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PubMed2006

The role of dermatologists, nurses and pharmacists in chronic dermatological treatment: patient and provider views and experiences.

Effectively co-ordinated treatment support from healthcare providers (doctors, nurses and pharmacists) may improve patients' adherence to treatment. The objective of this study was to identify patients' and providers' perceptions of the roles of different healthcare providers in dermatological treatment. Focus groups were used in two types of fora: patients with chronic dermatological diseases (n =2x6) and healthcare providers (n =2x6), including doctors, nurses and pharmacists working in dermatological care. Data were analysed according to the Consensual Qualitative Research approach. The respondents viewed the roles of the providers as complementary, but poorly co-ordinated. Treatment support is provided mainly by the nurse. During the doctor's appointment, diagnosis and treatment decisions are often prioritized, leaving limited time for treatment support. The pharmacist's provision of support is constrained by the lack of privacy and clinical history of individual patients. The most apparent "gap" in the chain of treatment support was between the pharmacist and the other providers. There was a wish for improved interprofessional collaboration to avoid giving conflicting advice. There is a need to improve interprofessional collaboration in dermatology, in order to optimize treatment support in clinical practice.

Adult↗

PubMed1993

Hospital and community pharmacists' attitudes towards clinical pharmacy.

This longitudinal study compared the attitudes of the Class of 1983 at the University of Toronto toward clinical pharmacy seven years after graduation with those they expressed at the point of graduation in 1983. Over three quarters of the original class responded by indicating agreement or disagreement with statements (on a 5-point scale) about clinical pharmacy in 1983 and 1989. While there was little difference between those who became hospital pharmacists versus those who became community pharmacists at the point of graduation, seven years later, the hospital pharmacists were significantly more favourable than their colleagues toward drug consulting aspects of clinical pharmacy. The community pharmacists were significantly more favourable than their colleagues toward patient counselling aspects of clinical pharmacy. It is concluded that the work setting has influenced these different preferences for how the ideal of clinical pharmacy is interpreted. We offer a possible explanation for the consistently positive, if divergent, orientations towards the ideal of clinical pharmacy.

Attitude of Health Personnel↗

PubMed1996

The pharmacist's role in the optimal delivery of primary care in a managed care world.

For managed care to continue positive growth, pharmacists will have to offer support measures for primary care physicians, even as efforts are made to increase the supply of these physicians. The pharmacy practice at Medical University of South Carolina Family Medicine Center has gained national recognition for providing an expansive role model for pharmacists who are committed to providing pharmaceutical care and related services in primary care surroundings. This article discusses managed care in the primary care arena and pharmacists' role in providing pharmaceutical care and teaching future pharmacists their role in a managed primary care world.

Family Practice↗

PubMed1980

A comparison of female and male pharmacists' employment benefits, salary, and job satisfaction.

This study compared women pharmacists' job characteristics, salary, benefits, and job satisfaction to those of their male colleagues. A mail questionnaire was sent to 1700 North Carolina employee pharmacists in August 1978. Approximately 478 pharmacists responded, yielding a 28% return rate. Job satisfaction was measured with the job descriptive index (JDI). Approximately 29% of women versus 5% of men worked part-time. To avoid biasing the results, further analysis excluded all part-time pharmacists. Women earned less than their male counterparts primarily because fewer women held management positions. Hypothesizing that the discrepancy was due to the recent entry of women into the profession, the data were analyzed holding age, years in practice, and time in present job constant. The significant difference in employment status by sex remained. No differences were found in job satisfaction by sex that were not attributable to age. Possible reasons for these results are hypothesized.

Attitude of Health Personnel↗

PubMed1985

Justification and implementation of an oncology pharmacist practitioner in an HMO setting.

The role of an oncology pharmacist practitioner in an outpatient clinic is described. The clinic provides cancer treatment and follow-up to approximately 60 to 80 patients per day. The hospital pharmacy department, the director of the medical oncology service, and the oncology nurse specialist presented a proposal to the clinic administration for the employment of a full-time pharmacist. Previously, the clinic nursing staff prepared all chemotherapeutic agents. The oncology pharmacist now prepares between 35 to 75 chemotherapy drug doses per day. As a result, nurses are able to devote more time to direct patient care. Through the application of inventory management, clinic drug costs have been reduced. In addition, patients undergoing chemotherapy no longer have to wait for their prescriptions since the oncology pharmacist calls them to the outpatient pharmacy. A valuable service has been introduced tht not only benefits the clinic personnel, but also assures that the patients receive the highest standards of care.

California↗

PubMed1985

Pharmacist facilitation of a home IV therapy treatment program.

