WorldWideScience

Sample records for rural pharmacy services

  1. Effect of Outsourced Pharmacies of Rural Healthcare Centers on Service Quality in Abharand Soltanieh Counties

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    Ali Maher

    2016-05-01

    Full Text Available Recently, a part of healthcare services has been assigned to the private sector to increase the quality of medical services, increase patient satisfaction and reduce costs. In this regard, the outsourcing approach has been significantly considered for pharmaceutical services provided by healthcare centers. The purpose of this study is to evaluate the effect of outsourced pharmacies of rural healthcare centers on service quality using structural equations modelling. The methodology used was descriptive using correlation by structural equations modelling. The studied population included those patients who provided their medicines from pharmacies of rural healthcare centers in Abhar and Soltanieh counties. The samples included 384 of these patients. Data was collected by outsourcing and service quality questionnaires. A structural equation modelling was used to analyze data by LISREAL software. Results indicated a positive significant effect of outsourced pharmacies of rural healthcare centers on quality of tangibles, reliability, responsiveness, assurance and empathy. findings emphasize the role of outsourcing on quality of services. Outsourced pharmacies of rural healthcare centers of Abhar and Soltanieh counties lead to improved service quality.

  2. An evaluation of a community pharmacy-based rural asthma management service.

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    Saini, Bandana; Filipovska, Julija; Bosnic-Anticevich, Sinthia; Taylor, Susan; Krass, Ines; Armour, Carol

    2008-04-01

    To compare the effect of a pharmacist-delivered rural asthma management service (RAMS) on health outcomes for people with asthma in a rural/regional area with 'standard care' delivered through community pharmacies. A parallel group controlled repeated measures study. Community pharmacies in Central West New South Wales. Standardised protocols and resources based on national asthma management guidelines, delivered by specially trained community pharmacists. Patients visited the pharmacy at baseline and 1, 3 and 6 months after baseline in the intervention group and at baseline plus 6 months after baseline in the control group. The intervention pharmacists (n = 12) were trained to deliver the RAMS model, while control pharmacists (n = 8) provided standard asthma care to their recruited patients. Fifty-one and 39 patients were recruited by intervention and control pharmacists. Asthma severity score which was a composite score based on recency, frequency and severity of asthma symptoms, and asthma history. Data compared at the final visit between groups indicated that the RAMS patient group demonstrated a significant reduction in the asthma severity scores (7.9 +/- 2.6 versus 10.4 +/- 2.6, P < 0.001); a reduction in the risk of non-adherence to medication scores (1.6 +/- 0.7 versus 2.3 +/- 1.1, P < 0.001); and an increase in the proportion of patients owning a written action plan (50% versus 23%, P = 0.04). These results indicated that the community pharmacy-based RAMS model can improve asthma outcomes for patients in rural settings, and similar models for asthma and other chronic diseases should be tested rigorously and adopted in rural primary care practice.

  3. Creating a new rural pharmacy workforce: Development and implementation of the Rural Pharmacy Health Initiative.

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    Scott, Mollie Ashe; Kiser, Stephanie; Park, Irene; Grandy, Rebecca; Joyner, Pamela U

    2017-12-01

    An innovative certificate program aimed at expanding the rural pharmacy workforce, increasing the number of pharmacists with expertise in rural practice, and improving healthcare outcomes in rural North Carolina is described. Predicted shortages of primary care physicians and closures of critical access hospitals are expected to worsen existing health disparities. Experiential education in schools and colleges of pharmacy primarily takes place in academic medical centers and, unlike experiential education in medical schools, rarely emphasizes the provision of patient care in rural U.S. communities, where chronic diseases are prevalent and many residents struggle with poverty and poor access to healthcare. To help address these issues, UNC Eshelman School of Pharmacy developed the 3-year Rural Pharmacy Health Certificate program. The program curriculum includes 4 seminar courses, interprofessional education and interaction with medical students, embedding of each pharmacy student into a specific rural community for the duration of training, longitudinal ambulatory care practice experiences, community engagement initiatives, leadership training, development and implementation of a population health project, and 5 pharmacy practice experiences in rural settings. The Rural Pharmacy Health Certificate program at UNC Eshelman School of Pharmacy seeks to transform rural pharmacy practice by creating a pipeline of rural pharmacy leaders and teaching a unique skillset that will be beneficial to healthcare systems, communities, and patients. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  4. Pharmacy Characteristics Associated with the Provision of Drug Therapy Services in Nonmetropolitan Community Pharmacies

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    Gadkari, Abhijit S.; Mott, David A.; Kreling, David H.; Bonnarens, Joseph K.

    2009-01-01

    Context: Higher prevalence of chronic diseases and reduced access to other health professionals in rural areas suggest that rural Medicare enrollees will benefit from pharmacist-provided drug therapy services (DTS). Purpose: The purpose of this study was to describe non-metropolitan community pharmacy sites in Wisconsin, the provision of DTS at…

  5. Rural patients' access to mobile phones and willingness to receive mobile phone-based pharmacy and other health technology services: a pilot study.

    Science.gov (United States)

    Sankaranarayanan, Jayashri; Sallach, Rory E

    2014-02-01

    This pilot study explores the patient-centered demand for mobile phone-based health (mobile health [m-health]) services in the rural United States by documenting rural patients' access to mobile phones and patients' willingness to receive m-health services. An anonymous institutional review board-approved survey was completed by patients visiting two rural pharmacies in Nebraska from August to October 2011. Patients who volunteered to complete the survey provided their demographic data, disease state information, health status, mobile phone access, and willingness to receive (in terms of using and giving time to) m-health services. The majority of the 24 survey respondents were 19-40 years old (52%), female (88%), married (63%), with excellent to very good health status (63%), with no comorbidities (83%), with ≤$100 monthly medication expenses (80%), with private insurance (78%), living within 5 miles of their pharmacy (71%), and reporting that m-health services are important to them (75%; 12/16). Approximately 95%, 81%, 73%, and 55% of respondents reported access to a mobile phone, voice mails, text messaging, and mobile phone applications, respectively. Of the respondents, 65%, 57%, 52%, and 48% were willing to receive prerecorded messages for appointment reminders from the doctor, disease information, medication use/self-care information, and symptom monitoring information, respectively. In total, 70%, 63%, 61%, 54%, and 50% were willing to receive prerecorded messages from the pharmacist containing contact requests, new/refill prescription reminders, information on medication problems, reviewing/monitoring of medication use, and medication self-management/preventive screenings/immunizations, respectively. Of 44% (7/16) respondents willing to give time for m-health services, 83% were willing to give 15 min, and 17% were willing to give 30 min every month. By demonstrating rural patients' demand for m-health (including pharmacy) services, this is one of the

  6. Marketing of rural and remote pharmacy practice via the digital medium.

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    Peterson, G M; Fitzmaurice, K D; Rasiah, R L; Kruup, H

    2010-08-01

    The shortage of community and hospital pharmacists is particularly acute in rural and remote areas of Australia. Pharmacy students, in particular, as those who may be able to alleviate this shortage, need to be made more aware of the challenges and rewards of rural pharmacy practice. A marketing tool was developed to promote rural and remote pharmacy practice as a career option. A DVD was produced from interviews with health professionals working in rural and remote areas of Australia. This DVD will complement current rural practical placements, which have been incorporated into the curriculum of Australian schools of pharmacy. Interviews were conducted with healthcare professionals from areas in Tasmania, Northern Queensland and the Northern Territory. Interviewees included pharmacists, graduate pharmacists, pharmacy students, aboriginal health workers and a general practitioner. Each of the interviewees was able to provide personal accounts of experiences in rural and remote healthcare, and roles and opportunities for pharmacists. A final draft of the DVD was shown to University of Tasmania students to assess the impact and quality of the production. A number of common themes arose from interviewing and these were subsequently converted into five key chapters of the DVD - Lifestyle, Belonging, Diversity, Indigenous Health and 'Give it a go'. The final DVD, produced from over 15 h of footage, runs for 35 min. Students reported positive feedback on both the technical quality and the information contained within the DVD; 37% of students who viewed the DVD felt that it increased their awareness of what rural pharmacy has to offer. The rural pharmacy, 'Enjoy the Lifestyle' DVD can be used to increase awareness of rural and remote pharmacy practice to students and other pharmacists, and complements other pharmacy workforce strategies for rural and remote areas of Australia. It could also be a useful approach for adaptation in other countries.

  7. Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies.

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    Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas

    2010-01-01

    The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic

  8. An assessment of the compliance with good pharmacy practice in an urban and rural district in Sri Lanka.

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    Wijesinghe, P R; Jayakody, R L; De A Seneviratne, R

    2007-02-01

    To evaluate the compliance of private pharmacies to good pharmacy practice (GPP) in an urban and rural district in Sri Lanka and identify deficiencies with a view to improving supply of safe and effective drugs to consumers. Lot quality assurance sampling (LQAS) method was used to determine the number of pharmacies that need to be studied and the threshold limit of defective elements. An inspection of 20 pharmacies in the urban and all 18 pharmacies in the rural district was carried out using a structured checklist. Compliance to seven subsystems of GPP was studied. Storage of drugs, maintenance of cold chain, dispensing and documentation were comprehensively substandard in both districts. Individual items of supervision in registration, physical environment and order of the pharmacy were also found to be substandard in both districts. This study shows that the LQAS method can be used to identify inadequate pharmacy services in the community as a whole. There was poor compliance to GPP by the private pharmacies in both districts. There are concerns about the quality of drugs and the safety of private pharmacy services to the community. Some of the deficiencies could be easily corrected by educating the pharmacists and authorised officers, and more effective and streamlined supervision.

  9. Assessment of pharmacists' delivery of public health services in rural and urban areas in Iowa and North Dakota.

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    Scott, David M; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

    2016-01-01

    The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists' delivery of public health services. To assess Iowa and North Dakota pharmacists' practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking.

  10. Prescription Opioid Misuse Among Rural Community Pharmacy Patients: Pilot Study for Screening and Implications for Future Practice and Research.

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    Cochran, Gerald T; Engel, Rafael J; Hruschak, Valerie J; Tarter, Ralph E

    2017-10-01

    Opioid misuse imposes a disproportionately heavy burden on individuals living in rural areas. Community pharmacy has the potential to expand and coordinate with health professionals to identify and intervene with those who misuse opioids. Rural and urban community pharmacy patients were recruited in this pilot project to describe and compare patterns of opioid misuse. We administered a health screening survey in 4 community pharmacies among patients filling opioid medications. Univariate statistics were used to assess differences in health characteristics and opioid medication misuse behaviors between rural and urban respondents. Multivariable statistics were used to identify risk factors associated with rural and urban opioid misuse. A total of 333 participants completed the survey. Participants in rural settings had poorer overall health, higher pain levels, lower education, and a higher rate of unemployment compared to patients in urban pharmacies. Rural respondents with illicit drug use (adjustable odds ratio [aOR]: 14.34, 95% confidence interval [CI] = 2.16-95.38), posttraumatic stress disorder (aOR: 5.44, 95% CI = 1.52-19.50), and ≤high school education (aOR: 6.68, 95% CI = 1.06-42.21) had increased risk for opioid misuse. Community pharmacy represents a promising resource for potential identification of opioid misuse, particularly in rural communities. Continued research must extend these findings and work to establish collaborative services in rural settings.

  11. Assessment of pharmacists’ delivery of public health services in rural and urban areas in Iowa and North Dakota

    Science.gov (United States)

    Scott, David M.; Strand, Mark; Undem, Teri; Anderson, Gabrielle; Clarens, Andrea; Liu, Xiyuan

    2016-01-01

    Background: The profession of pharmacy is expanding its involvement in public health, but few studies have examined pharmacists’ delivery of public health services. Objective: To assess Iowa and North Dakota pharmacists’ practices, frequency of public health service delivery, level of involvement in achieving the essential services of public health, and barriers to expansion of public health services in rural and urban areas. Methods: This study implemented an on-line survey sent to all pharmacists currently practicing pharmacy in Iowa and North Dakota. Results: Overall, 602 valid responses were analyzed, 297 in rural areas and 305 in urban areas. Three practice settings (chain stores [169, 28.2%], independent community pharmacies [162, 27.0%], and hospital pharmacies [156, 26.0%]) comprised 81.2% of the sample. Both chain and independent community pharmacists were more commonly located in rural areas than in urban areas (PDakota. These findings should be interpreted to be primarily due to differences in the role of the rural pharmacist and the quest for certain opportunities that rural pharmacists are seeking. PMID:28042356

  12. Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

    Science.gov (United States)

    Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A

    2018-05-15

    The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  13. Development of a pharmacy resident rotation to expand decentralized clinical pharmacy services.

    Science.gov (United States)

    Hill, John D; Williams, Jonathan P; Barnes, Julie F; Greenlee, Katie M; Cardiology, Bcps-Aq; Leonard, Mandy C

    2017-07-15

    The development of a pharmacy resident rotation to expand decentralized clinical pharmacy services is described. In an effort to align with the initiatives proposed within the ASHP Practice Advancement Initiative, the department of pharmacy at Cleveland Clinic, a 1,400-bed academic, tertiary acute care medical center in Cleveland, Ohio, established a goal to provide decentralized clinical pharmacy services for 100% of patient care units within the hospital. Patient care units that previously had no decentralized pharmacy services were evaluated to identify opportunities for expansion. Metrics analyzed included number of medication orders verified per hour, number of pharmacy dosing consultations, and number of patient discharge counseling sessions. A pilot study was conducted to assess the feasibility of this service and potential resident learning opportunities. A learning experience description was drafted, and feedback was solicited regarding the development of educational components utilized throughout the rotation. Pharmacists who were providing services to similar patient populations were identified to serve as preceptors. Staff pharmacists were deployed to previously uncovered patient care units, with pharmacy residents providing decentralized services on previously covered areas. A rotating preceptor schedule was developed based on geographic proximity and clinical expertise. An initial postimplementation assessment of this resident-driven service revealed that pharmacy residents provided a comparable level of pharmacy services to that of staff pharmacists. Feedback collected from nurses, physicians, and pharmacy staff also supported residents' ability to operate sufficiently in this role to optimize patient care. A learning experience developed for pharmacy residents in a large medical center enabled the expansion of decentralized clinical services without requiring additional pharmacist full-time equivalents. Copyright © 2017 by the American Society of

  14. 38 CFR 51.180 - Pharmacy services.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Pharmacy services. 51.180... FOR NURSING HOME CARE OF VETERANS IN STATE HOMES Standards § 51.180 Pharmacy services. The facility... aspects of the provision of pharmacy services in the facility; (2) Establishes a system of records of...

  15. 42 CFR 483.60 - Pharmacy services.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 5 2010-10-01 2010-10-01 false Pharmacy services. 483.60 Section 483.60 Public... Care Facilities § 483.60 Pharmacy services. The facility must provide routine and emergency drugs and... the provision of pharmacy services in the facility; (2) Establishes a system of records of receipt and...

  16. The geographic accessibility of pharmacies in Nova Scotia.

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    Law, Michael R; Heard, Deborah; Fisher, Judith; Douillard, Jay; Muzika, Greg; Sketris, Ingrid S

    2013-01-01

    Geographic proximity is an important component of access to primary care and the pharmaceutical services of community pharmacies. Variations in access to primary care have been found between rural and urban areas in Canadian and international jurisdictions. We studied access to community pharmacies in the province of Nova Scotia. We used information on the locations of 297 community pharmacies operating in Nova Scotia in June 2011. Population estimates at the census block level and network analysis were used to study the number of Nova Scotia residents living within 800 m (walking) and 2 km and 5 km (driving) distances of a pharmacy. We then simulated the impact of pharmacy closures on geographic access in urban and rural areas. We found that 40.3% of Nova Scotia residents lived within walking distance of a pharmacy; 62.6% and 78.8% lived within 2 km and 5 km, respectively. Differences between urban and rural areas were pronounced: 99.2% of urban residents lived within 5 km of a pharmacy compared with 53.3% of rural residents. Simulated pharmacy closures had a greater impact on geographic access to community pharmacies in rural areas than urban areas. The majority of Nova Scotia residents lived within walking or short driving distance of at least 1 community pharmacy. While overall geographic access appears to be lower than in the province of Ontario, the difference appears to be largely driven by the higher proportion of rural dwellers in Nova Scotia. Further studies should examine how geographic proximity to pharmacies influences patients' access to traditional and specialized pharmacy services, as well as health outcomes and adherence to therapy. Can Pharm J 2013;146:39-46.

  17. Integration of Rural Community Pharmacies into a Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis

    Directory of Open Access Journals (Sweden)

    Nicholas E. Hagemeier

    2015-01-01

    Full Text Available Purpose: Practice-based research networks (PBRN seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1 evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2 explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3 explore pharmacy key informant interest in PBRN participation. Methods: The sample consisted of community pharmacies within city limits of all Appalachian Research Network (AppNET PBRN communities in South Central Appalachia. A descriptive, cross-sectional, questionnaire-based study was conducted from November 2013 to February 2014. Bivariate and multivariate analyses were conducted to examine associations between key informant and practice characteristics, and PBRN interest and perceptions. Findings: A 47.8% response rate was obtained. Most key informants (88% were very or somewhat interested in participating in AppNET. Enrichment of patient care (82.8%, improved relationships with providers in the community (75.9%, and professional development opportunities (69.0% were perceived by more than two-thirds of respondents to be very beneficial outcomes of PBRN participation. Respondents ranked time constraints (63% and workflow disruptions (20% as the biggest barriers to PBRN participation. Conclusion: Key informants in rural Appalachian community pharmacies indicated interest in PBRN participation. Integration of community pharmacies into existing rural PBRNs could advance community level care coordination and promote improved health outcomes in rural and underserved areas.   Type: Original Research

  18. Hospital clinical pharmacy services in Vietnam.

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    Trinh, Hieu T; Nguyen, Huong T L; Pham, Van T T; Ba, Hai L; Dong, Phuong T X; Cao, Thao T B; Nguyen, Hanh T H; Brien, Jo-Anne

    2018-04-07

    Background Clinical pharmacy is key to the quality use of medicines. While there are different approaches in different countries, international perspectives may inform health service development. The Vietnamese Ministry of Health introduced a legal regulation of clinical pharmacy services in December 2012. Objective To describe the services, and to explore reported barriers and facilitators in implementing clinical pharmacy activities in Vietnamese hospitals after the introduction of Vietnamese Ministry of Health legal regulation. Setting Thirty-nine hospitals in Hanoi, Vietnam, including 22 provincial and 17 district hospitals. Method A mixed methods study was utilized. An online questionnaire was sent to the hospitals. In-depth interviews were conducted with pairs of nominated pharmacists at ten of these hospitals. The questionnaire focused on four areas: facilities, workforce, policies and clinical pharmacy activities. Main outcome measure Proportion of clinical pharmacy activities in hospitals. Themes in clinical pharmacy practice. Results 34/39 (87%) hospitals had established clinical pharmacy teams. Most activities were non-patient-specific (87%) while the preliminary patient-specific clinical pharmacy services were available in only 8/39 hospitals (21%). The most common non-patient-specific activities were providing medicines information (97%), reporting adverse drug reactions (97%), monitoring medication usage (97%). The patient specific activities varied widely between hospitals and were ad hoc. The main challenges reported were: lack of workforce and qualified clinical pharmacists. Conclusion While most hospitals had hospital-based pharmacy activities, the direct patient care was limited. Training, education and an expanded work forces are needed to improve clinical pharmacy services.

  19. Developing a Business Plan for Critical Care Pharmacy Services.

    Science.gov (United States)

    Erstad, Brian L; Mann, Henry J; Weber, Robert J

    2016-11-01

    Critical care medicine has grown from a small group of physicians participating in patient care rounds in surgical and medical intensive care units (ICUs) to a highly technical, interdisciplinary team. Pharmacy's growth in the area of critical care is as exponential. Today's ICU requires a comprehensive pharmaceutical service that includes both operational and clinical services to meet patient medication needs. This article provides the elements for a business plan to justify critical care pharmacy services by describing the pertinent background and benefit of ICU pharmacy services, detailing a current assessment of ICU pharmacy services, listing the essential ICU pharmacy services, describing service metrics, and delineating an appropriate timeline for implementing an ICU pharmacy service. The structure and approach of this business plan can be applied to a variety of pharmacy services. By following the format and information listed in this article, the pharmacy director can move closer to developing patient-centered pharmacy services for ICU patients.

  20. AN ANALYSIS OF PHARMACY SERVICES BY PHARMACIST IN COMMUNITY PHARMACY

    Directory of Open Access Journals (Sweden)

    Max Joseph Herman

    2013-03-01

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

  1. Designing pharmacy services based on grocery store patron preferences.

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    Lindstrom, Nicolette S Raya; Casper, Kristin A; Green, Tara R; Pedersen, Craig A

    2007-01-01

    To assess preferences of grocery store patrons concerning pharmacy services and identify study participant characteristics that may predict the success of pharmacy services in the community setting. Self-administered survey. Central Ohio from December 16, 2005, to January 12, 2006. 163 grocery store patrons. Eight grocery store survey events. Responses to survey items about (1) perceived importance of 28 pharmacy services, (2) identification of the 3 most important services, (3) frequency of grocery store and pharmacy use, (4) preferred methods of advertising pharmacy services, and (5) socioeconomic demographics. Preferred services delineated by various demographics also were analyzed. A total of 163 surveys were returned from study participants. Nine services appeared in both the top 12 overall preferred services and the 12 highest-ranked services. Statistically significant differences were observed among services ranked as important or very important by age, race, employment, income, caregiver status, and prescription drug coverage status. The three advertising tools selected most frequently included: weekly grocery store ads (68.6%), in-store signs (51.0%), and flyers attached to prescription bags (36.0%). Grocery store patrons would like a wide range of nontraditional pharmacy services that could be implemented into community pharmacies. Pharmacies in grocery stores need to provide both traditional and expanded pharmacy services to meet the desires and expectations of current and potential patients, and expanded marketing methods should be considered.

  2. Patient satisfaction with community pharmacy: comparing urban and suburban chain-pharmacy populations.

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    Malewski, David F; Ream, Aimrie; Gaither, Caroline A

    2015-01-01

    Patient satisfaction with pharmaceutical care can be a strong predictor of medication and other health-related outcomes. Less understood is the role that location of pharmacies in urban or suburban environments plays in patient satisfaction with pharmacy and pharmacist services. The purpose of this study was to serve as a pilot examining urban and suburban community pharmacy populations for similarities and differences in patient satisfaction. Community pharmacy patients were asked to self-administer a 30-question patient satisfaction survey. Fifteen questions addressed their relationship with the pharmacist, 10 questions addressed satisfaction and accessibility of the pharmacy, and five questions addressed financial concerns. Five urban and five suburban pharmacies agreed to participate. Data analysis included descriptive statistics and chi-square analysis. Most patients reported high levels of satisfaction. Satisfaction with pharmacist relationship and service was 70% or higher with no significant differences between locations. There were significant differences between the urban and suburban patients regarding accessibility of pharmacy services, customer service and some patient/pharmacist trust issues. The significant differences between patient satisfaction in the suburban and urban populations warrant a larger study with more community pharmacies in other urban, suburban and rural locations to better understand and validate study findings. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Community pharmacy minor ailment services in England: Pharmacy stakeholder perspectives on the factors affecting sustainability.

    Science.gov (United States)

    Nazar, Hamde; Nazar, Zachariah

    2018-05-14

    Self-care advice and management of minor ailments have long been provided in community pharmacies across England. However, formal pharmacy minor ailment service provision is geographically variable and has yet to gain recognition and political support as a valued sustainable service for nationwide adoption and commissioning. To investigate the sustainability potential of pharmacy minor ailment services from the perspective of community pharmacy stakeholders within the North East of England. A mixed methods approach was adopted to survey and interview stakeholders from the North East of England who commission; provide; and/or represent groups influencing the design, delivery and investment in community pharmacy clinical and public health services. The 40-item Programme Sustainability Assessment Tool, a validated instrument to assess a public health programme's capacity for sustainability across eight domains, was administered to fifty-three stakeholders, identified from a pharmacy minor ailments showcase event. The same stakeholders were invited for a semi-structured interview to explore issues further. Interviews were audio-recorded, transcribed verbatim, and underwent framework analysis. Forty-two (79.2% response rate) stakeholders representing commissioning, provider and influencing (e.g. Local Professional Network) organisations completed the assessment tool. Pharmacy minor ailment services were rated as unsustainable across the majority of the domains. Elements within the domain 'Partnerships' demonstrated potential for sustainability. Stakeholder interviews provided detailed explanation for the low scoring sustainability domains, highlighting the multifaceted challenges threatening these services. The Programme Sustainability Assessment Tool allowed stakeholders to evaluate the potential of pharmacy minor ailment services in England. Follow-up interviews highlighted that initial design and implementation of services was poorly conceived and lacked evidence

  4. Integration of outpatient infectious diseases clinic pharmacy services and specialty pharmacy services for patients with HIV infection.

    Science.gov (United States)

    Gilbert, Elise M; Gerzenshtein, Lana

    2016-06-01

    The integration of specialty pharmacy services and existing outpatient clinical pharmacy services within an infectious diseases (ID) clinic to optimize the care of patients with human immunodeficiency virus (HIV) infection is described. The management of HIV-infected patients is a highly specialized area of practice, often requiring use of complex medication regimens for reduction of HIV-associated morbidity and mortality prophylaxis and treatment of opportunistic infections, and prevention of HIV transmission. To maximize the effectiveness and safety of treatment with antiretroviral agents and associated pharmacotherapies, an interdisciplinary team is often involved in patient care. At Chicago-based Northwestern Medicine (NM), the outpatient ID clinic has long worked with an interdisciplinary care team including physicians, clinical pharmacists, nurses, and social workers to care for patients with HIV infection. In April 2014, specialty pharmacy services for patients with HIV infection were added to the NM ID clinic's care model to help maintain continuity of care and enhance patient follow-up. The care model includes well-defined roles for clinical pharmacists, pharmacy residents and students on rotation, and licensed pharmacy technicians. Specialty pharmacy services, including medication education, prescription fulfillment, assistance with medication access (e.g., navigation of financial assistance programs, completion of prior-authorization requests), and treatment monitoring, allow for closed-loop medication management of the HIV-infected patient population. Integration of specialty pharmacy services with the interdisciplinary care provided in the outpatient NM ID clinic has enhanced continuity of care for patients with HIV infection in terms of prescription filling, medication counseling, and adherence monitoring. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  5. Service quality in community pharmacy: an exploration of determinants.

    Science.gov (United States)

    White, Lesley; Klinner, Christiane

    2012-01-01

    Although various instruments have been developed to measure customer satisfaction with community pharmacy services, there is limited research regarding pharmacy staffs' understanding of service quality and its determinants. This study aimed to explore the perceptions of pharmacy staff regarding the factors that constitute a high level of service quality using the service quality determinants proposed by the Conceptual Model of Service Quality. Structured interviews were conducted with 27 pharmacy assistants and 6 pharmacists in 3 community pharmacies in Sydney. The interview questions focused on the participants' perceptions of consumer expectations, the translation of these perceptions into service quality specifications, the actual service delivery, and the communication to customers. From the pharmacy staff perspective, service quality is significantly limited by insufficient internal communication and control processes that impede role clarity and the resolution of conflicting role expectations among customer service personnel. Participants indicated that these problems could be alleviated through the implementation of more transparent, realistic, measurable, and accepted quality specifications by pharmacy management. The study indicates that the extent to which pharmacy management sets, maintains, and communicates service quality specifications to staff directly affects role clarity, role conflict, and organizational commitment among customer service staff, which in turn directly influence the level of service quality provided to the customers. Copyright © 2012 Elsevier Inc. All rights reserved.

  6. VACCINATION SERVICE IN THE PORTUGUESE PHARMACIES

    Directory of Open Access Journals (Sweden)

    Isabel Pimenta Jacinto

    2015-07-01

    Full Text Available Community Pharmacies’ legal framework (regulated by the decree-law nº 307/2007, 31st August established the possibility of provision of pharmaceutical services to promote health and well-being by pharmacies. Due to its characteristics in terms of access and geographical distribution, pharmacies are health providers which can contribute to increase the immunization coverage with benefits in terms of public health. In this article, it is described the national and international framework of the implementation of vaccination services in pharmacies and the results of its implementation. It is also conducted a reflection on strengthening the role of pharmacies and its contribution to the national targets for immunization coverage and public health.

  7. Three-year financial analysis of pharmacy services at an independent community pharmacy.

    Science.gov (United States)

    Doucette, William R; McDonough, Randal P; Mormann, Megan M; Vaschevici, Renata; Urmie, Julie M; Patterson, Brandon J

    2012-01-01

    To assess the financial performance of pharmacy services including vaccinations, cholesterol screenings, medication therapy management (MTM), adherence management services, employee health fairs, and compounding services provided by an independent community pharmacy. Three years (2008-10) of pharmacy records were examined to determine the total revenue and costs of each service. Costs included products, materials, labor, marketing, overhead, equipment, reference materials, and fax/phone usage. Costs were allocated to each service using accepted principles (e.g., time for labor). Depending on the service, the total revenue was calculated by multiplying the frequency of the service by the revenue per patient or by adding the total revenue received. A sensitivity analysis was conducted for the adherence management services to account for average dispensing net profit. 7 of 11 pharmacy services showed a net profit each year. Those services include influenza and herpes zoster immunization services, MTM, two adherence management services, employee health fairs, and prescription compounding services. The services that realized a net loss included the pneumococcal immunization service, cholesterol screenings, and two adherence management services. The sensitivity analysis showed that all adherence services had a net gain when average dispensing net profit was included. Most of the pharmacist services had an annual positive net gain. It seems likely that these services can be sustained. Further cost management, such as reducing labor costs, could improve the viability of services with net losses. However, even with greater efficiency, external factors such as competition and reimbursement challenge the sustainability of these services.

  8. Customer assessment of long-term care pharmacy provider services.

    Science.gov (United States)

    Clark, Thomas R

    2008-09-01

    Assess performance of long-term care pharmacy providers on key services offered to nursing facilities. Cross-sectional; nursing facility team. Random phone survey of nursing facility team members. 485 nursing facility team members (practicing in nursing facilities, interacting with > or = 1 consultant pharmacist); 46 members excluded, unable to identify facility's pharmacy provider. Directors of nursing, medical directors, and administrators were asked to rate long-term care pharmacy provider performance of eight commonly offered pharmacy services. All groups evaluated pharmacy provider performance of these services using a five-point scale. Results are broken down by employer type. Average rating for eight pharmacy services was 3.64. Top two services: "Labeling medications accurately" ranked in top 1-2 services for all groups (combined rating of 3.97) and "Provides medication administration system" ranked in top 1-3 services for all groups (combined rating of 3.95). One service, "Provides educational inservices," ranked lowest for all groups (combined rating of 3.54). In general, when looking at the eight services in combination for all providers, all services were ranked between Good and Very Good (average score of 3.64). Therefore, while the pharmacy provider is performing above average for these services, there is room for improvement in all of these services. These results can be used as a benchmark. Detailed data results and sample surveys are available online at www.ascp.com/supplements. These surveys can be used by the pharmacy provider to solicit assessments from their own facilities on these services.

  9. Promoting weight management services in community pharmacy: perspectives of the pharmacy team in Scotland.

    Science.gov (United States)

    Weidmann, Anita Elaine; MacLure, Katie; Marshall, Sarah; Gray, Gwen; Stewart, Derek

    2015-08-01

    Obesity has reached pandemic levels with more than 1.4 billion adults affected worldwide. While there is a need to systematically develop and evaluate community pharmacy based models of weight management, it is imperative to describe and understand the perspectives of pharmacy staff. In the UK, trained and accredited community pharmacy medicines counter assistants (MCAs) are commonly the front line staff involved in patient consultations and sale of over-the-counter medicines. To explore the beliefs and experiences of pharmacists and MCAs in the North-East of Scotland on community pharmacy weight management. All 135 community pharmacies in the North-East of Scotland. A qualitative approach of semi-structured telephone interviews with 31 pharmacists and 20 MCAs in the North-East of Scotland. The semi-structured interview schedule was developed with reference to key domains describing professional practice (i.e. awareness and knowledge, skills, practicalities, motivation, acceptance and beliefs) and contextualised with policy documents and published research on community pharmacy based weight management. Interviews were audio-recorded, transcribed and analysed thematically. Pharmacists' and MCAs' beliefs and experiences with delivering weight management services in community pharmacy. There were mixed responses from pharmacists and MCAs around pharmacy based weight management services from positive views of providing the service in community pharmacy to those more reticent who would always favour patients visiting their physician. While all described similar services e.g. measurement of weight, healthy eating advice, supply of products, they acknowledged that support was often opportunistic at the request of customers, with little integration of other providers. Roles described varied from pharmacist only functions to any staff member. While pharmacists generally felt comfortable and confident, MCAs gave more diverse responses. Both Pharmacist and MCAs highlighted

  10. Contested space in the pharmacy: public attitudes to pharmacy harm reduction services in the West of Scotland.

    Science.gov (United States)

    Gidman, Wendy; Coomber, Ross

    2014-01-01

    Internationally, community pharmacies have become increasingly involved in providing harm reduction services and health advice to people who use illicit drugs. This paper considers public opinion of community pharmacy services. It discusses attitudes to harm reduction services in the context of stigmatization of addiction and people who use drugs. This exploratory study involved twenty-six purposively sampled members of the public, from the West of Scotland, participating in one of 5 focus groups. The groups were composed to represent known groups of users and non-users of community pharmacy, none of whom were problem drug users. Three thematic categories were identified: methadone service users in community pharmacies; attitudes to harm reduction policies; contested space. Harm reduction service expansion has resulted in a high volume of drug users in and around some Scottish pharmacies. Even if harm reduction services are provided discretely users' behavior can differentiate them from other pharmacy users. Drug users' behavior in this setting is commonly perceived to be unacceptable and can deter other consumers from using pharmacy services. The results of this study infer that negative public opinion is highly suggestive of stereotyping and stigmatization of people who use drugs. Participants considered that (1) community pharmacies were unsuitable environments for harm reduction service provision, as they are used by older people and those with children; (2) current drug policy is perceived as ineffective, as abstinence is seldom achieved and methadone was reported to be re-sold; (3) people who use drugs were avoided where possible in community pharmacies. Community pharmacy harm reduction services increasingly bring together the public and drug users. Study participants were reluctant to share pharmacy facilities with drug users. This paper concludes by suggesting mechanisms to minimize stigmatization. Copyright © 2014 Elsevier Inc. All rights reserved.

  11. Measurement of patient satisfaction with community pharmacy services: a review.

    Science.gov (United States)

    Naik Panvelkar, Pradnya; Saini, Bandana; Armour, Carol

    2009-10-01

    The aim of this review is to conduct an in-depth analysis of the available literature in order to identify and evaluate studies measuring patient satisfaction with pharmacy services delivered by pharmacists in a community setting. An extensive literature search was conducted in five databases (Medline, Scopus, Embase, Psychinfo, International Pharmaceutical Abstracts) using the search terms "patient/client/consumer satisfaction" AND "community pharmacy/pharmacies" AND "pharmacy service/pharmaceutical services/pharmacy program/intervention/intervention studies". Only those articles where the main focus was measuring patient satisfaction with services delivered in community pharmacies were included in the review. Patient satisfaction was explored with three different levels of pharmacy services -- general services, intervention services and cognitive services. Twenty-four articles measuring patient satisfaction with community pharmacy services were retrieved. Of these, eleven measured patient satisfaction with general services, six measured satisfaction with intervention services and seven measured satisfaction with cognitive services. The majority of studies reviewed had adopted and measured satisfaction as a multidimensional construct. None of the studies reviewed tested any theoretical models of satisfaction. Further a lack of consistent instruments measuring patient satisfaction was observed, with most of the reviewed studies using self developed, non-validated or ad hoc instruments with items from various previously published papers. The review also observed high levels of patient satisfaction with pharmacy services be they general, intervention or cognitive services. This review found that patient satisfaction has been measured within the community pharmacy context to a certain degree. Further research is needed to develop and test instruments based on theoretical frameworks, to test satisfaction pre and post hoc and in well designed randomized controlled

  12. Consumers and Carers Versus Pharmacy Staff: Do Their Priorities for Australian Pharmacy Services Align?

    Science.gov (United States)

    McMillan, Sara S; Kelly, Fiona; Sav, Adem; Kendall, Elizabeth; King, Michelle A; Whitty, Jennifer A; Wheeler, Amanda J

    2015-10-01

    Health professionals, including pharmacists, are encouraged to meet the needs of their consumers in an efficient and patient-centred manner. Yet, there is limited information as to what consumers with chronic conditions need from pharmacy as a healthcare destination or how well pharmacy staff understand these needs. The aim of this study was to identify service user priorities for ideal community pharmacy services for consumers with chronic conditions and their carers, and compare these priorities with what pharmacy staff think these groups want. The nominal group technique was undertaken with pharmacist, pharmacy support staff, consumer and carer groups in four Australian regions between December 2012 and April 2013. Participant ideas and priorities for ideal services or care were identified, and contextual insight was obtained by thematic analysis. Twenty-one nominal group sessions are accepted, including 15 consumer and carer, four pharmacist and two pharmacy support staff groups. Pharmacy staff views generally aligned with consumer priorities, such as access, affordability, patient-centred care and continuity and coordinated care, yet diverged with respect to consumer information or education on medication and services. Fundamentally, consumers and carers sought streamlined access to information and medication, in a coordinated, patient-centred approach. Alleviating financial burden was a key consumer priority, with a call for the continuation and extension of medication subsidies. Overall, pharmacy staff had a reasonable understanding of what consumers would prioritise, but further emphasis on the importance, delivery, or both, of consumer information is needed. Greater consideration is needed from policy makers regarding the financial barriers to accessing medication for consumers with chronic conditions.

  13. Towards equitable access to medicines for the rural poor: analyses of insurance claims reveal rural pharmacy initiative triggers price competition in Kyrgyzstan.

    Science.gov (United States)

    Waning, Brenda; Maddix, Jason; Tripodis, Yorghos; Laing, Richard; Leufkens, Hubert Gm; Gokhale, Manjusha

    2009-12-14

    A rural pharmacy initiative (RPI) designed to increase access to medicines in rural Kyrgyzstan created a network of 12 pharmacies using a revolving drug fund mechanism in 12 villages where no pharmacies previously existed. The objective of this study was to determine if the establishment of the RPI resulted in the unforeseen benefit of triggering medicine price competition in pre-existing (non-RPI) private pharmacies located in the region. We conducted descriptive and multivariate analyses on medicine insurance claims data from Kyrgyzstan's Mandatory Health Insurance Fund for the Jumgal District of Naryn Province from October 2003 to December 2007. We compared average quarterly medicine prices in competitor pharmacies before and after the introduction of the rural pharmacy initiative in October 2004 to determine the RPI impact on price competition. Descriptive analyses suggest competitors reacted to RPI prices for 21 of 30 (70%) medicines. Competitor medicine prices from the quarter before RPI introduction to the end of the study period decreased for 17 of 30 (57%) medicines, increased for 4 of 30 (13%) medicines, and remained unchanged for 9 of 30 (30%) medicines. Among the 9 competitor medicines with unchanged prices, five initially decreased in price but later reverted back to baseline prices. Multivariate analyses on 19 medicines that met sample size criteria confirm these findings. Fourteen of these 19 (74%) competitor medicines changed significantly in price from the quarter before RPI introduction to the quarter after RPI introduction, with 9 of 19 (47%) decreasing in price and 5 of 19 (26%) increasing in price. The RPI served as a market driver, spurring competition in medicine prices in competitor pharmacies, even when they were located in different villages. Initiatives designed to increase equitable access to medicines in rural regions of developing and transitional countries should consider the potential to leverage medicine price competition as a means

  14. Towards equitable access to medicines for the rural poor: analyses of insurance claims reveal rural pharmacy initiative triggers price competition in Kyrgyzstan

    Directory of Open Access Journals (Sweden)

    Leufkens Hubert GM

    2009-12-01

    Full Text Available Abstract Background A rural pharmacy initiative (RPI designed to increase access to medicines in rural Kyrgyzstan created a network of 12 pharmacies using a revolving drug fund mechanism in 12 villages where no pharmacies previously existed. The objective of this study was to determine if the establishment of the RPI resulted in the unforeseen benefit of triggering medicine price competition in pre-existing (non-RPI private pharmacies located in the region. Methods We conducted descriptive and multivariate analyses on medicine insurance claims data from Kyrgyzstan's Mandatory Health Insurance Fund for the Jumgal District of Naryn Province from October 2003 to December 2007. We compared average quarterly medicine prices in competitor pharmacies before and after the introduction of the rural pharmacy initiative in October 2004 to determine the RPI impact on price competition. Results Descriptive analyses suggest competitors reacted to RPI prices for 21 of 30 (70% medicines. Competitor medicine prices from the quarter before RPI introduction to the end of the study period decreased for 17 of 30 (57% medicines, increased for 4 of 30 (13% medicines, and remained unchanged for 9 of 30 (30% medicines. Among the 9 competitor medicines with unchanged prices, five initially decreased in price but later reverted back to baseline prices. Multivariate analyses on 19 medicines that met sample size criteria confirm these findings. Fourteen of these 19 (74% competitor medicines changed significantly in price from the quarter before RPI introduction to the quarter after RPI introduction, with 9 of 19 (47% decreasing in price and 5 of 19 (26% increasing in price. Conclusions The RPI served as a market driver, spurring competition in medicine prices in competitor pharmacies, even when they were located in different villages. Initiatives designed to increase equitable access to medicines in rural regions of developing and transitional countries should consider the

  15. Discrete choice experiments of pharmacy services: a systematic review.

    Science.gov (United States)

    Vass, Caroline; Gray, Ewan; Payne, Katherine

    2016-06-01

    Background Two previous systematic reviews have summarised the application of discrete choice experiments to value preferences for pharmacy services. These reviews identified a total of twelve studies and described how discrete choice experiments have been used to value pharmacy services but did not describe or discuss the application of methods used in the design or analysis. Aims (1) To update the most recent systematic review and critically appraise current discrete choice experiments of pharmacy services in line with published reporting criteria and; (2) To provide an overview of key methodological developments in the design and analysis of discrete choice experiments. Methods The review used a comprehensive strategy to identify eligible studies (published between 1990 and 2015) by searching electronic databases for key terms related to discrete choice and best-worst scaling (BWS) experiments. All healthcare choice experiments were then hand-searched for key terms relating to pharmacy. Data were extracted using a published checklist. Results A total of 17 discrete choice experiments eliciting preferences for pharmacy services were identified for inclusion in the review. No BWS studies were identified. The studies elicited preferences from a variety of populations (pharmacists, patients, students) for a range of pharmacy services. Most studies were from a United Kingdom setting, although examples from Europe, Australia and North America were also identified. Discrete choice experiments for pharmacy services tended to include more attributes than non-pharmacy choice experiments. Few studies reported the use of qualitative research methods in the design and interpretation of the experiments (n = 9) or use of new methods of analysis to identify and quantify preference and scale heterogeneity (n = 4). No studies reported the use of Bayesian methods in their experimental design. Conclusion Incorporating more sophisticated methods in the design of pharmacy

  16. Pharmacy Service Orientation: a measure of organizational culture in pharmacy practice sites.

    Science.gov (United States)

    Clark, Bartholomew E; Mount, Jeanine K

    2006-03-01

    The importance of organizational culture in shaping everyday organizational life is well accepted, but little work has focused on organizational culture in pharmacy. Examining new pharmacists' experiences at various practice sites may help us to understand how these shape their professional ethos and practice habits. (1) Present development and assessment of the Pharmacy Service Orientation (PSO) measure, a tool for assessing pharmacists' impressions of pharmacy practice sites. (2) Use data gathered from a sample of new pharmacists to explore potential predictors of PSO, including type of practice site, type of pharmacy work experience, and type of pharmacy degree. Mail survey of randomly selected class of 1999 pharmacy graduates within 3 months of graduation (response rate: 259 of 1,850; 14%), each of whom reported on up to 6 different pharmacy practice sites for a total of 1,192 pharmacy observations. Pharmacy Service Orientation is scored on a 1-10 semantic differential scale and reliability was assessed using Cronbach's alpha. Predictors of PSO were explored using t test and ordinary least squares regression procedures. Reliability of the PSO across all observations was 0.86. When divided according to recency of experience and type of experience, reliabilities ranged from 0.78 to 0.87. Analysis of potential predictors of PSO showed that non-corporate-community sites had significantly greater pharmaceutical care-oriented cultures (mean PSOs of 7.42 and 5.13, respectively; PService Orientation is a reliable measure. Statistically significant differences in PSO comparisons by degree and by experience type are explained by significant differences between the PSOs of corporate-community and non-corporate-community sites.

  17. Developing a business-practice model for pharmacy services in ambulatory settings.

    Science.gov (United States)

    Harris, Ila M; Baker, Ed; Berry, Tricia M; Halloran, Mary Ann; Lindauer, Kathleen; Ragucci, Kelly R; McGivney, Melissa Somma; Taylor, A Thomas; Haines, Stuart T

    2008-02-01

    A business-practice model is a guide, or toolkit, to assist managers and clinical pharmacy practitioners in the exploration, proposal, development and implementation of new clinical pharmacy services and/or the enhancement of existing services. This document was developed by the American College of Clinical Pharmacy Task Force on Ambulatory Practice to assist clinical pharmacy practitioners and administrators in the development of business-practice models for new and existing clinical pharmacy services in ambulatory settings. This document provides detailed instructions, examples, and resources on conducting a market assessment and a needs assessment, types of clinical services, operations, legal and regulatory issues, marketing and promotion, service development and exit plan, evaluation of service outcomes, and financial considerations in the development of a clinical pharmacy service in the ambulatory environment. Available literature is summarized, and an appendix provides valuable citations and resources. As ambulatory care practices continue to evolve, there will be increased knowledge of how to initiate and expand the services. This document is intended to serve as an essential resource to assist in the growth and development of clinical pharmacy services in the ambulatory environment.

  18. Assessing the efficiency of hospital pharmacy services in Thai public district hospitals.

    Science.gov (United States)

    Rattanachotphanit, Thananan; Limwattananon, Chulaporn; Limwattananon, Supon; Johns, Jeff R; Schommer, Jon C; Brown, Lawrence M

    2008-07-01

    The purpose of this study was to assess the efficiency of hospital pharmacy services and to determine the environmental factors affecting pharmacy service efficiency. The technical efficiency of a hospital pharmacy was assessed to evaluate the hospital's ability to use pharmacy manpower in order to produce the maximum output of the pharmacy service. Data Envelopment Analysis (DEA) was used as an efficiency measurement. The two labor inputs were pharmacists and support personnel and the ten outputs were from four pharmacy activities: drug dispensing, drug purchasing and inventory control, patient-oriented activities, and health consumer protection services. This was used to estimate technical efficiency. A Tobit regression model was used to determine the effect of the hospital size, location, input mix of pharmacy staff, working experience of pharmacists at the study hospitals, and use of technology on the pharmacy service efficiency. Data for pharmacy service input and output quantities were obtained from 155 respondents. Nineteen percent were found to have full efficiency with a technical efficiency score of 1.00. Thirty-six percent had a technical efficiency score of 0.80 or above and 27% had a low technical efficiency score (location were significantly associated with pharmacy service efficiency.

  19. Future economic outlook of Nebraska rural community pharmacies based on break-even analysis of community operational costs and county population.

    Science.gov (United States)

    Keast, Shellie L; Jacobs, Elgene; Harrison, Donald; Farmer, Kevin; Thompson, David

    2010-09-01

    There is growing concern over increasingly limited access to local health care, including pharmacies, for rural citizens of the United States. Although geographically distant from most competitors, rural pharmacies may still struggle to generate an acceptable profit to remain economically viable. Therefore, a method for calculating the economic viability for a community pharmacy to recruit a potential new owner to assume the entrepreneurial risk is an important issue to consider when evaluating rural pharmacy access. The primary objective of this study was to use a modified break-even analysis to predict the future financial potential of the current pharmacy business to attract a new owner. The secondary objective was to forecast a risk level for a Nebraska county to sustain the number of pharmacies in the country beyond current ownership. This research used data provided by pharmacies that responded to a Nebraska Medicaid cost of dispensing (COD) survey in addition to data from the US Census Bureau, US Office of Management and Budget, and the Nebraska State Board of Pharmacy. Break-even analysis was used to determine the point where the prescription volume of the pharmacy not only covered the variable and fixed costs but also maintained a reasonable profit to attract new ownership. Counties were classified into 3 risk levels based on the projected available prescription volume and the number of pharmacies in each county. Sensitivity analysis was performed on the risk levels to determine the impact of variance in projected available prescription volume on the projected future outlook for the pharmacies in each county. Regression analysis of responses to the COD survey indicated that the annual break-even prescription volume ranged from 44,790 to 49,246 prescriptions per pharmacy per annum. The number of rural Nebraska pharmacies was projected to decline from 126 to 78. The number of counties in Nebraska without a single pharmacy was projected to increase from 19 to

  20. Community pharmacy-based asthma services--what do patients prefer?

    Science.gov (United States)

    Naik Panvelkar, Pradnya; Armour, Carol; Saini, Bandana

    2010-12-01

    Patient preferences can influence the outcomes of treatment and so understanding and organizing health-care services around these preferences is vital. To explore patient preferences for types of community pharmacy-based asthma services, to investigate the influence of "experience" in molding preferences for such services, and to identify aspects of the services that patients prefer over others. Semistructured face-to-face interviews were conducted with a convenience sample of two types of asthma patients: (1) those naïve to a specialized asthma service and (2) those who had experienced a specialized asthma service. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed. Eighteen interviews were conducted (8 experienced patients, 10 naïve patients). The majority of the patients wanted the pharmacist to play a greater role in their asthma management. Patients experiencing increased levels of service had increased levels of expectations as well as more specific preferences for various aspects of the service. The key aspects of an asthma service that all patients wanted their pharmacists to provide were the provision of information about asthma and its medications, lung function testing and monitoring of their asthma, and checking/correcting their inhaler technique. Patients also expressed a desire for skilled communication and behavioral aspects from the pharmacist such as friendliness, empathy, attentiveness, and dedicated time. Patients highlighted the importance of privacy in the pharmacy. There was a high level of satisfaction toward the currently delivered asthma service among both naïve and experienced patients. The provision of the specialized service was associated with increased patient loyalty to the particular pharmacy. All patients indicated a willingness to participate in future pharmacy-delivered specialized asthma services. Elements of the specialized pharmacy-based asthma services important from a patient's perspective were

  1. A pharmacogenetics service experience for pharmacy students, residents, and fellows.

    Science.gov (United States)

    Drozda, Katarzyna; Labinov, Yana; Jiang, Ruixuan; Thomas, Margaret R; Wong, Shan S; Patel, Shitalben; Nutescu, Edith A; Cavallari, Larisa H

    2013-10-14

    To utilize a comprehensive, pharmacist-led warfarin pharmacogenetics service to provide pharmacy students, residents, and fellows with clinical and research experiences involving genotype-guided therapy. First-year (P1) through fourth-year (P4) pharmacy students, pharmacy residents, and pharmacy fellows participated in a newly implemented warfarin pharmacogenetics service in a hospital setting. Students, residents, and fellows provided genotype-guided dosing recommendations as part of clinical care, or analyzed samples and data collected from patients on the service for research purposes. Students', residents', and fellows' achievement of learning objectives was assessed using a checklist based on established core competencies in pharmacogenetics. The mean competency score of the students, residents, and fellows who completed a clinical and/or research experience with the service was 97% ±3%. A comprehensive warfarin pharmacogenetics service provided unique experiential and research opportunities for pharmacy students, residents, and fellows and sufficiently addressed a number of core competencies in pharmacogenetics.

  2. Recommendations for Planning and Managing International Short-term Pharmacy Service Trips.

    Science.gov (United States)

    Johnson, Kalin L; Alsharif, Naser Z; Rovers, John; Connor, Sharon; White, Nicole D; Hogue, Michael D

    2017-03-25

    International pharmacy service trips by schools and colleges of pharmacy allow students to provide health care to medically underserved areas. A literature review (2000-2016) in databases and Internet searches with specific keywords or terms was performed to assess current practices to establish and maintain successful pharmacy service trips. Educational documents such as syllabi were obtained from pharmacy programs and examined. A preliminary draft was developed and authors worked on sections of interest and expertise. Considerations and current recommendations are provided for the key aspects of the home institution and the host country requirements for pharmacy service trips based on findings from a literature search and the authors' collective, extensive experience. Evaluation of the trip and ethical considerations are also discussed. This article serves as a resource for schools and colleges of pharmacy that are interested in the development of new pharmacy service trips and provides key considerations for continuous quality improvement of current or future activities.

  3. Attitudes toward working in rural areas of Thai medical, dental and pharmacy new graduates in 2012: a cross-sectional survey

    Science.gov (United States)

    2013-01-01

    Background Inequity in health workforce distribution has been a national concern of the Thai health service for decades. The government has launched various policies to increase the distribution of health workforces to rural areas. However, little is known regarding the attitudes of health workers and the factors influencing their decision to work in rural areas. This study aimed to explore the current attitudes of new medical, dental and pharmacy graduates as well as determine the linkage between their characteristics and the preference for working in rural areas. Methods A cross-sectional survey was conducted, using self-administered questionnaires, with a total of 1,225 medical, dental and pharmacy graduates. They were participants of the meeting arranged by the Ministry of Public Health (MOPH) on 1–2 April 2012. Descriptive statistics using mean and percentage, and inferential statistics using logistic regression with marginal effects, were applied for data analysis. Results There were 754 doctors (44.4%), 203 dentists (42.6%) and 268 pharmacists (83.8%) enrolled in the survey. Graduates from all professions had positive views towards working in rural areas. Approximately 22% of doctors, 31% of dentists and 52% of pharmacists selected ‘close proximity to hometown’ as the most important reason for workplace selection. The multivariable analysis showed a variation in attributes associated with the tendency to work in rural areas across professions. In case of doctors, special track graduates had a 10% higher tendency to prefer rural work than those recruited through the national entrance examination. Conclusions The majority of graduates chose to work in community hospitals, and attitudes towards rural work were quite positive. In-depth analysis found that factors influencing their choice varied between professions. Special track recruitment positively influenced the selection of rural workplaces among new doctors attending the MOPH annual meeting for

  4. Flexibility in community pharmacy: a qualitative study of business models and cognitive services.

    Science.gov (United States)

    Feletto, Eleonora; Wilson, Laura K; Roberts, Alison S; Benrimoj, Shalom I

    2010-04-01

    To identify the capacity of current pharmacy business models, and the dimensions of organisational flexibility within them, to integrate products and services as well as the perceptions of viability of these models. Fifty-seven semi-structured interviews were conducted with community pharmacy owners or managers and support staff in 30 pharmacies across Australia. A framework of organisational flexibility was used to analyse their capacity to integrate services and perceptions of viability. Data were analysed using the method of constant comparison by two independent researchers. The study found that Australian community pharmacies have used the four types of flexibility to build capacity in distinct ways and react to changes in the local environment. This capacity building was manifested in four emerging business models which integrate services to varying degrees: classic community pharmacy, retail destination pharmacy, health care solution pharmacy and networked pharmacy. The perception of viability is less focused on dispensing medications and more focused on differentiating pharmacies through either a retail or services focus. Strategic flexibility appeared to offer pharmacies the ability to integrate and sustainably deliver services more successfully than other types, as exhibited by health care solution and networked pharmacies. Active support and encouragement to transition from being dependent on dispensing to implementing services is needed. The study showed that pharmacies where services were implemented and showed success are those strategically differentiating their businesses to become focused health care providers. This holistic approach should inevitably influence the sustainability of services.

  5. Billing for outpatient transplant pharmacy services.

    Science.gov (United States)

    Maldonado, Angela Q; Seiger, Todd C; Urann, Christina L; McCleary, Jo Ann; Goroski, Angela L; Ojogho, Okechukwu N

    2012-01-15

    The economic impact of out-patient pharmacy services in a transplant program was evaluated. Full-time kidney transplant pharmacy services were implemented at Providence Sacred Heart Medical Center (PSHMC) in the fall of 2008, with two pharmacists combining hours to provide one full-time-equivalent position. At PSHMC, posttransplantation patients are seen three times per week. The number of patient visits with pharmacists for 2010 was compared with the total number of patient visits. The face-to-face time spent with the patient was translated to a level of billing that was associated with a set reimbursement schedule. For each patient encounter in which a pharmacist was involved, the incremental difference between the nursing and pharmacy levels of billing was examined, as were the levels most often billed by pharmacists. The difference in billing levels between pharmacists and nurses for the same patient encounter was also evaluated. Overall, pharmacist visits accounted for 208 (22%) of the 994 out-patient kidney transplant visits in 2010, with pharmacists billing at a higher level of acuity compared with nursing for the same patient encounter 48% of the time. This translated to an approximate increase of $100 per patient visit. For the one-year study period, pharmacists utilizing facility- fee billing increased out-patient reimbursement by approximately $10,000. By utilizing outpatient facility-fee billing for pharmacy services, the transplant program at PSHMC increased reimbursement in the outpatient setting.

  6. Informal learning processes in support of clinical service delivery in a service-oriented community pharmacy.

    Science.gov (United States)

    Patterson, Brandon J; Bakken, Brianne K; Doucette, William R; Urmie, Julie M; McDonough, Randal P

    The evolving health care system necessitates pharmacy organizations' adjustments by delivering new services and establishing inter-organizational relationships. One approach supporting pharmacy organizations in making changes may be informal learning by technicians, pharmacists, and pharmacy owners. Informal learning is characterized by a four-step cycle including intent to learn, action, feedback, and reflection. This framework helps explain individual and organizational factors that influence learning processes within an organization as well as the individual and organizational outcomes of those learning processes. A case study of an Iowa independent community pharmacy with years of experience in offering patient care services was made. Nine semi-structured interviews with pharmacy personnel revealed initial evidence in support of the informal learning model in practice. Future research could investigate more fully the informal learning model in delivery of patient care services in community pharmacies. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Potential for Pharmacy-Public Health Collaborations Using Pharmacy-Based Point-of-Care Testing Services for Infectious Diseases.

    Science.gov (United States)

    Gubbins, Paul O; Klepser, Michael E; Adams, Alex J; Jacobs, David M; Percival, Kelly M; Tallman, Gregory B

    Health care professionals must continually identify collaborative ways to combat antibiotic resistance while improving community health and health care delivery. Clinical Laboratory Improvement Amendments of 1988 (CLIA)-waived point-of-care (POC) testing (POCT) services for infectious disease conducted in community pharmacies provide a means for pharmacists to collaborate with prescribers and/or public health officials combating antibiotic resistance while improving community health and health care delivery. To provide a comprehensive literature review that explores the potential for pharmacists to collaborate with public health professionals and prescribers using pharmacy-based CLIA-waived POCT services for infectious diseases. Comprehensive literature review. PubMed and Google Scholar were searched for manuscripts and meeting abstracts for the following key words: infectious disease, community pharmacy, rapid diagnostic tests, rapid assay, and POC tests. All relevant manuscripts and meeting abstracts utilizing POCT in community pharmacies for infectious disease were reviewed. Information regarding the most contemporary evidence regarding CLIA-waived POC infectious diseases tests for infectious diseases and their use in community pharmacies was synthesized to highlight and identify opportunities to develop future collaborations using community pharmacy-based models for such services. Evidence demonstrates that pharmacists in collaboration with other health care professionals can leverage their knowledge and accessibility to provide CLIA-waived POCT services for infectious diseases. Testing for influenza may augment health departments' surveillance efforts, help promote rationale antiviral use, and avoid unnecessary antimicrobial therapy. Services for human immunodeficiency virus infection raise infection status awareness, increase access to health care, and facilitate linkage to appropriate care. Testing for group A streptococcal pharyngitis may curb inappropriate

  8. Identifying relationships between the professional culture of pharmacy, pharmacists' personality traits, and the provision of advanced pharmacy services.

