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At least 865 records · Page 48Linked to original sources

PubMed2003

Examining influences of pharmacists' communication with consumers about antibiotics.

A national study was conducted of community pharmacists to examine influences on their communication with consumers about antibiotics and antibiotic resistance. The objective was twofold: to explore the nature of barriers that might be changed to allow pharmacists greater participation in educational campaigns, and to discover which variables would best predict communication using a modification of the Theory of Reasoned Action model. Whereas most pharmacists agreed that their role in educating patients is important, they also noted several barriers prevent them from engaging in campaigns, such as time constraints, lack of educational materials, and fear of harming relations with physicians. Pharmacists' discussion about antibiotics in general was predicted primarily by attitudes about their role and efficacy, by their autonomy, and by enabling measures-such as pamphlets-that would better aid them in participating in a judicious antibiotic use campaign. Discussion about resistance was predicted by attitudes and enabling measures.

Adult↗

PubMed2001

[The roles of pharmacists on prior review of clinical trials].

A prior review system for clinical trials was introduced into The University of Tokyo Hospital in March 1999, for the purpose of supporting the Institutional Review Board (IRB). In this study, we investigated the effect of this system on IRB, and evaluated roles of pharmacists involved in utilizing this prior review system. An average period from the acceptance of regular application of each protocol to the approval of IRB was 1.7 months, and the period was significantly shorter than that before the introduction of this system (2.3 months). On the other hand, the number of instructions given to applicants increased to be 2.8 times before the introduction of this system, suggesting the improvement of the quality of this prior review system. In the prior review, the number of instructions pointed out from pharmacists concerning pharmacokinetics, pharmacodynamics, drug-interactions, adverse reactions, and the other matters related to investigational drugs was greater than that from doctors or nurses. According to the results of the surveys for doctors, nurses, and other clerical employees, pharmacists were indicated to review from a pharmaceutical point of view and their review was found to be very important. In conclusion, the prior review system was considered to be useful for the rational practice of clinical trials and pharmacists were recognized to be indispensable as reviewers on the prior review.

Clinical Trials as Topic↗

PubMed2003

[Pharmacy, pharmacists and society--pharmaceutical science and practice with philosophy].

In Japanese pharmaceutical community, there seems to be a lack of "Science of Science" and "Research on Research" which are to utilize unit sciences and research for the benefit of human being. In other words, pharmaceutical people in Japan should have much more pharmaceutical philosophy. The late Professor Komei Miyaki, founder Editor-in-Chief of FARUMASHIA, the monthly membership magazine of Pharmaceutical Society of Japan, under whom I worked as one of editorial board members, taught me that scientists should have their own philosophy of their sciences. Such a pharmaceutical philosophy as mentioned above should be established on the basis of complete separation of medical profession between doctors and pharmacists, which form the most important and necessary issue in safety assurance for patients with the complete zero defect (ZD action), as there is a long history for that in Europe since the separation was completed by King Friedrich II in 1240. Therefore, we have to learn the social status of European/American pharmacist practitioners who are the great No. 1 among all the professions. European pharmacists guarantee the safety of every chemical used for human body and pets, such as medicines, cosmetics, foods, tooth stuffs and so on. Regarding the pharmaceutical sciences in Japan also there seems to be a lack of pharmaceutical philosophy, as pharmaceutical scientists have no identity in research object that may be similar to basic scientists who are non-pharmacy graduates. Japanese sciences generally have developed along the lines of the Western model, reaching the current high level. We now not only should receive profits from the outside but also should embark on a mission to support pharmaceutical sciences throughout the world, especially Asian courtiers. At the present, we do not seem to be fulfilling our mission to do that, even though general activity includes significant international exchange. We have to make much more effort for international contribution/participation. For that, the most important and necessary issue is to make change in fundamental sense in Japanese pharmaceutical community, though an internationalization of technological issues is usually taken into consideration. In this connection, regarding the new drug development, we must have a change in the sense to establish pharmaceutical philosophy and jump up in conception from the existing one. Based on the above mentioned pharmaceutical philosophy, seven star pharmacists should be educated as described in 2000 FIP Statement of Policy: Good Pharmacy Education Practice, who could be a (1) care giver; (2) decision maker; (3) communicator; (4) leader; (5) manager; (6) life-long learner; (7) teacher.

