PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “Pharmacy Distribution”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,009 records · Page 56Linked to original sources
PubMed1962

Emergency health supplies: present status of procurement and control.

Until recently there was no substantial reserve of health supplies in Canada capable of supporting major peacetime or wartime disasters. In 1952, an $18,000,000 stockpile was authorized by the Federal Government of Canada. Purchases were made to a total of $15,500,000 with deliveries to exceed $13,000,000. Over $6,000000 worth of supplies was distributed to eight regional depots across Canada in safe and strategic locations. Plans were made for release and control of supplies to provincial governments for use at all levels of control, and a Resources Planning Unit has been organized. In Canada, undergraduate students in pharmacy receive special civil defence instruction in emergency health supplies service.

Canada↗
PubMed1982

Changing an automated drug inventory control system to a data base design.

A pharmacy department's change from indexed sequential access files to a data base management system (DBMS) for purposes of automated inventory control is described. The DBMS has three main functional areas: (1) inventory ordering and accountability, (2) charging of interdepartmental and intradepartmental orders, and (3) data manipulation with report design for management control. There are seven files directly related to the inventory ordering and accountability area. Each record can be accessed directly or through another file. Information on the quantity of a drug on hand, drug(s) supplied by a specific vendor, status of a purchase order, or calculation of an estimated order quantity can be retrieved quickly. In the drug master file, two records contain a reorder point and safety-stock level that are determined by searching the entries in the order history file and vendor master file. The intradepartmental and interdepartmental orders section contains five files assigned to record and store information on drug distribution. All items removed from the stockroom and distributed are recorded, and reports can be generated for itemized bills, total cost by area, and as formatted files for the accounts payable department. The design, development, and implementation of the DBMS took approximately a year using a part-time pharmacist and minimal outside help, while the previous system required constant expensive help of a programmer/analyst. The DBMS has given the pharmacy department a flexible inventory management system with increased drug control, decreased operating expenses, increased use of department personnel, and the ability to develop and enhance other systems.

Computers↗
PubMed1989

Development of the Clozaril Patient Management System.

The Clozaril Patient Management System (CPMS) has been developed to provide a 100% fail-safe system for monitoring white blood cell counts (WBCs) in patients being treated with clozapine (Clozaril/Leponex) in the United States and to provide comprehensive data collection on the incidence and development of agranulocytosis. CPMS provides a case administrator and a registered pharmacist. Their role is to support the physician by facilitating the determination of WBC's at a national laboratory and by distributing clozapine to the patient. Specific tasks of the case administrator include: keeping track of outpatient phlebotomy appointments, following up missed appointments, ensuring that WBCs are obtained and analyzed weekly by the national laboratory, following up the results of these tests, providing liason with the pharmacy, maintaining a data base for all patients receiving clozapine and conveying these data to the physician. Initial experience with this program in Cleveland is described in this paper. The characteristics of patients enrolled in CPMS, satisfaction with the program and its success in meeting predetermined objectives are described. Experience with 31 patients in this outpatient setting suggests that CPMS can be an effective, reliable system for assisting in blood monitoring of patients being treated with clozapine.

Adult↗
PubMed1979

Analysis of missing medication episodes in a unit dose system.

The unit dose drug distribution system at The Buffalo General Hospital in Buffalo, New York, was evaluated by an analysis of cases in which doses of medication were missing from the unit dose administration cart. When a dose was missing, the medication administration nurse reported the occurrence to the pharmacy. When time permitted, the cause of the missing dose was determined and recorded. Thirty causes for missing doses are cited. The causes were found to arise from misuse of the unit dose system by nurses, misunderstandings between the Nursery and Pharmacy Departments, or from oversights on the part of nurses or pharmacy personnel. Missing doses can be prevented in the future by instructing nurses in the use of the system, improving communication between the Departments of Pharmacy and Nursing concerning the needs of the patients, and being aware of mistakes that can occur so care can be taken to prevent them in both departments.

Evaluation Studies as Topic↗
PubMed2002

[Snake bites and antivenom availability in the urban community of Niamey, Niger].

