21 CFR 1304.04 - Maintenance of records and inventories.

Code of Federal Regulations, 2011 CFR

2011-04-01

... manual, or computer readable, form. (2) A registered retail pharmacy that possesses additional... this part for those additional registered sites at the retail pharmacy or other approved central...) Each registered pharmacy shall maintain the inventories and records of controlled substances as follows...

21 CFR 1304.04 - Maintenance of records and inventories.

Code of Federal Regulations, 2013 CFR

2013-04-01

... manual, or computer readable, form. (2) A registered retail pharmacy that possesses additional... this part for those additional registered sites at the retail pharmacy or other approved central...) Each registered pharmacy shall maintain the inventories and records of controlled substances as follows...

21 CFR 1304.04 - Maintenance of records and inventories.

Code of Federal Regulations, 2014 CFR

2014-04-01

... manual, or computer readable, form. (2) A registered retail pharmacy that possesses additional... this part for those additional registered sites at the retail pharmacy or other approved central...) Each registered pharmacy shall maintain the inventories and records of controlled substances as follows...

21 CFR 1304.04 - Maintenance of records and inventories.

Code of Federal Regulations, 2012 CFR

2012-04-01

... manual, or computer readable, form. (2) A registered retail pharmacy that possesses additional... this part for those additional registered sites at the retail pharmacy or other approved central...) Each registered pharmacy shall maintain the inventories and records of controlled substances as follows...

Nature, frequency and determinants of prescription modifications in Dutch community pharmacies

PubMed Central

Buurma, Henk; de Smet, Peter A G M; van den Hoff, Olga P; Egberts, Antoine C G

2001-01-01

Aims To examine the nature, frequency and determinants of prescription modifications in Dutch community pharmacies. Methods A prospective case-control study comparing modified prescriptions with nonmodified prescriptions was carried out in 141 Dutch community pharmacies. 2014 modified prescriptions (cases), collected in the selected pharmacies on a predetermined day in a specific period (25th February until 12th March 1999) and 2581 nonmodified prescriptions (controls) randomly selected on the same day were studied. The nature and frequency of prescription modifications and patient, drug and prescriber related determinants for a modified prescription were assessed. Results The overall incidence of prescription modifications was 4.3%, with a mean of 14.3 modifications per pharmacy per day. For prescription only medicines (POM) the incidence was 4.9%. The majority of POM modifications concerned a clarification (71.8%). In 22.2% a prescription could potentially have had clinical consequences when not altered; in more than half of the latter it concerned a dose error (13.7% of all cases). POM prescriptions of patients of 40–65 years had a significantly lower chance of modification compared with those of younger people (OR = 0.74 [0.64–0.86]). With respect to medication-class, we found a higher chance of POM modifications in the respiratory domain (OR = 1.48 [1.23-1.79]) and a decreased chance for nervous system POMs (OR = 0.71 [0.61–0.83]). With regard to prescriber-related determinants modifications were found three times more often in non printed prescriptions than in printed ones (OR = 3.30 [2.90-3.75]). Compared with prescriptions by the patient's own GP, prescriptions of specialists (OR = 1.82 [1.57-2.11]), other GP's (OR = 1.49 [1.02-2.17]) and other prescribers such as dentists and midwives (OR = 1.95 [1.06-3.57]) gave a higher probability of prescription modifications. When a GP had no on-line access to the computer of the pharmacy the chance of a modification was also higher (OR = 1.61 [1.33-1.94]). Multivariate analysis revealed that a nonprinted prescription was the strongest independent determinant of prescription modifications (OR = 3.32 [2.87-3.84]), remaining so after adjustment for GP computer link to the pharmacy and for type of prescriber. Conclusions At least 30% of Dutch community pharmacies corrected 2.8 POM prescriptions per pharmacy per working day, which could potentially have had clinical consequences if not altered. If the study sample is representative for The Netherlands, Dutch community pharmacies correct a total of approximately 4400 of these prescriptions per working day. Using computerized systems to generate prescriptions is an important strategy to reduce the incidence of prescription errors. PMID:11453894

The paperless labeling initiative: a proof-of-concept study.

PubMed

Ruchalski, Charles

2004-01-01

Traditional paper professional package inserts (PPIs) are used on a daily basis by a variety of healthcare providers to locate and disseminate drug information. Unfortunately, paper PPIs are sometimes not accessible to the healthcare provider, appear unreadable due to varied font sizes, and are often considered not to be user-friendly. In December 2000, the Food and Drug Administration proposed regulations that would revise the format of PPIs. To determine whether electronic delivery of PPI information is achievable in community pharmacy practice settings. Electronic PPIs are an alternative means of delivering this information. This 12-week proof-of-concept study evaluated the Health Information Designs/Thomson Healthcare and Etreby Computer Company for electronic delivery of PPIs in 6 chain and 4 independent community pharmacies, with 5 pharmacies evaluating each system. Participating pharmacists were asked 9 questions designed to determine the feasibility of implementing electronic PPI delivery, as well as pharmacist satisfaction with each system. Pharmacists deemed both systems to be accessible and user-friendly. Pharmacists from both groups felt that the electronic PPIs were challenging to read and that printing took too long. Future studies in a more diverse selection of dispensing sites, including pharmacies (community and hospital based), clinics, and physician practices, need to be performed to maximize the use of electronic PPIs.

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2013 CFR

2013-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2014 CFR

2014-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2010 CFR

2010-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2011 CFR

2011-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

42 CFR 456.712 - Annual report.

Code of Federal Regulations, 2012 CFR

2012-10-01

... program. (2) A description of how pharmacies performing prospective DUR without computers are expected to...) A description of the steps taken by the State Agency to monitor compliance by pharmacies with the... entities such as the Medicaid Fraud Control Unit and State Board of Pharmacy. The annual report also must...

Pharmacy costs associated with nonformulary drug requests.

PubMed

Sweet, B V; Stevenson, J G

2001-09-15

Pharmacy costs associated with handling nonformulary drug requests were studied. Data for all nonformulary drug orders received at a university hospital between August 1 and October 31, 1999, were evaluated to determine their outcome and the cost differential between the nonformulary drug and formulary alternative. Two sets of data were used to analyze medication costs: data from nonformulary medication request forms, which allowed the cost of nonformulary drugs and their formulary alternatives to be calculated, and data from the pharmacy computer system, which enabled actual nonformulary drug use to be captured. Labor costs associated with processing these requests were determined through time analysis, which included the potential for orders to be received at different times of the day and with different levels of technician and pharmacist support. Economic analysis revealed that the greatest cost saving occurred when converting nonformulary injectable products to formulary alternatives. Interventions were least costly during normal business hours, when all the satellite pharmacies were open and fully staffed. Pharmacists' interventions in oral product orders resulted in a net increase in expenditures. Incremental pharmacy costs associated with processing nonformulary medication requests in an inpatient setting are greater than the drug acquisition cost saving for most agents, particularly oral medications.

Creating organizational value by leveraging the multihospital pharmacy enterprise.

PubMed

Schenkat, Dan; Rough, Steve; Hansen, Amanda; Chen, David; Knoer, Scott

2018-04-01

The results of a survey of multihospital pharmacy leaders are summarized, and a road map for creating organizational value with the pharmacy enterprise is presented. A survey was designed to evaluate the level of integration of pharmacy services across each system's multiple hospitals, determine the most commonly integrated services, determine whether value was quantified when services were integrated, collect common barriers for finding value through integration, and identify strategies for successfully overcoming these barriers. The comprehensive, 59-question survey was distributed electronically in September 2016 to the top pharmacy executive at approximately 160 multihospital systems located throughout the United States. Survey respondents indicated that health systems are taking a wide range of approaches to integrating services systemwide. Several themes emerged from the survey responses: (1) having a system-level pharmacy leader with solid-line reporting across the enterprise increased the likelihood of integrating pharmacy services effectively, (2) integration of pharmacy services across a multihospital system was unlikely to decrease the number of pharmacy full-time equivalents within the enterprise, and (3) significant opportunities exist for creating value for the multihospital health system with the pharmacy enterprise, particularly within 4 core areas: system-level drug formulary and clinical standardization initiatives, supply chain initiatives, electronic health record integration, and specialty and retail pharmacy services. Consistently demonstrating strong organizational leadership, entrepreneurialism, and the ability to create value for the organization will lead to the system-level pharmacy leader and the pharmacy enterprise being well-positioned to achieve positive outcomes for patients, payers, and the broader health system. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

SimPharm: How Pharmacy Students Made Meaning of a Clinical Case Differently in Paper- and Simulation-Based Workshops

ERIC Educational Resources Information Center

Loke, Swee-Kin; Tordoff, June; Winikoff, Michael; McDonald, Jenny; Vlugter, Peter; Duffull, Stephen

2011-01-01

Several scholars contend that learning with computer games and simulations results in students thinking more like professionals. Bearing this goal in mind, we investigated how a group of pharmacy students learnt with an in-house developed computer simulation, SimPharm. Adopting situated cognition as our theoretical lens, we conducted a case study…

Designing organizational structures: Key thoughts for development.

PubMed

Killingsworth, Patricia; Eschenbacher, Lynn

2018-04-01

Current strategies and concepts to consider in developing a system-level organizational structure for the pharmacy enterprise are discussed. There are many different ways to design an organizational structure for the pharmacy enterprise within a health system. The size of the organization, the number of states in which it operates, and the geographic spread and complexity of the pharmacy business lines should be among the key considerations in determining the optimal organizational and decision-making structures for the pharmacy enterprise. The structure needs to support incorporation of the pharmacy leadership (both system-level executives and local leaders) into all strategic planning and discussions at the hospital and health-system levels so that they can directly represent the pharmacy enterprise instead of relying on others to develop strategy on their behalf. It is important that leaders of all aspects of the pharmacy enterprise report through the system's top pharmacy executive, who should be a pharmacist and have a title consistent with those of other leaders reporting at the same organizational level (e.g., chief pharmacy officer). Pharmacy leaders need to be well positioned within an organization to advocate for the pharmacy enterprise and use all resources to the best of their ability. As the scope and complexity of pharmacy services grow, it is critical to ensure that leadership of the pharmacy enterprise is unified under a single pharmacy executive team. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Implementation and quality assessment of a pharmacy services call center for outpatient pharmacies and specialty pharmacy services in an academic health system.

