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At least 19 recordsLinked to original sources
PubMed1985

Definition of clinical pharmacy as a specialty in clinical practice. Committee on Clinical Pharmacy as a Specialty. American Pharmacy Association.

Specialty credentialing has been discussed extensively and debated within pharmacy for more than ten years. Within the profession, there now appears to be a consensus on the need for and appropriateness of acknowledging professional practice areas as unique, defined entities. However, there remain substantive differences on how the definition of specialty practice should be constructed. One approach is to identify practice areas by functional activity (e.g., nuclear pharmacy, drug information) and/or therapeutic focus (e.g., psychopharmacy, clinical pharmacokinetics). A second approach is to define clinical pharmacy as a specialty practice that would, at least initially, coalesce clinical practitioners with the common denominator of an active role in the therapeutic decision-making process. The following document was developed by the Committee on Clinical Pharmacy as a Specialty (CCPS). The CCPS is independent of any formal organizational affiliations. It will serve as the preface to a petition that will be submitted to the Board of Pharmaceutical Specialties requesting recognition of clinical pharmacy as a specialty. The intention of the committee is to resolve the question of specialty status for clinical pharmacy through the Board of Pharmaceutical Specialties' review process. It is then hoped that pharmacy can move forward on the important issue of specialty credentialing.

Certification↗
PubMed1987

Qualifications for future hospital pharmacy directors as perceived by pharmacy directors and hospital administrators in Wisconsin.

Hospital pharmacy directors and administrators in Wisconsin were surveyed to determine their perceptions of the responsibilities, skills, postgraduate education, training, and experience necessary for hospital pharmacy directors during the next 10 years. Packages containing two identical questionnaires were mailed in April 1985 to the pharmacy directors at all 159 hospitals in Wisconsin. The pharmacy director and his or her immediate supervisor were asked to use a 5-point Likert-type scale to rate the importance of various responsibilities and skills and also to rank the most important responsibilities, skills, and issues. In addition, respondents answered forced-choice questions about postgraduate education and training and an open-ended question about academic coursework. All responses were compared by respondent characteristics and hospital size. There was a response rate of 48.1% to the questionnaire, representing 60.7% of the pharmacy directors (n = 96) and 34.6% of the administrators (n = 55). Both groups agreed on which responsibilities and issues will be very important (mean importance rating of greater than 4) for future pharmacy directors. However, administrators rated clinical and technical skills as significantly more important than did pharmacy directors. Only 48% of pharmacy directors believed that a residency is essential and preferred either a general or administrative residency coupled with an advanced degree, whereas more than 50% of the responding administrators favored residencies not affiliated with a degree program. The majority of pharmacy directors and administrators believed that both general staff and administrative experience is necessary for future pharmacy directors.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Pharmacy↗
PubMed1992

Legal status and functions of hospital-based pharmacy technicians and their relationship to clinical pharmacy services.

The relationships among (1) laws and regulations governing hospital-based pharmacy technicians, (2) functions pharmacy technicians perform, and (3) pharmacists' provision of clinical pharmacy services were studied. A state-level technician-restriction score was developed, based on state rules and regulations in effect in 1989. Scoring included (1) type of supervision required for hospital-based pharmacy technicians, (2) ratio of technicians to pharmacists, (3) pharmacist-only reconstitution of injectable products, and (4) pharmacist-only counting and pouring. Actual use of hospital pharmacy technicians was measured with the technician-use index, and overall provision of clinical pharmacy services was measured with the pharmaceutical-care index. Based on the technician-restriction scores, 25 states and the District of Columbia were categorized as having less restrictive laws and 25 states as having more restrictive laws. Technician use varied with hospital size, teaching affiliation, owner-ship, type of drug delivery system, and education level of the director of pharmacy. Use of pharmacy technicians increased with the severity of hospital-patient illness treated. A fair correlation was found between the pharmaceutical-care index and the technician-use index. A positive association was found between pharmacy technician use and pharmacists' provision of clinical pharmacy services.

Certification↗
PubMed1991

Pediatric pharmacy practice guidelines. Pediatric Pharmacy Administrative Group Committee on Pediatric Pharmacy Practice.

Pediatric patients are unique because of age-specific differences in metabolic capacity, disease processes that may make commercially available pharmaceutical preparations unacceptable for use, a lack of published information on the effects of many new pharmacotherapeutic agents in this population, and changes in population demographics caused by new diseases (e.g., AIDS) and new technologic applications. Comprehensive pharmaceutical services are essential for maximizing the benefits--while avoiding or minimizing adverse effects--of pharmacotherapy and new technologies. Comprehensive pharmaceutical services can help maximize the use of health-care resources in the pediatric population and assist in the development, implementation and evaluation of new methods of treatment that will benefit children everywhere.