    Science.gov (United States)

    Rosenthal, Meagen; Tsao, Nicole W; Tsuyuki, Ross T; Marra, Carlo A

    2016-01-01

    Legislative changes are affording pharmacists the opportunity to provide more advanced pharmacy services. However, many pharmacists have not yet been able to provide these services sustainably. Research from implementation science suggests that before sustained change in pharmacy can be achieved an improved understanding of pharmacy context, through the professional culture of pharmacy and pharmacists' personality traits, is required. The primary objective of this study was to investigate possible relationships between cultural factors, and personality traits, and the uptake of advanced practice opportunities by pharmacists in British Columbia, Canada. The study design was a cross-sectional survey of registered, and practicing, pharmacists from one Canadian province. The survey gauged respondents' characteristics, practice setting, and the provision of advanced pharmacy services, and contained the Organizational Culture Profile (OCP), a measure of professional culture, as well as the Big Five Inventory (BFI), a measure of personality traits. A total of 945 completed survey instruments were returned. The majority of respondents were female (61%), the average age of respondents was 42 years (SD: 12), and the average number of years in practice was 19 (SD: 12). A significant positive relationship was identified for respondents perceiving greater value in the OCP factors competitiveness and innovation and providing a higher number of all advanced services. A positive relationship was observed for respondents scoring higher on the BFI traits extraversion and the immunizations provided, and agreeableness and openness and medication reviews completed. This is the first work to identify statistically significant relationships between the OCP and BFI, and the provision of advanced pharmacy services. As such, this work serves as a starting place from which to develop more detailed insight into how the professional culture of pharmacy and pharmacists personality traits may

  9. Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

    Science.gov (United States)

    Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

    2015-09-01

    The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  10. Pharmacy students' provision of health promotion counseling services during a community pharmacy clerkship: a cross sectional study, Northwest Ethiopia.

    Science.gov (United States)

    Gelayee, Dessalegn Asmelashe; Mekonnen, Gashaw Binega

    2018-05-04

    Globally, undergraduate pharmacy education comprises practice programs aimed to address different competencies. This study was intended to investigate pharmacy students' provision of health promotion (HP) counseling services during a community pharmacy clerkship in Northwest Ethiopia. A prospective cross-sectional study was conducted on fifty one fifth-year pharmacy students immediately after completion of a 2-week community pharmacy clerkship. Data were collected through a self-administered questionnaire. Relationship between variables was examined using Pearson's Chi-square test of independence, Mann-Whitney U test, and Spearman's rank correlation coefficient. The mean number of HP counseling service types delivered during the clerkship was 6.3 ± 2.8 out of 12. It is positively correlated with the number of HP counseling service types delivered in students' previous training (rho =0.437, p = 0.001). Nearly half (n = 25, 49%) of the students were actively-involved (i.e delivered ≥ 7 types of HP counseling service types) in the service and those who were well involved in previous training are more likely to do the same during the clerkship (X 2  = 4.581, p = 0.032). The main barriers perceived to hinder health promotion service were clients' lack of time and interest as well as absence of a guideline for health promotion service. Community pharmacy clerkship is a good opportunity for pharmacy students to develop health promotion counseling skill. Clerkship performance can best be improved through successful exposures to similar activities in previous courses and students shall be encouraged to carry out self-assessments of their health promotion counseling practice against standards set for the clerkship.

  11. Collaboration with pharmacy services in a family practice for the medically underserved

    Directory of Open Access Journals (Sweden)

    Campbell K

    2009-12-01

    Full Text Available Objectives: Pharmacist-managed collaborative services in a family practice setting are described, and diabetes and hypertension outcomes are assessed.Methods: Pharmacist-managed clinics, pharmacotherapy consultations, and drug information services are provided for a medically underserved, predominantly African American population. A pharmacy residency director, an ambulatory care pharmacy resident and three PharmD candidate student pharmacists work directly with physicians, nurse practitioners, nurses, and social workers to form an interdisciplinary health care team. Providers utilize pharmacy services through consultations and referrals. Collaboration outcomes were evaluated in twenty-two patients with diabetes and thirty hypertensive patients. Patients were retrospectively followed throughout their history with pharmacy service. Hemoglobin A1c (A1C was tracked before referral to pharmacy services, 3 to 6 months after, and as the most current measure after at least 6 months. Blood pressure (BP was observed before pharmacy involvement, 2 to 4 months later, and then currently for at least 4 months with the service. The mean of the most current markers was calculated, and the percent of patients at their goal marker was compared to national averages.Results: Fifty percent of pharmacy service patients met the American Diabetes Association hemoglobin A1c goal of less than 7% in our evaluation compared to the national mean of 49.8% overall and 44% in African Americans. Thirty percent of patients were at their BP goal while 33.1% of patients without diabetes and 33.2% of patients with diabetes nationally are at goal. Conclusion: The medically underserved patients under the care of pharmacy services achieved a higher percentage at their A1C goal than the national mean. The percentage of patients who achieved their BP goals was comparable to the national average. Increasing utilization of pharmacy services in the family practice setting allows for

  12. Implementation of a pharmacogenomics service in a community pharmacy.

    Science.gov (United States)

    Ferreri, Stefanie P; Greco, Angelo J; Michaels, Natasha M; O'Connor, Shanna K; Chater, Rebecca W; Viera, Anthony J; Faruki, Hawazin; McLeod, Howard L; Roederer, Mary W

    2014-01-01

    OBJECTIVE To determine the feasibility of implementing a pharmacogenomics service in a community pharmacy. SETTING A single community pharmacy that is part of a regional chain known for offering innovative pharmacy services. PRACTICE DESCRIPTION Community pharmacists at the project site routinely provide clinical pharmacy services, including medication therapy management, immunizations, point-of-care testing, blood pressure monitoring, and diabetes education. PRACTICE INNOVATION The implementation of a pharmacogenomic testing and interpretation service for the liver isoenzyme cytochrome P450 2C19. PARTICIPANTS 18 patients taking clopidogrel, a drug metabolized by CYP2C19. MAIN OUTCOME MEASURES Rate of patient participation, rate of prescriber acceptance of pharmacist recommendation, time to perform genetic testing service, and number of claims submitted to and paid by insurance. RESULTS Of 41 patients taking clopidogrel and meeting project criteria, 18 (43.9%) enrolled and completed testing and interpretation of pharmacogenomic results. The mean time pharmacists spent completing all stages of the project with each participant was 76.6 minutes. The mean time to complete participation in the project (time between person's first and second visit) was 30.1 days. Nine patients had wild-type alleles, and pharmacists recommended continuation of therapy as ordered. Genetic variants were found in the other nine patients, and all pharmacist recommendations for modifications in therapy were ultimately accepted by prescribers. Overall, 17 patients consented to filing of reimbursement claims with their insurers. Five were not able to be billed due to submission difficulties. Of the remaining 12, none was paid. CONCLUSION A pharmacogenomics service can be an extension of medication therapy management services in a community pharmacy. Prescribers are receptive to having community pharmacists conduct pharmacogenomics testing, but reimbursement is a challenge.

  13. Email medication counseling services provided by Finnish community pharmacies.

    Science.gov (United States)

    Pohjanoksa-Mäntylä, Marika K; Kulovaara, Heidi; Bell, J Simon; Enäkoski, Marianne; Airaksinen, Marja S

    2008-12-01

    The importance of email as a mode of communication between medication users and pharmacists is likely to increase. However, little is known about the email medication counseling practices of community pharmacies. To determine the prevalence of email medication counseling services in Finland and to assess the accuracy and comprehensiveness of responses by pharmacies providing the opportunity for email medication counseling to inquiries related to use of antidepressants. An inventory was made of all Finnish community pharmacies that provided the opportunity for email medication counseling. Data related to the accuracy and comprehensiveness of responses were collected, using a virtual pseudo-customer method with 3 scenarios related to common concerns of patients on antidepressants. Two inquiries were emailed to each pharmacy that provided the opportunity for email medication counseling in January and February 2005. The responses were content analyzed by 2 researchers, using a prestructured scoring system. Almost one-third (30%, n = 182) of Finnish community pharmacies maintained a working Web site, and 94% of those provided the opportunity for email medication counseling. An online "ask-the-pharmacist" service was offered by 13% (n = 23) of the pharmacies with a Web site. Pharmacies responded to 54% of the email inquiries sent by the virtual pseudo-customers. The response rate and the content score ratio between mean and maximum scores varied among the scenarios. The content score ratio was highest for the scenarios concerning the adverse effects of fluoxetine (0.53, n = 55) and interactions with mirtazapine (0.52, n = 63) and lowest for the scenario related to sexual dysfunction and weight gain associated with citalopram (0.38, n = 52). Community pharmacies are potential providers of email medication counseling services. However, more attention should be directed to responding to consumer inquiries and to the content of these responses.

  14. Assessment of Family Planning Services at Community Pharmacies in San Diego, California

    Directory of Open Access Journals (Sweden)

    Sally Rafie

    2013-10-01

    Full Text Available Levonorgestrel emergency contraception and other contraceptive methods are available over-the-counter (OTC; however youth continue to face a number of barriers in accessing healthcare services, including lack of knowledge of the method, fear of loss of privacy, difficulties in finding a provider, and cost. A descriptive, nonexperimental, cross-sectional study of a sample of 112 community pharmacies in San Diego, California was conducted between December 2009 and January 2010 to assess community pharmacy practices related to the availability and accessibility of family planning health pharmacy services and products, particularly to youth. A majority (n = 79/112, 70.5% of the pharmacies carried a wide selection of male condoms; however, the other OTC nonhormonal contraceptive products were either not available or available with limited selection. A majority of the pharmacies sold emergency contraception (n = 88/111, 78.6%. Most patient counseling areas consisted of either a public or a semi-private area. A majority of the pharmacy sites did not provide materials or services targeting youth. Significant gaps exist in providing family planning products and services in the majority of community pharmacies in San Diego, California. Education and outreach efforts are needed to promote provision of products and services, particularly to the adolescent population.

  15. Development and implementation of the compensation plan for pharmacy services in Alberta, Canada.

    Science.gov (United States)

    Breault, Rene R; Whissell, Jeff G; Hughes, Christine A; Schindel, Theresa J

    To describe experiences with development and implementation of a compensation plan for pharmacy services delivered by pharmacists in community pharmacies. Community pharmacy practice in Alberta, Canada. Pharmacists in Alberta have one of the most progressive scopes of practice in North America. They have authority to prescribe drugs independently, administer drugs by injection, access electronic health records, and order laboratory tests. A publicly funded compensation plan for pharmacy services was implemented in 2012. Principles that guided development of the compensation plan aimed to 1) ensure payment for pharmacy services, 2) support pharmacists in using their full scope of practice, 3) enable the development of long-term relationships with patients, 4) facilitate expansion of services delivered by pharmacists, and 5) provide access to pharmacy services for all eligible Albertans. Services covered by the compensation plan include care planning, prescribing, and administering drugs by injection. The guiding principles were used to evaluate experiences with the compensation plan. Claims for pharmacy services covered by the compensation plan increased from 30,000 per month in July 2012 to 170,000 per month in March 2016. From September 2015 to August 2016, 1226 pharmacies submitted claims for services provided by 3901 pharmacists. The number of pharmacists with authorization to prescribe and administer injections continued to increase following implementation of the plan. Alberta's experiences with the development and implementation of the compensation plan will be of interest to jurisdictions considering implementation of remunerated pharmacy services. The potential impact of the plan on health and economic outcomes, in addition to the value of the services as perceived by the public, patients, pharmacists, and other health care providers, should also be explored. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  16. [Barriers for the implementation of cognitive services in Spanish community pharmacies].

    Science.gov (United States)

    Gastelurrutia, Miguel Angel; Fernández-Llimos, Fernando; Benrimoj, Shalom I; Castrillon, Carla Cristina; Faus, María José

    2007-09-01

    To identify and assess barriers for dissemination, implementation, and sustainability of different cognitive services in Spanish community pharmacies. Qualitative study through semi-structured interviews followed by a descriptive analysis. Two groups of experts related to Spanish community pharmacy were chosen. One with 15 community pharmacists with a relevant professional activity, while the other group (n=18) was related to pharmacy strategists. The lack of university clinical oriented learning, lack of pharmacists' attitude towards change and some uncertainty over their professional future were identified as barriers at the pharmacists' level. In relation to pharmacy as an organization the lack of clear messages by their leaders and the small volume of Spanish pharmacies were identified as barriers. In the category of pharmacy profession, the current reimbursement system, the lack of university clinical education, and the lack of leadership by current representative organizations were the barriers found. The lack of real involvement by health authorities, the lack of knowledge about the objectives of pharmacy cognitive services, and the lack of demand of these services by patients where also identified as barriers. Finally, 12 barriers were identified and grouped into 6 categories. These barriers fit in with the barriers identified in other countries.

  17. Consumer willingness to pay for pharmacy services: An updated review of the literature.

    Science.gov (United States)

    Painter, Jacob T; Gressler, Laura; Kathe, Niranjan; Slabaugh, S Lane; Blumenschein, Karen

    2018-02-02

    Quantifying the value of pharmacy services is imperative for the profession as it works to establish an expanded role within evolving health care systems. The literature documents the work that many have contributed toward meeting this goal. To date, however, the preponderance of evidence evaluates the value of pharmacist services to third-party payers; few published studies address the value that consumers place on these services. In 1999, a review of studies that used the contingent valuation method to value pharmacy services was published. The objective of this manuscript is to provide an update of that review. Relevant studies published in the English language were identified searching MEDLINE, ECONLIT and International Pharmaceutical Abstracts databases from January 1999 to November 2017. Only studies that specifically elicited willingness to pay for a community pharmacist provided service from actual or potential consumers were included. Thirty-one studies using the contingent valuation method to value pharmacy services were identified using the search strategy outlined. These studies included surveys in different demographic and geographic populations and valuing various pharmacy services. Improving the quality of studies using contingent valuation to value pharmacy services will aid the profession in marketing pharmacy services to consumers, and may assist practitioners who wish to implement various pharmacy services in their practice settings. A limited number of studies have been conducted, but the quality of contingent valuation studies valuing pharmacist services is improving. Understanding the pharmacy services that consumers value, and understanding the level of their monetary willingness to pay for those services will be crucial as the profession continues to work toward establishing a sustainable and economically viable role within the evolving health care systems. Copyright © 2018. Published by Elsevier Inc.

  18. Pharmacy and primary care perspectives on e-prescribing in a rural community: A focused ethnography.

    Science.gov (United States)

    Kooienga, Sarah; Singh, Reshmi L

    Electronic prescribing (ERx) is the ability for prescriber to send a digital prescription directly to a pharmacist through a dedicated secure network. A number of federally funded incentives such as the health information technology for economic and clinical health (HITECH) and Meaningful Use standards have led to ERx implementation. ERx is an integral part of primary care practice and today most community pharmacies are enabled to accept e-prescriptions. Little is known about the experience of rural pharmacists, primary care providers and patients regarding e-prescribing. This paper reports on the results of ERx from their perspectives. The findings are a portion of a larger qualitative descriptive study focused on the meaning of Meaningful Use in remote rural communities. One remote rural community in the Pacific Northwest was used for this research endeavor. Explore understandings of e-prescribing from both pharmacist and primary care provider perspective. Explore patients' understandings and experiences of e-prescribing. The conceptual model for this research was the Ecological Transactional Model. This model informed the research design, interview questions and analysis. A qualitative descriptive methodology - focused ethnography was used for this study. Six key informant interviews, 14 patient interviews and 15 hours of participant observation provided the data. Data analysis occurred collectively between a social pharmacy researcher, a primary care nurse practitioner-researcher and pharmacy graduate students. The research qualitatively identified contextual understandings and dimensions of ERx in this setting. Based on a focused ethnographic methodology, contextual understandings of rurality and role identity, both pharmacist and primary care provider, were explored. Perspectives on ERx of patients, clinic manager and RN staff were also elicited. Three dimensions of ERx were identified - technological, structural and communication. The structural

  19. Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia.

    Science.gov (United States)

    Ali Jadoo, Saad Ahmed; Aljunid, Syed Mohamed; Nur, Amrizal Muhammad; Ahmed, Zafar; Van Dort, Dexter

    2015-02-10

    The service weight is among several issues and challenges in the implementation of case-mix in developing countries, including Malaysia. The aim of this study is to develop the Malaysian Diagnosis Related Group (MY-DRG) case-mix pharmacy service weight in University Kebangsaan Malaysia-Medical Center (UKMMC) by identifying the actual cost of pharmacy services by MY-DRG groups in the hospital. All patients admitted to UKMMC in 2011 were recruited in this study. Combination of Step-down and Bottom-up costing methodology has been used in this study. The drug and supplies cost; the cost of staff; the overhead cost; and the equipment cost make up the four components of pharmacy. Direct costing approach has been employed to calculate Drugs and supplies cost from electronic-prescription system; and the inpatient pharmacy staff cost, while the overhead cost and the pharmacy equipments cost have been calculated indirectly from MY-DRG data base. The total pharmacy cost was obtained by summing the four pharmacy components' cost per each MY-DRG. The Pharmacy service weight of a MY-DRG was estimated by dividing the average pharmacy cost of the investigated MY-DRG on the average of a specified MY-DRG (which usually the average pharmacy cost of all MY-DRGs). Drugs and supplies were the main component (86.0%) of pharmacy cost compared o overhead cost centers (7.3%), staff cost (6.5%) and pharmacy equipments (0.2%) respectively. Out of 789 inpatient MY-DRGs case-mix groups, 450 (57.0%) groups were utilized by the UKMMC. Pharmacy service weight has been calculated for each of these 450 MY-DRGs groups. MY-DRG case-mix group of Lymphoma & Chronic Leukemia group with severity level three (C-4-11-III) has the highest pharmacy service weight of 11.8 equivalents to average pharmacy cost of RM 5383.90. While the MY-DRG case-mix group for Circumcision with severity level one (V-1-15-I) has the lowest pharmacy service weight of 0.04 equivalents to average pharmacy cost of RM 17.83. A mixed

  20. Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan.

    Science.gov (United States)

    Waning, Brenda; Maddix, Jason; Soucy, Lyne

    2010-07-13

    Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007). Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals. Health systems researchers must document the positive and negative

  1. 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.

  2. Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective

    Directory of Open Access Journals (Sweden)

    Fathima M

    2017-09-01

    % of those diagnosed with COPD were from regional areas. Conclusion: A brief community pharmacy-based COPD case-finding service utilizing the ISQ, LFT and GP referral is feasible and may lead to identification and diagnosis of a substantial number of people with COPD. This might be an important strategy for reducing the burden of COPD, particularly for those living in rural locations. Keywords: COPD, community pharmacy, case finding, case detection, screening

  3. Current status, challenges and the way forward for clinical pharmacy service in Ethiopian public hospitals.

    Science.gov (United States)

    Bilal, Arebu Issa; Tilahun, Zelalem; Gebretekle, Gebremedhin Beedemariam; Ayalneh, Belete; Hailemeskel, Bisrat; Engidawork, Ephrem

    2017-05-19

    Clinical pharmacy service has evolved steadily over the past few decades and is now contributing to the 'patient care journey' at all stages. It is improving the safety and effectiveness of medicines and has made a significant contribution to the avoidance of medication errors. In Ethiopia, clinical pharmacy service is in its initial phase, being started in July 2013. This study therefore aimed at assessing the status, challenges and way forward of clinical pharmacy service in the country. A cross-sectional survey was conducted in six regional states and one city- administration in September 2014. A total of 51 hospitals were included in the study. Both qualitative and quantitative methods were employed for data collection. A total of 160 pharmacy graduates, and 51 pharmacy heads participated in the study. Internal Medicine and Pediatric wards were the major wards where the graduates provide clinical pharmacy service. Almost 94% of the new graduates were found to be involved in clinical pharmacy service, but 47% of them rated their service as poor. The overall satisfaction of the graduates was close to 36%. Thirteen hospitals discontinued and two hospitals not even initiated the service largely due to shortage of pharmacists and lack of management support. About 44% of the surveyed hospitals documented the clinical pharmacy service provided using either developed or adopted formats. Lack of awareness by the medical fraternity, high attrition rate, lack of support from the management as well as from the health care team, readiness of the graduates to deliver the service, and shortage of pharmacists were identified by the key informants as the major stumbling block to deliver clinical pharmacy service. Clinical pharmacy service is initiated in most of the surveyed hospitals and a large proportion of the graduates were involved in the service. Although there is a great enthusiasm to promote clinical pharmacy service in the surveyed hospitals, efforts made to

  4. Practice change in community pharmacy: using change-management principles when implementing a pharmacy asthma management service in NSW, Australia.

    Science.gov (United States)

    Feletto, Eleonora; Lui, Grace Wan Ying; Armour, Carol; Saini, Bandana

    2013-02-01

    This study aimed to investigate the application of a research-based change-management tool, the Pharmacy Change Readiness Wheel (PCRW), in practice, and the impact it had on the implementation of an asthma service (Pharmacy Asthma Management Service or PAMS). All pharmacists implementing the PAMS in the state of New South Wales, Australia, were provided training using a custom-designed module explaining change readiness as it applied to the PAMS. This training and a self-administered PCRW checklist were completed before PAMS implementation. Following PAMS service delivery, semi-structured phone interviews were conducted with the pharmacists and any additional staff involved regarding their experiences of change management. Interviews were transcribed verbatim and content analysed. Thirty seven of the forty five pharmacies who delivered PAMS returned the PCRW checklist (82% response rate) and participants from 29 pharmacies were interviewed (29 pharmacists and six additional staff). Perception of readiness for change before service delivery was remarkably high. From the interviews conducted after service delivery it was evident that systematic management of the practice change using theoretical concepts had not really been undertaken and that many challenges were faced in the implementation of practice change (PAMS). The results of the content analysis from the interviews revealed that factors external or internal to the pharmacy or those related to the individual pharmacist could affect implementation of practice change. Change is not as straightforward as it may appear and is a multi-step process over time. Pharmacists were unaware of this. A change-management framework should be applied to specific services with enough flexibility so that pharmacists can individualise them for their pharmacies. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  5. Decentralized Impatient Pharmacy Service Study: Chief of Pharmacy Survey.

    Science.gov (United States)

    1980-04-01

    operation should *provide the pharmacist with more patient care contact if pharmacists are uti - lized as members of the hospital emergency team. Moreover...experience and knowledge, the pharmacist all too often remains an under-challenged and under-utilized member of the health care team. From April to June 1979...pharmacies surveyed reported having adequate space for Pharmacist -patient consultation and Drug information services. Unit dose medications were

  6. Barriers to the implementation of advanced clinical pharmacy services at Portuguese hospitals.

    Science.gov (United States)

    Brazinha, Isabel; Fernandez-Llimos, Fernando

    2014-10-01

    In some countries, such as Portugal, clinical pharmacy services in the hospital setting may be implemented to a lower extent than desirable. Several studies have analysed the perceived barriers to pharmacy service implementation in community pharmacy. To identify the barriers towards the implementation of advanced clinical pharmacy services at a hospital level in Portugal, using medication follow-up as an example. Hospital pharmacies in Portugal. A qualitative study based on 20 face-to-face semi-structured interviews of strategists and hospital pharmacists. The interview guide was based on two theoretical frameworks, the Borum's theory of organisational change and the Social Network Theory, and then adapted for the Portuguese reality and hospital environments. A constant comparison process with previously analysed interviews, using an inductive approach, was carried out to allow themes to emerge. Themes were organised following the Leavitt's Organizational Model: functions and objectives; hospital pharmacist; structure of pharmacy services; environment; technology; and medication follow-up based on the study topic. Barriers towards practice change. Medication follow-up appeared not to be a well-known service in Portuguese hospital pharmacies. The major barriers at the pharmacist level were their mind-set, resistance to change, and lack of readiness. Lack of time, excessive bureaucratic and administrative workload, reduced workforce, and lack of support from the head of the service and other colleagues were identified as structural barriers. Lack of access to patients' clinical records and cumbersome procedures to implement medication follow-up were recognised as technological barriers. Poor communication with other healthcare professionals, and lack of support from professional associations were the major environmental barriers. Few of the barriers identified by Portuguese hospital pharmacists were consistent with previous reports from community pharmacy. The mind

  7. Service provision in the wake of a new funding model for community pharmacy.

    Science.gov (United States)

    Smith, Alesha J; Scahill, Shane L; Harrison, Jeff; Carroll, Tilley; Medlicott, Natalie J

    2018-05-02

    Recently, New Zealand has taken a system wide approach providing the biggest reform to New Zealand community pharmacy for 70 years with the aim of providing more clinically orientated patient centred services through a new funding model. The aim of this study was to understand the types of services offered in New Zealand community pharmacies since introduction of the new funding model, what the barriers are to providing these services. A survey of all community pharmacies were undertaken between August, 2014 and February, 2015. Basic descriptive statistics were completed and group comparisons were made using the chi squared test with significance set at p funding attached. Costs and staff availability are the most common barriers to undertake services, more predominantly in patient centred services. This study was the first to provide an evaluation of service provision in response to a new funding model for New Zealand Community Pharmacies. A broad range of services are being undertaken in New Zealand community pharmacies including patient-centred services. A number of barriers to service provision were identified. This study provides a baseline for the current levels of service provision upon which future studies can compare to and evaluate any changes in service provision with differing funding models going forward.

  8. Clinical and financial impact of pharmacy services in the intensive care unit: pharmacist and prescriber perceptions.

    Science.gov (United States)

    MacLaren, Robert; Brett McQueen, R; Campbell, Jon

    2013-04-01

    To compare pharmacist and prescriber perceptions of the clinical and financial outcomes of pharmacy services in the intensive care unit (ICU). ICU pharmacists were invited to participate in the survey and were asked to invite two ICU prescriber colleagues to complete questionnaires. ICUs with clinical pharmacy services. The questionnaires were designed to solicit frequency, efficiency, and perceptions about the clinical and financial impact (on a 10-point scale) of pharmacy services including patient care (eight functions), education (three functions), administration (three functions), and scholarship (four functions). Basic services were defined as fundamental, and higher-level services were categorized as desirable or optimal. Respondents were asked to suggest possible sources of funding and reimbursement for ICU pharmacy services. Eighty packets containing one 26-item pharmacy questionnaire and two 16-item prescriber questionnaires were distributed to ICU pharmacists. Forty-one pharmacists (51%) and 46 prescribers (29%) returned questionnaires. Pharmacists had worked in the ICU for 8.3 ± 6.4 years and devoted 50.3 ± 18.7% of their efforts to clinical practice. Prescribers generally rated the impact of pharmacy services more favorably than pharmacists. Fundamental services were provided more frequently and were rated more positively than desirable or optimal services across both groups. The percent efficiencies of providing services without the pharmacist ranged between 40% and 65%. Both groups indicated that salary support for the pharmacist should come from hospital departments of pharmacy or critical care or colleges of pharmacy. Prescribers were more likely to consider other sources of funding for pharmacist salaries. Both groups supported reimbursement of clinical pharmacy services. Critical care pharmacy activities were associated with perceptions of beneficial clinical and financial outcomes. Prescribers valued most services more than pharmacists

  9. Retrospective financial analysis of medication therapy management services from the pharmacy's perspective.

    Science.gov (United States)

    McDonough, Randal P; Harthan, Aaron A; McLeese, Kelly E; Doucette, William R

    2010-01-01

    To determine the net financial gain or loss for medication therapy management (MTM) services provided to patients by an independent community pharmacy during 16 months of operation. Retrospective study. Independent community pharmacy in Iowa City, IA, from September 1, 2006, to December 31, 2007. Patients receiving MTM services during the specified period who had proper documentation of reimbursement for the services. MTM services were provided to the patient and documented by the pharmacist or student pharmacist. Net financial gains or losses for providing MTM services. Sensitivity analyses included costs that might be incurred under various conditions of operation. 103 initial and 88 follow-up MTM visits were conducted during a 16-month time period. The total cost for these services to the pharmacy was $11,191.72. Total revenue from these services was $11,195.00; therefore, the pharmacy experienced a net financial gain of $3.28. Sensitivity analyses were conducted, revealing the net gain/loss to the pharmacy if a student pharmacist was used and the net gain/loss if the pharmacist needed extra training to provide the services. Using a student pharmacist resulted in a net gain of $6,308.48, while extra training for the pharmacist resulted in a net loss of $1,602.72. The MTM service programs showed a positive financial gain after 16 months of operation, which should encourage pharmacists to incorporate these services into their practice.

  10. Enhanced clinical pharmacy service targeting tools: risk-predictive algorithms.

    Science.gov (United States)

    El Hajji, Feras W D; Scullin, Claire; Scott, Michael G; McElnay, James C

    2015-04-01

    This study aimed to determine the value of using a mix of clinical pharmacy data and routine hospital admission spell data in the development of predictive algorithms. Exploration of risk factors in hospitalized patients, together with the targeting strategies devised, will enable the prioritization of clinical pharmacy services to optimize patient outcomes. Predictive algorithms were developed using a number of detailed steps using a 75% sample of integrated medicines management (IMM) patients, and validated using the remaining 25%. IMM patients receive targeted clinical pharmacy input throughout their hospital stay. The algorithms were applied to the validation sample, and predicted risk probability was generated for each patient from the coefficients. Risk threshold for the algorithms were determined by identifying the cut-off points of risk scores at which the algorithm would have the highest discriminative performance. Clinical pharmacy staffing levels were obtained from the pharmacy department staffing database. Numbers of previous emergency admissions and admission medicines together with age-adjusted co-morbidity and diuretic receipt formed a 12-month post-discharge and/or readmission risk algorithm. Age-adjusted co-morbidity proved to be the best index to predict mortality. Increased numbers of clinical pharmacy staff at ward level was correlated with a reduction in risk-adjusted mortality index (RAMI). Algorithms created were valid in predicting risk of in-hospital and post-discharge mortality and risk of hospital readmission 3, 6 and 12 months post-discharge. The provision of ward-based clinical pharmacy services is a key component to reducing RAMI and enabling the full benefits of pharmacy input to patient care to be realized. © 2014 John Wiley & Sons, Ltd.

  11. A national survey of clinical pharmacy services in county hospitals in China.

    Science.gov (United States)

    Yao, Dongning; Xi, Xiaoyu; Huang, Yuankai; Hu, Hao; Hu, Yuanjia; Wang, Yitao; Yao, Wenbing

    2017-01-01

    Clinical pharmacy is not only a medical science but also an elaborate public health care system firmly related to its subsystems of education, training, qualification authentication, scientific research, management, and human resources. China is a developing country with a tremendous need for improvements in the public health system, including the clinical pharmacy service system. The aim of this research was to evaluate the infrastructure and personnel qualities of clinical pharmacy services in China. Public county hospitals in China. A national survey of clinical pharmacists in county hospitals was conducted. It was sampled through a stratified sampling strategy. Responses were analyzed using descriptive and inferential statistics. The main outcome measures include the coverage of clinical pharmacy services, the overall staffing of clinical pharmacists, the software and hardware of clinical pharmacy services, the charge mode of clinical pharmacy services, and the educational background, professional training acquisition, practical experience, and entry path of clinical pharmacists. The overall coverage of clinical pharmacy services on both the department scale (median = 18.25%) and the patient scale (median = 15.38%) does not meet the 100% coverage that is required by the government. In 57.73% of the sample hospitals, the staffing does not meet the requirement, and the size of the clinical pharmacist group is smaller in larger hospitals. In addition, 23.4% of the sample hospitals do not have management rules for the clinical pharmacists, and 43.1% do not have rational drug use software, both of which are required by the government. In terms of fees, 89.9% of the sample hospitals do not charge for the services. With regard to education, 8.5% of respondents are with unqualified degree, and among respondents with qualified degree, 37.31% are unqualified in the major; 43% of respondents lack the clinical pharmacist training required by the government. Most

  12. Impact of perceived innovation characteristics on adoption of pharmacy-based in-house immunization services.

    Science.gov (United States)

    Westrick, Salisa C; Mount, Jeanine K

    2009-02-01

    An in-house immunization service in which staff pharmacists administer vaccines was conceptualized as an innovation. Prior to making adoption decisions, community pharmacies evaluated characteristics of in-house immunization services. This study examined the impact of three specific characteristics (perceived benefit, perceived compatibility and perceived complexity) of in-house immunization services on community pharmacies' adoption decisions. A multi-stage mixed-mode survey design was used to collect data from key informants of community pharmacies in Washington State, USA. Key informants included pharmacy managers or pharmacists-on-duty who were able to answer questions related to immunization activities in their pharmacies. Perceived characteristics of in-house immunization services and pharmacy adoption decisions were measured in 2004 and in 2006-2007, respectively. Each perceived characteristic individually predicted adoption of in-house immunization services. When all three characteristics were included in logistic regression, perceived benefit was the only significant predictor of in-house immunization service adoption. Appropriate strategies, particularly promoting the benefit of in-house immunization services, should be implemented. The proposed model and findings may be applicable to other pharmacy-based innovative practices or other public health initiatives. We recommend that organizational leaders, researchers and practitioners consider the impact of perceived benefit and incorporate it when they design strategies to foster adoption of innovative practices. Doing this may increase the number of adopters and also increase diffusion rates for innovative services.

  13. Using the Consumer Experience with Pharmacy Services Survey as a quality metric for ambulatory care pharmacies: older adults' perspectives.

    Science.gov (United States)

    Shiyanbola, Olayinka O; Mott, David A; Croes, Kenneth D

    2016-05-26

    To describe older adults' perceptions of evaluating and comparing pharmacies based on the Consumer Experience with Pharmacy Services Survey (CEPSS), describe older adults' perceived importance of the CEPSS and its specific domains, and explore older adults' perceptions of the influence of specific CEPSS domains in choosing/switching pharmacies. Focus group methodology was combined with the administration of a questionnaire. The focus groups explored participants' perceived importance of the CEPSS and their perception of using the CEPSS to choose and/or switch pharmacies. Then, using the questionnaire, participants rated their perceived importance of each CEPSS domain in evaluating a pharmacy, and the likelihood of using CEPSS to switch pharmacies if their current pharmacy had low ratings. Descriptive and thematic analyses were done. 6 semistructured focus groups were conducted in a private meeting room in a Mid-Western state in the USA. 60 English-speaking adults who were at least 65 years, and had filled a prescription at a retail pharmacy within 90 days. During the focus groups, the older adults perceived the CEPSS to have advantages and disadvantages in evaluating and comparing pharmacies. Older adults thought the CEPSS was important in choosing the best pharmacies and avoiding the worst pharmacies. The perceived influence of the CEPSS in switching pharmacies varied depending on the older adult's personal experience or trust of other consumers' experience. Questionnaire results showed that participants perceived health/medication-focused communication as very important or extremely important (n=47, 82.5%) in evaluating pharmacies and would be extremely likely (n=21, 36.8%) to switch pharmacies if their pharmacy had low ratings in this domain. The older adults in this study are interested in using patient experiences as a quality metric for avoiding the worst pharmacies. Pharmacists' communication about health and medicines is perceived important and likely

  14. Balanced Scorecards As a Tool for Developing Patient-Centered Pharmacy Services

    Science.gov (United States)

    Enwere, Emmanuel N.; Keating, Ellen A.; Weber, Robert J.

    2014-01-01

    Having accurate data is essential for the pharmacy director to manage the department and develop patient-centered pharmacy services. A balanced scorecard (BSC) of essential department data, which is a broad view of a department’s function beyond its financial performance, is an important part of any department’s strategic plan. This column describes how the pharmacy director builds and promotes a department’s BSC. Specifically, this article reviews how the BSC supports the department’s mission and vision, describes the metrics of the BSC and how they are collected, and recommends how the pharmacy director can effectively use the scorecard results in promoting the pharmacy. If designed properly and updated consistently, a BSC can present a broad view of the pharmacy’s performance, serve as a guide for strategic decision making, and improve on the quality of its services. PMID:24958976

  15. Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective.

    Science.gov (United States)

    Fathima, Mariam; Saini, Bandana; Foster, Juliet M; Armour, Carol L

    2017-01-01

    Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case finding using microspirometry. The objective of this study was to assess the feasibility and effectiveness of COPD case-finding service provided by community pharmacists, utilizing a combination of risk assessment questionnaire and microspirometry. A 6-month service was conducted in 21 community pharmacies in Australia. Pharmacists trained in COPD case finding, including lung function test (LFT), invited their patients aged ≥35 years with a history of smoking and/or respiratory symptoms to participate. High-risk patients were identified via a COPD risk assessment questionnaire (Initial Screening Questionnaire [ISQ]) and underwent LFT. Pharmacists referred patients with a forced expiratory volume in 1 second (FEV 1 )/forced expiratory volume in 6 seconds (FEV 6 ) ratio 3 indicating high COPD risk. Of the 157 patients who were able to complete LFT, 61 (39%) had an FEV 1 /FEV 6 ratio of 3) were at a significantly higher risk of an FEV 1 /FEV 6 ratio of strategy for reducing the burden of COPD, particularly for those living in rural locations.

  16. Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan

    Directory of Open Access Journals (Sweden)

    Maddix Jason

    2010-07-01

    Full Text Available Abstract Background Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. Methods We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007. Results Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Conclusion Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals

  17. The relevance of political prestudies for implementation studies of cognitive services in community pharmacies

    DEFF Research Database (Denmark)

    Kaae, Susanne; Traulsen, Janine Marie; Søndergaard, Birthe

    2009-01-01

    BACKGROUND: Studies of cognitive services implementation in the pharmacy sector traditionally focus on individual and/or organizational factors to explain why some pharmacies are successful and others are not. The social and political context of the origins of these services is rarely part...... of the analysis. Researchers and practitioners in the field of pharmacy practice research are increasingly being encouraged to take into account the specific political and societal climate which often plays a defining role in the success or failure of cognitive services implementation in community pharmacies...

  18. Making an impact: an adventure into international pharmacy.

    Science.gov (United States)

    Hitch, William; Ransom, Matthew

    2009-01-01

    To support a medical team, organized by Shoulder to Shoulder, with pharmacy services in an effort to expand ongoing health care to a rural community in Honduras. Pharmacy services in a temporary medical clinic in a schoolhouse in Colomarigua, a small mountain village in Honduras. Pharmacy services and medical care to address acute care needs of the people of Colomarigua, Honduras, during a week-long clinic. Interpreters assisted with patient counseling. Medication labels with pictures that connected doses to mealtimes increased patient understanding and the potential for medications to be dosed correctly. Fill lines were drawn on delivery devices for pediatric suspensions. An effort was made to avoid polypharmacy by communicating with physicians about the different prescriptions that were being prescribed in each household. Not applicable. Not applicable. We created a temporary clinic with a pharmacy and provided medical care to more than 600 children and adults in the surrounding regions. The medical team identified need for a feeding program, and local Shoulder to Shoulder teams began activities to support the community's development. Education programs were initiated to allow promising local children access to higher education. Challenges to providing optimal pharmaceutical care included language barriers, space and flow of the pharmacy, and a limited formulary. Benefits included gaining a whole new perspective on pharmacotherapy, health, and the importance of service to those in need whether abroad or at home.

  19. The impact of pharmacy services on opioid prescribing in dental practice.

    Science.gov (United States)

    Stewart, Autumn; Zborovancik, Kelsey J; Stiely, Kara L

    To compare rates of dental opioid prescribing between periods of full and partial integration of pharmacy services and periods of no integration. This observational study used a retrospective chart review of opioid prescriptions written by dental providers practicing in a free dental clinic for the medically underserved over a period of 74 months. Pharmacy services were fully integrated into the practice model for 48 of the 74 months under study. During this time frame, all dental opioid orders required review by the pharmacy department before prescribing. Outcomes related to prescribing rates and errors were compared between groups, which were defined by the level of integrated pharmacy services. Demographic and prescription-specific data (drug name, dose, quantity, directions, professional designation of individual entering order) and clinic appointment data were collected and analyzed with the use of descriptive and inferential statistics. A total of 102 opioids were prescribed to 89 patients; hydrocodone-acetaminophen combination products were the most frequently used. Opioid prescribing rates were 5 times greater when pharmacy services were not integrated (P dental practice. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  20. Experience with the Implementation of Clinical Pharmacy Services and Processes in a University Hospital in Belgium.

    Science.gov (United States)

    Somers, Annemie; Claus, Barbara; Vandewoude, Koen; Petrovic, Mirko

    2016-03-01

    This article summarizes the experience with the development of clinical pharmacy services in the Ghent University Hospital in Belgium. Implementation of clinical pharmacy services in Belgian hospitals has not been evident because these activities were initially not structurally financed. The aim is to describe the strengths and weaknesses of the clinical pharmacy development process, and the milestones that enhanced the progress. Furthermore, the organisation of clinical pharmacy in the Ghent University Hospital is explained, including back- and front-office activities, seamless pharmaceutical care and medication safety improvement. Some working methods, procedures and tools are explained for different clinical pharmacy services. In particular, the clinical pharmacy projects for geriatric patients as well as the preparation of clinical pharmacy services for the accreditation process are explained. We also reflect on the organisation model and the future development of clinical pharmacy, taking into consideration facilitators and potential barriers.

  1. Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia.

    Science.gov (United States)

    Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

    2014-08-01

    Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia's obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers' needs is vital to the development of any new services or the evaluation of existing services. To explore Australian consumers' perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy-based service. An online cross-sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open-ended and closed questions exploring consumers' experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. A total of 403 consumers from New South Wales, Australia, completed the survey. The majority of respondents had previously not sought a pharmacist's advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy-based services in the future. Most consumers considered pharmacists' motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Although Australian consumers were willing to seek pharmacists' advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. © 2012 John Wiley & Sons Ltd.

  2. The UK Pharmacy Care Plan service: Description, recruitment and initial views on a new community pharmacy intervention.

    Directory of Open Access Journals (Sweden)

    Michael J Twigg

    Full Text Available The UK government advocates person-centred healthcare which is ideal for supporting patients to make appropriate lifestyle choices and to address non-adherence. The Community Pharmacy Future group, a collaboration between community pharmacy companies and independents in the UK, introduced a person-centred service for patients with multiple long-term conditions in 50 pharmacies in Northern England.Describe the initial findings from the set up and delivery of a novel community pharmacy-based person-centred service.Patients over fifty years of age prescribed more than one medicine including at least one for cardiovascular disease or diabetes were enrolled. Medication review and person-centred consultation resulted in agreed health goals and steps towards achieving them. Data were collated and analysed to determine appropriateness of patient recruitment process and quality of outcome data collection. A focus group of seven pharmacists was used to ascertain initial views on the service.Within 3 months of service initiation, 683 patients had baseline clinical data recorded, of which 86.9% were overweight or obese, 53.7% had hypertension and 80.8% had high cardiovascular risk. 544 (77.2% patients set at least one goal during the first consultation with 120 (22.1% setting multiple goals. A majority of patients identified their goals as improvement in condition, activity or quality of life. Pharmacists could see the potential patient benefit and the extended role opportunities the service provided. Allowing patients to set their own goals occasionally identified gaps to be addressed in pharmacist knowledge.Pharmacists successfully recruited a large number of patients who were appropriate for such a service. Patients were willing to identify goals with the pharmacist, the majority of which, if met, may result in improvements in quality of life. While challenges in delivery were acknowledged, allowing patients to identify their own personalised goals was

  3. Patients' reasons for accepting a free community pharmacy asthma service

    DEFF Research Database (Denmark)

    Kaae, Susanne; Sporrong, Sofia Kälvemark

    2015-01-01

    few studies have been conducted so far to explore why patients accept or decline offers of cognitive services at the pharmacy counter. Objective To explore patients’ reasons for accepting a particular cognitive service (the Inhaler Technique Assessment Service) a service intended to detect inhalation...... with 24 patients suffering mainly from asthma and COPD. Researchers from Copenhagen University conducted 11 long interviews and pharmacy internship students from Copenhagen University carried out 13 short interviews. The interviews were analyzed using descriptive analysis. Main outcome measure Patients......’ perceived needs of an inhalation counseling service as well as their motivation for accepting the service, including their accounts of how the service was orally offered by staff. Results The majority of participants were used to using inhaler devices. The participants felt, for several reasons, little need...

  4. Quality pharmacy services and key performance indicators in Polish NICUs: a Delphi approach.

    Science.gov (United States)

    Krzyżaniak, Natalia; Pawłowska, Iga; Bajorek, Beata

    2018-03-31

    Background Currently, there is no literature describing what a quality level of practice entails in Polish neonatal intensive care units (NICUs), nor are there any means of currently measuring the quality of pharmaceutical care provided to NICU patients. Objective To identify a set of essential pharmacist roles and pharmacy-relevant key performance indicators (KPI's) suitable for Polish neonatal intensive units (NICUs). Setting Polish hospital pharmacies and NICUs. Method Using a modified Delphi technique, potential KPI's structured along Donabedian's domains as well as pharmacy services were presented to an expert panel of stakeholders. Two online, consecutive Delphi rounds, were completed by panellists between August and September 2017. Main outcome measure To identify the minimum level of pharmacy services that should be consistently provided to NICU patients. Results A total of 16 panellists contributed to the expert panel. Overall, consensus of 75% was reached for 23 indicators and for 28 roles. When considering pharmacy services for the NICU, the experts were found to highly value traditional pharmacy roles, such as dispensing and extemporaneous compounding, however, they were still eager for roles in the other domains, such as educational and clinical services, to be listed as essential for NICU practice. Panellists were found to positively value the list of indicators presented, and excluded only 9 out of the total list. Conclusion There is a need for future research to establish a minimum standard of practice for Polish pharmacists to encourage the progression and standardisation of hospital pharmacy services to meet the level of practice seen in NICUs worldwide.

  5. Patient preferences for community pharmacy asthma services: a discrete choice experiment.

    Science.gov (United States)

    Naik-Panvelkar, Pradnya; Armour, Carol; Rose, John M; Saini, Bandana

    2012-10-01

    Specialized community pharmacy services, involving the provision of disease state management and care by pharmacists, have been developed and trialled and have demonstrated very good health outcomes. Most of these services have been developed from a healthcare professional perspective. However, for the future uptake and long-term sustainability of these services as well as for better and sustained health outcomes for patients, it is vital to gain an understanding of patients' preferences. We can then structure healthcare services to match these preferences and needs rather than around clinical viewpoints alone. The aim of this study was to elicit patient preferences for pharmacy-based specialized asthma services using a discrete choice experiment and to explore the value/importance that patients place on the different attributes of the asthma service. The existence of preference heterogeneity in the population was also investigated. The study was conducted with asthma patients who had recently experienced a specialized asthma management service at their pharmacy in New South Wales, Australia. Pharmacists delivering the asthma service mailed out the discrete choice questionnaires to participating patients at the end of 6 months of service provision. A latent class (LC) model was used to investigate each patient's strength of preference and preference heterogeneity for several key attributes related to asthma service provision: frequency of visits, access to pharmacist, interaction with pharmacy staff, availability of a private area for consultation, provision of lung function testing, type and depth of advice provision, number of days with asthma symptoms and cost of service. Eighty useable questionnaires (of 170 questionnaires sent out) were received (response rate 47.1%). The study identified various key elements of asthma services important to patients. Further, the LC analysis revealed three classes with differing patient preferences for levels of asthma service

  6. Views of the Scottish general public on community pharmacy weight management services: international implications.

    Science.gov (United States)

    Weidmann, Anita Elaine; Cunningham, Scott; Gray, Gwen; Hansford, Denise; Bermano, Giovanna; Stewart, Derek

    2012-04-01

    Obesity has reached pandemic levels, with more than 1.5 billion adults being affected worldwide. In Scotland two-thirds of men and more than half of women are either overweight or obese, placing Scotland overall third behind the United States of America and Mexico. All community pharmacies in Scotland are contracted to provide public health services such as smoking cessation and there is increasing interest in their contribution to weight management. Researching this area in Scotland may provide valuable information to facilitate the development of community pharmacy services in other parts of the UK and internationally. To describe the views of the Scottish general public on the provision of weight management services via community pharmacies. General public in Scotland. A cross-sectional postal questionnaire survey of 6,000 randomly selected members of the Scottish general public aged 18 years and over. Views on community pharmacy led weight management services. Questionnaires were returned by 20.6% (n = 1,236). Over half 60.1% (n = 751) agreed or strongly agreed that they had easy access to pharmacy services in general and around one-third agreed (35%; n = 438) that it was more convenient to obtain weight management advice from a pharmacist than it is to make an appointment with a GP. Most respondents however lacked awareness of the types of health services available through community pharmacy (13.2%; n = 162) and would not feel comfortable speaking to a pharmacist or medicines counter assistant about weight related issues (25%; n = 320). Concerns over privacy (47.3%; n = 592) and perceived lack of pharmacists' specialist knowledge (open comments) were identified as potential barriers to service uptake by the general public. Overall, respondents appear to be receptive to the idea of accessing weight management services through community pharmacy but a perceived lack of privacy, poor knowledge of pharmacists' skill level and of public health services available to

  7. Rural health service managers' perspectives on preparing rural health services for climate change.

    Science.gov (United States)

    Purcell, Rachael; McGirr, Joe

    2018-02-01

    To determine health service managers' (HSMs) recommendations on strengthening the health service response to climate change. Self-administered survey in paper or electronic format. Rural south-west of New South Wales. Health service managers working in rural remote metropolitan areas 3-7. Proportion of respondents identifying preferred strategies for preparation of rural health services for climate change. There were 43 participants (53% response rate). Most respondents agreed that there is scepticism regarding climate change among health professionals (70%, n = 30) and community members (72%, n = 31). Over 90% thought that climate change would impact the health of rural populations in the future with regard to heat-related illnesses, mental health, skin cancer and water security. Health professionals and government were identified as having key leadership roles on climate change and health in rural communities. Over 90% of the respondents believed that staff and community in local health districts (LHDs) should be educated about the health impacts of climate change. Public health education facilitated by State or Federal Government was the preferred method of educating community members, and education facilitated by the LHD was the preferred method for educating health professionals. Health service managers hold important health leadership roles within rural communities and their health services. The study highlights the scepticism towards climate change among health professionals and community members in rural Australia. It identifies the important role of rural health services in education and advocacy on the health impacts of climate change and identifies recommended methods of public health education for community members and health professionals. © 2017 National Rural Health Alliance Inc.

  8. Pharmacy services at admission and discharge in adult, acute, public hospitals in Ireland.

    LENUS (Irish Health Repository)

    Grimes, Tamasine

    2012-02-01

    OBJECTIVES: to describe hospital pharmacy involvement in medication management in Ireland, both generally and at points of transfer of care, and to gain a broad perspective of the hospital pharmacy workforce. METHODS: a survey of all adult, acute, public hospitals with an accident and emergency (A&E) department (n = 36), using a semi-structured telephone interview. KEY FINDINGS: there was a 97% (n = 35) response rate. The majority (n = 25, 71.4%) of hospitals reported delivery of a clinical pharmacy service. On admission, pharmacists were involved in taking or verifying medication histories in a minority (n = 15, 42.9%) of hospitals, while few (n = 6,17.1%) deployed staff to the A&E\\/acute medical admissions unit. On discharge, the majority (n = 30,85.7%) did not supply any take-out medication, a minority (n =5,14.3%) checked the discharge prescription, 51.4% (n = 18) counselled patients, 42.9% (n = 15) provided medication compliance charts and one hospital (2.9%) communicated with the patient\\'s community pharmacy. The number of staff employed in the pharmacy department in each hospital was not proportionate to the number of inpatient beds, nor the volume of admissions from A&E. There were differences identified in service delivery between hospitals of different type: urban hospitals with a high volume of admissions from A&E were more likely to deliver clinical pharmacy. CONCLUSIONS: the frequency and consistency of delivering pharmacy services to facilitate medication reconciliation at admission and discharge could be improved. Workforce constraints may inhibit service expansion. Development of national standards of practice may help to eliminate variation between hospitals and support service development.

  9. Hospital pharmacy services in teaching hospitals in Nepal: Challenges and the way forward

    Directory of Open Access Journals (Sweden)

    P Ravi Shankar

    2016-01-01

    Full Text Available In Nepal, a developing country in South Asia, hospital pharmacies in teaching hospitals faces a number of challenges. Design and location of the pharmacy is inadequate, the pharmacy is often rented out to private parties, there may be a lack of separation of outpatient and inpatient pharmacy services, medicines are not selected based on objective criteria, too many brands are stocked, pharmaceutical care services are not provided, and pharmaceutical promotion is not regulated within the hospital premises. Furthermore, there is often a lack of pharmacy management software to help dispensing, continuing pharmacy education is not provided, medicines are not compounded or packaged in house, there are problems with medicines availability and medicine quality, and drug utilization studies are not linked with initiatives to promote the rational use of medicines. In this article, the authors examine these challenges and put forward possible solutions.

  10. Building capacity to implement cognitive pharmaceutical services: Quantifying the needs of community pharmacies.

    Science.gov (United States)

    Feletto, Eleonora; Wilson, Laura Kate; Roberts, Alison Sarah; Benrimoj, Shalom Isaac

    2010-09-01

    Community pharmacy is an industry undergoing a transformation, evolving from a traditional product supply orientation to a business capable of incorporating services. The theoretical framework of organizational flexibility is used to understand how pharmacies' capacity can be built to provide services and identify key areas needing improvement. To determine the needs of pharmacies that were important and the elements requiring improvement when implementing and delivering services. A mail survey of 2006 Australian community pharmacies was used to identify needs for service implementation. A 25-item scale was used to measure the level of importance (importance measure) of the items and the level of improvement (improvement measure) when implementing services. An exploratory factor analysis was conducted to assess the construct validity and reliability. Responses were received from a total of 395 community pharmacies, with 355 usable responses (17.7%). Factor analysis yielded 3 factors on the importance measure, explaining 42.6% of the variance: (1) planning and performance (item loading range 0.749-0.455; Cronbach's alpha 0.806), (2) people and processes (0.829-0.392; 0.713), and (3) service awareness and infrastructure (0.723-0.310; 0.705). For the improvement measure, 46.9% of the variance was explained by 3 factors: (1) planning, performance, and service awareness (0.827-0.447; 0.858), (2) infrastructure (0.900-0.637; 0.822), and (3) people and processes (0.903-0.311; 0.707). The analyses showed that there are gaps in the capacity of community pharmacy that could be addressed through business and management programs. The theoretical framework of organizational flexibility was useful in highlighting the key areas for stimulating change. To effectively implement services and sustain service delivery, more sophisticated planning and performance monitoring systems are required, supported by changes to infrastructure and staff mix. The critical area for policy makers

  11. Development of a questionnaire to measure consumers' perceptions of service quality in Australian community pharmacies.

    Science.gov (United States)

    Mirzaei, Ardalan; Carter, Stephen R; Chen, Jenny Yimin; Rittsteuer, Claudia; Schneider, Carl R

    2018-06-11

    Recent changes within community pharmacy have seen a shift towards some pharmacies providing "value-added" services. However, providing high levels of service is resource intensive yet revenues from dispensing are declining. Of significance therefore, is how consumers perceive service quality (SQ). However, at present there are no validated and reliable instruments to measure consumers' perceptions of SQ in Australian community pharmacies. The aim of this study was to build a theory-grounded model of service quality (SQ) in community pharmacies and to create a valid survey instrument to measure consumers' perceptions of service quality. Stage 1 dealt with item generation using theory, prior research and qualitative interviews with pharmacy consumers. Selected items were then subjected to content validity and face validity. Stages 2 and 3 included psychometric testing among English-speaking adult consumers of Australian pharmacies. Exploratory factor analysis was used for item reduction and to explain the domains of SQ. In stage 1, item generation for SQ initially generated 113 items which were then refined, through content and face validity, down to 61 items. In stage 2, after subjecting the questionnaire to psychometric testing on the data from the first pharmacy (n = 374), the use of the primary dimensions of SQ was abandoned leaving 32 items representing 5 domains of SQ. In stage 3, the questionnaire was subject to further testing and item reduction in 3 other pharmacies (n = 320). SQ was best described using 23 items representing 6 domains: 'health and medicines advice', 'relationship quality', 'technical quality', 'environmental quality', 'non-prescription service', and 'health outcomes'. This research presents a theoretically-grounded and robust measurement scale developed for consumer perceptions of SQ in a community pharmacy. Copyright © 2018. Published by Elsevier Inc.

  12. The achievement of public health services in pharmacy practice: A literature review.

    Science.gov (United States)

    Strand, Mark A; Tellers, Jackie; Patterson, Alan; Ross, Alex; Palombi, Laura

    2016-01-01

    It is known that pharmacists are currently contributing to public health; however, the extent of this contribution as reported in the literature has not been examined. Investigating the ways that pharmacists are currently participating in public health is critical for the profession of pharmacy, pharmacy educators, and the public health community. The purpose of this study was to determine the reported contributions of pharmacy to each of the ten essential services of public health, and which of the five core competencies of public health were most frequently utilized in those contributions. A PubMed search was used to extract references that included both the words pharmacy and services in the title or abstract, and the words public health in any part of the document. A total of 247 references were extracted and categorized into the essential services and core competencies. The essential services Inform, Educate, and Empower, and Link to/Provide Care were more frequently represented in the literature, and the core competency of Health Policy and Administration was most frequently utilized. To further contribute to and integrate their contributions within population health, pharmacists must consider ways to strategically contribute to the essential services of public health and seek to increase competency in public health. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Effect of an Advanced Pharmacy Practice Experience on Medication Therapy Management Services in a Centralized Retail Pharmacy Program.

    Science.gov (United States)

    Vande Griend, Joseph P; Rodgers, Melissa; Nuffer, Wesley

    2017-05-01

    Medication therapy management (MTM) delivery is increasingly important in managed care. Successful delivery positively affects patient health and improves Centers for Medicare & Medicaid Services star ratings, a measure of health plan quality. As MTM services continue to grow, there is an increased need for efficient and effective care models. The primary objectives of this project were to describe the delivery of MTM services by fourth-year Advanced Pharmacy Practice Experience (APPE) students in a centralized retail pharmacy system and to evaluate and quantify the clinical and financial contributions of the students. The secondary objective was to describe the engagement needed to complete comprehensive medication reviews (CMRs) and targeted interventions. From May 2015 to December 2015, thirty-five APPE students from the University of Colorado Skaggs School of Pharmacy provided MTM services at Albertsons Companies using the OutcomesMTM and Mirixa platforms. Students delivered patient care services by phone at the central office and provided face-to-face visits at pharmacies in the region. With implementation of the MTM APPE in 2015, the team consisted of 2 MTM pharmacists and pharmacy students, as compared with 1 MTM pharmacist in 2014. The number of CMRs and targeted interventions completed and the estimated additional revenue generated during the 2015 time period were compared with those completed from May through December 2014. The patient and provider engagement needed to complete the CMRs and targeted interventions was summarized. 125 CMRs and 1,918 targeted interventions were billed in 2015, compared with 13 CMRs and 767 targeted interventions in 2014. An estimated $16,575-$49,272 of additional revenue was generated in 2015. To complete the interventions in 2015, the team engaged in 1,714 CMR opportunities and 4,686 targeted intervention opportunities. In this MTM rotation, students provided real-life care to patients, resulting in financial and clinical

  14. A structured patient identification model for medication therapy management services in a community pharmacy.

    Science.gov (United States)

    Pagano, Gina M; Groves, Brigid K; Kuhn, Catherine H; Porter, Kyle; Mehta, Bella H

    To describe the development and implementation of a structured patient identification model for medication therapy management (MTM) services within traditional dispensing activities of a community pharmacy to facilitate pharmacist-provided completion of MTM services. A daily clinical opportunity report was developed as a structured model to identify MTM opportunities daily for all MTM-eligible patients expecting to pick up a prescription. Pharmacy staff was trained and the standardized model was implemented at study sites. One hundred nineteen grocery store-based community pharmacies throughout Ohio, West Virginia, and Michigan. A structured patient identification model in a community pharmacy consists of reviewing a clinical opportunity report, identifying interventions for MTM-eligible patients, and possibly collaborating with an interdisciplinary team. This model allows pharmacists to increase MTM cases performed by providing a structured process for identifying MTM-eligible patients and completing MTM services. The development and implementation of a structured patient identification model in the community pharmacy was completed and consists of pharmacists reviewing a clinical opportunity report to identify MTM opportunities and perform clinical interventions for patients. In a 3-month pre- and post-implementation comparison, there was a 49% increase in the number of MTM services provided by pharmacists (P < 0.001). A structured patient identification model in the community pharmacy was associated with an increase in the amount of MTM services provided by pharmacists. This method could be a useful tool at a variety of community pharmacies to solve challenges associated with MTM completion. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  15. The Marketing Strategy of Pötting’s Pharmacy Using the Marketing Tool Service Blueprint

    OpenAIRE

    Šilberská, Tereza

    2015-01-01

    The diploma thesis is focused on marketing strategy plan of a private pharmacy using service blueprint as a marketing tool. At the beginning the thesis deals with characteristics of specifics and state regulations of pharmacy marketing. Then the thesis analyses Czech pharmacy market in particular with regard to the expansion of pharmacy chains and also puts emphasis on current pharmacy trends that influence management and marketing of private pharmacies. The main goal is firstly to describe t...

