on warfarin. This study highlights the possibility of alert fatigue contributing to the high prevalence of inappropriate alert over-ride text responses. PMID:22037888

Online versus Live Delivery of Education to Pharmacists in a Large Multicentre Health Region: A Non-inferiority Assessment of Learning Outcomes.

Science.gov (United States)

Taylor, Robert; Jung, Joanne; Loewen, Peter; Spencer, Carrie; Dossa, Anar; de Lemos, Jane

2013-07-01

The prevalence of online modules for continuing education in the health professions has been increasing in recent years. However, the effectiveness of online modules for pharmacist learning has not been thoroughly studied. The primary aim of this study was to determine if providing education to pharmacists through a self-paced enhanced online module was non-inferior to a face-to-face learning module with respect to knowledge application on the topic of postoperative insulin dosing. Secondary aims were to determine pharmacists' knowledge gain and retention, as well as their satisfaction with the modules. The participants in this prospective, randomized, parallel-group non-inferiority trial were pharmacists in a large multicentre health region. Outcomes were measured by comparing scores obtained on pre- and post-module knowledge-assessment questionnaires. A between-group difference in change on knowledge application scores of less than 25 percentage points was the predetermined non-inferiority margin. A total of 74 pharmacists consented to participate, 38 randomly assigned to use the enhanced online module and 36 to attend the face-to-face learning session. For questions examining knowledge application, the mean improvement achieved by the online learning group was 26 percentage points greater than that achieved by the face-to-face learning group (95% confidence interval [CI] 25 to 27; p online learning group was 7 percentage points less than that achieved by the face-to-face learning group (95% CI 2 to 12; p = 0.008). Therefore, the enhanced online module was deemed to be non-inferior to the face-to-face learning session in terms of knowledge application and knowledge gain. Insufficient data were available to analyze the secondary outcome of knowledge retention over time. Participant satisfaction was similar for the 2 groups (p = 0.62). The self-paced enhanced online module was non-inferior to facilitated face-to-face learning in terms of improving application and

Evaluation of failure modes of computerized planning phase of interstitial implants with high dose rate brachytherapy using HFMEA

International Nuclear Information System (INIS)

Biazotto, Bruna; Tokarski, Marcio

2014-01-01

This paper evaluates the failure modes of the computerized planning step in interstitial implants with high dose rate brachytherapy. The prospective tool of risk management Health Care Failure Mode and Effects Analysis (HFMEA) was used. Twelve subprocesses were identified, and 33 failure modes of which 21 justified new safety actions, and 9 of them were intolerable risks. The method proved itself useful in identifying failure modes, but laborious and subjective in their assessment. The main risks were due to human factors, which require training and commitment of management to their mitigation. (author)

Direct-to-consumer advertising: Australian pharmacists' experiences with non-prescription medicines.

Science.gov (United States)

Chaar, Betty; Kwong, Kenelm

2010-02-01

Direct-to-consumer advertising (DTCA) of over-the-counter or prescribed medicines is a highly controversial issue relating to public health care. Advocates highlight the advantages of DTCA in terms of patient awareness and autonomy. Opponents voice concerns about safety and patients' best interests. The views of physicians and consumers about DTCA have been widely investigated. There has been little research, however, in relation to pharmacists' experiences with DTCA and the impact of DTCA on pharmacy practice. The aim of this study was therefore to explore pharmacists' perceptions of DTCA in Australia and its impact on pharmacy practice. A semi-structured in-depth interview was conducted with a purposive convenience sample of retail pharmacists in Sydney, Australia. Interviews were recorded, transcribed ad verbatim and continued until data saturation. Emerging themes were extracted and analysed according to the grounded theory approach. Pharmacists participating in this study reported concern about potential harm to patient health and well-being as a result of the influence of DTCA. DTCA was seen to impede pharmacists in the discharge of their fundamental ethical responsibilities, leading to a strong sense of disempowerment. Pharmacists' gate-keeping role was challenged by DTCA encouraging consumers to self-medicate and inducing a range of drug-seeking behaviours. Although pharmacists acknowledged that DTCA may have a role in promoting patient autonomy, in practice DTCA compromised their role in safeguarding consumers from inappropriate use of medicines. This study highlighted that the impact of DTCA is not restricted to prescription medicines, but extended also to over-the-counter, pharmacist-only and other pharmacy-related products. Pharmacists perceived that DTCA disempowered them, compromising their role in safeguarding the community from inappropriate medicine use.

Is the ICU staff satisfied with the computerized physician order entry? A cross-sectional survey study

Science.gov (United States)

Fumis, Renata Rego Lins; Costa, Eduardo Leite Vieira; Martins, Paulo Sergio; Pizzo, Vladimir; Souza, Ivens Augusto; Schettino, Guilherme de Paula Pinto

2014-01-01

Objective To evaluate the satisfaction of the intensive care unit staff with a computerized physician order entry and to compare the concept of the computerized physician order entry relevance among intensive care unit healthcare workers. Methods We performed a cross-sectional survey to assess the satisfaction of the intensive care unit staff with the computerized physician order entry in a 30-bed medical/surgical adult intensive care unit using a self-administered questionnaire. The questions used for grading satisfaction levels were answered according to a numerical scale that ranged from 1 point (low satisfaction) to 10 points (high satisfaction). Results The majority of the respondents (n=250) were female (66%) between the ages of 30 and 35 years of age (69%). The overall satisfaction with the computerized physician order entry scored 5.74±2.14 points. The satisfaction was lower among physicians (n=42) than among nurses, nurse technicians, respiratory therapists, clinical pharmacists and diet specialists (4.62±1.79 versus 5.97±2.14, pdigitalization decreased the workload and contributed to the intensive care unit quality with a user-friendly and accurate system and that digitalization provided concise information within a reasonable time frame. PMID:24770682

PECS and VOCAs to enable students with developmental disabilities to make requests: An overview of the literature

NARCIS (Netherlands)

Lancioni, G.E.; O'Reilly, M.F.; Cuvo, A.J.; Singh, N.N.; Sigafoos, J.; Didden, H.C.M.

2007-01-01

This paper provides an overview of the literature dealing with the use of the Picture Exchange Communication System (PECS) and voice output communication aids (VOCAs) for promoting the performance of requests by students with developmental disabilities. Computerized and manual searches were carried

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

Science.gov (United States)

Hanna, Tamer; Bajorek, Beata; Lemay, Kate; Armour, Carol L

2014-01-01

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

Arkansas community pharmacists' opinions on providing immunizations.

Science.gov (United States)

Pace, Anne C; Flowers, Schwanda K; Hastings, Jan K

2010-10-01

To determine community pharmacists' attitudes and knowledge on providing immunizations including perceived barriers to immunizing. The study also examined the percentage of Arkansas pharmacists providing immunizations and the utilization of student pharmacists. Survey. Arkansas community pharmacies from February to March 2009. Community pharmacists. Mailed survey. Perceived barriers to providing immunizations, pharmacists' attitudes regarding immunizations, number of immunization-certified pharmacists, immunization administration rates within the last year, and senior student pharmacists utilization. A total of 350 surveys were mailed, and 129 were returned. In all, 79% of the respondents believed administering immunizations has advanced or significantly advanced the profession. Being certified and attitude toward providing immunizations were correlated; 37% of the respondents held certification to immunize, of which 77% reported immunizing within the last year. Commonly reported barriers included time (76%) followed by reimbursement and legal liability. Only half the respondents realized fourth year student pharmacists could immunize and only 33% of certified pharmacists utilized student pharmacists to immunize. Pharmacists perceive many barriers to providing immunizations. Training student pharmacists to give immunizations may not result in them providing immunizations upon graduation. Additional education on overcoming potential barriers and using senior student pharmacists to administer immunizations is needed.

Radiation exposure of the gonads in infant brain computerized tomography

International Nuclear Information System (INIS)

Berndt, L.; Rosenkranz, G.; Tellkamp, H.

1988-01-01

In 61 babies and infants the gonadal dose due to brain computerized tomography was determined over the symphysis by thermoluminescent dosimetry. The average radiation dose was 43 mGy corresponding with data reported. Shielding of the testes in infants is an additional burden and worth discussing because of the low absolute gonadal dose

Druggists and pharmacists as gatekeepers: sales routines and compliance with sales protocols for over-the-counter naproxen 275 mg medicines in the Netherlands.

Science.gov (United States)

van Hoof, Joris J; Cents, Michel H G; Megens, Nicole M J; van der Tang, Sijbrand J

2014-09-01

Since for the sales of over-the-counter (OTC) medicines, prescribing physicians are not involved, and written instructions on/in the medicine boxes are inefficient, druggists and pharmacists are important gatekeepers in preventing customers' accidents. In this study we investigated the sales routines, and compliance with sales protocols, in order to evaluate that gatekeeper's function. By means of the mystery shopping method, 228 pharmacies and drugstores in The Netherlands were visited and a naproxen 275mg medium-risk medicine was requested for a (fictitious) patient who was suffering from severe back pains. According to the sales protocols the vendors should never sell the requested medicine, because the mystery shoppers only gave an answer to one of the four mandatory sales protocol questions. Furthermore, the requested medicine is not the right or best choice for back pains. Four different scenarios were used in a 2×2 design (8-year-old patient vs. 25-year-old patient, and 1 box with 12 pills vs. 3 boxes with 12 pills). Of the drugstores and pharmacies only 16.7% complied with the sales protocols and did not sell the specific (or comparable) medicine, after asking all four mandatory questions (or already after one, two or three questions). Most vendors (83.3%) did not comply and sold the requested medicine, a comparable medicine, or even a more risky medicine after no question at all (or after asking some or even all four questions). Although both score low, pharmacists show better compliance (23.9%) than druggists (10.1%). When it comes to OTC medicines, druggists and pharmacists largely commit sloppy sales. The expected gatekeeping function of pharmacists and druggists is very limited, and customers might be in danger of inappropriate medicine selection, quantity and usage. We call for thorough evaluation of the over-the-counter system, improvement of the educational programs for medicine providers, and national campaigns to inform the public. Copyright �

WHAT MOTIVATES POLISH COMMUNITY PHARMACISTS TO PURSUIT OF POSTGRADUATE EDUCATION?.

Science.gov (United States)

Jasinska-Stroschein, Magdalena; Kurczewska, Urszula; Orszulak-Michalak, Daria

2017-03-01

Due to increasing importance of the advisory role for physicians and patients played by the pharmacist over the last decade, it seems appropriate to evaluate if and why pharmacists are interested in postgraduate medical education. The purpose of the study was to develop and validate an instrument to assess such motives, with special interest to Polish community pharmacists. A self-administered questionnaire was completed by a sample of participants of community pharmacist specialization programs and it was analyzed in relation to participants of other postgraduate courses. They were asked to rank their motives on a Likert-like scale and the underlying dimensions for study motives were identified using exploratory and confirmatory techniques. The reasons for taking specialization for community pharmacists were similar as compared to participants of other postgraduate studies. However, the autotelic factor was not so strong and the crucial reason was that such postgraduate training was required to be promoted in work. Basing on Polish results, we propose the division of motives into three groups - autotelic, instrumental and coincidental. The validated self-administered questionnaire based on this division displayed acceptable construct validity and internal consistency, and therefore can be proposed as an example tool to assess the particular motives and expectations of potential postgraduate students and employees in the pharmaceutical job market. The promotion of postgraduate education among pharmacists can improve the quality of pharmaceutical service.

Role of the pharmacist in delivering point-of-care therapy for ...

African Journals Online (AJOL)

The wide variation in biological effect, narrow therapeutic range and pharmacokinetic and pharmacodynamic characteristics of warfarin require monitoring of the international normalised ratio (INR). Point-of-care results that are readily accessible for interpretation, allows the pharmacist to make dose adjustments ...

Downsizing of health-system pharmacist positions.

Science.gov (United States)

Kahaleh, A A; Siganga, W; Holiday-Goodman, M; Lively, B T

1998-11-15

The effects of downsizing on institutional pharmacists were studied. A national mail survey was sent to a random sample of 533 members of ASHP in January 1997. The questionnaire was designed to determine (1) the influence of selected factors on the downsizing of pharmacist positions and (2) pharmacists' attitudes about downsizing. A total of 256 usable questionnaires were received, for a net response rate of 48%. Forty-four pharmacists, or 17%, had personally been affected by downsizing. Sixty-one percent of the pharmacists affected by downsizing had had administrative positions. After downsizing, only 32% of the pharmacists had an administrative position. Most of the pharmacists were currently employed. Thirty-five (79%) described their current job responsibilities as substantially changed. Two thirds made the same salaries or higher salaries. Pharmacists who had been downsized rated mergers, the impact of managed care, and the profit motive as the most influential causes of downsizing of pharmacist positions. The three most common negative comments about the impact of downsizing cited reduction in the quality of patient care, increased stress, and lowered morale. Most of the pharmacists believed that communication skills, education, cross-training, and clinical skills are keys to surviving downsizing. Most pharmacists whose positions were downsized said they went on to jobs with similar or higher salaries and substantially different responsibilities.

Integration of Community Pharmacists in Transition of Care (TOC) Services: Current Trends and Pharmacist Perceptions.

Science.gov (United States)

Zeleznikar, Elizabeth A; Kroehl, Miranda E; Perica, Katharine M; Thompson, Angela M; Trinkley, Katy E

2017-01-01

Barriers exist for patients transitioning from one health-care setting to another, or to home, and health-care systems are falling short of meeting patient needs during this time. Community pharmacist incorporation poses a solution to the current communication breakdown and high rates of medication errors during transitions of care (TOC). The purpose of this study was to determine community pharmacists' involvement in and perceptions of TOC services. Cross-sectional study using electronic surveys nationwide to pharmacists employed by a community pharmacy chain. Of 7236 pharmacists surveyed, 546 (7.5%) responded. Only 33 (6%) pharmacists reported their pharmacy participates in TOC services. Most pharmacists (81.5%) reported receiving discharge medication lists. The most common reported barrier to TOC participation is lack of electronic integration with surrounding hospitals (51.1%). Most pharmacists agreed that (1) it is valuable to receive discharge medication lists (83.3%), (2) receiving discharge medication lists is beneficial for patients' health (89.1%), (3) discharge medication list receipt improves medication safety (88.8%). Most pharmacists reported receiving discharge medication lists and reported discharge medication lists are beneficial, but less than half purposefully used medication lists. To close TOC gaps, health-care providers must collaborate to overcome barriers for successful TOC services.

The Preparedness of Pharmacist in Community Setting to Cope with Globalization Impact

Directory of Open Access Journals (Sweden)

Max Joseph Herman

2015-05-01

Full Text Available A descriptive study to identify the preparedness of pharmacist in community pharmacies to cope with globalization impact was conducted in 2009. This cross-sectional study was done in DKI Jakarta, Bali and Maluku. Informants were purposively determined involving pharmacists from schools of pharmacy, Indonesian Pharmacist Association (IAI, community pharmacies, Provincial and District Health Offices, as well as comunity pharmacy owners. Primary data were collected through in-depth interviews and observation using check-list in community pharmacy. Data were analyzed descriptively and qualitatively using triangulation method. Results of the study show that according to Health Offices and the Indonesian Pharmacist Association, pharmacists were not adequately prepared and pharmacists in stand alone community pharmacy are less prepared than those in a network or franchise pharmacy. Licensed pharmacists of network community pharmacy in the metropolis are going to prepare themselves to face the new patient-oriented paradigm and to meet the standard of pharmacy service, whereas stand-alone community pharmacy still prioritized fast service and lower drug price.

Collaboration between Hospital and Community Pharmacists to Improve Medication Management from Hospital to Home

Directory of Open Access Journals (Sweden)

Judith Kristeller

2017-05-01

Full Text Available Objective: The objective of this study is to determine if a model for patient-centered care that integrates medication management between hospital and community pharmacists is feasible and can improve medication adherence. Design: This was a randomized, non-blinded, interventional study of 69 patients discharged from a hospital to home. Process measures include the number and type of medication-related discrepancies or problems identified, patient willingness to participate, the quality and quantity of interactions with community pharmacists, hospital readmissions, and medication adherence. Setting: A 214-bed acute care hospital in Northeastern Pennsylvania and seventeen regional community pharmacies. Patients: Enrolled patients were hospitalized with a primary or secondary diagnosis of heart failure or COPD, had a planned discharge to home, and agreed to speak to one of seventeen community pharmacists within the study network (i.e., a network community pharmacist following hospital discharge. Intervention: Information about a comprehensive medication review completed by the hospital pharmacist was communicated with the network community pharmacist to assist with providing medication therapy management following hospital discharge. Results: Of 180 patients eligible for the study, 111 declined to participate. Many patients were reluctant to talk to an additional pharmacist, however if the patient’s pharmacist was already within the network of 17 pharmacies, they usually agreed to participate. The study enrolled 35 patients in the intervention group and 34 in the control group. An average of 6 medication-related problems per patient were communicated to the patient’s network community pharmacist after discharge. In the treatment group, 44% of patients had at least one conversation with the network community pharmacist following hospital discharge. There was no difference in post-discharge adherence between the groups (Proportion of Days

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

Science.gov (United States)

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

2015-06-09

A pharmacist managed anticoagulation service was initiated in a multi-physician family medicine clinic in December 2006. In order to determine the patient and physician satisfaction with the service, a study was designed to describe the patients' satisfaction with the warfarin education and management they received from the pharmacist, and to describe the physicians' satisfaction with the level of care provided by the pharmacist for patients taking warfarin. A self-administered survey was completed by both eligible patients receiving warfarin and physicians prescribing warfarin between December 2006 and May 2008. The patient survey collected information on patient demographics, satisfaction with warfarin education and daily warfarin management. The physician survey collected data about the satisfaction with patient education and daily anticoagulation management by the pharmacist. Seventy-six of 94 (81%) patients completed the survey. Fifty-nine percent were male with a mean age of 65 years (range 24-90). Ninety-six percent agreed/strongly agreed the pharmacist did a good job teaching the importance of warfarin adherence, the necessity of INR testing and the risks of bleeding. Eighty-five percent agreed/strongly agreed the risk of blood clots was well explained, 79% felt the pharmacist did a good job teaching about dietary considerations and 77% agreed/strongly agreed the pharmacist explained when to see a doctor. All patients felt the pharmacist gave clear instructions on warfarin dosing and INR testing. Four of nine physicians (44%) completed the survey. All agreed/strongly agreed the pharmacist was competent in the care provided, were confident in the care their patients received, would like the pharmacist to continue the service, and would recommend this program to other clinics. Patients and family physicians were satisfied with the pharmacist managed anticoagulation program and recommended continuation of the program. These results support the role of the

PECS and VOCAs to Enable Students with Developmental Disabilities to Make Requests: An Overview of the Literature

Science.gov (United States)

Lancioni, Giulio E.; O'Reilly, Mark F.; Cuvo, Anthony J.; Singh, Nirbhay N.; Sigafoos, Jeff; Didden, Robert

2007-01-01

This paper provides an overview of the literature dealing with the use of the Picture Exchange Communication System (PECS) and voice output communication aids (VOCAs) for promoting the performance of requests by students with developmental disabilities. Computerized and manual searches were carried out to identify the studies published during the…

'It's showed me the skills that he has': pharmacists' and mentors' views on pharmacist supplementary prescribing.

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Lloyd, Fran; Parsons, Carole; Hughes, Carmel M

2010-02-01

Supplementary prescribing has seen pharmacists assume greater responsibility for prescribing in collaboration with doctors. This study explored the context and experiences, in relation to the practice of supplementary prescribing, of pharmacists and physicians (who acted as their training mentors) at least 12 months after pharmacists had qualified as supplementary prescribers. The setting was primary and secondary healthcare sectors in Northern Ireland. Pharmacists and mentors who had participated in a pre-training study were invited to take part. All pharmacists (n = 47) were invited to participate in focus groups, while mentors (n = 35) were asked to participate in face-to-face semi-structured interviews. The research took place between May 2005 and September 2007. All discussions and interviews were audiotaped, transcribed and analysed using constant comparison. Nine pharmacist focus groups were convened (number per group ranging from three to six; total n = 40) and 31 semi-structured interviews with mentors were conducted. The six main themes that emerged were optimal practice setting, professional progression for prescribing pharmacists, outcomes for prescribing pharmacists, mentors and patients, relationships, barriers to implementation and the future of pharmacist prescribing. Where practised, pharmacist prescribing had been accepted, worked best for chronic disease management, was perceived to have reduced doctors' workload and improved continuity of care for patients. However, three-quarters of pharmacists qualified to practise as supplementary prescribers were not actively prescribing, largely due to logistical and organisational barriers rather than inter-professional tensions. Independent prescribing was seen as contentious by mentors, particularly because of the diagnostic element. Supplementary prescribing has been successful where it has been implemented but a number of barriers remain which are preventing the wider acceptance of this practice

Patients' willingness to pay for cognitive pharmacist services in community pharmacies.

Science.gov (United States)

Lakić, Dragana; Stević, Ivana; Odalović, Marina; Vezmar-Kovačević, Sandra; Tadić, Ivana

2017-10-31

To determine the general population willingness to pay for cognitive pharmacist service in community pharmacy, describe the behavior of participants regarding health care issues, and evaluate correlation between participants' sociodemographic characteristics or attitudes and their willingness to pay. A questionnaire-based survey was conducted among general population visiting community pharmacies. The participants were asked about receiving cognitive pharmacist services to identify and resolve potential medication therapy problems after the initiation of a new medicine to optimize health outcomes of the patients. A univariate and multivariate analysis were used to analyze associations between different variables and willingness to pay for pharmacy service. Of 444 respondents, 167 (38%) reported that they were willing to pay for a medication management service provided in the community pharmacy. Univariate analysis showed significant association between the willingness to pay for pharmacist-provided service and respondents' socio-demographic factors, health-related characteristics, and behavior, dilemmas, or need for certain pharmacist-provided service. The logistic regression model was statistically significant (χ2=4.599, Ppay for cognitive pharmacist services, which has not been fully recognized within the health care system. In future, pharmacists should focus on practical implementation of the service and models of funding.

Attitudes and knowledge of hospital pharmacists to adverse drug reaction reporting

Science.gov (United States)

Green, Christopher F; Mottram, David R; Rowe, Philip H; Pirmohamed, Munir

2001-01-01

Aims To investigate the attitudes of UK hospital pharmacists towards, and their understanding, of adverse drug reaction (ADR) reporting. Methods A postal questionnaire survey of 600 randomly selected hospital pharmacists was conducted. Results The response rate was 53.7% (n = 322). A total of 217 Yellow Cards had been submitted to the CSM/MCA by 78 (25.6%) of those responding. Half of those responding felt that ADR reporting should be compulsory and over three-quarters felt it was a professional obligation. However, almost half were unclear as to what should be reported, while the time available in clinical practice and time taken to complete forms were deemed to be major deterrents to reporting. Pharmacists were not dissuaded from reporting by the need to consult a medical colleague or by the absence of a fee. Education and training had a significant influence on pharmacists' participation in the Yellow Card Scheme. Conclusions Pharmacists have a reasonable knowledge and are supportive of the Yellow Card spontaneous ADR reporting scheme. However, education and training will be important in maintaining and increasing ADR reports from pharmacists. PMID:11167664

Using Discursis to enhance the qualitative analysis of hospital pharmacist-patient interactions.

Directory of Open Access Journals (Sweden)

Bernadette A M Chevalier

Full Text Available Pharmacist-patient communication during medication counselling has been successfully investigated using Communication Accommodation Theory (CAT. Communication researchers in other healthcare professions have utilised Discursis software as an adjunct to their manual qualitative analysis processes. Discursis provides a visual, chronological representation of communication exchanges and identifies patterns of interactant engagement.The aim of this study was to describe how Discursis software was used to enhance previously conducted qualitative analysis of pharmacist-patient interactions (by visualising pharmacist-patient speech patterns, episodes of engagement, and identifying CAT strategies employed by pharmacists within these episodes.Visual plots from 48 transcribed audio recordings of pharmacist-patient exchanges were generated by Discursis. Representative plots were selected to show moderate-high and low- level speaker engagement. Details of engagement were investigated for pharmacist application of CAT strategies (approximation, interpretability, discourse management, emotional expression, and interpersonal control.Discursis plots allowed for identification of distinct patterns occurring within pharmacist-patient exchanges. Moderate-high pharmacist-patient engagement was characterised by multiple off-diagonal squares while alternating single coloured squares depicted low engagement. Engagement episodes were associated with multiple CAT strategies such as discourse management (open-ended questions. Patterns reflecting pharmacist or patient speaker dominance were dependant on clinical setting.Discursis analysis of pharmacist-patient interactions, a novel application of the technology in health communication, was found to be an effective visualisation tool to pin-point episodes for CAT analysis. Discursis has numerous practical and theoretical applications for future health communication research and training. Researchers can use the software to

Using Discursis to enhance the qualitative analysis of hospital pharmacist-patient interactions.

Science.gov (United States)

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William N; Angus, Daniel J

2018-01-01

Pharmacist-patient communication during medication counselling has been successfully investigated using Communication Accommodation Theory (CAT). Communication researchers in other healthcare professions have utilised Discursis software as an adjunct to their manual qualitative analysis processes. Discursis provides a visual, chronological representation of communication exchanges and identifies patterns of interactant engagement. The aim of this study was to describe how Discursis software was used to enhance previously conducted qualitative analysis of pharmacist-patient interactions (by visualising pharmacist-patient speech patterns, episodes of engagement, and identifying CAT strategies employed by pharmacists within these episodes). Visual plots from 48 transcribed audio recordings of pharmacist-patient exchanges were generated by Discursis. Representative plots were selected to show moderate-high and low- level speaker engagement. Details of engagement were investigated for pharmacist application of CAT strategies (approximation, interpretability, discourse management, emotional expression, and interpersonal control). Discursis plots allowed for identification of distinct patterns occurring within pharmacist-patient exchanges. Moderate-high pharmacist-patient engagement was characterised by multiple off-diagonal squares while alternating single coloured squares depicted low engagement. Engagement episodes were associated with multiple CAT strategies such as discourse management (open-ended questions). Patterns reflecting pharmacist or patient speaker dominance were dependant on clinical setting. Discursis analysis of pharmacist-patient interactions, a novel application of the technology in health communication, was found to be an effective visualisation tool to pin-point episodes for CAT analysis. Discursis has numerous practical and theoretical applications for future health communication research and training. Researchers can use the software to support

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

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Hanna T

2014-03-01

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

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

Science.gov (United States)

Hanna, Tamer; Bajorek, Beata; LeMay, Kate; Armour, Carol L.

Objective To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists’ confidence, and appropriateness, in the context of asthma management. Methods Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios) modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG) by three expert researchers. Results In seven of nine scenarios (78%), the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency) in the majority of scenarios. Due to this, only 47% (76/162) of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162) of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. Conclusions Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way. PMID:24644524

A guided interview process to improve student pharmacists' identification of drug therapy problems.

Science.gov (United States)

Rovers, John; Miller, Michael J; Koenigsfeld, Carrie; Haack, Sally; Hegge, Karly; McCleeary, Erin

2011-02-10

To measure agreement between advanced pharmacy practice experience students using a guided interview process and experienced clinical pharmacists using standard practices to identify drug therapy problems. Student pharmacists enrolled in an advanced pharmacy practice experience (APPE) and clinical pharmacists conducted medication therapy management interviews to identify drug therapy problems in elderly patients recruited from the community. Student pharmacists used a guided interview tool, while clinical pharmacists' interviews were conducted using their usual and customary practices. Student pharmacists also were surveyed to determine their perceptions of the interview tool. Fair to moderate agreement was observed on student and clinical pharmacists' identification of 4 of 7 drug therapy problems. Of those, agreement was significantly higher than chance for 3 drug therapy problems (adverse drug reaction, dosage too high, and needs additional drug therapy) and not significant for 1 (unnecessary drug therapy). Students strongly agreed that the interview tool was useful but agreed less strongly on recommending its use in practice. The guided interview process served as a useful teaching aid to assist student pharmacists to identify drug therapy problems.

ANDROS: A code for Assessment of Nuclide Doses and Risks with Option Selection

International Nuclear Information System (INIS)

Begovich, C.L.; Sjoreen, A.L.; Ohr, S.Y.; Chester, R.O.

1986-11-01

ANDROS (Assessment of Nuclide Doses and Risks with Option Selection) is a computer code written to compute doses and health effects from atmospheric releases of radionuclides. ANDROS has been designed as an integral part of the CRRIS (Computerized Radiological Risk Investigation System). ANDROS reads air concentrations and environmental concentrations of radionuclides to produce tables of specified doses and health effects to selected organs via selected pathways (e.g., ingestion or air immersion). The calculation may be done for an individual at a specific location or for the population of the whole assessment grid. The user may request tables of specific effects for every assessment grid location. Along with the radionuclide concentrations, the code requires radionuclide decay data, dose and risk factors, and location-specific data, all of which are available within the CRRIS. This document is a user manual for ANDROS and presents the methodology used in this code

Knowledge and Practices About the Subject Emergency Contraception of the Pharmacists and Their Helpers in the Pharmacies in Manisa

Directory of Open Access Journals (Sweden)

Ayten Taspinar

2012-08-01

Full Text Available AIM: The study was carried out as descriptive to determine the knowledge and practices about the subject emergency contraception of the pharmacists and their helpers in the pharmacies in central Manisa. METHOD: The universe of the research was formed by the 113 pharmacies registered to Manisa chamber of pharmacists in the year 2008 and all the pharmacies were included in the study. 47 pharmacists and 88 helpers agreed to join the study. The research which was planned to be descriptive March-to-June 2008. A questionnaire was produced by researchers and filled in during face-to face interviews with the pharmacists and their helpers. RESULTS: The pharmacists and their helpers stated that combined pills (46.8% and 44.5% and condoms (41.5% and 42.7% the most requested family planning methods their pharmacy. It was determined that 48.9% of the pharmacists, 33% of the pharmacist’s helpers gave information to customers about their use of family planning methods, 38.3% of the pharmacists, 23.9 % of the pharmacist’s helpers gave information what to do in case of failure to use/ where to apply to. 91.5% of the pharmacists, 95.5% of the pharmacist’s helpers stated that they had emergency contraception (EC purpose pills in their pharmacies. It was determined that 61.7% of the pharmacists, 28.4% of the pharmacist’s helpers had the knowledge about EC, 61.7% of the pharmacists, 52.3% of the pharmacist’s helpers could consider the EC methods true, 68.1% of the pharmacists, 70.5% of the pharmacist’s helpers gave the correct answers to the question of when the EC – purpose pills would be used. 68.1% of the pharmacists, 45.5% of the pharmacist’s helpers stated that EC methods might have adverse effects, 14.9% of the pharmacists, 25% of the pharmacist’s helpers stated that EC methods were protect agains to STD or not information about it, 12.8% of the pharmacists, 9.1% of the pharmacist’s helpers stated that these pills might be effective after the

How does a Belgian health care provider deal with a request for emergency contraception?