Humans↗
PubMed1994

Evaluation of recent pharmacy graduates' practice patterns, professional lifelong learning, pharmacy organization memberships, and salary.

OBJECTIVES: To document information on recent bachelor of science (B.S.) pharmacy graduates' practice patterns, professional lifelong learning (PLL) methods, pharmacy organization memberships, and salary. The association between advanced training and education on PLL methods, pharmacy organization membership, and salary are explored. DATA SOURCES: Pertinent literature was identified by MEDLINE searches (1966-1992). STUDY DESIGN: The results of a Fall 1991 survey of recent B.S. pharmacy graduates (n = 371) of the University of Wisconsin School of Pharmacy are reported (55 percent response rate). RESULTS: Hospital pharmacists devoted more time to PLL outside of work (18.00 +/- 17.89 h/mo) than community pharmacists (9.93 +/- 8.76 h/mo), t = 5.02, degrees of freedom (df) = 289, p < 0.001. Graduates who had completed an advanced degree program, residency, or fellowship (advanced degree/training [ADT]) spent more time in PLL (17.76 +/- 10.63 h/mo) compared with graduates who had only obtained a B.S. degree (10.63 +/- 8.56 h/mo), t = 3.80, df = 311, p < 0.001. Graduates who had ADT were more likely to belong to multiple pharmacy organizations (2.14 +/- 1.38 organizations) than hospital pharmacists (1.61 +/- 1.27 organizations) and community pharmacists (1.11 +/- 1.06 organizations). Of the pharmacists who graduated in 1989 and 1990 (one to two years postgraduation), 55 percent belonged to the American Pharmaceutical Association. This declined to 19 percent of the graduates from 1984 and 1985 (six to seven years postgraduation), a 62 percent decline in membership. Membership in the American Society of Hospital Pharmacists (ASHP) was held by 19 percent of graduates one to two years after graduation; and 34 percent of graduates belonged to ASHP six to seven years after graduation, an 81 percent increase. Graduates with ADT (compared with graduates with the B.S. degree only) showed the strongest correlation of membership affiliation, which was about equal with ASHP (phi = 0.32) and ACCP (phi = 0.33). Although pharmacists changed their individual pharmacy organization memberships during the first seven years after graduation, there was no evidence of a decline in overall interest in pharmacy organization membership. Pharmacists who had completed ADT had an annual mean salary of $51,112 +/- $10,012; those pharmacists who did not complete an ADT program had an annual mean salary of $46,440 +/- $7802, a difference of $4672 per year. Hospital pharmacists who had obtained ADT had an annual mean salary of $51,840 +/- $9765; B.S. pharmacists without ADT in hospital practice had an annual mean salary of $43,603 +/- $8192, a difference of $8237 per year. CONCLUSIONS: Pharmacists' PLL methods, organization memberships, and salaries varied significantly by their practice site and the completion of an ADT program.

Education, Pharmacy, Continuing↗
PubMedDate not supplied

An assessment of recent pharmacy graduates' knowledge and competency, professional practice functions, and involvement in pharmacy teaching programs.

STUDY OBJECTIVES: To determine self-evaluated professional knowledge and competency, functions, demographic information, lifelong learning, degree and training status, practice sites, involvement in pharmacy teaching programs, and salary for recent pharmacy graduates. DESIGN: A survey of recent Bachelor of Science (B.S.) pharmacy graduates of the University of Wisconsin School of Pharmacy. MEASUREMENTS AND MAIN RESULTS: A total of 371 B.S. pharmacy graduates (55% response rate) provided information. Graduates who had an advanced degree or training (from many programs) after completing their B.S. pharmacy degree, and those who were teaching in pharmacy programs generally had higher self-rated levels of knowledge and competencies. Hospital pharmacists spent less of their work time in dispensing activities (33.82% +/- 30.39%) than community pharmacists (61.04% +/- 19.97%; t = 8.78, df = 288, p < 0.001); community pharmacists spent twice as much of their work time counseling and educating patients (16.65% +/- 10.47% vs 7.13% +/- 7.39%; t = 9.06, df = 288, p < 0.001). The amount of time pharmacists spent in dispensing functions had a negative association with knowledge and competencies in the sections on pharmacokinetic and disease process (r = -0.277, p < 0.01), patient communications (r = -0.272, p < 0.01), and administrative and economic aspects of practice (r = -0.210, p < 0.01) for all respondents. Pharmacists reported that they spent 13.78 +/- 14.06 hours per month outside work in professional lifelong learning. There was a negative association between the time pharmacists spent dispensing and the time they spent in professional lifelong learning (r = -0.239, p < 0.001), and a positive relationship between the time spent in such learning and the time providing information to prescribers and other health care professionals (r = 0.214, p < 0.001), monitoring patients (r = 0.216, p < 0.001), and performing primary care activities (r = 0.176, p < 0.001). Graduates reported a mean yearly salary of $46,879 +/- $8183. More hospital pharmacists were involved in teaching (48, 37%) than those practicing in a community setting (19, 12%). CONCLUSIONS: Practice site, advanced degree or training, lifelong learning, involvement in teaching programs, and time spent in various professional functions were associated with pharmacists' self-rated knowledge and competencies.

