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Biomedical subjects

Jill S Burkiewicz

Publications and source records attributed to Jill S Burkiewicz.

9 recordsLinked to original sources
PubMed2005

Update in handheld electronic resources for evidence-based practice in the community setting.

OBJECTIVE: To provide an update on the handheld electronic resources for evidence-based practice (EBP) in the community setting. DATA SOURCES: Electronic resources for EBP in the community setting were identified by compiling the commonly used, well-established resources and by searching MEDLINE and other Internet sites. Search terms included evidence-based medicine, evidence-based practice, resources, and abstraction. Only sources available for personal digital assistants were included. DATA EXTRACTION: Three databases were identified that provided abstraction and evaluation of the medical literature for the handheld platform. Content, features, ease of use, system requirements, and costs of each resource were evaluated. DATA SYNTHESIS: FIRSTConsult, InfoRetriever, and UpToDate were evaluated, and the utility of each in the community pharmacy setting was evaluated by tracking a clinically relevant example through each system. FIRSTConsult provides evidence-based information organized by diagnosis but is not searchable on the handheld platform. InfoRetriever focuses on searchable evidence-based summaries, while UpToDate includes comprehensive topic reviews. The latter 2 platforms have large system memory requirements. All 3 sources provide evidence-based abstraction of the medical literature for the PDA platform, convenient for use at the point of care in community pharmacy. CONCLUSIONS: While users may select a particular resource based on unique features, each provides evidence-based abstraction of the medical literature that is a practical approach to EBP in the community pharmacy setting.

Community Health Services↗
PubMed2005

Evidence-based practice by pharmacists: utilization and barriers.

BACKGROUND: Evidence-based medicine (EBM) is the use of the current best evidence from research to make practice and policy decisions. Little is known regarding the attitudes of pharmacists toward EBM. OBJECTIVE: To determine the attitudes of pharmacists toward EBM, the extent that pharmacists use evidence to make decisions, and identify barriers to the use of evidence. METHODS: A self-administered questionnaire was mailed to 2000 randomly selected Illinois licensed pharmacists. The questionnaire assessed the pharmacists' attitudes toward EBM, the extent to which recommendations are based on primary and tertiary literature, and perceived barriers to the use of EBM. RESULTS: Completed responses were received from 323 pharmacists (17.2% response rate). Overall, respondents had positive attitudes toward EBM (58% positive, 32% somewhat positive). Respondents thought research findings were useful (42%) or very useful (42%) to daily practice. Nearly one-half (49.8%) of respondents had conducted a primary literature search within the past year. Hospital pharmacists and pharmacists in other practice settings were more likely than community pharmacists to conduct a literature search in the past year (75%, 61%, and 30%, respectively; p < 0.001). Although 86% of respondents reported having Internet access at home, only 42% of all respondents identified that they had PubMed access at home. Common barriers to the use of EBM include lack of time (45%), physician attitudes toward pharmacist recommendations (19%), and access to resources (11%). CONCLUSIONS: Pharmacist respondents have positive attitudes toward EBM and the application of research findings to practice.

Adult↗
PubMed2005

Effect of access to anticoagulation management services on warfarin use in patients with atrial fibrillation.

STUDY OBJECTIVE: To determine the effect of access to ambulatory anticoagulation management services (AMS) on the rate of warfarin use in patients with atrial fibrillation. DESIGN: Retrospective medical record review. SETTING: Two ambulatory care clinics in the same managed care system: one with and one without access to pharmacist-managed AMS. PATIENTS: One hundred seventy-eight patients with atrial fibrillation diagnosed between June 2000 and June 2001. MEASUREMENTS AND MAIN RESULTS: Warfarin use was assessed overall and by contraindications and risk factors for stroke. Independent predictors of therapy were identified. The overall rate of warfarin use in atrial fibrillation was higher in the clinic with access to AMS than in the clinic without access (77.9% vs 61.7%, p=0.03). In patients with no known contraindications, warfarin use increased by 20.2% with access to AMS versus no access (80.2% vs 60.0%, p=0.023). Patients aged 65 years or older with one or more risk factors for stroke and no contraindications were more likely to receive warfarin in the clinic with access to AMS than in the clinic without access (85.1% vs 53.8%, p=0.001). Access to AMS was an independent predictor of warfarin use (odds ratio 2.19, 95% confidence interval [CI] 1.05-4.56). Female sex was an independent negative predictor of warfarin use (odds ratio 0.48, 95% CI 0.24-0.96). CONCLUSION: In the managed care setting, use of warfarin for stroke prophylaxis in patients with atrial fibrillation was higher in the ambulatory care clinic with access to pharmacist-managed AMS than in the clinic without access.

Age Factors↗