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At least 37 records · Page 2Linked to original sources
PubMed2004

Greater effect of enhanced pharmacist care on cholesterol management in patients with diabetes mellitus: a planned subgroup analysis of the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP).

STUDY OBJECTIVE: To determine the effect of enhanced pharmacist care on cholesterol management in patients with and without diabetes mellitus. METHODS: We conducted a planned subgroup analysis of the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP), a 54-center randomized trial of pharmacist intervention compared with usual care in patients at high risk for cardiovascular events. The patients involved had atherosclerotic disease or diabetes. We compared the effect of pharmacist intervention in patients with and without diabetes. The primary end point was a composite of performing a fasting cholesterol profile, or adding or increasing the dosage of a cholesterol-lowering drug. Secondary end points were individual components of the primary end point and change in 10-year risk for cardiovascular events, using the Framingham risk equation. RESULTS: Of the 675 patients enrolled in the SCRIP study, 294 (44%) had diabetes. Enhanced pharmacist care had a more beneficial effect on cholesterol management in those with diabetes (odds ratio [OR] 4.8) than without diabetes (OR 2.1), p=0.01. Secondary end points showed similar trends, and reduction in Framingham risk was greater in patients with diabetes than without. CONCLUSION: Pharmacist intervention for dyslipidemia appears to have a greater impact in patients with diabetes. Results of this substudy suggest that pharmacists should target this patient group for interventions in cholesterol risk management.

Aged↗
PubMed1995

Pharmacists as HIV/AIDS information resources: survey of Alabama pharmacists.

Alabama pharmacists were surveyed by researchers from the University of Alabama at Birmingham's School of Public Health in collaboration with investigators at the Schools of Pharmacy at Auburn University and Stamford University as part of a statewide pharmacists' demonstration project to mobilize pharmacists and pharmacy locations as information resources for HIV/AIDS education and prevention. The objectives of the survey were to: (1) establish a baseline of knowledge and attitudes among Alabama pharmacists about HIV/AIDS; (2) to assess Alabama pharmacists' willingness to assume the role of HIV/AIDS information resources in their communities; and (3) to identify perceived barriers to assuming the role of information resources. The results of the survey were used in the development of an educational intervention program and will be used subsequently to assess the impact of the implementation of the Alabama demonstration project. Findings from this project will serve as a basis for development of a nationwide project as part of a collaborative agreement between the Centers for Disease Control and Prevention's National Partnership Program and the Foundation of Pharmacists and Corporate America for AIDS Education.

Acquired Immunodeficiency Syndrome↗
PubMed2003

[The interchange between hospital pharmacists and pharmacists: evaluation of practical classes "chozaigijutsu-konwakai" from the participants].

We have held practical classes called chozaigijutsu-konwakai(Konwakai) for pharmacists working in drugstores every month since December 1994. Konwakai is composed of lectures and practice. The practice is carried out for pharmacists to obtain a better understanding of prescriptions and compounding them in exercises. In this study, we analyzed the answers to questionnaires distributed at the end of each konwakai to all participants. It was found that the age of participants as well as the length of compounding experience varied markedly, indicating that pharmacists of various generations are interested in konwakai. Regarding the contents of lectures and practice, the answers indicated that the practice was particularly useful, suggesting the importance of exercise for learning techniques in compounding. Since there were many requests for consultations on routine work, frequent communications between pharmacists in the hospital and drugstores appears necessary. In conclusion, regular meetings including practical classes such as konwakai are very important for pharmacists in drugstores that receive prescriptions from hospitals. Further efforts to improve the konwakai should be maid in the future.

Community Pharmacy Services↗
PubMed1996

Attitudes of community pharmacists, university-based pharmacists, and students toward on-line information resources.

The study sought to explore the attitudes of community pharmacists, university-based pharmacists, and pharmacy students before and after exposure to computerized systems of on-line information services. A 42-item attitudinal survey was administered to 21 community pharmacists, 7 university clinical pharmacist faculty, and 17 senior pharmacy students, prior to and at the end of a year of access to Grateful Med and BRS Colleague. Few significant differences were noted among the participants at baseline. No significant interaction-effect differences for type of participant or system used were found. Participants were generally positive about computers in general, the accuracy of on-line information services, their impact on knowledge and confidence, and their usefulness for pharmacists.