In order to appreciate certain aspects of the epidemiology of snake bites and the availability of antivenom in Niamey (the capital of Niger), we performed a series of retrospective and prospective studies. The retrospective study involved 175 snake bite patients hospitalised from 1 January 1997 to 31 December 1999 in the internal medicine and surgery wards of the two national hospitals of Niamey. The average age of patients was 29 years, with 3 years and 80 years as limits. The average number of snake bites was 58 cases per year with an annual incidence of approximately 10 cases for 100,000 inhabitants. Males were mainly concerned with a sex-ratio of 2.4 (124 males versus 51 females). Snake bites involved mostly teenagers (29.1%). 84.6% of bites occurred in persons aged 15 to 60 years. Incidence was higher during the farming period: 65% of cases occurred between June and October. Lethality reached 6.9%. However, 25.7% of the patients left hospital without staff permission before the end of the treatment. Complications represented 4.6% of the cases and consisted in necrosis, gangrene and coagulopathy. The treatment protocol was inconsistent, such that both therapeutic algorithm and formation are necessary. The prospective survey involved 41 pharmacies or drug middlemen and hospital drug stocks, prospected from 1 January to 31 May 2000. Antivenom was available in 1 hospital and 1 pharmacy and stocks could be considered sufficient for 1 year. However, it appeared that the supply policy had not been clearly defined.

Adolescent↗
PubMed1983

Pharmacy management strategies for responding to hospital reimbursement changes.

Pharmacy management strategies for responding to hospital reimbursement changes are described. On the assumption that the Medicare prospective pricing system and other fixed-rate reimbursement systems will force hospital pharmacists to reduce their operating expenses, several methods of reducing drug use and drug costs, rather than payroll costs, are described: (1) reduced price per unit purchased, (2) increased use of bid prices, (3) decrease in the size and dollar value of drug inventory, (4) drug formulary restrictions, (5) prescribing sanctions, (6) physician education on the relative costs of alternate therapies, (7) drug-use review, (8) use review applied to drug serum assays, (9) controlled access of drug industry representatives to hospital physicians, and (10) dispensing and drug-distribution efficiencies. Physician resistance to pharmacist intervention in drug prescribing and drug-use review should be anticipated; however, pharmacists should expect the support of hospital administrators in efforts to control drug use.

Costs and Cost Analysis↗
PubMed1990

A simplistic approach to establishing drug usage/quality assurance programs.

Eighty-eight percent of the hospitals accredited by the Joint Commission on Accreditation of Health Care Organizations don't fully comply with JCAHO standards in the area of drug usage evaluation, reports JCAHO in Hospitals, August 5, 1989. Why are so many hospital pharmacies receiving contingencies from JCAHO for QA/DUE? Do we lack a clear understanding of the required features and terms, and/or are we confused on how to best implement a comprehensive program? JCAHO has a number of publications which describe not only newer QA/DUE terminology and requirements but also a nine step process to establish a comprehensive program. This article will describe and summarize both terminology and the nine step process. Integration of the nine step process into the drug distribution system allows the pharmacists to identify drug related problems on an ongoing basis. This process is not only efficient but also cost effective. The article will provide simple examples of QA/DUE programs which dovetail with existing drug distribution processes. Lastly, current JCAHO published QA/DUE scoring guidelines will be discussed. The establishment of structured ongoing QA/DUE programs can begin to collect data vital to documenting the impact of the pharmacist on patient care.

Accreditation↗
PubMed2004

Portable medicine chests in Serbia during the 19th and the first half of the 20th century.

Portable medicine chests could be considered as the oldest type of pharmacy in the 19th century Serbia. Historically their emergence could be associated with the appearance of the first physicians who kept post in Serbia. They were foreigners engaged on a contract to work during the reign of Prince Milos Obrenovic. According to the data preserved at the State Archive of Serbia (Chancellery of the principality, State Council, Home Office - Medical Department), medicine chests existed as late as the middle of the last century. They were an important source for health protection of the Serbian people as well as for distribution of drugs during the course of the 19th century. This article aims to analyse the content of these chests, based on the archive data records referring to the regular supervision of the medicine chests conducted every fourth year by the district physician. The legal aspect of keeping the portable medicine chest will be discussed as well.

