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At least 955 records · Page 53Linked to original sources
PubMed2005

Survey of topical oral solutions for the treatment of chemo-induced oral mucositis.

PURPOSE: The objectives of this study were (1) to describe the usage of topical oral solutions in patients experiencing chemotherapy-induced oral mucositis (CIOM); and (2) to survey the care of oral mucositis provided to patients by clinical oncology pharmacists in institutional settings. METHODS: Surveys were distributed to institutional pharmacists in the US, who were asked to provide the components of their 'magic mouthwash'. Other questions included whether an institutional mucositis management guideline is available and what is the involvement of clinical pharmacy in mucositis care. RESULTS: Forty institutions returned surveys during the study period. The top five ingredients used to compound the magic mouthwash are diphenhydramine, viscous lidocaine, magnesium hydroxide/aluminum hydroxide, nystatin and corticosteroids. Most institutions administer the mouthwash every 4 hours (36%) or every 6 hours (36%). Of the surveyed institutions, 33% currently possess guidelines for the management of CIOM. CONCLUSIONS: Most institutions in the country formulate their topical solution, or magic mouthwash, with a variety of ingredients. There is a need to standardize the ingredients used to compound the magic mouthwash, in order to fully evaluate the efficacy of the solution to manage CIOM.

Administration, Buccal↗
PubMed2003

[The expected role of community pharmacist in society].

With recent advances in the separation of dispensing and prescribing drugs (Bungyo), the social role of community pharmacists has expanded. Therefore we carried out a questionnaire survey on the "image of community pharmacists" among patients/the public, physicians, and community pharmacists. The understanding of their role by community pharmacists differed slightly from that by patients/the public or physicians. Better mutual understanding among the three parties is necessary for smooth communication. Dispensing and handing over drugs to patients are not the only tasks required of community pharmacists. Evaluation of records of telephone drug counseling by the Japan Pharmaceutical Association revealed that many callers desired not only drug information but also the opinions and judgments of pharmacists. Providing drug information is an important task for community pharmacists. In addition, counseling on anxiety and worries about health may be necessary. Bungyo has also affected drug distribution. In this field, the role of community pharmacists in providing drug information may markedly change in the future.

Community Pharmacy Services↗
PubMed1979

Pharmacy services in a 240-bed Gordon Friesen-design hospital.

This article describes a typical Gordon Friesen-design institution in which the facility design and systems design complement one another to make an efficiently run hospital. The basic concepts of the hospital are to keep the nurse with the patient and to maintain a steady supply flow by centralizing responsibility for materials. Problems that occur in pharmacies of facilities designed by Friesen usually are related to logistics. The design of the institution make delivery of medication and communication with staff nurses more difficult. Pharmacy programs such as unit dose and intravenous admixtures, excellent examples of products in "patient-ready units," complement the other supply delivery systems that are typical of a Friesen-design institution. Good written and verbal communications between nursing staff and pharmacy can bring about a smoothly flowing pharmacy service that blends with the overall concept.

Hospital Administration↗
PubMed2003

The tough decisions that no one wants to make.

This article examines prescription drug benefit plan trends: past, current, short-term future and long-term future. It includes a brief discussion of each cost trend and its drivers, then asks the question, "What can be done to protect the pharmacy benefit budget, yet provide what is needed?" from three perspectives: (1) business, (2) stakeholders (management, human resource groups, physicians, employees) and (3) patients (employees and dependents). The article discusses therapeutic guidelines, physician education, reimbursement issues, distribution channels and the impact of business decisions on employees, dependents, stockholders, shareholder value, management, human resources and decision makers' own careers.

Advertising↗
PubMed1978

Revision and reorganization of a hospital pharmacy policy and procedure manual.

The development of a hospital pharmacy policy and procedure manual which can provide employees with an immediate source of current and reliable operating information is discussed. Flexibility and the capability to be readily revised were key factors in the design of the manual. A table of contents, a referencing system and physical specifications for the manual were determined. Policies and procedures on format, writing style, distribution, responsibility, revisions and additions, and review were established. Sample policies and procedures are presented. The concept of a procedure specialist to coordinate all activities regarding the manual was examined. It is recommended that all staff members participate in the development and revision of policies and procedures.