PubMed

Rim, Matthew H; Thomas, Karen C; Chandramouli, Jane; Barrus, Stephanie A; Nickman, Nancy A

2018-05-15

The implementation and quality assessment of a pharmacy services call center (PSCC) for outpatient pharmacies and specialty pharmacy services within an academic health system are described. Prolonged wait times in outpatient pharmacies or hold times on the phone affect the ability of pharmacies to capture and retain prescriptions. To support outpatient pharmacy operations and improve quality, a PSCC was developed to centralize handling of all outpatient and specialty pharmacy calls. The purpose of the PSCC was to improve the quality of pharmacy telephone services by (1) decreasing the call abandonment rate, (2) improving the speed of answer, (3) increasing first-call resolution, (4) centralizing all specialty pharmacy and prior authorization calls, (5) increasing labor efficiency and pharmacy capacities, (6) implementing a quality evaluation program, and (7) improving workplace satisfaction and retention of outpatient pharmacy staff. The PSCC centralized pharmacy calls from 9 pharmacy locations, 2 outpatient clinics, and a specialty pharmacy. Since implementation, the PSCC has achieved and maintained program goals, including improved abandonment rate, speed of answer, and first-call resolution. A centralized 24-7 support line for specialty pharmacy patients was also successfully established. A quality calibration program was implemented to ensure service quality and excellent patient experience. Additional ongoing evaluations measure the impact of the PSCC on improving workplace satisfaction and retention of outpatient pharmacy staff. The design and implementation of the PSCC have significantly improved the health system's patient experiences, efficiency, and quality. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Development and Implementation of a Curricular-wide Electronic Portfolio System in a School of Pharmacy

PubMed Central

Lopez, Tina C.; Trang, David D.; Farrell, Nicole C.; De Leon, Melissa A.; Villarreal, Cynthia C.; Maize, David F.

2011-01-01

The Feik School of Pharmacy collaborated with a commercial software development company to create a Web-based e-portfolio system to document student achievement of curricular outcomes and performance in pharmacy practice experiences. The multi-functional system also could be used for experiential site selection and assignment and continuing pharmacy education. The pharmacy school trained students, faculty members, and pharmacist preceptors to use the e-portfolio system. All pharmacy students uploaded the required number of documents and assessments to the program as evidence of achievement of each of the school's curricular outcomes and completion of pharmacy practice experiences. PMID:21829263

Creating a learning organization to help meet the needs of multihospital health systems.

PubMed

Ward, Angela; Berensen, Nannette; Daniels, Rowell

2018-04-01

The considerations that leaders of multihospital health systems must take into account in developing and implementing initiatives to build and maintain an exceptional pharmacy workforce are described. Significant changes that require constant individual and organizational learning are occurring throughout healthcare and within the profession of pharmacy. These considerations include understanding why it is important to have a succession plan and determining what types of education and training are important to support that plan. Other considerations include strategies for leveraging learners, dealing with a large geographic footprint, adjusting training opportunities to accommodate the ever-evolving demands on pharmacy staffs in terms of skill mix, and determining ways to either budget for or internally develop content for staff development. All of these methods are critically important to ensuring an optimized workforce. Especially for large health systems operating multiple sites across large distances, the use of technology-enabled solutions to provide effective delivery of programming to multiple sites is critical. Commonly used tools include live webinars, live "telepresence" programs, prerecorded programming that is available through an on-demand repository, and computer-based training modules. A learning management system is helpful to assign and document completion of educational requirements, especially those related to regulatory requirements (e.g., controlled substances management, sterile and nonsterile compounding, competency assessment). Creating and sustaining an environment where all pharmacy caregivers feel invested in and connected to ongoing learning is a powerful motivator for performance, engagement, and retention. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

[The application of new technologies to hospital pharmacy in Spain].

PubMed

Bermejo Vicedo, T; Pérez Menéndez Conde, C; Alvarez, Ana; Codina, Carlos; Delgado, Olga; Herranz, Ana; Hidalgo Correas, Francisco; Martín, Isabel; Martínez, Julio; Luis Poveda, José; Queralt Gorgas, María; Sanjurjo Sáez, María

2007-01-01

To describe the degree of introduction of new technologies in the medication use process in pharmacy services in Spain. A descriptive study via a survey into the degree of introduction of computer systems for: management, computerized physician order entry (CPOE), automated unit dose drug dispensing, preparation of parenteral nutrition solutions, recording drug administration, pharmaceutical care and foreseen improvements. The survey was sent by electronic mail to the heads of the pharmacy services of 207 hospitals throughout Spain. Response index: 82 hospitals (38.6%). 29 hospitals (36.7%) have a modular management system, 24 (30.4%) an integrated one and 34 (44.9%) a modular-integrated one. CPOE is utilised in 17 (22.4%). According to the size of the hospital, between 17.9 and 26.7% of unit dose dispensing is done online with a management software; between 5.1 and 33.3% of unit dose dispensing is automated. Automation of unit dose dispensing centred in the pharmacy service varies between 10 and 33.3%. Between 13.2 and 35.7% of automated in-ward dispensing systems are utilised. Administration records are kept manually on a computerised sheet at 23 (31.5%) of the hospitals; at 4 (5.4%) on CPOE and 7 (9.5%) online on the integral management programme and 4 (5.4%) on specific nursing softwares. Sixty-three per cent foresee the implementation of improvements in the short to medium term. The introduction of new technologies is being developed in Spain aiming to improve the safety and management of drugs, and there is a trend towards increasing their deployment in the near future. It is hoped that their fomentation could help to bring about process reengineering within pharmacy services in order to increase the time available for devotion to pharmaceutical care.

Pharmaceutical Education in Japan--Past, Present--, and Human Social Pharmacy Education in the Near Future.

PubMed

Okuda, Jun

2015-01-01

In this paper, the foundation of the 74 Japanese pharmacy schools was reviewed. From the early Meiji era until the beginning World War II, 21 schools including Tokyo University were established. After the war, the new four-year university system was introduced from America, and the above 21 schools became universities and 25 universities were newly founded. In 2006, clinical pharmacy was introduced from America, and the six-year undergraduate system began. This system was divided into 2 groups, 1) 6 year system of clinical pharmacy plus 4 years doctor course and 2) 4 years system of pharmaceutical sciences and a master degree lasting 2 years plus a 3 year doctor course. These two systems started in 2006. The students of clinical pharmacy course must take the 22 weeks of clerkships in a community pharmacy and hospital pharmacy. The graduates (8,446) in 2015 March took the National License Examination for pharmacist, and the pass rate was 72.65%. The entrance into pharmacy school is not easy; however, the passing of the National License Examination is more difficult. The aim of pharmacy education should be to foster pharmacists with a deeper understanding of society and with richer humanity for the patient. To achieve this, what needs to be included in the curriculum are the subjects of the human social pharmacy, such as philosophy of pharmacy, ethics, religions, history of pharmacy, pharmaceutical affairs law, economics, management, and social pharmacy. The inclusion of such subjects needs to be implemented in the near future. Of course, the study of pharmaceutical sciences is a life-long endeavor.

Evaluation of the first pharmacist-administered vaccinations in Western Australia: a mixed-methods study

PubMed Central

Hattingh, H Laetitia; Sim, T Fei; Parsons, R; Czarniak, P; Vickery, A; Ayadurai, S

2016-01-01

Objectives This study evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services. Design Mixed-methods methodology with both quantitative and qualitative data through surveys, pharmacy computer records and immuniser pharmacist interviews. Setting Community pharmacies in WA that provided pharmacist vaccination services between March and October 2015. Participants Immuniser pharmacists from 86 pharmacies completed baseline surveys and 78 completed exit surveys; computer records from 57 pharmacies; 25 immuniser pharmacists were interviewed. Main outcome measures Pharmacy and immuniser pharmacist profiles; pharmacist vaccination services provided and consumer profiles who accessed services. Results 15 621 influenza vaccinations were administered by immuniser pharmacists at 76 WA community pharmacies between March and October 2015. There were no major adverse events, and <1% of consumers experienced minor events which were appropriately managed. Between 12% and 17% of consumers were eligible to receive free influenza vaccinations under the National Immunisation Program but chose to have it at a pharmacy. A high percentage of vaccinations was delivered in rural and regional areas indicating that provision of pharmacist vaccination services facilitated access for rural and remote consumers. Immuniser pharmacists reported feeling confident in providing vaccination services and were of the opinion that services should be expanded to other vaccinations. Pharmacists also reported significant professional satisfaction in providing the service. All participating pharmacies intended to continue providing influenza vaccinations in 2016. Conclusions This initial evaluation of WA pharmacist vaccination services showed that vaccine delivery was safe. Convenience and accessibility were important aspects in usage of services. There is scope to expand pharmacist vaccination services to other vaccines and younger children; however, government funding to pharmacists needs to be considered. PMID:27650763

Delivery of pharmaceutical services at ward level in a teaching hospital.