Asia↗

PubMed2003

[A study of pharmacists' consciousness toward separation of medical practice from pharmaceutical dispensing].

Separation of medical practice from pharmaceutical dispensing had been a system with just the notation without the reality even after Showa era, although its concept was brought into Japan along with European medicine in Meiji era. Since 1970's, its concept has been prevailing gradually, and the so-called separation rate currently has reached to 47 percent. Increasingly keen attention has been paid recently by the public toward medicine in general. Taking into consideration these facts, a questionnaire survey was conducted for dispensing pharmacists in order to find out where pharmacists stand at present. Most of pharmacists (98.3%) answered that they practice patient counseling either by documents or by verbal communication, and that they take patient profiles. They said that patients could enjoy a proper medical treatment (32.9%) as well as a rational prescribing (14.3%). For a question asking what pharmacists should do to promote the separation of medical practice from pharmaceutical dispensing, 40.3% of them answered that they should make progress in their knowledge on drug therapy.

Adult↗

PubMed2005

Survey on understanding of and satisfaction with in-hospital pharmacist's work.

Since it is necessary to make more physicians and nurses fully understand the in-hospital pharmacist's work, a questionnaire survey was performed for physicians and nurses on their knowledge of and satisfaction with the work. The survey results were analyzed with multiple regression analysis to reflect the results specifically and objectively in the routine activities of the pharmacy. The results showed that physicians with experience of less than 1 year were not well aware of the pharmacists' work related to clinical trials and therapeutic drug monitoring, and that those with an experience of 1 year or longer were not well aware of the work related to clinical trials. Nurses with an experience of less than 5 years or 5 years or longer were not well aware of the work related to in-hospital pharmaceutical preparations. The pharmacists' work that affected the satisfaction of physicians and nurses include the provision of drug information, checking of prescriptions, guidance of patients on drug compliance, and management of nonprescription and poisonous drugs. The present multiple regression analysis was useful for understanding the current status of in-hospital jobs and objectively distinguishing jobs to be improved from those that might be continued in the present manner. Multiple regression analysis may be a useful analytical tool for improving pharmacists' work.

Comprehension↗

PubMed2001

Over-the-counter advice for genital problems: the role of the community pharmacist.

This year, in the UK, levonorgestrel was approved for sale in pharmacies for emergency contraception. This study assessed, using a postal questionnaire, the ability of community pharmacists to provide advice relating to sexual health, their comfort and training in this area, and their knowledge of local genitourinary medicine (GUM) services. Fifty-four per cent of pharmacists responded. Most (79%) did not know where their nearest GUM department was; only 21% had ever advised a patient to attend a GUM clinic. Twenty-nine per cent said they were not able to broach the possibility of a sexually transmitted infection (STI) with a patient of both sexes. Forty-four per cent had received training related to post-coital contraception. Greater liaison between GUM departments and community pharmacists is suggested as a way of increasing the proportion of patients presenting to a pharmacist who are referred appropriately to a GUM clinic.

Attitude of Health Personnel↗

PubMed2005

Consumer receptiveness to non-traditional roles for community pharmacists.

Healthcare is in a state of transition as providers are seeking to redefine their roles to accommodate marketplace pressures. The focus of this study was to examine consumer interest in receiving a portion of their healthcare services from community pharmacists. Overall, while consumers see value in pharmacists' services directly related to their medications, they may not be thinking of pharmacists in broader healthcare roles. If so, a strong marketing program will be needed to educate consumers on the qualifications of pharmacists and how there is value in the services they could provide.

