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Biomedical subjects

Claire Anderson

Publications and source records attributed to Claire Anderson.

15 recordsLinked to original sources
PubMed2006

Pharmacogenetics, the next challenge for pharmacy?

This commentary draws attention to and raises awareness of forthcoming pharmacogenetic technologies amongst the pharmacy profession. It aims to stimulate debate around the potential role that the pharmacy profession can play in the introduction of pharmacogenetic technologies into primary healthcare. This commentary discusses potential new roles for pharmacists involving pharmacogenetic technologies, giving attention to the way the profession may need to adapt to accommodate these.

Education, Pharmacy↗
PubMed2006

A study to investigate the extent of delivery of an intervention in asthma, in a UK national community pharmacy chain, using mystery customers.

OBJECTIVE: The objective of this study was to implement a brief intervention in asthma within a UK national pharmacy chain, and through the use of mystery customers, measure the extent of delivery of the intervention over a 4-month period. METHODS: Mystery customers gathered information on which of the asthma intervention questions were asked, and any lifestyle advice that was given. Additional information was collected on the type of store they visited and the personnel who served them. RESULTS: Mystery customer results indicate delivery rates of the intervention between 48.1 and 84.3% across the 4-month assessment period. This intervention was delivered by both pharmacists and healthcare staff, although the extent and content of delivery varied across the 4 months. CONCLUSION: The use of mystery customers has helped to assess the successful take up and delivery of this intervention. Based on the learning points gained throughout this study, future services can be designed for other condition areas. PRACTICE IMPLICATIONS: Each service that is designed needs to be simple to implement and deliver, and have the flexibility for pharmacists and staff to adapt the services to meet local requirements.

Asthma↗
PubMed2005

A qualitative study of pharmacists' perspectives on the supply of emergency hormonal contraception via patient group direction in the UK.

AIM: To investigate pharmacists' views and experiences of supplying emergency hormonal contraception (EHC) via a group prescribing protocol in community pharmacies in the UK. DESIGN: Qualitative study using depth interviews. SETTING: Community pharmacists in Manchester, Salford and Trafford (Greater Manchester), and Lambeth, Southwark and Lewisham (London) Health Action Zones in the UK. PARTICIPANTS: Forty-four community pharmacists supplying EHC in Manchester, Salford and Trafford, and Lambeth, Southwark and Lewisham (London). RESULTS: Pharmacists were broadly very positive about their experiences supplying EHC via the group prescribing protocol. Pharmacists identified many benefits of the EHC schemes for clients, in particular, improved access to EHC at no cost to clients. The confidential nature of the scheme was also seen as an advantage as was the scope for referral to other service providers. Pharmacists also believed that the scheme had benefits for the profession in terms of enhanced professional standing. However, their concerns included the extent of repeated use of EHC, the possible impact on contraceptive behaviors and sexually transmitted infections and its impact on male coercive sexual behavior. CONCLUSIONS: Although pharmacy supply of EHC may improve access for some clients and is perceived as a popular service, research into the implications of the schemes as identified in this study need to be conducted.

Anecdotes as Topic↗
PubMed2005

Development of the specialist menopause pharmacist (SMP) role within a research framework.

OBJECTIVE: To determine the potential contribution of a new healthcare practice model, the specialist menopause pharmacist (SMP) role. METHOD: Post pilot, the SMP's remit was proposed as combining clinical practice (service delivery) and research studies, with emphasis on strengthening liaison between the secondary and primary care sectors. Action research, a qualitative research technique, was selected to document role development in the first year. Here the pharmacist-researcher's focus was a local situation where the effects of a particular change, involving people who were part of the situation, were assessed. The change factor was the introduction of the pharmacist to the multi-disciplinary specialist team. The pharmacist-researcher did not attempt to hold anything constant but observed the changes occurring in a systematic manner. Analysis of on-going collaborative professional activity generated the hypothesis that the role was of use in enhancing patient care. Using triangulation and focusing on the descriptive phrase 'of use', it was then possible to study SMP implemented 'actions' that would be accepted as being 'useful' SMP functions. The aim was to test for reliability and obtain data with greater range and accuracy. The three studies undertaken included a controlled, questionnaire study asking for patients' views on the pharmacist service, auditing health professionals usage of the pharmacist operated telephone help-line, and assessing the impact of structured on-site training on community pharmacists. MAIN OUTCOME MEASURE: Overall impact and achievements over 3 years, against a background where the SMP role continued to develop during the study. RESULTS: Action research methodology engendered reflective practice, enabling the SMP to be both the service delivery provider (the intervention) and the researcher. This pharmacist practice model is accepted both by patients and health professional colleagues. The remit combines clinical practice with on-going research studies. In the UK setting, the SMP can undertake numerous liaison activities between secondary and primary care sectors to facilitate enhanced delivery of menopause patient care. CONCLUSION: Using an action research approach, and combining qualitative and quantitative methods to complement data collection, it was possible to assess the specialist pharmacist role in depth.