  16. Issues Facing Pharmacy Leaders in 2015: Suggestions for Pharmacy Strategic Planning

    Science.gov (United States)

    Weber, Robert J.

    2015-01-01

    Issues facing pharmacy leaders in 2015 include practice model growth and the role of pharmacy students, clinical privileging of health-system pharmacists and provider status, medication error prevention, and specialty pharmacy services. The goal of this article is to provide practical approaches to 4 issues facing pharmacy leaders in 2015 to help them focus their department’s goals. This article will address (1) advances in the pharmacy practice model initiative and the role of pharmacy students, (2) the current thinking of pharmacists being granted clinical privileges in health systems, (3) updates on preventing harmful medication errors, and (4) the growth of specialty pharmacy services. The sample template of a strategic plan may be used by a pharmacy department in 2015 in an effort to continue developing patient-centered pharmacy services. PMID:25717212

  17. Pharmacy users' expectations of pharmacy encounters: a Q-methodological study.

    Science.gov (United States)

    Renberg, Tobias; Wichman Törnqvist, Kristina; Kälvemark Sporrong, Sofia; Kettis Lindblad, Asa; Tully, Mary P

    2011-12-01

    Pharmacy practice is evolving according to general health-care trends such as increased patient involvement and public health initiatives. In addition, pharmacists strive to find new professional roles. Clients' expectations of service encounters at pharmacies is an under-explored topic but crucial to understanding how pharmacy practice can evolve efficiently. To identify and describe different normative expectations of the pharmacy encounter among pharmacy clients. Q methodology, an approach to systematically explore subjectivity that retains complete patterns of responses and organizes these into factors of operant subjectivity. Eighty-five regular prescription medication users recruited at Swedish community pharmacies and by snowballing. Seven factors of operant subjectivity were identified, and organized into two groups. Factors that emphasized the physical drug product as the central object of the pharmacy encounter were labelled as independent drug shopping; logistics of drug distribution; and supply of individual's own drugs. Factors that emphasized personal support as desirable were labelled competence as individual support; individualist professional relations, just take care of me; and practical health-care and lifestyle support. The systematic Q-methodological approach yielded valuable insights into how pharmacy clients construct their expectations for service encounters. They hold differentiating normative expectations for pharmacy services. Understanding these varying viewpoints may be important for developing and prioritizing among efficient pharmacy services. Clients' expectations do not correspond with trends that guide current pharmacy practice development. This might be a challenge for promoting or implementing services based on such trends. © 2010 Blackwell Publishing Ltd.

  18. Medication therapy management services in community pharmacy: a pilot programme in HIV specialty pharmacies.

    Science.gov (United States)

    Rosenquist, Ashley; Best, Brookie M; Miller, Teresa A; Gilmer, Todd P; Hirsch, Jan D

    2010-12-01

    Pharmacist-provided medication therapy management services (MTMS) have been shown to increase patient's adherence to medications, improve health outcomes and reduce overall medical costs. The purpose of this study was to describe a pilot programme that provided pharmacy-based MTMS for patients with HIV/AIDS in the state of California, USA. Pharmacists from the 10 pilot pharmacies were surveyed using an online data collection tool. Information was collected to describe the types of MTMS offered, proportion of patients actively using specific MTMS, pharmacist beliefs regarding effect on patient outcomes and barriers to providing MTMS, ability to offer MTMS without pilot programme funding and specialized pharmacist or staff training. Each responding pharmacy (7 of 10) varied in the number of HIV/AIDS patients served and prescription volume. All pharmacists had completed HIV/AIDS-related continuing education programmes, and some had other advanced training. The type of MTMS being offered varied at each pharmacy with 'individualized counselling by a pharmacist when overuse or underuse was detected' and 'refill reminders by telephone' being actively used by the largest proportion of patients. Most, but not all, pharmacists cited reimbursement as a barrier to MTMS provision. Pharmacists believed the MTMS they provide resulted in improved satisfaction (patient and provider), medication usage, therapeutics response and patient quality of life. The type of MTMS offered, and proportion of patients actively using, varied among participating pilot pharmacies. © 2010 Blackwell Publishing Ltd.

  19. Assessment of surveys for the management of hospital clinical pharmacy services.

    Science.gov (United States)

    Čufar, Andreja; Mrhar, Aleš; Robnik-Šikonja, Marko

    2015-06-01

    Survey data sets are important sources of data, and their successful exploitation is of key importance for informed policy decision-making. We present how a survey analysis approach initially developed for customer satisfaction research in marketing can be adapted for an introduction of clinical pharmacy services into a hospital. We use a data mining analytical approach to extract relevant managerial consequences. We evaluate the importance of competences for users of a clinical pharmacy with the OrdEval algorithm and determine their nature according to the users' expectations. For this, we need substantially fewer questions than are required by the Kano approach. From 52 clinical pharmacy activities we were able to identify seven activities with a substantial negative impact (i.e., negative reinforcement) on the overall satisfaction of clinical pharmacy services, and two activities with a strong positive impact (upward reinforcement). Using analysis of individual feature values, we identified six performance, 10 excitement, and one basic clinical pharmacists' activity. We show how the OrdEval algorithm can exploit the information hidden in the ordering of class and attribute values, and their inherent correlation using a small sample of highly relevant respondents. The visualization of the outputs turns out highly useful in our clinical pharmacy research case study. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Patients' value of asthma services in Australian pharmacies: the way ahead for asthma care.

    Science.gov (United States)

    Naik-Panvelkar, Pradnya; Armour, Carol; Rose, John; Saini, Bandana

    2012-04-01

    Long-term sustainability of health services requires an understanding of patients' values and preferences. The aim of this study was to evaluate patients' preferences as well as their willingness-to-pay (WTP) for a community pharmacy-delivered specialized asthma service using a discrete choice experiment (DCE). Patients with asthma in New South Wales, Australia, who had recently experienced a specialized asthma management service at their pharmacy were mailed DCE questionnaires. Patients were asked to choose between two hypothetical service models with varying attributes. Multinomial logit models estimated patients' marginal WTP. The study had a response rate of 47%. Patients greatly valued various aspects of the pharmacy-based specialized service and had marginal WTP values of AUD$18.00 for a private area, AUD$44.50 for lung function testing, AUD$9.18 for appointments with pharmacists, and AUD$22.80 for provision of comprehensive advice on asthma and its medications. The marginal WTP for the overall service was AUD$94.86. The findings of the study indicate that patients greatly value and are willing to pay for asthma services in pharmacies. The study results will help pharmacists and policy advisors in the development of individualized asthma services that patients will use, are willing to pay for, and thus are economically viable in the future.

  1. Consumer perspectives about weight management services in a community pharmacy setting in NSW, Australia

    Science.gov (United States)

    Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.

    2012-01-01

    Abstract Background  Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services. Objective  To explore Australian consumers’ perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy‐based service. Design  An online cross‐sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open‐ended and closed questions exploring consumers’ experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. Setting and participants  A total of 403 consumers from New South Wales, Australia, completed the survey. Results  The majority of respondents had previously not sought a pharmacist’s advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy‐based services in the future. Most consumers considered pharmacists’ motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Conclusion  Although Australian consumers were willing to seek pharmacists’ advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. PMID:22646843

  2. Measuring organizational flexibility in community pharmacy: Building the capacity to implement cognitive pharmaceutical services.

    Science.gov (United States)

    Feletto, Eleonora; Wilson, Laura Kate; Roberts, Alison Sarah; Benrimoj, Shalom Isaac

    2011-03-01

    Community pharmacy is undergoing transformation with increasing pressure to build its capacity to deliver cognitive pharmaceutical services ("services"). The theoretical framework of organizational flexibility (OF) may be used to assess the capacity of community pharmacy to implement change programs and guide capacity-building initiatives. To test the applicability of an existing scale measuring OF to the industry of community pharmacy in Australia. A mail survey was used to test a preexisting scale measuring OF amended from 28 items to 20 items testing 3 underlying factors of operational, structural, and strategic flexibility in the Australian community pharmacy context. The sample was 2006 randomly-stratified community pharmacies. A confirmatory factor analysis was conducted to assess the validity and reliability of the 1-factor models for each underlying construct and the full measurement model. Responses were received from a total of 395 (19.7%) community pharmacies. The 1-factor models of operational, structural, and strategic flexibility fit the data with appropriate respecification. Overall, the favorable fit of the individual factor constructs suggested that the multiple-factor measurement model should be tested. However, this model did not yield an interpretable response. Operational flexibility covaried negatively to the other factors, whereas structural and strategic flexibility shared covariance. Despite this, the results highlighting the individual factor fit suggest the constructs have application to pharmacy. The individual OF constructs were useful in the development and initial testing of a scale adapted for community pharmacy. When further developed and validated, the scale could be used to identify group of pharmacies that require individualized assistance to build capacity and integrate services and other new endeavors. Copyright © 2011 Elsevier Inc. All rights reserved.

  3. 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.

  4. Patient satisfaction with a chronic kidney disease risk assessment service in community pharmacies.

    Science.gov (United States)

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

    2018-04-01

    Patient satisfaction is an important determinant of the feasibility and sustainability of community pharmacy screening services. However, few studies have evaluated this, with no such study performed for a chronic kidney disease risk assessment service. The aim was to determine patient satisfaction with a chronic kidney disease risk assessment service performed in community pharmacies. Community pharmacies in the state of Tasmania, Australia. An anonymous nine-item satisfaction survey, with Likert-type scales, was developed following a literature review of existing surveys. Reliability of the nine-item scale was determined using Cronbach's alpha. Patients were asked an additional question on willingness to pay, with choices of amount from $5 to $25. The satisfaction survey was mailed to 389 patients who participated in the chronic kidney disease risk assessment study. Patient level of satisfaction with and willingness to pay for the chronic kidney disease service. Responses from 143 participants were included in the final analysis. Cronbach's alpha for the nine-item satisfaction scale was 0.87. The majority of participants agreed that the time required to undergo the risk assessment process was justified (90.2%); overall, they were satisfied with the chronic kidney disease risk assessment service (90.0%) and they felt comfortable with the pharmacist referring their results to their doctor (88.9%). Of 136 participants who answered the question on willingness to pay, 62.9% indicated that they would pay for the chronic kidney disease service. Of these, 29.2, 25.8 and 19.1% were willing to pay $20, $10 and $5, respectively. Patient satisfaction with the community pharmacy-based chronic kidney disease risk assessment was high. These findings provide support for the implementation of the service within community pharmacy practice.

  5. Pharmacists’ Attitudes and Perceived Barriers about Community Pharmacy-Based Cardiovascular Risk Screening Services

    Directory of Open Access Journals (Sweden)

    Zahra Jahangard-Rafsanjani

    2015-10-01

    Full Text Available  Background: Community pharmacies are considered as ideal settings to provide cardiovascular risk screening (CRS. However, little is known about pharmacists’ views on providing such services in developing countries including Iran. In the present study, we evaluated the pharmacists’ attitudes and perceived barriers to providing CRS services. Methods:In a cross-sectional study, a questionnaire in three sections was developed by the investigators (attitudes, perceived barriers, and demographics. Five likert items (5 points bipolar scale were designed to evaluate pharmacists’ attitudes about their professional role in providing CRS services in community pharmacies. Seven likert items were designed to assess the pharmacists’ perceived importance of possible barriers to providing the services. The study tool was distributed among a convenient sample of 500 pharmacists, who had participated in a national continuing education event. Results:The response rate was 44% and descriptive statistics and Chi squared test were used to analyze data. Results showed that 70.4% participants had an overall positive attitude to providing CRS services. Pharmacists who were pharmacy owner and pharmacist-in-charge simultaneously were more positive about providing CRS services. Lack of regulatory policy and compensation mechanism, limited physical space in pharmacy and time limitation were reported to be the most important barriers to providing CRS services (> 50% rated as highly important. Low human resource and time limitation were significantly associated with negative attitudes (P: 0.02 and 0.001, respectively.Conclusion:The Iranian pharmacists’ attitudes seem to be positive about providing CRS services; however, their perceived barriers should be addressed prior to CRS service implementation.

  6. Service quality and perceived customer value in community pharmacies.

    Science.gov (United States)

    Guhl, Dennis; Blankart, Katharina E; Stargardt, Tom

    2018-01-01

    A patient's perception of the service provided by a health care provider is essential for the successful delivery of health care. This study examines the value created by community pharmacies-defined as perceived customer value-in the prescription drug market through varying elements of service quality. We develop a path model that describes the relationship between service elements and perceived customer value. We then analyze the effect of perceived customer value on customer satisfaction and loyalty. We use data obtained from 289 standardized interviews on respondents' prescription fill in the last six months in Germany. The service elements personal interaction (path coefficient: 0.31), physical aspect (0.12), store policy (0.24), and availability (0.1) have a positive significant effect on perceived customer value. Consultation and reliability have no significant influence. We further find a strong positive interdependency between perceived customer value, customer satisfaction (0.75), and customer loyalty (0.71). Thus, pharmacies may enhance customer satisfaction and loyalty if they consider the customer perspective and focus on the relevant service elements. To enhance benefit, personal interaction appears to be most important to address appropriately.

  7. Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management.

    Science.gov (United States)

    Gregório, João; Russo, Giuliano; Lapão, Luís Velez

    2016-01-01

    The current financial crisis is pressing health systems to reduce costs while looking to improve service standards. In this context, the necessity to optimize health care systems management has become an imperative. However, little research has been conducted on health care and pharmaceutical services cost management. Pharmaceutical services optimization requires a comprehensive understanding of resources usage and its costs. This study explores the development of a time-driven activity-based costing (TDABC) model, with the objective of calculating the cost of pharmaceutical services to help inform policy-making. Pharmaceutical services supply patterns were studied in three pharmacies during a weekday through an observational study. Details of each activity's execution were recorded, including time spent per activity performed by pharmacists. Data on pharmacy costs was obtained through pharmacies' accounting records. The calculated cost of a dispensing service in these pharmacies ranged from €3.16 to €4.29. The cost of a counseling service when no medicine was supplied ranged from €1.24 to €1.46. The cost of health screening services ranged from €2.86 to €4.55. The presented TDABC model gives us new insights on management and costs of community pharmacies. This study shows the importance of cost analysis for health care services, specifically on pharmaceutical services, in order to better inform pharmacies' management and the elaboration of pharmaceutical policies. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. A Systematic Review of Evidence-Based Community Pharmacy Services Aimed at the Prevention of Cardiovascular Disease.

    Science.gov (United States)

    Sabater-Hernández, Daniel; Sabater-Galindo, Marta; Fernandez-Llimos, Fernando; Rotta, Inajara; Hossain, Lutfun N; Durks, Desire; Franco-Trigo, Lucia; Lopes, Livia A; Correr, Cassyano J; Benrimoj, Shalom I

    2016-06-01

    Cardiovascular disease (CVD) is the leading cause of death worldwide and has a substantial impact on people's health and quality of life. CVD also causes an increased use of health care resources and services, representing a significant proportion of health care expenditure. Integrating evidence-based community pharmacy services is seen as an asset to reduce the burden of CVD on individuals and the health care system. To (a) identify community pharmacy evidence-based services designed to help prevent CVD and (b) provide fundamental information that is needed to assess their potential adaptation to other community pharmacy settings. This review used the DEPICT database, which includes 488 randomized controlled trials (RCT) that address the evaluation of pharmacy services. Articles reviewing these RCTs were identified for the DEPICT database through a systematic search of the following databases: MEDLINE, Scopus, SciELO (Scientific Electronic Library Online), and DOAJ (Directory of Open Access Journals). The DEPICT database was reviewed to identify evidence-based services delivered in the community pharmacy setting with the purpose of preventing CVD. An evidence-based service was defined as a service that has been shown to have a positive effect (compared with usual care) in a high-quality RCT. From each evidence-based service, fundamental information was retrieved to facilitate adaptation to other community pharmacy settings. From the DEPICT database, 14 evidence-based community pharmacy services that addressed the prevention of CVD were identified. All services, except 1, targeted populations with a mean age above 60 years. Pharmacy services encompassed a wide range of practical applications or techniques that can be classified into 3 groups: activities directed at patients, activities directed at health care professionals, and assessments to gather patient-related information in order to support the previous activities. This review provides pharmacy service

  9. What proportion of prescription items dispensed in community pharmacies are eligible for the New Medicine Service?

    Science.gov (United States)

    Wells, Katharine M; Boyd, Matthew J; Thornley, Tracey; Boardman, Helen F

    2014-03-07

    The payment structure for the New Medicine Service (NMS) in England is based on the assumption that 0.5% of prescription items dispensed in community pharmacies are eligible for the service. This assumption is based on a theoretical calculation. This study aimed to find out the actual proportion of prescription items eligible for the NMS dispensed in community pharmacies in order to compare this with the theoretical assumption. The study also aimed to investigate whether the proportion of prescription items eligible for the NMS is affected by pharmacies' proximity to GP practices. The study collected data from eight pharmacies in Nottingham belonging to the same large chain of pharmacies. Pharmacies were grouped by distance from the nearest GP practice and sampled to reflect the distribution by distance of all pharmacies in Nottingham. Data on one thousand consecutive prescription items were collected from each pharmacy and the number of NMS eligible items recorded. All NHS prescriptions were included in the sample. Data were analysed and proportions calculated with 95% confidence intervals used to compare the study results against the theoretical figure of 0.5% of prescription items being eligible for the NMS. A total of 8005 prescription items were collected (a minimum of 1000 items per pharmacy) of which 17 items were eligible to receive the service. The study found that 0.25% (95% confidence intervals: 0.14% to 0.36%) of prescription items were eligible for the NMS which differs significantly from the theoretical assumption of 0.5%. The opportunity rate for the service was lower, 0.21% (95% confidence intervals: 0.10% to 0.32%) of items, as some items eligible for the NMS did not translate into opportunities to offer the service. Of all the prescription items collected in the pharmacies, 28% were collected by patient representatives. The results of this study show that the proportion of items eligible for the NMS dispensed in community pharmacies is lower than

  10. Smoking-cessation services in Iowa community pharmacies.

    Science.gov (United States)

    Aquilino, Mary L; Farris, Karen B; Zillich, Alan J; Lowe, John B

    2003-05-01

    To examine community pharmacy practice with regard to providing smoking-cessation counseling. Mailed survey. Iowa community pharmacies. A stratified random sample of pharmacists statewide. Descriptive statistics were computed for all study variables. Fisher exact test or chi2 analysis was performed on selected variables to determine the relationship of each item with pharmacists routinely offering smokers suggestions for quitting. Responses from 129 (38.2%) of 338 pharmacists indicated that although most felt it is important to offer smoking-cessation counseling, about half actually offer this service. Most pharmacists indicated they are prepared to provide counseling, but fewer than 25% had received formal training or were aware of national clinical practice guidelines. Those who had received specific training (p=0.020) or recently attended an educational program (p=0.014) on smoking cessation were more likely to counsel smokers. Primary barriers to providing counseling were lack of time, inability to identify smokers, low patient demand, and lack of reimbursement. Our findings suggest that opportunities exist for improving pharmacist education and reducing practice barriers in order to bridge the gap between pharmacists' knowledge and attitudes related to smoking-cessation counseling and their provision of patient counseling in community pharmacy practice.

  11. Healthcare professionals' perceptions related to the provision of clinical pharmacy services in the public health sector of Mexico: a case study.

    Science.gov (United States)

    Díaz de León-Castañeda, Christian; Gutiérrez-Godínez, Jéssica; Colado-Velázquez, Juventino Iii; Toledano-Jaimes, Cairo

    2018-04-22

    In Mexico, the Modelo Nacional de Farmacia Hospitalaria (MNFH, or National Hospital Pharmacy Model), published in 2009, mainly aims to promote the provision of clinical pharmacy services in private and public hospitals. However, there is little scientific documentation about the quality of these services. To explore healthcare professionals' perceptions related to the quality of clinical pharmacy services provision. A case-study based on a qualitative approach was performed at the pharmaceutical services unit at a public hospital located in Mexico City, which operates under the administrative control of the Ministry of Health. Donabedian's conceptual model was adapted to explore health care professionals' perceptions of the quality of clinical pharmacy services provision. Semi-structured interviews were carried out with pharmacists, physicians and nurses and then transcribed and analyzed via discourse analysis and codification techniques, using the software package Atlas. ti. Limitations in pharmaceutical human resources were identified as the main factor affecting coverage and quality in clinical pharmacy services provision. However, the development in pharmacy staff of technical competences and skills for clinical pharmacy service provision were recognized. Significant improvements in the rational use of medicines were associated with clinical pharmacy services provision. The perception analysis performed in this study suggested that it is necessary to increase pharmacy staff in order to improve interprofessional relationships and the quality of clinical pharmacy services provision. Copyright © 2018 Elsevier Inc. All rights reserved.

  12. Evaluation of pharmacy generalists performing antimicrobial stewardship services.

    Science.gov (United States)

    Carreno, Joseph J; Kenney, Rachel M; Bloome, Mary; McDonnell, Jane; Rodriguez, Jennifer; Weinmann, Allison; Kilgore, Paul E; Davis, Susan L

    2015-08-01

    Improvements in medication use achieved by pharmacy generalists using a care bundle approach to antimicrobial stewardship are reported. A six-month prospective, repeated-treatment, quasi-experimental study involving three month-long intervention periods and three month-long control periods was conducted in the setting of an existing antimicrobial stewardship program at a large hospital. The intervention involved prospective audit and feedback conducted by pharmacy generalists who were trained in an antimicrobial stewardship care bundle approach. During control months, a pharmacy generalist who was not trained in antimicrobial stewardship rounded with the multidisciplinary team and provided standard-of-care pharmacy services. The primary endpoint was compliance with a care bundle of four antimicrobial stewardship metrics: documentation of indication for therapy in the medical record, selection of empirical therapy according to institutional guidelines, documented performance of indicated culture testing, and deescalation of therapy when indicated. Two-hundred eighty-six patients were enrolled in the study: 124 in the intervention group and 162 in the control group. The cumulative rate of full compliance with all care bundle components during the six-month study was significantly greater during intervention months than during control months (68.5% versus 45.7%, p management. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  13. A conceptual framework of patient satisfaction with a pharmacy adherence service.

    Science.gov (United States)

    van den Berg, Melandi; Donyai, Parastou

    2014-02-01

    Patients do not adhere to their medicines for a host of reasons which can include their underlying beliefs as well as the quality of their interactions with healthcare professionals. One way of measuring the outcome of pharmacy adherence services is to assess patient satisfaction but no questionnaire exists that truly captures patients' experiences with these relatively new services. Our objective was to develop a conceptual framework specific to patient satisfaction with a community pharmacy adherence service based on criteria used by patients themselves. The study was based in community pharmacies in one large geographical area of the UK (Surrey). All the work was conducted between October 2008 and September 2010. This study involved qualitative non-participant observation and semi-structured interviewing. We observed the recruitment of patients to the medicines use review (MUR) service and also actual MUR consultations (7). We also interviewed patients (15). Data collection continued until no new themes were identified during analysis. We analysed interviews to firstly create a comprehensive account of themes which had significance within the transcripts, then created sub-themes within super-ordinate categories. We used a structure-process-outcome approach to develop a conceptual framework relating to patient satisfaction with the MUR. Favourable ethical opinion for this study was received from the NHS Surrey Research Ethics Committee on 2nd June 2008. Five super-ordinate themes linked to patient satisfaction with the MUR service were identified, including relationships with healthcare providers; attitudes towards healthcare providers; patients' experience of health, healthcare and medicines; patients' views of the MUR service; the logistics of the MUR service. In the conceptual framework, structure was conceptualised as existing relationships, environment, and time; process was conceptualised as related to recruitment and consultation stages; and outcome as two

  14. Exploring an increased role for Australian community pharmacy in mental health professional service delivery: evaluation of the literature.

    Science.gov (United States)

    Hattingh, H Laetitia; Scahill, Shane; Fowler, Jane L; Wheeler, Amanda J

    2016-12-01

    Australian general practitioners primarily treat mental health problems by prescribing medication dispensed by community pharmacists. Pharmacists therefore have regular interactions with mental health consumers and carers. This narrative review explored the potential role of community pharmacy in mental health services. Medline, CINAHL, ProQuest, Emerald, PsycINFO, Science Direct, PubMed, Web of Knowledge and IPA were utilised. The Cochrane Library as well as grey literature and "lay" search engines such as GoogleScholar were also searched. Four systematic reviews and ten community pharmacy randomised controlled trials were identified. Various relevant reviews outlining the impact of community pharmacy based disease state or medicines management services were also identified. International studies involving professional service interventions for mental health consumers could be contextualised for the Australian setting. Australian studies of pharmacy professional services for chronic physical health conditions provided further guidance for the expansion of community pharmacy mental health professional services.

  15. Factors affecting pharmacy engagement and pharmacy customer devotion in community pharmacy: A structural equation modeling approach.

    Science.gov (United States)

    Nitadpakorn, Sujin; Farris, Karen B; Kittisopee, Tanattha

    2017-01-01

    The concept of customer engagement and devotion has been applied in various service businesses to keep the customers with business However, a limited number of studies were performed to examine the context of customer engagement and devotion in pharmacy business which focus on the impact of customer perceptions about pharmacists, perceived quality of pharmacy structure, medication price strategy on pharmacy engagement and pharmacy customer devotion in a pharmacy providing pharmaceutical care to the customers. This study aimed to assess a conceptual model depicting the relationships among customer perceptions about pharmacists, pharmacy quality structure, medication price, customer engagement, and customer devotion. And also aimed to assess and measure if there is a direct or indirect relationship between these factors. A quantitative study was conducted by using self-administered questionnaires. Two hundred and fifty three customers who regularly visited the pharmacy were randomly recruited from a purposively selected 30 community pharmacies in Bangkok. The survey was completed during February to April 2016. A structural equation model (SEM) was used to assess the direct and indirect relationships between constructs. A total of 253/300 questionnaires were returned for analysis, and the response rate was 84%. Only perceptions about pharmacist in customers receiving professional pharmacy services was statically significant regarding relationship with pharmacy engagement (beta=0.45). Concurrently, the model from empirical data fit with the hypothetical model (p-value = 0.06, adjusted chi-square (CMIN/DF)=1.16, Goodness of Fit Index (GFI)=0.93, Comparatively Fit Index (CFI)=0.99, and Root Mean Square Error Approximation (RMSEA)=0.03). The study confirmed the indirect positive influence of customer perceptions about pharmacist on pharmacy customer devotion in providing pharmacy services via pharmacy engagement It was customer perceptions about pharmacist that influenced

  16. Factors affecting pharmacy engagement and pharmacy customer devotion in community pharmacy: A structural equation modeling approach

    Directory of Open Access Journals (Sweden)

    Nitadpakorn S

    2017-09-01

    Full Text Available Background: The concept of customer engagement and devotion has been applied in various service businesses to keep the customers with business However, a limited number of studies were performed to examine the context of customer engagement and devotion in pharmacy business which focus on the impact of customer perceptions about pharmacists, perceived quality of pharmacy structure, medication price strategy on pharmacy engagement and pharmacy customer devotion in a pharmacy providing pharmaceutical care to the customers. Objective: This study aimed to assess a conceptual model depicting the relationships among customer perceptions about pharmacists, pharmacy quality structure, medication price, customer engagement, and customer devotion. And also aimed to assess and measure if there is a direct or indirect relationship between these factors. Methods: A quantitative study was conducted by using self-administered questionnaires. Two hundred and fifty three customers who regularly visited the pharmacy were randomly recruited from a purposively selected 30 community pharmacies in Bangkok. The survey was completed during February to April 2016. A structural equation model (SEM was used to assess the direct and indirect relationships between constructs. Results: A total of 253/300 questionnaires were returned for analysis, and the response rate was 84%. Only perceptions about pharmacist in customers receiving professional pharmacy services was statically significant regarding relationship with pharmacy engagement (beta=0.45. Concurrently, the model from empirical data fit with the hypothetical model (p-value = 0.06, adjusted chi-square (CMIN/DF=1.16, Goodness of Fit Index (GFI=0.93, Comparatively Fit Index (CFI=0.99, and Root Mean Square Error Approximation (RMSEA=0.03. Conclusion: The study confirmed the indirect positive influence of customer perceptions about pharmacist on pharmacy customer devotion in providing pharmacy services via pharmacy

  17. Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

    Directory of Open Access Journals (Sweden)

    Shane Scahill

    2015-09-01

    Full Text Available Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Results: Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. Conclusion: The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole.

  18. Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy.

    Science.gov (United States)

    Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J

    2015-01-01

    Mental health-related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole.

  19. Welfare service in rural areas

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.Assessment......Many rural municipalities are challenged due to overall population decline and demographic changes and thus need to make adjustment to municipal services. Demographic profiles are central for assessing both needs, place bound resources and development potential of individual localities.......Assessment of development potential for individual localities using a place-based approach is in line with EU policies for rural development thereby setting a competitive framework for local development. This paper addresses place bound approaches in relation to service adjustment and discusses how local resources...... and place bound potentials are identified and how they are addressed in plans for future development. The paper draws on a study on service adjustments in rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are decided, how they are managed by rural communities...

  20. Immunization services offered in Québec (Canada) pharmacies

    Science.gov (United States)

    Sauvageau, Chantal; Dubé, Eve; Bradet, Richard; Mondor, Myrto; Lavoie, France; Moisan, Jocelyne

    2013-01-01

    Canadian Pharmacists are easy to reach. Although Québec pharmacists are not allowed to administer vaccines, they can: (1) promote vaccination, (2) counsel patients on vaccination, (3) sell vaccines and (4) provide vaccine administration by a nurse. Our objectives were to describe immunization services given in Québec pharmacies and assess the potential relation between, on one hand, pharmacy characteristics and difficulties perceived by pharmacists and, on the other hand, vaccine administration. In 2008–09, an anonymous questionnaire was mailed to all Québec pharmacy owners (n = 1663). Among the 1102 (66%) respondents, 90% stated that vaccines were sold, 27% that a nurse administered vaccines in their pharmacy and 44% were planning to offer vaccine administration in the next five years. Three out of four stated they were doing vaccine promotion and 65%, vaccine counselling. Half of respondents said they would be willing to administer vaccines themselves if legislative modifications were made. Recommendations for cold chain maintenance were followed in 23% of pharmacies selling vaccines. Presence of another health professional in the pharmacy, higher number of opening hours, not being located in the same building than a medical clinic and having an agreement to collaborate with a public health unit or a medical clinic for immunization were positively associated with vaccine administration in multivariate analysis. Higher perceived difficulties with lack of demand from patients were negatively associated with vaccine administration. Most pharmacists are willing to increase their involvement in immunization. Collaboration between public health professionals and pharmacists should be reinforced. PMID:23782530

  1. Forging a novel provider and payer partnership in Wisconsin to compensate pharmacists for quality-driven pharmacy and medication therapy management services.

    Science.gov (United States)

    Trapskin, Kari; Johnson, Curtis; Cory, Patrick; Sorum, Sarah; Decker, Chris

    2009-01-01

    To describe the Wisconsin Pharmacy Quality Collaborative (WPQC), a quality-based network of pharmacies and payers with the common goals of improving medication use and safety, reducing health care costs for payers and patients, and increasing professional recognition and compensation for pharmacist-provided services. Wisconsin between 2006 and 2009. Community (independent, chain, and health-system) pharmacies and private and public health care payers/purchasers with support from the McKesson Corporation. This initiative aligns incentives for pharmacies and payers through implementation of 12 quality-based pharmacy requirements as conditions of pharmacy participation in a practice-advancement pilot. Payers compensate network pharmacies that meet the quality-based requirements for two levels of pharmacy professional services (level 1, intervention-based services; level 2, comprehensive medication review and assessment services). The pilot project is designed to measure the following outcomes: medication-use quality improvements, frequency and types of services provided, drug therapy problems, patient safety, cost savings, identification of factors that facilitate pharmacist participation, and patient satisfaction. The Pharmacy Society of Wisconsin created the WPQC network, which consists of 53 pharmacies, 106 trained pharmacists, 45 student pharmacists, 6 pharmacy technicians, and 2 initial payers. A quality assurance process is followed approximately quarterly to audit the 12 network quality requirements. An evaluation of this collaboration is being conducted. This program demonstrates that collaboration among payers and pharmacists is possible and can result in the development of an incentive-aligned program that stresses quality patient care, standardized services, and professional service compensation for pharmacists. This combination of a quality-based credentialing process with a professional services reimbursement schedule is unique and has the promise to

  2. An evaluation of community pharmacy-based services for type 2 diabetes in an Indonesian setting: patient survey

    Directory of Open Access Journals (Sweden)

    Yosi Wibowo

    2015-12-01

    Full Text Available Background. Diabetes is an emerging chronic disease in developing countries. Its management in developing countries is mainly hospital/clinic based. The increasing diabetes burden in developing countries provides opportunities for community pharmacists to deliver a range of services. Since the management of diabetes requires the patient’s own involvement, it is important to gain their views in order to develop pharmacy-based diabetes services. Studies on diabetes patients’ views have been limited to developed countries.Objectives. To investigate, within a developing country setting (Indonesia, current use of pharmacy services by type 2 diabetes patients, and to evaluate their views regarding community pharmacists’ roles, and the characteristics that influence their views.Methods. A questionnaire survey was conducted within 10 purposefully selected community pharmacies in Surabaya, Indonesia. Each pharmacy recruited approximately 20 patients seeking antidiabetic medications. Usage of pharmacy services was identified using binary responses (‘yes’/‘no’ and views on pharmacists’ roles were rated using Likert scales; an open-ended question was used to identify patient perceived priority roles. Logistic regression models were used to determine characteristics associated with patients’ views.Results. A total of 196 pharmacy patients with type 2 diabetes responded (58.3% response rate. Most patients used community pharmacies for dispensing (100% and education on how to use medications (79.6%. There were mixed views towards pharmacists providing services beyond dispensing. The highest priorities identified were from the ‘patient education’ domain: education on medications (i.e., directions for use (64.5%, storage (26.6%, common/important adverse effects (25.5%; and the ‘monitoring’ domain: monitoring medication compliance (37.3%. Patients with higher incomes or who were working were less supportive of these expanded services

  3. Multiple pharmacy use and types of pharmacies used to obtain prescriptions.

    Science.gov (United States)

    Look, Kevin A; Mott, David A

    2013-01-01

    To evaluate trends and patterns in the prevalence of multiple pharmacy use (MPU) and to describe the number and types of pharmacies used by multiple pharmacy users from 2003 to 2009. Retrospective, cross-sectional, descriptive study. United States from 2003 to 2009. 89,941 responses to the Medical Expenditure Panel Survey over 7 years. Analysis of respondent pharmacy use behaviors. Annual use of more than one pharmacy and number and types of pharmacies used. MPU among patients using medications increased significantly during the study period (from 36.4% [95% CI 35.2-37.6] in 2003 to 43.2% [41.9-44.4] in 2009)-a relative increase of 18.7% ( P = 0.01). Multiple pharmacy users used between 2 and 17 different pharmacies per year to obtain prescription medications. Although approximately 70% of multiple pharmacy users used only two pharmacies, the proportion using three or more pharmacies increased from 24.1% (22.5-25.7) in 2003 to 29.1% (27.4-30.8) in 2009. Mail service pharmacy use had the largest relative increase among multiple pharmacy users during the study period (27.2%), and MPU was nearly twice as high (75%) among mail service users compared with non-mail service users. MPU is common on a national level and has increased greatly in recent years. Patient use of pharmacies that have the potential to share medication information electronically is low among multiple pharmacy users, suggesting increased workload for pharmacists and potential medication safety concerns. This has important implications for pharmacists, as it potentially impedes their ability to maintain accurate medication profiles for patients.

  4. A cross-sectional survey of the access of older people in the Scottish Highlands to general medical practices, community pharmacies and prescription medicines.

    Science.gov (United States)

    Rushworth, Gordon F; Cunningham, Scott; Pfleger, Sharon; Hall, Jenny; Stewart, Derek

    2018-01-01

    Access to medicines and healthcare is more problematic in remote and rural areas. To quantify issues of access to general practitioners (GPs), community pharmacies and prescribed medicines in older people resident in the Scottish Highlands. Anonymized questionnaires were mailed to a random sample of 2000 older people (≥60 years) resident in the Scottish Highlands. Questionnaire items were: access and convenience to GP and pharmacy services (10 items); prescribed medicines (13 items); attitudinal statements based on the Theoretical Domains Framework (12 items); quality of life (SF8, 8 items); and demographics (12 items). Results were analysed using descriptive, inferential and spatial statistics, and principal component analysis (PCA) of attitudinal items. With a response rate of 54.2%, the majority reported convenient access to GPs (89.1%) and community pharmacies (84.3%). Older age respondents (p rural areas to community pharmacies (p rural areas and taking five or more prescribed medicines. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. The impact of a person-centred community pharmacy mental health medication support service on consumer outcomes.

    Science.gov (United States)

    McMillan, Sara S; Kelly, Fiona; Hattingh, H Laetitia; Fowler, Jane L; Mihala, Gabor; Wheeler, Amanda J

    2018-04-01

    Mental illness is a worldwide health priority. As medication is commonly used to treat mental illness, community pharmacy staff is well placed to assist consumers. To evaluate the effectiveness of a multifaceted, community pharmacy medication support service for mental health consumers. Pharmacists and pharmacy support staff in three Australian states were trained to deliver a flexible, goal-oriented medication support service for adults with mental illness over 3-6 months. Consumer-related outcome measures included perceptions of illness and health-related quality of life, medication beliefs, treatment satisfaction and medication adherence. Fifty-five of 100 trained pharmacies completed the intervention with 295 of the 418 recruited consumers (70.6% completion rate); 51.2% of consumers received two or more follow-ups. Significant improvements were reported by consumers for overall perceptions of illness (p Consumers also reported an increase in medication adherence (p = 0.005). A community pharmacy mental health medication support service that is goal-oriented, flexible and individualised, improved consumer outcomes across various measures. While further research into the cost-effectiveness and sustainability of such a service is warranted, this intervention could easily be adapted to other contexts.

  6. Societal perspectives on community pharmacy services in West Bank - Palestine

    Directory of Open Access Journals (Sweden)

    Khdour MR

    2012-03-01

    Full Text Available Understanding the public's view of professional competency is extremely important; however little has been reported on the public’s perception of community pharmacists in PalestineObjectives: To determine the perception of Palestinian consumers of the community pharmacist and the services they offerMethod: This project used the survey methodology administered by structured interviews to consumers who attended the 39 randomly selected pharmacies, in six main cities in Palestine. The questionnaire had range of structured questions covering: Consumers’ patronage patterns, consumers’ interaction with community pharmacists, consumers’ views on how the pharmacist dealt with personal health issues, procedure with regard to handling private consultations.Results: Of 1,017 consumers approached, 790 consumers completed the questionnaire (77.7 %. Proximity to home and presence of knowledgeable pharmacist were the main reasons for patients to visit the same pharmacy. Physicians were identified as the preferred source of advice by 57.2% and pharmacists by 23.8%. Only 17% of respondents considered pharmacists as health professionals who know a lot about drugs and are concerned about and committed to caring for the public. In addition, 49% indicated that pharmacists spoke more quietly cross the counter during counseling and almost one third reported that the pharmacist used a private area within the pharmacy. The majority of respondents would be happy to receive different extended services in the community pharmacy like blood pressure monitoring.Conclusions: Palestinian consumers have a positive overall perception of community pharmacists and the services they offer. Awareness should be created amongst the public about the role of pharmacist and the added value they can provide as health care professional. There is a need to consider privacy when giving patient counseling to increase user satisfaction.

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

    Science.gov (United States)

    Rayes, Ibrahim K; Hassali, Mohamed A; Abduelkarem, Abduelmula R

    2015-01-01

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

  8. ASHP statement on the pharmacy technician's role in pharmacy informatics.

    Science.gov (United States)

    2014-02-01

    The American Society of Health- System Pharmacists (ASHP) believes that specially trained pharmacy technicians can assume important supportive roles in pharmacy informatics. These roles include automation and technology systems management, management of projects, training and education, policy and governance, customer service, charge integrity, and reporting. Such roles require pharmacy technicians to gain expertise in information technology (IT) systems, including knowledge of interfaces, computer management techniques, problem resolution, and database maintenance. This knowledge could be acquired through specialized training or experience in a health science or allied scientific field (e.g., health informatics). With appropriate safeguards and supervision, pharmacy technician informaticists (PTIs) will manage IT processes in health-system pharmacy services, ensuring a safe and efficient medication-use process.

  9. Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal.

    Science.gov (United States)

    Gyawali, Sudesh; Rathore, Devendra Singh; Adhikari, Kishor; Shankar, Pathiyil Ravi; K C, Vikash Kumar; Basnet, Suyog

    2014-04-28

    Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The 'Current Index of Medical Specialties' was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. Community pharmacies in Pokhara offer a wide range of services including, but not limited to

  10. Practice Change in Community Pharmacy: A Case Study of Multiple Stakeholders' Perspectives

    Directory of Open Access Journals (Sweden)

    Shara Elrod

    2012-01-01

    Full Text Available Objective: To obtain a multi-stakeholder perspective of community pharmacy practice change. Design: Qualitative study. Setting: Community pharmacy in rural Mississippi. Participants: Fourteen key stakeholders of the patient care practice including pharmacists (n=4, support staff (n=2, collaborating providers (n=4, patients (n=3, and a payer (n=1. Intervention: Semi-structured interviews and participant-observation techniques were used. Main outcome measures: Description of the community pharmacy's practice and business model and identification of practice change facilitators. Results: Change facilitators for this practice included: a positive reputation in the community, forming solid relationships with providers, and convenience of patient services. Communication in and outside of the practice, adequate reimbursement, and resource allocation were identified as challenges. Conclusions: This case study is a multi-stakeholder examination of community pharmacy practice change and readers are provided with a real-world example of a community pharmacy's successful establishment of a patient care practice.   Type: Case Study

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

    Directory of Open Access Journals (Sweden)

    Rayes IK

    2015-06-01

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

  12. Medication abortion: Potential for improved patient access through pharmacies.

    Science.gov (United States)

    Raifman, Sarah; Orlando, Megan; Rafie, Sally; Grossman, Daniel

    2018-05-08

    To discuss the potential for improving access to early abortion care through pharmacies in the United States. Despite the growing use of medications to induce termination of early pregnancy, pharmacist involvement in abortion care is currently limited. The Food and Drug Administration's Risk Evaluation and Mitigation Strategy (REMS) for Mifeprex® (mifepristone 200 mg), the principal drug used in early medication abortion, prohibits the dispensing of the drug by prescription at pharmacies. This commentary reviews the pharmacology of medication abortion with the use of mifepristone and misoprostol, as well as aspects of service delivery and data on safety, efficacy, and acceptability. Given its safety record, mifepristone no longer fits the profile of a drug that requires an REMS. The recent implementation of pharmacy dispensing of mifepristone in community pharmacies in Australia and some provinces of Canada has improved access to medication abortion by increasing the number of medication abortion providers, particularly in rural areas. Provision of mifepristone in pharmacies, which involves dispensing and patient counseling, would likely improve access to early abortion in the United States without increasing risks to women. Copyright © 2018 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  13. Pharmacist and physician perspectives on diabetes service delivery within community pharmacies in Indonesia: a qualitative study.

    Science.gov (United States)

    Wibowo, Yosi; Sunderland, Bruce; Hughes, Jeffery

    2016-05-01

    To explore perspectives of physicians and pharmacists on diabetes service delivery within community pharmacies in Indonesia. In depth interviews were conducted with 10 physicians and 10 community pharmacists in Surabaya, Indonesia, using a semi-structured interview guide. Nvivo version 9 was used to facilitate thematic content analysis to identify barriers/facilitators for community pharmacists to provide diabetes services. The identified themes indicating barriers/facilitators for diabetes service delivery within Indonesian community pharmacies included: (1) pharmacist factors - i.e. positive views (facilitator) and perceived lack of competence (barrier); (2) pharmacist-physician relationships - i.e. physicians' lack of support and accessibility (barriers); (3) pharmacist-patient relationships - i.e. perceived patients' lack of support and accessibility (barriers); (4) pharmacy environment - i.e. business orientation (barrier), lack of staff and poor pharmacist availability (barriers), and availability of supporting resources, such as counselling areas/rooms, procedures/protocols and IT systems for labelling and patient records (facilitators); and (5) external environment - i.e. a health system to support pharmacist roles, remuneration, marketing and professional assistance (facilitators). Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, Ikatan Apoteker Indonesia (Indonesian Pharmacists Association) and Ikatan Dokter Indonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities. © 2015 Royal Pharmaceutical Society.

  14. 42 CFR 440.20 - Outpatient hospital services and rural health clinic services.

    Science.gov (United States)

    2010-10-01

    ... Definitions § 440.20 Outpatient hospital services and rural health clinic services. (a) Outpatient hospital... services that are not generally furnished by most hospitals in the State. (b) Rural health clinic services... 42 Public Health 4 2010-10-01 2010-10-01 false Outpatient hospital services and rural health...

  15. Predictive Factors of Patient Satisfaction with Pharmacy Services in South Korea: A Cross-Sectional Study of National Level Data.

    Directory of Open Access Journals (Sweden)

    Sunkyung Lee

    Full Text Available Patient satisfaction has emerged as a prerequisite to improving patients' health behaviors leading to better health care outcomes. This study was to identify predictive determinants for patient satisfaction with pharmacy services using national-level data.A cross-sectional evaluation was conducted using 2008 Korean National Health and Nutrition Examination Survey (KNHANES data. To assess the predictive factors for patient satisfaction with pharmacy services, an ordinal logistic regression model was conducted adjusting for patient characteristics, clinical comorbidities, and perception of health.A total of 9,744 people, a representative sample of 48.2 million Koreans, participated in the 2008 KNHANES, of whom 2,188 (23.6% reported visits to pharmacy within the last 2 weeks prior to the survey. Of the patients who visited the pharmacy, 74.6% reported to be either "very satisfied" or "satisfied," and 25.4% responded as being "neutral," "dissatisfied," or "very dissatisfied." A multivariate ordinal logistic regression analysis with weighted observations revealed that patients with fair perception of health (adjusted OR 1.32; 95% CI 1.01-1.74; p<0.05 and those with middle to low family incomes (adjusted OR 1.34; 95% CI 1.02-1.76; p<0.05 were more likely to be satisfied with pharmacy services, and employment-based insurers were less likely to be satisfied with pharmacy services (adjusted OR 0.80; 95% CI 0.65-0.97; p<0.05.Our findings indicated that three out of four patients expressed satisfaction toward pharmacy services. Middle to low family incomes, fair perception of health, and employee insured individuals were significant predictors of patient satisfaction with pharmacy services.

  16. Doctors' and nurses' perceptions of a ward-based pharmacist in rural northern Sweden.

    Science.gov (United States)

    Sjölander, Maria; Gustafsson, Maria; Gallego, Gisselle

    2017-08-01

    Background This project is part of the prospective quasi experimental proof-of-concept investigation of clinical pharmacist intervention study to reduce drug-related problems among people admitted to a ward in a rural hospital in northern Sweden. Objective To explore doctors' and nurses' perceptions and expectations of having a ward-based pharmacist providing clinical pharmacy services. Setting Medical ward in a rural hospital in northern Sweden. Method Eighteen face-to-face semi-structured interviews were conducted with a purposive sample of doctors and nurses working on the ward where the clinical pharmacy service was due to be implemented. Semi-structured interviews were digitally recorded, transcribed and analysed using thematic analysis. Main outcome measure Perceptions and expectations of nurses and doctors. Results Doctors and nurses had limited experience of working with pharmacists. Most had a vague idea of what pharmacists can contribute within a ward setting. Participants, mainly nurses, suggested inventory and drug distribution roles, but few were aware of the pharmacists' skills and clinical competence. Different views were expressed on whether the new clinical pharmacy service would have an impact on workload. However, most participants took a positive view of having a ward-based pharmacist. Conclusion This study provided an opportunity to explore doctors' and nurses' expectations of the role of clinical pharmacists before a clinical pharmacy service was implemented. To successfully implement a clinical pharmacy service, roles, clinical competence and responsibilities should be clearly described. Furthermore, it is important to focus on collaborative working relationships between doctors, nurses and pharmacists.

  17. Comparison of patients' expectations and experiences at traditional pharmacies and pharmacies offering enhanced advanced pharmacy practice experiences.

    Science.gov (United States)

    Kassam, Rosemin; Collins, John B; Berkowitz, Jonathan

    2010-06-15

    To compare patients' expectations and experiences at pharmacies offering traditional APPE learning opportunities with those offering enhanced APPEs that incorporate pharmaceutical care activities. A survey of anchored measures of patient satisfaction was conducted in 2 groups of APPE- affiliated community pharmacies: those participating in an enhanced APPE model versus those participating in the traditional model. The enhanced intervention included preceptor training, a comprehensive student orientation, and an extended experience at a single pharmacy rather than the traditional 2 x 4-week experience at different pharmacies. While patient expectations were similar in both traditional and enhanced APPE pharmacies, patients in enhanced pharmacies reported significantly higher in-store satisfaction and fewer service gaps. Additionally, satisfaction was significantly higher for patients who had received any form of consultation, from either pharmacist or students, than those reporting no consultations. Including provision of pharmaceutical care services as part of APPEs resulted in direct and measurable improvements in patient satisfaction.

  18. Employing the nominal group technique to explore the views of pharmacists, pharmacy assistants and women on community pharmacy weight management services and educational resources.

    Science.gov (United States)

    Fakih, Souhiela; Marriott, Jennifer L; Hussainy, Safeera Y

    2016-04-01

    The objectives of this study were to investigate how pharmacists, pharmacy assistants and women feel about community pharmacy involvement in weight management, and to identify what pharmacists, pharmacy assistants and women want in weight management educational resources. Three homogenous and one heterogeneous nominal group (NG) sessions of up to 120-min duration were conducted with nine women, ten pharmacists and eight pharmacy assistants. The NG technique was used to conduct each session to determine the most important issues that should be considered surrounding community pharmacy weight management services and development of any educational resources. The heterogeneous NG session was used to finalise what women, pharmacists and pharmacy assistants want in educational resources. Overall, pharmacists, pharmacy assistants and women believe that pharmacy staff have an important role in the management of overweight and obesity because of their accessibility, trust and the availability of products in pharmacy. Regarding the most suitable healthcare professional(s) to treat overweight and obesity, the majority of participants believed that no one member of the healthcare team was most suitable and that overweight and obesity needs to be treated by a multidisciplinary team. The importance of having weight management educational resources for pharmacy staff and women that come from trustworthy resources without financial gain or commercialisation was also emphasised. Pharmacists, pharmacy assistants and women feel that community pharmacies have a definite role to play in weight management. Pharmacy-specific weight management educational resources that are readily available to pharmacy staff and women are highly desirable. © 2015 Royal Pharmaceutical Society.

  19. Municipal service provision in rural communities

    DEFF Research Database (Denmark)

    Nørgaard, Helle

    EU policies for rural development stress the importance of investments rather than subsidies and aim at integrating different sectoral policies in order to improve the coherence and effectiveness of public expenditure. Policies also emphasize a place-based approach for rural development and thereby...... hierarchies and considering local resources and place bound potentials.  This paper draws on a study of rural municipalities in Denmark examining how service adjustments e.g. closing of local schools are managed by rural municipalities and local communities. The paper further discusses whether rural...... municipalities can plan strategically, manage service provision and support place bound potential in rural communities in light of a competitive framework for local development....

  20. An evaluation of the impact of a restrictive retail food environment intervention in a rural community pharmacy setting

    Directory of Open Access Journals (Sweden)

    Leia M. Minaker

    2016-07-01

    Full Text Available Abstract Background Sugar-sweetened beverage consumption is associated with morbidity and mortality. The retail food environment influences food and beverage purchasing and consumption. This study assesses the impact of a community pharmacy’s removal of sweet beverages on overall community sales of carbonated soft drinks (CSD in a rural setting. We also examined whether the pharmacy intervention affected CSD sales in the town’s other food stores. Methods Weekly CSD sales data were acquired from the three food retailers in the town of Baddeck, Nova Scotia (January 1, 2013 to May 8, 2015, n = 123 weeks. Autoregressive integrated moving average (ARIMA analysis was used to analyse the interrupted time series data and estimate the impact of the pharmacy intervention (September 11, 2014 on overall CSD sales at the community level. Data were analysed in 2015. Results Before the intervention, the pharmacy accounted for approximately 6 % of CSD sales in the community. After the intervention, declines in total weekly average community CSD sales were not statistically significantly. CSD sales at the other food stores did not increase after the pharmacy intervention. Conclusions This study was among the first to examine the impact of a restrictive retail food environment intervention, and found a non-significant decline in CSD sales at the community level. It is the first study to examine a retail food environment intervention in a community pharmacy. Pharmacies may have an important role to play in creating healthy retail food environments.

  1. Social Pharmacy and Clinical Pharmacy-Joining Forces.

    Science.gov (United States)

    Almarsdottir, Anna Birna; Granas, Anne Gerd

    2015-12-22

    This commentary seeks to define the areas of social pharmacy and clinical pharmacy to uncover what they have in common and what still sets them apart. Common threats and challenges of the two areas are reviewed in order to understand the forces in play. Forces that still keep clinical and social pharmacy apart are university structures, research traditions, and the management of pharmacy services. There are key (but shrinking) differences between clinical and social pharmacy which entail the levels of study within pharmaceutical sciences, the location in which the research is carried out, the choice of research designs and methods, and the theoretical foundations. Common strengths and opportunities are important to know in order to join forces. Finding common ground can be developed in two areas: participating together in multi-disciplinary research, and uniting in a dialogue with internal and external key players in putting forth what is needed for the profession of pharmacy. At the end the question is posed, "What's in a name?" and we argue that it is important to emphasize what unifies the families of clinical pharmacy and social pharmacy for the benefit of both fields, pharmacy in general, and society at large.

  2. Pharmacy customers' experiences with the national online service for viewing electronic prescriptions in Finland.

    Science.gov (United States)

    Lämsä, Elina; Timonen, Johanna; Mäntyselkä, Pekka; Ahonen, Riitta

    2017-01-01

    To investigate (1) Finnish pharmacy customers' familiarity with My Kanta, the national online service for viewing electronic prescriptions (ePrescriptions), (2) how commonly My Kanta is used, (3) who the typical users are, and (4) users' experiences of the usability of My Kanta. A survey was conducted among pharmacy customers (aged ≥18) purchasing medicines for themselves. Questionnaires (N=2915) were distributed from 18 community pharmacies across Finland in autumn 2015. The data obtained was stored in SPSS for Windows and subjected to descriptive analysis, chi-square tests and logistic regression analysis. In total, 1288 respondents were included (response rate 44%). Most (62%) of the customers were familiar with My Kanta. The majority of them (78%) were using it to view their ePrescriptions. My Kanta was perceived as clear, easy to use and to provide a good overall picture of the prescribed medications. Familiarity with My Kanta was associated with a higher education than basic school, regular use of prescription medicines, and sufficient information received about ePrescriptions. Men used My Kanta more often than women. Respondents aged 75 or older were less likely to be familiar with and to use the service compared to 18-34year olds. Most of the Finnish pharmacy customers were familiar with the national online service, My Kanta, for viewing ePrescriptions. Service users perceived it as easy to use and beneficial in managing their overall medication. Customers under 75, those educated beyond basic school, those using prescription medicines regularly, and those who had obtained sufficient information about ePrescriptions were most likely to be familiar with My Kanta. Men and customers under 75 were the typical users of the service. Some customers, however, were unaware of the service, or unable or reluctant to use it. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  3. 75 FR 10272 - Notice Regarding 340B Drug Pricing Program-Contract Pharmacy Services

    Science.gov (United States)

    2010-03-05

    ... Regarding 340B Drug Pricing Program--Contract Pharmacy Services AGENCY: Health Resources and Services... drug pricing program by which manufacturers who sell covered outpatient drugs to particular covered... provisions, which had been previously limited to the Alternative Methods Demonstration Project program. FOR...

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

    Directory of Open Access Journals (Sweden)

    Michael Wong

    2014-03-01

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

  5. Exploring the relationship between mental health stigma, knowledge and provision of pharmacy services for consumers with schizophrenia.

    Science.gov (United States)

    O'Reilly, Claire L; Bell, J Simon; Kelly, Patrick J; Chen, Timothy F

    2015-01-01

    Pharmacists' provision of medication counseling and medication review has been shown to improve adherence and resolve drug-related problems. Lack of knowledge of mental health conditions and negative beliefs may act as a barrier to the provision of pharmacy services. It is unclear how pharmacists' knowledge and attitudes impact their provision of pharmacy services. To explore the relationship between pharmacists' level of mental health stigma, mental health literacy and behavioral intentions in relation to providing pharmacy services for consumers with schizophrenia. A survey instrument containing a measure of mental health literacy, the 7-item social distance scale, and 16 items relating to the provision of pharmacy services for consumers with schizophrenia compared to cardiovascular disease, was mailed to a random sample of 1000 pharmacists registered with the Pharmacy Board of New South Wales in November 2009. Multiple linear regression models were used to assess the relationship between stigma, knowledge and behavior. Responses were received from 188 pharmacists. Pharmacists were significantly more confident and comfortable to provide services to consumers with a cardiovascular illness than a mental illness. Social distance, β = -0.11 (95% CI: -0.22, -0.01, P = 0.03), and schizophrenia literacy scores, β = 1.02, (95% CI: 0.54, 1.50, P mental health stigma and high levels of schizophrenia literacy were associated with pharmacists being more willing to provide medication counseling and identify drug-related problems for consumers with schizophrenia. This demonstrates the importance of improving knowledge and stigma surrounding schizophrenia to improve service delivery for consumers taking medications for schizophrenia. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Complementing a Rural Pharmacy Course with CAM: Reflections from a Decade of Experience

    Directory of Open Access Journals (Sweden)

    Maree Simpson

    2014-03-01

    Full Text Available Substantial complementary medicines (CAM use is reported worldwide. Australian consumers use CAM for health maintenance, minor self-limiting disease states, and also for chronic conditions. The increasing use of CAM has required pharmacists to become increasingly more knowledgeable about CAM and the ethics of CAM recommendation. When the first Australian non-metropolitan pharmacy program was started at Charles Sturt University, in 1997, it was decided to incorporate two innovative courses to assist rurally educated students to engage with health consumers who expect pharmacists to be able to assist them with CAM. This discussion traces and reflects on the development, implementation and current situation of the Complementary Medicines for Pharmacy course. Over time, this course has evolved from a final year elective with a focus on familiarization to a mandated course with a phytomedicine focus to an integrated topic in final year with a focus on evidence, quality of evidence and professional decision-making demonstrated in a reflective professional portfolio. Of potentially greater importance, however, has been the introduction of complementary medicines as a topic in every year of the course with the goal of facilitating effective professional engagement with health consumers.

  7. Taking the pulse of Internet pharmacies.

    Science.gov (United States)

    Yang, Z; Peterson, R T; Huang, L

    2001-01-01

    Like most businesses, online pharmacy companies will only be successful if they make sure customers are satisfied with the service they receive. But what attributes of service quality lead to satisfaction and dissatisfaction? This study identified 19 Internet pharmacy service quality dimensions in three categories: (1) product cost and availability, (2) customer service, and (3) the online information system. Our analysis uncovered attributes that tend to determine consumer satisfaction and points out ways to improve overall service quality in the Internet pharmacy arena.

  8. The positive pharmacy care law: an area-level analysis of the relationship between community pharmacy distribution, urbanity and social deprivation in England.