Community Pharmacy Services↗
PubMed1998

Impact of the change in Connecticut syringe prescription laws on pharmacy sales and pharmacy managers' practices.

We assessed the impact of the 1992 change in Connecticut syringe prescription laws on pharmacy sales and pharmacy managers' sales practices. A mail survey was conducted in 1994 of all current pharmacy managers in the five largest cities in Connecticut (Hartford, New Haven, Waterbury, Bridgeport, and Stamford) and a random sample of those practicing in all other areas. Of these, 89.3% of the pharmacies in the five largest cities and 85.1% in the other areas had ever sold syringes without a prescription since the July 1992 law went into effect. Most pharmacists identified safety issues as very important in their personal decision about the sale of syringes without a prescription. Although the purpose of the change in the prescription law was to provide expanded access to sterile syringes by injection drug users (IDUs), only 31.4% of the managers who were allowed to sell in all instances and 18.1% of those who sold at their discretion were very willing to sell syringes to IDUs. In the logistic regression model of pharmacies with a sell-in-all-instances policy, the perceived benefit of the sale of syringes on health and community well-being was the only influence independently associated with managers support for nonprescription sales. Overall, managers reported they did not know what other pharmacists thought (40.4%) or did (42.9%) regarding the sale of syringes. When pharmacists had discretion over syringe sales, managers' beliefs about what other Connecticut pharmacists thought and did about the nonprescription sale of syringes remained a significant influence on the degree of support for sales. Most pharmacies implemented and maintained policies permitting the sale of syringes without a prescription. Several issues, including risk of discarded contaminated syringes around pharmacies and in the community and reluctance to sell to IDUs, reduced pharmacists willingness to sell syringes. Efforts to incorporate pharmacists as active partners in HIV prevention in IDUs should promote the sale of syringes without a prescription to IDUs as acceptable public health practice.

Acquired Immunodeficiency Syndrome↗
PubMed1984

Preparing students for the realities of contemporary pharmacy practice. American Association of Colleges of Pharmacy.

A report of the American Association of Colleges of Pharmacy Study Committee on the Preparation of Students for the Realities of Contemporary Pharmacy Practice is presented. The development of the committee and its charge are described. The report includes a description of the purpose and essential elements of contemporary pharmacy practice, and the barriers restricting their achievement that arise within the profession, society, and pharmacy education. Recommendations of the committee regarding curricular offerings, instructional strategies for developing problem-solving, communication, and self-learning skills, types of post-entry-level education and training programs, career counseling, student recruitment, pharmacy faculty, and intra- and interprofessional relations are discussed. The report calls for a combined effort on behalf of practitioners and educators to prepare graduates to enter practice in community, hospital, or long-term care pharmacy, and emphasizes the need to match these efforts to the dynamics of contemporary pharmacy practice.

Economics, Pharmaceutical↗
PubMed1992

Increasing pharmacy productivity by expanding the role of pharmacy technicians.

Efforts to meet growing clinical and distributive demands without increasing pharmacy staff are described. Real and expected increases in demands for services led pharmacists at a cancer center to seek ways of accommodating those demands within budgetary limits. Growth in the distributive workload was interfering with clinical consultation work. Research studies by the medical staff were resulting in complex dosage calculations and time-consuming compounding. Increasing requests for clinical services had to be met without compromising distributive services and teaching responsibilities and without raising costs. A plan of action was approved that included the use of a written test and a training manual to allow the hiring and retaining of skilled pharmacy technicians qualified to assume greater responsibilities. Technicians were assigned to enter drug orders into the computer, check other technicians, and dispense certain drugs. Greater use was made of commercially prepared i.v. solutions, and the floor stock was expanded. A comprehensive quality control program was concurrently put in place. The larger role for technicians not only enabled the pharmacy department to increase its distributive workload dramatically but reduced pharmacy medication errors and provided more time for clinical pharmacy practice. The number of pharmacist and technician full-time equivalents increased by only 1.5 in each category between 1985 and 1990. By making more use of pharmacy technicians, a pharmacy department was able to meet escalating demands for services with only a minor increase in personnel.