A pharmacist's knowledge and experience had strong impact on the success of a home intravenous (IV) infusion treatment program, as stated in the following case study. After reviewing the patient's medical history, clinical course, and drug therapy plan, the pharmacist made recommendations that simplified the home IV self-care program, without compromising the results. The article describes how the pharmacist's liaison between patient and physician resulted in successful treatment and avoided significant costs to the hospital and the State Medical Assistance Program (Pennsylvania Department of Public Welfare). As Diagnosis Related Groups (DRGs) become fully implemented, the pharmacist's services will become an even more important component of discharge planning.

Community Pharmacy Services↗

PubMed1980

Pharmacists' views of an experience in capitation reimbursement under the Iowa Medicaid drug program.

The Iowa Medicaid Drug Program recently performed a 2-year experiment in capitation reimbursement of pharmacies in two counties. The aim was to reduce costs and improve the quality of services by creating new economic incentives for pharmacists to expand their role in drug use control. This study is part of an evaluation of this experiment. It summarizes the responses to personal interviews held with the owners or managers of the 11 participating pharmacies and with four employee pharmacists. Almost all pharmacists considered capitation a big improvement over the traditional fee-for-service system of Medicaid payment. The benefit most commonly cites was the advance payment system that some respondents said reduced paperwork and improved their cash flow. Value was also seen in requiring Medicaid patients to designate and obtain services from a single pharmacy, but the pharmacists complained about lack of accurate lists of eligible patients and described wide variations in enforcement of the lock-in. Diversity also appeared in their discussion of problems encountered in making product substitutions. Deficiencies in comprehension and motivation were found to be especially prevalent among the salaried employees.

Attitude of Health Personnel↗

PubMed1999

[The effect of health care reform in Germany on the pharmacist's role in pharmacotherapy].

The present paper describes the pharmacist's role in Germany during the health-service reform and shows his prospects within pharmacological therapy and his role in contemporary modern society. However, emphasis is placed on the out-patient provision of drugs. The development of the recent years clearly indicates the effects of the health-service reform on all concerned in German health services. For this reason the present paper has been extended to include the description of the current social and health guidelines for health services. Moreover, it also describes the individual stages of the health-service reform in Germany between 1989 and 1997. The theoretical part was supported by patient's opinion polls. With examples of 500 interviewees from Bavaria and Baden-Württemberg, patient habits were surveyed regarding drug consumption, compliance, self-treatment, and drug information as well as the patient's expectations of the pharmacist. Depending on the growth of scientific knowledge in health services and on the need for medical care, the pharmacist's role has to undergo continuous changes, worldwide. Due to the analysis and scrutiny of the transformation of German health services--for Germany has a state health insurance in traditional solidarity--the present paper gives a prediction concerning further development, and, above all, the necessary changes in the pharmacist's work in the framework of health services to be carried out. Generally it is possible to say that the obtained knowledge has general validity which other countries can make use of while considering their local conditions.

Drug Therapy↗

PubMed1999

Telematics applications to support the role of the community pharmacists as self-medication advisors. TESEMED Consortium.

One of the applications developed within the EU-funded projects TESEMED and TESEMED-II is a program for the information and continuous training of community pharmacists, with the aim to empower them as advisors of the citizens about self-medication topics. Several programs are being developed on the basis of ad-hoc developed protocols about minor ailments (currently, cold and flu, haemorrhoids, constipation and cough). Each program includes three modules: a hypertextual version of the protocol, an interactive scheme of it, and an educational tool called Encounter Simulator, that trains the pharmacist about the protocol by means of simulated pharmacist-customer interactions. The testing of these applications with 84 community pharmacists offers positive results in terms of expectations, program characteristics and perceived usefulness.

Common Cold↗

PubMed1975

The pharmacist as a provider of primary care.

A survey was undertaken to document the primary health care role of the pharmacist in London, Ont. Of particular interest was the volume of primary contacts, the type of problem handled and the advice given by the pharmacist. The contribution of pharmacists in primary health care was found to be large, with neighbourhood pharmacies being the most active. Eighty percent of all problems were handled by recommending an over-the-counter drug. The pharmacist appears to be comfortable in this function, although a conflict may exist between his professional and merchant roles.

Ontario↗

PubMed2000

A Danish pharmacist in Wisconsin's Northwoods--Otto Boberg, 1885 to 1925.