History of Pharmacy↗
PubMed1993

An equilibrium model of drug utilization.

We propose an equilibrium model to assess the dispensing pattern of non-steroidal anti-inflammatory drugs (NSAIDs) among members of a health maintenance organization. The model incorporates observed patterns of patient switching among NSAIDs and identifies an implicit equilibrium distribution of drug dispensing, which may be used both to identify aberrations in prescription practice and to forecast the expected utilization of newly introduced drugs. NSAID dispensing patterns were stable for most quarters from 1987 to 1990. Introduction of two new NSAIDs and initiation of a pharmacy co-payment coincided with transient perturbation of the patterns. Dispensings of recently introduced NSAIDs achieved their equilibrium values in less than 2 years.

Adult↗
PubMedDate not supplied

Treatment regimens of STD patients in Cameroon: a need for intervention.

BACKGROUND AND OBJECTIVES: The management of patients with STDs is an important element in the fight against AIDS. To define effective STD control strategies a survey was carried out to understand the attitudes of STD patients and the treatment regimens they follow. STUDY DESIGN: The study was based on interviews with male patients with typical symptoms of urethritis leaving private pharmacies in Douala and Yaoundé. Each case was asked to answer a questionnaire comprising the origin of the therapeutic choice, the nature and cost of the treatment and any advice received. RESULTS: Fifty-six men in Douala and 86 in Yaoundé were recruited. The sources of prescription were dispensary (38%, 54%) private MD (9%, 15%) pharmacist (7%, 9%), diverse (46%, 21%) in Douala and Yaoundé respectively. At least two medicines were recommended in three-quarters of the patients. The most frequently used antibiotics were aminoglycosides and penicillin. The cost of the treatment ranged from $3.50 to $110. The more "medical" the initial visit, the higher was the cost of the prescribed treatment. In Douala only 49% of the prescribers advised the patients to treat their partners and condom promotion was done by 21% of the prescribers. CONCLUSION: This survey provides useful data on the care of patients with urethritis. Such surveys are simple, rapid, reasonable inexpensive (about $10,000) and contribute to the efficient design of STD control strategies. In addition, repeat survey to monitor the impact of the strategies are simple to carry out.

Adolescent↗
PubMed2003

Regional pharmaceutical preparation for biological and chemical terrorism.

BACKGROUND: The United States National Office of Domestic Preparedness has determined that the threat of a biological or chemical attack is very real. As an active participant of a 13-county regional task force, one of the roles of the poison center was to determine the pharmaceutical needs of the community in the event of a terrorist action and develop a financially responsible method of acquisition and storage. METHODS: Working with local health officials, an extensive literature review was conducted to identify possible biological and chemical poisons. Treatment recommendations were identified and an estimated amount to treat 5,000 people for 24hrs was determined. Instead of purchasing the medications, a unique solution utilizing a regional pharmacy wholesaler was used. DISCUSSION: An important element in a biological or chemical terrorist event is the availability of the pharmaceuticals and the capability of delivering them rapidly. The poison center is the ideal agency to help coordinate this endeavor since it is familiar with contemporary therapy and will be aware of the number, location, and status of casualties. Based on the expense involved in the purchase and storage of a large quantity of medications, utilizing a local pharmaceutical distribution company is fiscally responsible. Rotation through normal stock and being readily accessible is another benefit. CONCLUSION: The poison center serves a number of roles in the surveillance, recognition, and treatment of biological and chemical terrorism. Assisting in the development, implementation, and procurement of a pharmaceutical cache is yet another role.

Biological Warfare↗
PubMed1981

Management control of drug administration programs.

