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At least 847 records · Page 47Linked to original sources
PubMed2001

Pharmaceutical care program for patients with reactive airways disease.

A pharmaceutical care program for patients with reactive airways disease (RAD) is described. A pharmaceutical care program for patients with RAD was developed and implemented at 36 CVS pharmacies. The impact on patient outcomes, pharmacist job satisfaction, and other variables is currently being evaluated in a controlled trial with more than 1100 patient enrollees. Guiding the program are the beliefs that pharmacists must have clinically relevant, patient-specific data to provide appropriate care; that pharmacists must have adequate training to provide pharmaceutical care; that the program must be sensitive to organizational barriers, particularly time demands; and that there must be ongoing support for the program. The program has five components: (1) computer display of patient-specific data for patients enrolled in the study, (2) distribution of tailored patient education materials, (3) use of a resource guide to facilitate the implementation of pharmaceutical care, (4) strategies to reinforce and facilitate the program, and (5) pharmacist training. While developed for community pharmacies, the program is applicable to most ambulatory care pharmacy practices. A pharmaceutical care program for patients with RAD was developed for use in community pharmacies.

Community Pharmacy Services↗
PubMed1993

Is there a need for improved pharmacy services to the operating theatre?

A study to assess the control and handling of drugs within an operating theatre complex (10 theatres) of an 850-bed hospital, has revealed the presence of unusable medication and thus highlighted the need for improved pharmacy services. The aims and objectives of the pharmacy department to enhance such services included improvement of drug control of stock medication and the introduction of clinical pharmacy services within the operating theatre. To undertake this, three systems were evaluated with reference to systems already in use in the U.S.A. Operating theatre visits by a clinical pharmacist, coupled with the expansion of the existing drug distribution service, were identified as the most cost-effective methods that would allow the objectives to be met. Consequently, this has now been implemented within the operating theatre complex.

Evaluation Studies as Topic↗
PubMed2000

The role of the pharmacist in humanitarian aid in Bosnia-Herzegovina: the experience of Pharmaciens Sans Frontières.

BACKGROUND: Founded in 1985, Pharmaciens Sans Frontières (PSF) is a nongovemmental organization of pharmacists involved in humanitarian aid. PSF relied on approximately 100 expatriates in 1998, which included 50 pharmacists distributed throughout 24 missions (i.e., 14 emergency, 7 development, 3 assessment). It is necessary to add 200-250 local staff to this group. OBJECTIVE: To describe PSF's mission in Bosnia-Herzegovina from 1992 to 1999 and to define the pharmacist's impact in the supply of medicines and the development of pharmaceutical care and services. RESULTS: In April 1992, at the beginning of Sarajevo's siege, PSF sent a small team of three volunteer pharmacists to Bosnia-Herzegovina. The objective of the emergency phase (1992-1995) was to set up a massive supply program of essential medicines and medical and biologic materials and to implement a distribution system based on existing health centers. The signing of the Dayton peace agreement and a progressive return to peace and stability marked the beginning of the postemergency phase (1995-1997). This phase pursued previous objectives of establishing a distribution network and added the implementation of logistic centers. PSF widened its involvement to medical laboratory analysis, production of medicines, disposal of expired medications sent during the conflict, and the implementation of a national center for quality control. Currently, the development phase's (1998-1999) objective is to provide adequate support for the reorganization of pharmaceutical care and services by establishing pharmacy work groups and developing and maintaining good relationships with the international community and Bosnia-Herzegovina pharmacists. CONCLUSIONS: Humanitarian aid is essential in major conflicts, as seen in the case of Bosnia-Herzegovina. Although it is difficult to evaluate the impact of the distribution network implemented by PSF, it allowed for a better provisioning of medications to the general population. PSF played an important role in such cases. In fact, PSF provides its pharmaceutical expertise to these embattled areas not only by offering financial support to the logistics or supplying of medications, but by offering professional support to the organization/reorganization of the pharmaceutical practice.

Bosnia and Herzegovina↗
PubMed1987

Psychotropic drug monitoring in general practice in Italy: a two-year study.