Adult↗
PubMed2001

The reprofessionalisation of community pharmacy? An exploration of attitudes to extended roles for community pharmacists amongst pharmacists and General Practioners in the United Kingdom.

In the light of recent developments within the British National Health Service some sociologists have suggested that the medical profession's status is under threat. They have specified a range of factors contributing to this state of affairs, such as the new consumerism; however, it is thought that attempts by other, related occupations at reprofessionalisation are particularly significant in this trend. It may be possible to understand recent initiatives at extending community pharmacists' role within this framework. This paper suggests that while community pharmacy is developing strategies to enhance its professional status, it is not so much an attempt at usurping general practitioners'(GPs) (primary care doctors') role as a bid for survival, especially on the part of the rank and file. However, GPs do not necessarily see the initiatives in this light. Although many GPs are accommodating some changes in community pharmacy, they also perceive some of the initiatives as a threat to their autonomy and control, this was especially evident in representative bodies such as the Local Medical Committee. Doctors' accommodating attitudes were qualified with traditional attitudes of dominance such as 'limitation' and 'exclusion'. Such attitudes could prevent community pharmacy from achieving professional status. However, there is also evidence that pharmacists themselves contribute to this situation because many of them also attribute ultimate authority to doctors. Moreover, they are held back by internal occupational divisions particularly between retail pharmacists and employee pharmacists, with the former being the most insecure.

Attitude↗
PubMed1994

Maslach Burnout Inventory: factor structures for pharmacists in health maintenance organizations and comparison with normative data for USA pharmacists.

This study compared the factor structure and burnout scores obtained on the Maslach Burnout Inventory from 84 pharmacists in Health Maintenance Organizations (HMO) with the normative data for USA pharmacists. Results provided empirical support for the reliability and validity of the inventory to measure burnout within the profession of pharmacy. Values of Cronbach coefficient alpha for subscales of Emotional Exhaustion, Depersonalization, and Personal Accomplishment were similar to those obtained with the normative sample. Factor analysis was conducted to yield the best three-factor solution. Derived factor loadings matched the three hypothesized subscales. On Personal Accomplishment the mean subscale score for HMO pharmacists was significantly higher than the normative score. Given limitations of the small sample, research is indicated to substantiate use of the inventory among HMO pharmacists.

Adult↗
PubMed2005

[A historical and topical point: the pharmacists of the armies become again pharmacists, a title they had formerly...].

The decree number 2004-534 of june 14, 2004, has suppressed the name chemist in the title of the french military pharmacists. This title of chemist was originally used in the Navy, officially since 1919, where the pharmacists had the responsability of the laboratories of analytical chemistry. All the military pharmacists received it in 1965. However, pharmacists of the Army have had the possibility of becoming chemists in 1920. But this new title will certainely not prevent them to be occupied with the questions of chemistry in the french army.

Chemistry↗
PubMed1998

The role of the community pharmacist as an oral health adviser--an exploratory study of community pharmacists in Johannesburg, South Africa.

The aim of this study was to examine to what extent community pharmacists are currently acting as dental advisers, and to determine whether they would be willing to extend this role in the future. The data were collected by means of a random survey of community pharmacists in Johannesburg, and included: incidence and nature of dental enquiries; dental knowledge with respect to preventive measures; willingness to engage in promotion of oral health and prevention of oral disease. The results reveal an anomaly. On one hand community pharmacists seemed to be handling a substantial amount and range of inquiries related to oral health and dental disease, and were willing to fulfil a meaningful role as oral health advisers. On the other hand, however, they have received very little education on these matters and seemed to operate in isolation from dentists and other health professionals, which raises doubts about their ability to play a meaningful role in primary health care. Nevertheless, it is quite feasible for community pharmacists to play the role as envisaged, provided additional training and networking with dentists, oral hygienists, dental therapists and other relevant health professionals takes place.

Community Pharmacy Services↗
PubMed1981

Role of the clinical pharmacist in improving drug therapy. Clinical pharmacists in outpatient therapy.