Science.gov (United States)

Peremans, Lieve; Verhoeven, Veronique; Philips, Hilde; Denekens, Joke; Van Royen, Paul

2007-12-01

To evaluate how Belgian health care providers deal with a request for emergency contraception. In 2002-2003 we conducted 12 focus groups with pharmacists, general practitioners and school physicians. A skilled moderator accompanied by an observer conducted the focus groups using a semi-structured screenplay. All these health care providers agree with the free access to emergency contraception (EC), but experience considerable frustration with regard to the practical aspects and the legal framework. General practitioners (GPs) claim to spend a lot of time on requests for EC and they are concerned about the quality of the counselling provided in pharmacies. Pharmacists are creative when giving counselling in the pharmacy, but there is, nevertheless, a problem with a lack of privacy. School physicians are frustrated that there is no legal possibility to respond to a request for EC when they feel they are ideally placed to advise adolescents. The over-the-counter sale of EC offers women better access, but many barriers still interfere with optimal care. Pharmacists experience a lack of skills to communicate with adolescents and a lack of privacy to give counselling. GPs have good intentions, but are confronted with a lack of willingness on the part of the patients and also financial barriers. School physicians want more possibilities to help adolescents.

Rural Australian community pharmacists' views on complementary and alternative medicine: a pilot study

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Willis Jon A

2011-10-01

Full Text Available Abstract Background Complementary and alternative medicines (CAMs are being used increasingly across the world. In Australia, community pharmacists are a major supplier of these products but knowledge of the products and interactions with other medicines is poor. Information regarding the use of CAMs by metropolitan pharmacists has been documented by the National Prescribing Service (NPS in Australia but the views of rural/regional community pharmacists have not been explored. The aim of this pilot study was to explore the knowledge, attitudes and information seeking of a cohort of rural community pharmacists towards CAMs and to compare the findings to the larger NPS study. Methods A cross sectional self-administered postal questionnaire was mailed to all community pharmacists in one rural/regional area of Australia. Using a range of scales, data was collected regarding attitudes, knowledge, information seeking behaviour and demographics. Results Eighty eligible questionnaires were returned. Most pharmacists reported knowing that they should regularly ask consumers if they are using CAMs but many lacked the confidence to do so. Pharmacists surveyed for this study were more knowledgeable in regards to side effects and interactions of CAMs than those in the NPS survey. Over three quarters of pharmacists surveyed reported sourcing CAM information at least several times a month. The most frequently sought information was drug interactions, dose, contraindications and adverse effects. A variety of resources were used to source information, the most popular source was the internet but the most useful resource was CAM text books. Conclusions Pharmacists have varied opinions on the use of CAMs and many lack awareness of or access to good quality CAMs information. Therefore, there is a need to provide pharmacists with opportunities for further education. The data is valuable in assisting interested stakeholders with the development of initiatives to

Computerization of off-site dose calculations at two nuclear power plants

International Nuclear Information System (INIS)

Lei, W.; Robertson, C.E.; Moore, G.T.; Rawls, B.E.; Sipp, J.R.

1988-01-01

The Brunswick Nuclear Project (BNP) consists of two boiling water reactors designed to generate a total net output of 1642 MWe. Unit 2 achieved commercial production in 1975, and Unit 1 began commercial operation in 1977. The Harris nuclear Project (HNP) is an 860 MWe pressurized water reactor that entered commercial operation in May of 1987. both plant sites are operated by Carolina Power and Light Company (CP and L). During January 1984, BNP replaced its older effluent technical specifications (part of the plant's original license) with the newer generation of Radiological Effluent Technical Specifications (RETS) mandated by the U.S. Nuclear Regulatory Commission. The RETS for HNP were integrated directly into this initial technical specifications. The initial version of the ODCM for BNP was drafted by a vendor and then extensively rewritten by the plant staff. The manual for HNP was drafted by CP and L corporate staff. At the outset, it was realized how impractical it would be to attempt to manually perform all of the dose calculations and keep the necessary records. The alternative-computerization-required extensive in-plant and corporate efforts to identify the computing resources (hardware) needed, create the software for ODCM implementation, and test, verify, validate, and document the software. This paper discusses these efforts

A needs assessment of community pharmacists for pharmacist specialization in Canada.

Science.gov (United States)

Jorgenson, Derek; Penm, Jonathan; MacKinnon, Neil; Smith, Jennifer

2017-04-01

Pharmacists are increasingly providing specialized services. However, no process exists for specialist certification in Canada. The aim of this study was to determine the extent to which Canadian community pharmacists support the development of a certification system for specialization. This study utilized a cross-sectional online survey of licensed Canadian pharmacists identified through the member databases of national and regional pharmacy associations. A questionnaire was developed (in French and English) and distributed via email, on behalf of the researchers, by multiple pharmacy organizations in January 2015. Multivariate logistic regressions were conducted to identify which sub-groups of respondents supported the creation of a certification system and which supported mandatory certification. A total of 770 responses were received. Many respondents were practising specialists (30.0%, 205/683) and the most commonly reported specialty areas were diabetes, smoking cessation and geriatrics. Almost 85% (n = 653/770) supported creation of a Canadian certification process and 68.5% (n = 447/653) felt certification should be mandatory. Respondents believed that the primary benefit of a certification system was greater public confidence in pharmacist specialist skills. They also felt that the most important factor in the development of the system is to create national definitions for specialty practice. The main barrier was the lack of reimbursement for specialty services in Canada. The majority of Canadian community pharmacist respondents support the creation of a certification process for pharmacist specialization. Future study is required to confirm this finding in a larger sample and to determine the optimal model and the financial feasibility of a national system in Canada. © 2016 Royal Pharmaceutical Society.

Dose assessment in pediatric computerized tomography

International Nuclear Information System (INIS)

Vilarinho, Luisa Maria Auredine Lima

2004-01-01

The objective of this work was the evaluation of radiation doses in paediatric computed tomography scans, considering the high doses usually involved and the absence of any previous evaluation in Brazil. Dose values were determined for skull and abdomen examinations, for different age ranges, by using the radiographic techniques routinely used in the clinical centers investigated. Measurements were done using pencil shape ionization chambers inserted in polymethylmethacrylate (PMMA) phantoms. These were compact phantoms of different diameters were specially designed and constructed for this work, which simulate different age ranges. Comparison of results with published values showed that doses were lower than the diagnostic reference levels established to adults exams by the European Commission. Nevertheless, doses in paediatric phantoms were higher than those obtained in adult phantoms. The paediatric dose values obtained in Hospitals A and B were lower than the reference level (DRL) adopted by SHIMPTON for different age ranges. In the range 0 - 0.5 year (neonatal), the values of DLP in Hospital B were 94 por cent superior to the DRL For the 10 years old children the values of CTDI w obtained were inferior in 89 por cent for skull and 83 por cent for abdomen examinations, compared to the values published by SHRIMPTON and WALL. Our measured CTDI w values were inferior to the values presented for SHRIMPTON and HUDA, for all the age ranges and types of examinations. It was observed that the normalized dose descriptors values in children in the neonatal range were always superior to the values of doses for the adult patient. In abdomen examinations, the difference was approximately 90% for the effective dose (E) and of 57%.for CTDI w . (author)

Factors affecting the views and attitudes of Scottish pharmacists to continuing professional development.

Science.gov (United States)

Power, Ailsa; Grammatiki, Aikaterini; Bates, Ian; Mc Kellar, Susan; Johnson, B Julienne; Diack, H Lesley; Stewart, Derek; Hudson, Steve A

2011-12-01

To explore factors associated with Scottish pharmacists' views and attitudes to continuing professional development (CPD). A retrospective principal component analysis of 552 (22.8%) questionnaires returned from a sample of 2420 Scottish pharmacists randomly selected from the 4300 pharmacists registered with the Royal Pharmaceutical Society of Great Britain and with a Scottish address. Principal component analysis of questionnaire items (n = 19) revealed four factors associated with Scottish pharmacists' views and attitudes to CPD: having positive support in the workplace, having access to resources and meeting learning needs, having confidence in the CPD process and motivation to participate in the CPD process. Community pharmacists were identified as the subgroup of pharmacists that needed most support for CPD regarding all four factors, while pharmacists working in primary care felt that they had most support in the workplace in comparison to other sectors (P Scottish pharmacists' views and attitudes to CPD. This may provide an approach to facilitate comparison of CPD views and attitudes with intra and inter professional groupings. Further study may allow identification of good practice and solutions to common CPD issues. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

Rewards and advancements for clinical pharmacists.

Science.gov (United States)

Goodwin, S Diane; Kane-Gill, Sandra L; Ng, Tien M H; Melroy, Joel T; Hess, Mary M; Tallian, Kimberly; Trujillo, Toby C; Vermeulen, Lee C

2010-01-01

The American College of Clinical Pharmacy charged the Clinical Practice Affairs Committee to review and update the College's 1995 White Paper, "Rewards and Advancements for Clinical Pharmacy Practitioners." Because of the limited data on the present state of rewards and advancements for clinical pharmacists, an online survey of "front-line" clinical pharmacists and pharmacy managers was conducted (1126 total respondents, 14% response rate). The resulting White Paper discusses motivators and existing systems of rewards and advancements for clinical pharmacists, as well as perceived barriers to implementation of these systems. Clinical pharmacists reported work-life balance, a challenging position, and opportunities for professional advancement as the most important factors for career success. At the time of the survey, financial rewards appeared not to be a major motivator for clinical pharmacists. Managers underestimated the importance that clinical pharmacists place on work-life balance and favorable work schedules. Although almost two thirds of the clinical pharmacists surveyed had not developed a professional development plan, 84% indicated an interest in career planning. Both clinical pharmacists and managers rated the lack of a clear reward and advancement structure as the most important barrier to effective systems of rewards and advancements. Pharmacy managers and administrators are encouraged to develop effective systems of rewards and advancements for clinical pharmacists that positively impact patient care and the institution's mission; these systems will benefit the clinical pharmacist, the health care institution, and the patient.

Michigan Pharmacists Transforming Care and Quality: Developing a Statewide Collaborative of Physician Organizations and Pharmacists to Improve Quality of Care and Reduce Costs.

Science.gov (United States)

Choe, Hae Mi; Lin, Alexandra Tungol; Kobernik, Kathleen; Cohen, Marc; Wesolowicz, Laurie; Qureshi, Nabeel; Leyden, Tom; Share, David A; Darland, Rozanne; Spahlinger, David A

2018-04-01

Inappropriate drug use, increasing complexity of drug regimens, continued pressure to control costs, and focus on shared accountability for clinical measures drive the need to leverage the medication expertise of pharmacists in direct patient care. A statewide strategy based on the collaboration of pharmacists and physicians regarding patient care was developed to improve disease state management and medication-related outcomes. Blue Cross Blue Shield of Michigan (BCBSM) partnered with Michigan Medicine to develop and implement a statewide provider-payer program called Michigan Pharmacists Transforming Care and Quality (MPTCQ), which integrates pharmacists within physician practices throughout the state of Michigan. As the MPTCQ Coordinating Center, Michigan Medicine established an infrastructure integrating clinical pharmacists into direct patient care within patient-centered medical home (PCMH) practices and provides direction and guidance for quality and process improvement across physician organizations (POs) and their affiliated physician practices. The primary goal of MPTCQ is to improve patient care and outcomes related to Medicare star ratings and HEDIS measures through integration of clinical pharmacists into direct patient care. The short-term goal is to adopt and modify Michigan Medicine's integrated pharmacist practice model at participating POs, with the long-term goal of developing a sustainable model of pharmacist integration at each PO to improve patient care and outcomes. Initially, pharmacists are delivering disease management (diabetes, hypertension, and hyperlipidemia) and comprehensive medication review services with future plans to expand clinical services. In 2015, 10 POs participated in year 1 of the program. In collaboration with the MPTCQ Coordinating Center, each PO identified 1 "pharmacist transformation champion" (PTC). The PTC implemented the integrated pharmacist model at 2 or 3 practice sites with at least 2 practicing physicians per

The use of non-prescription medicines during lactation: A qualitative study of community pharmacists' attitudes and perspectives.

Science.gov (United States)

Sim, Tin Fei; Hattingh, H Laetitia; Sherriff, Jillian; Tee, Lisa B G

2018-05-01

Community pharmacists play a significant role in the provision of non-prescription medicines. There is evidence that women self-medicate and use non-prescription medicines whilst breastfeeding. Studies have demonstrated that breastfeeding women are likely to seek advice from pharmacists, presenting a unique opportunity for pharmacists to provide on-going support of these women especially in relation to the appropriate use of non-prescription medicines. This study aimed to explore community pharmacists' attitudes and perspectives towards the use of non-prescription medicines during breastfeeding. This exploratory study was conducted through semi-structured interviews with 30 community pharmacists in Western Australia, between July and September 2013. Transcribed data were analysed using descriptive and qualitative approaches. NVivo ® Version 10.0 was used to organise qualitative data and quotations to facilitate thematic analysis. Four major themes emerged. Despite the positive attitudes and favourable perceived knowledge level, participants often found themselves in a dilemma when required to make clinical recommendations especially in situations where there was a therapeutic need for treatment but clear guidelines or evidence to suggest safety of the medicines or treatment in lactation was absent. Despite the popularity of complementary medicines, participants felt more confident in providing advice in relation to conventional over complementary medicines. Whilst medication safety is within the field of expertise of pharmacists, the absence of information and safety data was seen as a major challenge and barrier to enable pharmacists to confidently provide evidence-based recommendations. This study has enhanced our understanding of the attitudes and perspectives of community pharmacists towards the use of non-prescription, including complementary medicines, during breastfeeding. Future studies are warranted to confirm the safety of commonly used or requested

Desirable Skills in New Pharmacists.

Science.gov (United States)

O'Brien, Catherine E; Flowers, Schwanda K; Stowe, Cindy D

2017-02-01

To compare survey responses between licensed pharmacists who work with or employ new graduates and graduating senior pharmacy students at a college of pharmacy. This was a retrospective analysis of surveys given to 2 groups of pharmacists and students. Responses to items regarding importance of desirable qualities in new pharmacists and level of preparation of new graduates were analyzed. Qualities included drug information, pharmacology, therapeutics, communication with patients/customers or health care professionals, professionalism, ethics, management, and conflict resolution. There was consensus between pharmacists and students regarding the importance of all items ( P > .05 for all comparisons). However, the percentage of pharmacists versus students who agreed that new graduates communicate effectively differed (86.7% vs 100%, respectively, P career fair, 64.1% chose communication as the 1 skill that would distinguish an applicant, and retail and hospital pharmacists displayed a statistically significant ( P skills essential for pharmacy practice but disagree on the level of preparation for effective communication. These results support ongoing efforts to improve the development of communication skills in the professional pharmacy curriculum.

Pharmacists' perceptions of facilitators and barriers to lifelong learning.

Science.gov (United States)

Hanson, Alan L; Bruskiewitz, Ruth H; Demuth, James E

2007-08-15

To reevaluate facilitators of and barriers to pharmacists' participation in lifelong learning previously examined in a 1990 study. A survey instrument was mailed to 274 pharmacists who volunteered to participate based on a prior random sample survey. Data based on perceptions of facilitators and barriers to lifelong learning, as well as self-perception as a lifelong learner, were analyzed and compared to a similar 1990 survey. The response rate for the survey was 88%. The top 3 facilitators and barriers to lifelong learning from the 2003 and the 1990 samples were: (1) personal desire to learn; (2) requirement to maintain professional licensure; and (3) enjoyment/relaxation provided by learning as change of pace from the "routine." The top 3 barriers were: (1) job constraints; (2) scheduling (location, distance, time) of group learning activities; and (3) family constraints (eg, spouse, children, personal). Respondents' broad self-perception as lifelong learners continued to be highly positive overall, but remained less positive relative to more specific lifelong learning skills such as the ability to identify learning objectives as well as to evaluate learning outcomes. Little has changed in the last decade relative to how pharmacists view themselves as lifelong learners, as well as what they perceive as facilitators and barriers to lifelong learning. To address factors identified as facilitators and barriers, continuing education (CE) providers should focus on pharmacists' time constraints, whether due to employment, family responsibilities, or time invested in the educational activity itself, and pharmacists' internal motivations to learn (personal desire, enjoyment), as well as external forces such as mandatory CE for relicensure.

Investigating strategies used by hospital pharmacists to effectively communicate with patients during medication counselling.

Science.gov (United States)

Chevalier, Bernadette A M; Watson, Bernadette M; Barras, Michael A; Cottrell, William Neil

2017-10-01

Medication counselling opportunities are key times for pharmacists and patients to discuss medications and patients' concerns about their therapy. Communication Accommodation Theory (CAT) describes behavioural, motivational and emotional processes underlying communication exchanges. Five CAT strategies (approximation, interpretability, discourse management, emotional expression and interpersonal control) permit identification of effective communication. To invoke CAT to investigate communication strategies used by hospital pharmacists during patient medication counselling. This was a theory-based, qualitative study using transcribed audiorecordings of patients and hospital pharmacists engaged in medication counselling. Recruited pharmacists practised in inpatient or outpatient settings. Eligible patients within participating pharmacists' practice sites were prescribed at least three medications to manage chronic disease(s). The extent to which pharmacists accommodate, or not, to patients' conversational needs based on accommodative behaviour described within CAT strategies. Twelve pharmacists engaged four patients (48 total interactions). Exemplars provided robust examples of pharmacists effectively accommodating or meeting patients' conversational needs. Non-accommodation mainly occurred when pharmacists spoke too quickly, used terms not understood by patients and did not include patients in the agenda-setting phase. Multiple strategy use resulted in communication patterns such as "information-reassurance-rationale" sandwiches. Most pharmacists effectively employed all five CAT strategies to engage patients in discussions. Pharmacists' communication could be improved at the initial agenda-setting phase by asking open-ended questions to invite patients' input and allow patients to identify any medication-related concerns or issues. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Pharmacy technician-to-pharmacist ratios: a state-driven safety and quality decision.

Science.gov (United States)

Bess, D Todd; Carter, Jason; DeLoach, Lindsey; White, Carol L

2014-01-01

To discuss the policy of pharmacy technician-to-pharmacist ratios by comparing Florida as an example of legislative-led authority versus Tennessee as an example of board of pharmacy-led ruling. Over the past 2 years, the Florida legislature has debated the issue of pharmacy staffing ratios, initially leaving the Florida Board of Pharmacy with little authority to advocate for and enact safe technician staffing ratios. Anticipating this situation, the Tennessee Board of Pharmacy created rules to meet pharmacy staffing needs while protecting the authority of the pharmacist-in-charge and promoting patient safety. Before enacting rules, members of the board toured the state and talked about proposed rule changes with pharmacists. The final rule sets the pharmacy technician-to-pharmacist ratio at 2:1 but permits a 4:1 ratio based on public safety considerations and availability of at least two Certified Pharmacy Technicians. Pharmacists and leaders within the profession should conduct further research on appropriate and safe ratios of pharmacy technicians to pharmacists, with a focus on safety and quality of care.

Assessment of Pharmacists Workforce in Ethiopia

African Journals Online (AJOL)

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Method: A national facility based census of the pharmacist workforce was conducted in Ethiopia. ... pharmacists practice in community, hospitals and other medical .... Higher proportion of female pharmacists than males were working .... Recognition they get for good work. 8 ..... pharmacists' empowerment and organizational.

Pharmacists' Attitudes and Perceived Barriers to Human Papillomavirus (HPV) Vaccination Services.

Science.gov (United States)

Hastings, Tessa J; Hohmann, Lindsey A; McFarland, Stuart J; Teeter, Benjamin S; Westrick, Salisa C

2017-08-07

Use of non-traditional settings such as community pharmacies has been suggested to increase human papillomavirus (HPV) vaccination uptake and completion rates. The objectives of this study were to explore HPV vaccination services and strategies employed by pharmacies to increase HPV vaccine uptake, pharmacists' attitudes towards the HPV vaccine, and pharmacists' perceived barriers to providing HPV vaccination services in community pharmacies. A pre-piloted mail survey was sent to 350 randomly selected community pharmacies in Alabama in 2014. Measures included types of vaccines administered and marketing/recommendation strategies, pharmacists' attitudes towards the HPV vaccine, and perceived system and parental barriers. Data analysis largely took the form of descriptive statistics. 154 pharmacists completed the survey (response rate = 44%). The majority believed vaccination is the best protection against cervical cancer (85.3%), HPV is a serious threat to health for girls (78.8%) and boys (55.6%), and children should not wait until they are sexually active to be vaccinated (80.1%). Perceived system barriers included insufficient patient demand (56.5%), insurance plans not covering vaccination cost (54.8%), and vaccine expiration before use (54.1%). Respondents also perceived parents to have inadequate education and understanding about HPV infection (86.6%) and vaccine safety (78.7%). Pharmacists have positive perceptions regarding the HPV vaccine. Barriers related to system factors and perceived parental concerns must be overcome to increase pharmacist involvement in HPV vaccinations.

Future expectations for Japanese pharmacists as compared to the rest of the world

OpenAIRE

井上, 裕; 森田, 夕貴; 滝川, 茉由; 高尾, 浩一; 金本, 郁男; 杉林, 堅次

2015-01-01

It is important to share information about other countries' pharmacists to optimize cross-border medical cooperation. This paper examines the dispensing systems and the work done by pharmacists in the United Kingdom, Germany, France, Thailand, and Malaysia so as to compare these countries' medical practices and develop a cohesive vision for the future of Japanese pharmacists. All five of the countries have dispensing assistants. Pharmacists in Japan have duties of inventory control, drug disp...

Assessing the quality of pharmacist answers to telephone drug information questions.

Science.gov (United States)

Woodward, C T; Stevenson, J G; Poremba, A

1990-04-01

A quality assurance (QA) program is described in which frontline pharmacists were asked test drug information questions via anonymous telephone calls. The program was instituted at a university hospital that began providing decentralized pharmaceutical services in 1985. Questions were developed on the basis of a pilot study conducted to determine the types and complexity of drug information questions received by frontline pharmacists at the hospital. Data on departmental clinical productivity were used to determine the number of questions that would be posed during each shift in the various service areas. The questions were posed during a 10-day period; the pharmacists were aware of the program, but the callers did not identify their affiliation with it. In response to 105 questions asked, 86 were judged to have been answered correctly, 13 answers were deemed incomplete, and 6 were judged incorrect. Pharmacists were more likely to respond incorrectly to complex questions and questions posed during the night shift. As a result of the audit, staff members with advanced clinical knowledge were asked to help less experienced pharmacists, the position of assistant director for drug information and staff development was created, and educational programs were instituted. The QA audit has been repeated twice. Posing test drug information questions via anonymous telephone calls is effective in assessing the quality of drug information provided by pharmacists in patient-care areas.

Value of pharmacist medication interviews on optimizing the electronic medication reconciliation process.

Science.gov (United States)

Lee, Audrey; Varma, Arjun; Boro, Maureen; Korman, Nancy

2014-06-01

Few studies have explored the impact of using different methods for obtaining accurate medication histories on medication safety. This study was conducted to compare the accuracy and clinical impact of pharmacist medication histories obtained by electronic medical record review (EMRR) alone with those obtained by direct interviews combined with EMRR. This 18-week prospective study included patients who were admitted to the Inpatient Medicine Service at the study institution and who had a pharmacist-conducted medication reconciliation EMRR within 48 hours of hospital admission. A chart review was performed to collect data to determine whether differences existed in the number of discrepancies, recommendations, and medication errors between the EMRR alone group compared to the EMRR combined with the patient interview group. Five hundred thirteen discrepancies were identified with the EMRR group compared to 986 from the combined EMRR and patient interview group (P < .001). Significantly more recommendations were made in the combination interview group compared to the EMRR alone group (260 vs 97; P < .001). Fewer medication errors were identified for the EMRR alone group compared to the combination interview group (55 vs 134; P < .001). The most common errors were omitted medications followed by extra dose/failure to discontinue therapy and wrong dose/frequency errors. Pharmacist-conducted admission medication interviews combined with EMRR can potentially identify harmful medication discrepancies and prevent medication errors.

Computerized tomography

International Nuclear Information System (INIS)

Rubashov, I.B.

1985-01-01

Operating principle is described for the devices of computerized tomography used in medicine for diagnosis of brain diseases. Computerized tomography is considered as a part of computerized diagnosis, as a part of information science. It is shown that computerized tomography is a real existed field of investigations in medicine and industrial production

Changing relationships: attitudes and opinions of general practitioners and pharmacists regarding the role of the community pharmacist.

NARCIS (Netherlands)

Muijrers, P.E.; Knottnerus, J.A.; Sijbrandij, J.; Janknegt, R.; Grol, R.P.T.M.

2003-01-01

BACKGROUND: Relationship between general practitioners and pharmacists. AIM: To explore similarities and differences in opinions between general practitioners and pharmacists about the pharmacist's role. To identify factors which determine the attitude of the general practitioner towards the role of

Talking to the Pharmacist (For Parents)

Science.gov (United States)

... exactly what allergies your child has and what medicines your child takes. This will help the pharmacist prevent harmful ... crush them to mix into foods? Will this medicine conflict with my child's other medicines, including over-the-counter medicines and ...

Measurement of radiation dose to ovaries from CT of the head and trunk

Energy Technology Data Exchange (ETDEWEB)

Al-Habdhan, M.A.M.; Kinsara, A.R. [King Abdul Aziz Univ., Nuclear Engineering Dept., Jeddah (Saudi Arabia)

2001-07-01

With the rise in concern about doses received by patients over recent years, there has been a growing requirement for information on typical doses and the range of dose received during Computerized Tomography (CT). This study was performed for the assessment of radiation dose to the ovaries from various CT protocols for head and trunk imaging. Thermo luminescent dosimeters (TLD) were used for the dosimetry measurement in an anthropomorphic Rando Alderson phantom. The wanted (obligatory) and unwanted (non-useful) radiation doses delivered to the ovaries during CT examinations of head, facial bone, orbits, abdomen, chest, pelvis, neck, nasopharynx, cervical spine, lumber spine and sacroiliac joint were assessed. The results are compared with the corresponding values published in the literature. A comparison of the received dose from CT examinations and general radiography examinations by the ovaries was made. It is found that relatively high doses of unwanted radiation are delivered with computerized tomography. (author)

ACCP Clinical Pharmacist Competencies.

Science.gov (United States)

Saseen, Joseph J; Ripley, Toni L; Bondi, Deborah; Burke, John M; Cohen, Lawrence J; McBane, Sarah; McConnell, Karen J; Sackey, Bryan; Sanoski, Cynthia; Simonyan, Anahit; Taylor, Jodi; Vande Griend, Joseph P

2017-05-01

The purpose of the American College of Clinical Pharmacy (ACCP) is to advance human health by extending the frontiers of clinical pharmacy. Consistent with this mission and its core values, ACCP is committed to ensuring that clinical pharmacists possess the knowledge, skills, attitudes, and behaviors necessary to deliver comprehensive medication management (CMM) in team-based, direct patient care environments. These components form the basis for the core competencies of a clinical pharmacist and reflect the competencies of other direct patient care providers. This paper is an update to a previous ACCP document and includes the expectation that clinical pharmacists be competent in six essential domains: direct patient care, pharmacotherapy knowledge, systems-based care and population health, communication, professionalism, and continuing professional development. Although these domains align with the competencies of physician providers, they are specifically designed to better reflect the clinical pharmacy expertise required to provide CMM in patient-centered, team-based settings. Clinical pharmacists must be prepared to complete the education and training needed to achieve these competencies and must commit to ongoing efforts to maintain competence through ongoing professional development. Collaboration among stakeholders will be needed to ensure that these competencies guide clinical pharmacists' professional development and evaluation by educational institutions, postgraduate training programs, professional societies, and employers. © 2017 Pharmacotherapy Publications, Inc.

A nationwide survey of pharmacists' perception of pharmacogenetics in the context of a clinical decision support system containing pharmacogenetics dosing recommendations.

Science.gov (United States)

Bank, Paul Cd; Swen, Jesse J; Guchelaar, Henk-Jan

2017-02-01

To benchmark Dutch pharmacists knowledge, experience and attitudes toward pharmacogenetics (PGx) with a specific focus on the effects of awareness of the Dutch Pharmacogenetics Working Group guidelines. A web-based survey containing 41 questions was sent to all certified Dutch pharmacists. A total of 667 pharmacists completed the survey (18.8%). Virtually all responders believed in the concept of PGx (99.7%). However, only 14.7% recently ordered a PGx test (≤6 months), 14.1% felt adequately informed and 88.8% would like to receive additional training on PGx. Being aware of the Dutch Pharmacogenetics Working Group guidelines did not have any significant effect on knowledge or adoption of PGx. Dutch pharmacists are very positive toward PGx. However, test adoption is low and additional training is warranted.

Pharmacists as providers: targeting pneumococcal vaccinations to high risk populations.