A psychotropic drug monitoring study in general practice was carried out in 1983 and 1984 using a computerized drug information system. The prescription data analysed in the study came from 68 general practitioners operating in south Verona and have been collected by 14 community pharmacies located in the same area. Benzodiazepine hypnotics were the most commonly prescribed drugs, followed by antidepressants and neuroleptics both in 1983 and in 1984. The distribution of the general practitioners in terms of low, medium and high prescribers was examined by analysing the rates of prescriptions per registered patient. The rates were obtained for the total number of prescriptions and also for each of the three different classes of psychotropic drug. The proportion of low and high prescribers decreased from 1983 to 1984 (18.3 versus 11.7 and 26.7 versus 16.7 for low and high prescribers respectively); this change was mainly due to the reduction in benzodiazepine prescriptions. No significant correlation was found between the rates of psychotropic drug prescriptions and list size. The monthly variation in prescription of the three drug classes followed a similar pattern during the two years; the fluctuations were clearly cyclical, more definitely in 1984 than in 1983 where the most relevant feature was the summer trough.

Adolescent↗
PubMed1994

"Talking about drug treatments--who should say what to whom?"--the second DTB symposium.

Information about medicines is as important as the quality of the medicines themselves. Without sufficient, accurate and understandable information the doctor cannot decide on the best treatment regimen to offer and ultimately the patient cannot decide what treatment to accept. The second annual Drug and Therapeutics Bulletin symposium, held in March, considered the provision of information, its production and distribution, and the legal, ethical and professional codes by which it is shaped. These issues were addressed by Ian Dodds-Smith (legal aspects), Nick Barber (pharmacy matters), Bonnie Sibbald (communication between hospital and general practice), Barbara Altounyan (the media), David Dickinson and Marianne Rigge (consumers), Gwen Parr and Justin Greenwood (the pharmaceutical industry) and Joe Collier (provision of consensus advice). The audience also made important contributions.

Advertising↗
PubMed2004

[Working conditions and workers' health impairments in drug distribution companies].

UNLABELLED: The aim of the study was to evaluate working conditions according to hygiene norms and to determine health impairments of drug distribution companies' workers. MATERIAL AND METHODS: Study was performed in summer of 2003 in drug distribution companies implementing good distribution practice. Study included 588 workers. Health impairments for technical personnel and pharmacists were revealed using a questionnaire. RESULTS: Microclimatic work conditions: temperature, humidity, air movement during summer season at 11% workplaces did not correspond to hygiene norms. The main health impairments for pharmacists were various ophthalmological disorders. For technical personnel main health impairments were musculoskeletal disorders, as back pain and varicosis. They are related with repetitive spinal column movements, incorrect weight lifting, long-fixed working position, etc. Based on criteria used for evaluation of workload, workers of drug distribution companies are attributable to strained work category.

Adult↗
PubMed1991

Use of bar codes in inpatient drug distribution.

The development and operation of a prototype inpatient drug distribution system that uses bar codes is described, and the impact of bar coding on the cassette-filling and verification process is summarized. A prototype pharmacy dispensing site was created to function in parallel with an existing satellite dispensing site that served 78 general medical-care beds. Supplemental labels encoded with an 11-digit unique product identification number, a 5-digit expiration date, and a 6-character lot number were generated and affixed to all unit dose packages dispensed from the prototype pharmacy site. The unit doses were labeled with Code 49 symbology; each label measured 0.8 x 1.25 inches. Each patient cassette was labeled using Code 39 symbology. A cost-benefit model was developed, and the two dispensing systems were compared with respect to (1) time to fill patient cassettes, (2) time to verify patient cassettes, (3) time to process patient charges and credits, (4) time to correct dispensing errors, (5) accuracy of the cassette-filling process, and (6) accuracy of the cassette verification process. Bar-code dispensing and verification saved 1.52 seconds per dose. Additionally, the cassette verification function was shifted from pharmacists to technicians. Estimated per-dose cost of the bar-code system was 2.73 cents. A measurable improvement in the accuracy of filling patient cassettes was documented. The feasibility of using bar codes in unit dose dispensing was demonstrated, and the prototype system was shown to produce cost efficiencies and patient-care benefits.

Clinical Pharmacy Information Systems↗
PubMedDate not supplied

[Study of narcotics and buprenorphine prescriptions in the Provence-Alps-Côte d'Azur region].