The relationship between type of drug administration (pharmacy technician versus nurse) and the efficiency and effectiveness of managerial control systems was studied. The sample included pharmacists, pharmacy technicians, and nurses working at one hospital that used technicians for drug administration for 9 of 22 units. Pharmacists and technicians completed a questionnaire for a unit where technicians administered drugs and for a unit where they provided all pharmaceutical services except drug administration. Nurses completed one questionnaire regarding their patient unit. A total of 368 questionnaires were distributed; the response rate was 83.7%. Using hierarchical multiple regression analysis, type of drug administration was the independent variable and complexity and variability of patient-unit technology were moderators of its effects on nine dependent variables. There was no main effect of type of drug administration or moderating effect of technology on number or percentage of medication errors. Pharmacists reported exercising more behavior control when supervising nurses than technicians. Nurses and technicians perceived that pharmacists exercised greater control on units where nurses performed drug administration tasks of low variability. While technicians and nurses provided drug administration services of similar quality, this study suggests that pharmacists can mange technicians more efficiently than nurses in drug administration tasks on units where the tasks are relatively routine.

Attitude of Health Personnel↗
PubMed2003

[Clinical and microbiological characteristics of nosocomial infections according to material of the IIIrd Surgical Clinic, UMBAL "St. George"--Plovdiv, over a 10-year period].

UNLABELLED: As a nosocomial (NI) infection we describe this one acquired in hospital due to proper conditions for spreading of virulent microbes. This is old problem with new vision in the field of use of powerful antibiotics and fast growth microbial resistance. AIM OF THE STUDY: To make an retrospective clinical investigation about the rate, type and etiology of NI as well as duration and outcome of treatment in our clinic and to compare the data with these quoted in literature. MATERIAL AND METHODS: We use hospital charts about the period of 1990-1999. Distribution of NI types was according to CDC criteria. RESULTS: For the period were operated on 14 932 patients. In 918 (6.15%) of them a NI was diagnosed. Sex ratio was 56% (514) man and 44% (404) women with a mean age of 56 years. After the treatment of patients with NI 86.48% (805) of them got better. 13.52% (102) were with unsuccessful treatment and got lethal exit. In 78 (76.47%) of death patients a pneumonia NI was developed. 633 antibiograms were received with 63.03% monoinfections and 22.59% polyinfections. In 91 cases smears were sterile. CONCLUSIONS: NI are one of the reasons for prolonged hospital stay and death of patients although fast development of pharmacy and new antimicrobial agents. It was centered on their prophylaxis.

Anti-Bacterial Agents↗
PubMed2001

Coprescribing and codispensing of cisapride and contraindicated drugs.

CONTEXT: Cisapride, an oral prokinetic drug indicated for the symptomatic treatment of nocturnal heartburn due to gastroesophageal reflux disease, was approved by the US Food and Drug Administration in July 1993. After reports of serious cardiac arrhythmias and deaths during administration of cisapride, most involving concomitant exposure to another drug, a series of label changes and warnings were issued in February 1995, October 1995, June 1998, and June 1999. Cisapride was removed from general distribution in July 2000. OBJECTIVE: To determine the frequency of contraindicted coprescribing and codispensings, in which cisapride and a contraindicated drug were prescribed or dispensed to the same patient for overlapping periods, and the proportion of contraindicated coprescribing by the same physicians and codispensing by the same pharmacies. DESIGN AND SETTING: Retrospective study of prescription claims from a managed care organization database for all patients with cisapride prescriptions between July 1993 and December 1998. PARTICIPANTS: A total of 38 757 adult and pediatric patients who had a cisapride prescription immediately preceded by at least 60 days of insurance eligibility. MAIN OUTCOME MEASURE: Proportion of cisapride prescriptions or dispensing occurring during the same treatment period as a drug contraindicated at that time prescribed by the same physicians or dispensed by the same pharmacies. RESULTS: Of 131 485 cisapride prescriptions dispensed after the warnings began, 4414 (3.4%) overlapped with at least 1 drug contraindicated in the labeling at the time of the prescription. Of all overlapping prescription pairs, 2190 (50%) were by the same physicians, 3908 (89%) were by the same pharmacies, and 765 (17%) were dispensed on the same day. CONCLUSION: Prescriptions dispensed by the same pharmacies accounted for a far higher proportion of contraindicated medication pairs than prescriptions from the same physicians. The pharmacy may be an important and underutilized intervention point to prevent contraindicated drugs from being used together.

Adolescent↗
PubMed2000

Out-of-pocket health care costs among older Americans.