    Science.gov (United States)

    Todd, Adam; Copeland, Alison; Husband, Andy; Kasim, Adetayo; Bambra, Clare

    2014-08-12

    To: (1) determine the percentage of the population in England that have access to a community pharmacy within 20 min walk; (2) explore any relationship between the walking distance and urbanity; (3) explore any relationship between the walking distance and social deprivation; and (4) explore any interactions between urbanity, social deprivation and community pharmacy access. This area level analysis spatial study used postcodes for all community pharmacies in England. Each postcode was assigned to a population lookup table and lower super output area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score). Access to a community pharmacy within 20 min walk. Overall, 89.2% of the population is estimated to have access to a community pharmacy within 20 min walk. For urban areas, that is 98.3% of the population, for town and fringe, 79.9% of the population, while for rural areas, 18.9% of the population. For areas of lowest deprivation (deprivation decile 1) 90.2% of the population have access to a community pharmacy within 20 min walk, compared to 99.8% in areas of highest deprivation (deprivation decile 10), a percentage difference of 9.6% (8.2, 10.9). Our study shows that the majority of the population can access a community pharmacy within 20 min walk and crucially, access is greater in areas of highest deprivation--a positive pharmacy care law. More research is needed to explore the perceptions and experiences of people--from various levels of deprivation--around the accessibility of community pharmacy services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  9. Testing evidence routine practice: Using an implementation framework to embed a clinically proven asthma service in Australian community pharmacy.

    Science.gov (United States)

    Fuller, Joanne M; Saini, Bandana; Bosnic-Anticevich, Sinthia; Garcia Cardenas, Victoria; Benrimoj, Shalom I; Armour, Carol

    Community pharmacists are well placed and evidence clearly demonstrates that they can be suitably trained to deliver professional services that improve the management of asthma patients in clinical, economic and humanistic terms. However the gap between this evidence and practice reality remains wide. In this study we measure the implementation process as well as the service benefits of an asthma service model. Using an effectiveness-implementation hybrid design, a defined implementation process (progression from Exploration through Preparation and Testing to Operation stages) supporting an asthma service (promoting asthma control and inhaler technique) was tested in 17 community pharmacies across metropolitan Sydney. Seven pharmacies reached the Operation stage of implementation. Eight pharmacies reached the Testing stage of implementation and two pharmacies did not progress beyond the Preparation stage of implementation. A total of 128 patients were enrolled in the asthma service with 110 patients remaining enrolled at the close of the study. Asthma control showed a positive trend throughout the service with the overall proportion of patients with 'poor' asthma control at baseline decreasing from 72% to 57% at study close. There was a statistically significant increase in the proportion of patients with correct inhaler technique from 12% at Baseline (Visit 1) to 33% at Visit 2 and 57% at study close. Implementation of the asthma service varied across pharmacies. Different strategies specific to practice sites at different stages of the implementation model may result in greater uptake of professional services. The asthma service led to improved patient outcomes overall with a positive trend in asthma control and significant change in inhaler technique. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Community Pharmacy Marketing: Strategies for Success

    Directory of Open Access Journals (Sweden)

    Kristina D. Wood

    2011-01-01

    Full Text Available Purpose: As community pharmacies are implementing increasingly more clinical services they are faced with a new challenge of marketing these services. This article discusses The Ohio State University College of Pharmacy Clinical Partners Program's (Clinical Partners experiences in marketing clinical services to patients, barriers encountered through these experiences, and presents suggestions for future marketing of services. Experience: Clinical Partners developed two targeted marketing projects and evaluated impact on patient enrollment in services. In January 2008, the pharmacy ran a series of radio advertisements, newspaper print advertisements, and face to face marketing in the community with the focus of each being patient care services. During this project five individuals expressed interest in Clinical Partners' services. Four indicated that they heard about Clinical Partners through the radio ad and one through the pharmacy website, though none chose to enroll in services. In 2009 Clinical Partners focused on marketing MTM in the form of a comprehensive medication review to current patients already enrolled in its anticoagulation management service. Following a three month period, 6 patients (8% of the 71 patients receiving the marketing intervention chose to enroll in MTM. Four additional patients have enrolled in MTM since conclusion of the project. Discussion: These projects and a review of available literature revealed barriers that pharmacies encounter when marketing clinical services to patients in an outpatient setting including patients' unawareness of the role a pharmacist can play outside dispensing medications, patients' belief they do not need clinical services, and patients' unwillingness to pay a pharmacist out of pocket for services. Future Implications: To overcome these identified challenges, community pharmacies should consider integration of marketing techniques such as tailoring marketing to a target population

  11. Community Pharmacy Marketing: Strategies for Success

    Directory of Open Access Journals (Sweden)

    Jennifer L. Rodis, Pharm.D., B.C.P.S.

    2011-01-01

    Full Text Available Purpose: As community pharmacies are implementing increasingly more clinical services they are faced with a new challenge of marketing these services. This article discusses The Ohio State University College of Pharmacy Clinical Partners Program’s (Clinical Partners experiences in marketing clinical services to patients, barriers encountered through these experiences, and presents suggestions for future marketing of services.Experience: Clinical Partners developed two targeted marketing projects and evaluated impact on patient enrollment in services. In January 2008, the pharmacy ran a series of radio advertisements, newspaper print advertisements, and face to face marketing in the community with the focus of each being patient care services. During this project five individuals expressed interest in Clinical Partners’ services. Four indicated that they heard about Clinical Partners through the radio ad and one through the pharmacy website, though none chose to enroll in services. In 2009 Clinical Partners focused on marketing MTM in the form of a comprehensive medication review to current patients already enrolled in its anticoagulation management service. Following a three month period, 6 patients (8% of the 71 patients receiving the marketing intervention chose to enroll in MTM. Four additional patients have enrolled in MTM since conclusion of the project.Discussion: These projects and a review of available literature revealed barriers that pharmacies encounter when marketing clinical services to patients in an outpatient setting including patients’ unawareness of the role a pharmacist can play outside dispensing medications, patients’ belief they do not need clinical services, and patients’ unwillingness to pay a pharmacist out of pocket for services.Future Implications: To overcome these identified challenges, community pharmacies should consider integration of marketing techniques such as tailoring marketing to a target

  12. Community pharmacy-based case finding for COPD in urban and rural settings is feasible and effective

    OpenAIRE

    Fathima, Mariam; Saini, Bandana; Foster, Juliet M; Armour, Carol L

    2017-01-01

    Mariam Fathima,1 Bandana Saini,1,2 Juliet M Foster,1 Carol L Armour1,3 1Woolcock Institute of Medical Research, Sydney Medical School, 2Faculty of Pharmacy, The University of Sydney, 3Central Sydney Area Health Service, Sydney, NSW, Australia Background and objective: Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case fin...

  13. Community pharmacy services for people with drug problems over two decades in Scotland: Implications for future development.

    Science.gov (United States)

    Matheson, Catriona; Thiruvothiyur, Manimekalai; Robertson, Helen; Bond, Christine

    2016-01-01

    In Scotland community pharmacies are heavily involved in service delivery for people with drug problems (PWDP) as documented through surveys of all community pharmacies in 1995, 2000 and 2006. A further survey in 2014 enabled trends in service demand/provision to be analysed and provides insight into future development. The lead pharmacist in every Scottish pharmacy (n=1246) was invited to complete a postal questionnaire covering attitudes towards PWDP and service provision and level of involvement in services (needle exchange, dispensing for PWDP and methadone supervision). Additional questions covered new services of take-home naloxone (THN) and pharmacist prescribing for opioid dependence. Telephone follow-up of non-responders covered key variables. A comparative analysis of four cross-sectional population surveys of the community pharmacy workforce (1995, 2000, 2006 and 2014) was undertaken. Completed questionnaires were returned by 709 (57%) pharmacists in 2014. Key variables (questionnaire or telephone follow-up) were available from 873 (70%). The proportion of pharmacies providing needle exchange significantly increased from 1995 to 2014 (8.6%, 9.5%, 12.2%, 17.8%, p<0.001) as did the proportion of pharmacies dispensing for the treatment of drug misuse (58.9%, 73.4%, 82.6% and 88%, p<0.001). Methadone was dispensed to 16,406 individuals and buprenorphine to 1777 individuals (increased from 12,400 and 192 respectively in 2006). Attitudes improved significantly from 1995 to 2014 (p<0.001). Being male and past training in drug misuse significantly predicted higher attitude scores (p<0.05) in all four years. Attitude score was a consistently significant predictor in all four years for dispensing for the treatment of drug misuse [OR=1.1 (1995 and 2006, CI 1.1-1.3, and 2014 CI 1.1-1.4) and 1.2 (2000), CI 1.3-1.5] and providing needle exchange [OR=1.1 (1995 and 2006), CI 1.1-1.2, 1.1-1.3 and 1.2 (2000 and 2014), CI 1.1-1.3 and 1.1-1.5]. In 2014, 53% of pharmacists

  14. The organizational framework of community pharmacies in Europe.

    Science.gov (United States)

    Martins, Sílvia Filipa; van Mil, J W Foppe; da Costa, Filipa Alves

    2015-10-01

    The role of the pharmacist has undergone profound changes over the recent years. In most European countries, the tendency seems to be that pharmacists are moving from being product-oriented to service-oriented. An interesting series of papers describing care related services of pharmacy in various countries has been published in 2006, but much has changed since then. This paper aims to provide an updated view on the overall health care sector in Europe, with a special focus on services in community pharmacy. To list and compare health care and community pharmacy structure in Europe; and to discuss the facilitators and barriers that can be found in health care systems and may promote or hinder the implementation of new community pharmacy services. European community pharmacy practice. A cross-sectional study was undertaken where data were collected using an online survey sent to a purposive sample of representatives from 27 European countries. Main outcome measure variation in professional community pharmacy services across Europe. Data were obtained from 22 respondents in 19 countries (70.4%). Health care is mainly provided by a form of public National Health Services in 17 of the 19 countries. Demographic criteria for founding new pharmacies were present in 17 countries. Medicines are exclusively available in pharmacies in approximately one third of the countries. Smoking cessation (93.8%), drug waste management (81.3%) and pharmaceutical care programmes for specific diseases (77.8%) were reported as the most widely disseminated services in European pharmacies. There are still major differences between community pharmacy practice in Europe. Differences are mostly due to the legal framework and remuneration issues, which impact on the range of services available from pharmacies to the community of each country.

  15. Factors that motivate young pharmacists to work in rural communities in the Ukraine.

    Science.gov (United States)

    Anzenberger, Peter; Popov, Sergey B; Ostermann, Herwig

    2011-01-01

    A number of identified factors can influence clinicians' location of practice decisions; however, little is known about the location decisions of pharmacists. In general, males are more likely to work in rural and remote regions, and students with a rural background are more likely to work in rural communities after graduation. In the Ukraine, pharmaceutical health care is important because a patient's first visit is often to the pharmacy, rather than to a GP. This study sought to understand what motivates Ukraine pharmacy students to practice in rural areas. The first part of the study used a quantitative design with questionnaires based on Füglistaller's model for measuring the motivation of entrepreneurs, because working in a rural Ukraine pharmacy means, in most cases, operating a privately owned pharmacy. The second part was qualitative to verify these results. The students' motivation to work in rural areas after graduation depended on their sex and place of birth, but this was not decisive. More influential were the factors that motivate operating a privately owned pharmacy. Within the group that considered working in a privately owned pharmacy in a rural community, motivation was more intrinsic (eg enjoys helping people), while negative factors were more external (eg financial risk). Students from the National University of Pharmacy in Kharkiv comprise the majority of pharmacists in the Ukraine. They are interested in working in a rural area as long as opportunities align with their individual expectations. The two main factors found that would supply more young graduates to rural areas were: (1) improving rural living conditions; and (2) fostering the mental attitude required for operating a private pharmacy. In addition, decreasing related bureaucracy, and increasing financial and fiscal grants may enhance medical and pharmaceutical health care in rural communities of the Ukraine.Key words: graduate pharmacists, living conditions, motivation, privately

  16. Stakeholder analysis for the development of a community pharmacy service aimed at preventing cardiovascular disease.

    Science.gov (United States)

    Franco-Trigo, L; Hossain, L N; Durks, D; Fam, D; Inglis, S C; Benrimoj, S I; Sabater-Hernández, D

    Participatory approaches involving stakeholders across the health care system can help enhance the development, implementation and evaluation of health services. These approaches may be particularly useful in planning community pharmacy services and so overcome challenges in their implementation into practice. Conducting a stakeholder analysis is a key first step since it allows relevant stakeholders to be identified, as well as providing planners a better understanding of the complexity of the health care system. The main aim of this study was to conduct a stakeholder analysis to identify those individuals and organizations that could be part of a leading planning group for the development of a community pharmacy service (CPS) to prevent cardiovascular disease (CVD) in Australia. An experienced facilitator conducted a workshop with 8 key informants of the Australian health care system. Two structured activities were undertaken. The first explored current needs and gaps in cardiovascular care and the role of community pharmacists. The second was a stakeholder analysis, using both ex-ante and ad-hoc approaches. Identified stakeholders were then classified into three groups according to their relative influence on the development of the pharmacy service. The information gathered was analyzed using qualitative content analysis. The key informants identified 46 stakeholders, including (1) patient/consumers and their representative organizations, (2) health care providers and their professional organizations and (3) institutions and organizations that do not directly interact with patients but organize and manage the health care system, develop and implement health policies, pay for health care, influence funding for health service research or promote new health initiatives. From the 46 stakeholders, a core group of 12 stakeholders was defined. These were considered crucial to the service's development because they held positions that could drive or inhibit progress

  17. Cost analysis of a novel HIV testing strategy in community pharmacies and retail clinics.

    Science.gov (United States)

    Lecher, Shirley Lee; Shrestha, Ram K; Botts, Linda W; Alvarez, Jorge; Moore, James H; Thomas, Vasavi; Weidle, Paul J

    2015-01-01

    To document the cost of implementing point-of-care (POC) human immunodeficiency virus (HIV) rapid testing in busy community pharmacies and retail clinics. Providing HIV testing services in community pharmacies and retail clinics is an innovative way to expand HIV testing. The cost of implementing POC HIV rapid testing in a busy retail environment needs to be documented to provide program and policy leaders with adequate information for planning and budgeting. Cost analysis from a pilot project that provided confidential POC HIV rapid testing services in community pharmacies and retail clinics. The pharmacy sites were operated under several different ownership structures (for-profit, nonprofit, sole proprietorship, corporation, public, and private) in urban and rural areas. We included data from the initial six sites that participated in the project. We collected the time spent by pharmacy and retail clinic staff for pretest and posttest counseling in an activity log for time-in-motion for each interaction. Pharmacists and retail clinic staff. HIV rapid testing. The total cost was calculated to include costs of test kits, control kits, shipping, test supplies, training, reporting, program administration, and advertising. The six sites trained 22 staff to implement HIV testing. A total of 939 HIV rapid tests were conducted over a median time of 12 months, of which 17 were reactive. Median pretest counseling time was 2 minutes. Median posttest counseling time was 2 minutes for clients with a nonreactive test and 10 minutes for clients with a reactive test. The average cost per person tested was an estimated $47.21. When we considered only recurrent costs, the average cost per person tested was $32.17. Providing POC HIV rapid testing services required a modest amount of staff time and costs that are comparable to other services offered in these settings. HIV testing in pharmacies and retail clinics can provide an additional alternative venue for increasing the

  18. Predictive Factors of Patient Satisfaction with Pharmacy Services in South Korea: A Cross-Sectional Study of National Level Data

    Science.gov (United States)

    Lee, Sunkyung; Godwin, Onyeka Peter; Kim, Kyungah; Lee, Euni

    2015-01-01

    Objectives Patient satisfaction has emerged as a prerequisite to improving patients’ health behaviors leading to better health care outcomes. This study was to identify predictive determinants for patient satisfaction with pharmacy services using national-level data. Methods A cross-sectional evaluation was conducted using 2008 Korean National Health and Nutrition Examination Survey (KNHANES) data. To assess the predictive factors for patient satisfaction with pharmacy services, an ordinal logistic regression model was conducted adjusting for patient characteristics, clinical comorbidities, and perception of health. Results A total of 9,744 people, a representative sample of 48.2 million Koreans, participated in the 2008 KNHANES, of whom 2,188 (23.6%) reported visits to pharmacy within the last 2 weeks prior to the survey. Of the patients who visited the pharmacy, 74.6% reported to be either “very satisfied” or “satisfied,” and 25.4% responded as being “neutral,” “dissatisfied,” or “very dissatisfied.” A multivariate ordinal logistic regression analysis with weighted observations revealed that patients with fair perception of health (adjusted OR 1.32; 95% CI 1.01–1.74; ppatient satisfaction with pharmacy services. PMID:26540165

  19. Managing obesity in pharmacy: the Australian experience.

    Science.gov (United States)

    Um, Irene S I; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

    2010-12-01

    To explore pharmacists' opinions about the provision of weight management services in community pharmacy and their attitudes towards the establishment of an accredited training course in weight management in pharmacy. Interviews were conducted with practising pharmacists on site in various community pharmacies in metropolitan Sydney, Australia. In-depth, semi-structured interviews with twenty practising pharmacists were conducted. Of the twenty interviewed pharmacists, sixteen were involved in the provision of one or more pharmacy based weight management programs in their pharmacies. Interviews were audio-recorded, transcribed and analysed using the grounded theory approach. The data were thematically analysed to identify facilitators and perceived barriers to the provision of high quality services, and pharmacists' willingness to undertake training and accreditation. Participants clearly perceived a role for pharmacy in weight management. Key facilitators to provision of service were accessibility and the perception of pharmacists as trustworthy healthcare professionals. The pharmacists proposed collaboration with other healthcare professionals in order to provide a service incorporating diet, exercise and behavioural therapy. A program that was not-product-centred, and supported by ethical marketing was favoured. Appropriate training and accreditation were considered essential to assuring the quality of such services. Barriers to the provision of high quality services identified were: remuneration, pharmacy infrastructure, client demand and the current marketing of product-centred programs. Australian pharmacists believe there is a role for pharmacy in weight management, provided training in accredited programs is made available. A holistic, evidence-based, multi-disciplinary service model has been identified as ideal.

  20. Strategies for gender-equitable HIV services in rural India

    Science.gov (United States)

    Sinha, Gita; Peters, David H; Bollinger, Robert C

    2009-01-01

    The emergence of HIV in rural India has the potential to heighten gender inequity in a context where women already suffer significant health disparities. Recent Indian health policies provide new opportunities to identify and implement gender-equitable rural HIV services. In this review, we adapt Mosley and Chen's conceptual framework of health to outline determinants for HIV health services utilization and outcomes. Examining the framework through a gender lens, we conduct a comprehensive literature review for gender-related gaps in HIV clinical services in rural India, focusing on patient access and outcomes, provider practices, and institutional partnerships. Contextualizing findings from rural India in the broader international literature, we describe potential strategies for gender-equitable HIV services in rural India, as responses to the following three questions: (1) What gender-specific patient needs should be addressed for gender-equitable HIV testing and care? (2) What do health care providers need to deliver HIV services with gender equity? (3) How should institutions enforce and sustain gender-equitable HIV services? Data at this early stage indicate substantial gender-related differences in HIV services in rural India, reflecting prevailing gender norms. Strategies including gender-specific HIV testing and care services would directly address current gender-specific patient needs. Rural care providers urgently need training in gender sensitivity and HIV-related communication and clinical skills. To enforce and sustain gender equity, multi-sectoral institutions must establish gender-equitable medical workplaces, interdisciplinary HIV services partnerships, and oversight methods, including analysis of gender-disaggregated data. A gender-equitable approach to rural India's rapidly evolving HIV services programmes could serve as a foundation for gender equity in the overall health care system. PMID:19244284

  1. Infrastructure of pharmacies of the primary health care in the Brazilian Unified Health System: Analysis of PNAUM - Services data.

    Science.gov (United States)

    Leite, Silvana Nair; Manzini, Fernanda; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mário; Farias, Mareni Rocha

    2017-11-13

    To characterize the infrastructure of the primary health care pharmacies of the Brazilian Unified Health System, aiming at humanizing the offered services. This is a cross-sectional study, of quantitative approach, from data obtained in the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). Information on 1,175 pharmacies/dispensing units were gathered from direct observation and assessment of dispensing units installations conducted by trained researchers who used a standardized form. The analyzed variables refer to the physical structure of pharmacies or medicine dispensing units of the health units under research. The pharmacy area was greater than 14 m2 in 40.3% of the sampled units, highlighting those from Midwest (56.9%) and Southeast (56.2%) regions and those of Northeast, with only 23.3%. About 80.2% units had waiting rooms with chairs for patients, 31.8% of them had dispensing areas inferior to 5m2, while in 46.2% these areas were superior to 10m2. Bars were found in service counters in 23.8% of health units, thus separating the patient from the professional; 44.1% had internet access. In most units, the area of medicine storage had no refrigerator or freezer for their exclusive storage and 13.7% had a specific room for pharmaceutical consultation. Aiming at achieving care humanization and improving working conditions for professionals, the structuring of the environment of pharmacy services is necessary. This would contribute to the better qualification of pharmacy services, comprising more than medicine delivery. Data on the Northeast region indicated less favorable conditions to the development of adequate dispensing services. Based on the panorama pointed out, we suggest the expansion of stimulus concerning the physical structure of pharmaceutical services, considering regional specificities.

  2. Organisational and extraorganisational determinants of volume of service delivery by English community pharmacies: a cross-sectional survey and secondary data analysis

    Science.gov (United States)

    Hann, Mark; Schafheutle, Ellen I; Bradley, Fay; Elvey, Rebecca; Wagner, Andrew; Halsall, Devina; Hassell, Karen

    2017-01-01

    Objectives This study aimed to identify the organisational and extraorganisational factors associated with existing variation in the volume of services delivered by community pharmacies. Design and setting Linear and ordered logistic regression of linked national data from secondary sources—community pharmacy activity, socioeconomic and health need datasets—and primary data from a questionnaire survey of community pharmacies in nine diverse geographical areas in England. Outcome measures Annual dispensing volume; annual volume of medicines use reviews (MURs). Results National dataset (n=10 454 pharmacies): greater dispensing volume was significantly associated with pharmacy ownership type (large chains>independents>supermarkets), greater deprivation, higher local prevalence of cardiovascular disease and depression, older people (aged >75 years) and infants (aged 0–4 years) but lower prevalence of mental health conditions. Greater volume of MURs was significantly associated with pharmacy ownership type (large chains/supermarkets>>independents), greater dispensing volume, and lower disease prevalence. Survey dataset (n=285 pharmacies; response=34.6%): greater dispensing volume was significantly associated with staffing, skill-mix, organisational culture, years open and greater deprivation. Greater MUR volume was significantly associated with pharmacy ownership type (large chains/supermarkets>>independents), greater dispensing volume, weekly opening hours and lower asthma prevalence. Conclusions Organisational and extraorganisational factors were found to impact differently on dispensing volume and MUR activity, the latter being driven more by corporate ownership than population need. While levels of staffing and skill-mix were associated with dispensing volume, they did not influence MUR activity. Despite recent changes to the contractual framework, the existing fee-for-service reimbursement may therefore not be the most appropriate for the delivery of

  3. Assistive Technology Service Delivery in Rural School Districts

    Science.gov (United States)

    Ault, Melinda Jones; Bausch, Margaret E.; Mclaren, Elizabeth M.

    2013-01-01

    Little is known about the implementation of assistive technology (AT) services for students in rural areas. This study investigated the AT service delivery in 10 rural districts across six states. The results indicated that students use AT across functional areas, but considerably fewer number of devices than do those not living in rural areas. AT…

  4. Pharmacy technician involvement in community pharmacy medication therapy management.

    Science.gov (United States)

    Lengel, Matthew; Kuhn, Catherine H; Worley, Marcia; Wehr, Allison M; McAuley, James W

    To assess the impact of technician involvement on the completion of medication therapy management (MTM) services in a community pharmacy setting and to describe pharmacists' and technicians' perceptions of technician involvement in MTM-related tasks and their satisfaction with the technician's role in MTM. Prospective observational study. In the fall of 2015, pharmacists and selected technicians from 32 grocery store-based community pharmacies were trained to use technicians within MTM services. Completed MTM claims were evaluated at all pharmacies for 3 months before training and 3 months after training. An electronic survey, developed with the use of competencies taught in the training and relevant published literature, was distributed via e-mail to trained employees 3 months after training. The total number of completed MTM claims at the 32 pharmacy sites was higher during the posttraining time period (2687 claims) versus the pretraining period (1735 claims). Of the 182 trained participants, 112 (61.5%) completed the survey. Overall, perceived technician involvement was lower than expected. However, identifying MTM opportunities was the most commonly reported technician MTM task, with 62.5% of technicians and 47.2% of pharmacists reporting technician involvement. Nearly one-half of technicians (42.5%) and pharmacists (44.0%) agreed or strongly agreed they were satisfied with the technician's role in MTM services, and 40.0% of technicians agreed that they were more satisfied with their work in the pharmacy after involvement in MTM. Three months after initial training of technicians in MTM, participation of technicians was lower than expected. However, the technicians involved most often reported identifying MTM opportunities for pharmacists, which may be a focus for future technician trainings. In addition, technician involvement in MTM services may increase satisfaction with many aspects of work for actively involved technicians. Copyright © 2018 American

  5. Empowering Rural Women through Mobile Services

    Science.gov (United States)

    Nagarajan, P.; Jiji, G. Wiselin

    2010-01-01

    This paper is intended as a gender issue to the rural finance practitioners. It highlights the questions that need to be asked and addressed to the gender mainstream. It will also be useful to gender experts to wish to increase their understanding on specific gender issues in rural finance through mobile services. It focuses on rural microfinance…

  6. Creating organizational value by leveraging the multihospital pharmacy enterprise.

    Science.gov (United States)

    Schenkat, Dan; Rough, Steve; Hansen, Amanda; Chen, David; Knoer, Scott

    2018-04-01

    The results of a survey of multihospital pharmacy leaders are summarized, and a road map for creating organizational value with the pharmacy enterprise is presented. A survey was designed to evaluate the level of integration of pharmacy services across each system's multiple hospitals, determine the most commonly integrated services, determine whether value was quantified when services were integrated, collect common barriers for finding value through integration, and identify strategies for successfully overcoming these barriers. The comprehensive, 59-question survey was distributed electronically in September 2016 to the top pharmacy executive at approximately 160 multihospital systems located throughout the United States. Survey respondents indicated that health systems are taking a wide range of approaches to integrating services systemwide. Several themes emerged from the survey responses: (1) having a system-level pharmacy leader with solid-line reporting across the enterprise increased the likelihood of integrating pharmacy services effectively, (2) integration of pharmacy services across a multihospital system was unlikely to decrease the number of pharmacy full-time equivalents within the enterprise, and (3) significant opportunities exist for creating value for the multihospital health system with the pharmacy enterprise, particularly within 4 core areas: system-level drug formulary and clinical standardization initiatives, supply chain initiatives, electronic health record integration, and specialty and retail pharmacy services. Consistently demonstrating strong organizational leadership, entrepreneurialism, and the ability to create value for the organization will lead to the system-level pharmacy leader and the pharmacy enterprise being well-positioned to achieve positive outcomes for patients, payers, and the broader health system. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  7. Pharmacies as providers of expanded health services for people who inject drugs: a review of laws, policies, and barriers in six countries.

    Science.gov (United States)

    Hammett, Theodore M; Phan, Son; Gaggin, Julia; Case, Patricia; Zaller, Nicholas; Lutnick, Alexandra; Kral, Alex H; Fedorova, Ekaterina V; Heimer, Robert; Small, Will; Pollini, Robin; Beletsky, Leo; Latkin, Carl; Des Jarlais, Don C

    2014-06-17

    People who inject drugs (PWID) are underserved by health providers but pharmacies may be their most accessible care settings. Studies in the U.S., Russia, Vietnam, China, Canada and Mexico employed a three-level (macro-, meso-, and micro-) model to assess feasibility of expanded pharmacy services for PWID. Studies employed qualitative and quantitative interviews, review of legal and policy documents, and information on the knowledge, attitudes, and practices of key stakeholders. Studies produced a mixed assessment of feasibility. Provision of information and referrals by pharmacies is permissible in all study sites and sale and safe disposal of needles/syringes by pharmacies is legal in almost all sites, although needle/syringe sales face challenges related to attitudes and practices of pharmacists, police, and other actors. Pharmacy provision of HIV testing, hepatitis vaccination, opioid substitution treatment, provision of naloxone for drug overdose, and abscess treatment, face more serious legal and policy barriers. Challenges to expanded services for drug users in pharmacies exist at all three levels, especially the macro-level characterized by legal barriers and persistent stigmatization of PWID. Where deficiencies in laws, policies, and community attitudes block implementation, stakeholders should advocate for needed legal and policy changes and work to address community stigma and resistance. Laws and policies are only as good as their implementation, so attention is also needed to meso- and micro- levels. Policies, attitudes, and practices of police departments and pharmacy chains as well as knowledge, attitudes, and practices of individual PWID, individual pharmacies, and police officers should support rather than undermine positive laws and expanded services. Despite the challenges, pharmacies remain potentially important venues for delivering health services to PWID.

  8. Implementing a clinical pharmacy service in hematology.

    Science.gov (United States)

    Farias, Tatiane Fernandes; Aguiar, Karina da Silva; Rotta, Inajara; Belletti, Klezia Morais da Silva; Carlotto, Juliane

    2016-01-01

    To implement a clinical pharmacy service focused on the comprehensive review of antineoplastic drugs used in therapy of hematological diseases. An interventional study was conducted in a Brazilian tertiary teaching hospital in two different periods, with and without a clinical pharmacy service, respectively. This service consisted of an antineoplastic prescription validation (analysis of patients' characteristics, laboratory tests, compliance with the therapeutic protocol and with pharmacotechnical parameters). When problems were detected, the pharmacist intervened with the physician or another health professional responsible for the patient. Inpatients and outpatients with hematological diseases were included. We found an increased detection of drug-related problem by 106.5% after implementing the service. Comparing the two periods, an increase in patients' age (26.7 years versus 17.6 years), a predominance of outpatients (54% versus 38%), and an increase in multiple myeloma (13% versus 4%) and non-Hodgkin lymphoma (16% versus 3%) was noted. The most commonly found problems were related to dose (33% versus 25%) and cycle day (14% versus 30%). With regard to clinical impact, the majority had a significant impact (71% versus 58%), and in one patient from the second period could have been fatal. The main pharmaceutical interventions were dose adjustment (35% versus 25%) and drug withdrawal (33% versus 40%). The pharmacy service contributed to increase the detection and resolution of drug-related problems, and it was an effective method to promote the safe and rational use of antineoplastic drugs. Implementar um serviço farmacêutico clínico centrado na revisão completa dos antineoplásicos utilizados no tratamento de doenças hematológicas. Estudo intervencional conduzido em um hospital universitário terciário brasileiro em dois períodos distintos, com base na ausência e na presença do serviço farmacêutico clínico, respectivamente. O referido servi

  9. Implementation and evaluation of a web based system for pharmacy stock management in rural Haiti.

    Science.gov (United States)

    Berger, Elisabeth J; Jazayeri, Darius; Sauveur, Marcel; Manasse, Jean Joel; Plancher, Inel; Fiefe, Marquise; Laurat, Guerline; Joseph, Samahel; Kempton, Kathryn; Fraser, Hamish S F

    2007-10-11

    Managing the stock and supply of medication is essential for the provision of health care, especially in resource poor areas of the world. We have developed an innovative, web-based stock management system to support nine clinics in rural Haiti. Building on our experience with a web-based EMR system for our HIV patients, we developed a comprehensive stock tracking system that is modeled on the appearance of standardized WHO stock cards. The system allows pharmacy staff at all clinics to enter stock levels and also to request drugs and track shipments. Use of the system over the last 2 years has increased rapidly and we now track 450 products supporting care for 1.78 million patient visits annually. Over the last year drug stockouts have fallen from 2.6% to 1.1% and 97% of stock requests delivered were shipped within 1 day. We are now setting up this system in our clinics in rural Rwanda.

  10. Evolution, current structure, and role of a primary care clinical pharmacy service in an integrated managed care organization.

    Science.gov (United States)

    Heilmann, Rachel M F; Campbell, Stephanie M; Kroner, Beverly A; Proksel, Jenel R; Billups, Sarah J; Witt, Daniel M; Helling, Dennis K

    2013-01-01

    The impact of the declining number of primary care physicians is exacerbated by a growing elderly population in need of chronic disease management. Primary care clinical pharmacy specialists, with their unique knowledge and skill set, are well suited to address this gap. At Kaiser Permanente of Colorado (KPCO), primary care clinical pharmacy specialists have a long history of integration with medical practices and are located in close proximity to physicians, nurses, and other members of the health care team. Since 1992, Primary Care Clinical Pharmacy Services (PCCPS) has expanded from 4 to 30 full-time equivalents (FTEs) to provide services in all KPCO medical office buildings. With this growth in size, PCCPS has evolved to play a vital role in working with primary care medical teams to ensure that drug therapy is effective, safe, and affordable. In addition, PCCPS specialists provide ambulatory teaching sites for pharmacy students and pharmacy residents. There is approximately 1 specialist FTE for every 13,000 adult KPCO members and every 9 clinical FTEs of internal medicine and family medicine physicians. All clinical pharmacy specialists in the pharmacy department are required to have a PharmD degree, to complete postgraduate year 2 residencies, and, as a condition of employment, to become board certified in an applicable specialty. The evolution, current structure, and role of PCCPS at KPCO, including factors facilitating successful integration within the medical team, are highlighted. Patient and nonpatient care responsibilities are described.

  11. Rural Runaways: Rurality and Its Implications for Services to Children and Young People Who Run Away

    Science.gov (United States)

    Franks, Myfanwy; Goswami, Haridhan

    2010-01-01

    This article debates options for service provision to young rural runaways in the UK. Using data drawn from two national surveys and follow-on qualitative studies, the authors trace urban myths of rurality and their effects on runaway provision. The authors review models of rural refuge, systemic advocacy and mobile services for rural runaways.…

  12. Pharmacists’ social authority to transform community pharmacy practice

    Directory of Open Access Journals (Sweden)

    Timothy McPherson, PhD, RPh

    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.

  13. 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

  14. Organisational and extraorganisational determinants of volume of service delivery by English community pharmacies: a cross-sectional survey and secondary data analysis.

    Science.gov (United States)

    Hann, Mark; Schafheutle, Ellen I; Bradley, Fay; Elvey, Rebecca; Wagner, Andrew; Halsall, Devina; Hassell, Karen; Jacobs, Sally

    2017-10-10

    This study aimed to identify the organisational and extraorganisational factors associated with existing variation in the volume of services delivered by community pharmacies. Linear and ordered logistic regression of linked national data from secondary sources-community pharmacy activity, socioeconomic and health need datasets-and primary data from a questionnaire survey of community pharmacies in nine diverse geographical areas in England. Annual dispensing volume; annual volume of medicines use reviews (MURs). National dataset (n=10 454 pharmacies): greater dispensing volume was significantly associated with pharmacy ownership type (large chains>independents>supermarkets), greater deprivation, higher local prevalence of cardiovascular disease and depression, older people (aged >75 years) and infants (aged 0-4 years) but lower prevalence of mental health conditions. Greater volume of MURs was significantly associated with pharmacy ownership type (large chains/supermarkets>independents), greater dispensing volume, and lower disease prevalence.Survey dataset (n=285 pharmacies; response=34.6%): greater dispensing volume was significantly associated with staffing, skill-mix, organisational culture, years open and greater deprivation. Greater MUR volume was significantly associated with pharmacy ownership type (large chains/supermarkets>independents), greater dispensing volume, weekly opening hours and lower asthma prevalence. Organisational and extraorganisational factors were found to impact differently on dispensing volume and MUR activity, the latter being driven more by corporate ownership than population need. While levels of staffing and skill-mix were associated with dispensing volume, they did not influence MUR activity. Despite recent changes to the contractual framework, the existing fee-for-service reimbursement may therefore not be the most appropriate for the delivery of cognitive (rather than supply) services, still appearing to incentivise quantity

  15. Opportunities and challenges in social pharmacy and pharmacy practice research

    DEFF Research Database (Denmark)

    Almarsdóttir, Anna Birna; Kaae, Susanne; Traulsen, Janine M

    2014-01-01

    Pharmacy practice and social pharmacy are two important research areas within pharmaceutical and health sciences. As the disciplines have undergone and are still undergoing changes, it is useful to reflect on the current state of their research as the basis for discussing further development....... The two areas are currently beset by a lack of consensus and charged all too often with evaluating narrowly focused pharmacy services. With the added challenge of diminished funding for research and the pressures to publish results, these fields have to accommodate a much broader research framework than...

  16. A stakeholder co-design approach for developing a community pharmacy service to enhance screening and management of atrial fibrillation.

    Science.gov (United States)

    Sabater-Hernández, Daniel; Tudball, Jacqueline; Ferguson, Caleb; Franco-Trigo, Lucía; Hossain, Lutfun N; Benrimoj, Shalom I

    2018-02-27

    Community pharmacies provide a suitable setting to promote self-screening programs aimed at enhancing the early detection of atrial fibrillation (AF). Developing and implementing novel community pharmacy services (CPSs) is a complex and acknowledged challenge, which requires comprehensive planning and the participation of relevant stakeholders. Co-design processes are participatory research approaches that can enhance the development, evaluation and implementation of health services. The aim of this study was to co-design a pharmacist-led CPS aimed at enhancing self-monitoring/screening of AF. A 3-step co-design process was conducted using qualitative methods: (1) interviews and focus group with potential service users (n = 8) to identify key needs and concerns; (2) focus group with a mixed group of stakeholders (n = 8) to generate a preliminary model of the service; and (3) focus group with community pharmacy owners and managers (n = 4) to explore the feasibility and appropriateness of the model. Data were analysed qualitatively to identify themes and intersections between themes. The JeMa2 model to conceptualize pharmacy-based health programs was used to build a theoretical model of the service. Stakeholders delineated: a clear target population (i.e., individuals ≥65 years old, with hypertension, with or without previous AF or stroke); the components of the service (i.e., patient education; self-monitoring at home; results evaluation, referral and follow-up); and a set of circumstances that may influence the implementation of the service (e.g., quality of the service, competency of the pharmacist, inter-professional relationships, etc.). A number of strategies were recommended to enable implementation (e.g.,. endorsement by leading cardiovascular organizations, appropriate communication methods and channels between the pharmacy and the general medical practice settings, etc.). A novel and preliminary model of a CPS aimed at enhancing the

  17. The Catch-22 of Pharmacy Practice in Pakistan’s Pharmacy Education

    Directory of Open Access Journals (Sweden)

    Atta Abbas

    2014-07-01

    Full Text Available New developments in the pharmacy education structure in Pakistan led to the formation of a separate department grouping high specialized services/subjects. However, inadequate planning has exposed a vacuity, as the educational authorities failed to develop a workforce before creating the specialized department. As a result, this vacuum is on the verge of being impinged by pharmacy professionals specialized in entirely different domains which would be detrimental to the future prospects of the development of pharmacy practice in Pakistan.

  18. Pharmaceutical assistance within the SUS: the experience of students in Rural Internship from a Pharmacy Course

    Directory of Open Access Journals (Sweden)

    Luciana Tarbes Mattana Saturnino

    2009-12-01

    Full Text Available The 2002 Brazilian Curricular Lines established a new curriculum for Pharmacy Programs, including amplified information about the Unified Health System (SUS. Following this, some Colleges have implemented a Rural Internship (RI discipline, as a way to promote: a adequate information on the SUS, and b students' interaction with pharmaceutical assistance. In this study we analyzed the perceptions of students enrolled in the Rural Internship program of the undergraduate Pharmacy Program at the Federal University of Minas Gerais. Eight students participated in this study and their perceptions and ideas were obtained by focus groups, both before and after the RI. This information was analyzed by content analysis. The students had a fragmented, distorted view on assistance, before as well as after taking the RI. Nevertheless, the RI provided students with a view of the professional realities and difficulties routinely faced by pharmacists in the public health system. The RI course of the Pharmacy Programs was viewed as an opportunity to improve the professional work within the SUS.As Diretrizes Curriculares de 2002 implantaram um novo currículo para o Curso de Farmácia, trazendo como propósito a aprendizagem para o Sistema Único de Saúde (SUS. Para atender a esta demanda, algumas Faculdades têm implantado a disciplina de Internato Rural (IR como forma de viabilizar o ensino para o SUS e a interação do aluno com a assistência farmacêutica. Este trabalho analisa a concepção de alunos do IR do Curso de Farmácia da Universidade Federal de Minas Gerais sobre a assistência farmacêutica e sobre a atividade do profissional farmacêutico no SUS. A coleta das informações foi realizada por meio da técnica do grupo focal antes e após o IR. Para a análise dos discursos foi utilizada a técnica da análise de conteúdo. Participaram do estudo oito estudantes. Observou-se que os alunos apresentavam uma visão fragmentada sobre a assist

  19. The lay user perspective on the quality of pharmaceuticals, drug therapy and pharmacy services--results of focus group discussions

    DEFF Research Database (Denmark)

    Traulsen, Janine Marie; Almarsdóttir, Anna Birna; Björnsdóttir, Ingunn

    2002-01-01

    This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in Iceland.......This article presents the results of a study on quality of pharmacy services and perceived risk of pharmaceuticals. The results presented here are part of a multi-study evaluation of major changes in drug distribution in Iceland....

  20. The I-Tribe Community Pharmacy Practice Model: professional pharmacy unshackled.

    Science.gov (United States)

    Alston, Greg L; Waitzman, Jennifer A

    2013-01-01

    To describe a mechanism by which pharmacists could create a disruptive innovation to provide professional primary care services via a Web-based delivery model. Several obstacles have prevented pharmacists from using available technology to develop business models that capitalize on their clinical skills in primary care. Community practice has experienced multiple sustaining innovations that have improved dispensing productivity but have not stimulated sufficient demand for pharmacy services to disrupt the marketplace and provide new opportunities for pharmacists. Pharmacists are in a unique position to bridge the gap between demand for basic primary medical care and access to a competent medical professional. Building on the historic strengths of community pharmacy practice, modern pharmacists could provide a disruptive innovation in the marketplace for primary care by taking advantage of new technology and implementing the I-Tribe Community Pharmacy Practice Model (I-Tribe). This model would directly connect pharmacists to patients through an interactive, secure Web presence that would liberate the relationship from geographic restrictions. The I-Tribe is a disruptive innovation that could become the foundation for a vibrant market in pharmacist professional service offerings. The I-Tribe model could benefit society by expanding access to primary medical care while simultaneously providing a new source of revenue for community practice pharmacists. Entrepreneurial innovation through I-Tribe pharmacy would free pharmacists to become the care providers envisioned by the profession's thought leaders.

  1. [Supply medicinal products improvement in outpatient care in a hospital pharmacy service].

    Science.gov (United States)

    Santiago Pérez, A; Peña Pedrosa, J A; Alguacil Pau, A I; Pérez Morales, A; Molina Muñoz, P; Benítez Giménez, M T

    Pharmaceutical care to outpatients is currently one of the main occupations of hospital pharmacy services (PEX). There are several questionnaires to measure the satisfaction of the PEX of a pharmacy service, and the results of these questionnaires can generate improvement actions that result in satisfaction. To verify if a satisfaction questionnaire for outpatients is valid for the generation of improvements in the care provided, and if after its implementation, the same questionnaire is able to detect changes in satisfaction. Prospective study of a single center carried out in a tertiary hospital in 2015 and 2016. A questionnaire previously validated with 16 Likert-type items was used. Demographic and classification data were collected. A descriptive analysis was performed and the internal consistency was calculated using the Cronbach's α value. A total of 258 questionnaires were collected in 2015 and 493 in 2016. There were no differences in the baseline characteristics of the patients and users of the service. The items with the lowest satisfaction scores in 2015 (comfort of the waiting room, dispensing privacy, drug pick-up time and medication pick-up time) guided the improvement actions to be implemented. In 2016 there was an improvement in the waiting time until collection in 12.3% (p = 0.002); in the comfort of the waiting room 4.9% (p = 0.304); business hours for medication collection, 10.7% (p = 0.013); and in the confidentiality of the dispensation 4% (p = 0.292). The remaining scores fluctuated minimally, with no statistical significance at all. A 5.1% improvement in overall satisfaction was found (p improve the care received in an outpatient unit of a pharmacy service. This same questionnaire is a tool to monitor the changes implemented to improve the care received. Copyright © 2018 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

  2. Cultivation and Implementation of Community-Engaged Pharmacy Services in a Free Clinic to Enhance Care for the Medically Underserved

    Directory of Open Access Journals (Sweden)

    Emmeline Tran, Pharm.D. Candidate

    2013-01-01

    Full Text Available Partnerships between community free clinics and academic medical centers improve patient outcomes and enhance learning opportunities for students. A community-academic partnership between the Maliheh Free Clinic and the University of Utah College of Pharmacy was formed to fulfill a community need for pharmacy services, to promote interdisciplinary patient care, and to provide an experiential opportunity for students. The Maliheh Free Clinic based in Salt Lake City, Utah provides free primary health care to uninsured individuals who live 150% below federal poverty guidelines. Three pharmacy services were developed and implemented. These include: 1 clinic chart reviews which involve written recommendations following a comprehensive assessment of the patient’s chart examining his or her disease states and the appropriateness of his or her medications; 2 medication reconciliations and discussion of pharmacy-related recommendations with patients during Diabetes Day, an inclusive interdisciplinary patient appointment that addresses important aspects of diabetes care; and 3 an insulin dose adjustment service through a collaborative practice agreement with the clinic to monitor a patient’s blood glucose levels and adjust his or her medications accordingly on a weekly basis.

  3. Rural adolescents' access to adolescent friendly health services.

    Science.gov (United States)

    Secor-Turner, Molly A; Randall, Brandy A; Brennan, Alison L; Anderson, Melinda K; Gross, Dean A

    2014-01-01

    The purpose of this study was to assess rural North Dakota adolescents' experiences in accessing adolescent-friendly health services and to examine the relationship between rural adolescents' communication with health care providers and risk behaviors. Data are from the Rural Adolescent Health Survey (RAHS), an anonymous survey of 14- to 19-year-olds (n = 322) attending secondary schools in four frontier counties of North Dakota. Descriptive statistics were used to assess participants' access to adolescent-friendly health services characterized as accessible, acceptable, and appropriate. Logistic regressions were used to examine whether participant-reported risk behaviors predicted communication with health care providers about individual health risk behaviors. Rural adolescents reported high access to acceptable primary health care services but low levels of effective health care services. Participant report of engaging in high-risk behaviors was associated with having received information from health care providers about the leading causes of morbidity and mortality. These findings reveal missed opportunities for primary care providers in rural settings to provide fundamental health promotion to adolescents. Copyright © 2014 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  4. Integrating a health information exchange into a community pharmacy transitions of care service.

    Science.gov (United States)

    Fanizza, Frank A; Ruisinger, Janelle F; Prohaska, Emily S; Melton, Brittany L

    2018-04-03

    To describe the incorporation of a state health information exchange (HIE) into a community pharmacy transitions of care (TOC) service and to assess its impact on 30-day readmission rates. Three suburban community pharmacies in Olathe, Kansas. Balls Food Stores is a grocery store chain which operates 21 supermarket community pharmacies in the Kansas City metropolitan area. Balls Food Stores launched a pharmacist-led self-referral TOC study in which a state HIE was utilized to collect discharge information from patients' electronic medical records (EMRs) to facilitate TOC comprehensive medication reviews (CMRs). Descriptive statistics were used to assess types and outcomes of identified drug therapy problems and the ability to access Kansas Health Information Network EMRs. A chi-square test was used to assess 30-day readmissions between patients who accepted and declined the service. Forty patients were identified for inclusion and 18 elected to participate in the service. The majority of participants were white females with a median age of 64.5 years. Out of 40 study patients, 85% had an EMR available; 12.5% of patients had a medication list included in their EMR hospitalization documentation. Participants who underwent the service had a statistically significantly lower rate of overall 30-day hospital readmission than those who declined (11.1% vs 36.4%, P = 0.032). Among the 18 TOC CMRs performed, 90 drug therapy problems were identified and 77 were resolved in collaboration with a patient, caregiver, or physician. Incorporation of a state HIE into a community pharmacist-led TOC service is a novel strategy for collecting patient data. During the study, no TOC participants were readmitted within 30 days. However, pharmacists found HIE data alone was insufficient to perform TOC CMRs for the majority of participants. In order to expand state HIE utilization, more health systems will need to upload a minimum standard data set to help facilitate care. Copyright © 2018

  5. The development of a caseload midwifery service in rural Australia.

    Science.gov (United States)

    Tran, Tara; Longman, Jo; Kornelsen, Jude; Barclay, Lesley

    2017-08-01

    The past two decades have seen progressive decline in the number of rural birthing services across Australia. Despite health system pressures on small birthing units to close there have been examples of resistance and survival. This descriptive study explored the evolution of a rural birthing service in a small town to offer insight into the process of transition which may be helpful to other small healthcare services in rural Australia. Quantitative data derived from birth registers on number and types of birth from 1993-2011 were analysed. Interviews were conducted between January and August 2012 with nine participants (GP obstetricians, midwives, a health service manager and a consumer representative). This rural maternity service developed gradually from a GP obstetrician-led service to a collaborative care team approach with midwifery leadership. This development was in response to a changing rural medical workforce, midwifery capacity and the needs and wants of women in the local community. Four major themes were developed from interview data: (1) development of the service (2) drivers of change (3) outcomes and (4) collaborative care and inter-professional practice. The success of this transition was reported to rest on strategic planning and implementation and respectful inter-professional practice and alignment of birth philosophy across the team. This team created a unified, progressive community-focused birthing service. The development of collaborative care models that embrace and build on established inter-professional relationships can maximise existing rural workforce potential and create a sustainable rural service into the future. Copyright © 2016 Australian College of Midwives. Published by Elsevier Ltd. All rights reserved.

  6. Self-medication with antibiotics in the Republic of Srpska community pharmacies: pharmacy staff behavior.

    Science.gov (United States)

    Marković-Peković, Vanda; Grubiša, Nataša

    2012-10-01

    Self-medication with antibiotics adds to the global risk of increased spread of bacterial resistance. Attitudes and behavior of health professionals also may reinforce self-medication with antibiotics. The aim of this study was to determine whether self-medication with antibiotics is possible in our community pharmacies and to what extent, and to evaluate the behavior and service of pharmacy health professionals regarding non-prescription antibiotic dispensation. An observational, cross-section study was conducted, and pseudo-patient methodology was used to establish the kind of professional service provided in case of patient's explicit demand to buy an antibiotic for treatment of self-diagnosed upper respiratory tract infection. Of the total 318 community pharmacies, 131 (41%) were visited and included in the study. Non-prescription antibiotics were dispensed in 76 (58%) pharmacies. Counseling and symptomatic therapy was offered in 88 (67%) pharmacies. In 25% of pharmacies, no symptomatic therapy was offered; instead, only an antibiotic was sold. Amoxicillin was sold in 85% of cases and, mostly, the one of 1.30 Euro per pack. Both oral and written use instructions were given in 78% cases, whereas none was given in 3% of cases. Self-medication with antibiotics occurs in our community pharmacies, despite being illegal. Pharmacy staff behavior can be a factor that puts patients at risk for self-medication with antibiotics. Community pharmacies are failing their tasks in enhancing rational use of antibiotics. Such a practice may be a consequence of weak enforcement and control over the legislation and professional standards. Copyright © 2012 John Wiley & Sons, Ltd.

  7. Pharmaceutical care in community pharmacies: practice and research in the US.

    Science.gov (United States)

    Christensen, Dale B; Farris, Karen B

    2006-01-01

    To describe the state of community pharmacy, including patient care services, in the US. Chain pharmacies, including traditional chains, mass merchandisers, and supermarkets, comprise more than 50% of community pharmacies in the US. Dispensing of drugs remains the primary focus, yet the incidence of patients being counseled on medications appears to be increasing. More than 25% of independent community pharmacy owners report providing some patient clinical care services, such as medication counseling and chronic disease management. Most insurance programs pay pharmacists only for dispensing services, yet there are a growing number of public and private initiatives that reimburse pharmacists for cognitive services. Clinical care opportunities exist in the new Medicare prescription drug benefit plan, as it requires medication therapy management services for specific enrollees. The private market approach to healthcare delivery in the US, including pharmacy services, precludes national and statewide strategies to change the basic business model. To date, most pharmacies remain focused on dispensing prescriptions. With lower dispensing fees and higher operating costs, community pharmacies are focused on increasing productivity and efficiency through technology and technicians. Pharmacists remain challenged to establish the value of their nondispensing-related pharmaceutical care services in the private sector. As the cost of suboptimal drug therapy becomes more evident, medication therapy management may become a required pharmacy benefit in private drug insurance plans. Pharmacy school curricula, as well as national and state pharmacy associations, continually work to train and promote community pharmacists for these roles. Practice research is driven primarily by interested academics and, to a lesser degree, by pharmacy associations. Efficient dispensing of prescriptions is the primary focus of community pharmacies in the US. Some well designed practice-based research

  8. 42 CFR 413.241 - Pharmacy arrangements.

    Science.gov (United States)

    2010-10-01

    ... 42 Public Health 2 2010-10-01 2010-10-01 false Pharmacy arrangements. 413.241 Section 413.241... Disease (ESRD) Services and Organ Procurement Costs § 413.241 Pharmacy arrangements. Effective January 1, 2011, an ESRD facility that enters into an arrangement with a pharmacy to furnish renal dialysis...

  9. Issues around household pharmaceutical waste disposal through community pharmacies in Croatia.

    Science.gov (United States)

    Jonjić, Danijela; Vitale, Ksenija

    2014-06-01

    Croatian regulations mandate pharmacies to receive unused medicines from households. Pharmacies are considered as producers and holders of pharmaceutical waste and are obliged to finance this service. Model where pharmacies are responsible for financing disposal of unused medicines without reimbursement is not common in Europe. Present service was not tested before implementation. To investigate the elements of the pharmaceutical waste disposal service provided by pharmacies, and to gain insight into the factors that might influence the effectiveness of the service. Setting All pharmacies in the city of Zagreb. Each pharmacy was asked to weigh the collected waste from the public during a period of 30 days, between June 1st and July 10th of 2011, absent from any media advertisement and answer a specifically designed questionnaire that was exploring possible connections between the amount of collected waste, type of pharmacy ownership, discretion while disposing, location of the container, appropriate labeling and to compare the amount of collected waste between neighborhoods. Quantity of collected unused medicines from the public. Of 210 pharmacies, 91 participated completing the questionnaire (43 % response rate). The total amount of collected waste was 505 kg. Pharmacies owned by the city of Zagreb had higher response rate (74 %) than privately owned pharmacies (36 %), and collected significantly higher amount of waste. Anonymity when disposing influenced collected quantity, while labelling and location of the container did not. There were differences in the amount of collected waste between neighborhoods due to the demographic characteristics and number of pharmacies per capita. The effectiveness of the pharmacy service of collecting unused medicines in Croatia shows a number of weaknesses. The amount of collected medicines is below the European average. Functioning of the service seems to be negatively influenced by the type of pharmacy ownership, distribution

  10. Measuring Administrative Burdens of e-Government Services for Rural SMEs

    Science.gov (United States)

    Costopoulou, Constantina; Ntaliani, Maria

    Administrative burdens comprise the second most important individual business constraint for SMEs. In this context, the Rural Inclusion project aims at reducing rural SMEs' administrative burdens related to particular public services. For succeeding this, it adopts, adapts, and deploys a Web infrastructure combining semantic services with a collaborative training and networking approach in five European rural regions. The paper presents the preliminary results of the initial phases of the project regarding the measurement of administrative burdens of SMEs in a specific rural region related to the service "Starting a new business".

  11. [Clinical pharmacy and surgery: Review].

    Science.gov (United States)

    Jarfaut, A; Nivoix, Y; Vigouroux, D; Kehrli, P; Gaudias, J; Kempf, J-F; Levêque, D; Gourieux, B

    2014-05-01

    Clinical pharmacy has been developed and evaluated in various medical hospital activities. Reviews conducted in this area reported a higher value of this discipline. In surgical services, evenly adverse drug events may occur, so clinical pharmacy activities must also help to optimize the management of drug's patient. The objectives of this literature review is to determine the profile of clinical pharmacy activities developed in surgical services and identify indicators. The research was conducted on Pubmed(®) database with the following keywords (2000-2013), "surgery", "pharmacy", "pharmacist", "pharmaceutical care", "impact" and limited to French or English papers. Studies dealing on simultaneously medical and surgical areas were excluded. Twenty-one papers were selected. The most frequently developed clinical pharmacy activities were history and therapeutic drug monitoring (antibiotics or anticoagulants). Two types of indicators were identified: activity indicators with the number of pharmaceutical interventions, their description and clinical signification, the acceptance rate and workload. Impact indicators were mostly clinical and economic impacts. The development of clinical pharmacy related to surgical patients is documented and appears to have, as for medical patients, a clinical and economical value. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  12. The Need and Use the Rural ICT Services in Iranian Rural Areas

    Directory of Open Access Journals (Sweden)

    Amir Mozafar Amini

    2015-11-01

    Full Text Available Nowadays, Internet access and use of information resources in all human societies are experiencing a rising trend, and different communities are used each with multiple infrastructures due to the benefits of ICT. The present study was based on applied research. In this research, a hybrid approach involving quantitative methods (survey and qualitative (observation, interviews was used. Statistical population of this study consists of two parts, the first part responsible for rural ICT offices, with a population of 125 people using Cochran Formula 80 subjects were selected as first sample, and the second part of the rural of first sample villages with a population of 84,836 people using Cochran formula and randomized-comparative method were studied as second sample. The questionnaire was subjected to reliability testing by using data collection in the pilot study with Cronbach’s Alpha value 0.73 to 0.95 for all variables. SPSS statistical software was used to analysis the data. The results of the study indicate that the overall performance of the agencies providing services to the rural was lower-middle in the offices in banking services has received first place, and the final ranking in the provision of health services. The results of study showed that rural employment, level education and family size effect on the rate of rural ICT offices.

  13. Future-proofing the pharmacy profession in a hypercompetitive market.

    Science.gov (United States)

    Singleton, Judith A; Nissen, Lisa M

    2014-01-01

    This paper highlights the hypercompetitive nature of the current pharmacy landscape in Australia and to suggest either a superior level of differentiation strategy or a focused differentiation strategy targeting a niche market as two viable, alternative business models to cost leadership for small, independent community pharmacies. A description of the Australian health care system is provided as well as background information on the current community pharmacy environment in Australia. The authors propose a differentiation or focused differentiation strategy based on cognitive professional services (CPS) which must be executed well and of a superior quality to competitors' services. Market research to determine the services valued by target customers and that they are willing to pay for is vital. To achieve the superior level of quality that will engender high patient satisfaction levels and loyalty, pharmacy owners and managers need to develop, maintain and clearly communicate service quality specifications to the staff delivering these services. Otherwise, there will be a proliferation of pharmacies offering the same professional services with no evident service differential. However, to sustain competitive advantage over the long-term, these smaller, independent community pharmacies will need to exploit a broad core competency base in order to be able to continuously introduce new sources of competitive advantage. With the right expertise, the authors argue that smaller, independent community pharmacies can successfully deliver CPS and sustain profitability in a hypercompetitive market. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. A mass merchandiser's role in enhancing pharmacy students' business plan development skills for medication therapy management services.

    Science.gov (United States)

    Moultry, Aisha Morris

    2011-09-10

    To develop a relationship between a pharmacy management course and a mass merchandiser and to determine whether involving pharmacy managers from the mass merchandiser in the course would enhance student skills in developing a business plan for medication therapy management services. The pharmacy managers from the mass merchandiser participated in lectures, provided panel discussions, and conducted a business plan competition. Learning was assessed by means of 4 examinations and 1 project (ie, the business plan). At the conclusion of the semester, surveys were administered to solicit student input and gain insight from pharmacy managers on the perceived value of this portion of the course. Students' average grade on the business plan assignment, which included the oral presentation, the peer assessment, and the written proposal, was 92.2%. Approximately 60% (n=53) of surveyed students agreed or strongly agreed that their management skills had improved because of the participation of pharmacy managers from the mass merchandiser. All of the managers enjoyed participating in the experience. The involvement of pharmacy managers from a mass merchandiser enhanced student learning in the classroom, and managers felt that their participation was an important contribution to the development of future pharmacists.