PubMed

Schellack, N; Martins, V; Botha, N; Meyer, J C

2009-03-01

Poor management of pharmaceuticals could lead to wastage of financial resources and poor services in the public sector. The main aim of the study was to investigate the quality of pharmaceutical services at ward level in a teaching hospital. The design of the study was descriptive. Three data collection instruments were designed and pilot-tested prior to the actual data collection. Two structured questionnaires were used to interview the sister-in-charge of each ward and the stock and drug controller at the pharmacy. A checklist for the management of pharmaceuticals was completed for each ward. Descriptive statistics were used to describe and summarise the data. Sisters-in-charge of 30 wards and the stock and drug controller at the pharmacy participated in the study. The relationship with the pharmacy was perceived to be average by 54% (n = 30) of the sisters-in-charge of the wards. Communication with the pharmacy was mainly by telephone and 57% of the sisters-in-charge mentioned that they experienced difficulties in conveying messages to the pharmacy. Ten of the wards received regular ward visits by a pharmacist. Expiry dates were checked by all wards but at different intervals. The majority of the wards (90%) used patient cards, which refer to prescription charts, for stock control and ordering from the pharmacy. Fridge temperatures were checked and charted on a daily basis by 30% of the wards. Written standard operating procedures (SOPs) were used by the pharmacy for issuing ward stock. Although 83% of the wards indicated that they used SOPs, evidence of written SOPs was not available. The results indicated that the management of pharmaceutical services at ward level could be improved. Implementation of appropriate communication systems will enhance cooperation between the pharmacy and the wards. A uniform ward stock control system, either by computer or stock cards, should be introduced. Regular ward visits by a pharmacist to oversee ward stock management are recommended. Standard operating procedures for use in the wards should be developed and implemented.

Issues Facing Pharmacy Leaders in 2015: Suggestions for Pharmacy Strategic Planning

PubMed Central

Weber, Robert J.

2015-01-01

Issues facing pharmacy leaders in 2015 include practice model growth and the role of pharmacy students, clinical privileging of health-system pharmacists and provider status, medication error prevention, and specialty pharmacy services. The goal of this article is to provide practical approaches to 4 issues facing pharmacy leaders in 2015 to help them focus their department’s goals. This article will address (1) advances in the pharmacy practice model initiative and the role of pharmacy students, (2) the current thinking of pharmacists being granted clinical privileges in health systems, (3) updates on preventing harmful medication errors, and (4) the growth of specialty pharmacy services. The sample template of a strategic plan may be used by a pharmacy department in 2015 in an effort to continue developing patient-centered pharmacy services. PMID:25717212

The association between pharmacy closures and prescription drug use: a retrospective analysis of Medicaid prescription claims in Iowa.

PubMed

Xiao, H; Sorofman, B; Manasse, H R

2000-03-01

The objectives of this study were 2-fold: (1) to examine the association of pharmacy closures with prescription drug use by Medicaid recipients in Iowa; and (2) to evaluate how drug utilization patterns differ between patients whose pharmacies closed and patients whose pharmacies remained open. A 2-group pretest-posttest study of Medicaid enrollees who may have been affected by pharmacy closures. Prescription medication use during the periods preceding and after pharmacy closures was compared. A comparison group was used to account for extraneous factors. Sixteen community pharmacies were selected from a pool of pharmacies that closed during 1994; 1092 patients were identified as the main users of these pharmacies, and a comparison group of 3491 patients whose main pharmacies had not closed also was identified. The average number of each patient's prescription claims for the 6 months preceding closing and the 6 months after closing was computed. Multiple regression analysis was conducted to determine whether any association existed between pharmacy closures and the use of prescription drugs. Patients whose pharmacies closed during 1994 had fewer prescription claims after the closings than before the closings. In contrast, patients whose pharmacies remained open had more prescription claims. This difference remains statistically significant after controlling for other factors, such as patient demographics and health status. A decrease in prescription drug use was associated with pharmacy closures. Attention should be directed to patient access to prescription medications in rural areas, as relatively more pharmacies close in rural areas.

Selecting a pharmacy layout design using a weighted scoring system.

PubMed

McDowell, Alissa L; Huang, Yu-Li

2012-05-01

A weighted scoring system was used to select a pharmacy layout redesign. Facilities layout design techniques were applied at a local hospital pharmacy using a step-by-step design process. The process involved observing and analyzing the current situation, observing the current available space, completing activity flow charts of the pharmacy processes, completing communication and material relationship charts to detail which areas in the pharmacy were related to one another and how they were related, researching applications in other pharmacies or in scholarly works that could be beneficial, numerically defining space requirements for areas within the pharmacy, measuring the available space within the pharmacy, developing a set of preliminary designs, and modifying preliminary designs so they were all acceptable to the pharmacy staff. To select a final layout that could be implemented in the pharmacy, those layouts were compared via a weighted scoring system. The weighted aspect further allowed additional emphasis on categories based on their effect on pharmacy performance. The results produced a beneficial layout design as determined through simulated models of the pharmacy operation that more effectively allocated and strategically located space to improve transportation distances and materials handling, employee utilization, and ergonomics. Facilities layout designs for a hospital pharmacy were evaluated using a weighted scoring system to identify a design that was superior to both the current layout and alternative layouts in terms of feasibility, cost, patient safety, employee safety, flexibility, robustness, transportation distance, employee utilization, objective adherence, maintainability, usability, and environmental impact.

An exploration of the utility of appraisals for the revalidation of pharmacy professionals in community pharmacy in Great Britain.

PubMed

Jee, Samuel D; Jacobs, Sally; Schafheutle, Ellen I; Elvey, Rebecca; Hassell, Karen; Noyce, Peter R

2013-01-01

With revalidation in pharmacy in the United Kingdom fast approaching, appropriate systems of revalidation in community pharmacy are required. With little known about the potential use of appraisals for evaluating fitness to practice in pharmacy professionals (pharmacists and pharmacy technicians) in this sector, research was undertaken to explore their potential utility in a revalidation process. To examine existing structures and processes in community pharmacy appraisals in Great Britain (ie, England, Scotland, and Wales) and consider the views of pharmacy stakeholders on if, and how, appraisals could contribute to revalidation of pharmacy professionals. Semi-structured telephone interviews were conducted with senior staff (eg, superintendents and professional development managers) from chain community pharmacies as well as pharmacy managers/owners from independent pharmacies. Senior staff from locum agencies and pharmacy technician stakeholders were also interviewed. Appraisals were in place for pharmacists in most chain pharmacies but not in independent pharmacies. Locum pharmacists were not appraised, either by the companies they worked for or by the locum agencies. Pharmacy managers/owners working in independent pharmacies were also not appraised. Pharmacy technicians were appraised in most chain pharmacies but only in some independent pharmacies. Where appraisals were in operation, they were carried out by line managers who may or may not be a pharmacist. Appraisals did not seem to cover areas relevant to fitness to practice but instead focused more on performance related to business targets. This was particularly true for those in more senior positions within the organization such as area managers and superintendent pharmacists. Existing systems of appraisal, on their own, do not seem to be suitable for revalidating a pharmacy professional. Considerable changes to the existing appraisal systems in community pharmacy and employer engagement may be necessary if they are to play a role in revalidation. Copyright © 2013 Elsevier Inc. All rights reserved.

Experience with a Drug Screening Program at a School of Pharmacy

ERIC Educational Resources Information Center

Cates, Marshall E.; Hogue, Michael D.

2012-01-01

Substance use and abuse among pharmacy students is a concern of pharmacy schools, boards of pharmacy, and training sites alike. Pharmacy students must complete approximately 30% of their academic coursework in experiential settings such as community pharmacies, hospitals, and other health systems as part of any accredited pharmacy school's…

76 FR 52320 - Privacy Act of 1974; System of Records

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-22

..., or other clinical circumstances as defined by system requirements. To provide a data warehouse... Defense. DHA 23 System name: Pharmacy Data Transaction Service (PDTS). System location: Primary: Emdeon... retail pharmacy network, and commercial pharmacies. Categories of records in the system: Electronic data...

Development of a Computer System To Educate Students To Evaluate and Interpret Published Drug Studies.

ERIC Educational Resources Information Center

Abate, Marie A.

The education of students in the techniques of critical appraisal of drug studies has been identified as a deficiency in many health sciences curricula. Errors in research design and inconsistencies in the reporting of study results persist in professional pharmacy and medical journals. Thus, thorough and accurate review and interpretation of…

Implementation of information systems at pharmacies - a case study from the re-regulated pharmacy market in Sweden.

PubMed

Hammar, Tora; Ohlson, Mats; Hanson, Elizabeth; Petersson, Göran

2015-01-01

When the Swedish pharmacy market was re-regulated in 2009, Sweden moved from one state-owned pharmacy chain to several private pharmacy companies, and four new dispensing systems emerged to replace the one system that had previously been used at all Swedish pharmacies for more than 20 years. The aim of this case study was to explore the implementation of the new information systems for dispensing at pharmacies. The vendors of the four dispensing systems in Sweden were interviewed, and a questionnaire was sent to the managers of the pharmacy companies. In addition, a questionnaire was sent to 350 pharmacists who used the systems for dispensing prescriptions. The implementation of four new dispensing systems followed a strict time frame set by political decisions, involved actors completely new to the market, lacked clear regulation and standards for functionality and quality assurance, was complex and resulted in variations in quality. More than half of the pharmacists (58%) perceived their current dispensing system as supporting safe dispensing of medications, 26% were neutral and 15% did not perceive it to support a safe dispensing. Most pharmacists (80%) had experienced problems with their dispensing system during the previous month. The pharmacists experienced problems included reliability issues, usability issues, and missing functionality. In this case study exploring the implementation of new information systems for dispensing prescriptions at pharmacies in Sweden, weaknesses related to reliability, functionality and usability were identified and could affect patient safety. The weaknesses of the systems seem to result from the limited time for the development and implementation, the lack of comprehensive and evidence-based requirements for dispensing systems, and the unclear distribution of quality assurance responsibilities among involved stakeholders. Copyright © 2015 Elsevier Inc. All rights reserved.

Evaluation of the first pharmacist-administered vaccinations in Western Australia: a mixed-methods study.