Manuals as Topic↗
PubMed1985

ASHP special interest group professional practice survey--1984.

Personal characteristics and professional practice patterns of enrollees in ASHP special interest groups (SIGs) were surveyed in early 1984. The mail questionnaire consisting of 23 items was sent to the entire universe of 3595 SIG enrollees, 514 of whom belonged to more than one SIG. The response rate was 64.7%. About two thirds of the respondents were between 25 and 39 years old; 73% were men. Nearly 36% had earned more than one academic degree, and 30% had completed an ASHP-accredited pharmacy residency. Most respondents spent a majority of their work time in a community nonprofit hospital (46%) or a university teaching hospital (22%). The following percentage of respondents spent some time in the functions indicated; the mean percentage of time those respondents spent in a function is given in parentheses: administration, 76% (52%); education, 69% (16%); drug distribution and control, 60% (17%); patient-oriented services, 47% (17%); drug information, 54% (12%); research, 28% (17%); pharmaceutical marketing/sales, 6% (25%); other, 12% (29%). The following percentage of respondents spent half or more of their practice time in the functions indicated: administration, 48%; drug distribution and control, 26%; education, 5%; and patient-oriented activities, 4%. By and large only a small percentage of SIG enrollees spent a majority of their practice time providing patient-specific services. This suggests that for most SIGs enrollment corresponds to an interest in a special practice area, not a heavy practice commitment to that area.

Adult↗
PubMedDate not supplied

Pharmacist involvement with immunizations: a decade of professional advancement.

OBJECTIVE: To review achievements in pharmacist-administered immunizations, emphasizing the period 1995 to 2004. DATA SOURCES: Published articles identified through PubMed (1995-2004) using the search terms pharmacist, pharmacy, and vaccine, immunization, or shots. Additional sources were identified from personal bibliographies collected by the authors during this decade, as well as the bibliographies of the retrieved articles. The later two sources resulted in manuscripts of primarily historical significance. STUDY SELECTION: More than 300 manuscripts were identified. The authors selected 15 studies that most clearly document the effect of pharmacist-administered immunizations for review. DATA EXTRACTION: By the authors. DATA SYNTHESIS: While pharmacists have been involved with vaccines dating back to the mid-1800s and the distribution of smallpox vaccine, only 10 years have passed since pharmacists began routinely immunizing patients in their communities as a standard practice activity. The Washington State Pharmacists Association initiated the first ongoing formalized training of pharmacists in vaccine administration in 1994. On November 1, 1996, the American Pharmaceutical (now Pharmacists) Association (APhA) began its nationally recognized training program for pharmacists, Pharmacy-Based Immunization DELIVERY: A National Certificate Program for Pharmacists. By 2004, an estimated 15,000 pharmacists and student pharmacists had been formally trained through recognized programs as vaccine experts, and the practice of pharmacist-administered immunizations, particularly for adult patients, has become routinely accepted as an important role of the pharmacist. Arguably, few initiatives have done more to move the pharmacy profession forward in direct patient care than the pharmacist-administered immunization movement. CONCLUSION: Pharmacists have made significant strides in immunizations over the past decade. Limited activities in the hospital sector have been particularly well documented, as have the perceptions of patients regarding acceptance of pharmacists as immunizers. The activities of community pharmacists are less well documented. More research is needed into novel approaches to pharmacist involvement in public health-focused immunization initiatives, along with continued research evaluating the current practice of pharmacist-administered immunizations.

Adolescent↗
PubMed1999

Potential utility of electronic drug compliance monitoring in measures of adverse outcomes associated with immunosuppressive agents.