  15. Social and economic value of Portuguese community pharmacies in health care.

    Science.gov (United States)

    Félix, Jorge; Ferreira, Diana; Afonso-Silva, Marta; Gomes, Marta Vargas; Ferreira, César; Vandewalle, Björn; Marques, Sara; Mota, Melina; Costa, Suzete; Cary, Maria; Teixeira, Inês; Paulino, Ema; Macedo, Bruno; Barbosa, Carlos Maurício

    2017-08-29

    Community pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal. The social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: "with service" versus "without service". It is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (M€), including 342.1 M€ in non-remunerated pharmaceutical services and 448.1 M€ in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 M€: 120.3 M€ in non-remunerated services and 24.5 M€ in potential savings with health resource consumption. Community pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society.

  16. Training resources and e-Government services for rural SMEs: the rural inclusion platform

    OpenAIRE

    Axel Maroudas; Pantelis Karamolegkos; Nikos Manouselis

    2010-01-01

    Rural Inclusion, a project supported by the Information and Communication Technologies Policy Support Programme of the European Commission, aims to adopt, adapt, and deploy a Web infrastructure, in rural settings, combining semantics with a collaborativetraining and networking approach, offering e-Government services that will be supported by a rigorous and reusable service process analysis and modeling, and facilitating the disambiguation of the small businesses needs and requirements when t...

  17. Rural Trends in Diagnosis and Services for Autism Spectrum Disorder

    Directory of Open Access Journals (Sweden)

    Ligia Antezana

    2017-04-01

    Full Text Available Rural communities face significant challenges regarding the adequate availability of diagnostic-, treatment-, and support-services for individuals with autism spectrum disorder (ASD. Specifically, a variety of factors, including geographic distance between families and service providers, low reliance on health care professionals, and cultural characteristics, contribute to the diminished availability and utilization of services. Together, these factors lead to risks for delayed ASD screening and diagnosis, yielding lower educational and functional outcomes. The purpose of this review is to outline the specific diagnosis and treatment barriers that affect individuals with ASD and their families in rural settings. Telehealth feasibility and efficacy research is also reviewed, suggesting that telecommunication services may offer an inroad for addressing the specific service barriers faced by rural communities. Together, the current review identifies specific needs for both research and support services that address the specific access barriers characteristic of rural settings.

  18. Big Data: Implications for Health System Pharmacy.

    Science.gov (United States)

    Stokes, Laura B; Rogers, Joseph W; Hertig, John B; Weber, Robert J

    2016-07-01

    Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services.

  19. Access all areas? An area-level analysis of accessibility to general practice and community pharmacy services in England by urbanity and social deprivation.

    Science.gov (United States)

    Todd, Adam; Copeland, Alison; Husband, Andy; Kasim, Adetayo; Bambra, Clare

    2015-05-08

    (1) To determine the percentage of the population in England that has access to a general practitioner (GP) premises within a 20 min walk (the accessibility); (2) explore the relationship between the walking distance to a GP premises and urbanity and social deprivation and (3) compare accessibility of a GP premises to that of a community pharmacy--and how this may vary by urbanity and social deprivation. This area-level analysis spatial study used postcodes for all GP premises and community pharmacies in England. Each postcode was assigned to a population lookup table and Lower Super Output Area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe, or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score 2010). Living within a 20 min walk of a GP premises. Overall, 84.8% of the population is estimated to live within a 20 min walk of a GP premises: 81.2% in the most affluent areas, 98.2% in the most deprived areas, 94.2% in urban and 19.4% in rural areas. This is consistently lower when compared with the population living within a 20 min walk of a community pharmacy. Our study shows that the vast majority of the population live within a 20 min walk of a GP premises, with higher proportions in the most deprived areas--a positive primary care law. However, more people live within a 20 min walk of a community pharmacy compared with a GP premises, and this potentially has implications for the commissioning of future services from these healthcare providers in England. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  20. Providing patient care in community pharmacies in Australia.

    Science.gov (United States)

    Benrimoj, Shalom I; Roberts, Alison S

    2005-11-01

    To describe Australia's community pharmacy network in the context of the health system and outline the provision of services. The 5000 community pharmacies form a key component of the healthcare system for Australians, for whom health expenditures represent 9% of the Gross Domestic Product. A typical community pharmacy dispenses 880 prescriptions per week. Pharmacists are key partners in the Government's National Medicines Policy and contribute to its objectives through the provision of cognitive pharmaceutical services (CPS). The Third Community Pharmacy Agreement included funding for CPS including medication review and the provision of written drug information. Funding is also provided for a quality assurance platform with which the majority of pharmacies are accredited. Fifteen million dollars (Australian) have been allocated to research in community pharmacy, which has focused on achieving quality use of medicines (QUM), as well as developing new CPS and facilitating change. Elements of the Agreements have taken into account QUM principles and are now significant drivers of practice change. Although accounting for 10% of remuneration for community pharmacy, the provision of CPS represents a significant shift in focus to view pharmacy as a service provider. Delivery of CPS through the community pharmacy network provides sustainability for primary health care due to improvement in quality presumably associated with a reduction in healthcare costs. Australian pharmacy practice is moving strongly in the direction of CPS provision; however, change does not occur easily. The development of a change management strategy is underway to improve the uptake of professional and business opportunities in community pharmacy.

  1. A required course in the development, implementation, and evaluation of clinical pharmacy services.

    Science.gov (United States)

    Skomo, Monica L; Kamal, Khalid M; Berdine, Hildegarde J

    2008-10-15

    To develop, implement, and assess a required pharmacy practice course to prepare pharmacy students to develop, implement, and evaluate clinical pharmacy services using a business plan model. Course content centered around the process of business planning and pharmacoeconomic evaluations. Selected business planning topics included literature evaluation, mission statement development, market evaluation, policy and procedure development, and marketing strategy. Selected pharmacoeconomic topics included cost-minimization analysis, cost-benefit analysis, cost-effectiveness analysis, cost-utility analysis, and health-related quality of life (HRQoL). Assessment methods included objective examinations, student participation, performance on a group project, and peer evaluation. One hundred fifty-three students were enrolled in the course. The mean scores on the objective examinations (100 points per examination) ranged from 82 to 85 points, with 25%-35% of students in the class scoring over 90, and 40%-50% of students scoring from 80 to 89. The mean scores on the group project (200 points) and classroom participation (50 points) were 183.5 and 46.1, respectively. The mean score on the peer evaluation was 30.8, with scores ranging from 27.5 to 31.7. The course provided pharmacy students with the framework necessary to develop and implement evidence-based disease management programs and to assure efficient, cost-effective utilization of pertinent resources in the provision of patient care.

  2. Perceptions, use and attitudes of pharmacy customers on complementary medicines and pharmacy practice.

    Science.gov (United States)

    Braun, Lesley A; Tiralongo, Evelin; Wilkinson, Jenny M; Spitzer, Ondine; Bailey, Michael; Poole, Susan; Dooley, Michael

    2010-07-20

    Complementary medicines (CMs) are popular amongst Australians and community pharmacy is a major supplier of these products. This study explores pharmacy customer use, attitudes and perceptions of complementary medicines, and their expectations of pharmacists as they relate to these products. Pharmacy customers randomly selected from sixty large and small, metropolitan and rural pharmacies in three Australian states completed an anonymous, self administered questionnaire that had been pre-tested and validated. 1,121 customers participated (response rate 62%). 72% had used CMs within the previous 12 months, 61% used prescription medicines daily and 43% had used both concomitantly. Multivitamins, fish oils, vitamin C, glucosamine and probiotics were the five most popular CMs. 72% of people using CMs rated their products as 'very effective' or 'effective enough'. CMs were as frequently used by customers aged 60 years or older as younger customers (69% vs. 72%) although the pattern of use shifted with older age. Most customers (92%) thought pharmacists should provide safety information about CMs, 90% thought they should routinely check for interactions, 87% thought they should recommend effective CMs, 78% thought CMs should be recorded in customer's medication profile and 58% thought pharmacies stocking CMs should also employ a complementary medicine practitioner. Of those using CMs, 93% thought it important for pharmacists to be knowledgeable about CMs and 48% felt their pharmacist provides useful information about CMs. CMs are widely used by pharmacy customers of all ages who want pharmacists to be more involved in providing advice about these products.

  3. How do patients with cancer pain view community pharmacy services? An interview study.

    Science.gov (United States)

    Edwards, Zoe; Blenkinsopp, Alison; Ziegler, Lucy; Bennett, Michael I

    2018-02-26

    Pain experienced by many patients with advanced cancer is often not well controlled and community pharmacists are potentially well placed to provide support. The study objective was to explore the views and experiences of patients with advanced cancer about community pharmacies, their services and attitudes towards having a community pharmacist pain medicines consultation. Purposive sampling of GP clinical information systems was used to recruit patients with advanced cancer, living in the community and receiving opioid analgesics in one area of England, UK between January 2015 and July 2016. Thirteen patients had a semi-structured interview which was audio-recorded and transcribed verbatim. Data were analysed deductively and inductively using Framework analysis and incorporating new themes as they emerged. The framework comprised Pain management, Experiences and expectations, Access to care and Communication. All patients reported using one regular community pharmacy citing convenience, service and staff friendliness as influential factors. The idea of a community pharmacy medicines consultation was acceptable to most patients. The idea of telephone consultations was positively received but electronic media such as Skype was not feasible or acceptable for most. Patients perceived a hierarchy of health professionals with specialist palliative care nurses at the top (due to their combined knowledge of their condition and medicines) followed by GPs then pharmacists. Patients receiving specialist palliative care described pain that was better controlled than those who were not. They thought medicines consultations with a pharmacist could be useful for patients before referral for palliative care. There is a need for pain medicines support for patients with advanced cancer, and unmet need appears greater for those not under the care of specialist services. Medicines consultations, in principle, are acceptable to patients both in person and by telephone, and the latter

  4. Reducing wait time in a hospital pharmacy to promote customer service.

    Science.gov (United States)

    Slowiak, Julie M; Huitema, Bradley E; Dickinson, Alyce M

    2008-01-01

    The purpose of this study was to compare the effects of 2 different interventions on wait times at a hospital outpatient pharmacy: (1) giving feedback to employees about customer satisfaction with wait times and (2) giving a combined intervention package that included giving more specific feedback about actual wait times and goal setting for wait time reduction in addition to the customer satisfaction feedback. The relationship between customer satisfaction ratings and wait times was examined to determine whether wait times affected customer service satisfaction. Participants were 10 employees (4 pharmacists and 6 technicians) of an outpatient pharmacy. Wait times and customer satisfaction ratings were collected for "waiting customers." An ABCBA' within-subjects design was used to assess the effects of the interventions on both wait time and customer satisfaction, where A was the baseline (no feedback and no goal setting); B was the customer satisfaction feedback; C was the customer satisfaction feedback, the wait time feedback, and the goal setting for wait time reduction; and A' was a follow-up condition that was similar to the original baseline condition. Wait times were reduced by approximately 20%, and there was concomitant increased shift in levels of customer satisfaction, as indicated by the correlation between these variables (r = -0.57 and P customer's wait time. Data from this study may provide useful preliminary benchmarking data for standard pharmacy wait times.

  5. 76 FR 30904 - Rural Utilities Service Telecommunications Loan and Loan Guarantee Program

    Science.gov (United States)

    2011-05-27

    ..., this new approach will give our customers increased flexibility to find and deploy technology that... DEPARTMENT OF AGRICULTURE Rural Utilities Service Rural Utilities Service Telecommunications Loan and Loan Guarantee Program AGENCY: Rural Utilities Service, USDA. ACTION: Notice of elimination of the...

  6. Feasibility of a rural palliative supportive service.

    Science.gov (United States)

    Pesut, B; Hooper, B P; Robinson, C A; Bottorff, J L; Sawatzky, R; Dalhuisen, M

    2015-01-01

    Healthcare models for the delivery of palliative care to rural populations encounter common challenges: service gaps, the cost of the service in relation to the population, sustainability, and difficulty in demonstrating improvements in outcomes. Although it is widely agreed that a community capacity-building approach to rural palliative care is essential, how that approach can be achieved, evaluated and sustained remains in question. The purpose of this community-based research project is to test the feasibility and identify potential outcomes of implementing a rural palliative supportive service (RPaSS) for older adults living with life-limiting chronic illness and their family caregiver in the community. This paper reports on the feasibility aspects of the study. RPaSS is being conducted in two co-located rural communities with populations of approximately 10 000 and no specialized palliative services. Participants living with life-limiting chronic illness and their family caregivers are visited bi-weekly in the home by a nurse coordinator who facilitates symptom management, teaching, referrals, psychosocial and spiritual support, advance care planning, community support for practical tasks, and telephone-based support for individuals who must commute outside of the rural community for care. Mixed-method collection strategies are used to collect data on visit patterns; healthcare utilization; family caregiver needs; and participant needs, functional performance and quality of life. A community-based advisory committee worked with the investigative team over a 1-year period to plan RPaSS, negotiating the best fit between research methods and the needs of the community. Recruitment took longer than anticipated with service capacity being reached at 8 months. Estimated service capacity of one nurse coordinator, based on bi-weekly visits, is 25 participants and their family caregivers. A total of 393 in-person visits and 53 telephone visits were conducted between

  7. The Professional Culture of Community Pharmacy and the Provision of MTM Services

    Directory of Open Access Journals (Sweden)

    Meagen M. Rosenthal

    2018-03-01

    Full Text Available The integration of advanced pharmacy services into community pharmacy practice is not complete. According to implementation research understanding professional culture, as a part of context, may provide insights for accelerating this process. There are three objectives in this study. The first objective of this study was to validate an adapted version of an organizational culture measure in a sample of United States’ (US community pharmacists. The second objective was to examine potential relationships between the cultural factors identified using the validated instrument and a number of socialization and education variables. The third objective was to examine any relationships between the scores on the identified cultural factors and the provision of MTM services. This study was a cross-sectional online survey for community pharmacists in the southeastern US. The survey contained questions on socialization/education, respondents’ self-reported provision of medication therapy management (MTM services, and the organizational culture profile (OCP. Analyses included descriptive statistics, a principle components analysis (PCA, independent samples t-test, and multivariate ordinal regression. A total of 303 surveys were completed. The PCA revealed a six-factor structure: social responsibility, innovation, people orientation, competitiveness, attention to detail, and reward orientation. Further analysis revealed significant relationships between social responsibility and years in practice, and people orientation and attention to detail and pharmacists’ training and practice setting. Significant positive relationships were observed between social responsibility, innovation, and competitiveness and the increased provision of MTM services. The significant relationships identified between the OCP factors and community pharmacist respondents’ provision of MTM services provides an important starting point for developing interventions to improve the

  8. The Professional Culture of Community Pharmacy and the Provision of MTM Services.

    Science.gov (United States)

    Rosenthal, Meagen M; Holmes, Erin R

    2018-03-21

    The integration of advanced pharmacy services into community pharmacy practice is not complete. According to implementation research understanding professional culture, as a part of context, may provide insights for accelerating this process. There are three objectives in this study. The first objective of this study was to validate an adapted version of an organizational culture measure in a sample of United States' (US) community pharmacists. The second objective was to examine potential relationships between the cultural factors identified using the validated instrument and a number of socialization and education variables. The third objective was to examine any relationships between the scores on the identified cultural factors and the provision of MTM services. This study was a cross-sectional online survey for community pharmacists in the southeastern US. The survey contained questions on socialization/education, respondents' self-reported provision of medication therapy management (MTM) services, and the organizational culture profile (OCP). Analyses included descriptive statistics, a principle components analysis (PCA), independent samples t-test, and multivariate ordinal regression. A total of 303 surveys were completed. The PCA revealed a six-factor structure: social responsibility, innovation, people orientation, competitiveness, attention to detail, and reward orientation. Further analysis revealed significant relationships between social responsibility and years in practice, and people orientation and attention to detail and pharmacists' training and practice setting. Significant positive relationships were observed between social responsibility, innovation, and competitiveness and the increased provision of MTM services. The significant relationships identified between the OCP factors and community pharmacist respondents' provision of MTM services provides an important starting point for developing interventions to improve the uptake of practice

  9. Perspectives of resettled African refugees on accessing medicines and pharmacy services in Queensland, Australia.

    Science.gov (United States)

    Bellamy, Kim; Ostini, Remo; Martini, Nataly; Kairuz, Therese

    2017-10-01

    The aim of this study was to explore the barriers to accessing medicines and pharmacy services among refugees in Queensland, Australia, from the perspectives of resettled African refugees. A generic qualitative approach was used in this study. Resettled African refugees were recruited via a purposive snowball sampling method. The researcher collected data from different African refugee communities, specifically those from Sudanese, Congolese and Somalian communities. Participants were invited by a community health leader to participate in the study; a community health leader is a trained member of the refugee community who acts as a 'health information conduit' between refugees and the health system. Invitations were done either face-to-face, telephonically or by email. The focus groups were digitally recorded in English and transcribed verbatim by the researcher. Transcripts were entered into NVIVO© 11 and the data were analysed using inductive thematic analysis. Four focus groups were conducted between October and November 2014 in the city of Brisbane with African refugees, one with five Somali refugees, one with five Congolese refugees, one with three refugee community health leaders from South Sudan, Liberia and Eritrea and one with three refugee community health leaders from Uganda, Burundi and South Sudan. Eleven sub-themes emerged through the coding process, which resulted in four overarching themes: health system differences, navigating the Australian health system, communication barriers and health care-seeking behaviour. With regard to accessing medicines and pharmacy services, this study has shown that there is a gap between resettled refugees' expectations of health services and the reality of the Australian health system. Access barriers identified included language barriers, issues with the Translating and Interpreter Service, a lack of professional communication and cultural beliefs affecting health care-seeking behaviour. This exploratory study has

  10. Financial risk management of pharmacy benefits.

    Science.gov (United States)

    Saikami, D

    1997-10-01

    Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

  11. Urban-rural disparity in utilization of preventive care services in China.

    Science.gov (United States)

    Liu, Xiang; Li, Ningxiu; Liu, Chaojie; Ren, Xiaohui; Liu, Danping; Gao, Bo; Liu, Yuanyuan

    2016-09-01

    Preventive care service is considered pivotal on the background of demographic ageing and a rise in chronic diseases in China. The disparity in utilization of preventive care services between urban and rural in China is a serious issue. In this paper, we explored factors associated with urban-rural disparity in utilization of preventive care services in China, and determined how much of the urban-rural disparity was attributable to each determinant of utilization in preventive care services. Using representative sample data from China Health and Nutrition Survey in 2011 (N = 12,976), the present study performed multilevel logistic model to examine the factors that affected utilization of preventive care services in last 4 weeks. Blinder-Oaxaca decomposition method was applied to divide the utilization of preventive care disparity between urban and rural residents into a part that can be explained by differences in observed covariates and unobserved part. The percentage of rural residents utilizing preventive care service in last 4 weeks was lower than that of urban residents (5.1% vs 9.3%). Female, the aged, residents with higher education level and household income, residents reporting self-perceived illness in last 4 weeks and physician-diagnosed chronic disease had higher likelihood of utilizing preventive care services. Household income was the most important factor accounting for 26.6% of urban-rural disparities in utilization of preventive care services, followed by education (21.5%), self-perceived illness in last 4 weeks (7.8%), hypertension (4.4%), diabetes (3.3%), other chronic diseases (0.8%), and health insurance (-1.0%). Efforts to reduce financial barriers for low-income individuals who cannot afford preventive services, increasing awareness of the importance of obtaining preventive health services and providing more preventive health services covered by health insurance, may help to reduce the gap of preventive care services utilization between

  12. A Mass Merchandiser's Role in Enhancing Pharmacy Students’ Business Plan Development Skills for Medication Therapy Management Services

    Science.gov (United States)

    2011-01-01

    Objectives. To develop a relationship between a pharmacy management course and a mass merchandiser and to determine whether involving pharmacy managers from the mass merchandiser in the course would enhance student skills in developing a business plan for medication therapy management services. Design. The pharmacy managers from the mass merchandiser participated in lectures, provided panel discussions, and conducted a business plan competition. Learning was assessed by means of 4 examinations and 1 project (ie, the business plan). At the conclusion of the semester, surveys were administered to solicit student input and gain insight from pharmacy managers on the perceived value of this portion of the course. Assessment. Students’ average grade on the business plan assignment, which included the oral presentation, the peer assessment, and the written proposal, was 92.2%. Approximately 60% (n = 53) of surveyed students agreed or strongly agreed that their management skills had improved because of the participation of pharmacy managers from the mass merchandiser. All of the managers enjoyed participating in the experience. Conclusions. The involvement of pharmacy managers from a mass merchandiser enhanced student learning in the classroom, and managers felt that their participation was an important contribution to the development of future pharmacists. PMID:21969719

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

    Science.gov (United States)

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

    2014-09-01

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

  14. Analysis of pharmacist-provided medication therapy management (MTM) services in community pharmacies over 7 years.

    Science.gov (United States)

    Barnett, Mitchell J; Frank, Jessica; Wehring, Heidi; Newland, Brand; VonMuenster, Shannon; Kumbera, Patty; Halterman, Tom; Perry, Paul J

    2009-01-01

    Although community pharmacists have historically been paid primarily for drug distribution and dispensing services, medication therapy management (MTM) services evolved in the 1990s as a means for pharmacists and other providers to assist physicians and patients in managing clinical, service, and cost outcomes of drug therapy. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA 2003) and the subsequent implementation of Medicare Part D in January 2006 for the more than 20 million Medicare beneficiaries enrolled in the Part D benefit formalized MTM services for a subset of high-cost patients. Although Medicare Part D has provided a new opportunity for defining the value of pharmacist-provided MTM services in the health care system, few publications exist which quantify changes in the provision of pharmacist-provided MTM services over time. To (a) describe the changes over a 7-year period in the primary types of MTM services provided by community pharmacies that have contracted with drug plan sponsors through an MTM administrative services company, and (b) quantify potential MTM-related cost savings based on pharmacists' self-assessments of the likely effects of their interventions on health care utilization. Medication therapy management claims from a multistate MTM administrative services company were analyzed over the 7-year period from January 1, 2000, through December 31, 2006. Data extracted from each MTM claim included patient demographics (e.g., age and gender), the drug and type that triggered the intervention (e.g., drug therapeutic class and therapy type as either acute, intermittent, or chronic), and specific information about the service provided (e.g., Reason, Action, Result, and Estimated Cost Avoidance [ECA]). ECA values are derived from average national health care utilization costs, which are applied to pharmacist self-assessment of the "reasonable and foreseeable" outcome of the intervention. ECA values are updated

  15. What factors influence physiotherapy service provision in rural communities? A pilot study.

    Science.gov (United States)

    Adams, Robyn; Sheppard, Lorraine; Jones, Anne; Lefmann, Sophie

    2014-06-01

    To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive sampling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery. © 2014 National Rural Health Alliance Inc.

  16. Rural women's perspectives of maternity services in the Midland Region of New Zealand.

    Science.gov (United States)

    Gibbons, Veronique; Lancaster, Gytha; Gosman, Kim; Lawrenson, Ross

    2016-09-01

    INTRODUCTION Rural women face many challenges with regards to maternity services. Many rural primary birthing facilities in New Zealand have closed. The Lead Maternity Carer (LMC) model of maternity care, introduced in 1990, has moved provision of rural maternity care from doctors to independent midwifery services. Shortages of rural midwives in the Midland region led to rural maternity care being seen as a vulnerable service. AIM To understand the views and experiences of rural women concerning maternity care, to inform the future design and provision of rural maternity services. METHODS Participants were drawn from areas purposively selected to represent the five District Health Boards comprising the Midland health region. A demographic questionnaire, focus groups and individual interviews explored rural women's perspectives of antenatal care provision. These were analysed thematically. RESULTS Sixty-two women were recruited. Key themes emerging from focus groups and interviews included: access to services, the importance of safety and quality of care, the need for appropriate information at different stages, and the role of partners, family and friends in the birthing journey. While most women were happy with access to services, quality of care, provision of information, and the role of family in their care, for some women, this experience could be enhanced. CONCLUSION Midwives are the frontline service for women seeking antenatal services. Support for rural midwives and for local birthing units is needed to ensure rural women receive services equal to that of their urban counterparts.

  17. Pharmacy Dashboard: An Innovative Process for Pharmacy Workload and Productivity.

    Science.gov (United States)

    Kinney, Ashley; Bui, Quyen; Hodding, Jane; Le, Jennifer

    2017-03-01

    Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy. Methods: Long Beach Memorial Hospital (462 adult beds) and Miller Children's and Women's Hospital of Long Beach (combined 324 beds) are tertiary not-for-profit, community-based hospitals that are served by one CIVAS pharmacy. Metrics to evaluate the effectiveness of CIVAS were developed and implemented on a dashboard in real-time from March 2013 to March 2014. Results: The metrics that were designed and implemented to evaluate the effectiveness of CIVAS were quality and value, financial resilience, and the department's people and culture. Using a dashboard that integrated these metrics, the accuracy of manufacturing defect-free products was ≥99.9%, indicating excellent quality and value of CIVAS. The metric for financial resilience demonstrated a cost savings of $78,000 annually within pharmacy by eliminating the outsourcing of products. People and value metrics on the dashboard focused on standard work, with an overall 94.6% compliance to the workflow. Conclusion: A unique dashboard that incorporated metrics to monitor 3 important areas was successfully implemented to improve the effectiveness of CIVAS pharmacy. These metrics helped pharmacy to monitor progress in real-time, allowing attainment of production goals and fostering continuous quality improvement through LEAN work.

  18. Pharmacy Dashboard: An Innovative Process for Pharmacy Workload and Productivity

    Science.gov (United States)

    Bui, Quyen; Hodding, Jane; Le, Jennifer

    2017-01-01

    Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy. Methods: Long Beach Memorial Hospital (462 adult beds) and Miller Children's and Women's Hospital of Long Beach (combined 324 beds) are tertiary not-for-profit, community-based hospitals that are served by one CIVAS pharmacy. Metrics to evaluate the effectiveness of CIVAS were developed and implemented on a dashboard in real-time from March 2013 to March 2014. Results: The metrics that were designed and implemented to evaluate the effectiveness of CIVAS were quality and value, financial resilience, and the department's people and culture. Using a dashboard that integrated these metrics, the accuracy of manufacturing defect-free products was ≥99.9%, indicating excellent quality and value of CIVAS. The metric for financial resilience demonstrated a cost savings of $78,000 annually within pharmacy by eliminating the outsourcing of products. People and value metrics on the dashboard focused on standard work, with an overall 94.6% compliance to the workflow. Conclusion: A unique dashboard that incorporated metrics to monitor 3 important areas was successfully implemented to improve the effectiveness of CIVAS pharmacy. These metrics helped pharmacy to monitor progress in real-time, allowing attainment of production goals and fostering continuous quality improvement through LEAN work. PMID:28439134

  19. Service Level Decision-making in Rural Physiotherapy: Development of Conceptual Models.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2016-06-01

    Understanding decision-making about health service provision is increasingly important in an environment of increasing demand and constrained resources. Multiple factors are likely to influence decisions about which services will be provided, yet workforce is the most noted factor in the rural physiotherapy literature. This paper draws together results obtained from exploration of service level decision-making (SLDM) to propose 'conceptual' models of rural physiotherapy SLDM. A prioritized qualitative approach enabled exploration of participant perspectives about rural physiotherapy decision-making. Stakeholder perspectives were obtained through surveys and in-depth interviews. Interviews were transcribed verbatim and reviewed by participants. Participant confidentiality was maintained by coding both participants and sites. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of regional, rural and remote communities. Thirty-nine surveys were received from participants in 11 communities. Nineteen in-depth interviews were conducted with physiotherapists and key decision-makers. Results reveal the complexity of factors influencing rural physiotherapy service provision and the value of a systems approach when exploring decision-making about rural physiotherapy service provision. Six key features were identified that formed the rural physiotherapy SLDM system: capacity and capability; contextual influences; layered decision-making; access issues; value and beliefs; and tensions and conflict. Rural physiotherapy SLDM is not a one-dimensional process but results from the complex interaction of clusters of systems issues. Decision-making about physiotherapy service provision is influenced by both internal and external factors. Similarities in influencing factors and the iterative nature of decision-making emerged, which enabled linking physiotherapy SLDM with

  20. Basic life support and cardiopulmonary resuscitation training for pharmacy students and the community by a pharmacy student committee.

    Science.gov (United States)

    Goddard, Kara B; Eppert, Heather D; Underwood, Elizabeth L; McLean, Katie Maxwell; Finks, Shannon W; Rogers, Kelly C

    2010-08-10

    To create a self-sufficient, innovative method for providing cardiopulmonary resuscitation (CPR) education within a college of pharmacy using a student-driven committee, and disseminating CPR education into the community through a service learning experience. A CPR committee comprised of doctor of pharmacy (PharmD) students at the University of Tennessee College of Pharmacy provided CPR certification to all pharmacy students. The committee developed a service learning project by providing CPR training courses in the community. Participants in the course were required to complete an evaluation form at the conclusion of each training course. The CPR committee successfully certified more than 1,950 PharmD students and 240 community members from 1996 to 2009. Evaluations completed by participants were favorable, with 99% of all respondents (n = 351) rating the training course as either "excellent" or "good" in each of the categories evaluated. A PharmD student-directed committee successfully provided CPR training to other students and community members as a service learning experience.

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

    Science.gov (United States)

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

    2016-09-01

    The aim of this study was to evaluate the attitudes towards physician-pharmacist collaboration among pharmacy students in order to develop an interprofessional education (IPE) opportunity through integrating cooperative learning (CL) into a team-based student-supported community service event. The study also aimed to assess the change in students' attitudes towards interprofessional collaboration after participation in the event. A bilingual version of the Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP(2)C) in English and Chinese was completed by pharmacy students enrolled in Wuhan University of Science and Technology, China. Sixty-four students (32 pharmacy students and 32 medical students) in the third year of their degree volunteered to participate in the IPE opportunity for community-based diabetes and hypertension self-management education. We found the mean score of SATP(2)C among 235 Chinese pharmacy students was 51.44. Cronbach's alpha coefficient was 0.90. Our key finding was a significant increase in positive attitudes towards interprofessional collaboration after participation in the IPE activity. These data suggest that there is an opportunity to deliver IPE in Chinese pharmacy education. It appears that the integration of CL into an interprofessional team-based community service offers a useful approach for IPE.

  2. Leadership styles of hospital pharmacy directors.

    Science.gov (United States)

    Parrett, E E; Hurd, P D; Northcraft, G; McGhan, W F; Bootman, J L

    1985-05-01

    The leadership styles of hospital pharmacy directors and the association between leadership style, participative management, and innovative pharmaceutical services were studied using a mail questionnaire. The questionnaire was sent to 570 randomly selected hospital pharmacy directors. Included were a validated instrument that measures task-oriented versus relationship-oriented leadership behavior and other questions about participation of staff members, innovative services, and respondents' personal characteristics. The response rate was 69%. The majority of respondents perceived their leadership as highly relationship-oriented as well as highly task-oriented. Respondents with the "high relationship-high task" leadership style had the highest scores for subordinate participation. There were no significant differences in scores for innovative services by leadership style. A positive correlation between scores for subordinate participation and scores for innovative services was demonstrated. Most hospital pharmacy directors used a management style in which relationships and staff participation were important.

  3. Identifying medication-related needs of HIV patients: foundation for community pharmacist-based services

    Directory of Open Access Journals (Sweden)

    Yardlee Kauffman

    2014-01-01

    Full Text Available Background: Patients living with HIV/AIDS have complex medication regimens. Pharmacists within community pharmacy settings can have a role managing patients living with HIV/AIDS. Patients' perspectives surrounding implementation about community pharmacist-based services is needed as limited information is available. Objective: To identify medication-related needs of HIV-infected patients who receive prescriptions from a community pharmacy. To determine patient perspectives and knowledge of community pharmacist-based services. Methods: A qualitative research study involving in-depth, semi-structured interviews with patients was conducted. Inclusion criteria included: HIV positive men and women at least 18 years of age who receive care at a HIV clinic, currently take medication(s and use a community pharmacy for all prescription fills. Patients were recruited from one urban and one rural health center. Patients answered questions about their perceptions and knowledge about the role and value of pharmacy services and completed a demographic survey. The recordings of the interviews were transcribed verbatim and were analyzed using principles of Grounded Theory. Results: Twenty-nine interviews were conducted: 15 participants from the urban site and 14 from the rural site. Five main themes emerged including: patients experience ongoing and varying medication-related needs; patients desire a pharmacist who is caring, knowledgeable and integrated with health care providers; patients expect ready access to drug therapy; patients value an individualized patient encounter, and patients need to be informed that a pharmacist-service exists. Conclusion: Patients with HIV value individualized and personal encounters with pharmacists at time intervals that are convenient for the patient. Patients felt that a one-on-one encounter with a pharmacist would be most valuable when initiating or modifying medication therapy. These patient perspectives can be useful for

  4. Clinical pharmacy cardiac risk service for managing patients with coronary artery disease in a health maintenance organization.

    Science.gov (United States)

    Sandhoff, Brian G; Nies, Leslie K; Olson, Kari L; Nash, James D; Rasmussen, Jon R; Merenich, John A

    2007-01-01

    A clinical pharmacy service for managing the treatment of coronary artery disease in a health maintenance organization is described. Despite the proven benefits of aggressive risk factor modification for patients with coronary artery disease (CAD), there remains a treatment gap between consensus- and evidence-based recommendations and their application in patient care. In 1998, Kaiser Permanente of Colorado developed the Clinical Pharmacy Cardiac Risk Service (CPCRS) to focus on the long-term management of patients with CAD to improve clinical outcomes. The primary goals of the CPCRS are to increase the number of CAD patients on lipid-lowering therapy, manage medications shown to decrease the risk of future CAD-related events, assist in the monitoring and control of other diseases that increase cardiovascular risk, provide patient education and recommendations for nonpharmacologic therapy, and act as a CAD information resource for physicians and other health care providers. Using an electronic medical record and tracking database, the service works in close collaboration with primary care physicians, cardiologists, cardiac rehabilitation nurses, and other health care providers to reduce cardiac risk in the CAD population. Particular attention is given to dyslipidemia, blood pressure, diabetes mellitus, and tobacco cessation. Treatment with evidence-based regimens is initiated and adjusted as necessary. Over 11,000 patients are currently being followed by the CPCRS. A clinical pharmacy service in a large health maintenance organization provides cardiac risk reduction for patients with CAD and helps close treatment gaps that may exist for these patients.

  5. Home Care Services and the Rural Elderly.

    Science.gov (United States)

    Hayslip, Bert, Jr.; And Others

    1980-01-01

    Independent studies examined a needs v an agency perspective on home health care service needs within a rural county. Interviews with 299 elderly, aged 60-93, revealed there were substantial needs for home health care services and the desire for services varied with residence within the county. (Author)

  6. The paradox of pharmacy: A profession's house divided.

    Science.gov (United States)

    Brown, Daniel

    2012-01-01

    To describe the paradox in pharmacy between the vision of patient care and the reality of community pharmacy practice and to explore how integrated reimbursement for the retail prescription and linking cognitive patient care services directly to prescription processing could benefit the profession. A dichotomy exists between what many pharmacists do and what they've been trained to do. Pharmacy leaders have formulated a vision for pharmacists to become more involved in direct patient care. All graduates now receive PharmD-level training, and some leaders call for requirements of postgraduate residency training and board certification for pharmacists who provide patient care. How such requirements would relate to community pharmacy practice is unclear. The retail prescription remains the primary link between the pharmacist and the health care consumer. Cognitive services, such as medication therapy management (MTM), need to be integrated into the standard workflow of community pharmacies so as to become a natural extension of the professional services rendered in the process of filling a prescription. Current prescription fees are not sufficient to support legitimate professional services. A proposed integrated pricing system for retail prescriptions includes a $15 professional fee that is scaled upward for value-added services, such as MTM. Pharmacy includes a diversity of practice that has historically been a source of division. For pharmacists to reach their potential as patient care providers, the various factions within the profession must forge a unified vision of the future that addresses all realms of practice.

  7. Reaching Rural Handicapped Children: The Transportation Situation in Rural Service Delivery. Making It Work in Rural Communities. A Rural Network Monograph.

    Science.gov (United States)

    Tucker, Jamie; And Others

    Almost everyone who responded to three transportation surveys of rural Handicapped Children's Early Education Program (HCEEP) projects identified transportation as a critical problem in the delivery of services to handicapped children in rural areas. Transportation problems encountered were attributed to environmental/geographic factors,…

  8. Description and analysis of hospital pharmacies in Madagascar.

    Science.gov (United States)

    Ratsimbazafimahefa, H R; Sadeghipour, F; Trouiller, P; Pannatier, A; Allenet, B

    2018-05-01

    Madagascar's health care system has operated without formal hospital pharmacies for more than two decades. The gradual integration of pharmacists in public hospitals since 2012 will allow the structuring of this field. This study was conducted to characterize the current situation regarding all aspects relating to the general functioning of hospital pharmacies and the services provided. This qualitative research used semi-structured interviews. Interviewees' perceptions about the general organization and functioning of hospital pharmacies and details on services provided were collected. The 16 interviewees were Ministry of Health staff members involved in hospital pharmacy, hospital directors, medical staff members and hospital pharmacy managers. Interviews were recorded, translated into French if conducted in Malagasy, and fully transcribed. Verbatim transcripts were coded according to the themes of hospital pharmacy and topical content analysis was performed. The principal issue perceived by interviewees was the heterogeneity of the system in terms of technical and financing management, with a main impact on the restocking of pharmaceutical products. The drug supply chain is not under control: no internal procedure has been established for the selection of pharmaceutical products, the quantification of needs is complex, stock management is difficult to supervise, a standard prescription protocol is lacking, dispensing is performed by unqualified staff, no pharmaceutical preparation is manufactured in the hospitals and administration occurs without pharmaceutical support. Progressive structuring of efficient hospital pharmacy services using the Basel statements for the future of hospital pharmacy is urgently needed to improve health care in Madagascar. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

  9. Reengineering the retail/ambulatory pharmacy for provision of biotechnology pharmaceutical services.

    Science.gov (United States)

    Schneider, P J

    1998-07-01

    Biotechnology products offer both problems and opportunities for pharmacists. On one hand, they are expensive to purchase and keep on inventory. Typical compensation for outpatient prescriptions does not offset the cost of maintaining the inventory, or providing the education and training that patients often need to use biotechnology products properly. On the other hand, there are issues related to proper storage, preparation, and administration for which pharmacists are well prepared to address. Pharmacists are also convenient, trusted, and provide service at relatively low cost. Examples of special services that pharmacists can provide to improve the use of biotechnology products include patient education, injection clinics, provision of medical supplies, and predrawing syringes for patients. Patients are often sent to many providers for these services, resulting in inconvenience and fragmentation of care. If new compensation methods can be established to support more comprehensive pharmacy services, the use of biotechnology products by patients will improve.

  10. The Roles of Pharmacy Schools in Bridging the Gap Between Law and Practice.

    Science.gov (United States)

    Adams, Alex J; Dering-Anderson, Allison; Klepser, Michael E; Klepser, Donald

    2018-05-01

    Progressive pharmacy laws do not always lead to progressive pharmacy practice. Progressive laws are necessary, but not sufficient for pharmacy services to take off in practice. Pharmacy schools can play critical roles by working collaboratively with community pharmacies to close the gap between law and practice. Our experiences launching pharmacy-based point-of-care testing services in community pharmacy settings illustrate some of the roles schools can play, including: developing and providing standardized training, developing template protocols, providing workflow support, sparking collaboration across pharmacies, providing policy support, and conducting research.

  11. [Globalization and its impact on pharmacy services in the Slovak Republic].

    Science.gov (United States)

    Malovecká, Ivona; Minarovič, Igor; Mináriková, Daniela; Lehocká, Lubica; Snopková, Miroslava; Foltán, Viliam

    2014-02-01

    Public pharmacies are excellent medical facilities having the largest number of contacts with patients. They are the facilities of the first and last contact with the health care system for the patient. Public pharmacies are unique and easily accessible places in the health care system with a high proficiency in the provision of pharmaceutical care and highly qualified medical staff. The aim of this paper was to determine geographical-demographic situation, the legal form of the ownership of public pharmacies, and the owner share of pharmacists on the capital of public pharmacies in Slovakia. The number on of providers of pharmaceutical care depends on the population at the level of regions, districts, towns and villages with differing tightness of binding. The most common legal form of the provider of pharmaceutical care in Slovakia in public pharmacies were limited companies with 73.6% share, a sole proprietor - pharmacist had 23.9%, and public limited companies had 1.3%. In the branches of public pharmacies the limited companies had 73.4% share, a sole proprietor - pharmacist had 26%, public limited companies had 1%. The owner share of the pharmacist on the capital in public pharmacies was 50.4%, and in the branches of public pharmacies it was 66%, owned by a sole proprietor or limited company.

  12. Effect of information, education and communication intervention on awareness about rational pharmacy practice in pharmacy students

    OpenAIRE

    Gharpure, Kunda; Thawani, Vijay; Sontakke, Smita; Chaudhari, Kiran; Bankar, Mangesh; Diwe, Rajendra

    2011-01-01

    Background: There is a growing indifference among the pharmacy practitioners towards their duty as information providers to the patients. The patients do not always get enough desired information about proper use of medicines from the prescribers also. This contributes to improper use of medicines by the patients. Objectives: To bring about awareness about rational pharmacy practice in pharmacy students for better service to the patients. Material and Methods: The final year students o...

  13. A New Approach to Health Services and Pharmacy in Cuba.

    Science.gov (United States)

    Sánchez, Alina M

    2015-12-01

    In December 17, 2014, U.S. President Barack Obama surprised the world by announcing his intention to enter into negotiations aimed at reestablishing diplomatic relations with Cuba. Since then, expectations and interest regarding the health system of that country have increased. This report focuses on the Cuban health and pharmacy systems from a practical and educational standpoint. Pharmaceutical services, strengths, opportunities, and challenges are described. Cuba's new trends toward patient-centered care are analyzed to provide insights for developing pharmaceutical care practice and implementing policies suitable for practice in all health care settings. © 2015 Pharmacotherapy Publications, Inc.

  14. Addressing Cultural Competency in Pharmacy Education through International Service Learning and Community Engagement

    Directory of Open Access Journals (Sweden)

    Rosemin Kassam

    2013-08-01

    Full Text Available This paper describes the design, implementation and evaluation of a course in international service learning and community engagement for pharmacy undergraduate students. The course offered students opportunities to cultivate cultural competency in an international setting foreign to their own—Sub-Saharan Africa. The experience consisted of pre-departure preparation seminars followed by subsequent community immersion to experience, explore and confront personal attitudes and perceptions. A key feature of this course was its emphasis on a continuing cycle of learning, community engagement and reflection. Three students participated, a near-maximum cohort. Their daily self-reflections were qualitatively analyzed to document the impact of their cultural learning and experiences and revealed meaningful learning in the domains of self-assessment and awareness of their personal and professional culture, exposure to a participatory health delivery model involving the patient, the community and a multidisciplinary team and opportunities to engage in patient care in a different cultural setting. This proof-of-concept course provided students with experiences that were life-changing on both personal and professional levels and confirmed the viability and relevance of international service learning for the pharmacy field within its university-wide mandate.

  15. Reasons why specialist doctors undertake rural outreach services: an Australian cross-sectional study.

    Science.gov (United States)

    O'Sullivan, Belinda G; McGrail, Matthew R; Stoelwinder, Johannes U

    2017-01-07

    The purpose of the study is to explore the reasons why specialist doctors travel to provide regular rural outreach services, and whether reasons relate to (1) salaried or private fee-for-service practice and (2) providing rural outreach services in more remote locations. A national cross-sectional study of specialist doctors from the Medicine in Australia: Balancing Employment and Life (MABEL) survey in 2014 was implemented. Specialists providing rural outreach services self-reported on a 5-point scale their level of agreement with five reasons for participating. Chi-squared analysis tested association between agreement and variables of interest. Of 567 specialists undertaking rural outreach services, reasons for participating include to grow the practice (54%), maintain a regional connection (26%), provide complex healthcare (18%), healthcare for disadvantaged people (12%) and support rural staff (6%). Salaried specialists more commonly participated to grow the practice compared with specialists in fee-for-service practice (68 vs 49%). This reason was also related to travelling further and providing outreach services in outer regional/remote locations. Private fee-for-service specialists more commonly undertook outreach services to provide complex healthcare (22 vs 14%). Specialist doctors undertake rural outreach services for a range of reasons, mainly to complement the growth and diversity of their main practice or maintain a regional connection. Structuring rural outreach around the specialist's main practice is likely to support participation and improve service distribution.

  16. Evaluating the Peruvian Rural Communication Services Project.

    Science.gov (United States)

    Mayo, John

    1988-01-01

    Reviews the Peruvian Rural Communication Services (PRCS) Project and outlines selected findings. Topics discussed include a brief description of Peru's economic and social conditions; satellite communication systems; audio teleconferencing; telephone service; planning and administration; research design features; data collection; and project…

  17. Framework for pharmacy services quality improvement--a bridge to cross the quality chasm. Part I. The opportunity and the tool.

    Science.gov (United States)

    Curtiss, Frederic R; Fry, Richard N; Avey, Steven G

    2004-01-01

    To review the literature on the subject of quality improvement principles and methods applied to pharmacy services and to describe a framework for current and future efforts in pharmacy services quality improvement and effective drug therapy management. The Academy of Managed Care Pharmacy produced the Catalog of Pharmacy Quality Indicators in 1997, followed by the Summary of National Pharmacy Quality Measures in February 1999. In April 2002, AMCP introduced Pharmacy's Framework for Drug Therapy Management in the 21st Century. The Framework documents include a self-assessment tool that details more than 250 specific "components" that describe tasks, behaviors, skills, functions, duties, and responsibilities that contribute to meeting customer expectations for effective drug therapy management. There are many opportunities for quality improvement in clinical, service, and cost outcomes related to drug therapy management. These may include patient safety; incidence of medical errors; adverse drug events; patient adherence to therapy; attainment of target goals of blood pressure, glucose, and lipid levels; risk reduction for adverse cardiac events and osteoporotic-related fractures; patient satisfaction; risk of hospitalization or mortality; and cost of care. Health care practitioners can measure improvements in health care quality in several ways including (a) a better patient outcome at the same cost, (b) the same patient outcome at lower cost, (c) a better patient outcome at lower cost, or (d) a significantly better patient outcome at moderately higher cost. Measurement makes effective management possible. A framework of component factors (e.g., tasks) is necessary to facilitate changes in the key processes and critical factors that will help individual practitioners and health care systems meet customer expectations in regard to drug therapy, thus improving these outcomes. Quality improvement in health care services in the United States will be made in incremental

  18. Effect of information, education and communication intervention on awareness about rational pharmacy practice in pharmacy students.

    Science.gov (United States)

    Gharpure, Kunda; Thawani, Vijay; Sontakke, Smita; Chaudhari, Kiran; Bankar, Mangesh; Diwe, Rajendra

    2011-07-01

    There is a growing indifference among the pharmacy practitioners towards their duty as information providers to the patients. The patients do not always get enough desired information about proper use of medicines from the prescribers also. This contributes to improper use of medicines by the patients. To bring about awareness about rational pharmacy practice in pharmacy students for better service to the patients. The final year students of Bachelor of Pharmacy (B. Pharm) from four colleges of Nagpur were enrolled for the study after informed consent. Their base knowledge was assessed through a written test which comprised of 27 objective questions related to rational pharmacy practice. This was followed by a series of seven articles on rational medicine use, published in leading local English news daily. The participants were reminded to read them on the day of publication of each article. As a backup, the articles were displayed on the notice board of respective colleges. Second intervention was a half day interactive session where series of six lectures were delivered to the participants on the right and wrong approaches in pharmacy practice. Posters about the do's and dont's of rational pharmacy practice were also displayed at the venue. The session was followed by a repeat test using the same pre-test to assess the change. Pre and post intervention data was compared using Fisher's Exact test. It was observed that the intervention did bring about a positive change in the attitude and knowledge of the final year Pharmacy students about rational pharmacy practice. The role of a pharmacist in health care provision is usually overlooked in India. Hence there is strong need for reinforcement in final year B. Pharm when most of the students go in for community service. Such interventions will be helpful in bringing about a positive change towards rational practice of pharmacy. This study showed that a properly timed and meticulously implemented intervention brings

  19. Outcomes, costs and stakeholders' perspectives associated with the incorporation of community pharmacy services into the National Health Insurance System in Thailand: a systematic review.

    Science.gov (United States)

    Asayut, Narong; Sookaneknun, Phayom; Chaiyasong, Surasak; Saramunee, Kritsanee

    2018-02-01

    Identify costs, outcomes and stakeholders' perspectives associated with incorporation of community pharmacy services into the Thai National Health Insurance System and their values to all stakeholders. Using a combination of search terms, a comprehensive literature search was performed using the Thai Journal Citation Index Centre, Health System Research Institute database, PubMed and references from recent reviews. Identified studies were published between January 2000 and December 2014. The review included publications in English and Thai on primary research undertaken in community pharmacies associated with the National Health Insurance System. Two independent authors performed study selection, data extraction and quality assessment. The literature search yielded 251 titles, with 18 satisfying the inclusion criteria. Clinical outcomes of community pharmacy services included control and reduction in blood pressure and blood sugar, improved adherence to medications, an increase in acceptance of interventions, and an increase in healthy behaviours. Thirty-three percentage of those at risk of diabetes and hypertension achieved normal blood sugar and blood pressure levels after being followed for 2-6 months by a community pharmacist. The cost of collaborative screening by community pharmacies and primary care units was US$ 4.5. Diabetes management costs were US$ 5.1-30.7. Community pharmacists reported high satisfaction rates. Stakeholders' perspectives revealed support for the community pharmacists' roles and the inclusion of community pharmacies as partners with the National Health Insurance System. Community pharmacy services improved outcomes for diabetic and hypertensive patients. This review supports the feasibility of incorporating community pharmacies into the Thai National Health System. © 2017 Royal Pharmaceutical Society.

  20. Individual- and neighborhood-level characteristics associated with support of in-pharmacy vaccination among ESAP-registered pharmacies: pharmacists' role in reducing racial/ethnic disparities in influenza vaccinations in New York City.

    Science.gov (United States)

    Crawford, Natalie D; Blaney, Shannon; Amesty, Silvia; Rivera, Alexis V; Turner, Alezandria K; Ompad, Danielle C; Fuller, Crystal M

    2011-02-01

    New York State (NYS) passed legislation authorizing pharmacists to administer immunizations in 2008. Racial/socioeconomic disparities persist in vaccination rates and vaccine-preventable diseases such as influenza. Many NYS pharmacies participate in the Expanded Syringe Access Program (ESAP), which allows provision of non-prescription syringes to help prevent transmission of HIV, and are uniquely positioned to offer vaccination services to low-income communities. To understand individual and neighborhood characteristics of pharmacy staff support for in-pharmacy vaccination, we combined census tract data with baseline pharmacy data from the Pharmacies as Resources Making Links to Community Services (PHARM-Link) study among ESAP-registered pharmacies. The sample consists of 437 pharmacists, non-pharmacist owners, and technicians enrolled from 103 eligible New York City pharmacies. Using multilevel analysis, pharmacy staff who expressed support of in-pharmacy vaccination services were 69% more likely to support in-pharmacy HIV testing services (OR, 1.69; 95% CI 1.39-2.04). While pharmacy staff who worked in neighborhoods with a high percent of minority residents were less likely to express support of in-pharmacy vaccination, those in neighborhoods with a high percent of foreign-born residents were marginally more likely to express support of in-pharmacy vaccination. While educational campaigns around the importance of vaccination access may be needed among some pharmacy staff and minority community residents, we have provided evidence supporting scale-up of vaccination efforts in pharmacies located in foreign-born/immigrant communities which has potential to reduce disparities in vaccination rates and preventable influenza-related mortality.

  1. Should Master's Level Training To Provide Rural Services Survive?

    Science.gov (United States)

    Keller, Peter A.

    Despite recent efforts to encourage federal funding of psychological services for underserved populations such as the elderly and residents of rural areas, ample evidence suggests that rural areas are underserved by psychologists. Drawing on data from rural and urban areas in Pennsylvania, this paper argues that master's level training can provide…

  2. The global pharmacy workforce: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    Anderson Claire

    2009-06-01

    Full Text Available Abstract The importance of health workforce provision has gained significance and is now considered one of the most pressing issues worldwide, across all health professions. Against this background, the objectives of the work presented here were to systematically explore and identify contemporary issues surrounding expansion of the global pharmacy workforce in order to assist the International Pharmaceutical Federation working group on the workforce. International peer and non-peer-reviewed literature published between January 1998 and February 2008 was analysed. Articles were collated by performing searches of appropriate databases and reference lists of relevant articles; in addition, key informants were contacted. Information that met specific quality standards and pertained to the pharmacy workforce was extracted to matrices and assigned an evidence grade. Sixty-nine papers were identified for inclusion (48 peer reviewed and 21 non-peer-reviewed. Evaluation of evidence revealed the global pharmacy workforce to be composed of increasing numbers of females who were working fewer hours; this decreased their overall full-time equivalent contribution to the workforce, compared to male pharmacists. Distribution of pharmacists was uneven with respect to location (urban/rural, less-developed/more-developed countries and work sector (private/public. Graduates showed a preference for completing pre-registration training near where they studied as an undergraduate; this was of considerable importance to rural areas. Increases in the number of pharmacy student enrolments and pharmacy schools occurred alongside an expansion in the number and roles of pharmacy technicians. Increased international awareness and support existed for the certification, registration and regulation of pharmacy technicians and accreditation of training courses. The most common factors adding to the demand for pharmacists were increased feminization, clinical governance measures

  3. Willingness to pay for rural telephone services: Implications for rural ...

    African Journals Online (AJOL)

    WTP) for rural telephone services and the implications on poverty reduction in Southeast Nigeria. The key research problem was the inability of the telephone providers or regulatory agencies to estimate the amount the people were willing to pay ...

  4. 47 CFR 22.228 - Cellular rural service area licenses subject to competitive bidding.

    Science.gov (United States)

    2010-10-01

    ... 47 Telecommunication 2 2010-10-01 2010-10-01 false Cellular rural service area licenses subject to... Procedures § 22.228 Cellular rural service area licenses subject to competitive bidding. Mutually exclusive initial applications for Cellular Rural Service Area licenses are subject to competitive bidding. The...

  5. Utilization of Mental Health Services by Veterans Living in Rural Areas.

    Science.gov (United States)

    Teich, Judith; Ali, Mir M; Lynch, Sean; Mutter, Ryan

    2017-06-01

    There is concern that veterans living in rural areas may not be receiving the mental health (MH) treatment they need. This study uses recent national survey data to examine the utilization of MH treatment among military veterans with a MH condition living in rural areas, providing comparisons with estimates of veterans living in urban areas. Multivariable logistic regression is utilized to examine differences in MH service use by urban/rural residence, controlling for other factors. Rates of utilization of inpatient and outpatient treatment, psychotropic medication, any MH treatment, and perceived unmet need for MH care are examined. There were significant differences in MH treatment utilization among veterans by rural/urban residence. Multivariate estimates indicate that compared to veterans with a MH condition living in urban areas, veterans in rural areas had 70% lower odds of receiving any MH treatment. Veterans with a MH condition in rural areas have approximately 52% and 64% lower odds of receiving outpatient treatment and prescription medications, respectively, compared to those living in urban areas. Differences in perceived unmet need for mental health treatment were not statistically significant. While research indicates that recent efforts to improve MH service delivery have resulted in improved access to services, this study found that veterans' rates of MH treatment are lower in rural areas, compared to urban areas. Continued efforts to support the provision of behavioral health services to rural veterans are needed. Telemedicine, using rural providers to their maximum potential, and engagement with community stakeholder groups are promising approaches. © 2016 National Rural Health Association.

  6. Utilization of maternal health services in rural primary health centers ...

    African Journals Online (AJOL)

    Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...

  7. Home Care Pharmacy Practice in Canada: A Cross-Sectional Survey of Services Provided, Remuneration, Barriers, and Facilitators.

    Science.gov (United States)

    Houle, Sherilyn; MacKeigan, Linda

    2017-01-01

    As the population ages, and individuals desire to remain in their homes as long as possible, the need for in-home care is expected to increase. However, pharmacists have rarely been included in studies of in-home care, and little is known about the prevalence or effectiveness of pharmacists' home-based services in Canada. To identify pharmacy practices in Canada that regularly provide in-home patient care and to identify specific services provided, remuneration obtained, and barriers and facilitators influencing the provision of home-based care. A link to a web-based survey was posted in e-newsletters of provincial, territorial, and national pharmacy associations in Canada. In addition, pharmacists known to the researchers as providing in-home clinical services were contacted directly. The survey was open from October to December 2015. Practices or organizations that performed at least one home visit per week for clinical purposes, with documentation of the services provided, were eligible to participate. One response per practice or organization was allowed. Seventeen practices meeting the inclusion criteria were identified, representing community, hospital, and clinic settings. Home visits were most commonly performed for individuals with complex medication regimens or nonadherence to medication therapy. The most common services were conducting medication reconciliation and reviews and counselling patients about medication adherence. No practices or organizations billed patients for these services, yet lack of remuneration was an important barrier identified by many respondents. Although 12 (71%) of the respondents collected data for evaluative purposes, collection of clinical or health system outcome data was rare. Few Canadian pharmacy practices that provide in-home patient care at least once a week could be identified. Data collection suitable to establish an evidence base for this service was infrequently performed by practices and organizations providing

  8. Evidence to service gap: cardiac rehabilitation and secondary prevention in rural and remote Western Australia.

    Science.gov (United States)

    Hamilton, Sandra; Mills, Belynda; McRae, Shelley; Thompson, Sandra

    2018-01-30

    Cardiovascular disease (CVD), a leading cause of morbidity and mortality, has similar incidence in metropolitan and rural areas but poorer cardiovascular outcomes for residents living in rural and remote Australia. Cardiac Rehabilitation (CR) is an evidence-based intervention that helps reduce subsequent cardiovascular events and rehospitalisation. Unfortunately CR attendance rates are as low as 10-30% with rural/remote populations under-represented. This in-depth assessment investigated the provision of CR and secondary prevention services in Western Australia (WA) with a focus on rural and remote populations. CR and Aboriginal Community Controlled Health Services were identified through the Directory of Western Australian Cardiac Rehabilitation and Secondary Prevention Services 2012. Structured interviews with CR coordinators included questions specific to program delivery, content, referral and attendance. Of the 38 CR services identified, 23 (61%) were located in rural (n = 11, 29%) and remote (n = 12, 32%) regions. Interviews with coordinators from 34 CR services (10 rural, 12 remote, 12 metropolitan) found 77% of rural/remote services were hospital-based, with no service providing a comprehensive home-based or alternative method of program delivery. The majority of rural (60%) and remote (80%) services provided CR through chronic condition exercise programs compared with 17% of metropolitan services; only 27% of rural/remote programs provided education classes. Rural/remote coordinators were overwhelmingly physiotherapists, and only 50% of rural and 33% of remote programs had face-to-face access to multidisciplinary support. Patient referral and attendance rates differed greatly across WA and referrals to rural/remote services generally numbered less than 5 per month. Program evaluation was reported by 33% of rural/remote coordinators. Geography, population density and service availability limits patient access to CR services in rural/remote WA. Current

  9. Implementation of a reimbursed medication review program: Corporate and pharmacy level strategies.

    Science.gov (United States)

    MacKeigan, Linda D; Ijaz, Nadine; Bojarski, Elizabeth A; Dolovich, Lisa

    In 2006, the Ontario drug plan greatly reduced community pharmacy reimbursement for generic drugs. In exchange, a fee-for-service medication review program was introduced to help patients better understand their medication therapy and ensure that medications were taken as prescribed. A qualitative study of community pharmacy implementation strategies was undertaken to inform a mixed methods evaluation of the program. To describe strategies used by community pharmacies to implement a government-funded medication review service. Key informant interviews were conducted with pharmacy corporate executives and managers, as well as independent pharmacy owners. All pharmacy corporations in the province were approached; owners were purposively sampled from the registry of the pharmacist licensing body to obtain diversity in pharmacy attributes; and pharmacy managers were identified through a mix of snowball and registry sampling. Thematic qualitative coding and analysis were applied to interview transcripts. 42 key informants, including 14 executives, 15 managers/franchisees, and 11 owners, participated. The most common implementation strategy was software adaptation to flag eligible patients and to document the service. Human resource management (task shifting to technicians and increasing the technician complement), staff training, and patient identification and recruitment processes were widely mentioned. Motivational strategies including service targets and financial incentives were less frequent but controversial. Strategies typically unfolded over time, and became multifaceted. Apart from the use of targets in chain pharmacies only, strategies were similar across pharmacy ownership types. Ontario community pharmacies appeared to have done little preplanning of implementation strategies. Strategies focused on service efficiency and quantity, rather than quality. Unlike other jurisdictions, many managers supported the use of targets as motivators, and very few reported

  10. Rural hospital ownership: medical service provision, market mix, and spillover effects.

    Science.gov (United States)

    Horwitz, Jill R; Nichols, Austin

    2011-10-01

    To test whether nonprofit, for-profit, or government hospital ownership affects medical service provision in rural hospital markets, either directly or through the spillover effects of ownership mix. Data are from the American Hospital Association, U.S. Census, CMS Healthcare Cost Report Information System and Prospective Payment System Minimum Data File, and primary data collection for geographic coordinates. The sample includes all nonfederal, general medical, and surgical hospitals located outside of metropolitan statistical areas and within the continental United States from 1988 to 2005. We estimate multivariate regression models to examine the effects of (1) hospital ownership and (2) hospital ownership mix within rural hospital markets on profitable versus unprofitable medical service offerings. Rural nonprofit hospitals are more likely than for-profit hospitals to offer unprofitable services, many of which are underprovided services. Nonprofits respond less than for-profits to changes in service profitability. Nonprofits with more for-profit competitors offer more profitable services and fewer unprofitable services than those with fewer for-profit competitors. Rural hospital ownership affects medical service provision at the hospital and market levels. Nonprofit hospital regulation should reflect both the direct and spillover effects of ownership. © Health Research and Educational Trust.