Adult↗

PubMedDate not supplied

More pharmacists in high-risk neighborhoods of New York City support selling syringes to injection drug users.

OBJECTIVE: To document changes in pharmacists' opinions and practices from the time of passage to implementation of a law permitting selling syringes without a prescription (the Expanded Syringe Access Demonstration Program [ESAP]). DESIGN: Two cross-sectional randomized telephone surveys. SETTING: High-risk neighborhoods of New York City. SUBJECTS: Pharmacists. MAIN OUTCOME MEASURES: Support for selling syringes without a prescription to injection drug users (IDUs). RESULTS: We completed 130 surveys at baseline (BL) in August 2000, from neighborhoods with high numbers of injection-related acquired immunodeficiency syndrome (AIDS) cases and 231 surveys at law change (LC) in January 2001. To correct for differences in sampling, we limited the analysis to pharmacies in ZIP Codes represented in both samples and weighted results to adjust for the median income level of those postal codes. From BL (n = 83) to LC (n = 84), law awareness increased (43% to 90%, P < .001), as did personal support for selling syringes without a prescription to IDUs (36% to 63%, P < .001). From BL to LC, a larger proportion of supporters believed that selling syringes was an important part of human immunodeficiency virus (HIV) prevention and would help decrease HIV transmission, and a smaller proportion was concerned about customer discomfort and increased drug use. A total of 40% of respondents were ESAP registered at LC but registration was not associated with support for selling syringes to IDUs. CONCLUSIONS: Support for ESAP among pharmacists increased in high-risk neighborhoods as the program was implemented. The finding that some pharmacists were ESAP registered but did not support selling syringes to IDUs and others were supportive, but not ESAP registered, may have program implications.

Attitude of Health Personnel↗

PubMedDate not supplied

Improving medication use through pharmacists' access to patient-specific health care information.

OBJECTIVE: To review and discuss the importance of pharmacists having access to patient-specific health care information in order to provide pharmaceutical care. DATA SOURCES: Articles identified through searches of MEDLINE and International Pharmaceutical Abstracts using the following key words: information, decision making, and pharmacist. STUDY SELECTION: English-language articles were evaluated for inclusion. DATA SYNTHESIS: Pharmacists have demonstrated their ability to positively affect patient outcomes related to medication use, including reducing patients' risk for medication-related adverse effects. CONCLUSION: Pharmacists, with proper access to patient-specific health care information, can reduce patients' risk for medication-related problems and improve the quality of their health care.

Computer Security↗

PubMedDate not supplied

Overactive bladder patients and role of the pharmacist.

OBJECTIVES: To summarize the prevalence, quality of life (QOL) implications, cost of illness, and pharmacotherapy of overactive bladder (OAB), and to describe the pharmacist's role in the management of patients with OAB. DATA SOURCES: Articles published between 1990 and 2001 identified through a MEDLINE search using the terms overactive bladder, unstable bladder, urinary incontinence, prevalence, cost of illness, quality of life, drug therapy, pharmacist, and pharmacy in various combinations. STUDY SELECTION: All studies providing information on OAB or urinary incontinence were retrieved. DATA EXTRACTION: By the authors. DATA SYNTHESIS: Published prevalence and cost studies focus primarily on urinary incontinence, which is only one possible symptom of OAB. Reported prevalence rates of urge and mixed incontinence in the United States range from 3% to 8% and 5% to 37%, respectively, and the highest prevalence has been found in geriatric and psychogeriatric populations. Associated costs are substantial. Total costs of OAB in the United States were estimated to be $12.6 billion in 2000. Patients with OAB score lower than the general population in QOL assessments. All aspects of QOL can be compromised by OAB, as physical, social, occupational, domestic, and sexual activities are often limited in OAB patients. The pharmacist is instrumental in improving an individual's QOL through ensuring safe and effective treatment for OAB. Oxybutynin and tolterodine (Detrol-Pharmacia) have been the mainstays of pharmacotherapy for OAB, but frequent adverse effects (including dry mouth) often prevent patients from adhering to treatment. Tolterodine, now available in a new long-acting formulation, has been proven safe and efficacious in the treatment of OAB, with fewer adverse effects and better tolerability than existing agents. CONCLUSION: Pharmacists can play an active role in helping identify and recommending interventions for OAB that can ultimately improve an individual's QOL.