PubMed

Hattingh, H Laetitia; Sim, T Fei; Parsons, R; Czarniak, P; Vickery, A; Ayadurai, S

2016-09-20

This study evaluated the uptake of Western Australian (WA) pharmacist vaccination services, the profiles of consumers being vaccinated and the facilitators and challenges experienced by pharmacy staff in the preparation, implementation and delivery of services. Mixed-methods methodology with both quantitative and qualitative data through surveys, pharmacy computer records and immuniser pharmacist interviews. Community pharmacies in WA that provided pharmacist vaccination services between March and October 2015. Immuniser pharmacists from 86 pharmacies completed baseline surveys and 78 completed exit surveys; computer records from 57 pharmacies; 25 immuniser pharmacists were interviewed. Pharmacy and immuniser pharmacist profiles; pharmacist vaccination services provided and consumer profiles who accessed services. 15 621 influenza vaccinations were administered by immuniser pharmacists at 76 WA community pharmacies between March and October 2015. There were no major adverse events, and <1% of consumers experienced minor events which were appropriately managed. Between 12% and 17% of consumers were eligible to receive free influenza vaccinations under the National Immunisation Program but chose to have it at a pharmacy. A high percentage of vaccinations was delivered in rural and regional areas indicating that provision of pharmacist vaccination services facilitated access for rural and remote consumers. Immuniser pharmacists reported feeling confident in providing vaccination services and were of the opinion that services should be expanded to other vaccinations. Pharmacists also reported significant professional satisfaction in providing the service. All participating pharmacies intended to continue providing influenza vaccinations in 2016. This initial evaluation of WA pharmacist vaccination services showed that vaccine delivery was safe. Convenience and accessibility were important aspects in usage of services. There is scope to expand pharmacist vaccination services to other vaccines and younger children; however, government funding to pharmacists needs to be considered. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Pharmacy Education and the Role of the Local Pharmacy at Gifu Pharmaceutical University Pharmacy.

PubMed

Teramachi, Hitomi

2016-01-01

Gifu Pharmaceutical University Pharmacy was established in front of Gifu University Hospital (GUH) as a pharmacy attached to the university, the first in Japan in 1998. When GUH moved in 2004, Gifu Pharmaceutical University Pharmacy was built in its current location. One of the priorities of the design of the new facility was easy access to those with disabilities. For example, ramps, wheelchair accessible restrooms, and handicap-friendly waiting-room chairs were installed. In cooperation with GUH, we introduced a two-dimensional bar code system for prescriptions. This promoted the efficiency of compounding medicines. In addition, starting in 2006, we introduced digital drug-history records at Gifu Pharmaceutical University Pharmacy. We also increased the staff of the affiliated pharmacy in 2006. We designed the system of the affiliated pharmacy for long-term pharmacy practice. Currently, we accept pharmacy students visiting pharmacy of early exposure and long-term pharmacy practice. Today, the pharmacy fills an average of 80 prescriptions a day, primarily from GUH. Our staff consists of six pharmacists, one full-time office manager, and three part-time office assistants. In keeping with our role as a community pharmacy, we hold regular lectures and an education forum for pharmacists. We also carry out clinical studies.

Student Ability, Confidence, and Attitudes Toward Incorporating a Computer into a Patient Interview.

PubMed

Ray, Sarah; Valdovinos, Katie

2015-05-25

To improve pharmacy students' ability to effectively incorporate a computer into a simulated patient encounter and to improve their awareness of barriers and attitudes towards and their confidence in using a computer during simulated patient encounters. Students completed a survey that assessed their awareness of, confidence in, and attitudes towards computer use during simulated patient encounters. Students were evaluated with a rubric on their ability to incorporate a computer into a simulated patient encounter. Students were resurveyed and reevaluated after instruction. Students improved in their ability to effectively incorporate computer usage into a simulated patient encounter. They also became more aware of and improved their attitudes toward barriers regarding such usage and gained more confidence in their ability to use a computer during simulated patient encounters. Instruction can improve pharmacy students' ability to incorporate a computer into simulated patient encounters. This skill is critical to developing efficiency while maintaining rapport with patients.

Experience with an Independent Study Program in Pathophysiology for Doctor of Pharmacy Students.

ERIC Educational Resources Information Center

Nahata, Milap C.

1986-01-01

A pharmacy doctoral program's independent-study component in pathophysiology, supported by computer-assisted instruction and self-evaluation, has the advantages of self-pacing, reduced faculty time commitment, and increased ability to work effectively with physicians. Disadvantages include student feeling of isolation, imbalanced content, and…

21 CFR 880.5440 - Intravascular administration set.

Code of Federal Regulations, 2012 CFR

2012-04-01

...) Classification. Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified...

21 CFR 880.5440 - Intravascular administration set.

Code of Federal Regulations, 2011 CFR

2011-04-01

...) Classification. Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified...

21 CFR 880.5440 - Intravascular administration set.

Code of Federal Regulations, 2013 CFR

2013-04-01

...) Classification. Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified...

21 CFR 880.5440 - Intravascular administration set.

Code of Federal Regulations, 2014 CFR

2014-04-01

...) Classification. Class II (special controls). The special control for pharmacy compounding systems within this classification is the FDA guidance document entitled “Class II Special Controls Guidance Document: Pharmacy Compounding Systems; Final Guidance for Industry and FDA Reviewers.” Pharmacy compounding systems classified...

Big Data: Implications for Health System Pharmacy

PubMed Central

Stokes, Laura B.; Rogers, Joseph W.; Hertig, John B.; Weber, Robert J.

2016-01-01

Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services. PMID:27559194

Big Data: Implications for Health System Pharmacy.

PubMed

Stokes, Laura B; Rogers, Joseph W; Hertig, John B; Weber, Robert J

2016-07-01

Big Data refers to datasets that are so large and complex that traditional methods and hardware for collecting, sharing, and analyzing them are not possible. Big Data that is accurate leads to more confident decision making, improved operational efficiency, and reduced costs. The rapid growth of health care information results in Big Data around health services, treatments, and outcomes, and Big Data can be used to analyze the benefit of health system pharmacy services. The goal of this article is to provide a perspective on how Big Data can be applied to health system pharmacy. It will define Big Data, describe the impact of Big Data on population health, review specific implications of Big Data in health system pharmacy, and describe an approach for pharmacy leaders to effectively use Big Data. A few strategies involved in managing Big Data in health system pharmacy include identifying potential opportunities for Big Data, prioritizing those opportunities, protecting privacy concerns, promoting data transparency, and communicating outcomes. As health care information expands in its content and becomes more integrated, Big Data can enhance the development of patient-centered pharmacy services.

Improving investigational drug service operations through development of an innovative computer system.

PubMed

Sweet, Burgunda V; Tamer, Helen R; Siden, Rivka; McCreadie, Scott R; McGregory, Michael E; Benner, Todd; Tankanow, Roberta M

2008-05-15

The development of a computerized system for protocol management, dispensing, inventory accountability, and billing by the investigational drug service (IDS) of a university health system is described. After an unsuccessful search for a commercial system that would accommodate the variation among investigational protocols and meet regulatory requirements, the IDS worked with the health-system pharmacy's information technology staff and informatics pharmacists to develop its own system. The informatics pharmacists observed work-flow and information capture in the IDS and identified opportunities for improved efficiency with an automated system. An iterative build-test-design process was used to provide the flexibility needed for individual protocols. The intent was to design a system that would support most IDS processes, using components that would allow automated backup and redundancies. A browser-based system was chosen to allow remote access. Servers, bar-code scanners, and printers were integrated into the final system design. Initial implementation involved 10 investigational protocols chosen on the basis of dispensing volume and complexity of study design. Other protocols were added over a two-year period; all studies whose drugs were dispensed from the IDS were added, followed by those for which the drugs were dispensed from decentralized pharmacy areas. The IDS briefly used temporary staff to free pharmacist and technician time for system implementation. Decentralized pharmacy areas that rarely dispense investigational drugs continue to use manual processes, with subsequent data transcription into the system. Through the university's technology transfer division, the system was licensed by an external company for sale to other IDSs. The WebIDS system has improved daily operations, enhanced safety and efficiency, and helped meet regulatory requirements for investigational drugs.

Pharmacy Education in the Context of Australian Practice

PubMed Central

Nation, Roger L.; Roller, Louis; Costelloe, Marian; Galbraith, Kirstie; Stewart, Peter; Charman, William N

2008-01-01

Accredited pharmacy programs in Australia provide a high standard of pharmacy education, attracting quality students. The principal pharmacy degree remains the 4-year bachelor of pharmacy degree; however, some universities offer graduate-entry master of pharmacy degrees taught in 6 semesters over a 2-year period. Curricula include enabling and applied pharmaceutical science, pharmacy practice, and clinical and experiential teaching, guided by competency standards and an indicative curriculum (a list of topics that are required to be included in a pharmacy degree curriculum before the program must be accredited by the Australian Pharmacy Council). Graduate numbers have increased approximately 250% with a dramatic increase from 6 pharmacy degree programs in 1997 to 21 such programs in 2008. Graduates must complete approximately 12 months of internship in a practice setting after graduation and prior to the competency-based registration examinations. An overview of pharmacy education in Australia is provided in the context of the healthcare system, a national system for subsidizing the cost of prescription medicines, the Australian National Medicines Policy and the practice of pharmacy. Furthermore, the innovations in practice and technology that will influence education in the future are discussed. PMID:19325951

Effectiveness of a Smoking Cessation Intervention in Dutch Pharmacies and General Practices

ERIC Educational Resources Information Center

Hoving, Ciska; Mudde, Aart N.; Dijk, Froukje; de Vries, Hein

2010-01-01

Purpose: The purpose of this paper is to test the effectiveness of a computer-tailored smoking cessation intervention, distributed through 75 Dutch general practices (GP) and 65 pharmacies (PH) in a randomised control trial. Design/methodology/approach: Respondents receive a tailored letter or a thank you letter (control condition). Main outcome…

The NAPLEX: Evolution, Purpose, Scope, and Educational Implications

PubMed Central

Boyle, Maria; Catizone, Carmen A.