Poor compliance with prescribed medications limits the effectiveness of many pharmacologic therapies and enhances their potential toxicities. Traditional methods of measuring drug-taking behavior, including direct observation, patient self-report, pill counts, and therapeutic drug level monitoring, all have well-described limitations in validity and interpretability. Electronic medication event monitoring has been used to assess compliance with therapies for hypertension, glaucoma, anemia, and epilepsy, overcoming many problems of traditional approaches. However, no published reports describe the use of electronic monitoring with immunosuppressive agents, despite their increasing use for non-life-threatening conditions and their many dose-dependent toxicities. Transplant recipients are thought to be at particular risk from noncompliance. Therefore, we undertook this study to assess the feasibility of electronically monitoring compliance with immunosuppressive drugs among renal allograft recipients. Twenty-five kidney transplant patients receiving immunosuppressive medications from a single pharmacy were enrolled. Each subject received electronic monitors with their immunosuppressive serum drug refills for cyclosporine and azathioprine. Each subject returned their monitors after the first month of this 2-month study for downloading data. The frequency distribution of interdose intervals were described. Two measures of average non-compliance were calculated for both drugs: the proportion of monitored days that had missed doses, and the proportion of missed doses. Once daily and twice daily regimens of cyclosporine were compared. Concordance in drug compliance between the two drugs was calculated for each subject and averaged over the study population. Twenty-two of 25 subjects missed one or more doses of cyclosporine or azathioprine. Seventeen (68%) subjects never missed four or more consecutive doses. Subjects were non-compliant with cyclosporine on 8.7% of monitored days, and non-compliance with azathioprine on 9.8% of monitored days. Subjects were non-compliant with 6.8% of their cyclosporine doses and 9.8% of their azathioprine doses. Patients were compliant with both drugs on 86.6% of days and were non-compliant with both drugs on 5.1% of days. Subjects were non-compliant with cyclosporine during 5% and 13.2% of monitored days for once and twice daily dosing regimens, respectively. Concordance analysis demonstrated that for 91.7% of days of monitoring, compliance information was identical for both drugs. This study demonstrated the feasibility of electronic medication event monitoring among kidney transplant patients. This methodology represents an important tool for monitoring compliance of immunosuppressive agents essential to their safe and effective use, and should be considered for use in future studies of these drugs and others with substantial dose-dependent toxicity.

Journal Article↗
PubMed2003

Medication errors in hospitals: computerized unit dose drug dispensing system versus ward stock distribution system.

AIM: The aim of this study was to evaluate the rates and types of drug prescription and administration errors in one pediatric nephrology ward, comparing two dispensing schemes: the first one defined as handwritten prescription plus ward stock distribution system (WSDS), and the second one as computerized prescription plus unit dose drug dispensing system (UDDDS). METHOD: Data were collected over an 8-week period, from 1 February to 31 March 1999. Two fifth-year pharmacy students photocopied prescription and administration documents on the ward each day, under the supervision of a senior pharmacist. The medical record analysis was used to compare the prescription with the administration report. Prescribing and administration medication errors were classified according to the American Society of Health-System Pharmacists. RESULTS: Prescribing errors: overall, for both dispensing schemes, a total of 511 prescriptions, resulting in 4532 prescribed drugs (an average of 9 drugs per prescription) were prescribed. The total prescription error rate was 20.7% (937 of 4532), resulting in 1.9 errors per patient per day. The computerized prescription error rate was 10.6% (419 of 3943), the handwritten prescription error rate was 87.9% (518 of 589). This difference was very significant (P < 0.0001). ADMINISTRATION ERRORS: The total opportunity of administration errors was 4589 (sum of administered and omitted drugs). The total administration error rate was 23.5% (1077 of 4589) including wrong administration time, and 11.7% (538 of 4589) excluding administration time. The administration error rate, including administration associated with time errors, was only 22.5% (888 of 3943) for computerized prescription + UDDDS, compared with 29.3% (189 of 646) for handwritten prescriptions plus WSDS (P < 0.001). Excluding administration associated with time errors, the administration error rates were 9.7% and 24.3%, respectively (P < 0.0001). CONCLUSION: The drug prescription and administration error rates were significantly decreased using computerized prescription plus UDDDS as compared with handwritten prescription plus WSDS in a pediatric unit (even with potential biases taken into account).