Otto Johan Sinius Boberg (1860-1825) exemplifies the immigrant pharmacists who helped convert the undisciplined drug trade of early America into a would-be profession. The education and inspiration of West European pharmacy that he brought with him did not square well with conditions in what had been the Old Northwest Territory. But the role of radical reformer or charismatic leader was foreign to his nature. He preferred a quiet determination and gradualism, focused at first on becoming an exceptional pharmacist among the roistering lumberjacks and dueling lumber barons of his hometown. Then, from about the turn of the century on, Otto came out from behind his counter to devote more time to his writings and to organizational efforts--working for the betterment of his calling. He and others like him, made an important difference during the period of transition in American pharmacy during the late nineteenth century. At age 65 Otto was continuing as a member of the State Board of Pharmacy, as Secretary of the Wisconsin Pharmaceutical Association, and as an analyst--although the drugstore and its management had been turned over to his pharmacist-son, Edwin. Then, on 23 October 1925, he died. Earlier that year the University of Wisconsin had recognized Boberg's exceptional service, as a pharmacist and analyst, to the people of his adopted state by conferring the honorary degree of "Master of Pharmacy." It was a title that Otto probably considered the highest possible compliment.

Denmark↗

PubMed1996

[Lavoisier and the Parisian pharmacists of his time].

In the 17th and 18th centuries, pharmacists were highly competent in experimentation and well-versed in chemical manipulations. Of necessity, Lavoisier had extensive rapport with them. Presented here are the attitudes regarding him by pharmacists who had their own shops during the twenty years preceding the Revolution. There were his adversaries (one implacable: Baumé; the other lightly mocking: Demachy), his defenders (one timorous: Bronigniart; the other enthusiastic: Cadet de Vaux), and finally and above all those who remained indifferent, although for the most part they had worked for brief periods with Lavoisier (Cadet de Gassicourt, Déyeux, Mitouard and Quinquet). And yet, Baumé and Cadet de Vaux, who were in opposition when faced with the ideas of the new chemistry, joined in their efforts to attempt to get Lavoisier out of prison, at the risk of being guillotined. Finally, the greatest hommage rendered to the pharmacists came from Lavoisier himself, who believing that he would be released from prison denied all of his assets, envisaged himself becoming a pharmacist.

Chemistry↗

PubMedDate not supplied

[Pharmacies and pharmacists in Senta from 1816-1966].

INTRODUCTION: This paper reviews historical data on the beginnings of pharmacy and first pharmacies in the world, with special emphasis on pharmacies at the territory of Vojvodina, as well as laws regulating education of pharmacists in the 19th century and work of pharmacies of that time. OUR INVESTIGATIONS: The first data on pharmacies of Senta date back to 1816 when Jozef Samanic submitted an application to open a pharmacy in Senta. The first pharmacy in Senta was founded in 1818 and was called "Kod crnog orla" (At the Black Eagle), whereas Jozef Helbling was the first pharmacist. He sold his pharmacy to Jozef Diener who then sold it to Ferenc Hajsler in 1826. The Hajslers owned this pharmacy in Senta for four generations. They were prominent and respected citizens of Senta. The second pharmacy in Senta was called "Narodna apoteka" (The Public Pharmacy) and was opened by Menjhart Muci in 1883, but was rented several times till 1935 when Lajos Herman bought it. In 1894 Kalmar Cizer got a permission to open the third pharmacy in Senta, but a year later he sold it to Vojislav Jovanović. In 1929 he sold it to Mor Glikstal. In 1911 the fourth pharmacy was opened by Dula Banfi and was called "Apoteka nada" (The Pharmacy of Hope). It was inherited by Boldizar Banfi, a prominent pharmacist in Senta. The fifth pharmacy was founded by Zvonimir Tolović and was called "Kod svetog Antuna" (At Saint Antun's). In 1929 he sold it to Laslo Husag. The sixth pharmacy was opened in 1938 by Obrad Popov. After the end of World War II in 1945, the first Public Pharmacy was founded. After that five public pharmacies were founded and they merged into one Public pharmacy in 1963. In 1966 there was a referendum and The Public Pharmacy became a part of the Medical Center founded on January 1, 1966. At the end, names of all registered pharmacists who used to work in Senta from 1818 to 1966 are listed, as well as dates when they began and finished working in our town.

History, 19th Century↗

PubMed2002

Improved medication use in long-term care: building on the consultant pharmacist's drug regimen review.