Education, Pharmacy, Continuing↗
PubMed2005

The Integrated Children's System: challenges of information sharing.

Information has to be shared within and between agencies if Every Child Matters (DH 2003a) is to bring real benefits to children in need and their families. The Integrated Children's System is a theoretical framework that offers a single approach to assessing, planning, intervention and reviewing based on an understanding of children's developmental needs in the context of their families and communities. It should not be seen as an IT project, but is closely linked to the electronic social care record and to NHS care record service developments. Health and social care professionals attempting to improve information management as part of better interagency working face a number of challenges including: confidentiality; a single identifier for children; common language and information exchange; system, organisational and staff issues. Despite many benefits, implementation of the integrated children's system presents managerial and organisational challenges which will require additional support.

Child↗
PubMed2004

The Scope of pharmacy ethics-an evaluation of the international research literature, 1990-2002.

This paper attempts to provide a critical overview of international published discourse relating to ethical issues in pharmacy practice from 1990 to 2002. We found that there is little research literature specifically addressing ethics in pharmacy practice and almost none addressing fundamental philosophical issues or values for pharmacy ethics. There is no dedicated journal for pharmacy ethics. Most material relating to pharmacy ethics is articulated as codes or pronouncements from professional bodies, as opinion or reflection in textbooks and in debate such as letters and articles. However, this should not be taken to mean that pharmacy and ethics are strangers; simply that such matters are not frequently analysed in published pharmacy literature. The presumption is usually that most matters of pharmacy ethics are very familiar and require no exploration or explanation. Where the research literature does target ethical issues, the most common method is to employ "the scenario approach". This term describes the technique of using a vignette or scenario from actual pharmacy practice and then exploring a variety of possible options to identify one or more defensible solutions. The vast majority of scenarios related to the delivery of healthcare per se; rather fewer derived from delivery of healthcare in a commercial environment. One notable exception to this approach is the body of work by Latif and colleagues on moral reasoning and community pharmacy practice. Our review suggests there is a need for the knowledge base in pharmacy ethics to be systematised and integrated into the wider scheme of general healthcare ethics. The principal areas in which research is needed include, how best to teach and assess "ethical competence" before practice; how to develop and update this competence in practising pharmacists; and how the business environment, particularly where there are corporate values and reward systems in operation, affects ethical competence. In addition, general research in pharmacy practice may benefit from a greater awareness and enquiry as to the ethical issues raised by the projects being undertaken.

Ethics, Pharmacy↗
PubMed2004

Using semi covert research to evaluate an emergency hormonal contraception service.

OBJECTIVE: The aim of our study was to evaluate whether the patient group direction protocol for supply of emergency hormonal contraception was being adhered to, that pharmacists were undertaking their professional duties appropriately and to evaluate how women researchers felt that the service was being delivered. METHOD: Semi covert research was used, two women researchers posed as clients seeking emergency contraception in a sample of participating community pharmacies. They used two rehearsed scenarios about unsafe sexual intercourse and missed doses of the oral contraceptive pill. All transactions were tape recorded and the recordings were used to produce the findings. The two women researchers posing as clients were also asked to record their feelings and experiences concerning the service on leaving the pharmacy. MAIN OUTCOME MEASURE: Adherence to the patient group direction protocol and women's perceptions of service provision. RESULTS: In both scenarios the protocol was largely adhered to and emergency contraception was supplied appropriately. The length of each consultation for both scenarios was between 10-15 min. The women reported that the pharmacists had been courteous, polite and non judgemental. The consultations were carried out in a private area or in the dispensary. The women had no concerns about confidentiality. CONCLUSION: Whilst there are clear limitations of this study in terms of the size of the sample, our results do highlight the fact that the PGD protocol was being utilised appropriately in most cases. In addition, neither woman reported any instances of judgmental or negative attitudes and commented favourably on the scope for discussion about emergency hormonal contraception and other important issues with the pharmacist.