Cost of Illness↗

PubMedDate not supplied

Unmet needs in the medication use process: perceptions of physicians, pharmacists, and patients.

OBJECTIVES: To explore the perception of unmet needs in the medication use process from the perspectives of three of the principal participants in the process--physicians, pharmacists, and patients--and to identify the individual(s) or strategy(ies) perceived to be the best or most likely candidate(s) to resolve the problems identified. PARTICIPANTS: Physicians (primary care, cardiology, oncology, and obstetrics/gynecology specialties), pharmacists (community and health-system settings), and patients from four medium-sized U.S. cities. The survey instrument was modified for each group. MAIN OUTCOME MEASURES: The medication use process was divided into nine steps, based on a previous study. A two-part question was framed for each step. In part A, respondents were asked to indicate their level of agreement (on a 5-point scale) about whether the step was being conducted appropriately. In part B, those who disagreed with a statement in part A were asked their opinions on the best possible candidate or strategy for improving that step. RESULTS: Both physicians and pharmacists identified four areas of unmet needs: timing of physician visit, patient counseling, patient use of medications, and patient monitoring. Each group held itself primarily responsible for the resolution of most of these problems. Patients did not identify any unmet needs from the survey. In responses to open-ended questions, however, they cited medication cost, appropriateness, access, and convenience as problems. CONCLUSION: Providers and patients reported substantially different perspectives on medication use problems and on improving the process. Addressing the unmet needs identified in this study will require better understanding, communication, and collaboration among physicians, pharmacists, and patients.

Adult↗

PubMedDate not supplied

Ability of clinical pharmacists in a community pharmacy setting to manage anticoagulation therapy.

OBJECTIVES: To determine the ability of community pharmacists within an anticoagulation clinic to keep international normalized ratios (INRs) within therapeutic ranges and, secondarily, to determine the incidence of bleeding and thromboembolic events and patient satisfaction. DESIGN: Retrospective observational study. SETTING: Eckerd PatientCARE Network in Eckerd pharmacies in Tampa Bay area of Florida. PATIENTS: 50 patients taking warfarin and having INR determinations for 6 consecutive months. INTERVENTIONS: Clinical pharmacists monitored patients' anticoagulation status using point-of-care analyzers and making dosage changes as needed under a collaborative agreement. Extensive patient education was provided to patients regarding their anticoagulation. Data were collected from the initial visit through the 6 consecutive months. Patients were surveyed to assess their satisfaction with the clinic. MAIN OUTCOME MEASURES: Percentage of INRs within therapeutic range and, secondarily, incidence of bleeding and thromboembolic events and patient satisfaction with the clinic. RESULTS: During the 6 months of initial therapy with warfarin, 243 of 435 (56%) INRs were in desired therapeutic ranges. A total of 15 bleeding episodes were reported, of which 10 were minor and 5 were significant. No thromboembolic events were reported. There was a 22% response rate to the survey, in which all statements were rated as above average to excellent. CONCLUSION: Community pharmacists in an anticoagulation clinic effectively manage anticoagulation therapy, as the results of this clinic are similar to those of clinics managed by pharmacists in other settings.

Aged↗

PubMedDate not supplied

Community pharmacists and Colleges of Pharmacy: the Ohio partnership.