Science.gov (United States)

Taitel, Michael; Cohen, Ed; Duncan, Ian; Pegus, Cheryl

2011-10-19

Older adults and persons with chronic conditions are at increased risk for pneumococcal disease. Severe pneumococcal disease represents a substantial humanistic and economic burden to society. Although pneumococcal vaccination (PPSV) can decrease risk for serious consequences, vaccination rates are suboptimal. As more people seek annual influenza vaccinations at community pharmacies, pharmacists have the ability to identify at-risk patients and provide PPSV. The objective of this study was to evaluate the impact of pharmacists educating at-risk patients on the importance of receiving a pneumococcal vaccination. Using de-identified claims from a large, national pharmacy chain, all patients who had received an influenza vaccination between August 1, 2010 and November 14, 2010 and who were eligible for PPSV were identified for the analysis. Based on the Advisory Committee on Immunization Practices recommendations, at-risk patients were identified as over 65 years of age or as aged 2-64 with a comorbid conditions. A benchmark medical and pharmacy claims database of commercial and Medicare health plan members was used to derive a PPSV vaccination rate typical of traditional care delivery to compare to pharmacy-based vaccination. Period incidence of PPSV was calculated and compared. Among the 1.3 million at-risk patients who were vaccinated by a pharmacist during the study period, 65,598 (4.88%) also received a pneumococcal vaccine. This vaccination rate was significantly higher than the benchmark rate of 2.90% (34,917/1,204,104; pvaccination rate (6.60%; 26,430/400,454) of any age group. Pharmacists were successful at identifying at-risk patients and providing additional immunization services. Concurrent immunization of PPSV with influenza vaccination by pharmacists has potential to improve PPSV coverage. These results support the expanding role of community pharmacists in the provision of wellness and prevention services. Copyright © 2011 Elsevier Ltd. All rights

Public Education Campaigns to Transform Perceptions of Pharmacists: Are They Worth the Investment?

Science.gov (United States)

Perepelkin, Jason; Abramovic, Melissa

2016-07-01

Recent public opinion polls consistently rank pharmacists as highly trusted health care professionals, but the reasoning for this ranking continues to remain vague and inconclusive. One possible explanation for this high ranking is that it is due in part to the limited expectations the public has of the profession. To gather comparative "before" and "after" data for this study, a self-administered, 33-item paper questionnaire was disseminated to 382 postsecondary (undergraduate) business students in a classroom setting. The questionnaire was designed to assess respondents' baseline perceptions toward (1) the pharmacy profession, in general, and (2) a prerecorded video of a simulated patient-pharmacist counseling session. Most respondents initially reported a "Poor/Fair" understanding of pharmacist education and training (52.1%), what to expect when having a prescription dispensed (55.5%), the content of a counseling session (49.7%), and pharmacist scope of practice (55.5%). After viewing the educational video, the number of respondents who reported a "Poor/Fair" understanding dropped to less than 5%; the majority of respondents reported a "Very Good/Excellent" understanding of pharmacist education and training (63.1%), what to expect when having a prescription dispensed (56.0%), the content of a counseling session (66.4%), and pharmacist scope of practice (60.5%). Results of this study demonstrated that using a public education-type video to increase public awareness for the pharmacy profession and pharmacist counseling duties significantly impacted respondents' knowledge and perception of value toward the profession and of pharmacist counseling.

[Targeting high-risk drugs to optimize clinical pharmacists' intervention].

Science.gov (United States)

Mouterde, Anne-Laure; Bourdelin, Magali; Maison, Ophélie; Coursier, Sandra; Bontemps, Hervé

2016-12-01

By the Order of 6 April 2011, the pharmacist must validate all the prescriptions containing "high-risk drugs" or those of "patients at risk". To optimize this clinical pharmacy activity, we identified high-risk drugs. A list of high-risk drugs has been established using literature, pharmacists' interventions (PI) performed in our hospital and a survey sent to hospital pharmacists. In a prospective study (analysis of 100 prescriptions for each high-risk drug selected), we have identified the most relevant to target. We obtained a statistically significant PI rate (P<0.05) for digoxin, oral anticoagulants direct, oral methotrexate and colchicine. This method of targeted pharmaceutical validation based on high-risk drugs is relevant to detect patients with high risk of medicine-related illness. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

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

Directory of Open Access Journals (Sweden)

Hesty Utami Ramadaniati

Full Text Available This study aimed to document and compare the nature of clinical pharmacists' interventions made in different practice settings within a children's hospital.The primary investigator observed and documented all clinical interventions performed by clinical pharmacists for between 35-37 days on each of the five study wards from the three practice settings, namely general medical, general surgical and hematology-oncology. The rates, types and significance of the pharmacists' interventions in the different settings were compared.A total of 982 interventions were documented, related to the 16,700 medication orders reviewed on the five wards in the three practice settings over the duration of the study. Taking medication histories and/or patient counselling were the most common pharmacists' interventions in the general settings; constituting more than half of all interventions. On the Hematology-Oncology Ward the pattern was different with drug therapy changes being the most common interventions (n = 73/195, 37.4% of all interventions. Active interventions (pharmacists' activities leading to a change in drug therapy constituted less than a quarter of all interventions on the general medical and surgical wards compared to nearly half on the specialty Hematology-Oncology Ward. The majority (n = 37/42, 88.1% of a random sample of the active interventions reviewed were rated as clinically significant. Dose adjustment was the most frequent active interventions in the general settings, whilst drug addition constituted the most common active interventions on the Hematology-Oncology Ward. The degree of acceptance of pharmacists' active interventions by prescribers was high (n = 223/244, 91.4%.The rate of pharmacists' active interventions differed across different practice settings, being most frequent in the specialty hematology-oncology setting. The nature and type of the interventions documented in the hematology-oncology were also different

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

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. 

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.

Patient surface doses in computerized tomography examinations

International Nuclear Information System (INIS)

Vekic, B.; Kovacevic, S.; Ranogajec Komor, M.; Duvnjak, N.; Marusic, P.; Anic, P.; Dolencic, P.

1996-01-01

Computed tomography (CT) has become a major source of the population exposure to diagnostic x-rays, and acknowledge of the doses delivered by the CT equipment has become very important. Considerable efforts should be made to keep these doses to a reasonable minimum, without sacrificing the image quality. The conditions of exposure in CT are quite different from dose in conventional x-ray imaging. This has required the development of specific techniques for assessing patient dose from CT. The aims of this work were to determine the dose delivered to various organs of patients undergoing computed tomography of abdomen, thorax, pelvis and kidney as measured on the surface of the body and to estimate the risk to the patients. Dosimetric measurements were performed at two different CT scanners (Siemens SOMATOM DR-H ver. HC-1 and Shimadzu SCT-4500TE). The dose absorbed by different organs (gonads, chest, thyroid and eye lens) and by the examined part of the body of 95 patients of various sex and age were measured with TLD-700. The doses absorbed by different organs during the diagnostic CT examination of the body depend on the technical parameters, such as the number of scan, mAs, the thickness of scans, scanning times, tube voltage and other characteristics, some of each depend on the type and severity of illness. Clinical parameters, such as patient size and composition, and patient cooperation with regard to the control and motion, also influence the dose and the image quality. The highest dose measured in this study (89.19 mGy) was delivered to kidney during CT examination of this organ. (author)

A theory-informed approach to mental health care capacity building for pharmacists.

Science.gov (United States)

Murphy, Andrea L; Gardner, David M; Kutcher, Stan P; Martin-Misener, Ruth

2014-01-01

Pharmacists are knowledgeable, accessible health care professionals who can provide services that improve outcomes in mental health care. Various challenges and opportunities can exist in pharmacy practice to hinder or support pharmacists' efforts. We used a theory-informed approach to development and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. Theories and frameworks including the Consolidated Framework for Implementation Research, the Theoretical Domains Framework, and the Behaviour Change Wheel were used to inform the conceptualization, development, and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. The More Than Meds program was developed and implemented through an iterative process. The main program components included: an education and training day; use of a train-the-trainer approach from partnerships with pharmacists and people with lived experience of mental illness; development of a community of practice through email communications, a website, and a newsletter; and use of educational outreach delivered by pharmacists. Theories and frameworks used throughout the program's development and implementation facilitated a means to conceptualize the component parts of the program as well as its overall presence as a whole from inception through evolution in implementation. Using theoretical foundations for the program enabled critical consideration and understanding of issues related to trialability and adaptability of the program. Theory was essential to the underlying development and implementation of a capacity-building program for enhancing services by pharmacists for people with lived experience of mental illness. Lessons learned from the development and implementation of this program are informing current research and evolution of the program.

Use of probiotics to prevent ventilator-associated pneumonia: A survey of pharmacists' attitudes.

Science.gov (United States)

Wheeler, Kathleen E; Cook, Deborah J; Mehta, Sangeeta; Calce, Adriana; Guenette, Melanie; Perreault, Marc M; Thiboutot, Zoé; Duffett, Mark; Burry, Lisa

2016-02-01

The primary objective of this survey was to describe pharmacists' attitudes regarding probiotic use in the intensive care unit (ICU); secondary objectives were to evaluate pharmacists' knowledge and use of probiotics for critically ill patients. The survey instrument was rigorously designed and pretested, then distributed in both English and French to Canadian ICU pharmacists. The online survey was open for 5 weeks, and 3 follow-up emails were sent to maximize response rates. Of 303 eligible surveys, 191 were returned (63.0%). Probiotics were available in the hospitals of 69.8% (113/162) of respondents, and 62.0% (101/163) indicated that they had used probiotics for at least 1 ICU patient in the previous year. Most pharmacists (137/171, 80.1%) said that they would "never" consider recommending probiotics for prevention of ventilator-associated pneumonia in ICU patients, and this response was more common (P = .0074) among pharmacists who were "unsure" about the safety of probiotics in this population when compared to those who felt that they knew how safe probiotics are. Most Canadian ICU pharmacists have used probiotics at least once in the ICU in the last year. However, based on uncertain efficacy and safety, most ICU pharmacists would not currently recommend probiotics for the prevention of ventilator-associated pneumonia. Copyright © 2015 Elsevier Inc. All rights reserved.

The role of pharmacists and emergency contraception: Are pharmacists' perceptions of emergency contraception predictive of their dispensing practices?

Science.gov (United States)

Richman, Alice R; Daley, Ellen M; Baldwin, Julie; Kromrey, Jeff; O'Rourke, Kathleen; Perrin, Kay

2012-10-01

Pharmacists can play a critical role in the access to emergency contraception (EC). We assessed if knowledge and attitudes were predictive of EC dispensing among a statewide sample of Florida pharmacists, who have legal authority to refuse to dispense medications. In 2008, surveys were mailed to a random sample of 1264 pharmacists registered with the Florida Board of Pharmacy. Data from 272 pharmacists (22% response rate) were analyzed using bivariate and multivariate logistic regression. Fifty-six percent of respondents incorrectly answered that EC causes birth defects, and 46% replied that it causes abortion. Only 22% said that EC can be purchased in advance of need. Many felt uncomfortable dispensing to adolescents (61%) and men (58%). Knowledge about EC was the most important predictor of dispensing [odds ratio (OR)=1.57, 95% confidence interval (CI) 1.22-2.03]. In particular, pharmacists who reported that EC does not act as an abortifacient were more likely to dispense it (OR=4.64, 95% CI 2.15-10.00). Correct information about EC was the most important predictor of pharmacists' dispensing EC. To expand availability of EC, pharmacists will have to become better informed. Copyright © 2012 Elsevier Inc. All rights reserved.

Medication adherence beliefs of U.S community pharmacists.

Science.gov (United States)

Witry, Matthew J

2018-05-01

There is increasing attention on the role of community pharmacists in improving medication adherence. There is a need to better understand pharmacist attitudes and experiences related to this role. To assess community pharmacist perceptions of patient reasons for non-adherence, characterize the adherence beliefs of community pharmacists, and test if there are demographic predictors of pharmacists' self-efficacy, outcome expectations, and role beliefs related to intervening on medication non-adherence. A cross-sectional survey was mailed using a 4-contact approach to 1000 pharmacists practicing in 5 Midwestern U.S. States. The survey included seven domains to address the study objectives. Descriptive statistics were calculated for demographic items, coefficient alphas tested the internal consistency of scales, and multiple regression was used to test the relationship between demographics and scale means. There were 261 usable responses giving a 29% response rate. Pharmacists perceived forgetting and instructions changing without a new prescription to be the most common reasons for late refills. A minority of pharmacists agreed that non-adherence involves a deliberate decision or that negative medication beliefs were common reasons for late refills. Pharmacists were confident, had positive outcome expectations, and positive role beliefs related to interacting with patients who have adherence issues. Barriers to adherence intervention included difficulties with follow-up and documentation. Also, over half of the pharmacists reported that discussing adherence makes patients defensive. Pharmacists had positive attitudes toward intervening on medication non-adherence although barriers to intervention are present. Pharmacists perceived non-intentional reasons for late refills to be more prevalent than intentional reasons. Pharmacists may benefit from additional non-adherence communication training and support targeted at identifying a broader range of non

Skills and knowledge of informatics, and training needs of hospital pharmacists in Thailand: A self-assessment survey.

Science.gov (United States)

Chonsilapawit, Teeraporn; Rungpragayphan, Suang

2016-10-01

Because hospital pharmacists have to deal with large amounts of health information and advanced information technology in practice, they must possess adequate skills and knowledge of informatics to operate efficiently. However, most current pharmacy curricula in Thailand barely address the principles and skills concerned with informatics, and Thai pharmacists usually acquire computer literacy and informatics skills through personal-interest training and self-study. In this study, we aimed to assess the skills and knowledge of informatics and the training needs of hospital pharmacists in Thailand, in order to improve curricular and professional development. A self-assessment postal survey of 73 questions was developed and distributed to the pharmacy departments of 601 hospitals throughout the country. Practicing hospital pharmacists were requested to complete and return the survey voluntarily. Within the 3 months of the survey period, a total of 805 out of 2002 surveys were returned. On average, respondents rated themselves as competent or better in the skills of basic computer operation, the Internet, information management, and communication. Understandably, they rated themselves at novice level for information technology and database design knowledge/skills, and at advanced beginner level for project, risk, and change management skills. Respondents believed that skills and knowledge of informatics were highly necessary for their work, and definitely needed training. Thai hospital pharmacists were confident in using computers and the Internet. They realized and appreciated their lack of informatics knowledge and skills, and needed more training. Pharmacy curricula and training should be developed accordingly. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Enhancing pharmacists' role in developing countries to overcome the challenge of antimicrobial resistance: a narrative review.

Science.gov (United States)

Sakeena, M H F; Bennett, Alexandra A; McLachlan, Andrew J

2018-01-01

Antimicrobial resistance (AMR) is a global health challenge and developing countries are more vulnerable to the adverse health impacts of AMR. Health care workers including pharmacists can play a key role to support the appropriate use of antimicrobials in developing countries and reduce AMR. The aim of this review is to investigate the role of pharmacists in the appropriate use of antibiotics and to identify how the pharmacists' role can be enhanced to combat AMR in developing countries. The databases MEDLINE, EMBASE, Web of Science and Google Scholar were searched for articles published between 2000 and the end of August 2017 that involved studies on the role of pharmacists in developing countries, the expanded services of pharmacists in patient care in developed countries and pharmacists' contributions in antimicrobial use in both developed and developing nations. In developing countries pharmacists role in patient care are relatively limited. However, in developed nations, the pharmacists' role has expanded to provide multifaceted services in patient care resulting in improved health outcomes from clinical services and reduced health care costs. Success stories of pharmacist-led programs in combating AMR demonstrates that appropriately trained pharmacists can be part of the solution to overcome the global challenge of AMR. Pharmacists can provide education to patients enabling them to use antibiotics appropriately. They can also provide guidance to their healthcare colleagues on appropriate antibiotic prescribing. This review highlights that appropriately trained pharmacists integrated into the health care system can make a significant impact in minimising inappropriate antibiotic use in developing countries. Strengthening and enhancing the pharmacists' role in developing countries has the potential to positively impact the global issue of AMR.

Errors detected in pediatric oral liquid medication doses prepared in an automated workflow management system.

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Bledsoe, Sarah; Van Buskirk, Alex; Falconer, R James; Hollon, Andrew; Hoebing, Wendy; Jokic, Sladan

2018-02-01

The effectiveness of barcode-assisted medication preparation (BCMP) technology on detecting oral liquid dose preparation errors. From June 1, 2013, through May 31, 2014, a total of 178,344 oral doses were processed at Children's Mercy, a 301-bed pediatric hospital, through an automated workflow management system. Doses containing errors detected by the system's barcode scanning system or classified as rejected by the pharmacist were further reviewed. Errors intercepted by the barcode-scanning system were classified as (1) expired product, (2) incorrect drug, (3) incorrect concentration, and (4) technological error. Pharmacist-rejected doses were categorized into 6 categories based on the root cause of the preparation error: (1) expired product, (2) incorrect concentration, (3) incorrect drug, (4) incorrect volume, (5) preparation error, and (6) other. Of the 178,344 doses examined, 3,812 (2.1%) errors were detected by either the barcode-assisted scanning system (1.8%, n = 3,291) or a pharmacist (0.3%, n = 521). The 3,291 errors prevented by the barcode-assisted system were classified most commonly as technological error and incorrect drug, followed by incorrect concentration and expired product. Errors detected by pharmacists were also analyzed. These 521 errors were most often classified as incorrect volume, preparation error, expired product, other, incorrect drug, and incorrect concentration. BCMP technology detected errors in 1.8% of pediatric oral liquid medication doses prepared in an automated workflow management system, with errors being most commonly attributed to technological problems or incorrect drugs. Pharmacists rejected an additional 0.3% of studied doses. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Roles and responsibilities of pharmacists with respect to natural health products: key informant interviews.

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Olatunde, Shade; Boon, Heather; Hirschkorn, Kristine; Welsh, Sandy; Bajcar, Jana

2010-03-01

Although many pharmacies sell natural health products (NHPs), there is no clear definition as to the roles and responsibilities (if any) of pharmacists with respect to these products. The purpose of this study was to explore pharmacy and stakeholder leaders' perceptions of pharmacists' professional NHP roles and responsibilities. Semi-structured key informant interviews were conducted with pharmacy leaders (n=17) and stakeholder (n=18) leaders representing consumers, complementary and alternative medicine practitioners, conventional health care practitioners, and industry across Canada. All participants believed a main NHP responsibility for pharmacists was in safety monitoring, although a one challenge identified in the interviews was pharmacists' general lack of NHP knowledge; however, stakeholder leaders did not expect pharmacists to be experts, but should have a basic level of knowledge about NHPs. Participants described pharmacists' professional roles and responsibilities for NHPs as similar to those for over-the-counter drugs; more awareness of existing NHP-related pharmacy policies is needed, and pharmacy owners/managers should provide additional training to ensure front-line pharmacists have appropriate knowledge of NHPs sold in the pharmacy. Copyright 2010 Elsevier Inc. All rights reserved.

Assessing Pharmacists' Attitudes and Barriers Involved with Immunizations

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Sarah Aldrich

2014-01-01

Full Text Available Pharmacists are considered the most accessible health care professional. Immunizations create an opportunity for the profession to grow and develop toward direct patient care. Between 1995 and 2004 programs involving immunizations led to a national initiative to train pharmacists that became a significant leap toward pharmacist's involvement in direct patient care. Although immunizations can be considered a catalyst to change the pharmacist's role, little was known about pharmacist's attitudes and the barriers involved with immunizing. Few studies have assessed barriers, attitudes, and practice issues experienced by immunizing pharmacists. The objective of this study was to determine pharmacists' attitudes toward immunizations and more specifically to assess possible barriers involved with this practice. Five hundred pharmacists were randomly selected for inclusion in the study from the State of Ohio Board of Pharmacy Database, of which 137 (27.4% completed the survey. A 37- item questionnaire was administered via an e-mail invitation to take an online survey using Qualtrics software with a Likert-type scale, where 1 = strongly disagree and 7 = strongly agree. Several topics were assessed regarding immunizations including time constraints, workflow constraints, adequacy of training, technician support, worksite conditions and space, immunization processes, reimbursement issues, safety issues, documentation issues, and the future direction of immunizations. Demographics included gender, age, degree, number of years practicing, practice site, and number of years immunizing. Seventy-three percent of pharmacists believed that immunizing could lead to prescription filling errors (mean=4.45, SD=1.79. Pharmacists strongly agreed that having more technicians on staff would make providing immunizations easier (mean=5.80, SD=1.39 and that they play a vital role in keeping the process running smoothly (mean=6.08, SD=1.16. Also, pharmacists strongly agreed

An examination of pharmacists' labor supply and wages.

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Polgreen, Linnea A; Mott, David A; Doucette, William R

2011-12-01

For the last decade, there has been a shortage of pharmacists for most of the United States. This shortage is in part because of demand-side phenomena (eg, increasing prescription drug use, increases in the complexity of drug regimens, and an aging population). However, there also may be supply-side causes. Although the number of pharmacy school graduates has increased, most graduates are women, many of whom may choose to work part-time. Because of the change in sex composition of the workforce, some researchers conclude that pharmacist shortages will be even more critical in the future. The goals of this article are to model pharmacists' decisions to work, estimate pharmacists' wages, and identify influences on the number of hours worked by pharmacists in the United States. Pharmacist labor supply is examined using a static, 3-step, empirical labor supply model that estimates the decision to work, hourly wages, and number of hours worked for U.S. pharmacists. Pharmacists have high starting wages but flat wage trajectories. Although many pharmacists are working part-time, this is true for women and men. Income effects do not dominate substitution effects, even at the high level of compensation found here. Results indicate that previous predictions brought about by the changing sex composition of the pharmacist labor force might not come to pass, and additional pharmacists may be attracted to the profession by higher wages and flexible schedules. Copyright © 2011 Elsevier Inc. All rights reserved.

Impact of a quality-assessment dashboard on the comprehensive review of pharmacist performance.

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Trinh, Long D; Roach, Erin M; Vogan, Eric D; Lam, Simon W; Eggers, Garrett G

2017-09-01

The impact of a quality-assessment dashboard and individualized pharmacist performance feedback on the adherence of order verification was evaluated. A before-and-after study was conducted at a 1,440-bed academic medical center. Adherence of order verification was defined as orders verified according to institution-derived, medication-related guidelines and policies. Formulas were developed to assess the adherence of verified orders to dosing guidelines using patient-specific height, weight, and serum creatinine clearance values from the electronic medical record at the time of pharmacist verification. A total of 5 medications were assessed by the formulas for adherence and displayed on the dashboard: ampicillin-sulbactam, ciprofloxacin, piperacillin-tazobactam, acyclovir, and enoxaparin. Adherence of order verification was assessed before (May 1-July 31, 2015) and after (November 1, 2015-January 31, 2016) individualized performance feedback was given based on trends identified by the quality-assessment dashboard. There was a significant increase in the overall adherence rate postintervention (90.1% versus 91.9%, p = 0.040). Among the 34 pharmacists who participated, the percentage of pharmacists with at least 90% overall adherence increased postintervention (52.9% versus 70.6%, p = 0.103). Time to verification was similar before and after the study intervention (median, 6.0 minutes; interquartile range, 3-13 minutes). The rate of documentation for nonadherent orders increased significantly postintervention (57.1% versus 68.5%, p = 0.019). The implementation of the quality-assessment dashboard, educational sessions, and individualized performance feedback significantly improved pharmacist order-verification adherence to institution-derived, medication-related guidelines and policies and the documentation rate of nonadherent orders. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Patient radiation exposure in computerized tomography

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Pavlov, V [Meditsinska Akademiya, Sofia (Bulgaria)

1980-01-01

Radiation exposure to patients undergoing axial computerized tomography as a tool of neurological X-ray diagnostics was studied. Doses thereby delivered were compared with those from routine head films at X-ray tube parameters 200 W, 70 kV, and 70 cm target-to-patient distance. Radiation exposures were analyzed with a view to improving shielding and procedural techniques. Comparisons were made using LiF TLD measurements with an Alderson phantom (standard for axial computer tomography). Skin and intracranial space doses were compared using two computers, Siretom I and Siretom 2000, for various positionings: frontal, fronto-lateral, temporal, temporo-occipital, and occipital. In addition, patient body doses with or without shielding and doses to subjects attending sick children or restless adults were examined. Achievable protection was estimated for lead shields of 0.5 mm lead equivalent. It was concluded that radiation doses delivered to neurologic patients undergoing axial computer tomography are smaller than those resulting from conventional X-ray examinations.

An approach to assess trends of pharmacist workforce production and density rate in Serbia.

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Milicevic, Milena Santric; Matejic, Bojana; Terzic-Supic, Zorica; Dedovic, Neveka; Novak, Sonja

2010-01-01

The policy dialog on human resource in health care is one of the central issues of the ongoing health care system reform in the Republic of Serbia. Pharmacists are the third largest health care professional group, after nurses and doctors. This study's objective was to analyze population coverage with pharmacists employed in the public sector of health care system of Serbia during 1961 - 2007, and to project their density by 2017. In this respect, additionally, time-series of annual number of enrolled and graduate pharmacy students were modelled. Time trends of routinely collected national statistical data, concerning the pharmacists, were analyzed by join point regression program, according to grid-search method. During the observed period of time, in Serbia, pharmacist workforce production and deployment trends were generally positive, but with different annual dynamic. Key findings were the slow rise of pharmacist workforce density rates per 100,000 population; the insufficient balance between pharmacists workforce supply side (annual number of enrolled and graduated students) and the public health care sector's ability to absorb annual number of pharmacy graduates. For ten years ahead, density rates of publicly active pharmacist workforce would probably increase for 46%, if no policy interventions were planned to adverse trends of pharmacist workforce production and deployment in public health care sector. The study results may be useful for variety of stakeholders to better understand how and why the supply and deployment of pharmacists were changing; and that the coordination among policy interventions is a crucial successes factor for a health workforce development plan implementation. The repercussions of any changes made to the pharmacy workforce, need to be considered carefully in advance.

Introducing a checking technician allows pharmacists to spend more time on patient-focused activities.

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Napier, Patti; Norris, Pauline; Braund, Rhiannon

2018-04-01

Internationally there is an increasing focus on the clinical and cognitive services that pharmacists can provide. Lack of time has been identified as a barrier to pharmacists increasing their clinical activities. Within the pharmacy workplace there are many tasks that can only be performed by a pharmacist. The final accuracy check of a dispensed prescription is currently the sole responsibility of pharmacists in New Zealand. This takes up a significant amount of time during a pharmacist's work day. The introduction of a checking technician role has been suggested to allow pharmacists more time to do more patient focused work. To investigate the amount of time pharmacy staff spend on specific activities and to establish whether the introduction of a checking technician into twelve pilot sites increased the amount of time that the pharmacists could spend on patient focused activities. This study utilised a self-reported work sampling technique in twelve pilot sites, selected from both the hospital and community settings. Work sampling using an electronic device was conducted at two time-points (before the implementation of a Pharmacy Accuracy Checking Technician (PACT) role and when the PACT was in place). Data was collected at 10 min intervals for the period of five days, a working week. Tasks were grouped into patient focused, dispensing and personal activities. The introduction of the PACT into the pilot sites saw a mean increase of 19% in pharmacists' patient focused activities and a mean 20% decrease in dispensing activities. The introduction of a checking technician role into New Zealand pharmacies demonstrated the potential to provide pharmacists with more time to spend on patient focused activities. Copyright © 2017 Elsevier Inc. All rights reserved.

Design and Evaluation of an Electronic Override Mechanism for Medication Alerts to Facilitate Communication Between Prescribers and Pharmacists.

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Russ, Alissa L; Chen, Siying; Melton, Brittany L; Saleem, Jason J; Weiner, Michael; Spina, Jeffrey R; Daggy, Joanne K; Zillich, Alan J

2015-07-01

Computerized medication alerts can often be bypassed by entering an override rationale, but prescribers' override reasons are frequently ambiguous to pharmacists who review orders. To develop and evaluate a new override mechanism for adverse reaction and drug-drug interaction alerts. We hypothesized that the new mechanism would improve usability for prescribers and increase the clinical appropriateness of override reasons. A counterbalanced, crossover study was conducted with 20 prescribers in a simulated prescribing environment. We modified the override mechanism timing, navigation, and text entry. Instead of free-text entry, the new mechanism presented prescribers with a predefined set of override reasons. We assessed usability (learnability, perceived efficiency, and usability errors) and used a priori criteria to evaluate the clinical appropriateness of override reasons entered. Prescribers rated the new mechanism as more efficient (Wilcoxon signed-rank test, P = 0.032). When first using the new design, 5 prescribers had difficulty finding the new mechanism, and 3 interpreted the navigation to mean that the alert could not be overridden. The number of appropriate override reasons significantly increased with the new mechanism compared with the original mechanism (median change of 3.0; interquartile range = 3.0; P < 0.0001). When prescribers were given a menu-based choice for override reasons, clinical appropriateness of these reasons significantly improved. Further enhancements are necessary, but this study is an important first step toward a more standardized menu of override choices. Findings may be used to improve communication through e-prescribing systems between prescribers and pharmacists. © The Author(s) 2015.

Non-prescription proton-pump inhibitors for self-treating frequent heartburn:the role of the Canadian pharmacist

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Armstrong, David; Nakhla, Nardine

2016-01-01

Heartburn and acid regurgitation are the cardinal symptoms of gastroesophageal reflux and occur commonly in the Canadian population. Multiple non-prescription treatment options are available for managing these symptoms, including antacids, alginates, histamine-H2 receptor antagonists (H2RAs), and proton-pump inhibitors (PPIs). As a result, pharmacists are ideally positioned to recommend appropriate treatment options based upon an individual’s needs and presenting symptoms, prior treatment response, comorbid medical conditions, and other relevant factors. Individuals who experience mild heartburn and/or have symptoms that occur predictably in response to known precipitating factors can manage their symptoms by avoiding known triggers and using on-demand antacids and/or alginates or lower-dose non-prescription H2RAs (e.g. ranitidine 150 mg). For those with moderate symptoms, lifestyle changes, in conjunction with higher-dose non-prescription H2RAs, may be effective. However, for individuals with moderate-to-severe symptoms that occur frequently (i.e. ≥2 days/week), the non-prescription (Schedule II) PPI omeprazole 20 mg should be considered. The pharmacist can provide important support by inquiring about the frequency and severity of symptoms, identifying an appropriate treatment option, and recognizing other potential causes of symptoms, as well as alarm features and atypical symptoms that would necessitate referral to a physician. After recommending an appropriate treatment, the pharmacist can provide instructions for its correct use. Additionally, the pharmacist should inquire about recurrences, respond to questions about adverse events, provide monitoring parameters, and counsel on when referral to a physician is warranted. Pharmacists are an essential resource for individuals experiencing heartburn; they play a crucial role in helping individuals make informed self-care decisions and educating them to ensure that therapy is used in an optimal, safe, and

Prescribing by pharmacists in Alberta and its relation to culture and personality traits.