Following the setting up by the Government of their project for the management of drug addicts, and under the guidance of the CEIP (Centre d'Evaluation et d'Information sur les Pharmacodépendances [Centre for Evaluation and Information on Drug Addiction]) in Marseille, a survey of prescriptions written on controlled-drug prescription pads was performed. The aims were threefold: to study the medicines prescribed, to follow up the legislation and to inform doctors and pharmacists. Copies of the prescriptions, dated between 1 January 1996 and 30 June 1996, which were sent by 81 per cent of the 216 pharmacies contacted in 15 towns in the Provence-Alpes-Côte d'Azur (PACA) region were studied. Various criteria, relating to writing of the prescriptions and distribution of the medicines to the patients, were coded and analysed. This survey showed that of 4 prescriptions, 3 were prescribed for maintenance and one for analgesic therapy. The patients receiving maintenance therapy were male in three-quarters of the cases, and were around 30 years old. Analgesics were prescribed in equal proportions for patients of both sexes, who were around 65 years old. Since it was put on the market, Subutex has been quickly prescribed.

Adult↗
PubMed1998

[Self-medication of the common cold].

Self-medication can be useful in the multisymptomatic management of the common cold and other preferentially non-febrile flu-like symptoms, especially as at present multicomponent remedies are available, which may make self-medication significantly easier with consequent better compliance of adult patients. Children, on the contrary, are not suitable acceptants of self-medication mediated by their parents because the sickness exhibits in children nearly exclusively febrile progress. The procedure of the therapy to be really effective and safe must be necessarily concentrated into pharmacies, where safety and efficacy of therapy are ensured by the pharmacist as the last link of contact between the patient and the drug. Any other distribution of the OTC drugs is therefore strictly unacceptable. Patients suffering from the common cold usually exhibit simultaneously various symptoms of the disease. These different symptoms are, however, experienced during the day with different intensity. During the day and often also in the course of the labour process there is a need to concentrate on the most bothersome symptoms, notably the relief of the nasal congestion with the exploration of the safest and most effective drug, such as pseudoephedrine. In addition, it is necessary to administer an effective nonsteroidal anti-inflammatory drug, preferably ibuprofen, which provides relief from symptoms caused by release of inflammatory mediators. In the night time there is a need of a multisymptom therapy which may relieve cough and any other disturbing cold symptoms to allow satisfactory beneficial, continuous, and refreshing sleep.

Adult↗
PubMed2000

A comparative analysis of generics markets in five European countries.

A generic medicine is a faithful copy of a mature drug--no longer under patent marketed with the chemical name of the active ingredient. This article analyses generics markets in five European countries: France, Germany Italy, The Netherlands and the U.K. The study investigate all the main issues--patent, approval to market, pricing and reimbursement, prescription and distribution--which affect the life cycle of a pharmaceutical product. The situation in the five countries varied widely. Because of European harmonization, patent legislation and approval procedures no longer affect much the development of generics. Only national legislation on patent protection approved before the EU directive came into force still plays a role. Approval differences seem to be due mainly to common practice, rather than to the regulations themselves. None of the countries have an efficient public information system on patent expiry. Generics have had more success in countries with more flexible pricing policies. Reimbursement has not yet been used widely to discriminate between generics and proprietary drugs. Financial incentives are based more on physicians' prescribing behaviour than on pharmacists. The freedom of pharmacy ownership and the consequent possibility of dispensing pharmaceuticals through different channels affects dramatically the structure of generics markets. A free market of wholesalers and retailers can enhance a comparative market, through horizontal and vertical integration all along the distribution chain. Such an environment has stimulate the success of unbranded generics by delegating strong purchasing power to distributors.

Commerce↗
PubMed2001

Impact of clinical pharmacy services on renal transplant patients' compliance with immunosuppressive medications.