We analyzed the effectiveness of clinical pharmacists in improving medical records and patient compliance with outpatient drug regimens. Records of patients followed up in a rheumatology and renal clinic were reviewed and compared with their pharmacy files. Records were evaluated for completeness and accuracy of drugs ordered by the clinic physician. Compliance was estimated by examining drug refills. This review was performed before (control group) and nine months after (study group) the introduction of a clinical pharmacist into the clinics. A six-month analysis demonstrates that the pharmacist significantly improved drug documentation, decreased the duplication of prescriptions, and improved compliance of prescribed drugs. The study suggests that the pharmacist improves documentation of drug therapy and estimated patient compliance; the decrease in duplicate prescriptions could prevent the risk of overdose and does reduce drug costs.

Ambulatory Care↗
PubMed2002

A randomized trial of the effect of community pharmacist intervention on cholesterol risk management: the Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP).

BACKGROUND: Despite clear evidence for the efficacy of lowering cholesterol levels, there is a deficiency in its real-world application. There is a need to explore alternative strategies to address this important public health problem. This study aimed to determine the effect of a program of community pharmacist intervention on the process of cholesterol risk management in patients at high risk for cardiovascular events. METHODS: A randomized controlled trial conducted in 54 community pharmacies (1998-2000) included patients at high risk for cardiovascular events (with atherosclerotic disease or diabetes mellitus with another risk factor). Patients randomized to pharmacist intervention received education and a brochure on risk factors, point-of-care cholesterol measurement, referral to their physician, and regular follow-up for 16 weeks. Pharmacists faxed a simple form to the primary care physician identifying risk factors and any suggestions. Usual care patients received the same brochure and general advice only, with minimal follow-up. The primary end point was a composite of performance of a fasting cholesterol panel by the physician or addition or increase in dose of cholesterol-lowering medication. RESULTS: The external monitoring committee recommended early study termination owing to benefit. Of the 675 patients enrolled, approximately 40% were women, and the average age was 64 years. The primary end point was reached in 57% of intervention patients vs 31% in usual care (odds ratio, 3.0; 95% confidence interval, 2.2-4.1; P<.001). CONCLUSIONS: A community-based intervention program improved the process of cholesterol management in high-risk patients. This program demonstrates the value of community pharmacists working in collaboration with patients and physicians.

Alberta↗
PubMed1999

Reduction in heart failure events by the addition of a clinical pharmacist to the heart failure management team: results of the Pharmacist in Heart Failure Assessment Recommendation and Monitoring (PHARM) Study.

BACKGROUND: The multidisciplinary approach to managing heart failure has been shown to improve outcomes. The role of a clinical pharmacist in treating heart failure has not been evaluated. METHODS: One hundred eighty-one patients with heart failure and left ventricular dysfunction (ejection fraction <45) undergoing evaluation in clinic were randomized to an intervention or a control group. Patients in the intervention group received clinical pharmacist evaluation, which included medication evaluation, therapeutic recommendations to the attending physician, patient education, and follow-up telemonitoring. The control group received usual care. The primary end point was combined all-cause mortality and heart failure clinical events. All clinical events were adjudicated by a blinded end point committee. RESULTS: Baseline characteristics were similar except for slightly higher age in the intervention group. Median follow-up was 6 months. All-cause mortality and heart failure events were significantly lower in the intervention group compared with the control group (4 vs 16; P= .005). In addition, patients in the intervention group received higher angiotensin-converting enzyme inhibitor doses as reflected by the median fraction of target reached (25th and 75th percentiles), 1.0 (0.5 and 1) and 0.5 (0.1875 and 1) in the intervention and control groups, respectively (P<.001). The use of other vasodilators in angiotensin-converting enzyme inhibitor-intolerant patients was higher in the intervention group (75% vs 26%; P= .02). CONCLUSIONS: Outcomes in heart failure can be improved with a clinical pharmacist as a member of the multidisciplinary heart failure team. This observation may be due to higher doses of angiotensin-converting enzyme inhibitors and/or closer follow-up.

Aged↗
PubMed2005

Interdisciplinary working between community pharmacists and community nurses: the views of community pharmacists.

Changing roles within primary care have been heralded by the implementation of nurse prescribing and the need to maximize skills within the existing workforce. This paper describes the views of community pharmacists regarding nurse prescribing and interdisciplinary working in primary care. Limited contact was reported between community pharmacists and prescribing nurses which contrasted with the reported frequency of contact with other health professionals. The community pharmacists reported positive views regarding teamworking and nurse prescribing which it is suggested provides a readiness to develop interdisciplinary working which hitherto had foundered on lack of contact and in consequence insufficient understanding of roles and a shared view of primary care.