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Rosenthal, Meagen M; Houle, Sherilyn K D; Eberhart, Greg; Tsuyuki, Ross T

2015-01-01

As evidence for the efficacy of pharmacists' interventions, governments worldwide are developing legislation to formalize new practice approaches, including independent prescribing by pharmacists. Pharmacists in Alberta became the first in Canada availed of this opportunity; however, uptake of such has been slow. One approach to understanding this problem is through an examination of pharmacists who have already gained this ability. The primary objective of this study was to gain descriptive insight into the culture and personality traits of innovator, and early adopter, Alberta pharmacists with Additional Prescribing Authorization using the Organizational Culture Profile and Big Five Inventory. The study was a cross-sectional online survey of Alberta pharmacists who obtained Additional Prescribing Authorization (independent prescribing authority), in the fall of 2012. The survey contained three sections; the first contained basic demographic, background and practice questions; the second section contained the Organizational Culture Profile; and the third section contained the Big Five Inventory. Sixty-five survey instruments were returned, for a response rate of 39%. Respondents' mean age was 40 (SD 10) years. The top reason cited by respondents for applying for prescribing authority was to improve patient care. The majority of respondents perceived greater value in the cultural factors of competitiveness, social responsibility, supportiveness, performance orientation and stability, and may be more likely to exhibit behavior in line with the personality traits of extraversion, agreeableness, conscientiousness and openness. Inferential statistical analysis revealed a significant linear relationship between Organizational Culture Profile responses to cultural factors of social responsibility and competitiveness and the number of prescription adaptations provided. This insight into the experiences of innovators and early adopter pharmacist prescribers can be used to

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

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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…

Chronology of prescribing error during the hospital stay and prediction of pharmacist's alerts overriding: a prospective analysis

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Bruni Vanida

2010-01-01

Full Text Available Abstract Background Drug prescribing errors are frequent in the hospital setting and pharmacists play an important role in detection of these errors. The objectives of this study are (1 to describe the drug prescribing errors rate during the patient's stay, (2 to find which characteristics for a prescribing error are the most predictive of their reproduction the next day despite pharmacist's alert (i.e. override the alert. Methods We prospectively collected all medication order lines and prescribing errors during 18 days in 7 medical wards' using computerized physician order entry. We described and modelled the errors rate according to the chronology of hospital stay. We performed a classification and regression tree analysis to find which characteristics of alerts were predictive of their overriding (i.e. prescribing error repeated. Results 12 533 order lines were reviewed, 117 errors (errors rate 0.9% were observed and 51% of these errors occurred on the first day of the hospital stay. The risk of a prescribing error decreased over time. 52% of the alerts were overridden (i.e error uncorrected by prescribers on the following day. Drug omissions were the most frequently taken into account by prescribers. The classification and regression tree analysis showed that overriding pharmacist's alerts is first related to the ward of the prescriber and then to either Anatomical Therapeutic Chemical class of the drug or the type of error. Conclusions Since 51% of prescribing errors occurred on the first day of stay, pharmacist should concentrate his analysis of drug prescriptions on this day. The difference of overriding behavior between wards and according drug Anatomical Therapeutic Chemical class or type of error could also guide the validation tasks and programming of electronic alerts.

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.

Use of simulated patients to assess the clinical and communication skills of community pharmacists.

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Weiss, Marjorie C; Booth, Anneka; Jones, Bethan; Ramjeet, Sarah; Wong, Eva

2010-06-01

To investigate the quality and appropriateness of Emergency Hormonal Contraception (EHC) supply from community pharmacies. Community pharmacies in the southwest of England during 2007. Two simulated patient ('mystery shopper') scenarios to each participating pharmacy, one where the supply of EHC would be appropriate (scenario 1) and one where there was a drug interaction between EHC and St John's Wort, and the supply inappropriate (scenario 2). Pharmacy consultations were rated using criteria developed from two focus groups: one with pharmacist academics and one with female university students. Feedback to pharmacists to inform their continuing professional development was provided. Scores on rating scales encompassing the clinical and communication skills of the participating community pharmacists completed immediately after each mystery shopper visit. 40 pharmacist visits were completed: 21 for scenario 1 and 19 for scenario 2. Eighteen pharmacists were visited twice. Five pharmacists visited for scenario 2 supplied EHC against professional guidance, although other reference sources conflicted with this advice. Pharmacies which were part of the local PGD scheme scored higher overall in scenario 1 (P = 0.005) than those not part of the scheme. Overall the communication skills of pharmacists were rated highly although some pharmacists used jargon when explaining the interaction for scenario 2. Formatively assessing communication skills in an integrative manner alongside clinical skills has been identified as an important part of the medical consultation skills training and can be incorporated into the routine assessment and feedback of pharmacy over-the-counter medicines advice.

Impact of High-Fidelity Simulation and Pharmacist-Specific Didactic Lectures in Addition to ACLS Provider Certification on Pharmacy Resident ACLS Performance.

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Bartel, Billie J

2014-08-01

This pilot study explored the use of multidisciplinary high-fidelity simulation and additional pharmacist-focused training methods in training postgraduate year 1 (PGY1) pharmacy residents to provide Advanced Cardiovascular Life Support (ACLS) care. Pharmacy resident confidence and comfort level were assessed after completing these training requirements. The ACLS training requirements for pharmacy residents were revised to include didactic instruction on ACLS pharmacology and rhythm recognition and participation in multidisciplinary high-fidelity simulation ACLS experiences in addition to ACLS provider certification. Surveys were administered to participating residents to assess the impact of this additional education on resident confidence and comfort level in cardiopulmonary arrest situations. The new ACLS didactic and simulation training requirements resulted in increased resident confidence and comfort level in all assessed functions. Residents felt more confident in all areas except providing recommendations for dosing and administration of medications and rhythm recognition after completing the simulation scenarios than with ACLS certification training and the didactic components alone. All residents felt the addition of lectures and simulation experiences better prepared them to function as a pharmacist in the ACLS team. Additional ACLS training requirements for pharmacy residents increased overall awareness of pharmacist roles and responsibilities and greatly improved resident confidence and comfort level in performing most essential pharmacist functions during ACLS situations. © The Author(s) 2013.

Net Income of Pharmacy Faculty Compared to Community and Hospital Pharmacists.

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

2016-09-25

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

A qualitative study of English community pharmacists' experiences of providing lifestyle advice to patients with cardiovascular disease.

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Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael

2015-01-01

Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Semi-structured interviews were conducted with fifteen pharmacists (1 supermarket; 7 multiple; 7 independent) recruited through multiple methods from community pharmacies across the Midlands, England. A thematic analysis was conducted using a Framework approach. Pharmacists categorized patients according to their perceptions of the patients' ability to benefit from advice. Many barriers to providing lifestyle advice were identified. Confidence to provide lifestyle advice varied, with pharmacists most comfortable providing lifestyle advice in conjunction with conversations about medicines. Some pharmacists felt lifestyle advice was an integral part of their role whilst others questioned whether pharmacists should give lifestyle advice at all, particularly when receiving no remuneration for doing so. Pharmacists viewed providing lifestyle advice as important but identified many barriers to doing so. Lifestyle advice provision was influenced by pharmacists' perceptions of patients. Professional identity and associated role conflict appeared to underpin many of the barriers to pharmacists providing lifestyle advice. Pharmacists may benefit from enhanced training to: increase their confidence to provide lifestyle advice; integrate lifestyle advice with regular pharmaceutical practice and challenge their perceptions of some patients' receptiveness to lifestyle advice and behavior change. Changes to the way UK pharmacists are remunerated may increase the provision of lifestyle advice. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

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

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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

Health Literacy Based Communication by Illinois Pharmacists

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Radhika Devraj

2015-01-01

Full Text Available Objectives: Health literacy has received attention as an important issue for pharmacists to consider when interacting with patients. Yet, there is little information about methods pharmacists use to communicate with patients and their extent of use of health literacy based interventions during patient interactions. The purpose of this study was to examine methods of communication and types of health literacy based interventions that practicing pharmacists use in Illinois. Methods: A survey instrument addressing the study purpose was designed along with other items that were part of a larger study. Eleven items in the survey referred to pharmacist-patient communication. The instrument was pilot tested before administering to a random sample of 1457 pharmacists from the Illinois Pharmacists Association. Data were primarily collected via a mailed survey using Dillman’s five step total design method (TDM. Two reminder letters were mailed at two week intervals to non-respondents. Results: Usable responses were obtained from 701 respondents (48.1% response rate. Using simple words (96% and asking patients open-ended questions to determine comprehension (85% were the most frequent methods that pharmacists used to communicate with patients. Only 18% of respondents always asked patients to repeat medication instructions to confirm understanding. The various recommended types of health literacy interventions were “always” performed by only 8 to 33% of the respondents. More than 50% of respondents indicated that they rarely or never had access to an interpreter (51%, or employed bilingual pharmacists (59%. Only 11% of pharmacists said that they rarely/never pay attention to nonverbal cues that may suggest low health literacy. Conclusions: Pharmacists infrequently use action oriented health literacy interventions such as using visual aids, having interpreter access, medication calendars, etc. Additional training on health literacy, its scope, and

Authority of Pharmacists to Administer Human Papillomavirus Vaccine: Alignment of State Laws With Age-Level Recommendations.

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Dingman, Deirdre A; Schmit, Cason D

One strategy to increase the uptake of human papillomavirus (HPV) vaccine among adolescents is through the use of pharmacists. Our objectives were to (1) use a publicly available database to describe the statutory and regulatory authority of pharmacists to administer the HPV vaccine in the United States and (2) discuss how the current status of laws may influence achievement of the Healthy People 2020 goal of 80% HPV vaccination rate for teenagers aged 13-15. Using information from the Centers for Disease Control and Prevention's (CDC's) Public Health Law Program database, we identified state laws in effect as of January 1, 2016, giving pharmacists authority to administer vaccines. We used a standardized analysis algorithm to determine whether states' laws (1) authorized pharmacists to administer HPV vaccine, (2) required third-party authorization for pharmacist administration, and (3) restricted HPV vaccine administration by pharmacists to certain patient age groups. Of 50 states and the District of Columbia, 40 had laws expressly granting pharmacists authority to administer HPV vaccine to patients, but only 22 had laws that authorized pharmacists to vaccinate preadolescents aged 11 or 12 (ie, the CDC-recommended age group). Pharmacists were granted prescriptive authority by 5 states, and they were given authority pursuant to general (non-patient-specific) third-party authorization (eg, a licensed health care provider) by 32 states or patient-specific third-party authorization by 3 states. Most states permitted pharmacists to administer HPV vaccines only to boys and girls older than 11 or 12, which may hinder achievement of the Healthy People 2020 goal for HPV vaccination. Efforts should be made to strengthen the role of pharmacists in addressing this public health issue.

Delegation: a solution to the workload problem? Observations and interviews with community pharmacists in England.

Science.gov (United States)

Lea, Victoria M; Corlett, Sarah A; Rodgers, Ruth M

2016-05-01

This study aims to describe how pharmacists utilise and perceive delegation in the community setting. Non-participant observations and semi-structured interviews with a convenience sample of community pharmacists working in Kent between July and October 2011. Content analysis was undertaken to determine key themes and the point of theme saturation informed sample size. Findings from observations were also compared against those from interviews. Observations and interviews were undertaken with 11 pharmacists. Observations showed that delegation occurred in four different forms: assumed, active, partial and reverse. It was also employed to varying extents within the different pharmacies. Interviews revealed mixed views on delegation. Some pharmacists presented positive attitudes towards delegation while others were concerned about maintaining accountability for delegated tasks, particularly in terms of accuracy checking of dispensed medication. Other pharmacists noted the ability to delegate was not a skill they found inherently easy. Comparison of observation and interview data highlighted discrepancies between tasks pharmacists perceived they delegated and what they actually delegated. Effective delegation can potentially promote better management of workload to provide pharmacists with additional time to spend on cognitive pharmaceutical services. To do this, pharmacists' reluctance to delegate must be addressed. Lack of insight into own practice might be helped by self-reflection and feedback from staff. Also, a greater understanding of legal accountability in the context of delegation needs to be achieved. Finally, delegation is not just dependent on pharmacists, but also on support staff; ensuring staff are empowered and equipped to take on delegated roles is essential. © 2015 Royal Pharmaceutical Society.

Development of a Collaborative Practice Agreement Template to Promote the Role of the Pharmacist in Managing Urinary Tract Infections in Long-term Care Residents

Science.gov (United States)

Fehrenbacher, Lynne; McDevitt, Kimberly; Palmer, Matthew; Traynor, Laura; Boero, Joe; Crnich, Christopher

2017-01-01

Abstract Background One of the CDC core elements of antimicrobial stewardship in nursing homes emphasizes the promotion of clinical practice change and integration of the dispensing and consultant pharmacist to improve antibiotic use. An opportunity to support this element is via collaborative practice agreements (CPA). A CPA is a voluntary agreement between one or more prescribers and pharmacists which delegates physician authority under defined conditions and/or limitations toward a common goal. The Wisconsin Healthcare-Associated Infections (HAI) in Long-term Care (LTC) Coalition aims to reduce and eliminate HAIs among LTC residents. A coalition emphasis has been to educate caregivers about appropriate evaluation and treatment of suspected urinary tract infection (UTI). Given this focus, we targeted the same cohort for CPA design. Methods A literature review resulted in no report of CPAs being applied to LTC residents on antibiotics for UTI. Recognizing the dispensing and consultant pharmacist role varies by organization, we drafted a multi-layered CPA that can be customized by facility. The draft was reviewed by physicians, pharmacists, and nurses with expertise in infectious diseases, LTC, and CPAs. Through frequent meetings and collaborative editing, consensus was achieved. The final CPA includes antibiotic renal dose adjustment, discontinuation of antibiotics in asymptomatic patients with negative urinalysis or culture, and oral antibiotic modification based on organism susceptibility. Results The CPA template is supported by the WI HAI in LTC Coalition. It has been presented at the state level and is available for use by LTC facilities and pharmacists that may apply any/all level(s) of the CPA. An organization policy template and initial CPA competency for pharmacists have been designed to support implementation. Committed pilot sites have been identified. Conclusion A CPA is an innovative approach to expand the role of the dispensing and consultant

The pharmacist's role in promoting preconception health.

Science.gov (United States)

El-Ibiary, Shareen Y; Raney, Erin C; Moos, Merry-K

2014-01-01

To review the pharmacist's role in preconception health. PubMed search using the terms preconception, immunizations, epilepsy, diabetes, depression, tobacco, asthma, hypertension, anticoagulation, pharmacist, pregnancy, and current national guidelines. Preconception health has become recognized as an important public health focus to improve pregnancy outcomes. Pharmacists have a unique role as accessible health care providers to optimize preconception health by screening women for tobacco use, appropriate immunizations, and current medication use. Counseling patients on preconception risk factors and adequate folic acid supplementation as well as providing recommendations for safe and effective management of chronic conditions are also critical and within the scope of practice for pharmacists. Pharmacists play an important role in medication screening, chronic disease state management, and preconception planning to aid women in preparing for healthy pregnancies.

Research on accounting transition from computerization to informationization

Directory of Open Access Journals (Sweden)

Shu Chen

2017-11-01

Full Text Available The application for computer technology, digitalization technology and network technology in the accounting field has promoted the development of accounting informationization. Accounting informationization is a product integrated with traditional accounting theory and modern information technology, which is an inevitable trend of continuous development of modern accounting. This paper discusses the basic concepts and characteristics of accounting computerization and informationization based on the normative research method and literature data method, analyzes the feasibility of accounting transition from computerization to informationization, and finally puts forward the specific approaches and ultimate goals of accounting transition from computerization to informationization.

Computerization of atomic level and transition data for the first and second ionization states of the elements hydrogen through phosphorous

International Nuclear Information System (INIS)

Henry, E.A.

1976-01-01

A computerized data base of atomic energy levels and atomic transition data has been developed from data published by the National Bureau of Standards. These data are of potential use for laser application. The MASTER CONTROL data-base management system is used. These computerized data can be requested from the ERDA Computer Program Exchange and Information Center of the Argonne National Laboratory or from the National Technical Information Service of the U.S. Department of Commerce

[Analysis of drug-related problems in a tertiary university hospital in Barcelona (Spain)].

Science.gov (United States)

Ferrández, Olivia; Casañ, Borja; Grau, Santiago; Louro, Javier; Salas, Esther; Castells, Xavier; Sala, Maria

2018-05-07

To describe drug-related problems identified in hospitalized patients and to assess physicians' acceptance rate of pharmacists' recommendations. Retrospective observational study that included all drug-related problems detected in hospitalized patients during 2014-2015. Statistical analysis included a descriptive analysis of the data and a multivariate logistic regression to evaluate the association between pharmacists' recommendation acceptance rate and the variable of interest. During the study period 4587 drug-related problems were identified in 44,870 hospitalized patients. Main drug-related problems were prescription errors due to incorrect use of the computerized physician order entry (18.1%), inappropriate drug-drug combination (13.3%) and dose adjustment by renal and/or hepatic function (11.5%). Acceptance rate of pharmacist therapy advice in evaluable cases was 81.0%. Medical versus surgical admitting department, specific types of intervention (addition of a new drug, drug discontinuation and correction of a prescription error) and oral communication of the recommendation were associated with a higher acceptance rate. The results of this study allow areas to be identified on which to implement optimization strategies. These include training courses for physicians on the computerized physician order entry, on drugs that need dose adjustment with renal impairment, and on relevant drug interactions. Copyright © 2018 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

From transitions to transformation - A study of pharmacists developing patient-centered communication skills.

Science.gov (United States)

Luetsch, Karen; Burrows, Judith

2017-08-12

Pharmacists' communication with patients often focuses on technical aspects of advice giving, while limiting socio-emotional content. To develop pharmacists' patient-centered communication a learning and practice module integrating motivational interviewing (MI) was designed for an online postgraduate program, and its impact on their self-described practice evaluated. To investigate whether training in patient-centered communication changes pharmacists' perceptions of communicating with patients, and how any changes in their communication style influenced interactions and relationships with patients. A descriptive, qualitative study analyzing reflective journal entries detailing pharmacists' experiences of implementing patient-centered communication in practice was designed, evaluating reflections on initial patient interactions after training and 9-12 weeks later. Using the framework method of content and thematic analysis, an evaluation framework was devised that integrated communication, change and learning theories. Reflections were categorized within the framework as transitional (e.g. using good communication skills), transactional (e.g. using MI techniques, achieving reciprocity) or transformational (e.g. describing transformative learning, changing frames of reference in understanding of patient-centeredness). Differences between the first and last journal entries were evaluated and analyzed using descriptive statistics. Eighty-nine pharmacists provided two reflective journal entries for evaluation. Over 9-12 weeks, pharmacists described a change in their perspective of patient-centeredness, how they expanded the socio-emotional aspects of communication and succeeded in difficult conversations. When applying the thematic evaluation framework to initial journal entries, 38 (42%) of reflections fell within the transitional category, 51 (58%) were deemed transactional and none transformational. This changed to 10 (11%) transitional, 45 (51%) transactional and

Role of pharmacists in reducing occupational exposure to HIV.

Science.gov (United States)

Morris, S N

1989-12-01

The role of pharmacists in reducing the occupational hazard of human immunodeficiency virus (HIV) transmission via needle-stick injuries is described. Some 40% of all pharmaceuticals used in hospitals are now administered by injection, and sales of large-volume injectable drug products continue to grow. Most needle-stick injuries in which health-care workers are exposed to HIV-contaminated blood occur during recapping of used needles, picking up and carrying the needle, or placing it in a receptacle. Pharmacists are responsible not only for the purchase, storage, dispensing, and use of drug products but also for providing information about their administration and safe disposal. Single-use vials, ampuls, and prefilled syringes must all be evaluated for availability, ease of use, and disposal. A major factor in drug-purchasing decisions must be the safety of nurses. Syringes that have been redesigned to eliminate the need for recapping offer a major safety advantage. Needle disposal units should be made more conveniently accessible. Pharmacists can help prevent the transmission of HIV to health-care workers by using their influence as educators and decision makers to reduce the risk of needle-stick injury.

Computerized dosimetry management systems within EDF

International Nuclear Information System (INIS)

Daubert, G.

1996-01-01

EDF, using the ALARA approach, has embarked an ambitious project of optimising the doses received in its power plants. In directing its choice of actions and the effectiveness of such actions, the French operator is using a computerized personal and collective dosimetry management system. This system provides for ongoing monitoring of dosimetry at personal, site and unit level or indeed for the entire population of EDF nuclear power plants. (author)

Qatar pharmacists' understanding, attitudes, practice and perceived barriers related to providing pharmaceutical care.

Science.gov (United States)

El Hajj, Maguy Saffouh; Al-Saeed, Hassna Sohil; Khaja, Maryam

2016-04-01

Pharmaceutical care (PC) is the philosophy of practice that includes identifying and resolving medication therapy problems to improve patient outcomes. The study objectives were to examine the extent of pharmaceutical care practice and the barriers to pharmaceutical care provision as perceived by Qatar pharmacists and to assess their level of understanding of pharmaceutical care and their attitudes about pharmaceutical care provision. Setting Qatar pharmacies. A cross sectional survey of all pharmacists in Qatar was made. Consenting pharmacists were given the option to complete the survey either online using an online software or as paper by fax or by hand. 1. Extent of pharmaceutical care practice in Qatar. 2. Barriers to pharmaceutical care provision in Qatar. 3. Qatar pharmacists' level of understanding of pharmaceutical care. 4. Qatar pharmacists' attitudes toward pharmaceutical care provision. Over 8 weeks, 274 surveys were collected (34 % response rate). More than 80 % of respondents had correct understanding of the aim of PC and of the pharmacist role in PC. However, only 47 % recognized the patient role in PC and only 35 % were aware of the differences between clinical pharmacy and PC. Yet, more than 80 % believed that they could be advocates when it comes to patients' medications and health matters. Concerning their practice, respondents reported spending little time on PC activities. Offering feedback to the physician about the patient progress was always or most of the time performed by 21 % of respondents. The top perceived barriers for PC provision included inconvenient access to patient medical information (78 %) and lack of staff and time (77 and 74 % respectively). Although PC is not incorporated into pharmacy practice, Qatar pharmacists showed positive attitudes toward PC provision. Further work should focus on improving their PC understanding and on overcoming all barriers.

The Iowa new practice model: Advancing technician roles to increase pharmacists' time to provide patient care services.

Science.gov (United States)

Andreski, Michael; Myers, Megan; Gainer, Kate; Pudlo, Anthony

-reimbursed services. This was mostly likely due to the increased time available to provide patient care. Reimbursed services per hour did not increase significantly mostly likely due to lack of payers. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Information for physicians and pharmacists about drugs that might cause dry mouth: a study of monographs and published literature.

Science.gov (United States)

Nguyen, Caroline T; MacEntee, Michael I; Mintzes, Barbara; Perry, Thomas L

2014-01-01

Over three-quarters of the older population take medications that can potentially cause dry mouth. Physicians or pharmacists rarely inform patients about this adverse effect and its potentially severe damage to the teeth, mouth and general health. The objectives of this study were to (1) identify warnings in the literature about dry mouth associated with the most frequently prescribed pharmaceutical products in Canada; and (2) consider how this information might be obtained by physicians, pharmacists and patients. Monographs on the 72 most frequently prescribed medications during 2010 were retrieved from the Compendium of Pharmaceuticals and Specialties (CPS, a standard drug information reference for physicians and pharmacists), the National Library of Medicine's 'DailyMed' database, directly from the manufacturers, and from a systematic search of biomedical journals. The CPS provided monographs for 43% of the medications, and requests to manufacturers produced the remaining monographs. Mentions of dry mouth were identified in 61% of the products (43% amongst CPS monographs; an additional 43% amongst manufacturers' monographs; 7% in the DailyMed database and 7% from biomedical journals); five medications had contradictory reports in different monographs. Nearly two-thirds (61%) of the most commonly prescribed medications can cause dry mouth, yet warnings about this adverse effect and its potentially serious consequences are not readily available to physicians, pharmacists, dentists or patients.

[Cooperation according to French Law "hospital, patients, health and territories": Pharmacists' involvement in Aquitaine region].

Science.gov (United States)

d'Elbée, M; Baumevieille, M; Dumartin, C

2017-06-01

In 2009, the French Act "Hospital, Patients, Health and Territories" (loi "Hôpital, Patients, Santé et Territoires") reorganized the outpatient care pathway and defined missions aimed at improving cooperation between pharmaceutical and medical professionals. Five years later, we conducted a survey among community pharmacists in order to assess the appropriation of these missions and the way cooperation was implemented. We also aimed to investigate factors that could hamper or ease the development of these activities in order to identify actions needed to improve pharmacists' involvement. In partnership with the local health authorities "Agence régionale de santé", we conducted a survey via an online questionnaire sent to pharmacy holders in July 2014 in Aquitaine region. Information was collected about the pharmacies, involvement in collaborative activities, and barriers to cooperation. Overall, 20% (249) of pharmacists responded to the survey. They owned predominantly rural pharmacies (46%) or neighborhood pharmacies (41%), with two pharmacists per pharmacy (48%). Regarding collaborative activities, the majority of pharmacists (78%) had conducted interviews with their patients taking vitamin K antagonist therapy and they were willing to continue (87%). The implication was less common concerning other actions such as referent pharmacist for nursing homes (19%) or activities relating to therapeutic educational programs for patients with chronic conditions (34%). The vast majority of respondents (85%) were not aware of opportunities to become a correspondent pharmacist. The main obstacles for engaging in these activities were the lack of time, lack of knowledge about these missions and the lack of remuneration. We identified differences in pharmacists' involvement in collaborative activities depending on selected characteristics of the pharmacies. The findings of this survey underlined pharmacists' acceptance of these missions and suggest that better information

Patient counseling practices in U.S. pharmacies: effects of having pharmacists hand the medication to the patient and state regulations on pharmacist counseling.

Science.gov (United States)

Kimberlin, Carole L; Jamison, Allison Newland; Linden, Stephan; Winterstein, Almut G

2011-01-01

To determine the amount and type of oral counseling given to shoppers posing as new patients with new prescriptions and to determine how state regulations, pharmacy and pharmacist characteristics, and environmental factors affect oral counseling practices. Cross-sectional, observational, correlational study. 41 states and the District of Columbia between January 28 and March 31, 2008. 365 community pharmacy staff members had interactions with shopper-patients. Shoppers presented new prescriptions in community pharmacies and recorded observations related to oral communication with pharmacy staff. Oral provision of medication information and risk information to shoppers by pharmacy staff, as well as questions asked of shoppers by pharmacy staff. Some form of oral communication related to a medication was reported in 68% of encounters. At least one informational item for either medication was provided for approximately 42% of encounters. At least one risk information item was provided in 22% of encounters. Logistic regression findings indicated that the strongest predictor of oral counseling, either providing information or asking questions, was the pharmacist being the pharmacy staff member who handed the medication to the patient, controlling for all other variables in the models. In addition, having strict state regulations specifying that pharmacists must counsel all patients receiving new prescriptions predicted whether patients received counseling. A more private area for prescription pick up also was a significant predictor. The importance of the direct encounter between the pharmacist and patient and strict state regulations mandating that pharmacists counsel patients with new prescriptions were highlighted by these findings.

Funding issues and options for pharmacists providing sessional services to rural hospitals in Australia.

Science.gov (United States)

Tan, Amy Cw; Emmerton, Lynne M; Hattingh, H Laetitia; La Caze, Adam

2015-06-01

Many of Australia' s rural hospitals operate without an on-site pharmacist. In some, community pharmacists have sessional contracts to provide medication management services to inpatients. This paper discusses the funding arrangements of identified sessional employment models to raise awareness of options for other rural hospitals. Semistructured one-on-one interviews were conducted with rural pharmacists with experience in a sessional employment role (n =8) or who were seeking sessional arrangements (n = 4). Participants were identified via publicity and referrals. Interviews were conducted via telephone or Skype for ~40-55 min each, recorded and analysed descriptively. A shortage of state funding and reliance on federal funding was reported. Pharmacists accredited to provide medication reviews claimed remuneration via these federal schemes; however, restrictive criteria limited their scope of services. Funds pooling to subsidise remuneration for the pharmacists was evident and arrangements with local community pharmacies provided business frameworks to support sessional services. Participants were unaware of each other's models of practice, highlighting the need to share information and these findings. Several similarities existed, namely, pooling funds and use of federal medication review remuneration. Findings highlighted the need for a stable remuneration pathway and business model to enable wider implementation of sessional pharmacist models.

Physicians' and Pharmacists' Experience and Expectations of the ...

African Journals Online (AJOL)

Purpose: To investigate physicians' and pharmacists' experience and expectations of the roles of pharmacists in hospital setting in Macau for the development of physician-pharmacist collaborative working relationship (CWR). Methods: A survey was conducted to address the research questions. The study population ...

The gender earnings gap among pharmacists.

Science.gov (United States)

Carvajal, Manuel J; Armayor, Graciela M; Deziel, Lisa

2012-01-01

A gender earnings gap exists across professions. Compared with men, women earn consistently lower income levels. The determinants of wages and salaries should be explored to assess whether a gender earnings gap exists in the pharmacy profession. The objectives of this study were to (1) compare the responses of male and female pharmacists' earnings with human-capital stock, workers' preferences, and opinion variables and (2) assess whether the earnings determination models for male and female pharmacists yielded similar results in estimating the wage-and-salary gap through earnings projections, the influence of each explanatory variable, and gender differences in statistical significance. Data were collected through the use of a 37-question survey mailed to registered pharmacists in South Florida, United States. Earnings functions were formulated and tested separately for male and female pharmacists using unlogged and semilog equation forms. Number of hours worked, human-capital stock, job preferences, and opinion variables were hypothesized to explain wage-and-salary differentials. The empirical evidence led to 3 major conclusions: (1) men's and women's earnings sometimes were influenced by different stimuli, and when they responded to the same variables, the effect often was different; (2) although the influence of some explanatory variables on earnings differed in the unlogged and semilog equations, the earnings projections derived from both equation forms for male and female pharmacists were remarkably similar and yielded nearly identical male-female earnings ratios; and (3) controlling for number of hours worked, human-capital stock, job preferences, and opinion variables reduced the initial unadjusted male-female earnings ratios only slightly, which pointed toward the presence of gender bias. After controlling for human-capital stock, job-related characteristics, and opinion variables, male pharmacists continued to earn higher income levels than female

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

Science.gov (United States)

Katoue, Maram G; Al-Taweel, Dalal

2016-01-01

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

Dosimetry of computerized tomography in the evaluation of hip dysplasia

Energy Technology Data Exchange (ETDEWEB)

Guyer, B.; Bassano, D.A.; Levinsohn, E.M.; Smith, D.S.; Cady, R.B.