2008-01-01

Since 2004, passing the North American Pharmacist Licensure Examination (NAPLEX) has been a requirement for earning initial pharmacy licensure in all 50 United States. The creation and evolution from 1952-2005 of the particular pharmacy competency testing areas and quantities of questions are described for the former paper-and-pencil National Association of Boards of Pharmacy Licensure Examination (NABPLEX) and the current candidate-specific computer adaptive NAPLEX pharmacy licensure examinations. A 40% increase in the weighting of NAPLEX Blueprint Area 2 in May 2005, compared to that in the preceding 1997-2005 Blueprint, has implications for candidates' NAPLEX performance and associated curricular content and instruction. New pharmacy graduates' scores on the NAPLEX are neither intended nor validated to serve as a criterion for assessing or judging the quality or effectiveness of pharmacy curricula and instruction. The newest cycle of NAPLEX Blueprint revision, a continual process to ensure representation of nationwide contemporary practice, began in early 2008. It may take up to 2 years, including surveying several thousand national pharmacists, to complete. PMID:18483600

The NAPLEX: evolution, purpose, scope, and educational implications.

PubMed

Newton, David W; Boyle, Maria; Catizone, Carmen A

2008-04-15

Since 2004, passing the North American Pharmacist Licensure Examination (NAPLEX) has been a requirement for earning initial pharmacy licensure in all 50 United States. The creation and evolution from 1952-2005 of the particular pharmacy competency testing areas and quantities of questions are described for the former paper-and-pencil National Association of Boards of Pharmacy Licensure Examination (NABPLEX) and the current candidate-specific computer adaptive NAPLEX pharmacy licensure examinations. A 40% increase in the weighting of NAPLEX Blueprint Area 2 in May 2005, compared to that in the preceding 1997-2005 Blueprint, has implications for candidates' NAPLEX performance and associated curricular content and instruction. New pharmacy graduates' scores on the NAPLEX are neither intended nor validated to serve as a criterion for assessing or judging the quality or effectiveness of pharmacy curricula and instruction. The newest cycle of NAPLEX Blueprint revision, a continual process to ensure representation of nationwide contemporary practice, began in early 2008. It may take up to 2 years, including surveying several thousand national pharmacists, to complete.

Automated mapping of pharmacy orders from two electronic health record systems to RxNorm within the STRIDE clinical data warehouse.

PubMed

Hernandez, Penni; Podchiyska, Tanya; Weber, Susan; Ferris, Todd; Lowe, Henry

2009-11-14

The Stanford Translational Research Integrated Database Environment (STRIDE) clinical data warehouse integrates medication information from two Stanford hospitals that use different drug representation systems. To merge this pharmacy data into a single, standards-based model supporting research we developed an algorithm to map HL7 pharmacy orders to RxNorm concepts. A formal evaluation of this algorithm on 1.5 million pharmacy orders showed that the system could accurately assign pharmacy orders in over 96% of cases. This paper describes the algorithm and discusses some of the causes of failures in mapping to RxNorm.

Community pharmacy practice in Japan--results of a survey.

PubMed

Iguchi, S; Ohnishi, M; Nishiyama, T; Hosono, K; Umezawa, C

1998-06-01

To survey the present condition of community pharmacies as future sites for pharmacy students' externship in Japan. A questionnaire consisting of 55 questions was sent to 425 graduates from Kobe Gakuin University, School of Pharmacy, who owned or worked in community pharmacies. Of the 85 responders, about half were owners and half employees of pharmacies. Ninety per cent of pharmacy owners operated three and fewer pharmacies. Fifty per cent of pharmacies only dispensed drugs, 32% handled both OTC drugs and dispensing, and 18% handled only OTC drugs. Among the 44 dispensing pharmacies, 16 were one-to-one type pharmacies, 13 were located in front of the big medical institutions, nine dispensed prescriptions from various medical institutions and five were hospital-owned pharmacies. Forty-five per cent of pharmacies employed 1-4 part-time pharmacists and 52% employed 1-4 pharmacist assistants. Thirty-one per cent of prescriptions came from internal medicine departments and the daily number of prescriptions dispensed by each pharmacy was in the range 10-99 for 41% of the pharmacies and 100-199 for 36% of the pharmacies. The average daily number of prescriptions dispersed by each pharmacist was in the range 30-39 for 29% of pharmacies and in the range 20-29 for 22% of pharmacies. Pharmaceutical information was provided at 73% of pharmacies and patients were counselled orally on their medication at 80% of pharmacies. Patients' medication histories were recorded at 88% pharmacies. Only 15% of pharmacies conducted patients' medication counselling at their home, but 34% of pharmacies were planning to start this service. Community pharmacists attended very few professional meetings or continuing education programmes and only 20% of them obtained information through computers. Forty-seven pharmacists out of the 85 obtained their information from medical representatives of pharmaceutical companies and 32 pharmacists through marketing specialists of wholesalers. Ninety per cent of community pharmacists who responded thought that separation of prescribing and dispensing functions would progress further in the future and 50% of them thought positively about the future social status of pharmacists. Most of our graduates who responded were willing to accept pharmacy students from Kobe Gakuin University as externs at their pharmacies. Despite the low response rate, our survey suggests that community pharmacy in Japan requires substantial improvement. This is to ensure that pharmacists working in that sector can provide the quality information that is required for the optimum management of patients and that the environment is suitable for pharmacy externships.

Reaching out to clinicians: implementation of a computerized alert system.

PubMed

Degnan, Dan; Merryfield, Dave; Hultgren, Steve

2004-01-01

Several published articles have identified that providing automated, computer-generated clinical alerts about potentially critical clinical situations should result in better quality of care. In 1999, the pharmacy department at a community hospital network implemented and refined a commercially available, computerized clinical alert system. This case report discusses the implementation process, gives examples of how the system is used, and describes results following implementation. The use of the clinical alert system in this hospital network resulted in improved patient safety as well as in greater efficiency and decreased costs.

Impact and appreciation of two methods aiming at reducing hazardous drug environmental contamination: The centralization of the priming of IV tubing in the pharmacy and use of a closed-system transfer device.

PubMed

Guillemette, Annie; Langlois, Hélène; Voisine, Maxime; Merger, Delphine; Therrien, Roxane; Mercier, Genevieve; Lebel, Denis; Bussières, Jean-François

2014-12-01

The main objective was to evaluate the impact of two methods aiming at reducing hazardous drug environmental contamination: the centralization of the priming of IV tubing in the pharmacy and the use of a closed-system transfer device. The secondary objective was to evaluate the satisfaction of pharmacy technicians using a survey. Sites in the hematology-oncology satellite pharmacy and care unit were analyzed for the presence of cyclophosphamide, ifosfamide and methotrexate before and after the centralization of the priming of IV tubing in the pharmacy and before and after using a closed-system transfer device. The limits of detection for cyclophosphamide, ifosfamide and methotrexate were, respectively, of 0.0015 ng/cm(2), 0.0012 ng/cm(2) and 0.0060 ng/cm(2). The pharmacy technician satisfaction was evaluated using a questionnaire. A total of 225 samples was quantified. After the centralization of priming in the pharmacy, no significant difference was found in the proportion of positive samples for cyclophosphamide, ifosfamide and methotrexate. Traces of cyclophosphamide found on the floor in patient care areas was significantly reduced (median[min-max] 0.08[0.06-0.09]ng/cm(2) vs. 0.03[0.02-0.05], p < 0.0001). After using a closed-system transfer device, a significant difference was found for the proportion of cyclophosphamide positive samples (15/45(33%) vs. 0/45(0%), p < 0.0001), but no significant difference was found for ifosfamide (12/45(27%) vs. 5/45(11%), p = 0.059) and methotrexate (1/45(2%) vs. 2/45(4%), p = 0.557). Pharmacy technicians raised issues following the centralization of priming (e.g. workload) and the use of closed-system transfer devices (e.g. spills, particles, workload and handling difficulties). The centralization of the priming of IV tubing in the pharmacy reduced floor contamination in patient care areas without increasing surface contamination in the pharmacy. Closed-system transfer devices reduced contamination in pharmacy, but handling issues were raised by pharmacy technicians. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

How do Community Pharmacies Recover from E-prescription Errors?

PubMed Central

Odukoya, Olufunmilola K.; Stone, Jamie A.; Chui, Michelle A.

2014-01-01

Background The use of e-prescribing is increasing annually, with over 788 million e-prescriptions received in US pharmacies in 2012. Approximately 9% of e-prescriptions have medication errors. Objective To describe the process used by community pharmacy staff to detect, explain, and correct e-prescription errors. Methods The error recovery conceptual framework was employed for data collection and analysis. 13 pharmacists and 14 technicians from five community pharmacies in Wisconsin participated in the study. A combination of data collection methods were utilized, including direct observations, interviews, and focus groups. The transcription and content analysis of recordings were guided by the three-step error recovery model. Results Most of the e-prescription errors were detected during the entering of information into the pharmacy system. These errors were detected by both pharmacists and technicians using a variety of strategies which included: (1) performing double checks of e-prescription information; (2) printing the e-prescription to paper and confirming the information on the computer screen with information from the paper printout; and (3) using colored pens to highlight important information. Strategies used for explaining errors included: (1) careful review of patient’ medication history; (2) pharmacist consultation with patients; (3) consultation with another pharmacy team member; and (4) use of online resources. In order to correct e-prescription errors, participants made educated guesses of the prescriber’s intent or contacted the prescriber via telephone or fax. When e-prescription errors were encountered in the community pharmacies, the primary goal of participants was to get the order right for patients by verifying the prescriber’s intent. Conclusion Pharmacists and technicians play an important role in preventing e-prescription errors through the detection of errors and the verification of prescribers’ intent. Future studies are needed to examine factors that facilitate or hinder recovery from e-prescription errors. PMID:24373898

Development and Implementation of a Combined Master of Science and PGY1/PGY2 Health-System Pharmacy Administration Residency Program at a Large Community Teaching Hospital.

