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PubMedDate not supplied

[Clinical pharmacy in lebanon: a pilot study regarding health care professionals' opinion].

INTRODUCTION: In Lebanon, clinical pharmacy is not professionally applied, despite being taught and required by the accreditation system of hospitals established by the Ministry of Health. The objective of our study is to evaluate the knowledge and attitude of medical professionals regarding the concept of clinical pharmacy. METHODS: It is a descriptive cross-sectional study, conducted in hospitals with doctors, nurses and administrators. Standardized self-filling questionnaires were distributed. RESULTS: The majority of physicians and of nurses found a clinical pharmacist intervention beneficial. All administrators were ready to accept a clinical pharmacist in their institution, since his/her presence would contribute to the reduction of hospitalization costs, mortality and morbidity. DISCUSSION: Medical professionals have a clear and positive idea regarding clinical pharmacy. CONCLUSION: Different steps are necessary in order to integrate clinical pharmacy in the Lebanese health care system.

Attitude of Health Personnel↗
PubMedDate not supplied

Medicare managed care: consumers' perspectives.

The 1997 CareData survey of members of Medicare risk health maintenance organizations (HMOs) measured the degree of satisfaction of Medicare managed care members with emphasis on pharmacy-related issues and specific disease treatment perceptions. The survey was a 12-page, self-administered questionnaire assessing more than 150 issues; it was distributed to 23,140 known enrollees of Medicare risk HMOs by their former employers between May and July 1997. A total of 12,265 Medicare beneficiaries enrolled in more than 70 major health plans in 23 US geographic markets completed and returned their questionnaires (response rate, 53%). The pharmacy benefit was cited by 75% of the respondents as the reason for joining their plan; 81% of the respondents reported being highly satisfied with the pharmacy benefit overall, with regional variations from a low of 60% to a high of 82%. The issues driving enrollees' satisfaction after being in their plan for a minimum of 6 months and a mean length of slightly more than 3 years were: satisfaction with customer service and plan administration (11.6% explained variance); the plan's concern for the member's well-being (10.6%); the belief that the care improved the member's health and well-being (9.2%); satisfaction with choice of specialists (5.3%); satisfaction with the pharmacy plan (5.1%); and satisfaction with the primary care physician (4.8%). Significant variations were seen among regions, plans, and the self-reported health status of the respondents.

Consumer Behavior↗
PubMed2004

[Drug administration to paediatric inpatient].

OBJECTIVE: Available commercial drugs in France are often unsuitable for children. The aim of this study was, for every medicinal form orally or parenterally administered, to identify and to quantify difficulties met by the nurses administering drugs to paediatric inpatients and to propose solutions to main identified problems. MATERIAL AND METHOD: The study was realized in 14 hospitals by direct observation. The observer, provided with a questionnaire, followed during a time slot of at least 2 h for one or several nurses and raised all the oral or injectable administrations. RESULTS: One thousand and nine hundred forty-six observations were performed. The children were 12.6 +/- 17 months old, and weighed 8.5 +/- 9.4 kg. Injectable drugs: half of the observations showed a posology and a mode of dilution not corresponding to the summary of product characteristics. Eight percent of orally administered drugs were injectable drugs. In 35.5% of cases, administered amount was lower than the quarter of the present quantity in the therapeutic unity. The rest of the therapeutic unity was thrown (77.2% of cases). Liquid oral forms: liquid oral forms were ready for use regarding 83.8% of cases. The medicine was readministered to the same patient (23.5%), and/or administered to other patients (80.0%). Capsules: 66.9% of the administered capsules were prepared by the hospital pharmacies. The pharmacies organized with an unit dose drug dispensing system produced significantly more preparations than those working by global distribution (P < 0.0001). In 58.4% of cases, the administered capsule was an off-label drug. Tablets: 46% of drug administration concerned a tablet without pediatric indication. 46.7% of tablets were cut, 74% were crushed. Bags: in 35.2% of observations, the bag was not administered in its entirety. CONCLUSION: Our study confirms the unsuitability of drugs to paediatric inpatients, the necessity of recommendations of good practices in the administration of drugs to paediatric inpatients, and proposes corrective actions.

Child↗
PubMed1996

Justifying and implementing an ophthalmic pharmacy practice.

The justification for and implementation of an ophthalmic care satellite pharmacy at the eye center of a university hospital are described. A pharmacy dedicated to ophthalmic care was developed in conjunction with a new eye care center. The eye center pharmacy staff, in consultation with other members of the pharmacy department, determined the services to be provided: preparing pharmaceuticals for operating room and clinic use, performing medication evaluations for all patients undergoing surgery, taking and documenting medication histories, providing distributive services, counseling surgical patients about their prescriptions and the care of their eyes after surgery, and checking on patients after discharge. Services were implemented after feedback was received from ophthalmology department physicians and from eye care pharmacies at other institutions. Before working in the eye center pharmacy, pharmacists received inservice instruction. To assist in its medication evaluation and counseling efforts, the pharmacy introduced a medical information form, which is used for both surgical and clinic patients. An adverse drug reaction-reporting program was also introduced. Establishment of a satellite pharmacy specializing in ophthalmic care resulted in improved outpatient and surgical pharmacy services and better provision of information on ophthalmic pharmaceuticals.

