PubMed Health⌕ Search

Biomedical subjects

Pauline Norris

Publications and source records attributed to Pauline Norris.

15 recordsLinked to original sources
PubMed2006

The influence of PHARMAC's National Hospital Pharmaceutical Strategy on Quality Use of Medicines activities in New Zealand hospitals.

AIM: To determine the influence of PHARMAC's National Hospital Pharmaceutical Strategy (NHPS) on Quality Use of Medicine (QUM) activities in New Zealand hospitals. METHOD: In July 2002 and July 2004, a questionnaire-based cross-sectional survey on QUM activities was administered to chief pharmacists at all 30 New Zealand public hospitals employing a pharmacist (29 in July 2004), to examine pre and post-NHPS activity. RESULTS: Both surveys achieved a 97% response rate. A range of QUM activities were undertaken in hospitals. Overall, Drug Utilisation Reviews (DURs) significantly decreased (67 vs 42) (p<0.05), although antimicrobial guidelines and intranet formularies significantly increased (p<0.05). PHARMAC's QUM initiatives, still evolving, did not appear to positively influence QUM activity in 2002-4. In 2004, PHARMAC put their original plans to coordinate QUM activity on hold and chose to participate in the processes of the Safe and Quality use of Medicines Group (SQM). Formed in 2003 by the District Health Boards of New Zealand, SQM focused attention on anticoagulants and high-risk medicines. CONCLUSION: QUM activities, similar in both periods, were not positively influenced by PHARMAC's Strategy.

Cross-Sectional Studies↗
PubMed2006

Establishing a baseline for the monitoring of medicines availability for children in the UK: 1998-2002.

AIM: To determine changes in the availability, in terms of licensing and formulations, of medicines for children in the UK between 1998 and 2002. METHODS: Using the Association of British Pharmaceutical Industry (ABPI) Compendium of Data Sheets and Summaries of Product Characteristics (SPC) 1998 and the Medicines Compendium 2002, licensed medicines available in the UK in the calendar years 1998 and 2002 were examined. RESULTS: In 1998, 61% of chemical entities/fixed-dose combinations were licensed in some form for children compared with 64% in 2002. Of the chemical entities/fixed-dose combinations with oral formulations, 250 (33%) in 1998 had an oral formulation suitable for use by children and in 2002 there were 284 (34%). Of the 129 new chemical entities registered in the UK between 1998 and 2002, only 30 (23%) were licensed for under the age of 12 years and 19 (15%) for the neonatal age group. A total of 480 medicines licensed for children were withdrawn from marketing but only cisapride and primidone had no generic or therapeutic alternatives. CONCLUSION: Although there was improvement in the availability of medicines for children in the UK over the 5-year period (1998-2002), considerable inequities still existed between children and adults.

Child↗
PubMed2006

How many antibiotic prescriptions are unsubsidised in New Zealand?

AIMS: To determine the proportion of prescriptions for antibiotics which were unsubsidised, in one town in one year, and to use this to develop a model which could be used to estimate the number of unsubsidised prescriptions. METHODS: Data on all prescriptions for antibiotics during 2002 were extracted from pharmacy computers in one town. Data were obtained from PharmHouse database on all subsidised prescriptions from the town pharmacies during 2002. (The PharmHouse database is a subset of the New Zealand Health Information System database and contains records of all the claims for medicines dispensed within New Zealand.) These were compared and the proportion of unsubsidised prescriptions for each antibiotic calculated. Weighted linear regression was used to develop a model of the relationship between the percentage of each drug subsidised, and patient and prescription characteristics obtainable in PharmHouse. RESULTS: 64.4% of antibiotic dispensings in the study town were subsidised, and therefore captured by the PharmHouse database. The proportion varied substantially between different antibiotics. For particular drugs, the proportion of drugs unsubsidised could be predicted by the price of the drug, the number of days it was prescribed for, and the number of patients aged under six who received subsidised prescriptions. CONCLUSIONS: Previous studies using PharmHouse data are likely to have significantly underestimated the extent of drug use. Further research is needed on whether this model can help to estimate the extent of unsubsidised prescriptions.

Anti-Bacterial Agents↗
PubMed2006

Antibiotic use for upper respiratory tract infections before and after a education campaign as reported by general practitioners in New Zealand.

AIM: To assess change in general practitioner (GP) management of upper respiratory tract infections (URTIs) during a nationwide project to reduce antibiotic consumption in a half-decade (1998 to 2002-3). METHOD: Telephone survey of 100 randomly selected Auckland GPs in 1998 and 2002-3. Sixty-five GPs were in both samples. RESULTS: A 69% response rate was recorded for an additional 35 GPs recruited in 2002-3. Of the 65 GPs interviewed at both periods, the number agreeing that most patients who consult for URTIs expect antibiotics decreased from 82% to 57%. Seventy-seven percent of GPs reported they were less likely to prescribe antibiotics, with over a quarter believing this change resulted from both GP and patient education. Common situations where GPs increased their antibiotic prescribing were patient request/expectation; smokers; older; or having sinusitis, purulent sputum, purulent nasal discharge, or imminent overseas travel. Thirty-nine percent of GPs reported an increasing use of delayed prescriptions over the half-decade. Reported use of amoxicillin clavulanate reduced from 21% to 4% (p<0.001). CONCLUSION: The GPs' response that they are less likely to prescribe antibiotics is consistent with the reduction in national antibiotic use. This may be related to the national campaign. The reduction may be a combination of combined GP and patient change.