Elderly and long-term care (LTC) patients often require complex medication regimens that increase their risk of adverse drug events or suboptimal pharmacotherapy. Currently, oversight of medication use in LTC facilities consists of a federally mandated monthly audit, the drug regimen review (DRR), performed by a consultant pharmacist, and yearly onsite government surveys. Although the DRR's purpose is to improve drug use and to avoid adverse drug events, the Centers for Medicare and Medicaid Services's (CMS) current DRR guidelines focus on a limited selection of medications and indications rather than on patient outcomes. An expanded model building on CMS's survey guidelines and the American Society of Consultant Pharmacists' Fleetwood Model is proposed to improve oversight of medication use. The proposed model includes using consultant pharmacists with demonstrated geriatric pharmacotherapy expertise, direct patient assessments by the pharmacist, increased interaction among healthcare professionals, evidence-based practices, and explicit patient outcome assessments. It is both feasible and timely: (1) the LTC prospective payment system aligns financial incentives between payers and providers; and (2) the Institute of Medicine has made quality improvement and error reduction a priority.

Aged↗

PubMed2003

[Newly-developed drug information services provided by hospital pharmacists].

Modern health care is supported by many health care professionals. Hospital pharmacists are required to accept increasing responsibilities for appropriate medication use, moving into more important roles within the health care system. Accurate drug information is indispensable for appropriate medication use, however, drug information is not always sufficiently utilized by physicians, and thus it is suggested that there is a need for providing individualized drug information (one to one advice to physicians). Hospital pharmacists must have access to patient-specific health care information and must monitor drug therapy directly in order to provide individualized drug information. Hospital pharmacists, with proper access to patient-specific health care information, can promote safer prescribing practices by advising both patients and physicians, and so can reduce patients' risk for medication-related problems and improve the quality of their health care. Optimal drug therapy is the goal for every patient. Together, using their respective knowledge bases, pharmacists and physicians could provide optimal drug therapy, benefiting both patients and the health care system.

Drug Information Services↗

PubMed2003

A randomized controlled trial of a pharmacist consultation program for family physicians and their elderly patients.

BACKGROUND: Pharmacists can improve patient outcomes in institutional and pharmacy settings, but little is known about their effectiveness as consultants to primary care physicians. We examined whether an intervention by a specially trained pharmacist could reduce the number of daily medication units taken by elderly patients, as well as costs and health care use. METHODS: We conducted a randomized controlled trial in family practices in 24 sites in Ontario. We randomly allocated 48 randomly selected family physicians (69.6% participation rate) to the intervention or the control arm, along with 889 (69.5% participation rate) of their randomly selected community-dwelling, elderly patients who were taking 5 or more medications daily. In the intervention group, pharmacists conducted face-to-face medication reviews with the patients and then gave written recommendations to the physicians to resolve any drug-related problems. Process outcomes included the number of drug-related problems identified among the senior citizens in the intervention arm and the proportion of recommendations implemented by the physicians. RESULTS: After 5 months, seniors in the intervention and control groups were taking a mean of 12.4 and 12.2 medication units per day respectively (p = 0.50). There were no statistically significant differences in health care use or costs between groups. A mean of 2.5 drug-related problems per senior was identified in the intervention arm. Physicians implemented or attempted to implement 72.3% (790/1093) of the recommendations. INTERPRETATION: The intervention did not have a significant effect on patient outcomes. However, physicians were receptive to the recommendations to resolve drug-related problems, suggesting that collaboration between physicians and pharmacists is feasible.

Aged↗

PubMed2003

[The title of pharmacist and its prerogatives].

By creating two access roads to the pharmaceutical profession, the law of Germinal was at the origin of the distinction between pharmacists 1st class ans pharmacists 2nd class. This distinction only died out at the end of XIXth century after having generated and extremely singular type of illegal exercise of pharmacy. The litigation yesteryear, based on the prerogatives attached to the title of pharmacist, found an echo in contemporary jurisprudence. In order to stop the use of the pharmacist's title by graduates working in a para-pharmacy, the legislator restricted the use of the title to those graduates exercising the pharmaceutical art only.

France↗

PubMed2004

[Roles of the hospital pharmacist and the cooperation between hospital pharmacy and insurance pharmacy in the introduction of home parenteral nutrition].

In the introduction of home parenteral nutrition (HPN), roles of the pharmacist are important from the viewpoint of drug therapy. In our hospital, patients are to be shifted to home medical care under the adequate guidance and proper adjustment by the cooperation between the clinical pharmacists and home medical care pharmacists. We are also enhancing the cooperation with the pharmacists in insurance pharmacies. At present, however, there are few insurance pharmacies that can concoct the injection of medicine, resulting in our insufficient responses to the needs of the patients. It is necessary and quite important to increase the number of insurance pharmacies that are allowed to manage the patient's medication as well as the concoction of injecting medicine. The cooperation between hospital pharmacy and insurance pharmacy (Yaku-Yaku Renkei in Japanese) is indispensable in order to promote home medical care; especially "the sharing of information" is most required between the two pharmacy groups.

Community Networks↗