Humans↗
PubMed1987

Pharmacy practice in the United States Navy.

The current status of pharmaceutical services in the United States Navy Medical Department is described. The mission of the Navy Medical Department is to provide comprehensive health care to the more than 2.7 million active-duty and retired Navy personnel and their dependents. A total of 144 Navy pharmacy officers, 50 civilian pharmacists employed by the Navy, and 650 Navy-trained technicians practice in 32 Naval hospitals. All Naval hospitals have unit dose drug distribution systems and complete i.v. admixture services as well as an extensive series of ambulatory-care clinics. Clinical pharmaceutical services provided in these facilities vary depending upon the size and purpose of the facility. Pharmaceutical services are supported by the TRIPHARM computer system. Navy pharmacy officers may choose to pursue full-time graduate studies or may follow career paths outside of pharmacy. Navy pharmacists currently serve in a variety of administrative positions, as instructors and curriculum directors in the two Navy technician training schools, and as commanding officers of drug screening laboratories. In times of combat, Navy pharmacists may be assigned to hospital ships or to medical facilities near the line of combat. The ability of Navy pharmacists to respond to innovations in pharmacy practice will be the key to the future success of Navy pharmacy practice. One of the major challenges facing Navy pharmacy in the next few years is the recruitment of qualified pharmacy officers.

Ambulatory Care↗
PubMed1991

Documentation of cost savings from decentralized clinical pharmacy services at a community hospital.

A pilot program designed to justify the costs of clinical pharmacy services through the use of workload documentation cards is described. At this community hospital, defining a philosophy of care was the first step in developing and implementing decentralized services. A patient-specific care model was chosen, and principles of patient-oriented service were outlined. Daily workload documentation cards were designed for recording pharmacist activities; distribution functions were noted on one side, clinical activities on the other. Direct cost savings that could be attributed to the clinical pharmacists' drug therapy recommendations were quantified and recorded on a second form. Sixty-three beds in four hospital units were chosen as sites of the pilot effort. At the end of the six-month study, an analysis of the cost-savings forms documented that clinical pharmacist activities produced an average savings of $1.49 per patient day. The break-even point at which pharmacist salary expenses would equal direct cost savings was determined to be one clinical pharmacist per 80 patient beds. A request to expand clinical services at the hospital was granted. By documenting clinical and distributive activities on a simple form and quantifying the savings associated with clinical interventions, this pilot program demonstrated the cost-effectiveness of clinical pharmacy services.

Centralized Hospital Services↗
PubMed1975

Implementation of the medication technician concept.

The implementation of a pharmacy-controlled medication technician program is discussed. Qualified candidates are selected and trained to administer medications to patients under the supervision of a pharmacist. A centralized unit dose drug distribution system is employed. The responsibilities of the technicians and the pharmacists are presented.

Allied Health Personnel↗
PubMed1985

Challenges in purchasing and inventory control.

In this concluding installment in a multipart series, issues that should be considered in the improvement of hospital pharmacy purchasing and inventory control systems are presented. Pharmacists must be aware of possible variation in bioavailability among different formulations of the same drug and evaluate new vendors critically. Hospital pharmacists and industry representatives should strive for a cooperative relationship by fostering ongoing dialogue. Pharmacists must continue to demand competitive bid prices on generically equivalent products of equal quality. Firm contact prices cannot be expected if product use estimates are unreliable. It is unethical to encourage additional price reductions on competitive products after a formal bid has been received. Institutions should limit their participation to one group purchasing organization or wholesaler for the competitive bid process. Inventory management through methods such as ABC analysis, economic-order quantities, calculated optimum reorder points, and other quantitative measurements should become commonplace. The use of data processing systems and devices can enable pharmacists to become more proficient at pharmaceutical purchasing and inventory control. The acquisition and distribution of pharmaceuticals in health-care institutions require good management to capture the opportunities in this area for pharmacy to contribute to fiscally sound health care.

Drug Industry↗
PubMed2004

Gastroprotection during the administration of non-steroidal anti-inflammatory drugs. A drug-utilization study.

There has been an increase of anti-ulcer drug consumption in Spain. A high proportion of this consumption may be due to the use of those drugs as gastroprotective agents when co-prescribed with non-steroidal anti-inflammatory drugs (NSAIDs). The aim of this study was to learn how these treatments are being used: the prevalence of use, the type of drug and the main features of patients. A sample of patients going to pharmacies with a NSAID prescription, with or without a gastroprotective agent, was obtained. A survey questionnaire was distributed to learn clinical and demographic data of the patients. Of the 942 patients interviewed, 41.6% were co-treated with a gastroprotective agent in addition to the NSAID. Most of these patients received proton-pump inhibitors and, to a lesser extent, histamine-2-receptor antagonists, antacids and prostaglandin analogues. The use of gastroprotective agents increased with age, treatment duration and illness chronicity; specialists prescribed a higher proportion of those co-treatments than did general practitioners. There was a high prescription rate of gastroprotective agents; in general, these were used according to recommendations. However, the type of gastroprotective agents being used does not seem to be justified by the current guidelines: histamine-2-receptor antagonists and antacid drugs have not proved their efficacy in this indication. The fact that one in four treatments with gastroprotective drugs was issued to patients without associated risk factors identifies a possible problem where an intervention could be appropriate.