Attitude of Health Personnel↗
PubMed2005

Long-term impact of a community pharmacist intervention on cholesterol levels in patients at high risk for cardiovascular events: extended follow-up of the second study of cardiovascular risk intervention by pharmacists (SCRIP-plus).

STUDY OBJECTIVE: To determine the effect of a community pharmacist intervention in patients at high risk for coronary heart disease on low-density lipoprotein cholesterol (LDL) levels 1 year after completion of the Second Study of Cardiovascular Risk Intervention by Pharmacists (SCRIP- plus ). METHODS: Patients who completed the original study were invited to make a single return visit to their community pharmacy so that the pharmacist could measure their fasting LDL level using a point-of-care device. The primary outcome was change in LDL level from the 6-month (final) visit to the extended follow-up evaluation. RESULTS: Of the 359 patients who completed the original 6-month visit, data were collected for 162 (45%) patients. The mean +/- SD LDL level at completion of the original study was 107.9 +/- 33.6 mg/dl (2.79 +/- 0.96 mmol/L) (an increase of 2.7 mg/dl [0.07 mmol/L], 95% confidence interval -19.3-7.3 [-0.5-0.19]). Sixty-one (38%) patients were at the target LDL level (< 96.7 mg/dl [< 2.50 mmol/L]). CONCLUSION: The LDL reduction was maintained 1 year after completion of the extended follow-up. Since most patients were still not at the target LDL level, this finding suggests that continuing intervention is necessary to help patients reach this target.

Aged↗
PubMed2001

[Role of pharmacists in the management of asthma in Africa. Survey among pharmacists from the city of Abidjan].

This questionnaire survey was conducted to assess delivery of asthma drugs in community pharmacies in Abidjan, Ivory Coast. Participation rate was 88.69%. All participants stated they provide care for asthma patients either during acute episodes or between acute episodes. It was found that a considerable number of patients come to community pharmacies for care without prior medical prescription. In case of acute episodes, care is provided by the pharmacist in 59.80% of the cases. Aerosol devices are the most widely used although the technical procedures required for correct inhalation were found to be poorly understood by pharmacists. Slow-release corticosteroids are widely delivered for chronic care. Pharmacists also provide information and advice on drug compliance and concerning the importance of regular medical care and eviction of allergens.

Anti-Asthmatic Agents↗
PubMed2001

Economic impact of community pharmacist intervention in cholesterol risk management: an evaluation of the study of cardiovascular risk intervention by pharmacists.

The Study of Cardiovascular Risk Intervention by Pharmacists, a randomized, controlled trial in over 50 community pharmacies in Alberta and Saskatchewan, Canada, demonstrated that a pharmacist intervention program improved cholesterol risk management in patients at high risk for cardiovascular disease. In a substudy, costs and consequences were analyzed to describe the economic impact of the program. Two perspectives were taken: a government-funded health care system and a pharmacy manager. Costs were reported in 1999 Canadian dollars. Incremental costs to a government payor and community pharmacy manager were $6.40/patient and $21.76/patient, respectively, during the 4-month follow-up period. The community pharmacy manager had an initial investment of $683.50. The change in Framingham risk function for the intervention group from baseline also was reported. The 10-year risk of cardiovascular disease decreased from 17.3% to 16.4% (p<0.0001) during the 4 months. The intervention program in this study led to a significant reduction in cardiovascular risk in the intervention group during the 4-month follow-up period. The incremental cost to provide the program appeared minimal from both government and pharmacy manager perspectives. It is hoped that these results could support negotiations for reimbursement of clinical pharmacy services with payors.

Aged↗
PubMed1979

Legal implications of the pharmacist's expanded clinical roles: a challenge to the clinical pharmacist's competencies.

Various sources have put forward the pharmacist as a clinician in addition to traditional functions. These expanded duties have been described as being beneficial to the health care system. This paper describes a project involving the clinical judgment and expertise of the doctor of pharmacy. The project validity and the competency of the doctor of pharmacy program(s) were challenged in the federal courts. The ruling in the case suggests a legal challenge to the pharmacist's clinical function(s).

Drug Prescriptions↗