1984-07-01

The usefulness of computerized tomography (CT) in the assessment of hip dysplasia has recently been given attention in the literature and concern regarding radiation dose has been raised. This study was undertaken to measure the radiation dose, both in and out of plaster, for plain films, arthrography, tomography, and CT. A method is suggested to reduce dosage by 80% without compromising diagnostic information. Our experience with 25 scans of patients aged 4 months to 39 years is presented.

Expanding Pharmacists' Scope of Practice to Include Immunization in Nova Scotia

Directory of Open Access Journals (Sweden)

Beth O'Reilly

2017-07-01

Full Text Available On 10 December 2010 An Act to Amend Chapter 36 of the Acts of 2001, the Pharmacy Act (Bill 7 received Royal Assent in Nova Scotia, including an amendment that enabled an expanded scope of pharmacy practice. Expanding pharmacists' scope of practice came about from recommendations by various federal and provincial government bodies as an attempt to improve accessibility to health care and decrease costs. In 2013, pharmacists in Nova Scotia began administering the influenza vaccine as part of the publicly funded program in attempts to improve vaccine coverage rates. Preliminary evaluation in Nova Scotia has shown an increase in influenza vaccination coverage. Although pharmacist administration of influenza vaccination may improve vaccination coverage and reduce demand on physician time, there may be tension created among the professions, which needs to be addressed and managed.

Nontraditional work schedules for pharmacists.

Science.gov (United States)

Mahaney, Lynnae; Sanborn, Michael; Alexander, Emily

2008-11-15

Nontraditional work schedules for pharmacists at three institutions are described. The demand for pharmacists and health care in general continues to increase, yet significant material changes are occurring in the pharmacy work force. These changing demographics, coupled with historical vacancy rates and turnover trends for pharmacy staff, require an increased emphasis on workplace changes that can improve staff recruitment and retention. At William S. Middleton Memorial Veterans Affairs Hospital in Madison, Wisconsin, creative pharmacist work schedules and roles are now mainstays to the recruitment and retention of staff. The major challenge that such scheduling presents is the 8 hours needed to prepare a six-week schedule. Baylor Medical Center at Grapevine in Dallas, Texas, has a total of 45 pharmacy employees, and slightly less than half of the 24.5 full-time-equivalent staff work full-time, with most preferring to work one, two, or three days per week. As long as the coverage needs of the facility are met, Envision Telepharmacy in Alpine, Texas, allows almost any scheduling arrangement preferred by individual pharmacists or the pharmacist group covering the facility. Staffing involves a great variety of shift lengths and intervals, with shifts ranging from 2 to 10 hours. Pharmacy leaders must be increasingly aware of opportunities to provide staff with unique scheduling and operational enhancements that can provide for a better work-life balance. Compressed workweeks, job-sharing, and team scheduling were the most common types of alternative work schedules implemented at three different institutions.

Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study

Directory of Open Access Journals (Sweden)

O'Brien Karen

2009-03-01

Full Text Available Abstract Background More women are requesting Emergency Hormonal Contraception (EHC at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. Methods Six Primary Care Trusts (PCTs that had contracted with pharmacies to provide free EHC, requested the largest EHC providers (≥ 40 doses annually to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. Results 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718 of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348/2904 EHC clients (46.4% who had been offered screening accepted a screening kit. 264 (17.6% of those who accepted a kit returned a sample, of whom 24 (9.1% were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015. Conclusion Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group.

Computerized assessment of the measurement of individual doses

International Nuclear Information System (INIS)

Kiibus, A.

1981-06-01

The department for the measurements of individual doses makes regular dose controls by means of film badges for approximately 14000 individuals. The operation is facilitated by a Honeywell Bull Mini 6 Mod 43 computer. The computer language is COBOL applied to registering of in-data such as delivery of badges, film development, calibration, invoices, recording of individual doses and customers. The print-out consists of customers, badge codes, dosimeter lists, development specifications, dose statements, addresses, bills, dose statistics and the register of individuals. As a consequence of charges the activity is financially self-supporting. (G.B.)

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.

Assessment of the pharmacist workforce in Ethiopia

African Journals Online (AJOL)

admin

Method: A national facility based census of the pharmacist workforce was conducted in Ethiopia. Pharmacists' job .... Female. N (%). Total No. of. Pharmacists,. N(%). Population Size. Density of .... 51(13.2). Marital Status. Single. 252 (64.1). Married. 136 (34.6). Divorced ..... Production, attrition and retention: In the memory of.

Carolina Power and Light Company's computerized Radiological Information Management System

International Nuclear Information System (INIS)

Meyer, B.A.

1987-01-01

Carolina Power and Lignt Company has recently implement a new version of their computerized Radiological Information management System. The new version was programmed in-house and is run on the Company's mainframe computers. In addition to providing radiation worker dose histories and current dose updates, the system provides real-time access control for all three of the Company's nuclear plants such as respirator and survey equipment control and inventory, TLD QC records, and many other functions

A qualitative study of English community pharmacists' experiences of providing lifestyle advice to patients with cardiovascular disease

OpenAIRE

Morton, Kirsty; Pattison, Helen; Langley, Chris; Powell, Rachael

2015-01-01

Background - Cardiovascular disease (CVD) progression is modifiable through lifestyle behaviors. Community pharmacists are ideally placed to facilitate self-management of cardiovascular health however research shows varied pharmacist engagement in providing lifestyle advice. Objective - This study explored community pharmacists' experiences and perceptions of providing lifestyle advice to patients with CVD. Methods - Semi-structured interviews were conducted with fifteen pharmacists (1 superm...

Clinical relevance of pharmacist intervention in an emergency department.

Science.gov (United States)

Pérez-Moreno, Maria Antonia; Rodríguez-Camacho, Juan Manuel; Calderón-Hernanz, Beatriz; Comas-Díaz, Bernardino; Tarradas-Torras, Jordi

2017-08-01

To evaluate the clinical relevance of pharmacist intervention on patient care in emergencies, to determine the severity of detected errors. Second, to analyse the most frequent types of interventions and type of drugs involved and to evaluate the clinical pharmacist's activity. A 6-month observational prospective study of pharmacist intervention in the Emergency Department (ED) at a 400-bed hospital in Spain was performed to record interventions carried out by the clinical pharmacists. We determined whether the intervention occurred in the process of medication reconciliation or another activity, and whether the drug involved belonged to the High-Alert Medications Institute for Safe Medication Practices (ISMP) list. To evaluate the severity of the errors detected and clinical relevance of the pharmacist intervention, a modified assessment scale of Overhage and Lukes was used. Relationship between clinical relevance of pharmacist intervention and the severity of medication errors was assessed using ORs and Spearman's correlation coefficient. During the observation period, pharmacists reviewed the pharmacotherapy history and medication orders of 2984 patients. A total of 991 interventions were recorded in 557 patients; 67.2% of the errors were detected during medication reconciliation. Medication errors were considered severe in 57.2% of cases and 64.9% of pharmacist intervention were considered relevant. About 10.9% of the drugs involved are in the High-Alert Medications ISMP list. The severity of the medication error and the clinical significance of the pharmacist intervention were correlated (Spearman's ρ=0.728/pclinical pharmacists identified and intervened on a high number of severe medication errors. This suggests that emergency services will benefit from pharmacist-provided drug therapy services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

Stakeholder experiences with general practice pharmacist services: a qualitative study.

Science.gov (United States)

Tan, Edwin C K; Stewart, Kay; Elliott, Rohan A; George, Johnson

2013-09-11

To explore general practice staff, pharmacist and patient experiences with pharmacist services in Australian general practice clinics within the Pharmacists in Practice Study. Qualitative study. Two general practice clinics in Melbourne, Australia, in which pharmacists provided medication reviews, patient and staff education, medicines information and quality assurance services over a 6-month period. Patients, practice staff and pharmacists. Semi-structured telephone interviews with patients, focus groups with practice staff and semi-structured interviews and periodic narrative reports with practice pharmacists. Data were analysed thematically and theoretical frameworks used to explain the findings. 34 participants were recruited: 18 patients, 14 practice staff (9 general practitioners, 4 practice nurses, 1 practice manager) and 2 practice pharmacists. Five main themes emerged: environment; professional relationships and integration; pharmacist attributes; staff and patient benefits and logistical challenges. Participants reported that colocation and the interdisciplinary environment of general practice enabled better communication and collaboration compared to traditional community and consultant pharmacy services. Participants felt that pharmacists needed to possess certain attributes to ensure successful integration, including being personable and proactive. Attitudinal, professional and logistical barriers were identified but were able to be overcome. The findings were explained using D'Amour's structuration model of collaboration and Roger's diffusion of innovation theory. This is the first qualitative study to explore the experiences of general practice staff, pharmacists and patients on their interactions within the Australian general practice environment. Participants were receptive of colocated pharmacist services, and various barriers and facilitators to integration were identified. Future research should investigate the feasibility and sustainability of

Reducing drug–herb interaction risk with a computerized reminder system

Directory of Open Access Journals (Sweden)

Lin SS

2015-02-01

Full Text Available Sheng-Shing Lin,1,2 Chiu-Lin Tsai,3 Ching-Yeh Tu,3 Ching-Liang Hsieh2,4,5 1Graduate Institute of Chinese Medicine, College of Chinese Medicine, China Medical University, 2Department of Chinese Medicine, China Medical University Hospital, 3Division of Chinese Medicine, Department of Pharmacy, China Medical University Hospital, 4Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, 5Research Center for Chinese Medicine and Acupuncture, China Medical University, Taichung, Taiwan Background: Traditional Chinese medicine (TCM and Western medicine are both popular in Taiwan. Approximately 14.1% of Taiwanese residents use Western drugs and Chinese herbs concurrently; therefore, drug–herb interaction is critical to patient safety. This paper presents a new procedure for reducing the risk of drug interactions.Methods: Hospital computer systems are modified to ensure that drug–herb interactions are automatically detected when a TCM practitioner is writing a prescription. A pop-up reminder appears, warning of interactions, and the practitioner may adjust doses, delete herbs, or leave the prescription unchanged. A pharmacist will receive interaction information through the system and provide health education to the patient.Results: During the 2011–2013 study period, 256 patients received 891 herbal prescriptions with potential drug–herb interactions. Three of the 50 patients who concurrently used ginseng and antidiabetic drugs manifested hypoglycemia (fasting blood sugar level ≤70 mg/dL.Conclusion: Drug–herb interactions can cause adverse reactions. A computerized reminder system can enable TCM practitioners to reduce the risk of drug–herb interactions. In addition, health education for patients is crucial in avoiding adverse reaction by the interactions. Keywords: Traditional Chinese medicine, Western medicine, adverse reaction

Hand dose distribution of workers at nuclear medicine department with PET

International Nuclear Information System (INIS)

Fueloep, M.; Bacek, D.; Povinec, P.; Cesnakova, Z; Vlk, P.; Husak, V.; Ptacek, J.

2008-01-01

In this study radio-pharmacists and physician hands during manipulation with syringes were recorded by video camera. The videos were analyzed and several hand phantoms were constructed to simulate the exposure geometries at which hands are irradiated by the highest doses. The hand dose distribution and conversion coefficient of ring dosimeter response to maximum dose equivalent of hand irradiation were evaluated by hand phantom experiments. Hand phantoms were performed from soft tissue equivalent material. FDG is commonly administered to patient by shielded syringe, which is connected on infusion line. At about 15% patients it is necessary to administered FDG directly without infusion line. For mapping hand dose dosimeters (TLD 100H calibrated on H p (0.07)) were located on fingers and wrist of hand phantom simulating physician hand. By ratio of dosimeter response at hand localities with maximum irradiation and ring dosimeter response was obtain value of about 30. It was proved that only one hand phantom was necessary for simulation of all radio-pharmacist operations with FDG during syringe preparation to patient PET. For this purpose by Monte Carlo simulations an effective position of radioactive source with regard to radio-pharmacist hands was found. (authors)

Hand dose distribution of workers at nuclear medicine department with PET

International Nuclear Information System (INIS)

Fueloep, M.; Bacek, D.; Povinec, P.; Cesnakova, Z; Vlk, P.; Husak, V.; Ptacek, J.

2009-01-01

In this study radio-pharmacists and physician hands during manipulation with syringes were recorded by video camera. The videos were analyzed and several hand phantoms were constructed to simulate the exposure geometries at which hands are irradiated by the highest doses. The hand dose distribution and conversion coefficient of ring dosimeter response to maximum dose equivalent of hand irradiation were evaluated by hand phantom experiments. Hand phantoms were performed from soft tissue equivalent material. FDG is commonly administered to patient by shielded syringe, which is connected on infusion line. At about 15% patients it is necessary to administered FDG directly without infusion line. For mapping hand dose dosimeters (TLD 100H calibrated on H p (0.07)) were located on fingers and wrist of hand phantom simulating physician hand. By ratio of dosimeter response at hand localities with maximum irradiation and ring dosimeter response was obtain value of about 30. It was proved that only one hand phantom was necessary for simulation of all radio-pharmacist operations with FDG during syringe preparation to patient PET. For this purpose by Monte Carlo simulations an effective position of radioactive source with regard to radio-pharmacist hands was found. (authors)

Pharmacist medication reviews to improve safety monitoring in primary care patients.

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Gallimore, Casey E; Sokhal, Dimmy; Zeidler Schreiter, Elizabeth; Margolis, Amanda R

2016-06-01

Patients prescribed psychotropic medications within primary care are at risk of suboptimal monitoring. It is unknown whether pharmacists can improve medication safety through targeted monitoring of at risk populations. Access Community Health Centers implemented a quality improvement pilot project that included pharmacists on an integrated care team to provide medication reviews for patients. Aims were to determine whether inclusion of a pharmacist performing medication reviews within a primary care behavioral health (PCBH) practice is feasible and facilitates safe medication use. Pharmacists performed medication reviews of the electronic health record for patients referred for psychiatry consultation. Reviews were performed 1-3 months following consultation and focused on medications with known suboptimal monitoring rates. Reviews were documented within the EHR and routed to the primary care provider. Primary outcome measures were change in percentage up-to-date on monitoring and AIMS assessment, and at risk of experiencing drug interaction(s) between baseline and 3 months postreview. Secondary outcome was provider opinion of medication reviews collected via electronic survey. Reviews were performed for 144 patients. Three months postreview, percentage up-to-date on recommended monitoring increased 18% (p = .0001), at risk for drug interaction decreased 20% (p improved safety monitoring of psychotropic medications. Results identify key areas for improvement that other clinics considering integration of similar pharmacy services should consider. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Efficacy and safety of a pharmacist-managed inpatient anticoagulation service for warfarin initiation and titration.

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Wong, Y M; Quek, Y-N; Tay, J C; Chadachan, V; Lee, H K

2011-10-01

Anticoagulation consultations provided by a pharmacist-staffed inpatient service, similar to the experience reported in outpatient anticoagulation clinics, can potentially improve anticoagulation control and outcomes. At Tan Tock Seng Hospital, a 1200-bed acute care teaching hospital in Singapore, pharmacist-managed anticoagulation clinics have been in place since 1997. Pharmacist-managed services were extended to inpatient consultations in anticoagulation management from April 2006. Our objective was to assess the effect of implementing a pharmacist-managed inpatient anticoagulation service. This was a single-centre cohort study. Baseline data from 1 January 2006 to 31 March 2006 were collected and compared with post-implementation data from 1 April 2006 to 31 March 2007. Patients newly started on warfarin for deep vein thrombosis, pulmonary embolism or atrial fibrillation in general medicine and surgery departments were included. The three endpoints were as follows: (i) percentage of international normalized ratios (INRs) achieving therapeutic range within 5 days, (ii) INRs more than 4 during titration and (iii) subtherapeutic INRs on discharge. A total of 26 patients in the control period were compared with 144 patients who had received dosing consultations by a pharmacist during the initiation of warfarin. The provision of pharmacist consult resulted in 88% compared to 38% (P < 0·001) of INR values achieving therapeutic range within 5 days. There was a reduction in INR values of more than 4 during titration from 27% to 2% (P < 0·001), and subtherapeutic INR values on discharge without low molecular weight heparin from 15% to 0% (P < 0·001). The mean time to therapeutic INR was reduced from 6·5 to 3·9 days (P < 0·001) and mean length of stay after initiation of warfarin from 11 to 7·7 days (P = 0·004). Inpatient anticoagulation care and outcomes were significantly improved by a pharmacist-managed anticoagulation service. The time to therapeutic INR was

Pharmacists' Scope of Practice: Supports for Canadians with Diabetes.

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Mansell, Kerry; Edmunds, Kirsten; Guirguis, Lisa

2017-12-01

The pharmacists' role in Canada has significantly advanced over the past decade, resulting in increasing access to primary care services. This study aimed to characterize pharmacists' expanded scope of practice as it relates to providing services to Canadians with diabetes. This environmental scan characterized services that could be useful to Canadians with diabetes in each of the provinces (excluding the territories): immunizations, medication prescribing, ordering and interpreting laboratory tests, and medication reviews. Researchers also collected information on pharmacists' access to health information. Data were collected from regulatory authorities in each province, from pharmacy stakeholders and through a web search. Pharmacists' scope of practice varies widely across the Canadian provinces. Three provinces have medication-review programs focused specifically on diabetes, and many people with diabetes can access publicly funded medication reviews. Other than in Quebec, pharmacists can provide influenza (publicly funded) and pneumococcal vaccinations (publicly funded in British Columbia, Alberta and Manitoba). All pharmacists in Canadian provinces can renew prescriptions to ensure continuity of therapy. Pharmacists have varying levels of other prescriptive authority. Pharmacists in all provinces (except Ontario) can access provincial prescription information; in 4 provinces, they can access laboratory results, and in 3 provinces, they can order and interpret laboratory results, such as glycated hemoglobin levels. Canadians with diabetes can expect to receive influenza vaccines and have medications renewed at their pharmacies. Many patients with diabetes qualify for a publicly funded medication review, and some provinces allow pharmacists to order and interpret laboratory results. This expanded scope provides greater opportunities for pharmacists to help support patients with diabetes in conjunction with other health-care team members. Copyright © 2017

Computerized clinical decision support systems for therapeutic drug monitoring and dosing: A decision-maker-researcher partnership systematic review

Directory of Open Access Journals (Sweden)

Weise-Kelly Lorraine

2011-08-01

Full Text Available Abstract Background Some drugs have a narrow therapeutic range and require monitoring and dose adjustments to optimize their efficacy and safety. Computerized clinical decision support systems (CCDSSs may improve the net benefit of these drugs. The objective of this review was to determine if CCDSSs improve processes of care or patient outcomes for therapeutic drug monitoring and dosing. Methods We conducted a decision-maker-researcher partnership systematic review. Studies from our previous review were included, and new studies were sought until January 2010 in MEDLINE, EMBASE, Evidence-Based Medicine Reviews, and Inspec databases. Randomized controlled trials assessing the effect of a CCDSS on process of care or patient outcomes were selected by pairs of independent reviewers. A study was considered to have a positive effect (i.e., CCDSS showed improvement if at least 50% of the relevant study outcomes were statistically significantly positive. Results Thirty-three randomized controlled trials were identified, assessing the effect of a CCDSS on management of vitamin K antagonists (14, insulin (6, theophylline/aminophylline (4, aminoglycosides (3, digoxin (2, lidocaine (1, or as part of a multifaceted approach (3. Cluster randomization was rarely used (18% and CCDSSs were usually stand-alone systems (76% primarily used by physicians (85%. Overall, 18 of 30 studies (60% showed an improvement in the process of care and 4 of 19 (21% an improvement in patient outcomes. All evaluable studies assessing insulin dosing for glycaemic control showed an improvement. In meta-analysis, CCDSSs for vitamin K antagonist dosing significantly improved time in therapeutic range. Conclusions CCDSSs have potential for improving process of care for therapeutic drug monitoring and dosing, specifically insulin and vitamin K antagonist dosing. However, studies were small and generally of modest quality, and effects on patient outcomes were uncertain, with no convincing

What does it take to change practice? Perspectives of pharmacists in Ontario.

Science.gov (United States)

Gregory, Paul A M; Teixeira, Beatriz; Austin, Zubin

2018-01-01

This is a time of rapid change in the profession of pharmacy. Anecdotally, there are concerns that the pace, extent and rate of practice evolution are lagging. There is little evidence documenting the influencers and mechanisms that drive practice changes forward in pharmacy in Canada. An exploratory qualitative method was selected, using both one-on-one interviews with self-categorized typical pharmacists and larger focus groups to provide context and confirmation of themes generated through interviews. Data were analyzed and coded using a constant-comparative iterative method, in order to generate themes related to the factors influencing pharmacists to actually change their practice. A total of 46 pharmacists meeting inclusion criteria participated in this study in focus groups, interviews or both. Nine themes were identified: 1) permission, 2) process pointers, 3) practice/rehearsal, 4) positive reinforcement, 5) personalized attention, 6) peer referencing, 7) physician acceptance, 8) patients' expectations and 9) professional identity supportive of a truly clinical role. One theme that did not emerge was payment, or remuneration, as a specific or isolated motivational factor for change. The complexity of practice change in pharmacy and the multiple factors highlighted in this study point to a more deliberate and concerted effort being needed by diverse pharmacy organizations (educators, regulators, employers, professional associations, etc.) to support pharmacists through the change management process. The "9 Ps of practice change" identified through this study can provide pharmacists with guidance in terms of how to better support evolution of the profession in a more time-efficient and effective manner.

A survey on the awareness and attitude of pharmacists and doctors towards the application of pharmacogenomics and its challenges in Qatar.

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Elewa, Hazem; Alkhiyami, Dania; Alsahan, Dima; Abdel-Aziz, Ahmed

2015-08-01

Pharmacists are expected to play an important role in applying pharmacogenomics discoveries to patient care. Despite the increased attention to genetic research in Qatar, clinicians' attitudes towards the application of pharmacogenomics are not yet explored. The aim of this study was to assess the awareness and attitude of pharmacists compared with doctors towards pharmacogenomics and its implications by submitting an electronic-based survey to all pharmacists and doctors currently working in a large medical corporation in Qatar. A cross-sectional survey instrument was developed based on literature review. Eligible participants were pharmacists and doctors currently practicing in Hamad Medical Corporation hospitals in Qatar. The survey comprised questions on demographic and professional characteristics. It also evaluated the awareness, attitudes and challenges towards pharmacogenomics and its application. We collected 202 surveys, 108 (53.2%) of which were pharmacists and the remaining 94 (46.5%) were doctors. The overall participants' mean total awareness score percentage was low (39% ± 22) and there were no difference between the mean score achieved by pharmacists and doctors. Pharmacists had significantly more positive attitudes than doctors towards: (i) taking the responsibility of applying pharmacogenomics to drug therapy selection, dosing and monitoring; (ii) perceiving a positive role of pharmacogenomics testing on the control of drug expenditure; and (iii) their willingness to participate in pharmacogenomics-related training sessions. Both pharmacists and doctors perceived lack of knowledge and guidelines as major challenges towards the application of pharmacogenomics in Qatar. Despite doctors' and pharmacists' low level of awareness towards pharmacogenomics, they both have positive attitudes towards the clinical implications of pharmacogenomics. Pharmacists are more motivated to learn about pharmacogenomics and are more willing to take initiatives in

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

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

Pharmaceutical care in Kuwait: hospital pharmacists' perspectives.

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Katoue, Maram G; Awad, Abdelmoneim I; Schwinghammer, Terry L; Kombian, Samuel B

2014-12-01

Pharmaceutical care practice has been championed as the primary mission of the pharmacy profession, but its implementation has been suboptimal in many developing countries including Kuwait. Pharmacists must have sufficient knowledge, skills, and positive attitudes to practise pharmaceutical care, and barriers in the pharmacy practice model must be overcome before pharmaceutical care can be broadly implemented in a given healthcare system. To investigate hospital pharmacists' attitudes towards pharmaceutical care, perceptions of their preparedness to provide pharmaceutical care, and the barriers to its implementation in Kuwait. Six general hospitals, eight specialized hospitals and seven specialized health centers in Kuwait. A descriptive, cross-sectional survey was distributed to all pharmacists working in the governmental hospitals in Kuwait (385 pharmacists). Data were collected via a pre-tested self-administered questionnaire. Descriptive statistics including percentages, medians and means Likert scale rating (standard deviations) were calculated and compared using statistical package for social sciences, version 20. Statistical significance was accepted at a p value of Kuwait. Completed surveys were received from 250 (64.9%) of the 385 pharmacists. Pharmacists expressed overall positive attitudes towards pharmaceutical care. They felt well prepared to implement the various aspects of pharmaceutical care, with the least preparedness in the administrative/management aspects. Pharmacists with more practice experience expressed significantly more positive attitudes towards pharmaceutical care (p = 0.001) and they felt better prepared to provide pharmaceutical care competencies (p Kuwait advocate implementation of pharmaceutical care while also appreciating the organizational, technical and professional barriers to its widespread adoption. Collaborative efforts between health authorities and educational institutions, and the integration of innovative approaches in

Pharmacist-patient communication in Swedish community pharmacies

DEFF Research Database (Denmark)

Olsson, Erika; Ingman, Pontus; Ahmed, Ban

2014-01-01

BACKGROUND: It is important that pharmacists counsel patients about their prescribed medicines, as it leads to improved therapeutic outcome, increases compliance, and decreases confusion and insecurity. Studies have shown that the number of patients getting any pharmaceutical counseling varies...... greatly. Swedish pharmacists claim that the focus of the dialog with the patient has switched from pharmaceutical counseling to economy and regulations. OBJECTIVE: The aim of this study was to determine the content and time disposition of the patient-pharmacist communication during dispensing...

[The gift of pharmacopoeias made by Mésaize to the Society of Pharmacists of Rouen].

Science.gov (United States)

Lafont, Olivier; Vettes, Jules

2015-12-01

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

Knowledge, attitudes, practices, and barriers related to research utilization: a survey among pharmacists in Malaysia.

Science.gov (United States)

Tan, Sin Yee; Hatah, Ernieda

2017-04-01

Background Research utilization is part of evidence-based practice referring to the process of reviewing and critiquing scientific research and applying the findings to one's own clinical practice. Many studies on research utilization have been conducted with doctors and nurses, but to our knowledge, none have been investigated amongst pharmacists. Objective To assess research utilization and its barriers among pharmacists and identify potential influencing factors. Setting Malaysia. Methods This cross-sectional survey was administered online and by mail to a convenient sample of pharmacists working in hospitals, health clinics, and retail pharmacies in rural and urban areas. Main outcome measure Pharmacists' research utilization knowledge, attitudes, and practices. Results Six hundred surveys were mailed to potential respondents, and 466 were returned (77.7% response rate). Twenty-eight respondents completed the survey online. The respondents' research utilization knowledge, attitudes, and practices were found to be moderate. Research utilization was associated with respondents' knowledge and attitude scores (P < 0.001). When factors related to research utilization were modelled, higher educational level was associated with higher level of research utilization (P < 0.001) while less involvement in journal clubs, more years of service (3-7 years and more than 7 years) were associated with low and moderate research utilization, respectively. The main reported barrier to research utilization was lack of sufficient authority to change patient care procedures. Conclusion Pharmacists' research utilization knowledge, attitudes, and practices can be improved by encouraging pharmacists to pursue higher degrees, promoting active participation in institutions' journal clubs, and introducing senior clinical pharmacist specialization.

How do pharmacists respond to complaints of acute insomnia? A simulated patient study.

Science.gov (United States)

Kippist, Carly; Wong, Keith; Bartlett, Delwyn; Saini, Bandana

2011-04-01

It is known that many people with insomnia choose to self medicate and present at community pharmacies, particularly in cases of acute insomnia. The objective of this study is to investigate how community pharmacists respond to complaints of acute insomnia from people who seek self treatment and determine the factors affecting this response. Community pharmacies in New South Wales, Australia. A simulated patient study was conducted in 100 randomly selected pharmacies located in Newcastle and Sydney, Australia. A standardized scenario of acute sleep onset insomnia and a scoring system was used in each pharmacy. Main outcome measures included supply/non supply of an over the counter sleep aid to the simulated patient, and scores for pharmacists for skills in eliciting information prior to supply of medication (Pre Supply Score), counseling about medication (Supply Score), or about sleep (Sleep Score). Of the 100 pharmacies, upon simulated patient presentation, 96% supplied a product, the remaining 4% referred to a physician. Non-pharmacological advice was provided in 42%. Pharmacists scored highly on advice provided with supply of a medication (Supply scores/4, 3.1 ± 0.9), but lower on skills in eliciting information prior to supply (Pre-supply score/8, 3.6 ± 1.9) and sleep related counselling (Sleep Score/9, 2.1 ± 1.7). Lower estimated pharmacist age, being in a chain type pharmacy, and having a visible symbol of quality accreditation were found to significantly improve (P Supply Score (P Supply scores (P < 0.05). The results of this study suggest that many pharmacists are responding appropriately to complaints of sleeplessness in terms of eliciting insomnia type and counseling about medicines use. However more education for pharmacists would help to further promote good sleep health, and address behaviors including reliance on medicines taking that can progressively worsen insomnia.

Survey of Retired Military Pharmacist's Transition to a Civilian Pharmacy Career Path.