Adult↗
PubMed2005

Academic administrators' attitudes towards interprofessional education in Canadian schools of health professional education.

Interprofessional education is an approach to educating and training students and practitioners from different health professions to work in a collaborative manner in providing client and/or patient-centred care. The introduction and successful implementation of this educational approach is dependent on a variety of factors, including the attitudes of students, faculty, senior academic administrators (e.g., deans and directors) and practitioners. The purpose of this study was to examine attitudes towards interprofessional teamwork and interprofessional education amongst academic administrators of post-secondary health professional education programs in Canada. A web-based questionnaire in English and French was distributed via e-mail messaging during January 2004 to academic administrators in Canada representing medicine, nursing, pharmacy, social work, occupational therapy and physiotherapy post-secondary educational programs. Responses were sought on attitudes towards interprofessional teamwork and interprofessional education, as well as opinions regarding barriers to interprofessional education and subject areas that lend themselves to interprofessional education. In general, academic administrators responding to the survey hold overall positive attitudes towards interprofessional teamwork and interprofessional education practices, and the results indicate there were no significant differences between professions in relation to these attitudinal perspectives. The main barriers to interprofessional education were problems with scheduling/calendar, rigid curriculum, turf battles and lack of perceived value. The main pre-clinical subject areas which respondents believed would lend themselves to interprofessional education included community health/prevention, ethics, communications, critical appraisal, and epidemiology. The results of this study suggest that a favourable perception of both interprofessional teamwork and interprofessional education exists amongst academic administrators of Canadian health professional education programs. If this is the case, the post-secondary system in Canada is primed for the introduction of interprofessional education initiatives which support the development of client and patient-centred collaborative practice competencies.

Administrative Personnel↗
PubMed1999

[Evaluation by HIV/AIDS specialists of risk of HIV infection in university students, based on different sex practices].

To detect the beliefs concerning the risk levels related to several sexual practices/habits and the HIV infection among undergraduate students and to compare their opinion with the AIDS experts were the objectives of this study. A 25-item questionnaire (Likert Probability Scale) about sexual practices/habits were answered by undergraduate students enrolled in the courses of nursing, medical school, pharmacy-biochemistry, psychology. Based on Factorial analysis and by using the Varimax Rotation System, 25 patients were distributed in 7 factors, and 5 patients were excluded. From the 20 patients, 5 were reunited in 2 factors and studied in this paper. Factor X reunited the patients 1 (vaginal intercourse with condom) and 2 (anal sex with condom). In factor Y the patients included were: 3 (heterosexual intercourse), 4 (vaginal intercourse without condom) and 5 (anal intercourse without condom). In 80% of the 5 patients, it was observed that the students have knowledge similar to the experts"s evidences But, continuing education is necessary to these people, as human beings and as future health care givers to the HIV infected/AIDS patients.

Adolescent↗
PubMedDate not supplied

The health of host communities: missing from printed travel health advice.

Travelers are becoming increasingly used to the need to seek appropriate health advice before embarking on trips, particularly to developing countries. Travel health advice is given in various ways and through various media.1 Printed material often accompanies a travel health professional's oral explanations. Leaflets, booklets, brochures and other printed material have been used for a long time. Some are customized by the travel health provider, some are produced by commercial bodies such as the pharmaceutical industry or travel goods producers, and some are given out by health authorities. All are either distributed by the health professional or are accessible to travelers for collection in clinics, in surgeries, in pharmacies or on the web.

Global Health↗
PubMed1989

Clinical career ladders: the Washington Hospital Center.

The clinical career ladder program developed for pharmacists at The Washington Hospital Center, an 852-bed not-for-profit teaching institution, is described. Many new pharmacists hired during a period of rapid departmental expansion from 1979 to 1984 lacked the knowledge and skills needed to practice effectively in an increasingly complex clinical environment. The existence of a single class of staff pharmacists led to inequities in salaries. A continuing-education program was instituted, but some mechanism of motivating the pharmacists and correcting problems in recruitment, retention, and productivity was needed. In 1984 the department implemented a clinical career ladder with four levels: staff pharmacist, clinical pharmacist, senior clinical pharmacist, and clinical services manager. Duties and responsibilities range from drug distribution, technical supervision, and provision of basic drug information at the staff pharmacist level to supervision of pharmacy services in specified patient-care areas, administrative supervision, and program planning and development at the clinical services manager level. Equity adjustments were made when the program was implemented. Employees who meet the minimum requirements and have received above-standard performance evaluations are considered for promotion. To be promoted to clinical services manager, an employee must apply formally. The program has reduced turnover, particularly among the most highly skilled and productive employees, and has attracted new employees. A career ladder eased problems in employee retention and recruitment, eliminated wage inequities, and became an important motivational force for the professional staff.

Career Mobility↗