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PubMed1992

Pharmacy promotion of tobacco use among children in Massachusetts.

The role played by pharmacies in the promotion and distribution of tobacco to children was assessed in a survey of 100 pharmacies. Of the 100 surveyed, 95 sold tobacco products, 50 advertised tobacco, 42 advertised the cigarette brands that are most appealing to children, and 23 displayed the Camel cartoon advertisements that have been identified as being targeted specifically at children. Candy tobacco products were sold in 22% of the pharmacies. Of the pharmacies selling tobacco, 81% were willing to sell it to minors illegally. The five pharmacies that did not carry tobacco products were independent stores. When compared to chain pharmacies, independent pharmacies more frequently advertised tobacco (p less than 0.05) but were not more likely to sell it to children. The authors contend that pharmacists who sell tobacco violate the profession's Code of Ethics and play an important role in the promotion of tobacco use among children.

Adolescent↗
PubMed2000

British community pharmacists' views of physician-assisted suicide (PAS).

OBJECTIVES: To explore British community pharmacists' views on PAS, including professional responsibility, personal beliefs, changes in law and ethical guidance. DESIGN: Postal questionnaire. SETTING: Great Britain. SUBJECTS: A random sample of 320 registered full-time community pharmacists. RESULTS: The survey yielded a response rate of 56%. The results showed that 70% of pharmacists agreed that it was a patient's right to choose to die, with 57% and 45% agreeing that it was the patient's right to involve his/her doctor in the process and to use prescription medicines, respectively. Forty-nine per cent said that they would knowingly dispense a prescription for use in PAS were it to be legalized and 54% believed it correct to refuse to dispense such a prescription. Although 53% believed it to be their right to know when they were being involved in PAS, 28% did not. Most pharmacists (90%) said that they would wish to see the inclusion of a practice protocol for PAS in the code of ethics of the Royal Pharmaceutical Society of Great Britain (CE-RPSGB) in the event of a change in the law on PAS. In addition, 89% would wish to see PAS included in the Conscience Clause of the CE-RPSGB. Males were found to be significantly less likely to favour PAS than females (p < 0.05), as were those declaring an ethnic/religious background of consideration when dealing with ethical issues in practice compared with their counterparts (p < 0.00005). CONCLUSION: Pharmacists view their professional responsibility in PAS to be more obligatory than a physician's, in having to provide the means for PAS. It is worrying that a proportion of the respondents prefer to remain in ignorance of the true purpose of a prescription for PAS; a finding at odds with current developments within the pharmaceutical profession. A practice protocol for PAS and an extension of the conscience clause should be considered in the event of PAS becoming legal. Such measures would allow the efficient provision of the pharmaceutical service whilst at the same respecting the personal beliefs of those who object to cooperating in the ending of a life.

Age Factors↗
PubMed1992

Hospital pharmacy in 1991: the year in review.

Issues and activities that dominated hospital pharmacy in 1991 are reviewed, and their relationship to political and economic trends of national and international importance is described. While rising costs, equitable reimbursement, and access to care continued to dominate the nation's health-care agenda in 1991, the growing interest in quality assurance was also noteworthy. Health-care reform will likely be a dominant issue during the current election year, and pharmacists are urged to play an active role in this restructuring process, both within their work settings and in their communities. Among the major concerns of hospital pharmacy in 1991 were the appropriate use of the new products of biotechnology, advances in computer and communications technology, and measuring and improving the quality of pharmaceutical care. Other issues highlighted in the literature included the need to articulate a mission statement concerning pharmaceutical care, the role of specialization in pharmacy practice, and the appropriate allocation of human resources. The literature of hospital pharmacy continues to provide insight into the progress of the profession and to serve as a benchmark that will gauge its future course.

Computers↗
PubMedDate not supplied

1992 National Clinical Pharmacy Services Study.

STUDY OBJECTIVE: To determine the extent of hospital-based clinical pharmacy services in 1992. DESIGN: National survey with trend comparison to 1989. SETTING: All 1597 United States acute care, general medical-surgical and pediatric hospitals with 50 or more licensed beds and one or more full-time pharmacists (43% of all U.S. hospitals). MEASUREMENTS AND MAIN RESULTS: Fourteen clinical pharmacy services, carefully defined to indicate pharmacist proactive or concurrent patient care provision, were assessed to determine pharmacists' specific patient care responsibilities. The percentage of hospitals offering each of the services increased from 1989 to 1992, with greatest growth in management of adverse drug reactions (22% increase), pharmacokinetic consultations (14%), and drug therapy protocols (12%). The mean percentage of patients actually receiving clinical pharmacy services ranged from 0.2% for pharmacist participation on the cardiac arrest team to 36.1% for daily monitoring of drug therapy. Pharmacists conducted clinical research in 13% of all hospitals, averaging 3.9 +/- 4.3 protocols per year with a total budget of $79,765 +/- $128,641. CONCLUSIONS: Clinical pharmacy services continue to expand; however, even the most common direct patient care service is provided to a small number of inpatients.