Science.gov (United States)

Bennett, David; Wellman, Greg; Mahmood, Maysaa; Freye, Ryan; Remund, Daniel; Samples, Phil L

2015-12-01

To explore variables relevant to transition to civilian pharmacy career path for retiring military pharmacists. A cross-sectional survey was designed to collect information from retired military pharmacists including demographics, military service information, postretirement employment and perceptions of transition, satisfaction, level of responsibility, work environment, rewards (level of financial compensation, opportunities for professional development and career advancement, health benefits), and level of supervisory support. The questionnaire also included additional items asking about their perception of their military experience, transition to civilian work and the impact the military career had on their personal and family life. Respondents included 140 retired pharmacists from the U.S. Army, Navy, Air Force, or Coast Guard. Factors found to be significant predictors of transition to civilian career included: bureaucracy in current job, time elapsed since retirement, extent to which an individual misses military structure and chain of command, access to military facilities and Veterans Administration benefits, and reporting little or no stress in committed long-term personal relationship while in the military. Findings suggest that the majority of retired military pharmacists perceived the transition to civilian professional sector was about what they expected or easier than expected. Reprint & Copyright © 2015 Association of Military Surgeons of the U.S.

Work-related well-being of South African hospital pharmacists

Directory of Open Access Journals (Sweden)

Sebastiaan Rothmann

2011-06-01

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.

Evaluating the Safety and Tolerability of Sacubitril/Valsartan for HFrEF Managed Within a Pharmacist Clinic.

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Pogge, Elizabeth K; Davis, Lindsay E

2018-04-01

The objective of this research was to describe the use of pharmacist-managed sacubitril/valsartan therapy in a multi-center, outpatient cardiac group. Sacubitril/valsartan, an angiotensin receptor-neprilysin inhibitor (ARNi), is a novel agent for the treatment of heart failure. An ARNi is recommended by national guidelines to be used in place of angiotensin-converting enzyme inhibitor (ACEi) or angiotensin receptor blocker (ARB) therapy for patients who remain symptomatic. A retrospective chart review was performed to identify patients initiated and fully titrated on sacubitril/valsartan therapy from July 7, 2015 to March 7, 2017. Fifty-two of the 72 symptomatic heart failure with reduced ejection fraction (HFrEF) patients prescribed sacubitril/valsartan during the 21-month period were included in this analysis. The average ejection fraction was 26%. The average age was 69 years. At baseline, 26.9% of patients were not on ACEi/ARB therapy and 13.5% were on target-dose therapy. After completing the uptitration process, the maximally tolerated dose of sacubitril/valsartan was 5.8% low-dose, 7.7% mid-dose, and 86.5% target-dose. Loop and thiazide diuretic use decreased significantly. There was a significant mean reduction in systolic blood pressure of 6 mmHg with no significant changes in serum creatinine, blood urea nitrogen, or potassium levels. With close monitoring and follow-up, ARNi therapy was a safe alternative to ACEi/ARB therapy for chronic symptomatic HFrEF when initiated within a pharmacist clinic.

Computerized photogrammetry used to calculate the brow position index.

Science.gov (United States)

Naif-de-Andrade, Naif Thadeu; Hochman, Bernardo; Naif-de-Andrade, Camila Zirlis; Ferreira, Lydia Masako

2012-10-01

The orbital region is of vital importance to facial expression. Brow ptosis, besides having an impact on facial harmony, is a sign of aging. Various surgical techniques have been developed to increase the efficacy of brow-lift surgery. However, no consensus method exists for an objective measurement of the eyebrow position due to the curvature of the face. Therefore, this study aimed to establish a method for measuring the eyebrow position using computerized photogrammetry. For this study, 20 orbital regions of 10 volunteers were measured by direct anthropometry using a digital caliper and by indirect anthropometry (computerized photogrammetry) using standardized digital photographs. Lines, points, and distances were defined based on the position of the anthropometric landmarks endocanthion and exocanthion and then used to calculate the brow position index (BPI). Statistical analysis was performed using Student's t test with a significance level of 5 %. The BPI values obtained by computerized photogrammetric measurements did not differ significantly from those obtained by direct anthropometric measurements (p > 0.05). The mean BPI was 84.89 ± 10.30 for the computerized photogrammetric measurements and 85.27 ± 10.67 for the direct anthropometric measurements. The BPI defined in this study and obtained by computerized photogrammetry is a reproducible and efficient method for measuring the eyebrow position. This journal requires that authors assign a level of evidence to each article.

The role of the pharmacist in hypertension management.

Science.gov (United States)

Di Palo, Katherine E; Kish, Troy

2018-04-24

Hypertension remains a vital, modifiable risk factor in the prevention of cardiovascular disease. However, many patients do not achieve their therapeutic goals for numerous reasons which can include poor disease insight and nonadherence. Pharmacists can be key players in controlling hypertension, given their medication knowledge and patient counseling skills, yet they remain an underutilized resource in the management of chronic disease states. Various models exist that allow pharmacists to provide direct patient-centered care but practices differ from state to state since pharmacists are not recognized nationally as healthcare providers. This article aims to provide an update on the proven methods in which pharmacists contribute to the management of hypertensive patients. Several recently published studies demonstrate the positive impact of pharmacist intervention and care on patient outcomes in ambulatory and community settings. These practice models include medication therapy management, collaborative drug therapy management, telehealth and team-based care. The role of the pharmacist in hypertension encompasses medication management, disease state education and patient counseling and is most successful when integrated into the patient's care team. Further validation through larger, prospective trials and evaluation of long-term outcomes, such as mortality, remain viable research opportunities.

Compilation of requests for nuclear data

International Nuclear Information System (INIS)

Weston, L.W.; Larson, D.C.

1993-02-01

This compilation represents the current needs for nuclear data measurements and evaluations as expressed by interested fission and fusion reactor designers, medical users of nuclear data, nuclear data evaluators, CSEWG members and other interested parties. The requests and justifications are reviewed by the Data Request and Status Subcommittee of CSEWG as well as most of the general CSEWG membership. The basic format and computer programs for the Request List were produced by the National Nuclear Data Center (NNDC) at Brookhaven National Laboratory. The NNDC produced the Request List for many years. The Request List is compiled from a computerized data file. Each request has a unique isotope, reaction type, requestor and identifying number. The first two digits of the identifying number are the year in which the request was initiated. Every effort has been made to restrict the notations to those used in common nuclear physics textbooks. Most requests are for individual isotopes as are most ENDF evaluations, however, there are some requests for elemental measurements. Each request gives a priority rating which will be discussed in Section 2, the neutron energy range for which the request is made, the accuracy requested in terms of one standard deviation, and the requested energy resolution in terms of one standard deviation. Also given is the requestor with the comments which were furnished with the request. The addresses and telephone numbers of the requestors are given in Appendix 1. ENDF evaluators who may be contacted concerning evaluations are given in Appendix 2. Experimentalists contemplating making one of the requested measurements are encouraged to contact both the requestor and evaluator who may provide valuable information. This is a working document in that it will change with time. New requests or comments may be submitted to the editors or a regular CSEWG member at any time

Individualized Dosing of Children's Liquid Medications in the Community Pharmacy Setting: A Survey of Parents and Guardians

Directory of Open Access Journals (Sweden)

Jamie Shelly

2013-01-01

Full Text Available Objectives: 1 To determine parents' and/or guardians' interest in having pharmacists provide children's liquid medications in a pre-measured, individualized dosing device 2 To assess parents' and/or guardians' perception of dosing liquid medications for a child. Design: Observational survey Setting: Regional chain pharmacy in North Carolina Participants: > 18 years old, parent/guardian of a childchain, responsible for administering child's liquid medication Intervention: 14 item questionnaire Main Outcome Measure: Interest in pharmacists providing children's liquid medications in pre-measured, individualized dosing devices Results: 250 questionnaires were mailed; 42 were marked "return to sender" (16.8%, 22 were returned completed (10.6%, and 20 of the 22 met inclusion criteria (9.6%. 95% of study participants reported being interested in having pharmacists provide children's liquid medications in the proposed dosing device, and 40% were willing to pay for such a service. 90% of respondents reported it is "not at all difficult" to understand the amount of dose a child is to receive, while 55% reported it is "not at all difficult" to measure doses. 25% of respondents reported sometimes using a kitchen spoon to measure a child's medication. Conclusion: Community pharmacists should explore providing children's liquid medications in an individualized dosing device, as study results determined parents are interested in and willing to pay for the theoretical device. Further large-scale studies would be beneficial in determining interest in and willingness to pay for the dosing device in various pharmacy settings nationwide.   Type: Original Research

Computerized tomography and conventional radiography: A comparison from the standpoint of X-ray physics and technology

Energy Technology Data Exchange (ETDEWEB)

Pfeiler, M; Linke, G [Siemens A.G., Erlangen (Germany, F.R.). Unternehmensbereich Medizinische Technik

1979-08-01

After a short explantation of the technical foundations of computerized tomography (CT) from terms used in conventional X-ray technique and CT the differences (dose distribution, image character) and similarities (quantum noise, beam quality) of both methods are discussed. Finally possible methods of quantitative evaluation of CT images and computation of longitudinal layers from a series of computerized tomograms are described. (author).

Patient Assessment Skills Pertinent to Practicing Pharmacists

Directory of Open Access Journals (Sweden)

Jennifer A. Wilson

2015-01-01

Full Text Available Objectives: To describe pharmacists’ opinions regarding which patient assessment skills are necessary to understand and/or perform to provide optimal patient care in pharmacy practice. Methods: An online questionnaire was distributed to pharmacists licensed in North Carolina (n=14,167, as identified by the Board of Pharmacy. The 80 patient assessment items in the questionnaire were derived from a course text book and faculty experience. Participants indicated whether they “need to understand and be able to perform”, “need to understand only”, or “not need to understand or be able to perform” each item in their current practice setting. Descriptive statistics were used to describe background demographics and perceived need for each item. Post-hoc chi-square analyses were performed to determine differences in need based on practice setting and Pharm.D. degree completion. Results: Of 1036 responses received, 770 were used in data analysis; incomplete questionnaires and non-practicing pharmacist responses were excluded. Fifty-nine percent of respondents held a Pharm.D. degree. Participants identified their practice site(s as inpatient (29%, outpatient (16%, community/retail (50%, long term care (5%, and other (8%. The top five patient assessment items respondents identified as important to understand and perform included automatic blood pressure measurement (63%, point of care testing (57%, manual blood pressure measurement (53%, heart rate measurement (52%, and peak flow meter use (47%. Post-hoc analyses showed a significant difference among those with a Pharm.D. versus those without for the response “need to understand and be able to perform” for 20 patient assessment items; a significant difference was also noted among practice settings for 29 items. Conclusions: The top items pharmacists identified they need to both understand and perform could be applied in various practice settings. The study results may guide which patient

Pharmacist-managed dose adjustment feedback using therapeutic drug monitoring of vancomycin was useful for patients with methicillin-resistant Staphylococcus aureus infections: a single institution experience

Directory of Open Access Journals (Sweden)

Hirano R

2016-10-01

Full Text Available Ryuichi Hirano,1 Yuichi Sakamoto,2 Junichi Kitazawa,2 Shoji Yamamoto,1 Naoki Tachibana2 1Department of Pharmacy, 2Laboratory Medicine and Blood Transfusion, Aomori Prefectural Central Hospital, Aomori-shi, Japan Background: Vancomycin (VCM requires dose adjustment based on therapeutic drug monitoring. At Aomori Prefectural Central Hospital, physicians carried out VCM therapeutic drug monitoring based on their experience, because pharmacists did not participate in the dose adjustment. We evaluated the impact of an Antimicrobial Stewardship Program (ASP on attaining target VCM trough concentrations and pharmacokinetics (PK/pharmacodynamics (PD parameters in patients with methicillin-resistant Staphylococcus aureus (MRSA infections. Materials and methods: The ASP was introduced in April 2012. We implemented a prospective audit of prescribed VCM dosages and provided feedback based on measured VCM trough concentrations. In a retrospective pre- and postcomparison study from April 2007 to December 2011 (preimplementation and from April 2012 to December 2014 (postimplementation, 79 patients were treated for MRSA infection with VCM, and trough concentrations were monitored (pre, n=28; post, n=51. In 65 patients (pre, n=15; post, n=50, 24-hour area under the ­concentration–time curve (AUC 0–24 h/minimum inhibitory concentration (MIC ratios were calculated. Results: Pharmacist feedback, which included recommendations for changing dose or using alternative anti-MRSA antibiotics, was highly accepted during postimplementation (88%, 29/33. The number of patients with serum VCM concentrations within the therapeutic range (10–20 μg/mL was significantly higher during postimplementation (84%, 43/51 than during preimplementation (39%, 11/28 (P<0.01. The percentage of patients who attained target PK/PD parameters (AUC 0–24 h/MIC >400 was significantly higher during postimplementation (84%, 42/50 than during preimplementation (53%, 8/15; P=0.013. There were

Development of consensus guidance to facilitate service redesign around pharmacist prescribing in UK hospital practice.

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Tonna, Antonella; McCaig, Dorothy; Diack, Lesley; West, Bernice; Stewart, Derek

2014-10-01

The last decade has seen a drive towards non-medical prescribing in the United Kingdom (UK). However, there is a dearth of any published literature on applying the principles of service redesign to support pharmacist prescribing in any sphere of practice. To develop consensus guidance to facilitate service redesign around pharmacist prescribing. UK hospital practice. The Delphi technique was used to measure consensus of a panel of expert opinion holders in Scotland. Individuals with key strategic and operational roles in implementing initiatives of pharmacy practice and medicines management were recruited as experts. An electronic questionnaire consisting of 30 statements related to pharmacist prescribing service redesign was developed. These were presented as five-point Likert scales with illustrative quotes. Consensus, defined as 70 % of panel members agreeing (ranked strongly agree/agree) with each statement. Responses were obtained from 35/40 (87.5 %) experts in round one and 29 (72.5 %) in round two. Consensus in round one was achieved for 27/30 of statements relating to aspects of generic 'service development' (e.g. succession planning, multidisciplinary working, quality evaluation, practice development and outcome measures) and 'pharmacist prescribing role development' (e.g. education and future orientation of service). Issues of disagreement were around targeting of pharmacist prescribing to clinical specialities and financial remuneration for prescribing in the hospital setting. Consensus guidance has been developed to facilitate service redesign around hospital pharmacist prescribing.

Attitudes towards conscientious objection among community pharmacists in Poland.

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Piecuch, Anna; Gryka, Malwina; Kozłowska-Wojciechowska, Małgorzata

2014-04-01

The European Council Resolution 1763 (2010), ‘‘The right to conscientious objection in lawful medical care’’, provoked a discussion among Polish pharmacists on the necessity for granting them the right to refuse to dispense medicinal products which invoke conscientious objection. To explore attitudes of Polish pharmacists towards the conscience clause. Pharmacies with public e-mail addresses in various parts of Poland (Lower Silesia Province, Mazovia Province, Kuyavia-Pomerania Province, and West Pomeranian Province). An online survey questionnaire addressed to 1,454 pharmacies. The participants were asked 8 questions,including a question addressed only to pharmacy managers and owners. Attitudes towards the right to conscientious objection for pharmacists. Ultimately, responses of 126 pharmacists (83 women, 43 men, average age-39 years of age) were taken into consideration. Most participants (92 %) have never refused to fill a prescription due to their beliefs; however, 15 % of participants state that if the conscience clause were legally sanctioned, they would exercise this right. Most participants(73 %) think that pharmacists should not have the right to conscientious objection. Almost half of participants who support implementation of the conscience clause would grant this right to pharmacists on a conditional basis, if the pharmacists were obliged to present other real options to the patient about obtaining a specific product. Pharmacists are rather reluctant to the idea of implementing the conscience clause, but despite a clear majority of its opponents, there seems to be a necessity for introducing such a regulation.

Assessment of the pharmacist workforce in Ethiopia | Gebretekle ...

African Journals Online (AJOL)

Method: A national facility based census of the pharmacist workforce was conducted in Ethiopia. Pharmacists' job satisfaction was also assessed taking cross-section of pharmacists from six regions by applying a stratified random sampling method. A self-administered questionnaire was employed for the quantitative data ...

Pharmacists' experience of conflict in community practice.

Science.gov (United States)

Austin, Zubin; Gregory, Paul A M; Martin, J Craig

2010-03-01

Interpersonal conflict may be characterized as intellectual disagreement with emotional entanglement. While interpersonal conflict has been studied and described in different health care settings, there is little research that focuses on community pharmacists and the ways in which they experience conflict in professional practice. To describe and characterize the experience of interpersonal conflict within community pharmacy practice. A self-reporting narrative log was developed in which actively recruited pharmacists reported and reflected upon their day-to-day experiences of interpersonal conflict in professional practice. Focus groups of pharmacists were convened following data analysis to provide context and confirmation of identified themes. Based on this analysis, an explanatory model for interpersonal conflict in community pharmacy practice was generated. Participants were actively recruited from community pharmacy settings in the Toronto (Canada) area. A total of 41 community pharmacists participated. Interpersonal conflict in pharmacy practice is ubiquitous and results from diverse triggers. A conflict stance model was developed, based on the worldview and the communication style of the individual pharmacist. Specific conflict stances identified were: imposing, thwarting, settling, and avoiding. Further testing and refinement of this model is required. Crown Copyright 2010. Published by Elsevier Inc. All rights reserved.

Team work and collaborative practice agreements among pharmacists and nurse practitioners.

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Funk, Kylee A; Weaver, Krystalyn K

The authors share their knowledge about partnering and establishing collaborative practice agreements with nurse practitioners. State laws and regulations were reviewed that affect pharmacists' ability to fully partner with nurse practitioners. Nurse practitioners' role in primary care is growing, and, in many states, nurse practitioners practice independently. Collaborative practice agreements (CPAs) enable pharmacists to work with prescribers more efficiently. Pharmacists' and nurse practitioners' scope-of-practice laws and regulations may prevent CPAs between pharmacists and nurse practitioners. State pharmacy practice acts were reviewed to demonstrate which states allow for partnership under a CPA. Pharmacists should consider opportunities to partner more closely with nurse practitioners to provide care, sometimes under a CPA. In states where laws or regulations prevent CPAs between pharmacists and nurse practitioners, pharmacists should advocate for policy change. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

How to best manage time interaction with patients? Community pharmacist workload and service provision analysis.

Science.gov (United States)

Gregório, João; Cavaco, Afonso Miguel; Lapão, Luís Velez

Primary health care disease management models are rooted in multidisciplinary participation; however, implementation of services is lagging behind desires and predictions. Barriers like workload and lack of demand have been described. The aim of this research is to observe the workload and work patterns of Portuguese community pharmacists, and relate it with the demand of pharmaceutical services. A time-and-motion observational study was performed to describe community pharmacists' workload in a sample of four pharmacies in the metropolitan Lisbon area. A reference list of activities to be observed was developed by reviewing other studies of community pharmacy work. This study took place during a weekday's 8-h shift, focusing on pharmacists' activities. Data to be collected included the type and duration of the activity, who performed it and where. To estimate the demand of pharmaceutical care services, "thematic-patient scenarios" were developed. These scenarios were based on the defined daily dose and package size of the most consumed medicines in Portugal, combined with data obtained from the four pharmacies' information systems on the day the observational study took place. Between 67.0% and 81.8% of the registered activities were pharmacist-patient interactions. These interactions summed 158.44 min, with a mean duration of 3.98 min per interaction. On average, participant pharmacies' professionals handled 4.2 prescriptions and 0.9 over-the-counter (OTC) consultations per hour. About one third of the day was spent performing administrative and non-differentiated tasks. About 54.92 min were registered as free time, 50% of which were "micro pauses" with 1 min or less. The most dispensed therapeutic subgroup was antihypertensive drugs, while the dispensation of antidiabetics was characterized by a high number of packages sold per interaction. From the developed scenarios, one can estimate that a chronic patient may visit the pharmacy 4-9 times per year

The social pharmacist: tweeting and posting the way to success.

Science.gov (United States)

Kaldy, Joanne

2010-01-01

Social networking sites such as Twitter, Facebook, and LinkedIn attract millions of users each day. People of all ages, backgrounds, and interests sign onto these sites daily to share observations, seek answers, offer information and links, talk to friends and family, and network with colleagues. For senior care pharmacists, social networking sites present an opportunity to connect with consumers, hold virtual meetings, manage projects, offer value-added services for current customers, and market to potential clients. Many have joined these online communities and use them regularly. At the same time, some pharmacists are hesitant to use these sites because they don't understand them, are worried about privacy or other issues, or they just don't need them.

Community pharmacists, Internet and social media: an empirical investigation.

Science.gov (United States)

Shcherbakova, Natalia; Shepherd, Marv

2014-01-01

Use of social media and Internet for health information sharing is expanding among patients, physicians, and other health care professionals. Research on professional use of social media by community pharmacists is limited. 1) To determine the extent to which Texas (U.S. state) independent community pharmacists use text messaging, email, Facebook, Twitter, and/or other information technology for professional communication with patients and health care professionals and identify the perceptions of Texas independent community pharmacists toward such usage; 2) to determine the extent to which Texas independent community pharmacists develop and employ their pharmacy websites to provide drug information and patient care services. A 25-item survey with questions addressing the objectives of the study as well as basic demographic questions (gender, age, and type of pharmacy degree) was mailed to a random sample of 1196 independent community pharmacists in Texas in January 2012. The study response rate was 23.7%, with 284 usable questionnaires returned. The majority of respondents reported that Internet access is available at their pharmacies (98% (278)), and 91% (258) are familiar with the term 'social media'. To communicate with health care professionals, 56% (n = 160) of respondents use email, 34% (n = 97) use text messages and 5% (n = 14) use Facebook. To communicate with patients, 36% (n = 102) of respondents use email, 30% (n = 86) use text messages and 7% (n = 19) use Facebook. The perceptions of pharmacists who communicate with patients using electronic tools about information related to drug therapy once a month or more frequently were more positive than those of pharmacists who never or hardly ever communicate with patients via electronic tools about drug therapy (P social media for professional pharmacist's communications and perceptions toward the use of social media in patient-pharmacist communications among independent community pharmacists in

Do no harm: the role of community pharmacists in regulating public access to prescription drugs in Saudi Arabia.

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Bahnassi, Anas

2016-04-01

Pharmacists have a crucial role to ensure regulated public access to prescription drugs. The study aimed to investigate the views of community pharmacists practising in Saudi Arabia on their role in the unauthorised supply of prescription drugs, consider the possible contributory factors and report pharmacists' suggested strategies to regulate supply. One hundred community pharmacists were invited to participate in an interview-based survey, including questions on demographic characteristics, and the unauthorised supply of prescription drugs. Descriptive statistics were conducted, and associations between categorical responses tested; a P value of ≤0.05 was considered significant. Responses to open questions were analysed thematically. In Saudi Arabia, there is widespread unregulated supply of prescription drugs; pharmacists are under pressure from patients to provide prescription drugs for a wide range of clinical conditions. There are safety and appropriateness concerns when drugs are provided based on patient demand rather than clinical need. Pharmacists do not maintain patient records with information on drugs supplied and associated actions. While most pharmacists supply prescription drugs without the necessary prescriber authorisation, they also this may jeopardise patients safety. While we have many concerns about this practice its present form, we believe pharmacists should have certain prescribing privileges within their areas of competence. A legal framework is needed to guarantee proper pharmacists' training, support, mentorship and access to the tools required to provide safe pharmacy practice. © 2015 Royal Pharmaceutical Society.

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

OpenAIRE

Greenhill, Nicola H.

2010-01-01

The importance of communication skills for pharmacists has been widely acknowledged. Research has shown that the use of good communication skills can improve patient health outcomes but little research has focussed on communication within new consultation based roles of pharmacists. This study aimed to explore the communication between pharmacists and patients in clinic style consultations and to investigate participant perceptions of communication and consultations. Eleven pharmacists ...

Needs analysis for educating community pharmacists to interface with prehospital stroke chain of survival.

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Denetclaw, Tina Harrach; Cefalu, Patricia; Manila, Louis L; Panagotacos, John J

2014-02-01

Awareness of the American Heart Association's Stroke Chain of Survival, and willingness to learn and share this information with the public, was assessed for community pharmacists practicing near a primary stroke center. Twenty-three community pharmacies local to a primary stroke center were identified and surveyed. The surveyor showed each pharmacist a flier with a mnemonic for assessing stroke symptoms, briefly explained steps in the Stroke Chain of Survival, and noted if the pharmacist was available, listened to the entire presentation, read the information on the flier, agreed to post the flier, and if the pharmacist made any comments. The surveyor also assessed whether the Stroke Chain of Survival was new information to each pharmacist. All subjects read the information on the flier. Twenty-two (95.7%) listened to the entire presentation, and 23 (100%) were willing to post the flier. Two (11%) indicated that the parent company does not allow public posting of noncorporate information but agreed to post the flier internally. Twenty-one (91%) expressed appreciation for receiving the information. Seventeen (74%) indicated that the Stroke Chain of Survival was new information to them, 14 (61%) spontaneously remarked on the importance of the information, and 4 (17%) asked for additional information. Community pharmacists surveyed were willing to interface with the prehospital phase of the Stroke Chain of Survival; nearly 75% of them required education to do so. Community pharmacies are potentially a venue for educating the public on the Stroke Chain of Survival. It may be necessary to approach community pharmacy corporate leadership to partner with such efforts. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

The pharmacist as prescriber: a discourse analysis of newspaper media in Canada.

Science.gov (United States)

Schindel, Theresa J; Given, Lisa M

2013-01-01

Legislation to expand the scope of practice for pharmacists to include authority to independently prescribe medications in Alberta, Canada was announced in 2006 and enacted in April 2007. To date, very little research has explored public views of pharmacist prescribing. This study analyzes newspaper media coverage of pharmacist prescribing 1 year before and 2 years after prescribing was implemented. News items related to pharmacist prescribing were retrieved from 2 national, Canadian newspapers and 5 local newspapers in Alberta over a 3-year period after the announcement of pharmacist prescribing. A purposive sample of 66 texts including news items, editorials, and letters were retrieved electronically from 2 databases, Newscan and Canadian Newsstand. This study uses social positioning theory as a lens for analyzing the discourse of pharmacist prescribing. The results demonstrate a binary positioning of the debate on pharmacist prescribing rights. Using social positioning theory as a lens for analysis, the results illustrate self- and other-positioning of pharmacists' expected roles as prescribers. Themes related to the discourse on pharmacist prescribing include qualifications, diagnosis, patient safety, physician support, and conflict of interest. Media representations of pharmacist prescribing point to polarized views that may serve to shape public, pharmacist, physician, and others' opinions of the issue. Multiple and contradictory views of pharmacist prescribing coexist. Pharmacists and pharmacy organizations are challenged to bring clarity and consistency about pharmacist prescribing to better serve the public interest in understanding options for health care services. Copyright © 2013 Elsevier Inc. All rights reserved.

Assessment of hospital pharmacists' clinical knowledge and ...

African Journals Online (AJOL)

Purpose: To evaluate hospital pharmacists' clinical knowledge and practical skill levels for pharmaceutical care. Methods: A quasi-experimental prospective longitudinal study design was used to evaluate the level of clinical skills with problem-based learning (PBL) sessions. Pharmacists' in three different government ...

Cancer awareness among community pharmacist: a systematic review.

Science.gov (United States)

Mensah, Kofi Boamah; Oosthuizen, Frasia; Bonsu, Adwoa Bemah

2018-03-16

The WHO recognises that community pharmacists are the most accessible healthcare professionals to the general public. Most patients regularly visit community pharmacies for health information and also seek advice from pharmacists with respect to signs and symptoms of cancer. As readily accessible health care professionals, community pharmacists are also in the best position to include cancer-screening initiatives into their practice. Pharmacists are therefore in a good position to raise awareness when they counsel people who buy over-the-counter medication for the control of possible cancer-related symptoms. The aim of this review was to critically appraise evidence gathered from studies that; (1) explore or assess knowledge of community pharmacist on signs and symptoms of cancer, (2) explore or assess knowledge of community pharmacist on cancer screening. EMBASE (ovid), CINAHL (EBSCOhost) and MEDLINE (EBSCOhost) were systematically searched for studies conducted between 2005 to July 2017. Studies that focused on knowledge of community pharmacist in cancer screening, signs and symptoms were included. A total of 1538 articles were identified from the search, of which 4 out of the 28 potentially relevant abstracts were included in the review. Findings of the selected studies revealed lack of sufficient knowledge on breast cancer screening, signs and symptoms. Both studies attributed knowledge limitation as the cause of reason for the key findings of their studies. The selected studies focused largely on breast cancer, which hinder the generalizability and transferability of the findings. Hence there is a need for more studies to be conducted in this area to draw a better conclusion.

Prescription Drug Monitoring Programs and Pharmacist Orientation Toward Dispensing Controlled Substances.

Science.gov (United States)

Fendrich, Michael; Bryan, Janelle K; Hooyer, Katinka

2018-01-03

We sought to understand how pharmacists viewed and used a newly implemented prescription drug monitoring program (PDMP). We also sought to understand pharmacist orientation toward dispensing of controlled substances and the people who obtain them. We conducted three mini focus groups. The focus group findings were used to inform the design of a structured survey. We emailed a survey to 160 pharmacists who were employed in one statewide community chain store; we obtained 48 survey responses. Focus groups findings suggested that, in relation to the dispensing of scheduled prescription medication, pharmacists were either "healthcare" oriented, "law-enforcement" oriented, or an orientation that combined these two perspectives. Surveys suggested that pharmacists found PDMPs easy to use and that they used them frequently - often to contact physicians directly. Surveys suggested that pharmacists were typically either "healthcare" oriented or "mixed" (combined perspectives). Pharmacist orientation was associated with the frequency with which they counseled patients about medication risk and the frequency with which they used the PDMP as the basis for contacting prescribers. Ongoing tracking of pharmacists' use of PDMPs is important both at the implementation stage and as PDMPs develop over time. The orientation construct developed here is useful in understanding pharmacist behavior and attitudes towards patients potentially at risk for misuse of controlled substance medications. Further research on this construct could shed light on barriers and incentives for pharmacist PDMP participation and use and provide guidance for pharmacist training, ultimately enhancing patient care.

Integration of pharmacists into a patient-centered medical home.