OBJECTIVES: Despite Medicare, elderly persons are exposed to substantial out-of-pocket health care cost burdens. As Medicare reform proposals are considered, it is important to determine the current size, distribution, and burden of these expenditures. METHODS: Data from the 1995 Medicare Current Beneficiary Survey were used to analyze out-of-pocket expenditures and their burden in relation to income; the proportion of total health care expenditures paid out-of-pocket; and the role of pharmacy, hospital, physician, and other services in overall out-of-pocket spending. RESULTS: Expenditures averaged 19.0% of income, for full-year Medicare beneficiaries alive during all of 1995. In bivariate analyses, higher-burden subgroups included those in poor health (28.5% of income), older than age 85 (22.4%), and with income in the lowest quintile (31.5%, despite Medicaid coverage for some). Those relying on fee-for-service Medicare only (23.0%) or with self-purchased supplemental insurance (25.5%) experienced more burden than those with employer-sponsored coverage or in HMOs. In multivariate analyses, functional impairment, number of medical conditions, self-perceived health and privately-purchased supplemental coverage were each associated with higher out-of-pocket burden, while HMO participation was associated with lower burden. Out-of-pocket expenditures averaged 15.2% of total health care expenditures with the proportion highest (22.6%) for those with no supplemental coverage. More than half of out-of-pocket payments for health care services were for prescription drugs and dental services. DISCUSSION: Out-of-pocket cost burdens fall most heavily on those with chronic health conditions and without employer-subsidized supplemental coverage or Medicaid. Impact of Medicare reform proposals on these subgroups needs to be carefully evaluated.

Aged↗
PubMed2000

Cost analysis of an Italian ICU.

BACKGROUND: Cost reduction is an important issue in medicine today, especially when considering ICUs, since they account for a large percentage of all hospital expenditure. Through a retrospective analysis of the data regarding the expenses incurred during the years 1996-97, we have been able to evaluate the total costs of our ICU and the influence that each component had on the final costs, thus gathering the necessary information for the improvement of the unit itself. METHODS: Retrospective analysis of a 5-bedded multidisciplinary ICU activity over a two-year period (1996-1997). Cost-related data have been supplied by the Hospital Administration as to wages, infrastructures, equipment buying and maintenance; by Hospital Pharmacy as to drugs and devices supplies; and by Laboratory and Radiology as to diagnostic investigations. RESULTS: According to our experience, physicians and non-medical staff account for more than 50% of the total expenditure--the latter slightly prevailing. Furthermore, we have assessed that the cost distribution is hardly comparable to that reported by other authors. CONCLUSIONS: It is useful to analyse the total distribution and to evaluate their nature only to gain the necessary data that will lead to a more effective management of the unit. Nevertheless, this methodology is valid within the cost analysis of our ICUs but the ICUs of other countries show great differences in the way they are structured and some of the use more reliable activity-based costing methodology.

Drug Costs↗
PubMed1994

Simulation studies of a wide area health care network.

There is an increasing number of efforts to install wide area health care networks. Some of these networks are being built to support several applications over a wide user base consisting primarily of medical practices, hospitals, pharmacies, medical laboratories, payors, and suppliers. Although on-line, multi-media telecommunication is desirable for some purposes such as cardiac monitoring, store-and-forward messaging is adequate for many common, high-volume applications. Laboratory test results and payment claims, for example, can be distributed using electronic messaging networks. Several network prototypes have been constructed to determine the technical problems and to assess the effectiveness of electronic messaging in wide area health care networks. Our project, Health Link, developed prototype software that was able to use the public switched telephone network to exchange messages automatically, reliably and securely. The network could be configured to accommodate the many different traffic patterns and cost constraints of its users. Discrete event simulations were performed on several network models. Canonical star and mesh networks, that were composed of nodes operating at steady state under equal loads, were modeled. Both topologies were found to support the throughput of a generic wide area health care network. The mean message delivery time of the mesh network was found to be less than that of the star network. Further simulations were conducted for a realistic large-scale health care network consisting of 1,553 doctors, 26 hospitals, four medical labs, one provincial lab and one insurer. Two network topologies were investigated: one using predominantly peer-to-peer communication, the other using client-server communication.(ABSTRACT TRUNCATED AT 250 WORDS)

Computer Communication Networks↗