BACKGROUND: Non-compliance with immunosuppressive medications may result in allograft rejection and is regarded as an important impediment to post-transplant care. This randomized, controlled trial evaluates the impact of clinical pharmacy services on renal transplant patients' compliance with immunosuppressive agents. METHODS: Patients who received a renal transplant at the Medical College of Georgia from February 1997 through January 1999 were randomized in the intervention or control group provided they met study criteria. In addition to routine clinic services at each clinic visit, patients in the intervention group received clinical pharmacy services, which included medication histories and review of patients' medications with an emphasis on optimizing medication therapy to achieve desired outcomes and minimizing adverse medication events. The clinical pharmacist also provided recommendations to the nephrologists with the goal of achieving desired outcomes. To promote medication compliance by using compliance enhancement strategies, the clinical pharmacist counseled patients concerning their medication therapy and instructed them how to properly take their medications. Patients in the control group received the same routine clinic services as the intervention group except that they did not have any clinical pharmacist interaction. Compliance rate (CR) was calculated and patient's compliance status was determined from the CR. The CR, the fraction of patients remaining compliant for each month, and the mean time patients were compliant were compared between groups. Whether there was a difference in the frequency of patients achieving 'target' immunosuppressive levels in the control and study groups was evaluated. RESULTS: The mean CR for patients who had clinical pharmacist intervention (n=12) was statistically higher than the control group's (n=12) mean CR (p<0.001). During the 12-month post-transplant study period, patients in the intervention group had a longer duration of compliance than patients in the control group (p<0.05). Additionally, patients who had clinical pharmacy services had a greater achievement of 'target' levels than patients who did not receive these services (p<0.05). CONCLUSIONS: Patients who received clinical pharmacy services with traditional patient care services had better compliance with immunosuppressants than patients who only received traditional patient care services. Results of this study suggest a multidisciplinary team that includes a clinical pharmacist as part of the care for post-transplant patients is beneficial for enhancing medication compliance.

Chi-Square Distribution↗
PubMed2006

Pharmacy student response to patient-simulation mannequins to teach performance-based pharmacotherapeutics.

OBJECTIVE: To design and implement a simulated patient-case assessment using a mannequin for critical care pharmacotherapeutic education of doctor of pharmacy students and to evaluate student satisfaction with the simulation. DESIGN: During the second year of the doctor of pharmacy program, all students were required to complete Introduction to Critical Care. This course consisted of didactic education, written patient-case sessions, and an interactive patient simulation session. Information on the patient case was distributed to students after completing the didactic portion of the course. Patient information was programmed into a simulation mannequin, which demonstrated characteristics of a critically ill human. Students were surveyed post-simulation to determine the effectiveness of the learning experience. ASSESSMENT: The majority of students (88%) were extremely satisfied with the experience. The facilitator was considered to be extremely useful in 75% of responses. CONCLUSION: By simulating a patient case, the facilitator was able to control students' learning environment, adapt the simulation to the level of the students' performance, and debrief students immediately. Ultimately, by involving students in actual patient cases early in the pharmacy curriculum, this type of education could produce pharmacists with a high level of expertise and confidence.

Critical Care↗
PubMed1992

1987 to 1991 cost and utilization of Class IV HIV patients.

The 1987 to 1991 direct medical costs and service utilization of Class IV Human Immunodeficiency Virus (HIV) patients cared for at a Group Health Cooperative of Puget Sound (GHC) are described and compared across four time periods: 1987-'88, 1989, 1990, and 1991. Cost and utilization information for an age- and sex-matched control group of GHC enrollees not having Class IV HIV conditions are also compared to those of the Class IV HIV group. Data are presented on pharmacy, inpatient care, outpatient visits by physician specialty, laboratory, radiology, home health/hospice and other costs. The costs of the Class IV HIV population are, on average, 20 times those of the control group. The percent distribution of the control group's costs did not experience much change from 1989 to 1991. Conversely, the Class IV HIV group experienced a shift in costs from the inpatient to outpatient setting from 1987-'88 to 1989. This shift was temporary, as the locus of care shifted back to the inpatient setting over the following 2 years. Anecdotal evidence suggests that antiretroviral treatment may have led to a period in which patients required less intensive settings to manage their illness. Inpatient costs may have increased as the initial benefit of zidovudine treatment began to wane. The Class IV HIV population had greater percent of total expenses in pharmacy, laboratory, radiology, and home health/hospice services, and lower percent of total expenses in outpatient primary and specialty care than the control group.

Adult↗
PubMedDate not supplied

Outcomes-based pharmacist reimbursement: reimbursing pharmacists for cognitive services part 1.