OBJECTIVE: To develop pharmacist practice standards, pharmacy preceptor standards, and objectives for students completing advanced practice community pharmacy rotations. SETTING: Ohio. PRACTICE DESCRIPTION: Pharmacy schools and community pharmacies that serve as advanced practice rotation sites. PRACTICE INNOVATION: Developed standards for preceptors and objectives for student experiences. INTERVENTIONS: Focus groups that included both community pharmacists and pharmacy faculty collaborated on defining key standards for advanced community pharmacy rotations. MAIN OUTCOME MEASURE: Not applicable. RESULTS: Three main documents were produced in this initiative, and these are provided as appendices to this article. Professional and patient care guidelines for preceptors define minimum standards for these role models. Expectations of pharmacists as preceptors provide insights for managing this student-teacher relationship, which is fundamentally different from the more common employer-employee and coworker relationships found in pharmacies of all types. Objectives for student experiences during advanced practice community pharmacy rotations present core expectations in clinical, dispensing, patient education, wellness, and drug information areas. CONCLUSION: Through this collaboration, Ohio colleges of pharmacy developed a partnership with practitioners in community settings that should enhance the Ohio experiential educational program for student pharmacists. Use of the established guidelines will help educators and practitioners achieve their shared vision for advanced practice community pharmacy rotations and promote high-quality patient care.

Community Pharmacy Services↗

PubMed1998

Community pharmacists' assessments and recommendations for treatment in four case scenarios.

OBJECTIVE: To evaluate community pharmacists' interpersonal skills, ability to make appropriate assessment of a patient' s drug-related problems, and ability to propose an appropriate therapeutic plan. DESIGN: A disguised shopper design was used. Four different case scenarios were designed, with input from a five-member community/primary care pharmacist advisory committee. Two different cases were assigned to each of two shoppers. One hundred and one pharmacies were shopped twice, totaling 202 shopping experiences. A three-member evaluation committee made up of clinical faculty members in ambulatory care and internal medicine assessed the appropriateness of the recommendations. SETTING: The study was conducted in 101 randomly selected community pharmacies in the Pittsburgh area, including both chain and independent pharmacies. MAIN OUTCOME MEASURES: Main outcome measures included the quality of the pharmacists' interpersonal skills, patient assessment skills, and recommendations. RESULTS: The majority of pharmacists demonstrated acceptable to good interpersonal skills. Overall, 31.7% of the recommendations were appropriate, while 39.1% were poor (i.e., recommendations that would likely worsen the patient's condition or potentially harm the patient). In 33.2% of the cases, recommendations were made without prior assessment of the patient's problems. CONCLUSIONS: A lack of clinical knowledge and skills should be considered as a barrier that must be overcome if the provision of pharmaceutical care is to become a reality in community practice.

Adult↗

PubMed1999

The impact of pharmacist interventions on health-related quality of life.

OBJECTIVE: To describe and evaluate pharmacy practice-based studies that include health-related quality of life (HRQL) as an outcome measure in assessments of pharmacist interventions and to recommend approaches for incorporating HRQL as a patient outcome in pharmacy practice-based intervention studies. METHODS: Citations were identified in MEDLINE, Healthstar, EMBASE, and International Pharmaceutical Abstracts from January 1988 to February 1999 using terms for health-related quality of life and pharmacist interventions. Abstracts were screened by two reviewers and articles that reported a pharmacist intervention performed with HRQL as an outcome measure were included. RESULTS: Of 689 citations identified by the literature search terms, 11 met the inclusion criteria. Nine studies contained a disease-specific focus. The SF-36, or its variations, was the only generic instrument used, and seven studies described using a disease-specific instrument. Pharmacist interventions inconsistently demonstrated positive effects on patient HRQL. DISCUSSION: Possible reasons for not detecting significant differences in HRQL include length of study period, insufficient sample size and power, selection bias, labeling effects, the type of measure applied, and lack of actual influence of pharmaceutical services on HRQL. Strategies to strengthen the design and methodologic approach, such as the reporting of effect size, are recommended. CONCLUSIONS: In order to demonstrate the positive effect of pharmaceutical services on patient health, pharmacy practice researchers should continue incorporating HRQL outcome measures, complemented by clinical, economic, and other humanistic outcome indicators.