Anti-Bacterial Agents↗
PubMed2006

Public views and use of antibiotics for the common cold before and after an education campaign in New Zealand.

AIMS: To assess changes in public knowledge, attitudes, and reported behaviour of antibiotic use in the management of the common cold and to compare with results of a 1998 study. The context is a nationwide project to reduce the consumption of antibiotics. METHOD: Cross-section survey: telephone interviews of random sample of consenting Auckland telephone subscribers aged over 15 years comparing 1998 and 2003 responses. RESULTS: A 55% response rate of eligible participants was recorded. No change was noted between 1998 and 2003 in public awareness that antibiotics are not helpful in treating viral infections (38%). However there was a significant reduction in those attending doctor for the common cold (24% to 15%). In 2003, patients were less likely to receive antibiotic prescription and more likely to receive a delayed prescription. CONCLUSIONS: The majority of general public still do not understand that the common cold does not need antibiotic treatment. The advertising campaign may have reduced doctor prescribing hence the reduction in antibiotic use from 1998 to 2003.

Adolescent↗
PubMed2006

Pediatric licensing status and the availability of suitable formulations for new medical entities approved in the United States between 1998 and 2002.

The availability of new medical entities for children in the United States was examined at the time of marketing approval and 3 years later. New medical entities approved in the United States in each of the years 1998 to 2002 were identified using the Center for Drug Evaluation and Research Web site. Each Physicians' Desk Reference published in the years 1998 to 2005 was examined to determine formulations and licensing information. For the 133 new medical entities licensed to be marketed in the period 1998 to 2002, the number licensed for children increased from 5 (4%) to 39 (29%) in the 3 years after registration. After 3 years' marketing, 79 (59%) drugs were in formulations suitable for children, and 27 (20%) of the new medical entities were licensed and had a suitable formulation for children. Incentives to improve access for children to medicines should focus more on demonstration of improved access.

Adolescent↗
PubMed2005

Capturing data on medicines usage: the potential of community pharmacy databases.

AIMS: The initial aim of the research projects was to examine the geographic distribution, patronage patterns, and loyalty of prescription clients around individual community pharmacies. A second aim was to explore the geographical and socioeconomic variation in the use of prescription medicines and prescribing trends both between and within therapeutic classes. METHODS: Geographic Information Systems (GIS) technology (including the tabulating, geocoding, and mapping functions) was used to analyse the information that is held in community pharmacy databases. RESULTS: These studies demonstrated the use of this technology to show variation in local use of prescription medicines, at both an individual level and a population level, through the analysis of data already held in community pharmacy databases. CONCLUSION: The use of GIS technology and pre-existing community pharmacy databases enables improved data capture on the prescription--and medication-related behaviour of health-service consumers.

Community Pharmacy Services↗
PubMed2005

Advertising of medicines on New Zealand television.

AIMS: To measure the frequency of advertising of medicines on New Zealand television and to describe the distribution of advertising. METHODS: A stratified random sample of 35 days (577.5 hours) of television was video-recorded, including five free to air channels for each day of the week. Videotapes were watched, then advertisements were recorded on a pre-designed form. RESULTS: 340 advertisements for medicines were identified, an average of 1 per 102 minutes; 37% of advertisements were for medicines available for general sale, 24% for dietary supplements, 21% for pharmacy- or pharmacist-only medicines, and 18% for prescription-only medicines. Four channels had similar amounts of advertising. Channels varied in the kind of medicines they had advertisements for. There were more advertisements per hour in the afternoon than in the morning or evening. Advertisements for medicines were found in a wide range of programmes, including children's programmes. CONCLUSIONS: People who watch particular programmes, or who watch television at some times of days may be exposed to considerably more than one medicine's advertisement per 102 minutes. While this study does not examine the effect of medicines advertisements on consumer behaviour, previous research suggests this may be significant.

Advertising↗
PubMed2005

Demographic variation in the use of antibiotics in a New Zealand town.

AIMS: To describe the use of antibiotics in one New Zealand town, and to investigate relationships between antibiotic use and gender, age, and socioeconomic status. METHODS: Data from dispensing computers in all community pharmacies in the town were extracted. All dispensings of antibiotics to residents in the town were identified. Discrete individuals were identified and, where possible, linked with data on gender, age and the socioeconomic status (NZDep) of the area in which they lived. RESULTS: 42% of residents in the town received one or more dispensing of antibiotics in 2002. These people, on average, received 2.1 dispensings. Children received antibiotics more often than adults, females more than males and there was a strong relationship between socioeconomic status and antibiotic dispensings. CONCLUSIONS: Rates of antibiotic use in the community are strongly influenced by age, gender and socioeconomic status.