Drug Utilization Review↗
PubMed2000

1998 national clinical pharmacy services study.

This study determined the extent of hospital-based clinical pharmacy services in 950 United States acute care, general, medical-surgical, and pediatric hospitals with 50 or more licensed beds in 1998 and compared results with data from similar national surveys in 1989, 1992, and 1995. Fifteen clinical pharmacy services were assessed to determine pharmacists' specific patient care responsibilities. Two services increased substantially over both the 9-year period and between 1995 and 1998: drug therapy protocol management and clinical pharmacokinetics consultations, which were offered in 70% and 80% of hospitals in 1998, respectively. Pharmacists' provision of in-service programs decreased 6% between 1995 and 1998, whereas other services remained constant. Pharmacists conducted clinical research in 14% of hospitals in 1998, averaging 7.2 +/- 19.7 protocols/department annually; total budget was $224,572 +/- 753,321; and mean clinical research funding increased 2.3-fold between 1995 and 1998. Clinical pharmacy services continue to expand, with pharmacists providing higher-level direct patient care related to drug therapy management and pharmacokinetics consultations.

Adverse Drug Reaction Reporting Systems↗
PubMed2001

Pharmaceutical care until the end: the role of pharmacists in euthanasia in The Netherlands.

Euthanasia and physician-assisted suicide continue to remain a controversial point of discussion in today's society. Patients will seek to increase their role in the decisions concerning their own health and death care. Pharmacists are also confronted with euthanasia: they not only have to provide the necessary drugs, but are also affected in every area of their life. Euthanasia can be seen as a contradiction to the mission of pharmacy practice. If, however, the activities of pharmacists include pharmaceutical care, the contradiction may not necessarily be present. Pharmaceutical care begins with the recognition that responsibilities of patient care cannot be relegated solely to other health professionals. Pharmaceutical care recognizes some of the most important needs of the terminally ill. If based on a patient-centered approach, euthanasia might be a logical last step in the efforts to alleviate the patient's sufferings.

Ethics, Pharmacy↗
PubMed2006

Influence of attitudes toward curriculum on dishonest academic behavior.

OBJECTIVES: The objective of this study was to examine possible associations between students' self-reported behaviors and opinions towards academic dishonesty, and their attitudes towards curriculum, assessment, and teaching within the pharmacy program. METHODS: A questionnaire was developed and distributed to undergraduate (pre-licensure) students at 4 schools of pharmacy in Canada, including students enrolled in the international pharmacy graduate program. RESULTS: More than 80% of respondents indicated they had participated in one or more of the act of academic dishonesty described in the questionnaire. A weak to moderate correlation was found between students' attitudes towards pharmacy education and their self-reported behaviors related to academic dishonesty. CONCLUSIONS: This study confirmed previous findings suggesting widespread academic dishonesty as well as a hierarchy of values with respect to students' perceptions regarding severity and importance of academic dishonesty. Despite methodological limitations inherent in examining academic dishonesty, there is a definite need to continue to examine this important issue. While this study indicated only a moderate correlation between attitudes towards curriculum and dishonest behaviors, the problem of academic misconduct is multifactorial and will require ongoing study.

Attitude↗
PubMedDate not supplied

[The new pharmacy practice: can pharmaceutical intervention improve therapeutical efficiency].

BACKGROUND: The pharmaceutical activity has experienced over the last 50 years an important evolution in terms of concepts and contents affecting not only pharmacists but the whole health professionals. The subject of this study were the characteristics and implications of that change. METHODS: We review the main conditions leading to this change and characteristics of the new pharmaceutical activity focused mainly on the filtrate and alert about drug related problems and the professional intervention facing a proper resolution. RESULTS AND CONCLUSIONS: Some preliminary results from an investigation about the mentioned conditions are presented supporting the idea that this new proposed pharmaceutical intervention model can actually improve benefits on therapeutical effectiveness and save resources.

Ethics, Pharmacy↗
PubMed2002

[Prosecution of Mélanie Hahnemann in 1847 at the court of Paris: illegal practise of pharmacy and medicine].