Science.gov (United States)

Scott, Mollie Ashe; Hitch, Bill; Ray, Lisa; Colvin, Gaye

2011-01-01

To define the joint principles of the patient-centered medical home (PCMH) and describe the integration of pharmacists into a PCMH. Family medicine residency training program in North Carolina from 2001 to 2011. Mountain Area Health Education Family Health Center is a family medicine residency training program that is part of the North Carolina Area Health Education Center system. The goal of the organization is to train and retain health care students and residents. The practice is recognized as a level III PCMH by the National Committee for Quality Assurance (NCQA) and seeks to provide quality, safe, patient-centered care according to the joint principles of PCMH. Pharmacists, nurses, nutritionists, care managers, Spanish translators, and behavioral medicine specialists work collaboratively with physicians to provide seamless, comprehensive care. The Department of Pharmacotherapy is embedded in the family medicine clinic. Three pharmacists and two pharmacy residents are involved in providing direct patient care services, ensuring access to community resources, assisting patients with transitions of care, providing interprofessional education, and participating in continuous quality improvement initiatives. The pharmacists serve as clinical pharmacist practitioners and provide medication therapy management services in a pharmacotherapy clinic, anticoagulation clinics, and an osteoporosis clinic and via an inpatient family medicine service. Multiple learners such as student pharmacists, pharmacy residents, and family medicine residents rotate through the various pharmacy clinics to learn about pharmacotherapeutic principles and the role of the pharmacist in PCMH. PCMH is a comprehensive, patient-centered, team-based approach to population management in the primary care setting. Pharmacists play a vital role in PCMH and make fundamental contributions to patient care across health care settings. Such innovations in the ambulatory care setting create a unique niche

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

Science.gov (United States)

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

2016-01-01

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

Development and validation of a questionnaire to measure moral distress in community pharmacists.

Science.gov (United States)

Astbury, Jayne L; Gallagher, Cathal T

2017-02-01

Background Pharmacists work within a highly-regulated occupational sphere, and are bound by strict legal frameworks and codes of professional conduct. This regulatory environment creates the potential for moral distress to occur due to the limitations it places on acting in congruence with moral judgements. Very little research regarding this phenomenon has been undertaken in pharmacy: thus, prominent research gaps have arisen for the development of a robust tool to measure and quantify moral distress experienced in the profession. Objective The aim of this study was to develop an instrument to measure moral distress in community pharmacists. Setting Community pharmacies in the United Kingdom. Method This study adopted a three-phase exploratory sequential mixed-method design. Three semi-structured focus groups were then conducted to allow pharmacists to identify and explore scenarios that cause moral distress. Each of the identified scenarios were developed into a statement, which was paired with twin seven-point Likert scales to measure the frequency and intensity of the distress, respectively. Content validity, reliability, and construct validity were all tested, and the questionnaire was refined. Main outcome measure The successful development of the valid instrument for use in the United Kingdom. Results This research has led to the development of a valid and reliable instrument to measure moral distress in community pharmacists in the UK. The questionnaire has already been distributed to a large sample of community pharmacists. Conclusion Results from this distribution will be used to inform the formulation of coping strategies for dealing with moral distress.

Analysis of pharmacist-patient communication using the Calgary-Cambridge guide.

Science.gov (United States)

Greenhill, Nicola; Anderson, Claire; Avery, Anthony; Pilnick, Alison

2011-06-01

This study explored communication between pharmacists and patients through application of the Calgary-Cambridge guide [1] to appointment-based pharmacist-patient consultations and considers use of the guide in pharmacy education. Eighteen patients attending appointment-based consultations with five pharmacists were recruited to this qualitative study. Consultations were audio-recorded and observed. Transcripts were coded according to the use of skills within the guide and analysed thematically. The results showed good use of many skills by pharmacists, particularly signposting and closing the session. Some skills were poorly represented such as listening effectively, eliciting the patient's perspective, effective use of computers and creating patient-centred consultations. A key theme of social conversation was present in the data but this skill was not defined in the guide. The Calgary-Cambridge guide was developed for use in medical consultations but its application to pharmacist-patient consultations showed that the guide could be successfully used in pharmacy with some minor alterations. Pharmacists may need more training to improve the use of specific communication skills including how to conduct a patient-centred consultation. The Calgary-Cambridge guide is well aligned with many aspects of pharmacist-patient consultations and could help pharmacists to improve their consultation skills. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Dose assessment in pediatric computerized tomography; Avaliacao de doses em tomografia computadorizada pediatrica

Energy Technology Data Exchange (ETDEWEB)

Vilarinho, Luisa Maria Auredine Lima

2004-07-01

The objective of this work was the evaluation of radiation doses in paediatric computed tomography scans, considering the high doses usually involved and the absence of any previous evaluation in Brazil. Dose values were determined for skull and abdomen examinations, for different age ranges, by using the radiographic techniques routinely used in the clinical centers investigated. Measurements were done using pencil shape ionization chambers inserted in polymethylmethacrylate (PMMA) phantoms. These were compact phantoms of different diameters were specially designed and constructed for this work, which simulate different age ranges. Comparison of results with published values showed that doses were lower than the diagnostic reference levels established to adults exams by the European Commission. Nevertheless, doses in paediatric phantoms were higher than those obtained in adult phantoms. The paediatric dose values obtained in Hospitals A and B were lower than the reference level (DRL) adopted by SHIMPTON for different age ranges. In the range 0 - 0.5 year (neonatal), the values of DLP in Hospital B were 94 por cent superior to the DRL For the 10 years old children the values of CTDI{sub w} obtained were inferior in 89 por cent for skull and 83 por cent for abdomen examinations, compared to the values published by SHRIMPTON and WALL. Our measured CTDI{sub w} values were inferior to the values presented for SHRIMPTON and HUDA, for all the age ranges and types of examinations. It was observed that the normalized dose descriptors values in children in the neonatal range were always superior to the values of doses for the adult patient. In abdomen examinations, the difference was approximately 90% for the effective dose (E) and of 57%.for CTDI{sub w} . (author)

Computerized x-ray dose-monitoring system

International Nuclear Information System (INIS)

Hummel, R.H.; Wesenberg, R.L.; Amundson, G.M.

1985-01-01

An x-ray dose-monitoring system using a small digital computer is described. Initially, and for every 6 months afterward, the system is calibrated using an exposure meter. For each exposure, the computer receives values of x-ray technique and beam geometry from the x-ray generator through a specially designed electronic interface. Then, by means of calibration data, entrance exposure, area exposure product, and integral dose are obtained and printed for each patient examined. The overall accuracy of the system is better than +/-20%. Operation is semiautomatic, requiring minimum operator intervention. Over 2000 patients have been monitored with the device. Because the system is computer-based, it offers the opportunity for statistical analysis of the data base created, as the results for each patient are stored on computer disk

Computerized adaptive testing item selection in computerized adaptive learning systems

NARCIS (Netherlands)

Eggen, Theodorus Johannes Hendrikus Maria; Eggen, T.J.H.M.; Veldkamp, B.P.

2012-01-01

Item selection methods traditionally developed for computerized adaptive testing (CAT) are explored for their usefulness in item-based computerized adaptive learning (CAL) systems. While in CAT Fisher information-based selection is optimal, for recovering learning populations in CAL systems item

Community pharmacists as educators in Danish residential facilities: a qualitative study.

Science.gov (United States)

Mygind, Anna; El-Souri, Mira; Pultz, Kirsten; Rossing, Charlotte; Thomsen, Linda A

2017-08-01

To explore experiences with engaging community pharmacists in educational programmes on quality and safety in medication handling in residential facilities for the disabled. A secondary analysis of data from two Danish intervention studies where community pharmacists were engaged in educational programmes. Data included 10 semi-structured interviews with staff, five semi-structured interviews and three open-ended questionnaires with residential facility managers, and five open-ended questionnaires to community pharmacists. Data were thematically coded to identify key points pertaining to the themes 'pharmacists as educators' and 'perceived effects of engaging pharmacists in competence development'. As educators, pharmacists were successful as medicines experts. Some pharmacists experienced pedagogical challenges. Previous teaching experience and obtained knowledge of the local residential facility before teaching often provided sufficient pedagogical skills and tailored teaching to local needs. Effects of engaging community pharmacists included in most instances improved cooperation between residential facilities and community pharmacies through a trustful relationship and improved dialogue about the residents' medication. Other effects included a perception of improved patient safety, teaching skills and branding of the pharmacy. Community pharmacists provide a resource to engage in educational programmes on medication handling in residential facilities, which may facilitate improved cooperation between community pharmacies and residential facilities. However, development of pedagogical competences and understandings of local settings are prerequisites for facilities and pharmacists to experience the programmes as successful. © 2016 Royal Pharmaceutical Society.

Preparing pharmacists to deliver a targeted service in hypertension management: evaluation of an interprofessional training program.

Science.gov (United States)

Bajorek, Beata V; Lemay, Kate S; Magin, Parker J; Roberts, Christopher; Krass, Ines; Armour, Carol L

2015-09-28

Non-adherence to medicines by patients and suboptimal prescribing by clinicians underpin poor blood pressure (BP) control in hypertension. In this study, a training program was designed to enable community pharmacists to deliver a service in hypertension management targeting therapeutic adjustments and medication adherence. A comprehensive evaluation of the training program was undertaken. Tailored training comprising a self-directed pre-work manual, practical workshop (using real patients), and practice scenarios, was developed and delivered by an inter-professional team (pharmacists, GPs). Supported by practical and written assessment, the training focused on the principles of BP management, BP measurement skills, and adherence strategies. Pharmacists' experience of the training (expectations, content, format, relevance) was evaluated quantitatively and qualitatively. Immediate feedback was obtained via a questionnaire comprising Likert scales (1 = "very well" to 7 = "poor") and open-ended questions. Further in-depth qualitative evaluation was undertaken via semi-structured interviews several months post-training (and post service implementation). Seventeen pharmacists were recruited, trained and assessed as competent. All were highly satisfied with the training; other than the 'amount of information provided' (median score = 5, "just right"), all aspects of training attained the most positive score of '1'. Pharmacists most valued the integrated team-based approach, GP involvement, and inclusion of real patients, as well as the pre-reading manual, BP measurement workshop, and case studies (simulation). Post-implementation the interviews highlighted that comprehensive training increased pharmacists' confidence in providing the service, however, training of other pharmacy staff and patient recruitment strategies were highlighted as a need in future. Structured, multi-modal training involving simulated and inter-professional learning is effective in preparing

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

Science.gov (United States)

Atkinson, Jeffrey; de Paepe, Kristien; Sánchez Pozo, Antonio; Rekkas, Dimitrios; Volmer, Daisy; Hirvonen, Jouni; Bozic, Borut; Skowron, Agnieska; Mircioiu, Constantin; Marcincal, Annie; Koster, Andries; Wilson, Keith; van Schravendijk, Chris; Wilkinson, Jamie

2016-01-01

This paper looks at the opinions of 241 European academics (who provide pharmacy education), and of 258 European community pharmacists (who apply it), on competences for pharmacy practice. A proposal for competences was generated by a panel of experts using Delphi methodology. Once finalized, the proposal was then submitted to a large, European-wide community of academics and practicing pharmacists in an additional Delphi round. Academics and community pharmacy practitioners recognized the importance of the notion of patient care competences, underlining the nature of the pharmacist as a specialist of medicines. The survey revealed certain discrepancies. Academics placed substantial emphasis on research, pharmaceutical technology, regulatory aspects of quality, etc., but these were ranked much lower by community pharmacists who concentrated more on patient care competences. In a sub-analysis of the data, we evaluated how perceptions may have changed since the 1980s and the introduction of the notions of competence and pharmaceutical care. This was done by splitting both groups into respondents 40 years old. Results for the subgroups were essentially statistically the same but with some different qualitative tendencies. The results are discussed in the light of the different conceptions of the professional identity of the pharmacist. PMID:28970385

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

Directory of Open Access Journals (Sweden)

Jeffrey Atkinson

2016-02-01

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

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.

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

Directory of Open Access Journals (Sweden)

Halila GC

2015-12-01

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

[Medical IT-ization and development of pharmacists business].

Science.gov (United States)

Miwa, Ryouju

2014-01-01

Two major trends are materializing: the super-aging of society and information technology (IT-ization). Thus, the most important action to benefit patients and society is to establish a medical information network supported by a trustworthy human network. This network should be organized by the people involved in local community healthcare. As such, it is essential for the human network to include not only hospitals and clinics (medical practitioners) but also community pharmacies (pharmacists). This need is apparent, because in the past, drug hazards recurred because fundamental improvement of the means to prevent those hazards was not possible without pharmacists where and when those incidences occurred. The medical information to be IT-ized would include drug notebooks and prescription cards, although electronic medical charts will be the ultimate source of information. The following points will be discussed in this paper: (a) Legal requirements for physical assessments by pharmacists, (b) Physical assessments by hospital pharmacists, (c) Physical assessments by community pharmacists, and (d) Security requirements for the Act for Protection of Personal Information, Articles 20-22.

Ethical responsibilities of pharmacists when selling complementary medicines: a systematic review.

Science.gov (United States)

Salman Popattia, Amber; Winch, Sarah; La Caze, Adam

2018-04-01

The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary medicines. This study reviews the academic literature that explores a pharmacist's responsibilities when selling complementary medicines. International Pharmaceutical Abstracts, Embase, PubMed, Cinahl, PsycINFO and Philosopher's index databases were searched for articles written in English and published between 1995 and 2017. Empirical studies discussing pharmacists' practices or perceptions, consumers' expectations and normative studies discussing ethical perspectives or proposing ethical frameworks related to pharmacists' responsibilities in selling complementary medicines were included in the review. Fifty-eight studies met the inclusion criteria. The majority of the studies discussing the responsibilities of pharmacists selling complementary medicines had an empirical focus. Pharmacists and consumers identified counselling and ensuring safe use of complementary medicines as the primary responsibilities of pharmacists. No formal ethical framework is explicitly employed to describe the responsibilities of pharmacists selling complementary medicines. To the degree any ethical framework is employed, a number of papers implicitly rely on principlism. The studies discussing the ethical perspectives of selling complementary medicines mainly describe the ethical conflict between a pharmacist's business and health professional role. No attempt is made to provide guidance on appropriate ways to resolve the conflict. There is a lack of explicit normative advice in the existing literature regarding the responsibilities of pharmacists selling complementary medicines. This review identifies the need to develop a detailed practice-specific ethical framework to guide pharmacists regarding their responsibilities when selling complementary medicines. © 2018 Royal Pharmaceutical Society.

Patient-pharmacist communication during a post-discharge pharmacist home visit.

NARCIS (Netherlands)

Ensing, H.T.; Vervloet, M.; Dooren, A.A. van; Bouvy, M.L.; Koster, E.S.

2018-01-01

Background With the shifting role of community pharmacists towards patient education and counselling, they are wellpositioned to conduct a post-discharge home visit which could prevent or solve drug-related problems. Gaining insight into the communication during these home visits could be valuable

Computerized access to materials data. A progress report

International Nuclear Information System (INIS)

Rumble, J. Jr.

1985-01-01

As the effort to build a comprehensive computerized materials data system grows, it becomes more obvious that the benefits will be far-reaching. During this workshop, the enthusiasm of the participants grew steadily until the questions became not''What,'' but ''When?''. The engineering community within the United States has banded together many times to advance progress in engineering capability. The computerized materials data system requires such an effort, and the rewards will be substantial. Chapter 3 identifies changes in the use of materials data in the Nuclear Power Industry. Chapter 4 describes the EPRI experience in building computerized materials databases. In Chapter 5, the National Materials Property Data Network is discussed. The next four chapters present summaries of the workshop discussions and its conclusions. Chapter 6 discusses the content of the proposed system, Chapter 7 its size and the data sources, and Chapter 8 the user interfaces and system capabilities. In Chapter 9, ways of making further progress are outlined

Changing effects of direct-to-consumer broadcast drug advertising information sources on prescription drug requests.

Science.gov (United States)

Lee, Annisa Lai

2009-06-01

This study tracks the changes of the effects of 4 information sources for direct-to-consumer drug advertising on patients' requests for prescription drugs from physicians since the inception of the "Guidance for Industry about Consumer-directed Broadcast Advertisements." The Guidance advises pharmaceuticals to use four information sources for consumers to seek further information to supplement broadcast drug advertisements: small-print information, the Internet, a toll-free number, and health-care providers (nurses, doctors, and pharmacists). Logistic models were created by using survey data collected by the Food and Drug Administration in 1999 and 2002. Results show that throughout the years, health-care providers remain the most used and strongest means associated with patients' direct requests for nonspecific and specific prescription drugs from doctors. The small-print information source gains power and changes from an indirect means associated with patients' discussing drugs with health-care providers to a direct means associated with patients' asking about nonspecific and specific drugs from their doctors. The Internet is not directly related to drug requests, but the effect of its association with patients seeking information from health-care providers grew 11-fold over the course of the study. The toll-free number lost its power altogether for both direct request for a prescription drug and further discussion with health-care providers. Patient demographics will be considered for specific policy implications.

Community pharmacists' burnout levels and related factors: an example from Turkey.

Science.gov (United States)

Calgan, Zeynep; Aslan, Dilek; Yegenoglu, Selen

2011-02-01

To determine community pharmacists' burnout levels and prevalences as well as factors associated with burnout. Study was conducted in Ankara, the capital of Turkey. In this cross-sectional study, 251 pharmacists were randomly selected from 1,504 community pharmacists registered in Ankara Chamber of Pharmacists. A questionnaire including questions related to pharmacists' individual and professional characteristics and Maslach Burnout Inventory was administered. The data was collected between February 27 and May 25, 2007. Three Maslach Burnout Inventory subscales (emotional exhaustion-EE, depersonalization-D, and personal accomplishment-PA) scores. Pharmacists' mean emotional exhaustion score was found to be 16.84 (SD: 6.25), depersonalization score was 4 (Range: 0-14), and personal accomplishment score was 22 (Range: 9-32). Of the pharmacists, 1.2% had high level of EE, .8% had high level of D, and 71.3% had high level of inefficacy. Age, marital status, work experience, work contentment, workload, time pressure, stress, and satisfaction with customers were found to be related with pharmacists' burnout levels. It can be useful to monitor pharmacists' burnout levels and prevalences periodically. Interventions on individual and organizational basis were needed to cope with burnout, respond to job demands, minimize the level of chronic stress, and increase work contentment and satisfaction.

Expressing and negotiating face in community pharmacist-patient interactions.

Science.gov (United States)

Murad, Muna S; Spiers, Judith A; Guirguis, Lisa M

2017-11-01

A collaborative patient-pharmacist interaction is fundamental to greater patient satisfaction with pharmacy care and improved medication adherence. Effective pharmacist-patient communication occurs when both pharmacist and patient are able to successfully attend to not only the typical tasks and goals of the interaction but also basic face needs that underlie all social interaction; autonomy, competence or esteem, and fellowship. Addressing face needs occurs through conventional and strategic communication strategies that respond to the emerging needs throughout an interaction. Pharmacist-patient interactions are not just about transfer of information and medications. Both parties assess the situation, the others' intentions within the context of their own goals and this influences how they choose to act throughout the interaction. Face-work Theory provides a framework to understand these interaction processes in pharmacist-patient communication. The aim of this study was to determine face needs, threats and the strategic communication strategies used to address these within community pharmacist-patient interactions. This exploratory descriptive study drew upon principles of ethology to first describe naturally occurring behaviour and then to interpret this behaviour within the context of Face-work theory. Twenty-five audio-recorded community pharmacist-patient interactions were collected and analyzed. The average length of these interactions was 3:67 min with a range of 0.39 s-9:35 min. Multiple face needs for both pharmacist and patient were evident in most interactions. Autonomy, competence and fellowship face needs were negotiated in the following contexts: participative relationships, concordant role expectations, sensitive topics, and negotiating expertise and knowledge. Competence face needs for both parties were the most dominant need found in negotiating role expectations. The most common communication strategies used to support face were solidarity

[Euthanasia and/or medically assisted suicide: Reflection on the new responsibility of the hospital pharmacist].

Science.gov (United States)

Boissinot, L; Benamou, M; Léglise, P; Mancret, R-C; Huchon-Bécel, D

2014-03-01

Concern about euthanasia and medically assisted suicide is currently growing around the world and particularly in France. Though not authorized at present in France, the role of hospital pharmacist in this issue needs to be discussed. This article aims to gather medical and legal literature of European Union member states on these issues and particularly in France. To propose a practical thinking on the possible role of hospital pharmacist. Among European Union, euthanasia and/or assisted suicide have already been introduced in some member states' laws. In France, Leonetti law currently sets the legal framework for the management of end of life. To address the society's demand on these issues, French President F. Hollande made two ethics committees responsible for working on it. Both were mainly against euthanasia and assisted suicide. Though a bit forgotten in this debate, hospital pharmacist needs to be associated in the thinking, as the main "drug-keeper". Indeed, guidelines are necessary to outline and ensure a safe drug use, complying with professional ethics, if lethal doses are voluntarily prescribed. Pharmaceutical work is in constant evolution and is addressing new issues still unanswered, including assisted suicide and euthanasia. French pharmaceutical authorities should seize upon them, in order to guarantee pharmaceutical ethics. These practices, if authorized by law, should remain exceptional, and law strictly enforced. The pharmacist could be one of these "lawkeepers". Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Influence of pharmacists expertise on physicians prescription ...

African Journals Online (AJOL)

Purpose: To explore the influence of pharmacist factors on prescription decisions of physicians. Methods: A survey of literature was carried out across online databases and 12 relevant articles were identified. The influence of pharmacist factors on physician prescription decisions was identified in the articles. A conceptual ...

Pharmacist-led screening in sexually transmitted infections: current perspectives

Directory of Open Access Journals (Sweden)

Wood H

2018-06-01

Full Text Available Helen Wood, Sajni Gudka School of Allied Health, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia Introduction: Sexually transmitted infection (STI screening is a crucial initiative that aims to reduce the increasing global prevalence of many common STIs such as chlamydia, gonorrhea, and herpes simplex virus (HSV. Many STIs are either asymptomatic or show mild symptoms that are often attributed to other infections; hence, screening is the only way to identify – and by extension, treat – them. In this way, the spread of STIs can be reduced, and the health implications of an untreated STI are minimized. Community pharmacies could provide an avenue to convenient, confidential STI screening by using noninvasive or minimally invasive sample collection techniques that are used by the consumer or pharmacist. We identified the most common STIs found globally and investigated the current and potential role of pharmacists in provision of STI screening interventions.Discussion: There is sufficient evidence for pharmacy-based chlamydia screening, with many consumers and pharmacists finding it an acceptable and highly valued service. Some evidence was found for pharmacy-based gonorrhea, hepatitis B virus (HBV, and human immunodeficiency virus (HIV screening. Appropriate sample collection for gonorrhea screening needs to be further examined in a pharmacy setting. HBV screening presented an increased risk of personal injury to pharmacists through the collection of whole blood specimens, which could be reduced through consumer self-sampling. Pharmacist-collected specimens for HIV is less risky as an oral swab can be used, nullifying the risk of transmission; but pre- and post-screen consultations can be time-intensive; hence, pharmacists would require remuneration to provide an ongoing HIV screening service. Not enough evidence was found for syphilis screening through community pharmacies; more studies are

Impact of Pharmacist-Conducted Comprehensive Medication Reviews for Older Adult Patients to Reduce Medication Related Problems.

Science.gov (United States)

Kiel, Whitney J; Phillips, Shaun W

2017-12-31

Older adults are demanding increased healthcare attention with regards to prescription use due in large part to highly complex medication regimens. As patients age, medications often have a more pronounced effect on older adults, negatively impacting patient safety and increasing healthcare costs. Comprehensive medication reviews (CMRs) optimize medications for elderly patients and help to avoid inappropriate medication use. Previous literature has shown that such CMRs can successfully identify and reduce the number of medication-related problems and improve acute healthcare utilization. The purpose of this pharmacy resident research study is to examine the impact of pharmacist-conducted geriatric medication reviews to reduce medication-related problems within a leading community health system in southwest Michigan. Furthermore, the study examines type of pharmacist interventions made during medication reviews, acute healthcare utilization, and physician assessment of the pharmacist's value. The study was conducted as a retrospective post-hoc analysis on ambulatory patients who received a CMR by a pharmacist at a primary care practice. Inclusion criteria included patients over 65 years of age with concurrent use of at least five medications who were a recent recipient of a CMR. Exclusion criteria included patients with renal failure, or those with multiple providers involved in primary care. The primary outcome was the difference in number of medication-related problems, as defined by the START and STOPP Criteria (Screening Tool to Alert doctors to Right Treatment/Screening Tool of Older Persons' Prescriptions). Secondary outcomes included hospitalizations, emergency department visits, number and type of pharmacist interventions, acceptance rate of pharmacist recommendations, and assessment of the pharmacist's value by clinic providers. There were a total of 26 patients that received a comprehensive medication review from the pharmacist and were compared to a

Factors Affecting Number of Diabetes Management Activities Provided by Pharmacists.

Science.gov (United States)

Lo, Annie; Lorenz, Kathleen; Cor, Ken; Simpson, Scot H

2016-12-01

Legislative changes since 2007 have given Alberta pharmacists additional authorizations and new practice settings, which should enhance provision of clinical services to patients. This study examined whether these changes are related to the number of diabetes management activities provided by pharmacists. Cross-sectional surveys of Alberta pharmacists were conducted in 2006 and 2015. Both questionnaires contained 63 diabetes management activities, with response options to indicate how frequently the activity was provided. Respondents were grouped by survey year, practice setting, diabetes-specific training and additional authorizations. The number of diabetes management activities provided often or always were compared among groups by using analysis of variance. Data from 128 pharmacists participating in the 2006 survey were compared with 256 pharmacists participating in the 2015 survey; overall mean age was 41.6 (±10.9) years, 245 (64%) were women, mean duration of practice was 16.1 (±11.8) years, 280 (73%) were community pharmacists, 75 (20%) were certified diabetes educators (CDEs), and 100 (26%) had additional prescribing authorization (APA). Pharmacists provided a mean of 28.7 (95% CI 26.3 to 31.2) diabetes management activities in 2006 and 35.2 (95% CI 33.4-37.0) activities in 2015 (p<0.001). Pharmacists who were CDEs provided significantly more activities compared to other pharmacists (p<0.001). In 2015, working in a primary care network and having APA were also associated with provision of more activities (p<0.05 for both comparisons). Pharmacists provided more diabetes management activities in 2015 than in 2006. The number of diabetes management activities was also associated with being a CDE, working in a primary care network or having APA. Copyright © 2016 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Emergency department discharge prescription interventions by emergency medicine pharmacists.

Science.gov (United States)

Cesarz, Joseph L; Steffenhagen, Aaron L; Svenson, James; Hamedani, Azita G

2013-02-01

We determine the rate and details of interventions associated with emergency medicine pharmacist review of discharge prescriptions for patients discharged from the emergency department (ED). Additionally, we evaluate care providers' satisfaction with such services provided by emergency medicine pharmacists. This was a prospective observational study in the ED of an academic medical center that serves both adult and pediatric patients. Details of emergency medicine pharmacist interventions on discharge prescriptions were compiled with a standardized form. Interventions were categorized as error prevention or optimization of therapy. The staff of the ED was surveyed related to the influence and satisfaction of this new emergency medicine pharmacist-provided service. The 674 discharge prescriptions reviewed by emergency medicine pharmacists during the study period included 602 (89.3%) for adult patients and 72 (10.7%) for pediatric patients. Emergency medicine pharmacists intervened on 68 prescriptions, resulting in an intervention rate of 10.1% (95% confidence interval [CI] 8.0% to 12.7%). The intervention rate was 8.5% (95% CI 6.4% to 11.1%) for adult prescriptions and 23.6% for pediatric prescriptions (95% CI 14.7% to 35.3%) (difference 15.1%; 95% CI 5.1% to 25.2%). There were a similar number of interventions categorized as error prevention and optimization of medication therapy, 37 (54%) and 31 (46%), respectively. More than 95% of survey respondents believed that the new pharmacist services improved patient safety, optimized medication regimens, and improved patient satisfaction. Emergency medicine pharmacist review of discharge prescriptions for discharged ED patients has the potential to significantly improve patient care associated with suboptimal prescriptions and is highly valued by ED care providers. Copyright © 2012. Published by Mosby, Inc.

Hospital discharge: What are the problems, information needs and objectives of community pharmacists? A mixed method approach

Directory of Open Access Journals (Sweden)

Brühwiler LD

2017-09-01

Full Text Available Background: After hospital discharge, community pharmacists are often the first health care professionals the discharged patient encounters. They reconcile and dispense prescribed medicines and provide pharmaceutical care. Compared to the roles of general practitioners, the pharmacists’ needs to perform these tasks are not well known. Objective: This study aims to a Identify community pharmacists’ current problems and roles at hospital discharge, b Assess their information needs, specifically the availability and usefulness of information, and c Gain insight into pharmacists’ objectives and ideas for discharge optimisation. Methods: A focus group was conducted with a sample of six community pharmacists from different Swiss regions. Based on these qualitative results, a nationwide online-questionnaire was sent to 1348 Swiss pharmacies. Results: The focus group participants were concerned about their extensive workload with discharge prescriptions and about gaps in therapy. They emphasised the importance of more extensive information transfer. This applied especially to medication changes, unclear prescriptions, and information about a patient's care. Participants identified treatment continuity as a main objective when it comes to discharge optimisation. There were 194 questionnaires returned (response rate 14.4%. The majority of respondents reported to fulfil their role as defined by the Joint-FIP/WHO Guideline on Good Pharmacy Practice (rather badly. They reported many unavailable but useful information items, like therapy changes, allergies, specifications for “off-label” medication use or contact information. Information should be delivered in a structured way, but no clear preference for one particular transfer method was found. Pharmacists requested this information in order to improve treatment continuity and patient safety, and to be able to provide better pharmaceutical care services. Conclusion: Surveyed Swiss community

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

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

Pharmacy clients' attitudes to expanded pharmacist prescribing and the role of agency theory on involved stakeholders.