Allied Health Personnel↗
PubMed1991

Creating the optimal nursing-pharmacy interface: a strategic plan for the pharmacy manager.

These strategies certainly do not represent an exhaustive list of the possibilities. They cover some of the major issues and reflect observed elements that exist in institutions that enjoy frequent positive interactions at the pharmacy-nursing interface. Anecdotal observations and comments confirm that in such institutions there exists greater efficiency in the drug-use process, greater job satisfaction, and better patient care than in those institutions where there are strained relationships at the pharmacy-nursing interface. The remaining articles in this issue provide specific examples to document these benefits. The pharmacy manager who makes a concerted, proactive effort to use some of the information in this article and the others to establish a positive, highly interactive pharmacy-nursing interface will experience these same rewards. Progress may occur more slowly in some institutions due to long-standing difficulties. Pharmacy initiatives may be viewed with skepticism. In these situations, actions speak much louder than words; demonstrate change (e.g., decentralization) on a pilot basis without additional resources to generate a groundswell of acceptance at the grassroots level. This will in turn contribute to a much more serious consideration of any proposal that does include increased resources or reallocation of resources (from nursing to pharmacy). No matter how difficult or frustrating it might be to implement these strategies, the potential results are worthy of the efforts.

Clinical Pharmacy Information Systems↗
PubMed1998

Diabetes prevalence and hospital and pharmacy use in the Veterans Health Administration (1994). Use of an ambulatory care pharmacy-derived database.

OBJECTIVE: To develop a diabetes registry from an outpatient pharmacy database to systematically analyze the prevalence of diabetes, patterns of glycemic medication and glucose monitoring, pharmacy costs, and hospital use related to diabetes care in the Veterans Health Administration (VHA) in fiscal year (FY) 1994. RESEARCH DESIGN AND METHODS: Veterans with diabetes were identified using a software program that extracted the social security number (SSN) of patients receiving insulin, sulfonylurea agents, or glucose-monitoring supplies. The cumulative FY94 cost for a drug was calculated by multiplying the units dispensed times the unit cost for each fill, using the actual drug cost that was in effect at the time of dispensing. Admission data were obtained by crossmatching the SSN registry with the VHA Austin Mainframe Patient Treatment Files to retrieve associated diagnosis-related groups (DRG), Physicians' Current Procedural Terminology (CPT), and International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) codes. RESULTS: From among 1,180,260 unique patients, 139,646 veterans with diabetes receiving insulin, oral agents, or glucose-monitoring strips were identified, accounting for a prevalence of 11.83% from 62 Veterans Administration medical centers. There were 63,078 individuals (52%) who received oral agents, of whom 26.3% also received blood glucose-monitoring supplies; 46,664 individuals (39%) received insulin, of whom 53.2% received blood glucose-monitoring supplies; and 9,440 individuals (8%) received both oral agents and insulin during FY94, with 64.4% receiving blood glucose-monitoring supplies. Only 1,482 (1.2%) individuals received monitoring supplies alone, and 129 patients (0.1%) were provided with an insulin pump. Using an adjusted data set, 12% of veterans accounted for 24% of all outpatient pharmacy costs, with an average expenditure of $622 for veterans with diabetes compared with $276 for veterans without diabetes. There was $454 (73%) for non-diabetes-specific prescriptions and $168 (27%) for prescriptions related to glycemic control. Of pharmacy expenditures for glycemic control, $101 (60.1%) was attributed to insulin, oral agents, and supplies, while $67 (39.9%) was attributable to glucose monitoring. Veterans with diabetes were admitted 1.6 times as frequently as veterans without diabetes. CONCLUSIONS: This study demonstrates the feasibility of using a pharmacy-based electronic diabetes database in a payor system that can track both claims and individual classes of medication based on a unique identifier number. While the prevalence of diabetes in the VHA is high relative to other health care systems and the general population, patterns of medication usage, pharmacy costs, and relative admission frequency are comparable to results from the private sector.

Ambulatory Care↗