PubMed

Gazda, Nicholas P; Griffin, Emily; Hamrick, Kasey; Baskett, Jordan; Mellon, Meghan M; Eckel, Stephen F; Granko, Robert P

2018-04-01

Purpose: The purpose of this article is to share experiences after the development of a health-system pharmacy administration residency with a MS degree and express the need for additional programs in nonacademic medical center health-system settings. Summary: Experiences with the development and implementation of a health-system pharmacy administration residency at a large community teaching hospital are described. Resident candidates benefit from collaborations with other health-systems through master's degree programs and visibility to leaders at your health-system. Programs benefit from building a pipeline of future pharmacy administrators and by leveraging the skills of residents to contribute to projects and department-wide initiatives. Tools to assist in the implementation of a new pharmacy administration program are also described and include rotation and preceptor development, marketing and recruiting, financial evaluation, and steps to prepare for accreditation. Conclusion: Health-system pharmacy administration residents provide the opportunity to build a pipeline of high-quality leaders, provide high-level project involvement, and produce a positive return on investment (ROI) for health-systems. These programs should be explored in academic and nonacademic-based health-systems.

Computer simulation as a teaching aid in pharmacy management--Part 1: Principles of accounting.

PubMed

Morrison, D J

1987-06-01

The need for pharmacists to develop management expertise through participation in formal courses is now widely acknowledged. Many schools of pharmacy lay the foundations for future management training by providing introductory courses as an integral or elective part of the undergraduate syllabus. The benefit of such courses may, however, be limited by the lack of opportunity for the student to apply the concepts and procedures in a practical working environment. Computer simulations provide a means to overcome this problem, particularly in the field of resource management. In this, the first of two articles, the use of a computer model to demonstrate basic accounting principles is described.

Logistics or patient care: which features do independent Finnish pharmacy owners prioritize in a strategic plan for future information technology systems?

PubMed

Westerling, Anna M; Haikala, Veikko E; Bell, J Simon; Airaksinen, Marja S

2010-01-01

To determine Finnish community pharmacy owners' requirements for the next generation of software systems. Descriptive, nonexperimental, cross-sectional study. Finland during December 2006. 308 independent pharmacy owners. Survey listing 126 features that could potentially be included in the new information technology (IT) system. The list was grouped into five categories: (1) drug information and patient counseling, (2) medication safety, (3) interprofessional collaboration, (4) pharmacy services, and (5) pharmacy internal processes. Perceived value of potential features for a new IT system. The survey was mailed to all independent pharmacy owners in Finland (n = 580; response rate 53% [n = 308]). Respondents gave priority to logistical functions and functions related to drug information and patient care. The highest rated individual features were tracking product expiry (rated as very or quite important by 100% of respondents), computerized drug-drug interaction screening (99%), an electronic version of the national pharmaceutical reference book (97%), and a checklist-type drug information database to assist patient counseling (95%). In addition to the high ranking for logistical features, Finnish pharmacy owners put a priority on support for cognitive pharmaceutical services in the next IT system. Although the importance of logistical functions is understandable, the owners demonstrated a commitment to strategic health policy goals when planning their business IT system.

Medicine shortages--a study of community pharmacies in Finland.

PubMed

Heiskanen, K; Ahonen, R; Karttunen, P; Kanerva, R; Timonen, J

2015-02-01

To explore the frequency, the reasons behind, and the consequences of medicine shortages in Finnish community pharmacies. During the 27-day study period in the autumn of 2013, randomly selected pharmacies reported on medicines that were in short supply from orders made to wholesalers. Altogether 129 (66%, n=195) pharmacies participated in the study, and the study material consisted of 3311 report forms. Of the study pharmacies, 79.8% had medicine shortages daily or almost daily. Medicines in short supply were most commonly medicines that affect the nervous system (30.8%) and the cardiovascular system (17.5%). The reason behind the shortage was reported to the pharmacies in 11.2% of the shortage cases. The medicine shortages caused problems for the pharmacies in 33.0% of the cases. In most cases (67.0%) the medicine shortages did not cause problems for the pharmacies, usually because a substitutable product was available (48.5%). Medicine shortages are common in Finnish community pharmacies. Medicines in short supply were commonly used medicines. The reason behind the shortage was rarely told to the pharmacies. Medicine shortages caused problems for the pharmacies in one-third of all the shortage cases. These shortages may be significant for the customers or the pharmacies, as they cause customer dissatisfaction and increase the workload of the pharmacy staff. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in the outpatient pharmacy.

PubMed

Nanji, Karen C; Rothschild, Jeffrey M; Boehne, Jennifer J; Keohane, Carol A; Ash, Joan S; Poon, Eric G

2014-01-01

Electronic prescribing systems have often been promoted as a tool for reducing medication errors and adverse drug events. Recent evidence has revealed that adoption of electronic prescribing systems can lead to unintended consequences such as the introduction of new errors. The purpose of this study is to identify and characterize the unrealized potential and residual consequences of electronic prescribing on pharmacy workflow in an outpatient pharmacy. A multidisciplinary team conducted direct observations of workflow in an independent pharmacy and semi-structured interviews with pharmacy staff members about their perceptions of the unrealized potential and residual consequences of electronic prescribing systems. We used qualitative methods to iteratively analyze text data using a grounded theory approach, and derive a list of major themes and subthemes related to the unrealized potential and residual consequences of electronic prescribing. We identified the following five themes: Communication, workflow disruption, cost, technology, and opportunity for new errors. These contained 26 unique subthemes representing different facets of our observations and the pharmacy staff's perceptions of the unrealized potential and residual consequences of electronic prescribing. We offer targeted solutions to improve electronic prescribing systems by addressing the unrealized potential and residual consequences that we identified. These recommendations may be applied not only to improve staff perceptions of electronic prescribing systems but also to improve the design and/or selection of these systems in order to optimize communication and workflow within pharmacies while minimizing both cost and the potential for the introduction of new errors.

Seasonal influenza vaccination delivery through community pharmacists in England: evaluation of the London pilot

PubMed Central

Atkins, Katherine; van Hoek, Albert Jan; Watson, Conall; Baguelin, Marc; Choga, Lethiwe; Patel, Anika; Raj, Thara; Jit, Mark; Griffiths, Ulla

2016-01-01

Objective To evaluate the effectiveness and cost of the pan-London pharmacy initiative, a programme that allows administration of seasonal influenza vaccination to eligible patients at pharmacies. Design We analysed 2013–2015 data on vaccination uptake in pharmacies via the Sonar reporting system, and the total vaccination uptake via 2011–2015 ImmForm general practitioner (GP) reporting system data. We conducted an online survey of London pharmacists who participate in the programme to assess time use data, vaccine choice, investment costs and opinions about the programme. We conducted an online survey of London GPs to assess vaccine choice of vaccine and opinions about the pharmacy vaccine delivery programme. Setting All London boroughs. Participants London-based GPs, and pharmacies that currently offer seasonal flu vaccination. Interventions Not applicable. Main outcome measures Comparison of annual vaccine uptake in London across risk groups from years before pharmacy vaccination introduction to after pharmacy vaccination introduction. Completeness of vaccine uptake reporting data. Cost to the National Health Service (NHS) of flu vaccine delivery at pharmacies with that at GPs. Cost to pharmacists of flu delivery. Opinions of pharmacists and GPs regarding the flu vaccine pharmacy initiative. Results No significant change in the uptake of seasonal vaccination in any of the risk groups as a result of the pharmacy initiative. While on average a pharmacy-administered flu vaccine dose costs the NHS up to £2.35 less than a dose administered at a GP, a comparison of the 2 recording systems suggests there is substantial loss of data. Conclusions Flu vaccine delivery through pharmacies shows potential for improving convenience for vaccine recipients. However, there is no evidence that vaccination uptake increases and the use of 2 separate recording systems leads to time-consuming data entry and missing vaccine record data. PMID:26883237

Seasonal influenza vaccination delivery through community pharmacists in England: evaluation of the London pilot.

PubMed

Atkins, Katherine; van Hoek, Albert Jan; Watson, Conall; Baguelin, Marc; Choga, Lethiwe; Patel, Anika; Raj, Thara; Jit, Mark; Griffiths, Ulla

2016-02-16

To evaluate the effectiveness and cost of the pan-London pharmacy initiative, a programme that allows administration of seasonal influenza vaccination to eligible patients at pharmacies. We analysed 2013-2015 data on vaccination uptake in pharmacies via the Sonar reporting system, and the total vaccination uptake via 2011-2015 ImmForm general practitioner (GP) reporting system data. We conducted an online survey of London pharmacists who participate in the programme to assess time use data, vaccine choice, investment costs and opinions about the programme. We conducted an online survey of London GPs to assess vaccine choice of vaccine and opinions about the pharmacy vaccine delivery programme. All London boroughs. London-based GPs, and pharmacies that currently offer seasonal flu vaccination. Not applicable. Comparison of annual vaccine uptake in London across risk groups from years before pharmacy vaccination introduction to after pharmacy vaccination introduction. Completeness of vaccine uptake reporting data. Cost to the National Health Service (NHS) of flu vaccine delivery at pharmacies with that at GPs. Cost to pharmacists of flu delivery. Opinions of pharmacists and GPs regarding the flu vaccine pharmacy initiative. No significant change in the uptake of seasonal vaccination in any of the risk groups as a result of the pharmacy initiative. While on average a pharmacy-administered flu vaccine dose costs the NHS up to £2.35 less than a dose administered at a GP, a comparison of the 2 recording systems suggests there is substantial loss of data. Flu vaccine delivery through pharmacies shows potential for improving convenience for vaccine recipients. However, there is no evidence that vaccination uptake increases and the use of 2 separate recording systems leads to time-consuming data entry and missing vaccine record data. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Emerging frontiers of pharmacy education in Saudi Arabia: The metamorphosis in the last fifty years.