  11. Towards understanding the availability of physiotherapy services in rural Australia.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2016-01-01

    A recent exploration of factors affecting rural physiotherapy service provision revealed considerable variation in services available between communities of the study. Multiple factors combined to influence local service provision, including macro level policy and funding decisions, service priorities and fiscal constraints of regional health services and capacity and capabilities at the physiotherapy service level. The aim of this article is to describe the variation in local service provision, the factors influencing service provision and the impact on availability of physiotherapy services. A priority-sequence mixed methods design structured the collection and integration of qualitative and quantitative data. The investigation area, a large part of one Australian state, was selected for the number of physiotherapy services and feasibility of conducting site visits. Stratified purposive sampling permitted exploration of rural physiotherapy with subgroups of interest, including physiotherapists, their colleagues, managers, and other key decision makers. Participant recruitment commenced with public sector physiotherapists and progressed to include private practitioners, team colleagues and managers. Surveys were mailed to key physiotherapy contacts in each public sector service in the area for distribution to physiotherapists, their colleagues and managers within their facility. Private physiotherapist principals working in the same communities were invited by the researcher to complete the physiotherapy survey. The survey collected demographic data, rural experience, work setting and number of colleagues, services provided, perspectives on factors influencing service provision and decisions about service provision. Semi-structured interviews were conducted with consenting physiotherapists and other key decision makers identified by local physiotherapists. Quantitative survey data were recorded in spreadsheets and analysed using descriptive statistics. Interviews

  12. OneVA Pharmacy

    Data.gov (United States)

    Department of Veterans Affairs — The OneVA Pharmacy application design consists of 3 main components: VistA Medication Profile screen, Health Data Record Clinical Data Service (HDR/CDS), and OneVA...

  13. Maternity Care Services Provided by Family Physicians in Rural Hospitals.

    Science.gov (United States)

    Young, Richard A

    The purpose of this study was to describe how many rural family physicians (FPs) and other types of providers currently provide maternity care services, and the requirements to obtain privileges. Chief executive officers of rural hospitals were purposively sampled in 15 geographically diverse states with significant rural areas in 2013 to 2014. Questions were asked about the provision of maternity care services, the physicians who perform them, and qualifications required to obtain maternity care privileges. Analysis used descriptive statistics, with comparisons between the states, community rurality, and hospital size. The overall response rate was 51.2% (437/854). Among all identified hospitals, 44.9% provided maternity care services, which varied considerably by state (range, 17-83%; P maternity care, a mean of 271 babies were delivered per year, 27% by cesarean delivery. A mean of 7.0 FPs had privileges in these hospitals, of which 2.8 provided maternity care and 1.8 performed cesarean deliveries. The percentage of FPs who provide maternity care (mean, 48%; range, 10-69%; P maternity care who are FPs (mean, 63%; range, 10-88%; P maternity care services in US rural hospitals, including cesarean deliveries. Some family medicine residencies should continue to train their residents to provide these services to keep replenishing this valuable workforce. © Copyright 2017 by the American Board of Family Medicine.

  14. Identifying maternity services in public hospitals in rural and remote Australia.

    Science.gov (United States)

    Longman, Jo; Pilcher, Jennifer M; Donoghue, Deborah A; Rolfe, Margaret; Kildea, Sue V; Kruske, Sue; Oats, Jeremy J N; Morgan, Geoffrey G; Barclay, Lesley M

    2014-06-01

    This paper articulates the importance of accurately identifying maternity services. It describes the process and challenges of identifying the number, level and networks of rural and remote maternity services in public hospitals serving communities of between 1000 and 25000 people across Australia, and presents the findings of this process. Health departments and the national government's websites, along with lists of public hospitals, were used to identify all rural and remote Australian public hospitals offering maternity services in small towns. State perinatal reports were reviewed to establish numbers of births by hospital. The level of maternity services and networks of hospitals within which services functioned were determined via discussion with senior jurisdictional representatives. In all, 198 rural and remote public hospitals offering maternity services were identified. There were challenges in sourcing information on maternity services to generate an accurate national picture. The nature of information about maternity services held centrally by jurisdictions varied, and different frameworks were used to describe minimum requirements for service levels. Service networks appeared to be based on a combination of individual links, geography and transport infrastructure. The lack of readily available centralised and comparable information on rural and remote maternity services has implications for policy review and development, equity, safety and quality, network development and planning. Accountability for services and capacity to identify problems is also compromised.

  15. Health-Related Quality of Life of Rural Clients Seeking Telepsychology Services

    Directory of Open Access Journals (Sweden)

    Kevin R. Tarlow

    2014-01-01

    Full Text Available Sixty million US residents live in rural areas, but health policies and interventions developed from an urban mindset often fail to address the significant barriers to health experienced by these local communities. Telepsychology, or psychological services delivered by distance via technology, is an emerging treatment modality with special implications for underserved rural areas. This study found that a sample of rural residents seeking telepsychology services (n=94 had low health-related quality of life (HRQOL, often due to cooccurring physical and mental health diagnoses including high rates of depression. However, a brief telepsychology treatment delivered to rural clients (n=40 was associated with an improvement in mental health-related quality of life (d = 0.70,  P<.001. These results indicate that despite the complex health needs of these underserved communities, telepsychology interventions may help offset the disparities in health service access in rural areas.

  16. Community participation to design rural primary healthcare services.

    Science.gov (United States)

    Farmer, Jane; Nimegeer, Amy

    2014-03-21

    This paper explores how community participation can be used in designing rural primary healthcare services by describing a study of Scottish communities. Community participation is extolled in healthcare policy as useful in planning services and is understood as particularly relevant in rural settings, partly due to high social capital. Literature describes many community participation methods, but lacks discussion of outcomes relevant to health system reconfiguration. There is a spectrum of ideas in the literature on how to design services, from top-down standard models to contextual plans arising from population health planning that incorporates community participation. This paper addresses an evidence gap about the outcomes of using community participation in (re)designing rural community health services. Community-based participatory action research was applied in four Scottish case study communities in 2008-10. Data were collected from four workshops held in each community (total 16) and attended by community members. Workshops were intended to produce hypothetical designs for future service provision. Themes, rankings and selections from workshops are presented. Community members identified consistent health priorities, including local practitioners, emergency triage, anticipatory care, wellbeing improvement and health volunteering. Communities designed different service models to address health priorities. One community did not design a service model and another replicated the current model despite initial enthusiasm for innovation. Communities differ in their receptiveness to engaging in innovative service design, but some will create new models that fit in a given budget. Design diversity indicates that context influences local healthcare planning, suggesting community participation impacts on design outcomes, but standard service models maybe useful as part of the evidence in community participation discussions.

  17. Randomized, community-based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City.

    Science.gov (United States)

    Crawford, Natalie D; Amesty, Silvia; Rivera, Alexis V; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M

    2013-09-01

    Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful.

  18. The behavioral consequences of service quality: an empirical study in the Chinese retail pharmacy industry.

    Science.gov (United States)

    Chen, Yuwen; Fu, Frank Q

    2015-01-01

    This study focuses on the impacts of service quality and examines the mediating effects of customer satisfaction and customer loyalty on willingness to pay more. The authors collected survey data from 479 actual retail pharmacy customers in China and used the structural equation modeling approach to test the hypotheses. The results reveal six dimensions of service quality and the differential impact of these dimensions on customer satisfaction and behavioral intentions. This study contributes to the existing literature by exploring the dimensionality of the service quality construct and mediating effects of customer satisfaction and customer loyalty in a non-Western setting.

  19. Improving medication adherence: a framework for community pharmacy-based interventions

    Directory of Open Access Journals (Sweden)

    Pringle J

    2015-11-01

    Full Text Available Janice Pringle,1 Kim C Coley2 1Program Evaluation and Research Unit, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA; 2Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA Abstract: Evidence supports that patient medication adherence is suboptimal with patients typically taking less than half of their prescribed doses. Medication nonadherence is associated with poor health outcomes and higher downstream health care costs. Results of studies evaluating pharmacist-led models in a community pharmacy setting and their impact on medication adherence have been mixed. Community pharmacists are ideally situated to provide medication adherence interventions, and effective strategies for how they can consistently improve patient medication adherence are necessary. This article suggests a framework to use in the community pharmacy setting that will significantly improve patient adherence and provides a strategy for how to apply this framework to develop and test new medication adherence innovations. The proposed framework is composed of the following elements: 1 defining the program's pharmacy service vision, 2 using evidence-based, patient-centered communication and intervention strategies, 3 using specific implementation approaches that ensure fidelity, and 4 applying continuous evaluation strategies. Within this framework, pharmacist interventions should include those services that capitalize on their specific skill sets. It is also essential that the organization's leadership effectively communicates the pharmacy service vision. Medication adherence strategies that are evidence-based and individualized to each patient's adherence problems are most desirable. Ideally, interventions would be delivered repeatedly over time and adjusted when patient's adherence circumstances change. Motivational interviewing principles are particularly well

  20. Aging in Rural Appalachia: Perspectives from Geriatric Social Service Professionals

    Directory of Open Access Journals (Sweden)

    Natalie D. Pope

    2014-09-01

    Full Text Available This paper uses qualitative methodology to explore the experience of growing old in rural Appalachia. Given the growing population of older adults seeking and utilizing services, it is important to understand the challenges and specific needs related to aging. Within the context of rural Appalachia, these challenges and needs may be different than those in urban areas or areas outside of the region itself. From interviews with 14 geriatric service providers in rural southeast Ohio, the authors were able to identity three prevalent themes associated with aging in rural North Central Appalachia: scarcity of resources, valuing neighbors and family, and the prevalence of drug use. These findings suggest that preparation and ongoing training of rural geriatric social workers should include attention to topics such as substance abuse and strengthening social support networks that often exist in these regions.

  1. Weight management in community pharmacy: what do the experts think?

    Science.gov (United States)

    Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B

    2013-06-01

    The increasing prevalence of obesity and overweight adults creates a significant public health burden and there is great potential for pharmacists to be involved in the provision of weight management services, other than the mundane supply of commercial products. In order to provide optimal services that can be integrated into the healthcare system, a best practice model for weight management services in community pharmacy should be in place. We sought experts' and key stakeholders' opinions on this matter. (1) To identify components of a best practice model of a weight management service feasible in Australian community pharmacy. (2) To identify the role of pharmacists and the training requirements to up-skill pharmacists to competently provide weight management services. (3) To elicit any practical suggestions that would contribute to successful implementation of weight management services in pharmacy. Australian primary care sector. Semi-structured interviews were conducted with a purposive sample of 12 participants including Australian experts in obesity and representatives of main Australian professional organisations in pharmacy. Interviews were digitally recorded, transcribed verbatim and thematically analysed using the framework approach. Recommended components of pharmacy-based weight management services and training requirements. Participants perceived two potential roles for pharmacists involved in weight management: health promotion and individualised service. Multi-component interventions targeting all three areas: diet, physical activity and behaviour change were emphasised. Physical assessment (e.g. weight, waist circumference measurements), goal setting, referral to allied healthcare professionals and on-going support for weight maintenance were also proposed. Participants suggested pharmacists should undergo formal training and identified various training topics to improve pharmacists' knowledge, attributes and skills to acquire competencies

  2. 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.

  3. The walk out of the rural kitchen : towards planning energy services for sustainable rural livelihoods in Sudan

    NARCIS (Netherlands)

    Ahmed, Nouralla

    2008-01-01

    This thesis is about rural energy services, the problems with accessibility and the consequences of their inaccessibility on rural livelihoods in the traditional rural areas of Sudan. The thesis is organised in six chapters. Chapter 1 starts by providing a background to the political and economic

  4. A global picture of pharmacy technician and other pharmacy support workforce cadres.

    Science.gov (United States)

    Koehler, Tamara; Brown, Andrew

    Understanding how pharmacy technicians and other pharmacy support workforce cadres assist pharmacists in the healthcare system will facilitate developing health systems with the ability to achieve universal health coverage as it is defined in different country contexts. The aim of this paper is to provide an overview of the present global variety in the technician and other pharmacy support workforce cadres considering; their scope, roles, supervision, education and legal framework. A structured online survey instrument was administered globally using the Survey Monkey platform, designed to address the following topic areas: roles, responsibilities, supervision, education and legislation. The survey was circulated to International Pharmaceutical Federation (FIP) member organisations and a variety of global list serves where pharmaceutical services are discussed. 193 entries from 67 countries and territories were included in the final analysis revealing a vast global variety with respect to the pharmacy support workforce. From no pharmacy technicians or other pharmacy support workforce cadres in Japan, through a variety of cadre interactions with pharmacists, to the autonomous practice of pharmacy support workforce cadres in Malawi. From strictly supervised practice with a focus on supply, through autonomous practice for a variety of responsibilities, to independent practice. From complete supervision for all tasks, through geographical varied supervision, to independent practice. From on the job training, through certificate level vocational courses, to 3-4 year diploma programs. From well-regulated and registered, through part regulation with weak implementation, to completely non-regulated contexts. This paper documents wide differences in supervision requirements, education systems and supportive legislation for pharmacy support workforce cadres globally. A more detailed understanding of specific country practice settings is required if the use of pharmacy

  5. Pharmaceutical care in community pharmacies: practice and research in Denmark

    DEFF Research Database (Denmark)

    Herborg, Hanne; Sørensen, Ellen Westh; Frøkjaer, Bente

    2007-01-01

    % offer inhalation counseling, a reimbursed service. Research in pharmacy practice is well established and conducted primarily at universities and at Pharmakon A/S, which is owned by the Danish Pharmaceutical Association. DISCUSSION: Extended services in clinical pharmacy are priorities for all Danish...

  6. Reconceptualising risk: Perceptions of risk in rural and remote maternity service planning.

    Science.gov (United States)

    Barclay, Lesley; Kornelsen, Jude; Longman, Jo; Robin, Sarah; Kruske, Sue; Kildea, Sue; Pilcher, Jennifer; Martin, Tanya; Grzybowski, Stefan; Donoghue, Deborah; Rolfe, Margaret; Morgan, Geoff

    2016-07-01

    to explore perceptions and examples of risk related to pregnancy and childbirth in rural and remote Australia and how these influence the planning of maternity services. data collection in this qualitative component of a mixed methods study included 88 semi-structured individual and group interviews (n=102), three focus groups (n=22) and one group information session (n=17). Researchers identified two categories of risk for exploration: health services risk (including clinical and corporate risks) and social risk (including cultural, emotional and financial risks). Data were aggregated and thematically analysed to identify perceptions and examples of risk related to each category. fieldwork was conducted in four jurisdictions at nine sites in rural (n=3) and remote (n=6) Australia. 117 health service employees and 24 consumers. examples and perceptions relating to each category of risk were identified from the data. Most medical practitioners and health service managers perceived clinical risks related to rural birthing services without access to caesarean section. Consumer participants were more likely to emphasise social risks arising from a lack of local birthing services. our analysis demonstrated that the closure of services adds social risk, which exacerbates clinical risk. Analysis also highlighted that perceptions of clinical risk are privileged over social risk in decisions about rural and remote maternity service planning. a comprehensive analysis of risk that identifies how social and other forms of risk contribute to adverse clinical outcomes would benefit rural and remote people and their health services. Formal risk analyses should consider the risks associated with failure to provide birthing services in rural and remote communities as well as the risks of maintaining services. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  7. 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

  8. Evaluation of the implementation of a clinical pharmacy service on an acute internal medicine ward in Italy.

    Science.gov (United States)

    Lombardi, Nicola; Wei, Li; Ghaleb, Maisoon; Pasut, Enrico; Leschiutta, Silvia; Rossi, Paolo; Troncon, Maria Grazia

    2018-04-10

    Successful implementation of clinical pharmacy services is associated with improvement of appropriateness of prescribing. Both high clinical significance of pharmacist interventions and their high acceptance rate mean that potential harm to patients could be avoided. Evidence shows that low acceptance rate of pharmacist interventions can be associated with lack of communication between pharmacists and the rest of the healthcare team. The objective of this study was to evaluate the effect of a structured communication strategy on acceptance rate of interventions made by a clinical pharmacist implementing a ward-based clinical pharmacy service targeting elderly patients at high risk of drug-related problems. Characteristics of interventions made to improve appropriateness of prescribing, their clinical significance and intervention acceptance rate by doctors were recorded. A clinical pharmacy intervention study was conducted between September 2013 and December 2013 in an internal medicine ward of a teaching hospital. A trained clinical pharmacist provided pharmaceutical care to 94 patients aged over 70 years. The clinical pharmacist used the following communication and marketing tools to implement the service described: Strengths, Weaknesses, Opportunities and Threats (SWOT) analysis; Specific, Measurable, Achievable, Realistic and Timely (SMART) goals; Awareness, Interest, Desire, Action (AIDA) model. A total of 740 interventions were made by the clinical pharmacist. The most common drug classes involved in interventions were: antibacterials for systemic use (11.1%) and anti-parkinson drugs (10.8%). The main drug-related problem categories triggering interventions were: no specific problem (15.9%) and prescription writing error (12.0%). A total of 93.2% of interventions were fully accepted by physicians. After assessment by an external panel 63.2% of interventions (96 interventions/ per month) were considered of moderate clinical significance and 23.4% (36

  9. Consequences of low birth weight, maternal illiteracy and poor access to medical care in rural India: infantile iatrogenic Cushing syndrome.

    Science.gov (United States)

    Karande, Sunil

    2015-08-21

    Home delivery, low birth weight babies and maternal illiteracy among the poor in rural India are frequent. The rural poor prefer to seek healthcare from private providers, most of whom have no formal medical training and buy medicines from private pharmacies without a prescription owing to a weakly regulated environment. This report is of a 4-month-old baby from a remote village in northern India, who presented with exogenous Cushing syndrome. This baby was a full-term low birth weight home delivery. As the baby was not growing well, treatment was started at 1 month by a private doctor with betamethasone drops The mother on her own volition continued giving the betamethasone drops by buying the medicine over the counter from a private pharmacy. This case highlights the gaps in essential health services in rural India and the steps being taken to improve the situation. 2015 BMJ Publishing Group Ltd.

  10. Characteristics of Patients Accepting and Declining Participation in a Transition of Care Service Provided by a Community Pharmacy

    Directory of Open Access Journals (Sweden)

    Julianne M Kowalski, PharmD

    2017-02-01

    Full Text Available Objectives: To identify characteristics of patients who accepted or declined an appointment for a transition of care service provided by an independent community pharmacist and identify the most common reasons patients declined the service. Methods: A transition of care service was offered by a community pharmacy to patients discharged to home from the cardiac unit of a local hospital. The community pharmacist approached patients prior to discharge for recruitment into the service. Outcomes included service acceptance rate, LACE score at discharge, readmission risk category, age, gender, geographic home location, and reason for refusing the service. Descriptive statistics and logistic regression were used to compare characteristics between those who accepted or declined the service. Reasons for decline were assessed using content analysis. Results: Of the 87 patients that were included in the analysis, 21 patients received the transitions of care service (24.1%. None of the characteristics were found to be statistically significant between patients who received or declined the service. Patients at a moderate risk for readmission seemed more likely to accept the pharmacist-run appointment than those at high risk (27.9% vs 15.3%; P = 0.29. Of the 66 patients who declined, 51 gave a reason (77.3%. Thirty-nine patients saw no benefit (76.5%, five patients had perceived barriers (10%, and seven patients gave reasons that fell into both categories (13.5%. Conclusions: This evaluation did not find a statistically significant difference in characteristics between those patients who accepted or declined participation in a pharmacist-run transition of care service. Patients may be less likely to accept pharmacist-run transition of care appointments primarily due to no perceived benefits. To increase participation, we need to understand the patient’s health beliefs, educate patients on pharmacy services, and implement changes to recruit potential

  11. Evaluation of community pharmacies regarding dispensing practices of antibiotics in two districts of central Nepal.

    Directory of Open Access Journals (Sweden)

    Mukhtar Ansari

    Full Text Available To evaluate the status of community pharmacies, their staff, and practices toward dispensing antibiotics.Cross-sectional, prospective.Community pharmacies in two districts of central Nepal, from March 2016 to May 2016.A systematic random sampling approach was adopted to sample 161 community pharmacies. Data on the registration status of pharmacies, qualification or training of dispensing staff, and the practice of dispensing antibiotics were collected using a pre-tested questionnaire. Face to face interviews were carried out by a previously trained interviewer. Data were analyzed for descriptive and inferential statistics using IBM SPSS Statistics 21.Among 161 community pharmacies, 25% were not registered and most of them were located in rural areas. It was typical (66.5% to dispense antibiotics without prescription and most (91.4% of the staffs involved in dispensing were non-pharmacists. Furthermore, the study revealed common practices of replacing one brand of antibiotic with other brands (66%, dispensing incomplete courses of antibiotics (73%, and not giving any advice regarding antibiotic use (39% or completion of a full course of therapy (80%. There were significant (p < 0.001 relationships between the location of pharmacies (rural vs urban and the qualifications of the pharmacy staff.Dispensing antibiotics without prescription and by non-pharmacists are common in this region. The study also found several issues regarding the irrational use of antibiotics. Thus, there is an urgent need to address these issues and promote the informed use of antibiotics.

  12. Adopting an Advanced Community Pharmacy Practice Experiential Educational Model Across Colleges of Pharmacy

    Directory of Open Access Journals (Sweden)

    Jennifer L. Rodis

    2011-01-01

    Full Text Available Objective: To discuss the experience of sharing an experiential model of education and practice development between two colleges of pharmacy and to provide a framework to guide faculty in this type of collaboration. Case Study: The Ohio State University College of Pharmacy (OSU COP Partner for Promotion (PFP program was developed in response to the need for advancing practice in the community pharmacy setting. After successful implementation of this program, the PFP program design and materials were shared, adapted, and implemented at the University of Utah College of Pharmacy (Utah COP. Collaborating faculty developed a framework based on lessons learned through this experience which proposes key guiding strategies as considerations to address prior to embarking on sharing any aspect of an educational program or model between institutions. Each step of the framework is described and applied to the process followed by The OSU COP and Utah COP in sharing the PFP program. Additional considerations related to transfer of educational models are discussed. Results/Conclusion: Sharing the education model and materials associated with the PFP program between institutions has enhanced experiential opportunities for students and helped develop residency training sites in the community setting. In addition, the relationship between the two colleges has contributed to faculty development, as well as an increase in community pharmacy service development with community pharmacy partners at each institution. It is hoped this experience will help guide collaborations between other colleges of pharmacy to enhance education of future pharmacists while positively impacting pharmacy practice, teaching, and research by faculty.   Type: Case Study

  13. Adopting an Advanced Community Pharmacy Practice Experiential Educational Model Across Colleges of Pharmacy

    Directory of Open Access Journals (Sweden)

    Jennifer L. Rodis, Pharm.D., BCPS

    2011-01-01

    Full Text Available Objective: To discuss the experience of sharing an experiential model of education and practice development between two colleges of pharmacy and to provide a framework to guide faculty in this type of collaboration.Case Study: The Ohio State University College of Pharmacy (OSU COP Partner for Promotion (PFP program was developed in response to the need for advancing practice in the community pharmacy setting. After successful implementation of this program, the PFP program design and materials were shared, adapted, and implemented at the University of Utah College of Pharmacy (Utah COP. Collaborating faculty developed a framework based on lessons learned through this experience which proposes key guiding strategies as considerations to address prior to embarking on sharing any aspect of an educational program or model between institutions. Each step of the framework is described and applied to the process followed by The OSU COP and Utah COP in sharing the PFP program. Additional considerations related to transfer of educational models are discussed.Results/Conclusion: Sharing the education model and materials associated with the PFP program between institutions has enhanced experiential opportunities for students and helped develop residency training sites in the community setting. In addition, the relationship between the two colleges has contributed to faculty development, as well as an increase in community pharmacy service development with community pharmacy partners at each institution. It is hoped this experience will help guide collaborations between other colleges of pharmacy to enhance education of future pharmacists while positively impacting pharmacy practice, teaching, and research by faculty.

  14. Provision of oncology services in remote rural areas: a Scottish perspective.

    Science.gov (United States)

    Smith, S M; Campbell, N C

    2004-05-01

    There is a paucity of research into rural health care services. In particular little is known about the provision of specialist cancer services for patients who live in remote rural areas of the UK. This study set out to investigate current models of medical and clinical oncology care in Scotland. A national survey with key health professionals was conducted to identify rural oncology schemes currently in operation. Detailed quantitative data about the schemes together with qualitative data on how health professionals view current models of care were collected by a computer-assisted telephone survey. Schemes that currently provide outpatient and chemotherapy oncology services for remote rural patients fell into three categories: central clinics (5); shared care outreach clinics with chemotherapy provision (11); and shared care outreach clinics without chemotherapy provision (7). All radiotherapy was conducted at central clinics (5). Widely varying practices in delivery of cancer care were found across the country. The main issues for professionals about current models of care involved expertise, travelling and accessibility (for patients), communication and expansion of the rural service. Nation-wide consistency in cancer care has still to be achieved. Travelling for treatment was seen to take its toll on all patients but particularly for the very remote, elderly and poor. Most professionals believe that an expansion of rural services would be of benefit to these patients. It is clear, however, that the proper infrastructure needs to be in place in terms of local expertise, ensured quality of care, and good communication links with cancer centres before this could happen.

  15. Mobile bone densitometry service in rural South Australia

    International Nuclear Information System (INIS)

    Tucker, K.N.; Schultz, C.G.; Chatterton, B.E.

    1997-01-01

    Full text: Twenty per cent of South Australia's population live rurally, with limited access to modern medical services. The Mobile Bone Densitometry Unit was established to address this problem. The Unit began in 1994 with cooperation from private industry. In fostering the service, many issues were addressed, including choice of appropriate sites; selection of a liaison person at each site; towing of the Unit; transportation and accommodation of staff; education of local health professionals and community members; promotion of the service to the community: and timely reporting of results to referring doctors. The scanner is an Hologic ODR-1000+ densitometer, housed in a 5.9 1.8 metre, 2200 kg caravan. It is necessary to reduce vibration and motion during travel, control the internal environment, and have an electrically clean power supply. Addressing these parameters result in the critical value for quality control being 2500 patients, averaging 13 patients/working day. The mean age of the patients was 64 y (range 30-90 y), with 93 % of patients being >50 y. Results show a normally distributed Z score, suggesting that non-selected 'normal' population is being studied and the Hologic normal range matches that of the South Australian rural community. Local communities have utilised the service to full capacity resulting in future visits being extended. In conclusion, it is possible to provide a high quality, reliable bone densitometry service to rural communities

  16. Request of pharmaceutical care service in a private owned community pharmacy.

    Directory of Open Access Journals (Sweden)

    Pires CF

    2006-03-01

    Full Text Available Pharmacists, more than drug producer, is being a co-responsible for drug therapy and promoter of the rational use of medicines, enhancing their role. Appearance of a new philosophy, pharmaceutical care, came to organize, enhance and allowing this new role of the pharmacist in primary health care. Objectives of the present study were to determine the existence and to characterize the request for pharmaceutical care services and to assess the wiliness to pay for these services in a privately owned community pharmacy. An interview following a check-list was used by researchers to gather data. In 236 interviewed customers, 88.1% did not know the term ‘pharmaceutical care’, 67.2% showed to be interested on the service. Regarding the wiliness to pay, 39.9% conditioned it to the amount, and 10.1% stated that they would pay for the service. This allows us to conclude than in this setting, a demand existed, what allows repeating this survey in other settings, what lead us to the necessity of defining a standard of practice in Brazil, and in the rest of the world, to provide care to those who need it.

  17. Implementation of a mental health medication management intervention in Australian community pharmacies: Facilitators and challenges.

    Science.gov (United States)

    Hattingh, H Laetitia; Kelly, Fiona; Fowler, Jane; Wheeler, Amanda J

    Community pharmacists are in an ideal position to promote and provide mental health medication management services. However, formalised or structured pharmacy services to support consumers with mental health conditions are scarce. Australian mental health consumers indicated a need for targeted community pharmacy mental health services which presented an opportunity to develop an intervention that were integrated with remunerated professional services. The study aimed to pilot a mental health medication management intervention in Australian community pharmacies. Pharmacists worked in partnership with consumers, carers and mental health workers over three to six months to set and support achievement of individual goals related to medicines use, physical health and mental wellbeing. This paper provides a comparison of community pharmacies that successfully delivered the intervention with those that did not and identifies facilitators and challenges to service implementation. One hundred pharmacies opted to pilot the delivery of the intervention in three Australian states (Queensland, Western Australia and northern New South Wales). Of those, 55 successfully delivered the intervention (completers) whilst 45 were unsuccessful (non-completers). A mixed methods approach, including quantitative pharmacy surveys and qualitative semi-structured interviews, was used to gather data from participating pharmacies. Following intervention development, 142 pharmacists and 21 pharmacy support staff attended training workshops, received resource kits and ongoing support from consumer and pharmacist mentors throughout intervention implementation. Baseline quantitative data was collected from each pharmacy on staff profile, volume of medicines dispensed, the range of professional services delivered and relationships with health professionals. At the completion of the study participants were invited to complete an online exit survey and take part in a semi-structured interview that

  18. INVESTMENTS AND SERVICES ON THE RURAL DEVELOPMENT IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Popa Ana

    2013-04-01

    Full Text Available The article started with the modern connection observed between sectors in EU -primary, secondary and tertiary- on rural areas, where agriculture becomes essential. First, this connection is manifested in Romania under the impact of the main directions of the Common Agricultural Policy (CAP during 2014-2020, namely: a more market-oriented production, but also related to the public, promoting food security, while considering environmental issues and, in addition, achieve cooperation and alignment to the European Economic Area, including equality in European funding. Secondly, there is a dedicated rural development policy, which is supported by a series of investments, but imposed a number of directions that will lead to the expansion of tertiary sector measures, marketing, tourism, ecology, and promoting social inclusion, poverty reduction and economic development in rural areas. Other influences are generated by foreign direct investments-FDI in rural areas. The conclusion is based on the fragility of the rural sector in Romania, compared to other European countries and highlights specific areas of interest of stakeholders for the following issues: improving policies and decisions, access to markets, infrastructure development, access to financial services, access to knowledge, services innovation and risk reduction.

  19. "Click for Closer Care": A Content Analysis of Community Pharmacy Websites in Four Countries.

    Science.gov (United States)

    Zwier, Sandra

    2017-06-14

    Combinations of professional and commercial communication are typically very controversial, particularly in health care communication on the Internet. Websites of licensed community pharmacies on the other hand tend to raise remarkably little controversy, although they typically contain controversial combinations of clinical and commercial services previously unprecedented in professional health care communication. The aim of this study was to fill the void of knowledge about the combination of clinical and commercial services presented on the websites of licensed community pharmacies. A content analysis of clinical and commercial services presented in a random sample of 200 licensed community pharmacy websites from Great Britain, the Netherlands, the Canadian provinces British Columbia and Manitoba, and the Australian states New South Wales and Western Australia was conducted. The top five specific services mentioned on the community pharmacy websites were cosmetic products (126/200, 63.0%), medication refill request options (124/200, 62.0%), over-the-counter medicine (115/200, 57.5%), complementary and alternative medicine (107/200, 53.5%), and home medical aids (98/200, 49.0%). On average, 72.5% (145/200) of the community pharmacy websites across the 4 countries included a combination of clinical and commercial services. A combination of clinical and commercial services was more often present on chain pharmacy websites (120/147, 82.8%) than single pharmacy websites (25/53, 47%; Ppharmacy websites, followed by the Australian, British, and Dutch pharmacy websites, respectively (Ppharmacies' homepages contained a combination of clinical and commercial images (107/200, 53.5%), and almost half of the homepage menus contained a combination of clinical and commercial items (99/200, 49.5%). The latter were, again, more common on chain pharmacy than single pharmacy websites (Ppharmacies in Great Britain, the Netherlands, Canada, and Australia combine clinical services

  20. Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review.

    Science.gov (United States)

    Hindi, Ali M K; Schafheutle, Ellen I; Jacobs, Sally

    2018-04-01

    The United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. However, patient and public awareness of community pharmacy services has been limited. To identify and synthesize the research literature pertaining to patient and public perspectives on: existing community pharmacy services, extended pharmacist roles and strategies to raise awareness of community pharmacy services. Systematic search of 8 electronic databases; hand searching of relevant journals, reference lists and conference proceedings. UK studies investigating patient or public views on community pharmacy services or pharmacist roles from 2005 to 2016. Data were extracted into a grid and subjected to narrative synthesis following thematic analysis. From the 3260 unique papers identified, 30 studies were included. Manual searching identified 4 additional studies. Designs using questionnaires (n = 14, 41%), semi-structured interviews (n = 8, 24%) and focus groups (n = 6, 18%) made up the greatest proportion of studies. Most of the studies (n = 28, 82%) were published from 2010 onwards and covered perceptions of specific community pharmacy services (n = 31). Using a critical appraisal checklist, the overall quality of studies was deemed acceptable. Findings were grouped into 2 main themes "public cognizance" and "attitudes towards services" each with 4 subthemes. Patients and the public appeared to view services as beneficial. Successful integration of extended pharmacy services requires pharmacists' clinical skills to be recognized by patients and physicians. Future research should explore different approaches to increase awareness. © 2017 The Authors. Health Expectations published by John Wiley & Sons Ltd.

  1. Facilitators for practice change in Spanish community pharmacy.

    Science.gov (United States)

    Gastelurrutia, Miguel A; Benrimoj, S I Charlie; Castrillon, Carla C; de Amezua, María J Casado; Fernandez-Llimos, Fernando; Faus, Maria J

    2009-02-01

    To identify and prioritise facilitators for practice change in Spanish community pharmacy. Spanish community pharmacies. Qualitative study. Thirty-three semi-structured interviews were conducted with community pharmacists (n = 15) and pharmacy strategists (n = 18), and the results were examined using the content analysis method. In addition, two nominal groups (seven community pharmacists and seven strategists) were formed to identify and prioritise facilitators. Results of both techniques were then triangulated. Facilitators for practice change. Twelve facilitators were identified and grouped into four domains (D1: Pharmacist; D2: Pharmacy as an organisation; D3: Pharmaceutical profession; D4: Miscellaneous). Facilitators identified in D1 include: the need for more clinical education at both pre- and post-graduate levels; the need for clearer and unequivocal messages from professional leaders about the future of the professional practice; and the need for a change in pharmacists' attitudes. Facilitators in D2 are: the need to change the reimbursement system to accommodate cognitive service delivery as well as dispensing; and the need to change the front office of pharmacies. Facilitators identified in D3 are: the need for the Spanish National Professional Association to take a leadership role in the implementation of cognitive services; the need to reduce administrative workload; and the need for universities to reduce the gap between education and research. Other facilitators identified in this study include: the need to increase patients' demand for cognitive services at pharmacies; the need to improve pharmacist-physician relationships; the need for support from health care authorities; and the need for improved marketing of cognitive services and their benefits to society, including physicians and health care authorities. Twelve facilitators were identified. Strategists considered clinical education and pharmacists' attitude as the most important, and

  2. Study protocol: Evaluating the impact of a rural Australian primary health care service on rural health

    Directory of Open Access Journals (Sweden)

    Buykx Penny

    2011-03-01

    Full Text Available Abstract Background Rural communities throughout Australia are experiencing demographic ageing, increasing burden of chronic diseases, and de-population. Many are struggling to maintain viable health care services due to lack of infrastructure and workforce shortages. Hence, they face significant health disadvantages compared with urban regions. Primary health care yields the best health outcomes in situations characterised by limited resources. However, few rigorous longitudinal evaluations have been conducted to systematise them; assess their transferability; or assess sustainability amidst dynamic health policy environments. This paper describes the study protocol of a comprehensive longitudinal evaluation of a successful primary health care service in a small rural Australian community to assess its performance, sustainability, and responsiveness to changing community needs and health system requirements. Methods/Design The evaluation framework aims to examine the health service over a six-year period in terms of: (a Structural domains (health service performance; sustainability; and quality of care; (b Process domains (health service utilisation and satisfaction; and (c Outcome domains (health behaviours, health outcomes and community viability. Significant international research guided the development of unambiguous reliable indicators for each domain that can be routinely and unobtrusively collected. Data are to be collected and analysed for trends from a range of sources: audits, community surveys, interviews and focus group discussions. Discussion This iterative evaluation framework and methodology aims to ensure the ongoing monitoring of service activity and health outcomes that allows researchers, providers and administrators to assess the extent to which health service objectives are met; the factors that helped or hindered achievements; what worked or did not work well and why; what aspects of the service could be improved and how

  3. Rural vs urban hospital performance in a 'competitive' public health service.

    Science.gov (United States)

    Garcia-Lacalle, Javier; Martin, Emilio

    2010-09-01

    In some western countries, market-driven reforms to improve efficiency and quality have harmed the performance of some hospitals, occasionally leading to their closure, mostly in rural areas. This paper seeks to explore whether these reforms affect urban and rural hospitals differently in a European health service. Rural and urban hospital performance is compared taking into account their efficiency and perceived quality. The study is focused on the Andalusian Health Service (SAS) in Spain, which has implemented a freedom of hospital choice policy and a reimbursement system based on hospital performance. Data Envelopment Analysis, the Mann-Whitney U test and Multidimensional Scaling techniques are conducted for two years, 2003 and 2006. The results show that rural and urban hospitals perform similarly in the efficiency dimension, whereas rural hospitals perform significantly better than urban hospitals in the patient satisfaction dimension. When the two dimensions are considered jointly, some rural hospitals are found to be the best performers. As such, market-driven reforms do not necessary result in a difference in the performance of rural and urban hospitals. Copyright 2010 Elsevier Ltd. All rights reserved.

  4. Swiss community pharmacies' on the Web and pharmacists' experiences with E-commerce: longitudinal study and Internet-based questionnaire survey.

    Science.gov (United States)

    Zehnder, Simon; Bruppacher, Rudolf; Ruppanner, Hans; Hersberger, Kurt E

    2004-03-03

    There are multiple ways in which community pharmacies can present themselves on the Internet, e.g., as a platform for drug information or as an advertising platform for their services. To estimate the number of Swiss community pharmacies on the Internet over the period of 32 months (2000-2003), to describe their current e-commerce services, and to explore the experiences and plans these pharmacies have with regard to their Internet presence. A longitudinal study was performed to determine the number of Swiss German pharmacies on the Internet by conducting Internet searches in 2000, 2001, and 2003. In April 2002, a cross-sectional Internet-based survey was administered to explore the pharmacies' experiences and plans regarding their Web sites. As of April 2003, 373 (44%) of 852 community pharmacies from the German speaking part of Switzerland were on the Internet. One hundred eighty four listed an e-mail address and were asked to complete a questionnaire. Of the 107 pharmacies answering the survey questions (58% response rate): 46% had been on the Internet for 1 to 2 years; 33% of the Web sites are part of a pharmacy group's Web portal; 31% of the pharmacies plan to expand their Internet appearance in the future; 74% provide e-commerce services, with 81% of those pharmacies filling five or less orders per month; and 12% plan on expanding their e-commerce services in the future. The number of community pharmacies offering Internet services steadily increased over 32 months. Given the importance of the Internet as a tool for information, communication, and advertising for pharmacy products and services, it can be expected that the increase will continue. Pharmacy-group portals are important promoters of pharmacies on the Internet. For many community pharmacies, Internet portals that provide an Internet presence for the pharmacies and provide regularly-updated content (e.g., health news, tips, drug information) seem to be the most effective solutions. Even though 40

  5. Swiss Community Pharmacies' on the Web and Pharmacists' Experiences with E-commerce: Longitudinal study and Internet-based questionnaire survey

    Science.gov (United States)

    Bruppacher, Rudolf; Ruppanner, Hans; Hersberger, Kurt E

    2004-01-01

    Background There are multiple ways in which community pharmacies can present themselves on the Internet, e.g., as a platform for drug information or as an advertising platform for their services. Objective To estimate the number of Swiss community pharmacies on the Internet over the period of 32 months (2000-2003), to describe their current e-commerce services, and to explore the experiences and plans these pharmacies have with regard to their Internet presence. Methods A longitudinal study was performed to determine the number of Swiss German pharmacies on the Internet by conducting Internet searches in 2000, 2001, and 2003. In April 2002, a cross-sectional Internet-based survey was administered to explore the pharmacies' experiences and plans regarding their Web sites. Results As of April 2003, 373 (44%) of 852 community pharmacies from the German speaking part of Switzerland were on the Internet. One hundred eighty four listed an e-mail address and were asked to complete a questionnaire. Of the 107 pharmacies answering the survey questions (58% response rate): 46% had been on the Internet for 1 to 2 years; 33% of the Web sites are part of a pharmacy group's Web portal; 31% of the pharmacies plan to expand their Internet appearance in the future; 74% provide e-commerce services, with 81% of those pharmacies filling five or less orders per month; and 12% plan on expanding their e-commerce services in the future. Conclusions The number of community pharmacies offering Internet services steadily increased over 32 months. Given the importance of the Internet as a tool for information, communication, and advertising for pharmacy products and services, it can be expected that the increase will continue. Pharmacy-group portals are important promoters of pharmacies on the Internet. For many community pharmacies, Internet portals that provide an Internet presence for the pharmacies and provide regularly-updated content (e.g., health news, tips, drug information) seem to

  6. AN EXPLORATIVE STUDY OF PHARMACY-BASED BONE MINERAL DENSITY TESTING

    Directory of Open Access Journals (Sweden)

    AZMI SARRIFF

    2006-01-01

    Full Text Available The aim of this paper is to assess the future of pharmacy-based osteoporosis screening services in Malaysia through a survey involving retail pharmacists as well as the general public. An ethnographic-style research strategy method was used involving community pharmacists, and men and women above 50 years old. Pharmacists were interviewed as to whether they would offer such a service and how much they would charge for it. Information regarding knowledge on screening and osteoporosis was also obtained. Patients were queried as to whether they would go to the pharmacy for testing and how much they were willing to pay for such a service. The study found that around half of the pharmacists (n = 30 were willing to offer such a service (56.7%. Reasons cited for not willing to offer such a service were lack of public response and high capital. Those agreeable (88.2% to offer such a service said they would charge between RM0 to RM50 per patient. The majority (64.7% of those who answered in the affirmative claimed to have poor knowledge on screening, while 58.8% claimed to have good knowledge on osteoporosis. Among the public (n = 50; 31 female, 19 male, 66% claimed they would not go to the pharmacy for testing. Majority (46% preferred to go to the government hospital. Of the 17 willing to go to the pharmacy, the majority (64.7% were willing to pay between RM0 to RM50 for the Bone Mineral Density (BMD test. BMD testing can be professionally and financially rewarding for pharmacists. As such, pharmacists need to take appropriate steps to implement BMD testing services in the pharmacy. Incorporating an education component into such a service is vital. Although the future of pharmacy-based BMD testing looks bleak in Malaysia, necessary steps can be taken to overcome this problem by increasing public awareness on the severity of osteoporosis.

  7. Pharmacists’ journey to clinical pharmacy practice in Ethiopia: Key informants’ perspective

    Directory of Open Access Journals (Sweden)

    Alemayehu B Mekonnen

    2013-09-01

    Full Text Available Objective: Clinical pharmacy practice has developed internationally to expand the role of a pharmacist well beyond the traditional roles of compounding and supplying drugs to roles more directly in caring for patients and providing medication consultation to staff. This area of practice is at the infant stage in Ethiopia. The aim of this study was to explore key informants’ perspective in the implementation of clinical pharmacy practice in Jimma University Specialized Hospital, Ethiopia. Method: A qualitative study was conducted through in-depth interviews with the heads of departments (internal medicine, paediatrics, surgery, nurse, pharmacy, medical director, administration and pharmacy student representatives. Qualitative data analysis was done after audiotapes were transcribed verbatim and notes were compiled. Results: All of the respondents interviewed express diverse and conflicting perspectives on pharmacists’ role, varying from a health-care professional to a business man. Despite this, the current pace of change worldwide takes the professions’ mission to that of a provider of clinical pharmacy services. The data ascertained the change in pharmacy practice, and integrating clinical pharmacy services within the health-care system should be seen as a must. Pharmacists should delineate from a business perspective and focus on widening the scope of the profession of pharmacy and should come close to the patient to serve directly. Conclusions: Although the perception of people on traditional roles of pharmacists was weak, there were promising steps in developing clinical pharmacy practice within the health-care system. Moreover, the results of this study revealed a high demand for this service among health-care providers.

  8. A survey of selected Internet pharmacies in the United States.

    Science.gov (United States)

    Peterson, A M

    2001-01-01

    To determine whether differences in the provision of pharmacy services exist among different types of Internet pharmacies. Survey of selected pharmacies with a presence on the Internet. Data were abstracted onto a data collection form for further analysis. Data collection was limited to 3 weeks. U.S.-based Internet pharmacies that allow patients to purchase prescription medications online. Pharmacies were identified using a metasearch engine with the search terms "Internet pharmacy" and "Internet pharmacist." Survey. Comparisons of availability of 10 commonly used products representing a variety of product categories, prescription verification methods, and privacy issues; and determinations of site navigability, drug information and provider access, and payment methods. Sites were categorized as "chain pharmacy extensions," "mail order pharmacies," "independent pharmacy extensions," and "online pharmacies." Thirty-three sites were reviewed. There was significant variation among the four types of pharmacies selling prescriptions over the Internet. Most pharmacies provided all of the drugs in the survey. Patients were required to provide their own prescription at 88% of the sites, and 75% of sites used mail or fax to verify prescription integrity. More than 50% of sites had privacy policies posted, and 64% used cookies. Chain pharmacy extensions required completion of an average of 10.2 pages to order drugs versus 2.4 to 4 pages for all other site types. Drug information was written at an eighth-grade reading level at 36% of the sites. More than two-thirds of the sites provided a toll-free telephone for a health care professional. Nearly 80% of the sites accepted health insurance, and 95% accepted credit cards; however, only 40% used a secure transmission mechanism for patient or payment information. Internet pharmacies provide varying levels of service. Policies regarding the use of the Internet for obtaining medications should focus on improving the privacy of

  9. Social Pharmacy and Clinical Pharmacy—Joining Forces

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    Anna Birna Almarsdottir

    2015-12-01

    Full Text Available This commentary seeks to define the areas of social pharmacy and clinical pharmacy to uncover what they have in common and what still sets them apart. Common threats and challenges of the two areas are reviewed in order to understand the forces in play. Forces that still keep clinical and social pharmacy apart are university structures, research traditions, and the management of pharmacy services. There are key (but shrinking differences between clinical and social pharmacy which entail the levels of study within pharmaceutical sciences, the location in which the research is carried out, the choice of research designs and methods, and the theoretical foundations. Common strengths and opportunities are important to know in order to join forces. Finding common ground can be developed in two areas: participating together in multi-disciplinary research, and uniting in a dialogue with internal and external key players in putting forth what is needed for the profession of pharmacy. At the end the question is posed, “What’s in a name?” and we argue that it is important to emphasize what unifies the families of clinical pharmacy and social pharmacy for the benefit of both fields, pharmacy in general, and society at large.

  10. An Innovative Approach to Pharmacy Law Education Utilizing a Mock Board of Pharmacy Meeting

    Directory of Open Access Journals (Sweden)

    D. Todd Bess

    2016-03-01

    Full Text Available A thorough understanding of pharmacy law by students is important in the molding of future pharmacy practitioners, but a standardized template for the best way to educate students in this area has not been created. A mock Board of Pharmacy meeting was designed and incorporated into the Pharmacy Law course at the University of Tennessee College of Pharmacy. Students acted as Board of Pharmacy members and utilized technology to decide outcomes of cases and requests addressed in a typical 2 day Tennessee Board of Pharmacy meeting. The actual responses to those cases, as well as similar cases and requests addressed over a 5 year period, were revealed to students after they made motions on mock scenarios. The mock Board of Pharmacy meeting engages the students in a way that lectures alone often fail to achieve with some initial evidence of successful student learning. Utilizing this teaching format as a law education tool challenges the status quo of pharmacy education and may serve as an impetus and catalyst for future innovations. 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. Dr. Wang’s time was partly supported by the National Institute on Aging of the National Institutes of Health under Award Number R01AG040146 and R01AG049696. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.   Type: Idea Paper

  11. Organization of public services in remote rural areas in developing countries: application to decentralized rural electrification

    International Nuclear Information System (INIS)

    Bui, D.N.

    2005-01-01

    The electrical sector has traditionally been organized as a natural monopoly. The intensity in capital of the grid and the public service obligation of electrical distribution led to the creation of electrical companies with exclusive territorial concessions. This approach has recently been challenged because of its failure to electrify remote rural villages in developing countries. A new set of solutions appeared under the umbrella of Decentralized Rural Electrification (DRE) thanks to technological innovations that replace collective infrastructures with individual systems. However, the widespread deployment of decentralized technologies remains impaired by numerous obstacles at various levels: institutional, legal, organizational, social, financial... New models that take into account the specificities of DRE must now be imagined. The study of two case studies in Morocco and India provide insightful examples of possible strategies to accelerate the deployment of DRE and therefore attain the objectives of rural electrification. Two major policies stand out: public service delegation and the approach of delivering equipment by the public market. Even though these models are too recent to conclude on their viability and permanence, they provide guidelines for the public and private players of the sector to generalize the access to electrical services to rural populations in developing countries, and contribute to their development. (author)

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

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    Mekonnen AB

    2013-03-01

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

  13. Rationing is a reality in rural physiotherapy: a qualitative exploration of service level decision-making.

    Science.gov (United States)

    Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

    2015-03-27

    Deciding what health services are provided is a key consideration in delivering appropriate and accessible health care for rural and remote populations. Despite residents of rural communities experiencing poorer health outcomes and exhibiting higher health need, workforce shortages and maldistribution mean that rural communities do not have access to the range of services available in metropolitan centres. Where demand exceeds available resources, decisions about resource allocation are required. A qualitative approach enabled the researchers to explore participant perspectives about decisions informing rural physiotherapy service provision. Stakeholder perspectives were obtained through surveys and in-depth interviews. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of rural, regional and remote communities. Thirty-nine surveys were received from participants in eleven communities. Nineteen in-depth interviews were conducted with physiotherapist and key decision-makers. Increasing demand, organisational priorities, fiscal austerity measures and workforce challenges were identified as factors influencing both decision-making and service provision. Rationing of physiotherapy services was common to all sites of this study. Rationing of services, more commonly expressed as service prioritisation, was more evident in responses of public sector physiotherapy participants compared to private physiotherapists. However, private physiotherapists in rural areas reported capacity limits, including expertise, space and affordability that constrained service provision. The imbalance between increasing service demands and limited physiotherapy capacity meant making choices was inevitable. Decreased community access to local physiotherapy services and increased workforce stress, a key determinant of retention, are two results of such choices or decisions

  14. Rural Women, Money and Financial Service.

    Science.gov (United States)

    Jiggins, Janice

    1985-01-01

    The author points out the multifaceted aspects of the problems associated with rural women's need for money and financial services and outlines innovative schemes in this area such as the bank for the landless in Bangladesh, a savings and loan cooperative for market women in Nicaragua, and a savings development movement in Zimbabwe. (CT)

  15. A Study of the Application of Big Data in a Rural Comprehensive Information Service

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    Leifeng Guo

    2015-05-01

    Full Text Available Big data has attracted extensive interest due to its potential tremendous social and scientific value. Researchers are also trying to extract potential value from agriculture big data. This paper presents a study of information services based on big data from the perspective of a rural comprehensive information service. First, we introduce the background of the rural comprehensive information service, and then we present in detail the National Rural Comprehensive Information Service Platform (NRCISP, which is supported by the national science and technology support program. Next, we discuss big data in the NRCISP according to data characteristics, data sources, and data processing. Finally, we discuss a service model and services based on big data in the NRCISP.

  16. Transformation of the rural PV market through the National Rural Water Service Delivery Program

    International Nuclear Information System (INIS)

    2009-03-01

    The primary objective of the project is to reduce the country's energy-related Co2 emissions by substituting solar Pv to fossil fuels to provide basic water pumping services to the non-electrified rural communities in the Middle-South region. A secondary objective is to institutionalize the use of solar Pv for low-head irrigation and basic domestic (lighting, Tv) and community (health clinics, telecom, schools) uses in rural areas as a substitute for fossil fuel-based energy sources (paraffin, diesel and LPG). The activities proposed in the project are designed to: (I) remove barriers to the wide-scale utilization of solar Pv for solar pumping; (II) meet the basic energy needs of community based organizations; and (III) reinforce public-private partnerships in promoting solar Pv technology. This project will assist with the introduction of solar Pv in the Government rural water program - which is a unique opportunity to tap a sizable Pv market within the country - and will ensure sustain ability through the involvement of the private sector in the provision of water services

  17. For more than love or money: attitudes of student and in-service health workers towards rural service in India.

    Science.gov (United States)

    Ramani, Sudha; Rao, Krishna D; Ryan, Mandy; Vujicic, Marko; Berman, Peter

    2013-11-21

    While international literature on rural retention is expanding, there is a lack of research on relevant strategies from pluralistic healthcare environments such as India, where alternate medicine is an integral component of primary care. In such contexts, there is a constant tug of war in national policy on "Which health worker is needed in rural areas?" and "Who can, realistically, be got there?" In this article, we try to inform this debate by juxtaposing perspectives of three cadres involved in primary care in India-allopathic, ayurvedic and nursing-on rural service. We also identify key incentives for improved rural retention of these cadres. We present qualitative evidence from two states, Uttarakhand and Andhra Pradesh. Eighty-eight in-depth interviews with students and in-service personnel were conducted between January and July 2010. Generic thematic analysis techniques were employed, and the data were organized in a framework that clustered factors linked to rural service as organizational (salary, infrastructure, career) and contextual (housing, children's development, safety). Similar to other studies, we found that both pecuniary and non-pecuniary factors (salary, working conditions, children's education, living conditions and safety) affect career preferences of health workers. For the allopathic cadre, rural primary care jobs commanded little respect; respondents from this cadre aimed to specialize and preferred private sector jobs. Offering preferential admission to specialist courses in exchange for a rural stint appears to be a powerful incentive for this cadre. In contrast, respondents from the Ayurvedic and nursing cadres favored public sector jobs even if this meant rural postings. For these two cadres, better salary, working and rural living conditions can increase recruitment. Rural retention strategies in India have predominantly concentrated on the allopathic cadre. Our study suggests incentivizing rural service for the nursing and Ayurvedic

  18. Community pharmacy customer segmentation based on factors influencing their selection of pharmacy and over-the-counter medicines.

    Science.gov (United States)

    Kevrekidis, Dimitrios Phaedon; Minarikova, Daniela; Markos, Angelos; Malovecka, Ivona; Minarik, Peter

    2018-01-01

    customer segments that varied in the consumer preferences concerning the selection of pharmacy and OTCs, the evaluation of pharmaceutical services and products, and demographic characteristics.

  19. Rural Women Veterans' Use and Perception of Mental Health Services.

    Science.gov (United States)

    Ingelse, Kathy; Messecar, Deborah

    2016-04-01

    While the total number of veterans in the U.S. is decreasing overall, the number of women veterans is significantly increasing. There are numerous barriers which keep women veterans from accessing mental health care. One barrier which can impact receiving care is living in a rural area. Veterans in rural areas have access to fewer mental health services than do urban residing veterans, and women veterans in general have less access to mental health care than do their male colleagues. Little is known about rural women veterans and their mental health service needs. Women, who have served in the military, have unique problems related to their service compared to their male colleagues including higher rates of post-traumatic stress disorder (PTSD) and military sexual trauma (MST). This qualitative study investigated use of and barriers to receiving mental health care for rural women veterans. In-depth interviews were conducted with ten women veterans who have reported experiencing problems with either MST, PTSD, or combat trauma. All ten women had utilized mental health services during active-duty military service, and post service, in Veterans Administration (VA) community based-outpatient clinics. Several recurring themes in the women's experience were identified. For all of the women interviewed, a sentinel precipitating event led to seeking mental health services. These precipitating events included episodes of chronic sexual harassment and ridicule, traumatic sexual assaults, and difficult combat experiences. Efforts to report mistreatment were unsuccessful or met with punishment. All the women interviewed reported that they would not have sought services without the help of a supportive peer who encouraged seeking care. Barriers to seeking care included feeling like they were not really a combat veteran (in spite of serving in a combat unit in Iraq); feeling stigmatized by providers and other military personnel, being treated as crazy; and a lack of interest

  20. The WHO UNESCO FIP Pharmacy Education Taskforce

    Directory of Open Access Journals (Sweden)

    Rouse Mike

    2009-06-01

    Full Text Available Abstract Pharmacists' roles are evolving from that of compounders and dispensers of medicines to that of experts on medicines within multidisciplinary health care teams. In the developing country context, the pharmacy is often the most accessible or even the sole point of access to health care advice and services. Because of their knowledge of medicines and clinical therapeutics, pharmacists are suitably placed for task shifting in health care and could be further trained to undertake functions such as clinical management and laboratory diagnostics. Indeed, pharmacists have been shown to be willing, competent, and cost-effective providers of what the professional literature calls "pharmaceutical care interventions"; however, internationally, there is an underuse of pharmacists for patient care and public health efforts. A coordinated and multifaceted effort to advance workforce planning, training and education is needed in order to prepare an adequate number of well-trained pharmacists for such roles. Acknowledging that health care needs can vary across geography and culture, an international group of key stakeholders in pharmacy education and global health has reached unanimous agreement that pharmacy education must be quality-driven and directed towards societal health care needs, the services required to meet those needs, the competences necessary to provide these services and the education needed to ensure those competences. Using that framework, this commentary describes the Pharmacy Education Taskforce of the World Health Organization, United Nations Educational, Scientific and Cultural Organization and the International Pharmaceutical Federation Global Pharmacy and the Education Action Plan 2008–2010, including the foundation, domains, objectives and outcome measures, and includes several examples of current activities within this scope.