Recently married, the Hahnemanns came to Paris in 1835. The great man, 80, was authorised to practice in France. His wife Mélanie always assisted him in writing prescriptions, and in recruiting patients. When he died in 1843, she was continuing to practise assisted or not by a physician, Deleau or Croserio. A young pharmacist, Charles LeThiére, lived close to her as her adoptive son, grandson of the famous painter Guillaume Guillon-LeThière who was the director of the French Academy of Fine Arts of Rome at the Villa Medici, grandson as well of the Roman pharmacist Giuseppe Meli. Early Charles remained orphan and was educated by Mélanie. In 1844, he obtained his pharmaceutical graduation at the Ecole supérieure de Pharmacie de Paris. In 1847, she was accused of illegal practising of medicine and pharmacy. She claimed that she held the degree of doctor in homeopathy granted to her by the Academy of Pennsylvania. The court condemned her on the medical side considering that she earned money without legal certification in medicine. But as the drugs were prepared by a pharmacist, and delivered free of charge to the patients, no sentence was pronounced against her neither against LeThière. However, the court tempted to object that LeTière did not meet all the legal requirements for practising his pharmaceutical activity, especially aruging that he did not own an open shop of pharmacy, and that he did not declare his activity to the authorities in Paris. This point underline the fact that during the XIXth century the French law (21 germinal An XI- 1803), obliged the starting drug industry to be in dependence of the shops of pharmacy opened to the public, owned by a graduated pharmacist. As defender Mrs. Hahnemann chose the quite known solicitor Chaix d'Estange. Many testimonies came for justifying her capability of medical prescribing from artists, officers, writers and several aristocrats. From abroad came the supports of American doctors, Hempel, Hering and Hull. But the core question motivating her sentence came from the medical lobby acting in Paris led by the professor Orfila. Among the adepts of the homeopathy themselves, raised division and rivalry, but all considering that Mélanie Hahnemann's behavior was criticable. The court fined her for hundred francs that she paid. Then, she kept the circle of her friends and continued in medical counselling.

Ethics, Pharmacy↗
PubMed2005

"We are white coats whirling round"--moral distress in Swedish pharmacies.

OBJECTIVE: The extended role of pharmacists has made pharmacy practice more complex and increased the moral responsibility of pharmacy staff. Consequently, ethics has become an important part of their daily work. In health care, ethical dilemmas have been shown to cause distress, usually referred to as "moral distress". Moral distress among hospital personnel has been well described and discussed in numerous studies. There are very few similar studies in pharmacy settings. This article reports on the results of an investigation concerning whether and in what situations moral distress is present in pharmacy practice. METHOD: A questionnaire derived from focus group data, covering ethically troubling situations in pharmacy settings, was distributed to all staff of three pharmacies in Sweden. RESULTS: The results show that moral distress is experienced in the day-to-day pharmacy practice, and that it is in many ways connected to care providing. For example, prioritizing between customers was reported as very stressful. Younger personnel reported higher moral distress than their older colleagues did. However, there were no differences between pharmacies. A lack of support structures, such as meetings where ethical issues can be discussed, was reported by all the participating pharmacies. CONCLUSION: It is reasonable to assume that moral distress is even more present in pharmacy practice than in other health care areas as it is, in general, much more sensitive and exposed to the modern, demanding customer. The meeting with the customer is on a more neutral ground than in, for example, a hospital setting. Although there are ethical codes for pharmacists, they are not enough. Moral distress is experienced anyway; general codes and personal coping strategies must be supplemented with support from the management and work organization. There is a need to look more closely at specific factors related to the degree and extension of moral distress, going beyond individual coping strategies.

Attitude of Health Personnel↗
PubMed1998

Cryptolepis sanguinolenta: an ethnobotanical approach to drug discovery and the isolation of a potentially useful new antihyperglycaemic agent.

Evidence has been published that a wide array of plant-derived active principles, representing numerous classes of chemical compounds, demonstrate activity consistent with their possible use in the treatment of patients with Type 2 diabetes mellitus (DM). Despite these interesting observations, to date, metformin is the only ethical drug approved for treatment of Type 2 DM derived from a medicinal plant. Why is this so, given the fact that higher plants are such a potential source of new drugs? The answer to this rhetorical question may lie in the reliance of most pharmaceutical companies on random, in vitro, mechanism-based, high throughput screening in the initial phases of plant drug research. In this article we describe an alternative pathway to discovery of drugs for the treatment of Type 2 DM: on based on an ethnomedical approach, involving ethnobotany and traditional medicine. In particular, we present evidence that cryptolepine, an indoloquinolone alkaloid isolated from Cryptolepis sanguinolenta, significantly lowers glucose when given orally to a mouse model of diabetes. The antihyperglycaemic effect of cryptolepine leads to a significant decline in plasma insulin concentration, associated with evidence of an enhancement in insulin-mediated glucose disposal. Finally, cryptolepine increases glucose uptake by 3T3-L1 cells. These data permit us to conclude that an ethnobotanical approach to drug discovery can identify a potentially useful drug for the treatment of Type 2 DM.

Adipose Tissue↗