PubMed

Asiri, Yousif A

2011-01-01

The trends in the quality of biomedical education in pharmacy schools have witnessed significant changes in the 21st century. With the advent of continuous revision and standardization processes of medical curricula throughout the world, the focus has been on imparting quality education. This pedagogic paradigm has shifted to pharmacy schools. In Saudi Arabia, the concept of "medical and pharmacy education" is relatively new as mainstream pharmacy curriculum and universities were established only half a century ago. This period has seen major changes in the dimension of "pharmacy education" to keep pace with the education systems in the United States and Europe. As our knowledge and perceptions about pharmaceuticals change with time, this motivates educators to search for better teaching alternatives to the ever increasing number of enthusiastic and budding pharmacists. Recently, the academic system in Saudi Arabian Pharmacy has adopted a more clinically-oriented Pharm. D. curriculum. This paper deals with the major changes from the inception of a small pharmacy faculty in 1959, the College of Pharmacy at the King Saud University, Riyadh, to the model of progress and a prototype of pharmacy colleges in Saudi Arabia. The fifty year chronological array can be regarded as an epitome of progress in pharmacy education in Saudi Arabia from its traditional curriculum to the modern day Pharm. D. curriculum with a high population growth and expanding health care sector, the demand for qualified pharmacists is growing and is projected to grow considerably in the future. The number of pharmacy graduates is increasing each year by many folds and to meet the needs the system lays stress upon a constant revising and updating of the current curriculum from a global perspective.

Role of Pharmacy Education in Growing the Pharmacy Practice Model

PubMed Central

Kennerly, Julie; Weber, Robert J.

2013-01-01

The Director’s Forum series is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems. This article focuses on pharmacy academia’s (“Academy”) role in transforming an organization’s pharmacy practice model. Pharmacy students can assume an integrated and accountable role in the practice model by having defined responsibilities for patient care. This role will produce students who are best trained to meet the challenges of pharmacy practice and health care reform. To make the students successful in this role, the pharmacy director must have a specific plan for integrating pharmacy students into the model and establishing relationships with Academy leadership, most importantly with the dean of the school or college of pharmacy. If successfully executed, the relationship between the Academy and the pharmacy department will enhance the mission of developing patient-centered pharmacy services. PMID:24421485

Creating a new rural pharmacy workforce: Development and implementation of the Rural Pharmacy Health Initiative.

PubMed

Scott, Mollie Ashe; Kiser, Stephanie; Park, Irene; Grandy, Rebecca; Joyner, Pamela U

2017-12-01

An innovative certificate program aimed at expanding the rural pharmacy workforce, increasing the number of pharmacists with expertise in rural practice, and improving healthcare outcomes in rural North Carolina is described. Predicted shortages of primary care physicians and closures of critical access hospitals are expected to worsen existing health disparities. Experiential education in schools and colleges of pharmacy primarily takes place in academic medical centers and, unlike experiential education in medical schools, rarely emphasizes the provision of patient care in rural U.S. communities, where chronic diseases are prevalent and many residents struggle with poverty and poor access to healthcare. To help address these issues, UNC Eshelman School of Pharmacy developed the 3-year Rural Pharmacy Health Certificate program. The program curriculum includes 4 seminar courses, interprofessional education and interaction with medical students, embedding of each pharmacy student into a specific rural community for the duration of training, longitudinal ambulatory care practice experiences, community engagement initiatives, leadership training, development and implementation of a population health project, and 5 pharmacy practice experiences in rural settings. The Rural Pharmacy Health Certificate program at UNC Eshelman School of Pharmacy seeks to transform rural pharmacy practice by creating a pipeline of rural pharmacy leaders and teaching a unique skillset that will be beneficial to healthcare systems, communities, and patients. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Recent Trends on the Future of Graduate Education in the Pharmaceutical Sciences and Research

PubMed Central

Kushwaha, KSS; Kushwaha, N; Rai, AK

2010-01-01

Harmonization of pharmacy education has to be made a global agenda that will encompass the developments that have taken place in basic, medical, pharmaceutical sciences in serving the needs and expectations of the society. The professional pharmacy curriculum is designed to produce pharmacists who have the abilities and skills to provide drug information, education, and pharmaceutical care to patients; manage the pharmacy and its medication distribution and control systems; and promote public health. Required coursework for all pharmacy students includes pharmaceutical chemistry; pharmaceutics (drug dosage forms, delivery, and disposition in the human body) pharmacology; therapeutics (the clinical use of drugs and dietary supplements in patients); drug information and analysis; pharmacy administration (including pharmacy law, bioethics, health systems, pharmacoeconomics, medical informatics); clinical skills (physical assessment, patient counseling, drug therapy monitoring for appropriate selection, dose, effect, interactions, use); and clinical pharmacy practice in pharmacies, industry, health maintenance organizations, hospital wards, and ambulatory care clinics. PMID:21264127

Advertising, computers, and pharmacy liability. A Michigan court's decision has ramifications for pharmaceutical care.

PubMed

Cacciatore, G G

1996-11-01

Arbor Drugs, Inc., advertised that its computer could detect dangerous drug interactions. A pharmacist failed to warn a patient accordingly and the patient suffered a stroke as a result of an interaction between tranylcypromine and a decongestant. The Michigan Court of Appeals held that this failure to warn was actionable under the theories of negligence and fraud as well as under the Michigan Consumer Protection Act. The court's basic message is that pharmacies may be held legally responsible for preventing harm when they represent themselves as being capable of doing so.

42 CFR Appendix F to Part 5 - Criteria for Designation of Areas Having Shortages of Pharmacy Professional(s)

Code of Federal Regulations, 2012 CFR

2012-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

42 CFR Appendix F to Part 5 - Criteria for Designation of Areas Having Shortages of Pharmacy Professional(s)

Code of Federal Regulations, 2014 CFR

2014-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

42 CFR Appendix F to Part 5 - Criteria for Designation of Areas Having Shortages of Pharmacy Professional(s)

Code of Federal Regulations, 2010 CFR

2010-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

42 CFR Appendix F to Part 5 - Criteria for Designation of Areas Having Shortages of Pharmacy Professional(s)

Code of Federal Regulations, 2011 CFR

2011-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

42 CFR Appendix F to Part 5 - Criteria for Designation of Areas Having Shortages of Pharmacy Professional(s)

Code of Federal Regulations, 2013 CFR

2013-10-01

... for the delivery of pharmacy services. 2. The number of pharmacists serving the area is less than the estimated requirement for pharmacists in the area, and the computed pharmacist shortage is at least 0.5. 3. Pharmacists in contiguous areas are overutilized or excessively distant from the population of the area under...

Investigation of a computer virus outbreak in the pharmacy of a tertiary care teaching hospital.

PubMed

Bailey, T C; Reichley, R M

1992-10-01

A computer virus outbreak was recognized, verified, defined, investigated, and controlled using an infection control approach. The pathogenesis and epidemiology of computer virus infection are reviewed. Case-control study. Pharmacy of a tertiary care teaching institution. On October 28, 1991, 2 personal computers in the drug information center manifested symptoms consistent with the "Jerusalem" virus infection. The same day, a departmental personal computer began playing "Yankee Doodle," a sign of "Doodle" virus infection. An investigation of all departmental personal computers identified the "Stoned" virus in an additional personal computer. Controls were functioning virus-free personal computers within the department. Cases were associated with users who brought diskettes from outside the department (5/5 cases versus 5/13 controls, p = .04) and with College of Pharmacy student users (3/5 cases versus 0/13 controls, p = .012). The detection of a virus-infected diskette or personal computer was associated with the number of 5 1/4-inch diskettes in the files of personal computers, a surrogate for rate of media exchange (mean = 17.4 versus 152.5, p = .018, Wilcoxon rank sum test). After education of departmental personal computer users regarding appropriate computer hygiene and installation of virus protection software, no further spread of personal computer viruses occurred, although 2 additional Stoned-infected and 1 Jerusalem-infected diskettes were detected. We recommend that virus detection software be installed on personal computers where the interchange of diskettes among computers is necessary, that write-protect tabs be placed on all program master diskettes and data diskettes where data are being read and not written, that in the event of a computer virus outbreak, all available diskettes be quarantined and scanned by virus detection software, and to facilitate quarantine and scanning in an outbreak, that diskettes be stored in organized files.

Financial risk management of pharmacy benefits.

PubMed

Saikami, D

1997-10-01

Financial risk management of pharmacy benefits in integrated health systems is explained. A managed care organization should assume financial risk for pharmacy benefits only if it can manage the risk. Horizontally integrated organizations often do not have much control over the management of drug utilization and costs. Vertically integrated organizations have the greatest ability to manage pharmacy financial risk; virtual integration may also be compatible. Contracts can be established in which the provider is incentivized or placed at partial or full risk. The main concerns that health plans have with respect to pharmacy capitation are formulary management and the question of who should receive rebates from manufacturers. The components needed to managed pharmacy financial risk depend on the type of contract negotiated. Health-system pharmacists are uniquely positioned to take advantage of opportunities opening up through pharmacy risk contracting. Functions most organizations must provide when assuming pharmacy financial risk can be divided into internal and external categories. Internally performed functions include formulary management, clinical pharmacy services and utilization management, and utilization reports for physicians. Functions that can be outsourced include claims processing and administration, provider- and customer support services, and rebates. Organizations that integrate the pharmacy benefit across the health care continuum will be more effective in controlling costs and improving outcomes than organizations that handle this benefit as separate from others. Patient care should not focus on payment mechanisms and unit costs but on developing superior processes and systems that improve health care.

Use of Computer-Based Case Studies in a Problem-Solving Curriculum.

ERIC Educational Resources Information Center

Haworth, Ian S.; And Others

1997-01-01

Describes the use of three case studies, on computer, to enhance problem solving and critical thinking among doctoral pharmacy students in a physical chemistry course. Students are expected to use specific computer programs, spreadsheets, electronic mail, molecular graphics, word processing, online literature searching, and other computer-based…

Benchmarking new frontiers in managed care pharmacy.

PubMed

Pigg, Cynthia; Cihak, Joan

2008-04-01

In 2006, the Foundation for Managed Care Pharmacy-a nonprofit charitable trust affiliated with the Academy of Managed Care Pharmacy-sponsored a survey that was conducted by The HSM Group, a national healthcare market research and consulting firm, and supported by an unrestricted grant from Merck & Co. The survey was repeated in 2007 and was designed to track the evolution of new healthcare trends, gauge the role of managed care pharmacy experts in these trends and the initiatives evolving from them, and disseminate that information to the various stakeholders of the industry. The authors examine the responses of 186 respondents from 71 national health plans, 54 pharmacy benefit management companies, as well as several hospitals, health systems, physician groups, or pharmacies. Survey findings highlight emerging trends in healthcare today and provide insight into the role of managed care pharmacy experts in today's healthcare environment, as well as other variables that may affect the future of the US healthcare delivery system.