Adolescent↗
PubMed2004

Feedback from community pharmacy users on the contribution of community pharmacy to improving the public's health: a systematic review of the peer reviewed and non-peer reviewed literature 1990-2002.

OBJECTIVE: To systematically review feedback from pharmacy users on their perceptions and experiences of health-related advice and services provided from community pharmacies. METHODS: The focus of the review was community pharmacy activities in relation to promoting health and well-being, preventing ill-health and maintaining health. Searches were conducted for peer-reviewed (international) and non-peer-reviewed (UK) research. Electronic databases searched included MEDLINE, EMBASE, Cochrane Library and International Pharmaceutical Abstracts; hand searches of key journals and conference abstracts, key informants. Key informants in the UK were contacted to identify unpublished studies. The inclusion period was 1990 onwards. Data extraction and synthesis Data were abstracted into a matrix by one author with a sample checked by a second. The Health Development Agency's Evidence Base 2000 standards and the evidence categories used by the Department of Health in the National Service Frameworks were applied to each item. MAIN RESULTS: Seven peer reviewed papers and 13 non-peer reviewed reports were identified for inclusion in the review. Consumer usage of pharmacies is almost universal with prescription supplies and purchase of over the counter medicines predominating. Evidence shows that not only is usage low for general health advice, but that pharmacists are perceived as 'drugs experts' rather than experts on health and illness. Emergency hormonal contraception and head lice management schemes have been well received. There is a need to consider privacy and confidentiality surrounding advice giving. CONCLUSIONS: Users of community pharmacy-based health development initiatives express a high level of satisfaction. If community pharmacies are to be used to their full extent, then actions to extending the public's awareness and acceptance of the pharmacist's role in giving advice will be crucial. Further research will be needed to measure any change in premises development on the public's perception of the level of privacy in pharmacies.

Confidentiality↗
PubMed2003

Supplying emergency contraception via community pharmacies in the UK: reflections on the experiences of users and providers.

This paper discusses findings from an evaluation of a scheme to provide free emergency hormonal contraception (EHC) via community pharmacies in the North-West of England. Drawing on interview data with pharmacists taking part in the scheme and focus groups with users, we tentatively suggest that the scheme was largely well received. The benefits of the service, cited by both pharmacists and users, included enhanced access to EHC, at times when it was needed, and at no cost to the user. In particular, users noted a welcome absence of judgmental attitudes when accessing the service. Pharmacists too were positive about the service, not least because they believed that it conferred enhanced professional status. However, both users and pharmacists had a number of major concerns about the schemes, centring on the potential for misuse, changes in contraceptive behaviour and the impact on sexually transmitted infections. We conclude that more research is needed to explore these issues.

Adult↗
PubMed2003

Systematic review of the effectiveness of community pharmacy-based interventions to reduce risk behaviours and risk factors for coronary heart disease.

BACKGROUND: The aim of the study was to provide a critical and comprehensive overview of the published peer-reviewed evidence relating to community pharmacy-based activity in the reduction of risk behaviours and risk factors for coronary heart disease (CHD). METHOD: Electronic databases were searched from 1 January 1990 to 1 February 2001. Hand searches for the same period were undertaken of specific journals and proceedings of peer-reviewed conference abstracts. Data abstracted from publications included: participants/setting; study designs intervention including training); outcome measures; key findings. RESULTS: Four randomized controlled trials (RCTs) were identified, two in smoking cessation and two in lipid management. All met review criteria and were included. Two (RCTs) involving 976 subjects and three non-randomized experimental studies were identified that evaluated the effectiveness of community pharmacy advice in smoking cessation. Two controlled trials and one before-and-after study investigated the effect of training on pharmacists' smoking cessation advice. One attitudinal survey collected data on reactive and proactive smoking cessation advice-giving by community pharmacists. Two RCTs involving 642 subjects, and two observational studies were identified for community pharmacy-based lipid management. The published studies provided evidence of clinical and cost-effectiveness of community pharmacy services from UK RCTs in smoking cessation, and from US and Canadian RCTs in lipid management in the prevention of heart disease. Although the role of the community pharmacy in disease detection and case finding has been widely discussed, only a small number of studies was found. The findings indicated that further investigation is warranted in these areas. CONCLUSION: The peer-reviewed literature demonstrates the contribution of community pharmacy-based services to the reduction of risk behaviours and risk factors for CHD. The evidence supports the wider provision of smoking cessation and lipid management through community pharmacies. Health commissioners and planners can use the findings of this review to incorporate community pharmacy based health development activities into local health services. Further research is needed into the contribution of community pharmacy to disease detection and case finding as part of local public health strategies.