  1. Rural Satellite Services--Getting the Mixture Right.

    Science.gov (United States)

    Stahmer, Anna

    1987-01-01

    This discussion of satellite services for education and rural development in less developed countries emphasizes the importance of adequate telephone systems to support development programs. Programs in Peru, Indonesia, and the West Indies are highlighted, and current and future problems in planning satellite systems are reviewed. (LRW)

  2. Pharmacy travel health services: current perspectives and future prospects

    Directory of Open Access Journals (Sweden)

    Houle SKD

    2018-03-01

    Full Text Available Sherilyn KD HouleSchool of Pharmacy, University of Waterloo, Waterloo, ON, CanadaAbstract: Rates of international travel are increasing annually, with particular growth observed in travel to Southeast Asia and to emerging economies. While all patients traveling across geographic regions are recommended to receive a pre-travel consultation to consider their individual risks, many do not, or receive care and recommendations that are not consistent with current evidence-based guidelines. As experts in drug therapy, and given the largely preventive nature of most travel health recommendations, pharmacists are well suited to help address this need. Pharmacists generally possess a high degree of knowledge and confidence with more commonly observed travel health topics in community practice such as travelers’ diarrhea; however, training in more specialized travel health topics such as travel vaccinations and traveling at altitude has generally been lacking from pharmacy curricula. Pharmacists with an interest in providing pre-travel consultations are encouraged to pursue additional training in this specialty and to consider Certificate in Travel Health designation from the International Society of Travel Medicine. Future roles for pharmacists to include the prescribing of medications and vaccines for travel and the in-pharmacy administration of travel vaccinations may improve patient access to pre-travel consultations and recommended preventive measures, improving the health of travelers and potentially reducing the burden of communicable disease worldwide. Pharmacists providing travel care to patients are also reminded to consider noninfectious risks of illness and injury abroad and to counsel patients on strategies to minimize these risks in addition to providing drug and vaccine recommendations.Keywords: pharmacist, community pharmacy, travel, vaccination

  3. Managing Conflict: A Guide for the Pharmacy Manager.

    Science.gov (United States)

    Haumschild, Ryan J; Hertig, John B; Weber, Robert J

    2015-06-01

    Managing conflict among a variety of people and groups is a necessary part of creating a high performance pharmacy department. As new pharmacy managers enter the workforce, much of their success depends on how they manage conflict. The goal of this article is to provide a guide for the pharmacy director on conflict in the workplace. By evaluating each type of conflict, we can learn how to respond when it occurs. Resolving conflict requires a unique and individualized approach, and the strategy used may often be based on the situational context and the personality of the employee or manager. The more that pharmacy leaders can engage in conflict resolution with employees and external leaders, the more proactive they can be in achieving positive results. If pharmacy directors understand the source of conflicts and use management strategies to resolve them, they will ensure that conflicts result in a more effective patient-centered pharmacy service.

  4. Pharmacy Automation in Navy Medicine: A Study of Naval Medical Center San Diego

    Science.gov (United States)

    2015-09-01

    Whittlesea, C. (2013). The impact of automation on workload and dispensing errors in a hospital pharmacy . International Journal of Pharmacy Practice , 21...Welsh NHS hospitals. International Journal of Pharmacy Practice , 16, 175–188. Lin, A. C., Huang, Y.-C., Punches, G., & Chen, Y. (2007). Effect of a...expectations of outpatient pharmacy services in a teaching hospital. International Journal of Pharmacy Medicine , 5(3), 128–132. 79 INITIAL

  5. Refer-To-Pharmacy: Pharmacy for the Next Generation Now! A Short Communication for Pharmacy

    OpenAIRE

    Gray, Alistair

    2015-01-01

    Refer-to-Pharmacy is the first fully integrated hospital to community pharmacy referral system. This article explains the importance of these referrals for patients and health economies to improve medicines optimisation, and how Refer-to-Pharmacy works in both hospital and community pharmacies.

  6. The ethics of leadership in pharmacy.

    Science.gov (United States)

    Redman, B K

    1995-10-01

    The pharmacy profession's responsibility to provide ethical leadership to its members is explained, and areas where pharmacy should take a leadership role are described. Changes taking place in health care offer many opportunities for pharmacy in its transformation into a fully clinical discipline. The profession needs to address the ethical issues that will affect it as part of this revolution. The role pharmacy is taking to eliminate medication misadventuring will be a test case for the profession's ability to exert the leadership it must, as part of its new definition of itself. Pharmacy needs to define the structure, process, and outcomes necessary to improve its own practice to avoid drug misadventuring, with a clear set of practice and ethical standards, and engage medicine and nursing to adopt similar standards. Pharmacy should also take a leadership role in health care reform, working with other clinicians to ensure that the changes provide better outcomes for patients. Health care professionals are bound together by a common moral purpose: to act in the patient's best interest. Thus, each health profession is a moral community, which must determine and promote ethical behavior among its members. Pharmacy must practice ethical leadership: it must define and prove its contribution to patient outcomes, further develop legal and ethical standards, and examine its responsibilities for vulnerable patient groups such as children. It must work to overcome the traditional dominance of medicine; pharmacy, nursing, and medicine must come together in service of the patient and develop a cross-professional conception of ethics. Pharmacy also must participate in the broader debate about health care. Pharmacy has begun to take a leadership role among the health professions through its efforts to eliminate medication misadventuring. Additional leadership challenges for the profession are suggested.

  7. Community pharmacy customer segmentation based on factors influencing their selection of pharmacy and over-the-counter medicines

    Directory of Open Access Journals (Sweden)

    Dimitrios Phaedon Kevrekidis

    2018-01-01

    , received the highest ratings. Conclusions: The community pharmacy market comprised of distinct customer segments that varied in the consumer preferences concerning the selection of pharmacy and OTCs, the evaluation of pharmaceutical services and products, and demographic characteristics. Keywords: Customer segmentation, Consumer behavior, Pharmacy selection, OTCs’ purchase, Pharmacy customers’ profiles, Cluster analysis

  8. Refer-To-Pharmacy: Pharmacy for the Next Generation Now! A Short Communication for Pharmacy

    Directory of Open Access Journals (Sweden)

    Alistair Gray

    2015-12-01

    Full Text Available Refer-to-Pharmacy is the first fully integrated hospital to community pharmacy referral system. This article explains the importance of these referrals for patients and health economies to improve medicines optimisation, and how Refer-to-Pharmacy works in both hospital and community pharmacies.

  9. Multipath for Agricultural and Rural Information Services in China

    Science.gov (United States)

    Ge, Ningning; Zang, Zhiyuan; Gao, Lingwang; Shi, Qiang; Li, Jie; Xing, Chunlin; Shen, Zuorui

    Internet cannot provide perfect information services for farmers in rural regions in China, because farmers in rural regions can hardly access the internet by now. But the wide coverage of mobile signal, telephone line, and television network, etc. gave us a chance to solve the problem. The integrated pest management platform of Northern fruit trees were developed based on the integrated technology, which can integrate the internet, mobile and fixed-line telephone network, and television network, to provide integrated pest management(IPM) information services for farmers in rural regions in E-mail, telephone-voice, short message, voice mail, videoconference or other format, to users' telephone, cell phone, personal computer, personal digital assistant(PDA), television, etc. alternatively. The architecture and the functions of the system were introduced in the paper. The system can manage the field monitoring data of agricultural pests, deal with enquiries to provide the necessary information to farmers accessing the interactive voice response(IVR) in the system with the experts on-line or off-line, and issue the early warnings about the fruit tree pests when it is necessary according to analysis on the monitoring data about the pests of fruit trees in variety of ways including SMS, fax, voice and intersystem e-mail.The system provides a platform and a new pattern for agricultural technology extension with a high coverage rate of agricultural technology in rural regions, and it can solve the problem of agriculture information service 'last kilometer' in China. The effectiveness of the system was certified.

  10. Patients’ perceived value of pharmacy quality measures: a mixed-methods study

    Science.gov (United States)

    Shiyanbola, Olayinka O; Mort, Jane R

    2015-01-01

    Objective To describe patients’ perceived value and use of quality measures in evaluating and choosing community pharmacies. Design Focus group methodology was combined with a survey tool. During the focus groups, participants assessed the value of the Pharmacy Quality Alliance's quality measures in evaluating and choosing a pharmacy. Also, participants completed questionnaires rating their perceived value of quality measures in evaluating a pharmacy (1 being low value and 5 being high) or choosing a pharmacy (yes/no). Thematic analysis and descriptive statistics were used to analyse the focus groups and surveys, respectively. Setting Semistructured focus groups were conducted in a private meeting space of an urban and a rural area of a Mid-western State in the USA. Participants Thirty-four adults who filled prescription medications in community pharmacies for a chronic illness were recruited in community pharmacies, senior centres and public libraries. Results While comments indicated that all measures were important, medication safety measures (eg, drug-drug interactions) were valued more highly than others. Rating of quality measure utility in evaluating a pharmacy ranged from a mean of 4.88 (‘drug-drug interactions’) to a mean of 4.0 (‘absence of controller therapy for patients with asthma’). Patients were hesitant to use quality information in choosing a pharmacy (depending on the participant's location) but might consider if moving to a new area or having had a negative pharmacy experience. Use of select quality measures to choose a pharmacy ranged from 97.1% of participants using ‘drug-drug interactions’ (medication safety measure) to 55.9% using ‘absence of controller therapy for patients with asthma’. Conclusions The study participants valued quality measures in evaluating and selecting a community pharmacy, with medication safety measures valued highest. The participants reported that the quality measures would not typically cause a

  11. Construct validation of an instrument to measure patient satisfaction with pharmacy services in Nigerian hospitals.

    Science.gov (United States)

    Afolabi, M O; Afolabi, E R I; Faleye, B A

    2012-12-01

    Patient satisfaction is a multidimensional construct that reflects the type and quality of service provided by healthcare providers, how well it is delivered, and the extent to which the expectations and needs of patients are met. As a performance measure, patient satisfaction has been defined as the personal evaluation of health care services and providers. To develop a patient satisfaction scale, that could be used to assess the quality of pharmacy services provided in Nigerian hospitals and to determine the construct validity of the scale with a view to identifying the factors that may be considered relevant to the target users. The questionnaire was a 35-item inventory titled "Patient Satisfaction Survey (PSS)". This study was carried out in three university teaching hospitals located in Southwestern Nigeria. The patient satisfaction survey instrument (PSS) was administered on 506 clinic outpatients who patronised the hospital pharmacies. Participation in the study was voluntary with appropriate informed consent. Ethical approval was obtained for this study from the Medical and Ethics Committee of Obafemi Awolowo University Teaching Hospital Complex (OAUTHC). Patients with post secondary education were in the majority with a frequency of 224 (44.3%) subjects. This was followed by a frequency of 116 (22.9%) for those with secondary education. Eighty-seven (17.2%) of those included in the main study had primary education 64 (12.7%) did not receive any formal education. Fifteen (3%) out of the 506 sampled did not indicate their level of education. This study developed a scale to measure patient satisfaction with pharmaceutical services in selected Nigerian university teaching hospitals. The final 25 item scale presents significant and stable coefficients of correlation and yielded six derived dimensions of patient satisfaction.

  12. Discrete choice experiments in pharmacy: a review of the literature.

    Science.gov (United States)

    Naik-Panvelkar, Pradnya; Armour, Carol; Saini, Bandana

    2013-02-01

    Discrete choice experiments (DCEs) have been widely used to elicit patient preferences for various healthcare services and interventions. The aim of our study was to conduct an in-depth scoping review of the literature and provide a current overview of the progressive application of DCEs within the field of pharmacy. Electronic databases (MEDLINE, EMBASE, SCOPUS, ECONLIT) were searched (January 1990-August 2011) to identify published English language studies using DCEs within the pharmacy context. Data were abstracted with respect to DCE methodology and application to pharmacy. Our search identified 12 studies. The DCE methodology was utilised to elicit preferences for different aspects of pharmacy products, therapy or services. Preferences were elicited from either patients or pharmacists, with just two studies incorporating the views of both. Most reviewed studies examined preferences for process-related or provider-related aspects with a lesser focus on health outcomes. Monetary attributes were considered to be important by most patients and pharmacists in the studies reviewed. Logit, probit or multinomial logit models were most commonly employed for estimation. Our study showed that the pharmacy profession has adopted the DCE methodology consistent with the general health DCEs although the number of studies is quite limited. Future studies need to examine preferences of both patients and providers for particular products or disease-state management services. Incorporation of health outcome attributes in the design, testing for external validity and the incorporation of DCE results in economic evaluation framework to inform pharmacy policy remain important areas for future research. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  13. Management of hypertension in an Australian community pharmacy setting - patients' beliefs and perspectives.

    Science.gov (United States)

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

    2017-08-01

    To explore patients' perspectives and experiences following a trial of a pharmacist-led service in hypertension management. A qualitative study comprising individual interviews was conducted. Patients of a community pharmacy, where a pharmacist-led hypertension management service had been trialled in selected metropolitan regions in Sydney (Australia), were recruited to the study. Emergent themes describing patients' experiences and perspectives on the service were elicited via thematic analysis (using manual inductive coding). Patients' (N = 18) experiences of the service were extremely positive, especially around pharmacists' monitoring of blood pressure and provision of advice about medication adherence. Patients' participation in the service was based on their trust in, and relationship with, their pharmacist. The perception of working in a 'team' was conveyed through the pharmacist's caring style of communication and the relaxed atmosphere of the community pharmacy. Patients felt that the community pharmacy was an obvious place for such a service because of their regular contact with the pharmacist, but was limited because the pharmacists were not able to prescribe medication. Patients were extremely positive about the role of, and their experience of, the pharmacy-based hypertension management service. Factors contributing to the patients' positive experiences provide important insights for community pharmacy practice. Good rapport with the pharmacist and a long-term relationship underpin patient engagement in such services. Restrictions on the pharmacists' scope of practice prevent their expertise, and the benefits of their accessibility as a primary point of contact, from being fully realised. © 2016 Royal Pharmaceutical Society.

  14. The impact of a reproductive health franchise on client satisfaction in rural Nepal.

    Science.gov (United States)

    Agha, Sohail; Karim, Ali Mehryar; Balal, Asma; Sosler, Steve

    2007-09-01

    This study evaluates the impact of a nurse and paramedic reproductive health franchise in rural Nepal on client satisfaction and utilization of services. A quasi-experimental study design, with baseline and follow-up measurements on nonequivalent control groups, was used to assess the effects of the intervention. The study collected data from exit interviews with male and female clients at clinics and from household interviews with married women. Our assessment covers the project's performance for about a year of actual implementation. Client satisfaction with the quality of services increased across a range of indicators at intervention clinics but not at control clinics. Overall satisfaction with services also increased only at intervention clinics but not at control clinics. Consistent with these changes, loyalty increased among clients of franchised clinics. The analysis showed a positive relationship between client satisfaction and loyalty. Although the project's implementation was examined over a relatively short period of time, there appears to have been a net positive effect of the intervention on obtaining family planning products from medical stores/pharmacies. The study shows that franchising reproductive health services increases a provider's interest in delivering better quality services in rural areas of a developing country.

  15. Older teen attitudes toward birth control access in pharmacies: a qualitative study.

    Science.gov (United States)

    Wilkinson, Tracey A; Miller, Courtney; Rafie, Samantha; Landau, Sharon Cohen; Rafie, Sally

    2018-03-01

    To examine adolescent attitudes toward accessing contraception through a new pharmacist prescribing model in the State of California. In-depth telephone interviews were conducted in summer 2015 with 30 females ages 18 to 19 in California. Participants were recruited using a social media advertisement. Semi-structured interviews utilized open-ended questions to understand teens' experiences with pharmacies, experiences obtaining contraception, and views on pharmacist prescribing of contraception. Responses were transcribed and qualitatively analyzed using an independent-coder method to identify salient themes. Participants were ethnically diverse and primarily living in suburban areas. All participants had completed high school and many had completed one year of college. Nearly all participants were supportive of California's new law allowing pharmacist prescribing of contraception. Thematic analyses revealed that while participants were satisfied with traditional service providers and valued those relationships, they appreciated the benefit of increased access and convenience of going directly to a pharmacy. Participants expected increased access to contraception in pharmacies would lead to both personal and societal benefits. They expressed concerns regarding parental involvement, as well as confidentiality in the pharmacy environment and with insurance disclosures. Older teens in California are very supportive of pharmacies and pharmacists as direct access points for contraception, but confidentiality concerns were noted. Policy makers and pharmacies can incorporate study findings when designing policies, services, and physical pharmacy spaces to better serve teens. Further research is warranted after pharmacies implement this new service to assess teen utilization and satisfaction as well as outcomes. Several states recently passed legislation enabling pharmacists to prescribe contraception and other states are considering similar legislation. Older teens are

  16. Legal and organisational innovation in the Italian pharmacy system: commercial vs public interest.

    Science.gov (United States)

    Santuari, Alceste

    2017-10-01

    Pharmacy services are undoubtedly an important part of primary care. Pharmacists are entrepreneurs and simultaneously they are entrusted with a public mission in the health care sector. Pharmacies then reflect a contrast between a commercial/economic objective and public interest, which is to be identified with citizens' universal right to health care services. This is the reason why in Italy, as in many other EU countries, pharmacies supply their services according to a prior authorisation granted by public authorities. In common with many EU countries, this authorisation is secured according to a demographic criterion. It is only by means of these licensed pharmacies that citizens can buy drugs under medical prescription. Accordingly, the health system is to be driven by public interest, which has yet to prove how competing interests may be regulated in serving health needs. In the light of EU law, the article advocates for an innovative legal and organisational tool whereby to organise the Italian pharmacy system in order to combine economic consideration and public benefit.

  17. Patient satisfaction with pharmaceutical care delivery in community pharmacies

    Directory of Open Access Journals (Sweden)

    Kassam R

    2012-04-01

    Full Text Available Rosemin Kassam1, John B Collins2, Jonathan Berkowitz31School of Population and Public Health, Faculty of Medicine, 2Department of Educational Studies, Faculty of Education, 3Sauder School of Business, University of British Columbia, Vancouver, British Columbia, CanadaBackground: The purpose of this study was to validate previously published satisfaction scales in larger and more diversified patient populations; to expand the number of community pharmacies represented; to test the robustness of satisfaction measures across a broader demographic spectrum and a variety of health conditions; to confirm the three-factor scale structure; to test the relationships between satisfaction and consultation practices involving pharmacists and pharmacy students; and to examine service gaps and establish plausible norms.Methods: Patients completed a 15-question survey about their expectations regarding pharmaceutical care-related activities while shopping in any pharmacy and a parallel 15 questions about their experiences while shopping in this particular pharmacy. The survey also collected information regarding pharmaceutical care consultation received by the patients and brief demographic data.Results: A total of 628 patients from 55 pharmacies completed the survey. The pilot study’s three-factor satisfaction structure was confirmed. Overall, satisfaction measures did not differ by demographics or medical condition, but there were strong and significant store-to-store differences and consultation practice advantages when pharmacists or pharmacists-plus-students participated, but not for consultations with students alone.Conclusion: Patient satisfaction can be reliably measured by surveys structured around pharmaceutical care activities. The introduction of pharmaceutical care in pharmacies improves patient satisfaction. Service gap details indicated that pharmacy managers need to pay closer attention to various consultative activities involving patients

  18. The use of social media in pharmacy practice and education.

    Science.gov (United States)

    Benetoli, Arcelio; Chen, Timothy F; Aslani, Parisa

    2015-01-01

    Social media is becoming increasingly ubiquitous. It has significant potential as a health communication and educational tool, and may provide a medium for the delivery of health-related services. This systematic review aimed to investigate the use of social media in professional pharmacy practice and pharmacy education, and includes an evaluation of the research designs utilized. Medline, Embase, PubMed, IPA, and CINAHL databases were broadly searched for peer-reviewed research studies about pharmacy and social media (SM). The search was restricted to years 2000 to June 2013, with no other restrictions applied. Key words used were within three concept areas: "social media" and "pharmacist or student" and "pharmacy." Twenty-four studies met the inclusion criteria. SM was broadly addressed as a general concept in 3 of the 24 studies. The other 21 studies investigated/used specific SM tools. Fourteen of those addressed social networking sites (SNS), four wikis, two blogs, and one Twitter. The studies' foci were to describe SM use (n = 17 studies) by pharmacist, pharmacy educators, and pharmacy students and investigate usage related topics (such as e-professionalism and student-educator boundary issues); or the use of SM as an educational tool in pharmacy education (n = 7). Pharmacy students were the subject of 12 studies, pharmacists of six, and faculty members and administrators of four. Survey methods were used in 17 studies, alone or with an additional method; focus groups were used in two; interviews in one; and direct observation of social media activity in seven. Results showed that SM in general and SNS in particular were used mainly for personal reasons. Wikis, Facebook, and Twitter were used as educational tools in pharmacy education with positive feedback from students. Research investigating the use of SM in the practice of pharmacy is growing; however, it is predominantly descriptive in nature with no controlled studies identified. Although some

  19. Improved services to enrollees into an HIV rural care and treatment ...

    African Journals Online (AJOL)

    Better quality of services is essential for the sustainability of HIV programs, in particular in rural Sub-Saharan Africa, to support the increasing number of individuals treated with combination antiretroviral therapy (cART). However, longitudinal data from rural care and treatment centers (CTC) are scarce. The objective was to ...

  20. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Directory of Open Access Journals (Sweden)

    Resham Bahadur Khatri

    Full Text Available Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers.We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis.Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center.The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  1. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study.

    Science.gov (United States)

    Khatri, Resham Bahadur; Dangi, Tara Prasad; Gautam, Rupesh; Shrestha, Khadka Narayan; Homer, Caroline S E

    2017-01-01

    Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries.

  2. [Present Status and Problems of Management and Guidance for Visiting Pharmacy Service to In-home Patients by Hospital Pharmacists].

    Science.gov (United States)

    Nakamura, Masumi; Kishita, Yoshie; Asada, Miyako; Otsuka, Megumi; Takeshita, Sachiko; Hama, Norihisa; Hayashi, Seigo; Ito, Tomoki; Nishio, Masayuki; Nakamura, Masaki

    2018-03-01

    We conducted a survey of the background of 41 patients who received management and guidance from an in-home visiting pharmacy service and of the contents of support by the pharmacist, using patients' medical records from May 2016 to March 2017. Support comprised delivery of medicine to alleviate a burden to caregiver, suggesting medication, adjusting remaining medicines, and providing support during hospitalization. Out of 285 visits, there were 32 visits for which a medical fee could not be claimed. The main reasons for this were delivery of medicine on the day of visiting medical care, management of prescribed medicine at home, and delivery of temporal medicines. We used SWOT analysis to examine the problems and to consider improvements. The results showed that the different method for calculating medical fees is disadvantage for the hospital pharmacy, compared with the health insurance pharmacy. On the other hand, an advantage for the hospital pharmacist is that he or she can refer to the patient's medical records and support them during hospitalization.

  3. 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.

  4. Index of Access: a new innovative and dynamic tool for rural health service and workforce planning.

    Science.gov (United States)

    McGrail, Matthew R; Russell, Deborah J; Humphreys, John S

    2017-10-01

    Objective Improving access to primary health care (PHC) remains a key issue for rural residents and health service planners. This study aims to show that how access to PHC services is measured has important implications for rural health service and workforce planning. Methods A more sophisticated tool to measure access to PHC services is proposed, which can help health service planners overcome the shortcomings of existing measures and long-standing access barriers to PHC. Critically, the proposed Index of Access captures key components of access and uses a floating catchment approach to better define service areas and population accessibility levels. Moreover, as demonstrated through a case study, the Index of Access enables modelling of the effects of workforce supply variations. Results Hypothetical increases in supply are modelled for a range of regional centres, medium and small rural towns, with resulting changes of access scores valuable to informing health service and workforce planning decisions. Conclusions The availability and application of a specific 'fit-for-purpose' access measure enables a more accurate empirical basis for service planning and allocation of health resources. This measure has great potential for improved identification of PHC access inequities and guiding redistribution of PHC services to correct such inequities. What is known about the topic? Resource allocation and health service planning decisions for rural and remote health settings are currently based on either simple measures of access (e.g. provider-to-population ratios) or proxy measures of access (e.g. standard geographical classifications). Both approaches have substantial limitations for informing rural health service planning and decision making. What does this paper add? The adoption of a new improved tool to measure access to PHC services, the Index of Access, is proposed to assist health service and workforce planning. Its usefulness for health service planning is

  5. Nuclear pharmacy education: international harmonization

    International Nuclear Information System (INIS)

    Shaw, S.M.; Cox, P.H.

    1998-01-01

    Education of nuclear pharmacists exists in many countries around the world. The approach and level of education varies between countries depending upon the expectations of the nuclear pharmacist, the work site and the economic environment. In Australia, training is provided through distance learning. In Europe and Canada, nuclear pharmacists and radiochemists receive postgraduate education in order to engage in the small-scale preparation and quality control of radiopharmaceuticals as well as research and development. In the U.S.A., nuclear pharmacy practitioners obtain basic knowledge primarily through undergraduate programs taken when pursuit the first professional degree in pharmacy. Licensed practitioners in pharmacy enter the practice of nuclear pharmacy through distance learning programs or short courses. While different approaches to education exist, there is a basic core of knowledge and a level of competence required of all nuclear pharmacists and radiochemists providing radiopharmaceutical products and services. It was with this realization that efforts were initiated to develop harmonization concepts and documents pertaining to education in nuclear pharmacy. The benefits of international harmonization in nuclear pharmacy education are numerous. Assurance of the availability of quality professionals to provide optimal products and care to the patient is a principle benefit. Spanning national barriers through the demonstration of self governance and unification in education will enhance the goal of increased freedom of employment between countries. Harmonization endeavors will improve existing education programs through sharing of innovative concepts and knowledge between educators. Documents generated will benefit new educational programs especially in developing nations. A committee on harmonization in nuclear pharmacy education was formed consisting of educators and practitioners from the international community. A working document on education was

  6. Customer interest in and experience with various types of pharmacy counselling - a qualitative study

    DEFF Research Database (Denmark)

    Kaae, Susanne; Traulsen, Janine M; Nørgaard, Lotte S

    2014-01-01

    of counselling services with respect to medicine. The pharmacy staff does not seem to realize these barriers. CONCLUSIONS: For pharmacies to encourage customer interest in pharmacy counselling, the staff should start taking the identified barriers into account when planning communication strategies....... counselling at the present time, in order to develop the patient-pharmacy relationship for the benefit of both patients and pharmacies. DESIGN: Short semi-structured interviews were carried out with pharmacy customers by pharmacy internship students. SETTING AND PARTICIPANTS: One hundred and eight customers...... in 35 independent pharmacies across Denmark were interviewed during the spring of 2011. MAIN VARIABLES STUDIED: Customers were interviewed about their expectations of pharmacies in general and their experiences with medical counselling in particular. RESULTS: Customers perceive community pharmacies very...

  7. A consistent professional brand for pharmacy-the need and a path forward.

    Science.gov (United States)

    Speedie, Marilyn K; Anderson, Lowell J

    The authors draw on their broad experiences in the profession to put forth their assessment of the critical need for all elements of the pharmacy profession to agree upon its core services, and to deliver those services in all pharmacies. And also the need to promote the value of those services to patients, payers, and other providers. Since the advent of pharmaceutical care, the profession has changed its curricula and its regulations to reflect the value of direct patient care. For many reasons, the practice has not been unified in delivering these services-lack of definition of what constitutes the service, principally. This has led to the "tower of babel" that exists because of the many names given to these patient-care services by various professional organizations, colleges, payers, and government agencies. Lack of inclusion in benefit design with value-based compensation is also recognized as an important barrier for a pharmacist wishing to provide direct patient-care services. The authors believe this issue to be critical for the profession, and appeal to JCPP and its member organizations to provide leadership to the various pharmacy associations and colleges to put immediate energy and resources into the definitions, labels, and branding of pharmacy practice. This leadership is essential if the profession's organizations and colleges are to promote the whole of practice and payment for the entirety of services pharmacists provide. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  8. [Medical Service Information Seeking Behaviors in Rural and Urban Patients in Sichuan Province].

    Science.gov (United States)

    Zhang, Wen-Jie; Xue, Li; Chen, Rao; Duan, Zhan-Qi; Liu, Dan-Ping

    2018-03-01

    To understand how rural and urban patients seek medical service information in Sichuan province. A self-designed questionnaire was distributed randomly to patients who visited primary,secondary and tertiary health facilities in Chengdu,Yibin and Suining,collecting data in relation to their sources of medical service information,as well as the contents and credibility of the information. The major sources of medical service information came from friends,past experiences and television programs,which were consistent with the most desirable access channels. The urban patients were more likely to trust (5.3%) and use (10.6%) the Internet to obtain medical service information compared with their rural counterparts (3.4% and 5.5%,respectively, P marketing strategies for urban and rural patients should be developed to channel patients to appropriate health facilities. Copyright© by Editorial Board of Journal of Sichuan University (Medical Science Edition).

  9. Globalisation, rural restructuring and health service delivery in Australia: policy failure and the role of social work?

    Science.gov (United States)

    Alston, Margaret

    2007-05-01

    The impacts of globalisation and rural restructuring on health service delivery in rural Australia have been significant. In the present paper, it is argued that declining health service access represents a failure of policy. Rural communities across the world are in a state of flux, and Australia is no different: rural communities are ageing at faster rates than urban communities and young people are out-migrating in large numbers. During the past 5 years, rural Australia has also experienced a severe and widespread drought that has exacerbated rural poverty, and impacted on the health and well-being of rural Australians. Australian governments have responded to globalising forces by introducing neoliberal policy initiatives favouring market solutions and championing the need for self-reliance among citizens. The result for rural Australia has been a withdrawal of services at a time of increased need. This paper addresses the social work response to these changes.

  10. A Survey of Pharmacy Education in Thailand.

    Science.gov (United States)

    Chanakit, Teeraporn; Low, Bee Yean; Wongpoowarak, Payom; Moolasarn, Summana; Anderson, Claire

    2014-11-15

    To explore the current status of pharmacy education in Thailand. The International Pharmaceutical Federation of the World Health Organization's (FIP-WHO) Global Survey of Pharmacy Schools was used for this study. The survey instrument was distributed to the deans of the 19 faculties (colleges) of pharmacy in Thailand. More than half the colleges have been in existence less than 20 years, and the government owns 80% of them. There were 2 paths of admission to study pharmacy: direct admission and central admission system. The doctor of pharmacy (PharmD) programs can be divided into 4 types. Approximately 60% of all teaching staff holds a doctoral degree. Regarding the work balance among teaching staff, around 60% focus on teaching activities, 20% focus on research, and less than 20% focus on patient care services concurrent with real practice teaching. The proportion of student time dedicated to theory, practice, and research in PharmD programs is 51.5%, 46.7%, and 1.8%, respectively. Sites owned by the colleges or by others were used for student training. Colleges followed the Office of the National Education Standards' Internal Quality Assurance (IQA) and External Quality Assurance (EQA), and the Pharmacy Council's Quality Assessment (ONESQA). This study provides a picture of the current status of curriculum, teaching staff, and students in pharmacy education in Thailand. The curriculum was adapted from the US PharmD program with the aim of meeting the country's needs and includes industrial pharmacy and public health tracks as well as clinical tracks. However, this transition in pharmacy education in Thailand needs to be monitored and evaluated.

  11. Barriers to Rural Induced Abortion Services in Canada: Findings of the British Columbia Abortion Providers Survey (BCAPS)

    Science.gov (United States)

    Norman, Wendy V.; Soon, Judith A.; Maughn, Nanamma; Dressler, Jennifer

    2013-01-01

    Background Rural induced abortion service has declined in Canada. Factors influencing abortion provision by rural physicians are unknown. This study assessed distribution, practice, and experiences among rural compared to urban abortion providers in the Canadian province of British Columbia (BC). Methods We used mixed methods to assess physicians on the BC registry of abortion providers. In 2011 we distributed a previously-published questionnaire and conducted semi-structured interviews. Results Surveys were returned by 39/46 (85%) of BC abortion providers. Half were family physicians, within both rural and urban cohorts. One-quarter (17/67) of rural hospitals offer abortion service. Medical abortions comprised 14.7% of total reported abortions. The three largest urban areas reported 90% of all abortions, although only 57% of reproductive age women reside in the associated health authority regions. Each rural physician provided on average 76 (SD 52) abortions annually, including 35 (SD 30) medical abortions. Rural physicians provided surgical abortions in operating rooms, often using general anaesthesia, while urban physicians provided the same services primarily in ambulatory settings using local anaesthesia. Rural providers reported health system barriers, particularly relating to operating room logistics. Urban providers reported occasional anonymous harassment and violence. Conclusions Medical abortions represented 15% of all BC abortions, a larger proportion than previously reported (under 4%) for Canada. Rural physicians describe addressable barriers to service provision that may explain the declining accessibility of rural abortion services. Moving rural surgical abortions out of operating rooms and into local ambulatory care settings has the potential to improve care and costs, while reducing logistical challenges facing rural physicians. PMID:23840578

  12. Trends in Rural Water Supply: Towards a Service Delivery Approach

    Directory of Open Access Journals (Sweden)

    Patrick Moriarty

    2013-10-01

    The papers in this special issue argue that tackling these challenges requires a shift in emphasis in rural water supply in developing countries: away from a de-facto focus on the provision of hardware for first-time access towards the proper use of installed hardware as the basis for universal access to rural water services. The outline of the main actions required to achieve this shift are becoming clearer. Chief amongst these are the professionalisation of community management and/or provision of direct support to community service providers; adoption of a wider range of service delivery models than community management alone; and addressing the sustainable financing of all costs with a particular focus on financing capital maintenance (asset management and direct support costs. This introductory paper provides an overview of these issues and a guide to the other articles, which demonstrate these points.

  13. Strategies for Employee Learning in Professional Service Firms: A Study of Community Pharmacies in Australia

    Science.gov (United States)

    Kotey, Bernice; Saini, Bandana; While, Lesley

    2011-01-01

    The study investigated employee learning strategies in community pharmacies in Australia and the factors that explain differences among pharmacies in the strategies employed. A qualitative methodology was applied, involving semi-structured interviews with owners, managers, or senior employees of 12 pharmacies. The findings revealed learning…

  14. Predicting tobacco sales in community pharmacies using population demographics and pharmacy type.

    Science.gov (United States)

    Hickey, Lisa M; Farris, Karen B; Peterson, N Andrew; Aquilino, Mary L

    2006-01-01

    To determine whether the population demographics of the location of pharmacies were associated with tobacco sales in pharmacies, when controlling for pharmacy type. Retrospective analysis. Iowa. All retailers in Iowa that obtained tobacco licenses and all pharmacies registered with the Iowa Board of Pharmacy in 2003. MAIN OUTCOME MEASURE AND INTERVENTIONS: Percentage of pharmacies selling tobacco (examined by pharmacy type using chi-square analysis); median income and distribution of race/ethnicity in the county for pharmacies that did or did not sell tobacco (t tests); predictors of whether a pharmacy sold tobacco (logistic regression using the independent variables county-level demographic variables and pharmacy characteristics). County gender composition, race/ethnicity make-up, and income levels were different for tobacco-selling and -nonselling pharmacies. Logistic regression showed that whether a pharmacy sold tobacco was strongly dependent on the type of pharmacy; compared with independent pharmacies (of which only 5% sold tobacco products), chain pharmacies were 34 times more likely to sell tobacco products, mass merchandiser outlets were 47 times more likely to stock these goods, and grocery stores were 378 times more likely to do so. Pharmacies selling tobacco were more likely to be located in counties with significantly higher numbers of multiracial groups. The best predictor of whether an Iowa pharmacy sells tobacco products is type of pharmacy. In multivariable analyses, population demographics of the county in which pharmacies were located were generally not predictive of whether a pharmacy sold tobacco.

  15. Availability and Primary Health Care Orientation of Dementia-Related Services in Rural Saskatchewan, Canada.

    Science.gov (United States)

    Morgan, Debra G; Kosteniuk, Julie G; Stewart, Norma J; O'Connell, Megan E; Kirk, Andrew; Crossley, Margaret; Dal Bello-Haas, Vanina; Forbes, Dorothy; Innes, Anthea

    2015-01-01

    Community-based services are important for improving outcomes for individuals with dementia and their caregivers. This study examined: (a) availability of rural dementia-related services in the Canadian province of Saskatchewan, and (b) orientation of services toward six key attributes of primary health care (i.e., information/education, accessibility, population orientation, coordinated care, comprehensiveness, quality of care). Data were collected from 71 rural Home Care Assessors via cross-sectional survey. Basic health services were available in most communities (e.g., pharmacists, family physicians, palliative care, adult day programs, home care, long-term care facilities). Dementia-specific services typically were unavailable (e.g., health promotion, counseling, caregiver support groups, transportation, week-end/night respite). Mean scores on the primary health care orientation scales were low (range 12.4 to 17.5/25). Specific services to address needs of rural individuals with dementia and their caregivers are limited in availability and fit with primary health care attributes.

  16. Incorporating a Weight Management Skills Workshop in Pharmacy Curricula in Australia.

    Science.gov (United States)

    Um, Irene S; Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B

    2016-05-25

    Objective. To develop, implement, and evaluate a competency-based weight management skills workshop for undergraduate pharmacy students in an Australian university. Design. A 3-hour workshop titled "Weight Management in Pharmacy" was implemented with a cohort of fourth-year undergraduate pharmacy students (n=180). Learning activities used included case-based learning, hands-on experience, role-play, and group discussion. Assessment. A 22-item attitudinal survey instrument and the validated Obesity Risk Knowledge (ORK-10) scale were administered at baseline and postworkshop to evaluate the impact of this educational workshop. There was significant improvement in the students' ORK scores and students' perceived level of self-confidence in performing weight management skills. Conclusion. An educational workshop designed to enhance professional competencies in weight management ensured graduates were "service-ready" and had the appropriate knowledge, skills, and attributes to deliver patient-centered pharmacy-based weight management services.

  17. HIV Testing and HIV/AIDS Treatment Services in Rural Counties in 10 Southern States: Service Provider Perspectives

    Science.gov (United States)

    Sutton, Madeline; Anthony, Monique-Nicole; Vila, Christie; McLellan-Lemal, Eleanor; Weidle, Paul J.

    2010-01-01

    Context: Forty percent of AIDS cases are reported in the southern United States, the region with the largest proportion of HIV/AIDS cases from rural areas. Data are limited regarding provider perspectives of the accessibility and availability of HIV testing and treatment services in southern rural counties. Purpose: We surveyed providers in the…

  18. Barriers to utilization of childbirth services of a rural birthing center in Nepal: A qualitative study

    Science.gov (United States)

    Shrestha, Khadka Narayan; Homer, Caroline S. E.

    2017-01-01

    Background Maternal mortality and morbidity are public health problems in Nepal. In rural communities, many women give birth at home without the support of a skilled birth attendant, despite the existence of rural birthing centers. The aim of this study was to explore the barriers and provide pragmatic recommendations for better service delivery and use of rural birthing centers. Methods We conducted 26 in-depth interviews with service users and providers, and three focus group discussions with community key informants in a rural community of Rukum district. We used the Adithya Cattamanchi logic model as a guiding framework for data analysis. Results Irregular and poor quality services, inadequate human and capital resources, and poor governance were health system challenges which prevented service delivery. Contextual barriers including difficult geography, poor birth preparedness practices, harmful culture practices and traditions and low level of trust were also found to contribute to underutilization of the birthing center. Conclusion The rural birthing center was not providing quality services when women were in need, which meant women did not use the available services properly because of systematic and contextual barriers. Approaches such as awareness-raising activities, local resource mobilization, ensuring access to skilled providers and equipment and other long-term infrastructure development works could improve the quality and utilization of childbirth services in the rural birthing center. This has resonance for other centers in Nepal and similar countries. PMID:28493987

  19. The provision of neuropsychological services in rural/regional settings: professional and ethical issues.

    Science.gov (United States)

    Allott, Kelly; Lloyd, Susan

    2009-07-01

    Despite rapid growth of the discipline of clinical neuropsychology during recent times, there is limited information regarding the identification and management of professional and ethical issues associated with the practice of neuropsychology within rural settings. The aim of this article is to outline the characteristics unique to practicing neuropsychology in rural communities and to describe the potential professional and ethical dilemmas that might arise. Issues are illustrated using examples from neuropsychological practice in a rural/regional setting in Victoria, Australia. Relative to urban regions, there is an inequality in the distribution of psychologists, including neuropsychologists, in rural areas. The unique characteristics of rural and regional communities that impact on neuropsychological practice are: 1) limited resources in expertise, technology, and community services, 2) greater travel distances and costs, 3) professional isolation, and 4) beliefs about psychological services. These characteristics lower the threshold for particular ethical issues. The ethical issues that require anticipation and careful management include: 1) professional competence, 2) multiple relationships, and 3) confidentiality. Through increased awareness and management of rural-specific professional and ethical issues, rural neuropsychologists can experience their work as rewarding and enjoyable. Specific guidelines for identifying, managing, and resolving ethically and professionally challenging situations that may arise during rural practice are provided.

  20. Determinants of maternity care services utilization among married adolescents in rural India.

    Directory of Open Access Journals (Sweden)

    Prashant Kumar Singh

    Full Text Available Coupled with the largest number of maternal deaths, adolescent pregnancy in India has received paramount importance due to early age at marriage and low contraceptive use. The factors associated with the utilization of maternal healthcare services among married adolescents in rural India are poorly discussed.Using the data from third wave of National Family Health Survey (2005-06, available in public domain for the use by researchers, this paper examines the factors associated with the utilization of maternal healthcare services among married adolescent women (aged 15-19 years in rural India. Three components of maternal healthcare service utilization were measured: full antenatal care, safe delivery, and postnatal care within 42 days of delivery for the women who gave births in the last five years preceding the survey. Considering the framework on causes of maternal mortality proposed by Thaddeus and Maine (1994, selected socioeconomic, demographic, and cultural factors influencing outcome events were included as the predictor variables. Bi-variate analyses including chi-square test to determine the difference in proportion, and logistic regression to understand the net effect of predictor variables on selected outcomes were applied. Findings indicate the significant differences in the use of selected maternal healthcare utilization by educational attainment, economic status and region of residence. Muslim women, and women belonged to Scheduled Castes, Scheduled Tribes, and Other Backward Classes are less likely to avail safe delivery services. Additionally, adolescent women from the southern region utilizing the highest maternal healthcare services than the other regions.The present study documents several socioeconomic and cultural factors affecting the utilization of maternal healthcare services among rural adolescent women in India. The ongoing healthcare programs should start targeting household with married adolescent women belonging to

  1. Benchmarking in academic pharmacy departments.

    Science.gov (United States)

    Bosso, John A; Chisholm-Burns, Marie; Nappi, Jean; Gubbins, Paul O; Ross, Leigh Ann

    2010-10-11

    Benchmarking in academic pharmacy, and recommendations for the potential uses of benchmarking in academic pharmacy departments are discussed in this paper. Benchmarking is the process by which practices, procedures, and performance metrics are compared to an established standard or best practice. Many businesses and industries use benchmarking to compare processes and outcomes, and ultimately plan for improvement. Institutions of higher learning have embraced benchmarking practices to facilitate measuring the quality of their educational and research programs. Benchmarking is used internally as well to justify the allocation of institutional resources or to mediate among competing demands for additional program staff or space. Surveying all chairs of academic pharmacy departments to explore benchmarking issues such as department size and composition, as well as faculty teaching, scholarly, and service productivity, could provide valuable information. To date, attempts to gather this data have had limited success. We believe this information is potentially important, urge that efforts to gather it should be continued, and offer suggestions to achieve full participation.

  2. Developing and testing evidence-based weight management in Australian pharmacies: A Healthier Life Program.

    Science.gov (United States)

    Um, Irene S; Krass, Ines; Armour, Carol; Gill, Timothy; Chaar, Betty B

    2015-10-01

    Pharmacies represent a valuable opportunity to deliver weight management services, rather than just the routine supply of weight-loss products. In order to provide optimal services and translation of evidence-based weight management in community pharmacy, a best practice model program was designed and pilot tested to facilitate implementation of such services in pharmacies in Australia. To develop and pilot a pharmacist-delivered, evidence-based, non-product-centred weight management service for community pharmacy in Australia. Setting Sydney, New South Wales, Australia. A pharmacy-based weight management service called the A Healthier Life Program (AHLP), for overweight and obese individuals, was developed based on current Australian weight management guidelines and recommendations made by key stakeholders. The pharmacist undertook training to acquire specific competencies to deliver the program. The AHLP involved six individual face-to-face sessions with the pharmacist over 3 months. The intervention targeted three areas: diet, physical activity and behavioural change. Weight, BMI, waist circumference, blood pressure, dietary intake, and physical activity levels at 3 months were compared with values at baseline. Qualitative feedback on participants' satisfaction and willingness to pay were also analysed. Eight pharmacies provided the AHLP between February and December 2013. Thirty-four participants were enrolled in the AHLP; mean age 50.7 years (SD 15.7) and mean BMI 34.3 kg/m(2) (SD 5.3). Of the 22 (65%) participants who completed the program, six had achieved the target weight loss of ≥5%. The mean change in weight was -3.5 kg (95% CI -4.8, -2.2) and waist circumference -2.0 cm (95% CI -2.8, -1.3) for program completers at 3 months. Furthermore, participants reported overall positive experiences of the program, and identified accessibility of the pharmacy and high comfort level with the pharmacist, as the major advantages. The AHLP was well received and

  3. Principles of economics crucial to pharmacy students' understanding of the prescription drug market.

    Science.gov (United States)

    Rattinger, Gail B; Jain, Rahul; Ju, Jing; Mullins, C Daniel

    2008-06-15

    Many pharmacy schools have increased the amount of economics coursework to which pharmacy students are exposed in their prepharmacy and pharmacy curriculums. Students obtain competencies aimed at understanding the basic concepts of microeconomic theory, such as supply and demand. However, pharmacy students often have trouble applying these principles to real world pharmaceuticals or healthcare markets. Our objective is to make economics more relevant for pharmacy students. Specifically, we detail and provide pharmacy-relevant examples of the effects of monopoly power, barriers to marketplace entry, regulatory environment, third party insurance, information asymmetry and unanticipated changes in the marketplace on the supply and demand for pharmaceuticals and healthcare services.

  4. Principles of Economics Crucial to Pharmacy Students' Understanding of the Prescription Drug Market

    Science.gov (United States)

    Jain, Rahul; Ju, Jing; Mullins, C. Daniel

    2008-01-01

    Many pharmacy schools have increased the amount of economics coursework to which pharmacy students are exposed in their prepharmacy and pharmacy curriculums. Students obtain competencies aimed at understanding the basic concepts of microeconomic theory, such as supply and demand. However, pharmacy students often have trouble applying these principles to real world pharmaceuticals or healthcare markets. Our objective is to make economics more relevant for pharmacy students. Specifically, we detail and provide pharmacy-relevant examples of the effects of monopoly power, barriers to marketplace entry, regulatory environment, third party insurance, information asymmetry and unanticipated changes in the marketplace on the supply and demand for pharmaceuticals and healthcare services. PMID:18698403

  5. Organisational culture: an important concept for pharmacy practice research.

    Science.gov (United States)

    Scahill, Shane; Harrison, Jeff; Carswell, Peter; Babar, Zaheer-Ud-Din

    2009-10-01

    Throughout the developed world, community pharmacy is under considerable pressure to play a greater part in delivering effective primary health care. The requirement to adopt new roles continues to challenge community pharmacy and drive change. The factors that determine the ability of community pharmacy to effectively deliver services for health gain are complex and include; policy, professional, financial and structural elements. There is also evidence to suggest that organisational culture may influence the effectiveness of an organisation. In order to address this there is a need to understand the dimensions of organisational culture that lead to successful implementation of the change necessary for community pharmacy to become a more effective primary health care organisation. In this commentary, we introduce the concept of organisational culture, outline two frameworks for studying culture, and argue the benefits of pursuing an organisational culture research agenda for the evolution of pharmacy practice and research.

  6. Planning Pharmacies: An Operational Method to Find the Best Location

    Directory of Open Access Journals (Sweden)

    Simona Tondelli

    2014-05-01

    Full Text Available The theme of the spatial distribution of the pharmacies on the territory is closely connected to urban planning and to services supply. In Italy, the regulatory change that took place in 2012, triggered partly by the need to adhere more to a constantly changing economic system, has led to a revision of the existing situation, consisting both on the method to quantify the pharmacies distribution and on the efficiency of the service. If Law 27/2012 has effectively allowed municipalities to increase the number of pharmacies that they can settle on the municipal territory, it has also started a process of rethinking the logic of pharmacies location and of their catchment areas. In this framework, the present paper aims to discuss the merits of a regulatory evolutions that sparked the process of liberalization of locations, integrating the law guidelines and goals with an operating logic process, usable and useful to translate goals into planning actions in a continuous dialogue between law and territory, constraints and opportunities, equity and accessibility of the care services. Following this logic operations, we have investigated the urban context of Castelfranco Emilia, assuming the location of new offices on the basis of pharmaceutical analyzes.

  7. Perception of patients accessing out- patient pharmacy on the ...

    African Journals Online (AJOL)

    Conclusion: Patients' overall perception of pharmacy services was above average. There is need for improvement in the quality of services, especially in the availability of essential drugs at competitive prices and provision of adequate counselling and drug information services to patients. Keywords: Patient satisfaction, ...

  8. Disruptive innovation in community pharmacy - Impact of automation on the pharmacist workforce.

    Science.gov (United States)

    Spinks, Jean; Jackson, John; Kirkpatrick, Carl M; Wheeler, Amanda J

    Pharmacy workforce planning has been relatively static for many decades. However, like all industries, health care is exposed to potentially disruptive technological changes. Automated dispensing systems have been available to pharmacy for over a decade and have been applied to a range of repetitive technical processes which are at risk of error, including record keeping, item selection, labeling and dose packing. To date, most applications of this technology have been at the local level, such as hospital pharmacies or single-site community pharmacies. However, widespread implementation of a more centralized automated dispensing model, such as the 'hub and spoke' model currently being debated in the United Kingdom, could cause a 'technology shock,' delivering industry-wide efficiencies, improving medication accessibility and lowering costs to consumers and funding agencies. Some of pharmacists' historical roles may be made redundant, and new roles may be created, decoupling pharmacists to a certain extent from the dispensing and supply process. It may also create an additional opportunity for pharmacists to be acknowledged and renumerated for professional services that extend beyond the dispensary. Such a change would have significant implications for the organization and funding of community pharmacy services as well as pharmacy workforce planning. This paper discusses the prospect of centralized automated dispensing systems and how this may impact on the pharmacy workforce. It concludes that more work needs to be done in the realm of pharmacy workforce planning to ensure that the introduction of any new technology delivers optimal outcomes to consumers, insurers and the pharmacy workforce. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Use of a pharmacy technician to facilitate postfracture care provided by clinical pharmacy specialists.

    Science.gov (United States)

    Irwin, Adriane N; Heilmann, Rachel M F; Gerrity, Theresa M; Kroner, Beverly A; Olson, Kari L

    2014-12-01

    The ability of a pharmacy technician to support the patient screening and documentation-related functions of a pharmacist-driven osteoporosis management service was evaluated. A two-phase prospective study was conducted within a large integrated health system to assess a pharmacy technician's performance in supporting a multisite team of clinical pharmacy specialists providing postfracture care. In phase I of the study, a specially trained pharmacy technician provided support to pharmacists at five participating medical offices, helping to identify patients requiring pharmacist intervention and, when applicable, collecting patient-specific clinical information from the electronic health record. In phase II of the study, the amount of pharmacist time saved through the use of technician support versus usual care was evaluated. The records of 127 patient cases were reviewed by the pharmacy technician during phase I of the study, and a pharmacist agreed with the technician's determination of the need for intervention in the majority of instances (92.9%). An additional 91 patient cases were reviewed by the technician in phase II of the research. With technician support, pharmacists spent less time reviewing cases subsequently determined as not requiring intervention (mean ± S.D., 5.0 ± 3.8 minutes per case compared with 5.2 ± 4.5 minutes under the usual care model; p = 0.78). In cases requiring intervention, technician support was associated with a reduction in the average pharmacist time spent on care plan development (13.5 ± 7.1 minutes versus 18.2 ± 16.6 minutes with usual care, p = 0.34). The study results suggest that a pharmacy technician can accurately determine if a patient is a candidate for pharmacist intervention and collect clinical information to facilitate care plan development. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  10. The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study.

    Science.gov (United States)

    Harvey, Jasmine; Avery, Anthony J; Waring, Justin; Barber, Nick

    2012-12-20

    The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three

  11. Identifying rural-urban differences in the predictors of emergency ambulance service demand and misuse.

    Science.gov (United States)

    Wong, Ho Ting; Lin, Teng-Kang; Lin, Jen-Jia

    2018-06-13

    This study aims to assess rural-urban differences in the predictors of emergency ambulance service (EAS) demand and misuse in New Taipei City. Identifying the predictors of EAS demand will help the EAS service managing authority in formulating focused policies to maintain service quality. Over 160,000 electronic EAS usage records were used with a negative binomial regression model to assess rural-urban differences in the predictors of EAS demand and misuse. The factors of 1) ln-transformed population density, 2) percentage of residents who completed up to junior high school education, 3) accessibility of hospitals without an emergency room, and 4) accessibility of EAS were found to be predictors of EAS demand in rural areas, whereas only the factor of percentage of people aged above 65 was found to predict EAS demand in urban areas. For EAS misuse, only the factor of percentage of low-income households was found to be a predictor in rural areas, whereas no predictor was found in the urban areas. Results showed that the factors predicting EAS demand and misuse in rural areas were more complicated compared to urban areas and, therefore, formulating EAS policies for rural areas based on the results of urban studies may not be appropriate. Copyright © 2018. Published by Elsevier B.V.

  12. International Mentoring Programs: Leadership Opportunities to Enhance Worldwide Pharmacy Practice.

    Science.gov (United States)

    Ubaka, Chukwuemeka; Brechtelsbauer, Erich; Goff, Debra A

    2017-07-01

    Health-system and community pharmacy practice in the United States is experiencing transformational change; however, this transformation is lagging in the international arena. As a result, efforts are being made to provide support and education to the international pharmacy leaders and practitioners. This article describes one effort, the Mandela Washington Fellows Program, and suggests areas where pharmacy leaders can be involved to help advance the practice of pharmacy on an international level. The Mandela Washington Fellows Program for young Africa leaders consists of a US-Africa pharmacy-mentoring program identified ranging from educational opportunities to collaboration for implementation of patient care programs. The specifics of the mentoring program include daily meetings, clinic and ward rounds, round table discussions with mentors, and visits to various hospital care systems. Lessons were learned and strategies for sustaining the program are discussed. These types of programs represent leadership opportunities that may not be apparent to most pharmacy directors, but expanding their view to helping international pharmacists expand their practice only strengthens the professional goal of providing patient-centered pharmacy services.

  13. The impact of innovation funding on a rural health nursing service: the Reporoa experience.

    Science.gov (United States)

    Connor, Margaret; Nelson, Katherine; Maisey, Jane

    2009-07-01

    Health Reporoa Inc. offers a first contact rural nursing service to the village of Reporoa and surrounding districts. From 2003 to 2006 it became a project site through selection for the Ministry of Health (MoH) primary health care nursing innovation funding. Health Reporoa Inc. successfully achieved its project goals and gained an ongoing contract from Lakes District Health Board to consolidate and further expand its services at the close of the funding period. This paper examines the impact of the innovation funding during the project period and in the two years that followed. The major impact came through an expansion of the accessible free health service to the local population; advancing nursing practice; increased connection to the nursing profession and wider health community, and enhanced affirmation of the nursing contribution. The rural nursing service model developed at Health Reporoa, through the benefit of innovation funding, can now act as a blueprint for other rural health services, particularly those in high deprivation areas.

  14. Hospital diversification: how to involve the pharmacy.

    Science.gov (United States)

    Smith, J E; Black, B L

    1987-05-01

    Participation by hospital pharmacy departments in planning and development of diversified services is described. Diversification requires market planning. Seven basic marketing steps are identification of mission, goals, and objectives; identification of growth strategies (market penetration, market development, product development, and diversification); market analysis of external factors (size, growth, and logistics; reimbursement and financial considerations; competition; regulatory issues; and legal issues); market analysis of internal factors (departmental organization and reporting lines, demographics of the institution, and costs and productivity associated with the new service); program development and design; implementation; and evaluation. Hospitals can diversify by expanding acute-care services through management contracts and mergers; developing new services to include long-term-care, ambulatory-care, occupational-health, and wellness programs; starting other health-care ventures, such as consulting, continuing medical education, and continuing education for nurses; and expanding into non-health-care businesses. Vertical diversification is finding new markets for existing services; horizontal diversification is development of new services for new markets. To diversify, an institution may need to change its corporate structure; it may form a family of corporations that includes a university, nonprofit hospitals, holding companies, for-profit corporations, joint ventures, and service organizations. Through diversification, institutions and pharmacy departments can create alternative sources of funding and offer more comprehensive services to patients.

  15. Egypt : Operational Framework for Integrated Rural Sanitation Service Delivery

    OpenAIRE

    World Bank

    2005-01-01

    The Framework presented in this report links - for the first time in the Egyptian context - access to investment in rural sanitation services to quantifiable water quality (and health) improvements, in a given hydrologic basin. The Framework provides an integrated, institutional structure of relevant Government agencies and of serviced communities, which is built on integrated water resources management (IWRM) principles: treating water as a holistic resource, management at the lowest appropr...

  16. Rural development NGOS and service delivery to the very poor: An empirical analysis of a training center in rural Cameroon

    OpenAIRE

    Balgah Roland Azibo; Emmanuel Yenshu Vubo; Innocent Ndoh Mbue; Jude Ndzifon Kimengsi

    2015-01-01

    The role of development nongovernmental organizations (DNGOs) in driving change, servicing the very poor and reducing poverty especially in rural areas in developing countries has been generally affirmed in the rural economics literature. This romantic image accounts to a large extent for the exponential numeric growth observed in the sector, and for burgeoning research on the subject by rural development economists. However, not enough empirical evidence exists on the extent to which such or...

  17. Catering and gastronomy services in the rural tourism: the case of Lubuskie voivodeship.

    Science.gov (United States)

    Woźniczko, Magdalena; Orłowski, Dominik; Zelazna, Krystyna

    2007-01-01

    In this paper we showed the results of studies about gastronomy services in the rural tourism and the range of this services using about which the respondents talked. The studies also took the feeding offer (rural dishes and regional feeding) influence for the choosing the rest offer in the countryside. In the studies took part people who live in the countryside and have homesteads and of course tourist rest in their homesteads.

  18. Emerging and encouraging trends in e-prescribing adoption among providers and pharmacies.

    Science.gov (United States)

    Gabriel, Meghan E; Furukawa, Michael F; Vaidya, Varun

    2013-09-01

    The objective of this study is to describe the growth in provider (physician, nurse practitioner, and physician assistant) adoption of e-prescribing and the growth in pharmacies actively accepting e-prescriptions using nationally representative data from December 2008 to December 2012. Additionally, this study explored e-prescribing adoption variation by urban and rural counties. Descriptive analysis of nationally representative, transactional e-prescribing data. Data for this analysis were from Surescripts. Surescripts is a leading e-prescription network utilized by a majority of all chain, franchise, or independently owned pharmacies in the United States routing prescriptions for more than 240 million patients through their network. The total number of prescribers, including physicians, nurse practitioners, and physician assistants e-prescribing via an electronic health record (EHR) on the Surescripts network has increased from 7% to 54%. Additionally, the number of pharmacies actively accepting e-prescriptions is 94%. These increases in pharmacies actively accepting e-prescriptions and the provider's eprescribing mirror the increase in the volume of e-prescriptions sent on the Surescripts network. This analysis shows that the vast majority of pharmacies in the United States are able to accept e-prescriptions and over half of providers are e-prescribing via an EHR.