Adult↗
PubMed2005

Quality Use of Medicines activities in New Zealand hospitals from 2000 to 2002.

AIMS: To review current activities promoting Quality Use of Medicines (QUM) in New Zealand hospitals in 2000-2002, and to identify attitudes to possible centralisation of activities. METHOD: Questionnaire-based cross-sectional survey of 30 New Zealand public hospitals. Respondents were chief pharmacists in all hospitals employing at least one pharmacist. RESULTS: Twenty-nine hospitals (96.7%) responded; 3 were linked to a tertiary hospital for QUM activities. From the 26 independent hospitals, 64 Drug Utilisation Reviews (DURs) and 63 hospital-wide campaigns were reported, and 103 medicines information bulletins produced. Nineteen (63.3%) hospitals had their own hospital formulary. Twenty-four percent of respondents reported they would use centrally-developed guidelines only if in total agreement with their own. All hospitals reported disseminating drug expenditure information; feedback comments were predominantly from financial and nursing managers. All hospitals reported providing some form of drug information service (DI) and two-thirds a drug utilisation service (DU); 70% of total dedicated staff-time to these services was in tertiary hospitals. An increase in staff-time (fulltime-equivalent staff/100 beds) for clinical pharmacists, and DU+DI pharmacists, was associated with an increase in the number of DURs undertaken (p<0.05). CONCLUSION: A range of activities to promote QUM were undertaken in New Zealand hospitals, with greater activity in tertiary and secondary hospitals. Respondents reported some resistance to centrally-developed guidelines. Promotion of QUM may be assisted by an increase in clinical pharmacy resources.

Cross-Sectional Studies↗
PubMed2005

Effect of the pediatric exclusivity provision on children's access to medicines.

AIMS: To determine the paediatric licensing status in the USA, UK, Australia and New Zealand of the 79 medicines granted paediatric exclusivity in the USA, and to assess the importance of those medicines to paediatric practice. METHODS: The medicines granted a patent extension in the USA as of 10 November 2003 were identified from the FDA website. Data on paediatric licensing were obtained from the Physicians Desk Reference (USA), the Electronic Medicines Compendium (UK), the Australian Prescription Products Guide (Australia) and the MedSafe website (New Zealand). A questionnaire was administered to seven paediatric consultants to assess the importance of the 79 PEMs for use in children. The questionnaire sought opinions on each drug, by age grouping, regarding: usefulness in patients with the condition, number of patients likely to be treated with each drug in a year, and acceptable therapeutic alternatives. RESULTS: Fifty-eight (73%) of the medicines had attained paediatric licensing in the USA. Sixty were licensed for adults in all four countries and of these 45 (75%) were licensed for children under 12 years in the USA compared with 31 (52%) to 33 (55%) for the other three countries. The proportion of these medicines licensed for children under 1 month, under 2 years and under 6 years of age ranged from 10% to 58% and there were no significant differences between the countries. For all four countries perceived usefulness and predicted numbers of patients both had some influence on the odds of a medicine having paediatric licensing. CONCLUSIONS: Improvements in licensing of some medicines for children have occurred in the USA, relative to the UK, Australia and New Zealand, subsequent to the Paediatric Exclusivity Provision. Improvements occurred for children over the age of six, but not for younger children.

Age Factors↗
PubMed2002

Which sorts of pharmacies provide more patient counselling?

OBJECTIVE: This paper investigates the characteristics of pharmacies that are associated with the degree of counselling provided to customers purchasing medicines. METHODS: Twelve 'mystery shoppers' (research assistants posing as normal customers) purchased restricted medicines at 180 pharmacies around New Zealand. One drug (diclofenac) and one class of drugs (vaginal antifungals) were purchased. The amount of counselling provided was recorded, and linked to profile data on the pharmacies, obtained through a questionnaire, from Census data, and from direct observations of pharmacies. RESULTS: Location within a city, a large town, or strip shopping did not affect the level of counselling pharmacies provided. Pharmacies adjacent to medical centres gave significantly less counselling to diclofenac purchasers than other pharmacies. No consistent relationship was found between pharmacy size and the level of counselling provided. There were large differences between areas of the country. A strong negative relationship was found between the amount of counselling given about thrush, and the proportion of Pacific Island people in the population around the pharmacy. Although only some results reached statistical significance, there seems to have been a similar trend for pharmacies to provide less counselling in areas with more Maori people and with higher levels of social deprivation. CONCLUSIONS: Regional variation in the provision of pharmacy services, and in particular the tendency for pharmacies to provide less counselling in areas that are likely to have higher health care needs, must be addressed if pharmacies are to fulfil their potential as health care providers.

Chi-Square Distribution↗