OBJECTIVES: (1) Describe the structure of an outcomes-based method of pharmacist reimbursement for cognitive services, (2) outline the structure of an intervention program, (3) explain a mechanism to increase the provision of pharmacists. cognitive services, and (4) summarize findings from the first year of operations of this outcomes-based pharmacist reimbursement program (OBPR). METHODS: A cross-sectional descriptive study was completed using the claims submitted by pharmacists to summarize findings from the first year of operations of this OBPR. The program involves collaboration between pharmacy benefit managers (PBMs) and community pharmacists to improve medication use. Pharmacists were reimbursed for (1) converting therapeutic regimens to generic drugs or preferred formulary medications when a prescriber contact is required; (2) conducting patient education and follow-up after initiation of new medications, changes in drug therapy, or following an over-the-counter (OTC) consultation; and (3) resolving drug-therapy problems. An efficient, no-cost billing system was created. Pharmacies participating in this program are located in cities throughout Iowa, ranging in population from a few hundred to more than 100,000. The main outcome measures were descriptive statistics of prescriptions, intervention claims, and pharmacist participation in the program. Frequency distributions and descriptive statistics were used to summarize the first year of claims. Comparisons of averages were completed with t tests. Chi-square tests were used to compare frequency distributions. RESULTS: Data analysis for the first year of operation, July 1, 2000, through June 30, 2001, showed that 11,326 enrollees obtained 124,768 prescriptions. The majority of individuals (n=8335, 74%) received some intervention service. The majority (90%) of intervention services were patient education and follow-up on new prescriptions or changes in prescriptions. More than 200 individuals had drug-related problems. There was variability in the level of service per pharmacy as the median number of intervention services was 30, while the mean was 113?188, among those providing any interventions. CONCLUSION: This unique system of outcomes-based pharmacist reimbursement permits community pharmacists to document and bill for cognitive services. It has demonstrated that PBMs and community pharmacists can work together to improve drug therapy, and it may reduce health care costs.

Journal Article↗
PubMed1984

Control of antibiotic-resistant bacteria: memorandum from a WHO meeting. World Health Organization Scientific Working Group on Antimicrobial Resistance.

A memorandum based on the report of the World Health Organization Working Group on Antimicrobial Resistance is presented. National and international surveillance of antibiotic resistance is needed for improvement of antibiotic prescribing, for formulation of government policy on antibiotic use in humans and animals, and for encouraging responsible marketing and promotion by antibiotic manufacturers. Surveillance should include sensitivity tests of human pathogens and periodic monitoring of fecal flora of healthy persons. Guidelines for rational antibiotic use in hospitals include basing antibiotic selection on tested or expected sensitivity, using an agent with as narrow a spectrum as possible, choosing appropriate dosage and route, and use of the drug for the shortest possible time. Both therapeutic and prophylactic antibiotic use are addressed in the guidelines. Use of a limited formulary and use of pharmacy records to monitor antibiotic consumption are recommended. Hospital regulation of contact between pharmaceutical industry representatives and physicians is suggested. Areas are identified for bacteriologic, clinical, epidemiologic, and health-services research to improve antibiotic use. Surveillance of bacterial resistance should be coordinated worldwide. National formularies for antibiotics should be developed, and nonphysicians who distribute antibiotics should be trained in their proper use.

Animals↗
PubMed1995

Implementation and evaluation of an automated dispensing system.

An institution's experience in replacing a traditional unit dose cassette-exchange system with an automated dispensing system is described. A 24-hour unit dose cassette-exchange system was replaced with an automated dispensing system (Pyxis's Medstation Rx) on a 36-bed cardiovascular surgery unit and an 8-bed cardiovascular intensive care unit. Significantly fewer missing doses were reported after Medstation Rx was implemented. No conclusions could be made about the impact of the system on the reporting of medication errors. The time savings for pharmacy associated with the filling, checking, and delivery of new medication orders equated to about 0.5 full-time equivalent (FTE). Medstation Rx also saved substantial nursing time for acquisition of controlled substances and for controlled-substance inventory taking at shift changes. A financial analysis showed that Medstation Rx could save the institution about $1 million over five years if all personnel time savings could be translated into FTE reductions. The automated system was given high marks by the nurses in a survey; 80% wanted to keep the system on their unit. Pilot implementation of an automated dispensing system improved the efficiency of drug distribution over that of the traditional unit dose cassette-exchange system.

Attitude of Health Personnel↗