Child↗
PubMed2001

Costs of high-dose chemotherapy and peripheral blood progenitor cell autograft for breast cancer.

The aim of the study was to analyze the real cost of single or tandem high-dose chemotherapy (HDC) and peripheral blood progenitor cell autologous transplant (PBPCT) in patients with breast cancer. We analyzed the costs of 40 PBPCT performed in 20 patients. Tandem transplant was planned for each patient. Resources used and direct costs were identified for each patient. The study was carried out using the hospital perspective and monetary values were reported in 1999 Euro. The mean cost of whole procedure for single transplant was 20,816.63 Euro, while the mean cost of tandem transplant was 38,770.83 Euro. The cost distribution in the two groups was similar: the most expensive phase of procedure was the supportive phase post transplant (about 60% of total cost), with the categories of cost most represented being professional fees (about 28%) and pharmacy (about 35%). Awaiting more convincing trials of the clinical advantage of HDC in breast cancer, our analytical evaluation of transplant costs for different therapeutic options, single or tandem, permits identification of the most expensive categories in order to intervene for cost savings.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1985

A retrospective-prospective study of medication errors: basis for an ongoing monitoring program.

Medication error surveillance is an important component of the quality assurance program of any hospital. The present study was undertaken in an attempt to determine the reliability of data collected retrospectively on medication error forms, as compared to data obtained from a prospective observational study within the same hospital. The results indicate that for many parameters reasonably reliable information can be obtained from voluntarily submitted error reports. Other observations made during the study were also useful to both the nursing and pharmacy departments in their efforts to minimize the occurrence of errors. Based on the information provided by this study, a more formalized medication error surveillance program has been established and a number of changes in the drug distribution and administration systems have been proposed.

Hospital Bed Capacity, 500 and over↗
PubMed1983

Reducing lost drug charges by monitoring computer-generated interdepartmental transfers.

The use of computerized interdepartmental transfer records to identify lost drug charges and a program to capture those charges are described. All charges for medications ordered on floor-stock requisitions for the operating room and various intensive-care units in a 400-bed hospital were entered into the pharmacy's computer. Medications ordered on requisitions that were not stamped with a specific patient's name were charged to the patient-care unit using the computer's interdepartmental transfer program. Computer reports itemizing these charges indicated that over $5100 per month was being lost, approximately half of which originated from the operating room. To reduce lost charges, an improved method of drug-inventory control was implemented in the operating room, and two nurses were hired to coordinate the drug-distribution system in this area. In addition, nurses in other intensive-care units were informed about the liabilities associated with failure to charge for medications, and incentive programs were developed to improve compliance with these procedures. During the first six months after implementation of these measures, monthly lost charges were reduced by a mean of 86%. The use of computerized interdepartmental transfer records to identify lost pharmacy charges may help to justify the cost of computer systems.

Computers↗
PubMed2003

Pattern of antibiotic use in a trachoma-endemic region of Nepal: implications for mass azithromycin distribution.

PURPOSE: To investigate antibiotic utilization in a rural district of western Nepal that is currently receiving azithromycin as part of a trachoma program and is being monitored by the Centers for Disease Control and Prevention (CDC) for drug resistance. METHODS: Antibiotic purchase receipts were collected for 3 months from all medicine halls, pharmacies, and government sub-health posts in a sub-district of Western Nepal. Supplementary surveys of antibiotic sales were performed in different seasons. RESULTS: Macrolides account for 3.9% of total antibiotic use, far less than quinolones, penicillins, tetracyclines, and sulfonamides. CONCLUSIONS: If trachoma programs in Western Nepal generate transient macrolide resistance in pneumococcus and other bacteria, the epidemiological impact may not be great, as macrolides are not commonly used in the area.

Anti-Bacterial Agents↗