  19. A Lifestyle Medicine Clinic in a Community Pharmacy Setting

    Directory of Open Access Journals (Sweden)

    Thomas L. Lenz

    2010-06-01

    Full Text Available Chronic diseases continue to be a significant burden to the health care system. Pharmacists have been able to show that drug therapy for patients with chronic diseases can be improved through medication therapy management (MTM services but have yet to become significantly involved in implementing lifestyle modification programs to further control and prevent chronic conditions. A novel and innovative lifestyle medicine program was started by pharmacists in a community pharmacy in 2008 to more comprehensively prevent and manage chronic conditions. The lifestyle medicine program consists of designing seven personalized programs for patients to address physical activity, nutrition, alcohol consumption, weight control, stress management, sleep success, and tobacco cessation (if needed. The lifestyle medicine program complements existing MTM services for patients with hypertension, dyslipidemia, and/or diabetes. This program is innovative because pharmacists have developed and implemented a method to combine lifestyle medicine with MTM services to not only manage chronic conditions, but prevent the progression of those conditions and others. Several innovative tools have also been developed to enhance the effectiveness of a lifestyle medicine program. This manuscript describes the program's pharmacy setting, pharmacy personnel, participants and program details as well as the tools used to integrate a lifestyle medicine program with MTM services. Type: Clinical Experience

  20. Identifying consumer segments in health services markets: an application of conjoint and cluster analyses to the ambulatory care pharmacy market.

    Science.gov (United States)

    Carrol, N V; Gagon, J P

    1983-01-01

    Because of increasing competition, it is becoming more important that health care providers pursue consumer-based market segmentation strategies. This paper presents a methodology for identifying and describing consumer segments in health service markets, and demonstrates the use of the methodology by presenting a study of consumer segments in the ambulatory care pharmacy market.

  1. The impact of medication synchronization on quality care criteria in an independent community pharmacy.

    Science.gov (United States)

    Hinson, Jessica L; Garofoli, Gretchen K; Elswick, Betsy M

    To determine the impact of a comprehensive medication synchronization program in an independent community pharmacy by (1) evaluating changes in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and (2) examining the change in monthly prescription volume. Independent community pharmacy in Morgantown, WV. Waterfront Family Pharmacy is a single-location independent community pharmacy located in Morgantown, WV. The pharmacy consists of four full-time pharmacists and is the primary practice site for one community pharmacy PGY-1 resident. The pharmacy provides a variety of clinical services, including vaccine administration, medication therapy management, and diabetes education services. In September 2014, Waterfront Family Pharmacy started a comprehensive medication synchronization program. Change in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and change in monthly prescription volume. At the end of 6 months there was improvement in all targeted EQuIPP scores. There was a 7% improvement in proportion of days covered (PDC) for cholesterol-reducing agents, a 9.5% improvement in PDC for oral glycemic agents, a 1.2% improvement in PDC for renin-angiotensin system antagonists, and a 1.8% reduction in the use of high-risk medications in the elderly. There was also an average increase in monthly prescription volume of 4.8% over the first 6 months after the implementation of the comprehensive medication synchronization program. The implementation of a comprehensive medication synchronization program in an independent community pharmacy may result in benefits including improved EQuIPP scores and increased prescription volume. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  2. Pharmacy alternatives (image)

    Science.gov (United States)

    ... common source for obtaining prescriptions is the local pharmacy. Usually the pharmacy is located in a drug or grocery store. ... some insurance companies have chosen is mail-order pharmacy. Once a pharmacy has been chosen it is ...

  3. The Function Analysis of Informationization in New Rural Cooperatives Medical Service Management

    Science.gov (United States)

    Zhou, Yuefeng; Liu, Min

    The establishment of new rural cooperative medical system is an important action for comprehensive affluent society. It is an important measure for Central Party Committee and State Council to solve "three rural" issue effectively and to overall urban and rural, regional, coordinated economic and social development, building a well-off society in the new situation. It has important role to alleviate farmers to see a doctor expensively, see a doctor difficultly, reduce the burden on farmers and improve their level of health protection and quality of life, solve the problem of poor because of illness and the problem of returning poor due to illness, promote the production and rural economic development and stability in the rural areas. This article will analyze the function of informationization in new rural cooperative medical service management selectively.

  4. Community pharmacy-based medication therapy management services: financial impact for patients

    Directory of Open Access Journals (Sweden)

    Ruisinger JF

    2012-09-01

    Full Text Available Objective: To determine the direct financial impact for patients resulting from Medication Therapy Management (MTM interventions made by community pharmacists. Secondary objectives include evaluating the patient and physician acceptance rates of the community pharmacists’ recommended MTM interventions.Methods: This was a retrospective observational study conducted at 20 Price Chopper and Hen House grocery store chain pharmacies in the Kansas City metro area from January 1, 2010 to December 31, 2010. Study patients were Medicare Part D beneficiaries eligible for MTM services. The primary outcome was the change in patient out-of-pocket prescription medication expense as a result of MTM services.Results: Of 128 patients included in this study, 68% experienced no out-of-pocket financial impact on their medication expenses as a result of MTM services. A total of 27% of the patients realized a cost-savings (USD440.50 per year, (SD=289.69 while another 5% of patients saw a cost increase in out-of-pocket expense (USD255.66 per year, (SD=324.48. The net financial impact for all 128 patients who participated in MTM services was an average savings of USD102.83 per patient per year (SD=269.18, p<0.0001. Pharmacists attempted a total of 732 recommendations; 391 (53% were accepted by both the patient and their prescriber. A total of 341 (47% recommendations were not accepted because of patient refusal (290, 85% or prescriber refusal (51, 15%.Conclusions: Patient participation in MTM services reduces patient out-of-pocket medication expense. However, this savings is driven by only 32% of subjects who are experiencing a financial impact on out-of-pocket medication expense. Additionally, the majority of the pharmacists’ recommended interventions (53% were accepted by patients and prescribers.

  5. Influences on Malaysian Pharmacy Students' Career Preferences

    Science.gov (United States)

    Kwai Chong, David Weng; Ahmadi, Keivan; Se, Wong Pei; Hassali, Mohammed Azmi; Hata, Ernieda Mohammed; Hadi, Muhammed Abdul; Sridhar, Sathvik Belagodu; Ahmed, Syed Imran; Yean, Low Bee; Efendie, Benny

    2010-01-01

    Objectives To identify and evaluate factors affecting the career preferences of fourth-year bachelor of pharmacy (BPharm) students in Malaysia in the presence of a 4-year period of mandatory government service. Methods A validated self-administered questionnaire was used in this cross-sectional study to collect data from final-year BPharm students enrolled at 3 government-funded universities and 1 private university in Malaysia. Both descriptive and inferential statistics were used for data analysis. Results Three hundred fourteen students responded (213 from public universities and 101 from the private university). Approximately 32% of public university students and 37% of private university students ranked their own interest in pharmacy as the reason for undertaking pharmacy degree studies; 40.4% of public and 19.8% of private university respondents stated that they would enter a nonpharmacy-related career upon graduation if given the choice. Public university students ranked hospital pharmacy as their choice of first career setting (4.39, p = 0.001), while private students ranked community pharmacy first (4.1, p = 0.002). On a scale of 1 to 5, salary received the highest mean score (3.9 and 4.0, p = 0.854) as the extrinsic factor most influencing their career choice. Conclusions Final-year students at Malaysian public universities were most interested in hospital pharmacy practice as their first career step upon graduation, while private university students were most interested in community pharmacy. The top 3 extrinsic factors rated as significant in selecting a career destination were salary, benefits, and geographical location. PMID:21301600

  6. Pharmacies

    Data.gov (United States)

    Department of Homeland Security — Pharmacies in the United States and Territories A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under...

  7. How youth-friendly are pharmacies in New Zealand? Surveying aspects of accessibility and the pharmacy environment using a youth participatory approach.

    Science.gov (United States)

    Horsfield, Emma; Kelly, Fiona; Clark, Terryann; Sheridan, Janie

    2014-01-01

    undertaken in consultation with young people. We recommend the use of youth participation approaches in future pharmacy practice research into youth health services. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. What Impact Does Behavior of Doctors and Patients on Service Integration of Multi-institutional Readmission cross Township—county Hospitals in Rural China

    OpenAIRE

    Zhang, Yan; Tang, Wenxi; Zhang, Liang

    2017-01-01

    Background: With the change of rural residents’ disease spectrum and patients with chronic diseases boom, multi-institutional health service utilization of rural residents and the continuous service demands are growing sharply in rural China.Objective: Evaluate the service integration of multi-institutional readmission cross township—county hospitals (MRCTCH) in rural China, and figure out determines of service integration.Methods: This study featured 7 sample counties in rural China. Based o...

  9. Interprofessional Approach to Increase Billable Care-Events in a Rural Community

    Directory of Open Access Journals (Sweden)

    Geoffrey A Twigg

    2017-02-01

    Full Text Available Objectives: The study was designed to build a financially stable, replicable, and interprofessional program around a Center of Excellence (COE model exclusively in a community pharmacy setting. This involved creating a separate pharmacy-based clinic within the community pharmacy with recognized rendering providers by payers allowing pharmacists to bill incident to for services and increase the quality of patient clinical outcomes. Setting: Apple Discount drugs in Salisbury, MD is a multi-site independent community pharmacy setting offering traditional pharmacy services along with several pharmacist run clinical programs. Practice Innovation: The pharmacy developed an interprofessional team around a Center of Excellence (COE model as a separate medical clinic within the community pharmacy as a subsidiary of the parent company that was staffed with healthcare providers that are recognized by payers to bill for services. Main Outcome Measures: Outcomes of the study included analysis of the number of patients seen, the ability to obtain reimbursement for the clinical services offered, and changes in A1C and BMI to support the clinical value of pharmacist intervention. Results: A total of 309 patients with diabetes were seen over a 16 month period, including 120 patients who completed the 10 hour diabetes training program. Clinical outcomes showed an improvement in A1C from 9.1 pre enrollment to 7.5 post intervention, and a drop in BMI from 35.7 pre enrollment to 32.4 post intervention. The pharmacy was also able to increase the amount of reimbursement for services provided. Conclusions: The development of a pharmacy based clinic business model inside of a community pharmacy has increased the amount of clinically billed services for the pharmacy. Improvements in clinical outcomes led to an acceptance of the pharmacist as a member of the patient’s care team by patients, local physician’s offices, and third party payers. Funding: This work was

  10. Impact of Previous Pharmacy Work Experience on Pharmacy School Academic Performance

    Science.gov (United States)

    Mar, Ellena; T-L Tang, Terrill; Sasaki-Hill, Debra; Kuperberg, James R.; Knapp, Katherine

    2010-01-01

    Objectives To determine whether students' previous pharmacy-related work experience was associated with their pharmacy school performance (academic and clinical). Methods The following measures of student academic performance were examined: pharmacy grade point average (GPA), scores on cumulative high-stakes examinations, and advanced pharmacy practice experience (APPE) grades. The quantity and type of pharmacy-related work experience each student performed prior to matriculation was solicited through a student survey instrument. Survey responses were correlated with academic measures, and demographic-based stratified analyses were conducted. Results No significant difference in academic or clinical performance between those students with prior pharmacy experience and those without was identified. Subanalyses by work setting, position type, and substantial pharmacy work experience did not reveal any association with student performance. A relationship was found, however, between age and work experience, ie, older students tended to have more work experience than younger students. Conclusions Prior pharmacy work experience did not affect students' overall academic or clinical performance in pharmacy school. The lack of significant findings may have been due to the inherent practice limitations of nonpharmacist positions, changes in pharmacy education, and the limitations of survey responses. PMID:20498735

  11. Impact of previous pharmacy work experience on pharmacy school academic performance.

    Science.gov (United States)

    Mar, Ellena; Barnett, Mitchell J; T-L Tang, Terrill; Sasaki-Hill, Debra; Kuperberg, James R; Knapp, Katherine

    2010-04-12

    To determine whether students' previous pharmacy-related work experience was associated with their pharmacy school performance (academic and clinical). The following measures of student academic performance were examined: pharmacy grade point average (GPA), scores on cumulative high-stakes examinations, and advanced pharmacy practice experience (APPE) grades. The quantity and type of pharmacy-related work experience each student performed prior to matriculation was solicited through a student survey instrument. Survey responses were correlated with academic measures, and demographic-based stratified analyses were conducted. No significant difference in academic or clinical performance between those students with prior pharmacy experience and those without was identified. Subanalyses by work setting, position type, and substantial pharmacy work experience did not reveal any association with student performance. A relationship was found, however, between age and work experience, ie, older students tended to have more work experience than younger students. Prior pharmacy work experience did not affect students' overall academic or clinical performance in pharmacy school. The lack of significant findings may have been due to the inherent practice limitations of nonpharmacist positions, changes in pharmacy education, and the limitations of survey responses.

  12. Willingness to Pay for Rural Telephone Services: Implications for ...

    African Journals Online (AJOL)

    Global Approaches to Extension Practice: A Journal of Agricultural Extension ... This study assessed Willingness to Pay (WTP) for rural telephone services and the implications for agricultural technology transfer in Southeast Nigeria. ... The sample was made up of 240 agro-based entrepreneurs and 60 extension staff.

  13. The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study

    Science.gov (United States)

    2012-01-01

    Background The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. Method We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. Results In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we

  14. The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study

    Directory of Open Access Journals (Sweden)

    Harvey Jasmine

    2012-12-01

    Full Text Available Abstract Background The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2 has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. Method We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. Results In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual

  15. Injudicious Provision of Subtherapeutic Doses of Antibiotics in Community Pharmacies

    Directory of Open Access Journals (Sweden)

    Mohamed E Amin

    2017-02-01

    Results: The simulated client visited 104 pharmacies and was sold an antibiotic at 68 pharmacies in total. A cold group with one or more antibiotic pills was provided in 31 pharmacies. Upon request for two antibiotic pills, 2-8 antibiotic pills were provided in 30 pharmacies whereas an antibiotic carton was provided in three pharmacies. In four pharmacies, the simulated client was sold a cold group containing an antibiotic as well as another antibiotic upon request. Beta-lactam antibiotics comprised 76% of antibiotics provided. In five encounters, the simulated client was told that the cold group contained an antibiotic when, in fact, it did not. Conclusions: Subtherapeutic doses of antibiotics are provided at dangerous rates in Alexandria’s community pharmacies. Interventions are urgently needed to tackle different factors contributing to this dangerous practice. 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: Original Research

  16. Health care policy and community pharmacy: implications for the New Zealand primary health care sector.

    Science.gov (United States)

    Scahill, Shane; Harrison, Jeff; Carswell, Peter; Shaw, John

    2010-06-25

    The aim of our paper is to expose the challenges primary health care reform is exerting on community pharmacy and other groups. Our paper is underpinned by the notion that a broad understanding of the issues facing pharmacy will help facilitate engagement by pharmacy and stakeholders in primary care. New models of remuneration are required to deliver policy expectations. Equally important is redefining the place of community pharmacy, outlining the roles that are mooted and contributions that can be made by community pharmacy. Consistent with international policy shifts, New Zealand primary health care policy outlines broad directives which community pharmacy must respond to. Policymakers are calling for greater integration and collaboration, a shift from product to patient-centred care; a greater population health focus and the provision of enhanced cognitive services. To successfully implement policy, community pharmacists must change the way they think and act. Community pharmacy must improve relationships with other primary care providers, District Health Boards (DHBs) and Primary Health Organisations (PHOs). There is a requirement for DHBs to realign funding models which increase integration and remove the requirement to sell products in pharmacy in order to deliver services. There needs to be a willingness for pharmacy to adopt a user pays policy. General practitioners (GPs) and practice nurses (PNs) need to be aware of the training and skills that pharmacists have, and to understand what pharmacists can offer that benefits their patients and ultimately general practice. There is also a need for GPs and PNs to realise the fiscal and professional challenges community pharmacy is facing in its attempt to improve pharmacy services and in working more collaboratively within primary care. Meanwhile, community pharmacists need to embrace new approaches to practice and drive a clearly defined agenda of renewal in order to meet the needs of health funders, patients

  17. 7 CFR 2.48 - Administrator, Rural Business-Cooperative Service.

    Science.gov (United States)

    2010-01-01

    ... organizations throughout the world on subjects related to the development and operation of agricultural... Product Market Development Grant program (note to 7 U.S.C. 1621). (29) Administer the Agriculture... 7 Agriculture 1 2010-01-01 2010-01-01 false Administrator, Rural Business-Cooperative Service. 2...

  18. ARCHITECTURE IMPACT IN IMPROVING THE QUALITY OF SERVICES IN RETAIL PHARMACIES: CASE STUDY PRISHTINA, KOSOVO

    Directory of Open Access Journals (Sweden)

    Arta Jakupi

    2017-09-01

    Full Text Available Aim of this study is to analyse the performance of the pharmacist and the wellbeing of the patients on the actual pharmacy layout (in retail pharmacies in Pristina, Kosovo and recognize the modifications that need to be done in architectural design of pharmacies, in improving the quality of care, communication, decrease of the dispensing errors and providing more private spaces to patients. Retail pharmacies are more complex environment as in the same time besides being health care institution are also a retail business environment, therefore there is a need for a more comprehensive analysis regarding the workflow. The mixed methodology has been used, by employing questionaries’ as quantitative method and empirical study of direct observation and interviews as qualitative means. The layout proposals are not envisioned to be implemented as a retail models, but, as ideas to provoke and encourage discussion. Kosovo retail pharmacies are a fast growing market and as such functioning self-sufficiently, which means that they can easily adapt to the local marketplace circumstances and cultural context. It is important for the retail pharmacies to test out the recommendations and challenge its environment in aim of equally maximize productivity and workflow, by keeping incorrectness to a minimum.

  19. Building a sustainable workforce in a rural and remote health service: A comprehensive and innovative Rural Generalist training approach.

    Science.gov (United States)

    Orda, Ulrich; Orda, Sabine; Sen Gupta, Tarun; Knight, Sabina

    2017-04-01

    Historically it has been challenging to recruit and retain an appropriately trained medical workforce to care for rural and remote Australians. This paper describes the Queensland North West Hospital and Health Service (NWHHS) workforce redesign, developing education strategies and pathways to practice, thereby improving service provision, recruitment and retention of staff. The Mount Isa-based Medical Education Unit sought accreditation for a Rural Generalist (RG) training pathway from Internship to Fellowship with the Australian College of Rural and Remote Medicine (ACRRM) and the Regional Training Provider (RTP). This approach enhanced the James Cook University (JCU) undergraduate pathway for rurally committed students while improving recruitment and retention of RMOs/Registrars. Accreditation was achieved through collaboration with training providers, accreditation agencies, ACRRM and a local general practice. The whole pathway from ignore Internship to Fellowship is offered with the RG Intern intake as a primary allocation site beginning in 2016. Comprehensive supervision and excellent clinical exposure provide an interesting and rewarding experience - for staff at all levels. Since 2013 RMO locum rates have been <1%. Registrars on the ACRRM pathway and Interns increased from 0 to 7 positions each in 2015, with similar achievements in SMO staffing. Three RMOs expressed interest in a Registrar position, CONCLUSIONS: Appropriate governance is needed to develop and advertise the program. This includes the NWHHS, the RG Pathway and JCU. © 2016 National Rural Health Alliance Inc.

  20. Marginalization and health service coverage among indigenous, rural, and urban populations: a public health problem in Mexico.

    Science.gov (United States)

    Roldán, José; Álvarez, Marsela; Carrasco, María; Guarneros, Noé; Ledesma, José; Cuchillo-Hilario, Mario; Chávez, Adolfo

    2017-12-01

      Marginalization is a significant issue in Mexico, involving a lack of access to health services with differential impacts on Indigenous, rural and urban populations. The objective of this study was to understand Mexico’s public health problem across three population areas, Indigenous, rural and urban, in relation to degree of marginalization and health service coverage.   The sampling universe of the study consisted of 107 458 geographic locations in the country. The study was retrospective, comparative and confirmatory. The study applied analysis of variance, parametric and non-parametric, correlation and correspondence analyses.   Significant differences were identified between the Indigenous, rural and urban populations with respect to their level of marginalization and access to health services. The most affected area was Indigenous, followed by rural areas. The sector that was least affected was urban.   Although health coverage is highly concentrated in urban areas in Mexico, shortages are mostly concentrated in rural areas where Indigenous groups represent the extreme end of marginalization and access to medical coverage. Inadequate access to health services in the Indigenous and rural populations throws the gravity of the public health problem into relief.

  1. A cluster-randomized controlled knowledge translation feasibility study in Alberta community pharmacies using the PARiHS framework: study protocol.

    Science.gov (United States)

    Rosenthal, Meagen M; Tsuyuki, Ross T; Houle, Sherilyn Kd

    2015-01-01

    Despite evidence of benefit for pharmacist involvement in chronic disease management, the provision of these services in community pharmacy has been suboptimal. The Promoting Action on Research Implementation in Health Services (PARiHS) framework suggests that for knowledge translation to be effective, there must be evidence of benefit, a context conducive to implementation, and facilitation to support uptake. We hypothesize that while the evidence and context components of this framework are satisfied, that uptake into practice has been insufficient because of a lack of facilitation. This protocol describes the rationale and methods of a feasibility study to test a facilitated pharmacy practice intervention based on the PARiHS framework, to assist community pharmacists in increasing the number of formal and documented medication management services completed for patients with diabetes, dyslipidemia, and hypertension. A cluster-randomized before-after design will compare ten pharmacies from within a single organization, with the unit of randomization being the pharmacy. Pharmacies will be randomized to facilitated intervention based on the PARiHS framework or usual practice. The Alberta Context Tool will be used to establish the context of practice in each pharmacy. Pharmacies randomized to the intervention will receive task-focused facilitation from an external facilitator, with the goal of developing alternative team processes to allow the greater provision of medication management services for patients with diabetes, hypertension, and dyslipidemia. The primary outcome will be a process evaluation of the needs of community pharmacies to provide more clinical services, the acceptability and uptake of modifications made, and the willingness of pharmacies to participate. Secondary outcomes will include the change in the number of formal and documented medication management services in the aforementioned chronic conditions provided 6 months before, versus after, the

  2. The Implementation of TTG Book Service Done By Community Library in Rural Area

    Directory of Open Access Journals (Sweden)

    Pawit Muhammad Yusup

    2016-06-01

    Full Text Available The problem of poverty in rural areas cannot be separated from the following aspects: poverty, lack of education facilities, low level of entrepreneurial skills, health, lack of learning facilities, population distribution, infrastructure and facilities are inadequate, access to information, and other aspects that are still limited. The Village Library and Community Library as part of the affordable infrastructure and learning facilities are, not yet available in every village. This study tried to introduce pilot models Appropriate Technology Implementation Services Book through Rural Libraries and the community library to a number of poor people in the village. The result could contribute in improving the skills of a number of rural poor in entrepreneurship-based reading. This service models can be applied in other similar villages.

  3. Prescription Drug Plan Formulary, Pharmacy Network, and P...

    Data.gov (United States)

    U.S. Department of Health & Human Services — These public use files contain formulary, pharmacy network, and pricing data for Medicare Prescription Drug Plans and Medicare Advantage Prescription Drug Plans...

  4. Pharmacy-based statewide naloxone distribution: A novel "top-down, bottom-up" approach.

    Science.gov (United States)

    Morton, Kate J; Harrand, Brianna; Floyd, Carly Cloud; Schaefer, Craig; Acosta, Julie; Logan, Bridget Claire; Clark, Karen

    To highlight New Mexico's multifaceted approach to widespread pharmacy naloxone distribution and to share the interventions as a tool for improving pharmacy-based naloxone practices in other states. New Mexico had the second highest drug overdose death rate in 2014 of which 53% were related to prescription opioids. Opioid overdose death is preventable through the use of naloxone, a safe and effective medication that reverses the effects of prescription opioids and heroin. Pharmacists can play an important role in providing naloxone to individuals who use prescription opioids. Not applicable. Not applicable. A multifaceted approach was utilized in New Mexico from the top down with legislative passage of provisions for a statewide standing order and New Mexico Department of Health support for pharmacy-based naloxone delivery. A bottom up approach was also initiated with the development and implementation of a training program for pharmacists and pharmacy technicians. Naloxone Medicaid claims were used to illustrate statewide distribution and utilization of the pharmacist statewide standing order for naloxone. Percent of pharmacies dispensing naloxone in each county were calculated. Trained pharmacy staff completed a program evaluation form. Questions about quality of instruction and ability of trainer to meet stated objectives were rated on a Likert scale. There were 808 naloxone Medicaid claims from 100 outpatient pharmacies during the first half of 2016, a 9-fold increase over 2014. The "A Dose of R x eality" training program evaluation indicated that participants felt the training was free from bias and met all stated objectives (4 out of 4 on Likert scale). A multi-pronged approach coupling state and community collaboration was successful in overcoming barriers and challenges associated with pharmacy naloxone distribution and ensured its success as an effective avenue for naloxone acquisition in urban and rural communities. Copyright © 2017 American Pharmacists

  5. Are all pharmacy staff interested in potential future roles?

    Science.gov (United States)

    Braund, Rhiannon; Chesney, Kate Marie; Keast, Emilia Paulina; Ng, Lye Jinn; Qi, Sarah; Samaranayaka, Sashika; Wang, Eddie

    2012-12-01

    To determine the current perceived roles and responsibilities of pharmacy staff in community pharmacies in New Zealand, and attitudes to proposed new advanced roles for pharmacy staff. Structured interviews were conducted within five community pharmacies, including at least two pharmacists, two dispensary staff and two pharmacy assistants. The interviews were structured to determine previous experience, current roles and responsibilities and the perceived future roles of pharmacy staff within a community pharmacy setting. Thematic analysis from 27 interviews identified key findings. Current roles appeared to be fairly well defined. Pharmacy assistants listed key roles as customer interactions and sales focus, noting that the dispensary was outside their area of responsibility. Technicians identified their role as being dispensary focused while pharmacists saw their role as the 'final check' to ensure accuracy as well as providing dispensing, counselling and managerial roles. With potential future roles, the assistants were less interested than the other groups, citing contentment with current situation and training as a barrier. Some technicians indicated an interest in furthering their roles, but many were reluctant and saw that additional training was too time consuming. Whilst pharmacists appeared to be interested in further scopes of practice, they appeared more reluctant to do this at the expense of handing dispensing responsibility to a non-pharmacist. Whilst there is a push for pharmacists to provide advanced clinical services, it is important to acknowledge that many staff working within community pharmacies are satisfied with their current role. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.

  6. Access to health services in Western Newfoundland, Canada: Issues, barriers and recommendations emerging from a community-engaged research project

    Directory of Open Access Journals (Sweden)

    Janelle Hippe

    2014-06-01

    Full Text Available Research indicates that people living in rural and remote areas of Canada face challenges to accessing health services. This article reports on a community-engaged research project conducted by investigators at Memorial University of Newfoundland in collaboration with the Rural Secretariat Regional Councils and Regional Partnership Planners for the Corner Brook–Rocky Harbour and Stephenville–Port aux Basques Rural Secretariat Regions of Newfoundland and Labrador. The aim of this research was to gather information on barriers to accessing health services, to identify solutions to health services’ access issues and to inform policy advice to government on enhancing access to health services. Data was collected through: (1 targeted distribution of a survey to communities throughout the region, and (2 informal ‘kitchen table’ discussions to discuss health services’ access issues. A total of 1049 surveys were collected and 10 kitchen table discussions were held. Overall, the main barriers to care listed in the survey included long wait times, services not available in the area and services not available at time required. Other barriers noted by survey respondents included transportation problems, financial concerns, no medical insurance coverage, distance to travel and weather conditions. Some respondents reported poorer access to maternal/child health and breast and cervical screening services and a lack of access to general practitioners, pharmacy services, dentists and nurse practitioners. Recommendations that emerged from this research included improving the recruitment of rural physicians, exploring the use of nurse practitioners, assisting individuals with travel costs,  developing specialist outreach services, increasing use of telehealth services and initiating additional rural and remote health research. Keywords: rural, remote, healthcare, health services, social determinants of health

  7. Was Pharmacy Their Preferred Choice? Assessing Pharmacy Students’ Motivation to Study Pharmacy, Attitudes and Future Career Intentions in Sierra Leone

    Directory of Open Access Journals (Sweden)

    Peter Bai James

    2018-06-01

    Full Text Available Background: There is a dearth of skilled pharmaceutical workforce in the African region, and this is partly due to a limited number of prospective students entering the profession. An understanding of the factors that influence the choice of pharmacy as a career is needed to attract highly motivated and skilled individuals into the profession. Therefore, the objective of this study was to assess pharmacy students’ motivation to study pharmacy, their attitude and future career intentions in Sierra Leone. Methods: A cross-sectional questionnaire-based survey of undergraduate pharmacy students enrolled at the College of Medicine, and Allied Health Sciences, University of Sierra Leone (COMAHS – USL was carried out between May and June 2015. Descriptive statistics, as well as chi-square and Fisher exact two-tailed tests were used to analyze the data. Results: Close to a quarter (24.3% of pharmacy students surveyed chose pharmacy as their preferred major. The choice of pharmacy as a preferred major was common among first-year students, (p=0.001, those who were married (p<0.001 and have had pharmacy practice experience (p<0.001. Motivation for choosing pharmacy was assessed based on three domains (education, personal and career-related factors.Students cited a subject teacher at school ̸ College (66.7% as the most education-related influence, while friends and family members (61.1% was the major personal-related factor. Also, students considered the desire for self-employment in a healthcare related job (27.8%, and excellent career opportunities (27.8% as the major career-related factors that influenced their choice of pharmacy as a preferred major. Medicine was the first choice of study among the majority (95% of students that chose pharmacy as a second choice when seeking admission into the university. Pharmacy students demonstrated a positive attitude toward the profession, and considered drug manufacturing (47.3% and hospital pharmacy (43

  8. Establishing a clinical pharmacy technician at a United States Army military treatment facility.

    Science.gov (United States)

    Evans, Jennifer L; Gladd, Ellen M; Gonzalez, Alicia C; Tranam, Salman; Larrabee, Joni M; Lipphardt, Sarah E; Chen, Tina T; Ronn, Michael D; Spain, John

    2016-01-01

    To describe the creation of a clinical pharmacy technician position within the U.S. Army and to identify the personal skills and characteristics required to meet the demands of this role. An outpatient military treatment facility located in Maryland. The clinical pharmacy technician position was designed to support clinical pharmacy services within a patient-centered medical home. Funding and a position description were established to hire a clinical pharmacy technician. Expected duties included administrative (45%), patient education (30%), and dispensing (25%). Local policy, in accordance with federal law and U.S. Army regulations, was developed to define the expanded technician responsibility to deliver patient medication education. In the initial 3 months, the clinical pharmacy technician spent 24 hours per week on clinical activities, affording an additional 10-15 hours per week for clinical pharmacists to provide patient care. Completed consults increased from 41% to 56%, and patient-pharmacist encounters increased from 240 to 290 per month. The technician, acting as a clinical pharmacist extender, also completed an average of 90 patient encounters independently each month. As a result of these improvements, the decision was made to hire a second technician. Currently, the technicians spend 28-40 hours per week on clinical activities, offsetting an average of 26 hours per week for the clinical pharmacists. A patient-centered medical home clinical pharmacy technician can reduce the administrative workload for clinical pharmacists, improve their efficiency, and enhance the use of clinical pharmacy services. Several characteristics, particularly medication knowledge, make pharmacy technicians particularly suited for this role. The results from the implementation of a clinical pharmacy technician at this military treatment facility resulted in an Army-wide expansion of the position and suggested applicability in other practice sites, particularly in federal

  9. Key Economic Parameters for an Optimal Pharmacy Network in a Regulated Environment

    Directory of Open Access Journals (Sweden)

    Franjo MLINARIC

    2016-10-01

    Full Text Available Pharmacies are an integral part of the modern healthcare system which strives for a holistic and effi cient care. General practitioners and pharmacists are held in high esteem among local communities as they are the fi rst point of contact when people have health issues. However, a strong demand for health services in developed countries and its present fi nancing schemes undermined the sustainability of the whole health system (8.9% of GDP in 2013 and growing. According to WHO and EU recommendations, the whole healthcare system shall accept a holistic approach and focus on education, prevention and proper medicine consume. Part of this strategy is a seamless care concept, where medical doctors and pharmacists build a team around the well-being of a patient. Financing scheme incentives and KPI’s (key performance indicators will be focused on keeping people healthy, instead of paying for procedures. The future healthcare ecosystem obliges pharmacists to optimize network coverage and to extend health services. Nevertheless, their growth strategy needs to be gradual, considering the present level of network coverage, the low pace of private and public expenditures for medicine and services, and the fact that a new fi nancing model for pharmacies is still unknown. Thus, we expect the development of pharmacy network in regulated environment to be fi nanced predominantly from retained earnings in publicly owned pharmacies and by awarding pharmacy concessions.

  10. Preceptors' Need For Support In Tutoring Pharmacy Students in Finnish Community Pharmacies

    Directory of Open Access Journals (Sweden)

    Ulla Löfhjelm

    2016-11-01

    Full Text Available A pharmacy degree in Finland includes a six-month obligatory internship. The internship is integrated with theoretical studies and adds up to 30 European Credit Transfer and Accumulation System (ECTS credits of the BSc (Pharm degree. Learning is supported by reflective assignments from the university. The preceptors have an important role in organizing the internship and tutoring students successfully in community pharmacy settings. Objective: to assess whether the preceptors of University of Helsinki’s teaching pharmacies need pedagogic support in tutoring and if so, in which core pharmaceutical tasks or tutoring skills. Methods: The survey was sent to all preceptors of University of Helsinki´s teaching pharmacies (n=326 in 2011 (response rate 58%, n=190. The data was analyzed statistically using Excel (version 12.3.6. The open-ended questions were analyzed by qualitative content analysis. Results: The majority of preceptors found their skills in tutoring the students mainly good. However, assessment of learning (27% of the respondents, giving feedback (23% and organizing the learning situations supportive for learning (23% were the areas in which the preceptors mostly indicated a need for support. Teaching current care guidelines and pharmaceutical care (36% and multi-professional collaboration (28% were the areas in which the preceptors expressed that they needed to update their skills. Conclusions: The faculty should focus the support on the pedagogic skills of preceptors, particularly in improving their skills in assessment of learning and in reflective dialogue. In addition, their skills in teaching clinical and patient care aspects of pharmacy practice should be enhanced. 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

  11. Study to Measure the impact of Pharmacists and Pharmacy Services (STOMPP on Medication Non-Adherence: Medication Adherence and Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    Sharrel Pinto, BS Pharm, DMM, MS, PhD

    2018-02-01

    Full Text Available Objective: To compare the impact of various pharmacy-based services on medication adherence and clinical outcomes. Design: Prospective, randomized control trial Setting: A local endocrinology group (clinic setting and community pharmacies belonging to a regional integrated delivery network (IDN in Toledo, OH Population: Subjects included within this study had type 2 diabetes, were prescribed a minimum of five medications, at least 18 years of age, having the ability to self-administer medications as prescribed, and be able to speak and understand English. Subjects were required to have Paramount health insurance, must be willing and able to provide informed consent, actively participate in the assigned MTM sessions, and have adequate transportation to attend the sessions at a participating pharmacy.  Methods: Patients were recruited through flyers at practice sites, referrals from physicians and pharmacists, and direct mailers. Members of the research team would screen patients to assess their eligibility to participate in the study. Patients who fit the inclusion criteria were randomized into one of the following four different groups: Pill Bottle (PB, Blister Pack (BP, Pill Bottle + Medication Therapy Management (PB+MTM, and Adherence Pharmacy (BP+MTM. Patients enrolled in the BP groups had their medications synchronized. Patients in the AP group were given the option to have their medications delivered, if needed. Practice innovation: We partnered with a regional integrated delivery network (IDN with multiple community pharmacy practice sites and a practice group of endocrinologists. A new practice model called Adherence Pharmacy was conceptualized and implemented within the community setting and was accessible to patients. Main Outcomes Measures: Medication adherence, measured using proportions of days covered (PDC and pill count scores at baseline, 3 months, 6 months, 9 months, and 12 months; Hemoglobin A1c (HbA1c, body mass index (BMI

  12. Quality indicators to compare accredited independent pharmacies and accredited chain pharmacies in Thailand.

    Science.gov (United States)

    Arkaravichien, Wiwat; Wongpratat, Apichaya; Lertsinudom, Sunee

    2016-08-01

    Background Quality indicators determine the quality of actual practice in reference to standard criteria. The Community Pharmacy Association (Thailand), with technical support from the International Pharmaceutical Federation, developed a tool for quality assessment and quality improvement at community pharmacies. This tool has passed validity and reliability tests, but has not yet had feasibility testing. Objective (1) To test whether this quality tool could be used in routine settings. (2) To compare quality scores between accredited independent and accredited chain pharmacies. Setting Accredited independent pharmacies and accredited chain pharmacies in the north eastern region of Thailand. Methods A cross sectional study was conducted in 34 accredited independent pharmacies and accredited chain pharmacies. Quality scores were assessed by observation and by interviewing the responsible pharmacists. Data were collected and analyzed by independent t-test and Mann-Whitney U test as appropriate. Results were plotted by histogram and spider chart. Main outcome measure Domain's assessable scores, possible maximum scores, mean and median of measured scores. Results Domain's assessable scores were close to domain's possible maximum scores. This meant that most indicators could be assessed in most pharmacies. The spider chart revealed that measured scores in the personnel, drug inventory and stocking, and patient satisfaction and health promotion domains of chain pharmacies were significantly higher than those of independent pharmacies (p pharmacies and chain pharmacies in the premise and facility or dispensing and patient care domains. Conclusion Quality indicators developed by the Community Pharmacy Association (Thailand) could be used to assess quality of practice in pharmacies in routine settings. It is revealed that the quality scores of chain pharmacies were higher than those of independent pharmacies.

  13. Characteristics of good quality pharmaceutical services common to community pharmacies and dispensing general practices.

    Science.gov (United States)

    Grey, Elisabeth; Harris, Michael; Rodham, Karen; Weiss, Marjorie C

    2016-10-01

    In the United Kingdom, pharmaceutical services can be delivered by both community pharmacies (CPs) and dispensing doctor practices (DPs). Both must adhere to minimum standards set out in NHS regulations; however, no common framework exists to guide quality improvement. Previous phases of this research had developed a set of characteristics indicative of good pharmaceutical service provision. To ask key stakeholders to confirm, and rank the importance of, a set of characteristics of good pharmaceutical service provision. A two-round Delphi-type survey was conducted in south-west England and was sent to participants representing three stakeholder groups: DPs, CPs and patients/lay members. Participants were asked to confirm, and rank, the importance of these characteristics as representing good quality pharmaceutical services. Thirty people were sent the first round survey; 22 participants completed both rounds. Median ratings for the 23 characteristics showed that all were seen to represent important aspects of pharmaceutical service provision. Participants' comments highlighted potential problems with the practicality of the characteristics. Characteristics relating to patient safety were deemed to be the most important and those relating to public health the least important. A set of 23 characteristics for providing good pharmaceutical services in CPs and DPs was developed and attained approval from a sample of stakeholders. With further testing and wider discussion, it is hoped that the characteristics will form the basis of a quality improvement tool for CPs and DPs. © 2016 Royal Pharmaceutical Society.

  14. Work group design in pharmacy: the pharmacist-technician team.

    Science.gov (United States)

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

    1987-05-01

    The contemporary pharmacy practice manager faces the challenge of designing pharmacy service programs that not only satisfy the needs of the patient, but at the same time satisfy and motivate the pharmacists and technicians who sustain the programs. This research examined the team design, which has been recommended but not fully described in the literature. This application did not explore the full potential of the team design in the hospital pharmacy setting. More study is needed in this area to assess the impact of work group design on the expansion of clinical programs, employee turnover rates, quality and quantity of work produced, and, most important, the impact on job satisfaction enjoyed by pharmacists and technicians.

  15. ASHP national survey of pharmacy practice in hospital settings: Dispensing and administration--2014.

    Science.gov (United States)

    Pedersen, Craig A; Schneider, Philip J; Scheckelhoff, Douglas J

    2015-07-01

    The results of the 2014 ASHP national survey of pharmacy practice in hospital settings that pertain to dispensing and administration are described. A stratified random sample of pharmacy directors at 1435 general and children's medical-surgical hospitals in the United States were surveyed by mail. In this national probability sample survey, the response rate was 29.7%. Ninety-seven percent of hospitals used automated dispensing cabinets in their medication distribution systems, 65.7% of which used individually secured lidded pockets as the predominant configuration. Overall, 44.8% of hospitals used some form of machine-readable coding to verify doses before dispensing in the pharmacy. Overall, 65% of hospital pharmacy departments reported having a cleanroom compliant with United States Pharmacopeia chapter 797. Pharmacists reviewed and approved all medication orders before the first dose was administered, either onsite or by remote order view, except in procedure areas and emergency situations, in 81.2% of hospitals. Adoption rates of electronic health information have rapidly increased, with the widespread use of electronic health records, computer prescriber order entry, barcodes, and smart pumps. Overall, 31.4% of hospitals had pharmacists practicing in ambulatory or primary care clinics. Transitions-of-care services offered by the pharmacy department have generally increased since 2012. Discharge prescription services increased from 11.8% of hospitals in 2012 to 21.5% in 2014. Approximately 15% of hospitals outsourced pharmacy management operations to a contract pharmacy services provider, an increase from 8% in 2011. Health-system pharmacists continue to have a positive impact on improving healthcare through programs that improve the efficiency, safety, and clinical outcomes of medication use in health systems. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  16. Alcohol brief intervention in community pharmacies: a feasibility study of outcomes and customer experiences.

    Science.gov (United States)

    Khan, Natasha S; Norman, Ian J; Dhital, Ranjita; McCrone, Paul; Milligan, Peter; Whittlesea, Cate M

    2013-12-01

    Studies indicate that community pharmacy-based alcohol brief intervention (BI) is feasible. However, few studies report significant reductions in post-BI alcohol consumption and customer experience. Cost-effectiveness has not been previously examined. This 5 month study adopted a single group pre- and post-experimental design to: (1) assess uptake of the community pharmacy alcohol BI service; (2) establish post-BI changes in alcohol consumption for hazardous drinkers; (3) report the acceptability of the service to customers who received it; and (4) undertake a preliminary economic evaluation of the service through establishing whether pharmacy-based alcohol BI affected health and social care costs, including lost employment costs, and whether it was cost-effective. 26 community pharmacies in south London, UK. Trained pharmacists used the AUDIT-C and a retrospective 7-day Drinking Diary to identify risky drinkers and inform feedback and advice. Harmful drinkers were referred to their general practitioner and/or specialist alcohol services. A confidential service feedback questionnaire was completed by alcohol BI recipients. Baseline and 3-month follow-up telephone interviews were conducted with hazardous and low risk drinkers to assess post-BI alcohol use change and service cost-effectiveness. AUDIT-C, 7-day alcohol unit consumption, drinking days, cost utilisation data. Of the 663 eligible customers offered alcohol BI, 141 (21 %) took up the service. Three-quarters of customers were identified as risky drinkers. Follow-up interviews were conducted with 61 hazardous/low risk drinkers (response rate = 58 %). Hazardous drinkers were found to significantly reduce their 7-day alcohol unit consumption and drinking days, but not AUDIT-C scores. The majority of harmful drinkers (91 %, n = 10) who were contactable post-BI had accessed further alcohol related services. Customer feedback was generally positive. Over 75 % of customers would recommend the service to others. The

  17. Reflections on the role of the pharmacy regulatory authority in enhancing quality related event reporting in community pharmacies.

    Science.gov (United States)

    Boyle, Todd A; Bishop, Andrea C; Mahaffey, Thomas; Mackinnon, Neil J; Ashcroft, Darren M; Zwicker, Bev; Reid, Carolyn

    2014-01-01

    Given the demanding nature of providing pharmacy services, coupled with the expanded scope of practice of the professions in jurisdictions around the world, greater commitment to continuous quality improvement through adoption of quality-related event (QRE) reporting is necessary to ensure patient safety. Pharmacy regulatory authorities (PRAs) are in a unique position to enhance QRE reporting and learning through the standardization of expected practice. This study was aimed to gain a better understanding of the perceived roles of PRAs in enhancing QRE reporting and learning in community pharmacies, and identifying regulatory best practices to execute such roles. A purposive case sampling approach was used to identify PRA staff members from two groups (Deputy registrars and pharmacy inspectors) in 10 Canadian jurisdictions to participate in focus groups in the fall of 2011. Focus groups were used to explore perceptions of the role of PRAs in enhancing and promoting QRE reporting and learning, and perceived barriers to effective implementation in practice. Thematic analysis was used to analyze the qualitative data. Two focus groups were conducted, one with seven Deputy registrars/Practice managers, and one with nine pharmacy inspectors. Five themes were identified, including (1) defining QRE reporting and compliance, (2) navigating role conflict, (3) educating for enhanced QRE reporting and learning, (4) promoting the positive/removing the fear of QREs, and (5) tailoring QRE reporting and learning consistency. Overall, participants perceived a strong role for PRAs in enhancing QRE reporting and learning and providing education for pharmacies to support their compliance with reporting standards. However, PRAs must navigate the conflict inherent in both educating and promoting a process for achieving a standard while simultaneously inspecting compliance to that standard. Ensuring pharmacies have autonomy in operationalizing standards may help to mitigate this conflict

  18. Attitude of would-be medical graduates toward rural health services: An assessment from Government Medical Colleges in Chhattisgarh

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    Meeta Jain

    2016-01-01

    Full Text Available Background: Understanding the attitude toward rural health care among future medical graduates, the health workforce of the near future, is an important exercise. Objective: The objective of this study is to understand the attitude of third year MBBS students in a Government Medical College of Chhattisgarh toward rural health services. Methodology: A cross-sectional study was conducted in 2014 using a semi-open-ended questionnaire. The analysis was primarily descriptive, and nonparametric test of significance was used. Results: Of a total of 293 students, 263 (89.7% rated the current rural health services to be unsatisfactory. Nearly 44% students were willing to serve in the rural area. There was no statistical difference among willing and nonwilling 3rd year Part I students regarding willingness to join rural services but mostly not willing among 3rd year Part II. Majority (66.2% were only willing to work in rural areas for <1 year. The oft-mentioned reason was reservation or added marks in postgraduate entrance examination by more than two-third respondents, “health services for the poor” by nearly two-third respondents and followed by “gain of knowledge about rural people and their diseases.” Nearly 10% would-be medical graduates perceived no apparent benefit. The greatest perceived disadvantage was “lack of infrastructural facilities” by more than 80% of the respondents, while “lack of education opportunities for children and basic amenities for family members” was a concern for nearly three-fourth of respondents. Less than half of the respondents thought that there were no career growth opportunities in rural practice. Conclusion: If the identified perceived factors of nonwillingness are taken care off, it would lead to a drastic increase in the number of doctors joining rural service. Not only that but also this would lead to more doctors staying in their position for a longer duration than currently mandated. This would

  19. The availability of pharmacies in the United States: 2007-2015.

    Directory of Open Access Journals (Sweden)

    Dima Mazen Qato

    variation by pharmacy type and across counties. For example, the provision of home-delivery services ranged from less than <1% of mass retailers to 67% of independent stores and was not associated with county demographics, including ambulatory disability population and percent of the population aged ≥65 years.Despite modest growth of pharmacies in the U.S., the availability of pharmacies, and pharmacy characteristics associated with access to prescription medications, vary substantially across local areas. Policy efforts aimed at improving access to prescription medications should ensure the availability of pharmacies and their accommodations align with local population needs.

  20. Pharmacy Access to Emergency Contraception in Rural and Frontier Communities

    Science.gov (United States)

    Bigbee, Jeri L.; Abood, Richard; Landau, Sharon Cohen; Maderas, Nicole Monastersky; Foster, Diana Greene; Ravnan, Susan

    2007-01-01

    Context: Timely access to emergency contraception (EC) has emerged as a major public health effort in the prevention of unintended pregnancies. The recent FDA decision to allow over-the-counter availability of emergency contraception for adult women presents important rural health implications. American women, especially those living in rural and…

  1. Atrial fibrillation screening in pharmacies using an iPhone ECG: a qualitative review of implementation.

    Science.gov (United States)

    Lowres, Nicole; Krass, Ines; Neubeck, Lis; Redfern, Julie; McLachlan, Andrew J; Bennett, Alexandra A; Freedman, S Ben

    2015-12-01

    Atrial fibrillation guidelines advocate screening to identify undiagnosed atrial fibrillation. Community pharmacies may provide an opportunistic venue for such screening. To explore the experience of implementing an atrial fibrillation screening service from the pharmacist's perspective including: the process of study implementation; the perceived benefits; the barriers and enablers; and the challenges for future sustainability of atrial fibrillation screening within pharmacies. Setting Interviews were conducted face-to-face in the pharmacy or via telephone, according to pharmacist preference. The 'SEARCH-AF study' screened 1000 pharmacy customers aged ≥65 years using an iPhone electrocardiogram, identifying 1.5 % with undiagnosed atrial fibrillation. Nine pharmacists took part in semi-structured interviews. Interviews were transcribed in full and thematically analysed. Qualitative analysis of the experience of implementing an AF screening service from the pharmacist's perspective. Four broad themes relating to service provision were identified: (1) interest and engagement in atrial fibrillation screening by pharmacists, customers, and doctors with the novel, easy-to-use electrocardiogram technology serving as an incentive to undergo screening and an education tool for pharmacists to use with customers; (2) perceived benefits to the pharmacist including increased job satisfaction, improvement in customer relations and pharmacy profile by fostering enhanced customer care and the educational role of pharmacists; (3) implementation barriers including managing workflow, and enablers such as personal approaches for recruitment, and allocating time to discuss screening process and fears; and, (4) potential for sustainable future implementation including remuneration linked to government or pharmacy incentives, combined cardiovascular screening, and automating sections of risk-assessments using touch-screen technology. Atrial fibrillation screening in pharmacies is well

  2. Development of Clinical Pharmacy in Switzerland: Involvement of Community Pharmacists in Care for Older Patients.

    Science.gov (United States)

    Hersberger, Kurt E; Messerli, Markus

    2016-03-01

    The role of the community pharmacist in primary care has been undergoing change in Switzerland in parallel to international developments: it has become more clinically and patient oriented. Special services of community pharmacists to older patients taking long-term or multiple medications, discharged from hospitals or experiencing cognitive impairment or disability have been developed. These services require more clinical knowledge and skills from community pharmacists and are based on, for example, 'simple or intermediate medication reviews' focused primarily to improve medication adherence and rational drug use by a patient. Reflecting the new role of community pharmacies, this article describes the current services provided by community pharmacies in Switzerland, e.g., 'polymedication check', 'weekly pill organizer', and 'services for chronic patients', as well as new Swiss educational and reimbursement systems supporting development of these services. In the international context, involvement of community pharmacists in patient-oriented care is growing. This review summarizes positive and negative experiences from implementation of community pharmacy services in Switzerland and provides examples for the development of such services in other countries.

  3. Pharmacy Education in Vietnam

    Science.gov (United States)

    Bedouch, Pierrick; Nguyen, Thi-Hoai; Nguyen, Thi-Lien-Huong; Hoang, Thi-Kim-Huyen; Calop, Jean; Allenet, Benoît

    2013-01-01

    Pharmacy education programs in Vietnam are complex and offer various career pathways. All include theory and laboratory modules in general, foundation, and pharmaceutical knowledge; placements in health facilities; and a final examination. The various pharmacy degree programs allow specialization in 1 or more of 5 main fields: (1) drug management and supply, (2) drug development and production, (3) pharmacology and clinical pharmacy, (4) traditional medicine and pharmacognosy, and (5) drug quality control, which are offered as main specialization options during the reformed undergraduate and postgraduate programs. However, pharmacy education in Vietnam in general remains product oriented and clinical pharmacy training has not received adequate attention. Only students who have obtained the bachelor of pharmacy degree, which requires a minimum of 5 years of study, are considered as fully qualified pharmacists. In contrast, an elementary diploma in pharmacy awarded after 1 year of pharmacy study permits entry into more junior pharmacy positions. Since the 2000s, there has been a surge in the number and types of schools offering pharmacy qualifications at various levels. PMID:23966717

  4. A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services.

    Science.gov (United States)

    Mitchell, Olivia; Malatzky, Christina; Bourke, Lisa; Farmer, Jane

    2018-03-23

    The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically diverse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated. © 2018 National Rural Health Alliance Ltd.

  5. The service blueprint as a tool for designing innovative pharmaceutical services.

    Science.gov (United States)

    Holdford, D A; Kennedy, D T

    1999-01-01

    To describe service blueprints, discuss their need and design, and provide examples of their use in advancing pharmaceutical care. Service blueprints are pictures or maps of service processes that permit the people involved in designing, providing, managing, and using the service to better understand them and deal with them objectively. A service blueprint simultaneously depicts the service process and the roles of consumers, service providers, and supporting services. Service blueprints can be useful in pharmacy because many of the obstacles to pharmaceutical care are a result of insufficient planning by service designers and/or poor communication between those designing services and those implementing them. One consequence of this poor design and communication is that many consumers and third party payers are uninformed about pharmacist roles. Service blueprints can be used by pharmacists to promote the value of pharmaceutical care to consumers and other decision makers. They can also assist in designing better pharmaceutical services. Blueprints are designed by identifying and mapping a process from the consumer's point of view, mapping employee actions and support activities, and adding visible evidence of service at each consumer action step. Key components of service blueprints are consumer actions, "onstage" and "backstage" employee actions, and support processes. Blueprints can help pharmacy managers identify and correct problems with the service process, provide pharmacy employees an opportunity to offer feedback in the planning stages of services, and demonstrate the value of pharmaceutical services to consumers. Service blueprints can be a valuable tool for designing, implementing, and evaluating pharmacy services.

  6. Role of Leadership and Employee Engagement towards Individual Performance of Pharmacy Employees

    Directory of Open Access Journals (Sweden)

    Susi A. Rahayu

    2012-09-01

    Full Text Available Employees dissatisfaction to the head of the hospital pharmacy will decrease employees performance and unsatisfied customers. To solve the problems, employees should be based on performance as customer expectations in providing services. One of the ways to improve the performance of the employees, they must feel engage to the work. One of the factors to improve employee engagement is the leadership factor. Therefore, it is necessary to study the impact of leadership on individual performance employee in hospital pharmacy and also the influence of employee engagement as a mediator. A total of 79 employees from the pharmacy in two private hospitals in Bandung became the participants. This study used the technique of partial least squares to test the hypothesized relationships. The results showed that there were significant between leadership to employee engagement (t value (12,84 > t-table (1.64, the significance of employee engagement on individual performance (t value (3.83 > t-table (1.64. In contrast, there was no influence and significance in leadership on individual performance (t value (0.45 < t-table (1.64. Employee engagement fully mediated the relationship between leadership and individual performance. Therefore, improving pharmacy services is a set of actions and involvement of pharmacy employees who are consistent, sustainable and clear.

  7. Customer satisfaction with mobile operators’ services in Lithuanian rural areas

    OpenAIRE

    Pilelienė, Lina; Grigaliūnaitė, Viktorija

    2017-01-01

    In tough competitive conditions of Lithuanian mobile services market, customer satisfaction becomes one of the most important factors for customer retention and attraction. Lithuanian mobile market can be described as being in a maturity stage of its life-cycle: the prices and services of different mobile operators are quite similar. However, the network coverage and signal strength differs – main differences can be observed in rural areas of the country. Therefore, the scientific...

  8. [Medical and entrepreneurial character of the community pharmacy].

    Science.gov (United States)

    Malovecká, Ivona; Minarovič, Igor; Mináriková, Daniela; Snopková, Miroslava; Lehocká, Lubica; Foltán, Viliam

    2014-04-01

    Community pharmacy provides citizens with pharmaceutical care and runs its health care business on the market with state regulatory interventions. These restrictions affect its stability and because of that it has to be constantly monitored. The convenient way of monitoring the financial health of a community pharmacy is the use of financial analysis and its outcomes that are profitability, liquidity, debt and productivity ratios. The aim of this paper was to determine the economic situation in the public pharmacy services in Slovakia. A representative set of community pharmacies was established that reflected the criteria of localization by regions in Slovakia, the size of the city or municipality and the legal form of the subject. The financial analysis for the years 2007-2012 showed a declining return on sales (in 2012 to 1.98 %), a decreasing current liquidity (in 2012 to 1.87 %), a declining quick ratio (in 2012 to 1.08 %), a decrease in the time receivables turnover (in 2012 to 53.8 days), a slight increase in the inventory turnover time - days sales in inventory (in 2012 to 36.5 days) and increased turnover time commitments - liabilities turnover (in 2012 to 86.3 days). community pharmacy financial health profitability liquidity productivity.

  9. Disparities in dental health of rural Australians: hospitalisation rates and utilisation of public dental services in three communities in North Queensland.

    Science.gov (United States)

    Carlisle, Karen; Larkins, Sarah; Croker, Felicity

    2017-01-01

    The oral health of rural Australians continues to lag behind that of those living in metropolitan areas. Research has shown that people living in rural areas are more likely to suffer from dental caries (decay), visit the dentist less often and have poorer access to oral health services. The purpose of the study was to examine hospitalisations for dental conditions and utilisation of public dental services in three rural communities in Queensland compared with the whole of Queensland. Aggregated hospitalisation data for dental conditions and counts of public outpatient service data were requested for residents of three rural communities in Queensland and for the whole of Queensland for the calendar year 2013. Hospitalisation rates per 1000 and risk ratios were calculated to examine the risk of hospitalisation for dental procedures for those living in the selected rural communities and the rest of Queensland. Data were grouped by gender, age and Indigenous status and comparisons made between Queensland and the rural communities. Outpatient service data were converted to percentage of all services delivered to allow comparisons between groups of different sizes. Population data were grouped into age cohorts and compared with the proportion of public oral health services delivered to each age cohort. Residents of the rural communities were twice as likely to be hospitalised and children aged 0-14 years living in the communities were three times more likely to be hospitalised for dental conditions compared to residents of the rest of Queensland. Outpatient oral service data showed that the proportion of services delivered to children aged up to 14 years living in the rural communities was less than the whole of Queensland. Interestingly, in one rural community where the public dental service was open to all, the distribution of public oral health services aligned with the age distribution of the population. The study showed that residents of these rural communities

  10. Pharmacy executive leadership issues and associated skills, knowledge, and abilities.

    Science.gov (United States)

    Meadows, Andrew B; Maine, Lucinda L; Keyes, Elizabeth K; Pearson, Kathy; Finstuen, Kenn

    2005-01-01

    To identify challenges that current and future pharmacy executives are facing or will face in the future and to define what skills, knowledge, and abilities (SKAs) are required to successfully negotiate these challenges. Delphi method for executive decision making. Civilian pharmacy profession. 110 pharmacists who graduated from the GlaxoSmithKline Executive Management Program for Pharmacy Leaders. Two iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants were asked to identify five major issues they believed to be of greatest importance to pharmacy leaders in the next 5-10 years and name specific SKAs that might be needed by future leaders to successfully deal with those issues. An expert panel reviewed the issues, classified issues into specific domains, and titled each domain. Round 2-participants rated the SKAs on a 7-point scale according to their individual assessment of importance in each domain. For Delphi rounds 1 and 2, response rates were 21.8% and 18.2%, respectively. More than 100 total issue statements were identified. The expert panel sorted the issues into five domains: management and development of the pharmacy workforce, pharmacy finance, total quality management of work-flow systems, influences on the practice of pharmacy, and professional pharmacy leadership. Five of the top 15 SKAs-and all four highest ranked items--came from the professional pharmacy leadership domain, including ability to see the big picture, ability to demonstrate the value of pharmacy services, ability to lead and manage in an ethical manner, and skills for influencing an organization's senior leadership. Through successful integration of communication skills, critical thinking, and problem solving techniques, future public-sector pharmacy executives will be better equipped to effectively position their organizations and the profession for the challenges that lie ahead.

  11. Extending access to essential services against constraints: the three-tier health service delivery system in rural China (1949-1980).

    Science.gov (United States)

    Feng, Xing Lin; Martinez-Alvarez, Melisa; Zhong, Jun; Xu, Jin; Yuan, Beibei; Meng, Qingyue; Balabanova, Dina

    2017-05-23

    China has made remarkable progress in scaling up essential services during the last six decades, making health