Community Pharmacy Services↗
PubMed2002

Evaluation of patient information Internet web sites about menopause and hormone replacement therapy.

OBJECTIVES: To evaluate quality of web based information on the menopause and hormone replacement therapy, to identify whether site ownership is an indicator of both web site and content quality, and therefore to provide guidance for healthcare professionals over which sites are suitable for recommendation to patients. METHODS: A search of web sites was conducted using eight commonly used search engines and two key terms ('menopause' and 'hormone replacement therapy') limited to English language. Thus, a sample of 25 sites (of varied ownership) was generated. Using a specific scoring tool, each site was assessed on factual information provided and quality of site. For each criterion, a score of 1-5 was assigned, and two mean scores were generated. Each site was also assessed in a semi-structured qualitative manner. RESULTS: The mean informational value of the sites sampled was 3.129 (out of a maximum of 5) but with a range of 1.6-4.6. The mean value of the sample for the quality of web sites was higher (3.504) but again over a broad range (2.5-4.5). Certain types of ownership were associated with higher quality sites, including the pharmaceutical industry, community pharmacies, governments, and charities. CONCLUSIONS: The information about menopause and HRT on the web is often of dubious calibre, with incomplete information being commonly provided. Therefore it is recommended that healthcare professionals direct women to sites owned by the pharmaceutical industry, community pharmacies, governments, and charities. In doing so it would be prudent to advise women that commercial sites may be biased towards particular products.

Female↗
PubMed2002

Using the Internet to develop an international learning community of pharmacists.

Until recent years, the level of interaction across a profession, necessary to provide for an optimum learning environment which supports professional development, has only been significantly possible in face-to-face interaction and has therefore been place and time dependent. With the explosive development of the internet, communication barriers are breaking down and international interaction, networking and collaboration is becoming increasingly possible. This short report describes the manner in which an Internet-based postgraduate study programme, entitled "Enhancing Pharmacy Practice" has made use of these communication opportunities to develop an international learning community of pharmacists. Programme evaluation data collected from surveys completed online by participants and content analysis of online discussion groups during the first four modules of the programme, demonstrates that there is a high level of interaction amongst participants. It also suggests that this interaction has contributed to the learning experience and professional growth of the participants and impacted positively upon their practice.

Cooperative Behavior↗
PubMed2002

Regional pulmonary perfusion in patients with acute pulmonary edema.

UNLABELLED: Redistribution of pulmonary blood flow (PBF) away from edematous regions of the lung is characteristic of experimental acute lung injury (ALI), helping to preserve ventilation-perfusion matching and gas exchange. The purpose of this study was to determine if such perfusion redistribution occurs in acute pulmonary edema in humans. METHODS: We measured the regional distribution of lung water concentration (LWC) and PBF with PET in 9 patients with ALI, 7 patients with non-ALI pulmonary edema, and 7 healthy subjects. RESULTS: The average patient chest radiographic score was 7.5 +/- 2.2 (scale: 0-12, where > or =4 met our criterion for pulmonary edema). The mean partial pressure of oxygen, arterial/fraction of inspired oxygen ratio (PaO(2)/FIO(2)) was 192 +/- 78. LWC was 35 +/- 4 mL H(2)O/100 mL lung versus 20 +/- 5 mL H(2)O/100 mL lung in the healthy subjects (P < 0.05). On average, the ventral-to-dorsal regional distribution of PBF was similar in patients with pulmonary edema and healthy subjects, regardless of the etiology of the pulmonary edema. However, LWC and an index of perfusion redistribution away from edematous lung regions, when combined, were a significant determinant of the PaO(2)/FIO(2) (coefficient of determination [R2] = 0.53; P = 0.03). CONCLUSION: These results suggest that hypoxic vasoconstriction is severely blunted in ALI. The perfusion redistribution that does exist contributes slightly to improved oxygenation during early pulmonary edema in humans.

Adult↗