Science.gov (United States)

Hoti, Kreshnik; Hughes, Jeffery; Sunderland, Bruce

2011-02-01

To examine the views of regular pharmacy clients on pharmacist prescribing and employ agency theory in considering the relationship between the stakeholders involved. Computer assisted telephone interviews were conducted with 400 pharmacy clients recruited around Australia. Potential respondents were identified using a random number generation function in Microsoft Excel. Data were analysed with SPSS version 17 using one-way analysis of variance, principal component analysis and linear regression. The relationships between the main stakeholders involved were explored using agency theory. A total of 1153 answered calls recruited 400 consenting pharmacy clients. Most respondents (71%) trusted pharmacists adopting an expanded role in prescribing, however the majority (66%) supported this only after a diagnosis had been made by a doctor. Those who accepted pharmacist diagnosing and prescribing preferred that this was limited to pain management and antibiotics. Most respondents (64%) considered that expanded pharmacist prescribing would improve their access to prescription medicines, although those over 65 years of age were less supportive than younger respondents. Factors which contributed positively to clients' perception of trust in an expanded prescribing role for pharmacists were identified, and improved access to medicines was found to be the strongest predictor (P Agency theory would conceptualize the introduction of pharmacist prescribers, as disrupting the principal (patient) agent (doctor) relationship. Its introduction would best be facilitated by careful change management. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

A Longitudinal Approach to Changes in the Motivation of Dutch Pharmacists in the Current Continuing Education System.

Science.gov (United States)

Tjin A Tsoi, Sharon L; de Boer, Anthonius; Croiset, Gerda; Kusurkar, Rashmi A; Koster, Andries S

2018-03-01

Objective. To explore the changes in motivation of Dutch pharmacists for Continuing Education (CE) in the Dutch CE system. Methods. Pharmacists' motivation was measured across three time points with the Academic Motivation Scale, based on the Self-Determination Theory of motivation. The Latent Growth Modelling technique was used to analyze these data. Results. Over a period of 21 months, Controlled Motivation had increased and Relative Autonomous Motivation of Dutch pharmacists had decreased. Traineeship was the only demographic factor with a significant influence on the change in motivation. No subgroups with different trajectories could be identified. Conclusion. Relative Autonomous Motivation of Dutch pharmacists for CE decreases over time. This indicates a loss of Autonomous Motivation ("good" motivation) in favor of Controlled Motivation ("bad" motivation). Further research needs to be conducted to gain a better understanding of the association between pharmacist motivation and the features of the current CE system.

Impact of pharmacist intervention on antibiotic use and prophylactic antibiotic use in urology clean operations.

Science.gov (United States)

Zhou, Y; Ma, L-Y; Zhao, X; Tian, S-H; Sun, L-Y; Cui, Y-M

2015-08-01

The use of prophylactic antibiotics in clean operations was routine in China before 2011. Along with the appeal for using antibiotics rationally by WHO in 2011, China launched a national special rectification scheme on clinical use of antibiotics from April that year. The scheme, aimed at achieving rational use of antibiotics, made pharmacists part of the responsible medical team. Our objective was to describe the impacts of pharmacist intervention on the use of antibiotics, particularly in urology clean operations. Pharmacists participated in antibiotic stewardship programmes of the hospital and urological clinical work and conducted real-time interventions at the same time from 2011 to 2013. Data on the use of antibiotics between 2010 and 2013 in urology were collected. Comparison of the 2013 data with those of 2010 showed that antibiotic use density [AUD= DDDs*100/(The number of patients who were treated the same period*Average days in hospital). DDDs = Total drug consumption (g)/DDD. DDD is the Defined Daily Dose] decreased by 57·8(58·8%); average antibiotic cost decreased by 246·94 dollars; the cost of antibiotics as a percentage of total drug cost decreased by 27·7%; the rate of use of antibiotics decreased from 100% to 7·3%. The study illustrates how an antibiotic stewardship programme with pharmacist participation including real-time interventions can promote improved antibiotic-prescribing and significantly decrease costs. © 2015 John Wiley & Sons Ltd.

Exploring example models of cross-sector, sessional employment of pharmacists to improve medication management and pharmacy support in rural hospitals.

Science.gov (United States)

Tan, Amy Cw; Emmerton, Lynne M; Hattingh, Laetitia; La Caze, Adam

2015-01-01

Many rural hospitals in Australia are not large enough to sustain employment of a full-time pharmacist, or are unable to recruit or retain a full-time pharmacist. The absence of a pharmacist may result in hospital nurses undertaking medication-related roles outside their scope of practice. A potential solution to address rural hospitals' medication management needs is contracted part-time ('sessional') employment of a local pharmacist external to the hospital ('cross-sector'). The aim of this study was to explore the roles and experiences of pharmacists in their provision of sessional services to rural hospitals with no on-site pharmacist and explore how these roles could potentially address shortfalls in medication management in rural hospitals. A qualitative study was conducted to explore models with pharmacists who had provided sessional services to a rural hospital. A semi-structured interview guide was informed by a literature review, preliminary research and stakeholder consultation. Participants were recruited via advertisement and personal contacts. Consenting pharmacists were interviewed between August 2012 and January 2013 via telephone or Skype for 40-55 minutes. Thirteen pharmacists with previous or ongoing hospital sessional contracts in rural communities across Australia and New Zealand participated. Most commonly, the pharmacists provided weekly services to rural hospitals. All believed the sessional model was a practical solution to increase hospital access to pharmacist-mediated support and to address medication management gaps. Roles perceived to promote quality use of medicines were inpatient consultation services, medicines information/education to hospital staff, assistance with accreditation matters and system reviews, and input into pharmaceutical distribution activities. This study is the first to explore the concept of sessional rural hospital employment undertaken by pharmacists in Australia and New Zealand. Insights from participants

Individualized Dosing of Children’s Liquid Medications in the Community Pharmacy Setting: A Survey of Parents and Guardians

Directory of Open Access Journals (Sweden)

Lingxiao Zhai, MS

2013-01-01

Full Text Available Objectives: 1 To determine parents’ and/or guardians’ interest in having pharmacists provide children’s liquid medications in a pre-measured, individualized dosing device 2 To assess parents’ and/or guardians’ perception of dosing liquid medications for a child. Design: Observational survey Setting: Regional chain pharmacy in North Carolina Participants: > 18 years old, parent/guardian of a child <13 who had prescription filled for liquid medication within the pharmacy chain, responsible for administering child’s liquid medication Intervention: 14 item questionnaire Main Outcome Measure: Interest in pharmacists providing children’s liquid medications in pre-measured, individualized dosing devices Results: 250 questionnaires were mailed; 42 were marked “return to sender” (16.8%, 22 were returned completed (10.6%, and 20 of the 22 met inclusion criteria (9.6%. 95% of study participants reported being interested in having pharmacists provide children’s liquid medications in the proposed dosing device, and 40% were willing to pay for such a service. 90% of respondents reported it is “not at all difficult” to understand the amount of dose a child is to receive, while 55% reported it is “not at all difficult” to measure doses. 25% of respondents reported sometimes using a kitchen spoon to measure a child’s medication. Conclusion: Community pharmacists should explore providing children’s liquid medications in an individualized dosing device, as study results determined parents are interested in and willing to pay for the theoretical device. Further large-scale studies would be beneficial in determining interest in and willingness to pay for the dosing device in various pharmacy settings nationwide.

[Thermolabile drugs: pharmacist intervention as a guarantee of cold chain maintenance].

Science.gov (United States)

Ricote-Lobera, I; Santos-Mena, B; Fraile-Gil, S; Ortiz-Martín, B; Hidalgo-Correas, F J; García-Díaz, B

2014-05-01

To determine whether pharmacist is able to guarantee cold chain maintenance of thermolabile drugs during transport using the available information in the reception process and to compare these results with those obtained in a subsequent intervention phase, in which the manufacturing laboratories were contacted. Intervention study, prospective and comparative"before-after". It was analyzed the storage conditions during transport of all thermolabile drugs received in a 400-bed hospital for 3 months, excluding those from clinical trials. The intervention allowed to ensure cold chain maintenance in 76,5% (n = 488) of received drugs, representing an increase of 41,8% (IC 95% 36,7-46,6%; p cold chain maintenance of received thermolabile drugs without temperature monitoring device (64,6%). Reports requested from laboratories allowed to increase significantly that percentage. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Pharmacist's Intervention in the Control of Blood Sugar Levels in ...

African Journals Online (AJOL)

Background: The extended roles of pharmacists in Nigeria in the improvement of quality of health care at the primary health care (PHC) level is currently poorly executed even though pharmacists have been proven to be involved in interventional activities in health care delivery. Objective: To evaluate pharmacists' ...

The perceptions of Zimbabwean Pharmacists of their overall job ...

African Journals Online (AJOL)

We investigated the perceptions of Zimbabwean pharmacists of their overall job satisfaction and the factors associated with it. A random sample of 120 licensed pharmacists working in community, and hospital pharmacies and industry in Zimbabwe participated in this cross-sectional study. Pharmacists were highly satisfied ...

Introduction to CRRIS: a computerized radiological risk investigation system for assessing atmospheric releases of radionuclides

International Nuclear Information System (INIS)

Baes, C.F. III; Miller, C.W.; Kocher, D.C.; Sjoreen, A.L.; Murphy, B.D.

1985-08-01

The CRRIS is a Computerized Radiological Risk Investigation System consisting of eight fully integrated computer codes which calculate environmental transport of atmospheric releases of radionuclides and resulting doses and health risks to individuals or populations. Each code may also be used alone for various assessment applications. Radionuclides are handled by the CRRIS either in terms of the released radionuclides or the exposure radionuclides which consist of both the released nuclides and decay products that grow in during environmental transport. The CRRIS is not designed to simulate short-term effects. 51 refs

No filter: A characterization of #pharmacist posts on Instagram.

Science.gov (United States)

Hindman, F Mark; Bukowitz, Alison E; Reed, Brent N; Mattingly, T Joseph

The primary objective was to characterize the underlying intent of Instagram posts using the hashtag metadata term "#pharmacist" over a 1-year period. The secondary objective was to determine whether statistically significant relationships existed between the categories and the 2 dichotomous variables tested, self-portrayed images, and relation to health care. Retrospective, cross-sectional, mixed methods, exploratory, descriptive study. A review of available Instagram posts using the hashtag metadata "#pharmacist" from November 4, 2014, to November 3, 2015. Data were collected using software provided by NEXT Analytics. A sample of 14 random days was selected. Six hundred sixty-one Instagram posts containing "#pharmacist" in the caption. Categorization of post (including both picture and primary caption), self-portrayed images (i.e., "selfie"), and health care-related images. One thousand three hundred thirty-eight posts were collected from the 14-day sample. Of the posts, 661 (49.4%) were analyzed; the remainder were excluded for being written in a non-English language or containing "#pharmacist" in the comments of the post, rather than the primary caption; 19.7% of all posts fell into the Celebration category, followed by Work Experience and Advertisement with 18.6% and 12.6%, respectively. The remainder of the categories contained 10% or fewer posts. Less than 25% of posts were self-portrayed images, and 88% of posts were deemed health care-related. Instagram is an emerging social media platform that can be used to expand patient education, professional advocacy, and public health outreach. In this study, the majority of #pharmacist posts were celebratory in nature, and the majority were determined to be related to health care. Posts containing #pharmacist may provide the opportunity to educate the public regarding the knowledge and capabilities of pharmacists. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Creation New Patient Information Leaflets with Diabetes by Pharmacists and Assesment Conducted by Patients.

Science.gov (United States)

Arai, Motoharu; Maeda, Kazuto; Satoh, Hiroki; Miki, Akiko; Sawada, Yasufumi

2016-10-01

We created a draft of new patient information leaflets to ensure patients' proper use of drugs and to highlight safety issues and improvement plans extracted and proposed by small group discussions (SGD) with pharmacists. A total of 3 SGDs (participants: 15 pharmacists) were conducted with the aim of improving patient information leaflets for oral diabetes drugs. First, the disadvantages and advantages of the current instructions as well as requests for ideal patient information leaflets were obtained from participants. Conventional patient information leaflets that could be improved were useful to understand drug efficacy, adverse effects, and instructions for daily consumption of medicines, and to encourage patients to re-check drugs at home and inform their family of the measures to be taken in the case of adverse effects from the standpoint of patients. However, some disadvantages arose; for example, the instructions were difficult to read because of small lettering and illustrations and too much text. It was not tailored for individual patients, and descriptions about serious adverse effects caused patients much anxiety. Therefore, we have created a draft of new patient information leaflets with diabetes that are simpler and easier to understand and use concise wording and illustrations that are impactful.

Exploring community pharmacists' experiences of surveying patients for drug utilization research purposes

DEFF Research Database (Denmark)

Frisk, Pia; Bergman, Ulrika; Kälvemark Sporrong, Sofia

2015-01-01

pharmacists. This study is part of a validation of that data acquisition method. Objectives (1) To explore the experiences of the pharmacists involved, (2) to explore a random or systematic exclusion of eligible patients by the pharmacists, and (3) to find areas of improvement to the applied method...... of surveying. Setting 72 Swedish community pharmacies, distributed all over the country. Method (a) A questionnaire was distributed to approximately 400 dispensing pharmacists at the pharmacies conducting the patient surveys; (b) semi-structured telephone interviews conducted with 19 pharmacists at 12...... of the pharmacies. Main outcome measure Proportions of pharmacists reporting positive and negative experiences of structured survey interviews, the nature of their experiences, proportion of pharmacists reporting to avoid survey interviews and reasons for doing so, and suggested areas of improvement. Results...

Seasonal influenza vaccination delivery through community pharmacists in England: evaluation of the London pilot

Science.gov (United States)

Atkins, Katherine; van Hoek, Albert Jan; Watson, Conall; Baguelin, Marc; Choga, Lethiwe; Patel, Anika; Raj, Thara; Jit, Mark; Griffiths, Ulla

2016-01-01

Objective To evaluate the effectiveness and cost of the pan-London pharmacy initiative, a programme that allows administration of seasonal influenza vaccination to eligible patients at pharmacies. Design We analysed 2013–2015 data on vaccination uptake in pharmacies via the Sonar reporting system, and the total vaccination uptake via 2011–2015 ImmForm general practitioner (GP) reporting system data. We conducted an online survey of London pharmacists who participate in the programme to assess time use data, vaccine choice, investment costs and opinions about the programme. We conducted an online survey of London GPs to assess vaccine choice of vaccine and opinions about the pharmacy vaccine delivery programme. Setting All London boroughs. Participants London-based GPs, and pharmacies that currently offer seasonal flu vaccination. Interventions Not applicable. Main outcome measures Comparison of annual vaccine uptake in London across risk groups from years before pharmacy vaccination introduction to after pharmacy vaccination introduction. Completeness of vaccine uptake reporting data. Cost to the National Health Service (NHS) of flu vaccine delivery at pharmacies with that at GPs. Cost to pharmacists of flu delivery. Opinions of pharmacists and GPs regarding the flu vaccine pharmacy initiative. Results No significant change in the uptake of seasonal vaccination in any of the risk groups as a result of the pharmacy initiative. While on average a pharmacy-administered flu vaccine dose costs the NHS up to £2.35 less than a dose administered at a GP, a comparison of the 2 recording systems suggests there is substantial loss of data. Conclusions Flu vaccine delivery through pharmacies shows potential for improving convenience for vaccine recipients. However, there is no evidence that vaccination uptake increases and the use of 2 separate recording systems leads to time-consuming data entry and missing vaccine record data. PMID:26883237

Community Pharmacist Attitudes on Medication Synchronization Programs

Directory of Open Access Journals (Sweden)

Matthew Witry

2017-05-01

Full Text Available Background: Medication synchronization is a service offered by an increasing number of community pharmacies that aligns refilling of a patient’s multiple medications. Purported benefits include increased adherence and improved dispensing efficiency. Objective: To assess community pharmacist agreement with a set of declarative statements about medication synchronization programs and to identify variation related to pharmacist characteristics. Methods: In 2015, a cross-sectional survey was mailed to 1,000 pharmacists from 5 Midwestern U.S. states using 4-contacts and an online option. Respondents used a 7-point Likert scale to agree or disagree with 5 statements about medication synchronization. Demographic and workplace characteristics were collected. Data were analyzed using descriptive statistics and factor analysis. Multiple linear regression tested the relationship between pharmacist characteristics and a 4-item attitude composite. Results: There were 258 usable responses for a response rate of 28.8%. About half (45.0% reported their pharmacy offered medication synchronization. Most pharmacists (82.6% agreed this service has a positive impact on patient adherence but 57% agreed that a “significant change to workflow” was or would be required. Pharmacist agreement that the program provides financial benefits to the pharmacy was higher than agreement that the service provides more opportunities for patient interactions (p<0.001. In the multiple regression analysis, having a PharmD and working at a pharmacy offering Medication Therapy Management were associated with more positive scores on the medication synchronization benefits composite whereas working in a staff role (rather than a manager/owner was lower. No demographic predictors were significantly associated with agreeing that a significant change to workflow would be required for implementation. Conclusions: Pharmacists generally were positive about medication synchronization

Radiation protection in computerized tomography diagnostics; Strahlenschutz in der Computertomografie

Energy Technology Data Exchange (ETDEWEB)

Grust, Andreas [Radiologie am Hauptbahnhof, Duesseldorf (Germany)

2012-11-01

The essential advantage of computerized tomography (CT) compared to projecting radiographic techniques is the display of organs free of superposition using a 3D data set and additional enhanced contrast resolution. CT is a mostly objective and examination-independent technique that has developed towards an indispensable tool for tumor diagnostics and traumatology. With respect to the total amount of X-ray diagnostic examinations CT is a rather seldom used technique, nevertheless causing a disproportionately high amount of the collective effective dose of the German population. This disadvantage triggers the necessity to work on a radiation dose reduction. The author discusses the issues X-ray tube current reduction, layer thickness, pitch factor, scan length, dose modulation, adaptive collimation, and iterative reconstruction.

Patient safety problem identification and solution sharing among rural community pharmacists.

Science.gov (United States)

Galt, Kimberly A; Fuji, Kevin T; Faber, Jennifer

2013-01-01

To implement a communication network for safety problem identification and solution sharing among rural community pharmacists and to report participating pharmacists' perceived value and impact of the network on patient safety after 1 year of implementation. Action research study. Rural community pharmacies in Nebraska from January 2010 to April 2011. Rural community pharmacists who voluntarily agreed to join the Pharmacists for Patient Safety Network in Nebraska. Pharmacists reported errors, near misses, and safety concerns through Web-based event reporting. A rapid feedback process was used to provide patient safety solutions to consider implementing across the network. Qualitative interviews were conducted 1 year after program implementation with participating pharmacists to assess use of the reporting system, value of the disseminated safety solutions, and perceived impact on patient safety in pharmacies. 30 of 38 pharmacists participating in the project completed the interviews. The communication network improved pharmacist awareness, promoted open discussion and knowledge sharing, contributed to practice vigilance, and led to incorporation of proactive safety prevention practices. Despite low participation in error and near-miss reporting, a dynamic communication network designed to rapidly disseminate evidence-based patient safety strategies to reduce risk was valued and effective at improving patient safety practices in rural community pharmacies.

Hospital pharmacists' evaluation of drug wholesaler services.

Science.gov (United States)

Allen, W O; Ryan, M R; Roberts, K B

1983-10-01

Services provided by drug wholesalers were evaluated by hospital pharmacists. A survey was mailed to 1500 randomly selected pharmacy directors. Respondents indicated availability and use of 26 customer services. Pharmacists rated the services that they used on the basis of importance of the service and satisfaction with the service. The 644 returned questionnaires indicated that most services were available to a large majority of respondents. Most services used were rated as important or essential. Most respondents were satisfied with wholesaler services; the service with which the most respondents were dissatisfied was stocking of pharmaceuticals in single-unit packaging. Of other services that were widely used and rated important, prompt crediting for delivery errors, few out-of-stock items, frequent pickup of return merchandise, and stocking of injectable pharmaceuticals received low satisfaction ratings. Same-day delivery service and emergency delivery of prescription items were unavailable to more than 40% of respondents. Hospital pharmacists were generally satisfied with services provided by drug wholesalers. Wholesalers should be aware of the particular service needs of hospital pharmacists, and further studies of these needs should be conducted.

GP and pharmacist inter-professional learning - a grounded theory study.

Science.gov (United States)

Cunningham, David E; Ferguson, Julie; Wakeling, Judy; Zlotos, Leon; Power, Ailsa

2016-05-01

Practice Based Small Group Learning (PBSGL) is an established learning resource for primary care clinicians in Scotland and is used by one-third of general practitioners (GPs). Scottish Government and UK professional bodies have called for GPs and pharmacists to work more closely together to improve care. To gain GPs' and pharmacists' perceptions and experiences of learning together in an inter-professional PBSGL pilot. Qualitative research methods involving established GP PBSGL groups in NHS Scotland recruiting one or two pharmacists to join them. A grounded theory method was used. GPs were interviewed in focus groups by a fellow GP, and pharmacists were interviewed individually by two researchers, neither being a GP or a pharmacist. Interviews were audio-recorded, transcribed and analysed using grounded theory methods. Data saturation was achieved and confirmed. Three themes were identified: GPs' and pharmacists' perceptions and experiences of inter-professional learning; Inter-professional relationships and team-working; Group identity and purpose of existing GP groups. Pharmacists were welcomed into GP groups and both professions valued inter-professional PBSGL learning. Participants learned from each other and both professions gained a wider perspective of the NHS and of each others' roles in the organisation. Inter-professional relationships, communication and team-working were strengthened and professionals regarded each other as peers and friends.

Current Human Reliability Analysis Methods Applied to Computerized Procedures

Energy Technology Data Exchange (ETDEWEB)

Ronald L. Boring

2012-06-01

Computerized procedures (CPs) are an emerging technology within nuclear power plant control rooms. While CPs have been implemented internationally in advanced control rooms, to date no US nuclear power plant has implemented CPs in its main control room (Fink et al., 2009). Yet, CPs are a reality of new plant builds and are an area of considerable interest to existing plants, which see advantages in terms of enhanced ease of use and easier records management by omitting the need for updating hardcopy procedures. The overall intent of this paper is to provide a characterization of human reliability analysis (HRA) issues for computerized procedures. It is beyond the scope of this document to propose a new HRA approach or to recommend specific methods or refinements to those methods. Rather, this paper serves as a review of current HRA as it may be used for the analysis and review of computerized procedures.

Pharmacist-driven antimicrobial optimization in the emergency department.

Science.gov (United States)

Davis, Lucretia C; Covey, Robin B; Weston, Jaye S; Hu, Bee Bee Y; Laine, Gregory A

2016-03-01

A pharmacist-driven antimicrobial optimization service in the non-trauma emergency department (ED) of an 864-bed non-profit tertiary care teaching hospital was reviewed to assess its value. Local antimicrobial resistance patterns of urine, wound, stool, and blood cultures were also studied to determine whether or not empiric prescribing practices should be modified. A retrospective electronic chart review was performed for ED patients with positive cultures during two different three-month periods. During Period 1, ED nursing management performed positive culture follow-up. During Period 2, ED clinical pharmacists performed this role. The primary objective was to determine the value of the pharmacist-driven antimicrobial optimization service as measured by the number of clinical interventions made when indicated. The secondary objective was to examine resistance patterns of urine and wound isolates in order to determine if empiric prescribing patterns in the ED should be modified. During Period 1, there were 499 patient visits with subsequent positive cultures. Of those, 76 patients (15%) were discharged home. Nursing management intervened on 21 of 42 (50%) positive cultures that required an intervention; in Period 2, there were 473 patient visits with subsequent positive cultures, and 64 (14%) were discharged home. Pharmacists intervened on 24 of 30 (80%) cultures where an intervention was indicated resulting in a 30% increase in interventions for inappropriate therapy (p = 0.01). A review of the secondary objective revealed a 38% fluoroquinolone resistance rate of E. coli, the most frequently isolated urinary organism. Pharmacist-driven antimicrobial stewardship program resulted in a 30% absolute increase in interventions for inappropriate therapy as compared to the nursing-driven model. This stewardship program has further demonstrated the value of ED pharmacists. Pharmacist interventions should help to ensure that infections are resolved through modification of

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.

Do pharmacists use social media for patient care?

Science.gov (United States)

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

2017-04-01

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

An Analysis of Job Satisfaction among Iranian Pharmacists through Various Job Characteristics.

Science.gov (United States)

Foroughi Moghadam, Mohamad Javad; Peiravian, Farzad; Naderi, Azadeh; Rajabzadeh, Ali; Rasekh, Hamid Reza

2014-01-01

Pharmacists and pharmaceutical services are among the most important resources and programs in providing health for a society. Pharmacists as the key players in presenting health services, greatly impact on the health of a society and if they suffer low job satisfaction, their dissatisfaction may relatively threaten health in a society. This study was conducted to determine Iranian pharmacists' job satisfaction and additionally, some causes of dissatisfaction among pharmacists have been diagnosed. A job satisfaction questionnaire was developed and reliability tests were done by some experts in field of pharmacy practice. A sample of 700 pharmacists was selected among ten leading provinces of the country and questionnaires were distributed at the continuing pharmacy education conferences. Three essential factors named "Endogenous Satisfaction", "Exogenous Satisfaction" and "Current Sense of Being Pharmacists" was considered as the main job satisfaction factors. Generally low scores of exogenous and endogenous job satisfaction were concluded among pharmacists while most of them were highly satisfied with being pharmacist. Male pharmacists were more satisfied than their female colleagues and a positive relationship between age and work experience with exogenous job satisfaction was found. Low levels of job satisfaction which were found among Iranian pharmacists could be considered as a deficiency of health system in Iran. Fortunately, inherent interest in the pharmacy profession found among Iranian pharmacists is an optimistic point at which policy-makers could develop their modifying policies. Health policy-makers must endeavor to take other steps to issue solutions for this current problem.

Assessing the knowledge of asthma among community pharmacists ...

African Journals Online (AJOL)

Purpose: To assess the knowledge of community pharmacists about asthma and its management. Methods: Seventy-six registered community pharmacists in. Edo State completed a structured questionnaire consisting of open and close ended questions which addressed issues relating to their knowledge of asthma

Training pharmacists to deliver a complex information technology intervention (PINCER) using the principles of educational outreach and root cause analysis.

Science.gov (United States)

Sadler, Stacey; Rodgers, Sarah; Howard, Rachel; Morris, Caroline J; Avery, Anthony J

2014-02-01

To describe the training undertaken by pharmacists employed in a pharmacist-led information technology-based intervention study to reduce medication errors in primary care (PINCER Trial), evaluate pharmacists' assessment of the training, and the time implications of undertaking the training. Six pharmacists received training, which included training on root cause analysis and educational outreach, to enable them to deliver the PINCER Trial intervention. This was evaluated using self-report questionnaires at the end of each training session. The time taken to complete each session was recorded. Data from the evaluation forms were entered onto a Microsoft Excel spreadsheet, independently checked and the summary of results further verified. Frequencies were calculated for responses to the three-point Likert scale questions. Free-text comments from the evaluation forms and pharmacists' diaries were analysed thematically. All six pharmacists received 22 h of training over five sessions. In four out of the five sessions, the pharmacists who completed an evaluation form (27 out of 30 were completed) stated they were satisfied or very satisfied with the various elements of the training package. Analysis of free-text comments and the pharmacists' diaries showed that the principles of root cause analysis and educational outreach were viewed as useful tools to help pharmacists conduct pharmaceutical interventions in both the study and other pharmacy roles that they undertook. The opportunity to undertake role play was a valuable part of the training received. Findings presented in this paper suggest that providing the PINCER pharmacists with training in root cause analysis and educational outreach contributed to the successful delivery of PINCER interventions and could potentially be utilised by other pharmacists based in general practice to deliver pharmaceutical interventions to improve patient safety. © 2013 The Authors. IJPP © 2013 Royal Pharmaceutical Society.

Core drug-drug interaction alerts for inclusion in pediatric electronic health records with computerized prescriber order entry.

Science.gov (United States)

Harper, Marvin B; Longhurst, Christopher A; McGuire, Troy L; Tarrago, Rod; Desai, Bimal R; Patterson, Al

2014-03-01

The study aims to develop a core set of pediatric drug-drug interaction (DDI) pairs for which electronic alerts should be presented to prescribers during the ordering process. A clinical decision support working group composed of Children's Hospital Association (CHA) members was developed. CHA Pharmacists and Chief Medical Information Officers participated. Consensus was reached on a core set of 19 DDI pairs that should be presented to pediatric prescribers during the order process. We have provided a core list of 19 high value drug pairs for electronic drug-drug interaction alerts to be recommended for inclusion as high value alerts in prescriber order entry software used with a pediatric patient population. We believe this list represents the most important pediatric drug interactions for practical implementation within computerized prescriber order entry systems.

Pharmacists' perceptions of professionalism on social networking sites.

Science.gov (United States)

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

Social networking sites (SNS) are a new venue for communication, and health care professionals, like the general population, are using them extensively. However, their behavior on SNS may influence public perceptions about their professionalism. This study explored how pharmacists separate professional and personal information and activities on SNS, their perceptions of professional behavior on SNS, and opinions on guidelines in this area. In-depth, semi-structured interviews were conducted with international practising pharmacists (n = 31) recruited from a range of countries (n = 9). Initially, pharmacists known to the research team were invited, and thereafter, participants were recruited using a snowballing technique. The interviews lasted from 30 to 120 min. All interviews were recorded, transcribed verbatim, and thematically analyzed. A majority of participants mixed professional and personal information and activities on SNS, and about one third adopted a separation strategy where professional information and activities were clearly separated from personal ones (e.g. two different SNS accounts, or one particular SNS for professional use and another platform for personal purposes). Most participants expressed concern over how pharmacists present themselves and behave in SNS when they reported (un)professional behaviors of peers they had observed. Examples of perceived unprofessional behaviors included revealing details of personal life and activities; open complaints about the pharmacy sector, co-workers, physicians, and patients; inappropriate description of pharmacists' roles and activities; and breaches of patient confidentiality. Positive professional behaviors, such as expression of compassion for patients, examples of effective patient management, promotion of pharmacists' role, and correction of misleading health information being spread online were also observed. There was no consensus on having professional social media guidelines. Some preferred