Community Pharmacy Services↗

PubMed2003

Economic impact of pharmacists' interventions with nonsteroidal antiinflammatory drugs.

OBJECTIVE: To estimate the economic impact of community pharmacists' interventions following the detection of problems related to nonsteroidal antiinflammatory drugs (NSAIDs), whether in a prescription or self-medication format. The evaluation focused on the gastroduodenal adverse events that could be avoided and the subsequent savings of healthcare resources spent on treating these adverse effects. METHODS: A previous study conducted during a 12-week period in 924 French community pharmacies provided the number of interventions for drug-related problems concerning NSAIDs. A simulation model was constructed to compare 2 strategies: a systematic pharmacist's intervention and the absence of intervention. The base-case patient was assumed to have been taking an NSAID for 3 months. The model's inputs were extracted from medical literature and from an institutional medical database. RESULTS: In this study, 608 interventions were the results of NSAID-related problems. All of these interventions reduced the risk of gastrointestinal adverse events and avoided a total cost of 37 300. CONCLUSIONS: This model indicates that the dispensing of NSAIDs by pharmacists and related pharmaceutical care activities have a positive impact by reducing the number of gastrointestinal complications. The model quantifies the costs thus avoided. It also underlines the necessity of effective collaboration between the prescriber and the pharmacist if optimal patient management is to be achieved.

Anti-Inflammatory Agents, Non-Steroidal↗

PubMed2005

Effectiveness of interventions by community pharmacists to improve patient adherence to chronic medication: a systematic review.

OBJECTIVE: To systematically review the impact of interventions by community pharmacists on patients' adherence with chronic medication. DATA SOURCES: A MEDLINE search (1966-November 30, 2003) and a review of reference sections were done to identify all pertinent English- and German-language journal articles. Search terms included compliance, adherence, persistence, discontinuation, pharmacist, and intervention. STUDY SELECTION AND DATA EXTRACTION: From each relevant study, the following data were extracted: study design, country, disease, number of patients, patients' age and gender, type of intervention, duration of follow-up, method of measurement of adherence and adherence rate, and data concerning the quality of the included studies. DATA SYNTHESIS: A total of 162 studies were identified, of which 18 matched our inclusion criteria. Twelve were randomized controlled trials and 6 were non-crossover single-group trials. Eight studies showed significant improvement of adherence at one or more time points. Eight studies did not show any effect, 7 of which were randomized controlled trials. In most studies, adherence rates at baseline were high compared with rates reported in the general population. Counseling, monitoring, and education during weekly or monthly appointments showed some effect. However, these same types of interventions showed no effect in other studies. The overall quality of the included studies was low. CONCLUSIONS: Currently, it is impossible to identify an overall successful adherence-improving strategy performed by pharmacists. More well-designed and well-conducted studies on the effectiveness of interventions by a community pharmacist to improve patient adherence to chronic medication need to be performed.

Community Pharmacy Services↗

PubMed2006

Ensuring that patients receive full cardiac pharmacotherapy services: a pharmacist's call to arms.

While clinical trials have proven that use of certain cardiovascular drugs improves morbidity and mortality, these drugs are not widely used, they are by and large prescribed in suboptimal doses, and their benefit is further diminished by nonadherence. Pharmacists have the ability to improve the survival of patients with cardiovascular risks. This can only be accomplished through the efforts of the individual pharmacist and the further development of health-system management services. Pharmacists need to leverage their access to patients, their large patient base, and their knowledge of refill dates to improve patient care. Support and development of more pharmacist-directed anticoagulation, hyperlipidemia, and hypertension clinics are also needed.

Cardiovascular Agents↗