Preventing dispensing errors by alerting for drug confusions in the pharmacy information system-A survey of users.

PubMed

Campmans, Zizi; van Rhijn, Arianne; Dull, René M; Santen-Reestman, Jacqueline; Taxis, Katja; Borgsteede, Sander D

2018-01-01

Drug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system. To evaluate the experiences of pharmacists and pharmacy technicians with alerts for drug name and strength confusion. In May 2017, a cross-sectional survey of pharmacists and pharmacy technicians was performed in community pharmacies in the Netherlands using an online questionnaire. Of the 269 respondents, 86% (n = 230) had noticed the alert for drug name confusion, and 26% (n = 67) for drug strength confusion. Of those 230, 9% (n = 20) had experienced that the alert had prevented dispensing the wrong drug. For drug strength confusion, this proportion was 12% (n = 8). Respondents preferred to have an alert for drug name and strength confusion in the pharmacy information system. 'Alert fatigue' was an important issue, so alerts should only be introduced for frequent confusions or confusions with serious consequences. Pharmacists and pharmacy technicians were positive about having alerts for drug confusions in their pharmacy information system and experienced that alerts contributed to the prevention of dispensing errors. To prevent alert fatigue, it was considered important not to include all possible confusions as a new alert: the potential contribution to the prevention of drug confusion should be weighed against the risk of alert fatigue.

Quality assurance in European pharmacy education and training*

PubMed Central

Guimarāes Morais, Jose A.; Cavaco, Afonso M.; Rombaut, Bart; Rouse, Michael J.; Atkinson, Jeffrey

A survey of quality assurance (QA) systems in European faculties of pharmacy was carried out under the auspices of the European Association of Faculties of Pharmacy PHARMINE consortium. A questionnaire based on the quality criteria of the International Pharmaceutical Federation and the Accreditation Council for Pharmacy Education (USA) was sent out to European faculties. Replies were obtained from 28 countries. Just above half has a working QA system. QA scores were high concerning matters such as complete curriculum and training, use of European Credit Transfer System, students’ representation and promotion of professional behavior. QA scores were low concerning matters such as evaluation of achievement of mission and goals, and financial resources. The PHARMINE consortium now has a basis upon which to elaborate and promote QA in European pharmacy faculties. PMID:24198856

A global picture of pharmacy technician and other pharmacy support workforce cadres.

PubMed

Koehler, Tamara; Brown, Andrew

Understanding how pharmacy technicians and other pharmacy support workforce cadres assist pharmacists in the healthcare system will facilitate developing health systems with the ability to achieve universal health coverage as it is defined in different country contexts. The aim of this paper is to provide an overview of the present global variety in the technician and other pharmacy support workforce cadres considering; their scope, roles, supervision, education and legal framework. A structured online survey instrument was administered globally using the Survey Monkey platform, designed to address the following topic areas: roles, responsibilities, supervision, education and legislation. The survey was circulated to International Pharmaceutical Federation (FIP) member organisations and a variety of global list serves where pharmaceutical services are discussed. 193 entries from 67 countries and territories were included in the final analysis revealing a vast global variety with respect to the pharmacy support workforce. From no pharmacy technicians or other pharmacy support workforce cadres in Japan, through a variety of cadre interactions with pharmacists, to the autonomous practice of pharmacy support workforce cadres in Malawi. From strictly supervised practice with a focus on supply, through autonomous practice for a variety of responsibilities, to independent practice. From complete supervision for all tasks, through geographical varied supervision, to independent practice. From on the job training, through certificate level vocational courses, to 3-4 year diploma programs. From well-regulated and registered, through part regulation with weak implementation, to completely non-regulated contexts. This paper documents wide differences in supervision requirements, education systems and supportive legislation for pharmacy support workforce cadres globally. A more detailed understanding of specific country practice settings is required if the use of pharmacy support workforce cadres is to be optimized. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

Opinion comparison concerning future information technology in Finnish community pharmacies.

PubMed

Westerling, Anna Marietta; Hynninen, Jaana Tuulikki; Haikala, Veikko Ewald; Airaksinen, Marja S

2010-12-01

To compare the opinions of community pharmacy owners, managers and personnel concerning the key features of the future information technology system needed in Finnish community pharmacies. The study was targeted to the pharmacists working in community pharmacies as managers (owners and staff pharmacists with M.Sc. degree) or personnel responsible for dispensing and patient counselling (pharmacists with B.Sc. degree). A national cross-sectional survey to all of Finnish community pharmacy owners (n = 580) and staff pharmacists (B.Sc. and M.Sc. degrees, n = 1709) working in community pharmacies, was conducted in order to determine differences in opinions between these occupation groups with different professional duties. The response rates were 53% for pharmacy owners (n = 308) and 22% for staff pharmacists (n = 373). The main outcome measure was the perceived importance of 89 potential features for a new IT system ranked by using a five-point Likert scale. The responding community pharmacy managers and staff pharmacists had differences in their ranking of more than half (52%) of the potential features listed in the survey questionnaire. The features related to the pharmacy's internal processes, such as financial management, sales and marketing management and stock holding, were ranked significantly higher by the managers, while the personnel prioritized the features supporting pharmaceutical service provision and personnel management. The managers and personnel shared their opinion on the importance of features supporting drug information and patient counselling, medication safety and interprofessional collaboration. The managers and staff pharmacists have different views of the importance of IT features, reflecting their different professional duties in the community pharmacy. A high priority was given for the features familiar to the users and needed in their daily practice. This indicates the need for involving different occupation groups in planning the new IT systems for community pharmacies.

Providing patient care in community pharmacies in Australia.

PubMed

Benrimoj, Shalom I; Roberts, Alison S

2005-11-01

To describe Australia's community pharmacy network in the context of the health system and outline the provision of services. The 5000 community pharmacies form a key component of the healthcare system for Australians, for whom health expenditures represent 9% of the Gross Domestic Product. A typical community pharmacy dispenses 880 prescriptions per week. Pharmacists are key partners in the Government's National Medicines Policy and contribute to its objectives through the provision of cognitive pharmaceutical services (CPS). The Third Community Pharmacy Agreement included funding for CPS including medication review and the provision of written drug information. Funding is also provided for a quality assurance platform with which the majority of pharmacies are accredited. Fifteen million dollars (Australian) have been allocated to research in community pharmacy, which has focused on achieving quality use of medicines (QUM), as well as developing new CPS and facilitating change. Elements of the Agreements have taken into account QUM principles and are now significant drivers of practice change. Although accounting for 10% of remuneration for community pharmacy, the provision of CPS represents a significant shift in focus to view pharmacy as a service provider. Delivery of CPS through the community pharmacy network provides sustainability for primary health care due to improvement in quality presumably associated with a reduction in healthcare costs. Australian pharmacy practice is moving strongly in the direction of CPS provision; however, change does not occur easily. The development of a change management strategy is underway to improve the uptake of professional and business opportunities in community pharmacy.

Barriers and facilitators to recovering from e-prescribing errors in community pharmacies.

PubMed

Odukoya, Olufunmilola K; Stone, Jamie A; Chui, Michelle A

2015-01-01

To explore barriers and facilitators to recovery from e-prescribing errors in community pharmacies and to explore practical solutions for work system redesign to ensure successful recovery from errors. Cross-sectional qualitative design using direct observations, interviews, and focus groups. Five community pharmacies in Wisconsin. 13 pharmacists and 14 pharmacy technicians. Observational field notes and transcribed interviews and focus groups were subjected to thematic analysis guided by the Systems Engineering Initiative for Patient Safety (SEIPS) work system and patient safety model. Barriers and facilitators to recovering from e-prescription errors in community pharmacies. Organizational factors, such as communication, training, teamwork, and staffing levels, play an important role in recovering from e-prescription errors. Other factors that could positively or negatively affect recovery of e-prescription errors include level of experience, knowledge of the pharmacy personnel, availability or usability of tools and technology, interruptions and time pressure when performing tasks, and noise in the physical environment. The SEIPS model sheds light on key factors that may influence recovery from e-prescribing errors in pharmacies, including the environment, teamwork, communication, technology, tasks, and other organizational variables. To be successful in recovering from e-prescribing errors, pharmacies must provide the appropriate working conditions that support recovery from errors.

European Pharmacy Students' Experience With Virtual Patient Technology

PubMed Central

Madeira, Filipe

2012-01-01

Objective. To describe how virtual patients are being used to simulate real-life clinical scenarios in undergraduate pharmacy education in Europe. Methods. One hundred ninety-four participants at the 2011 Congress of the European Pharmaceutical Students Association (EPSA) completed an exploratory cross-sectional survey instrument. Results. Of the 46 universities and 23 countries represented at the EPSA Congress, only 12 students from 6 universities in 6 different countries reported having experience with virtual patient technology. The students were satisfied with the virtual patient technology and considered it more useful as a teaching and learning tool than an assessment tool. Respondents who had not used virtual patient technology expressed support regarding its potential benefits in pharmacy education. French and Dutch students were significantly less interested in virtual patient technology than were their counterparts from other European countries. Conclusion. The limited use of virtual patients in pharmacy education in Europe suggests the need for initiatives to increase the use of virtual patient technology and the benefits of computer-assisted learning in pharmacy education. PMID:22919082

Pharmacy Students’ Attitudes and Perceptions of “Virtual Worlds” as an Instructional Tool for Clinical Pharmacy Teaching

PubMed Central

Englund, Claire; Gustafsson, Maria; Gallego, Gisselle

2017-01-01

The objectives of this study were to explore pharmacy students’ perceptions and experiences of three-dimensional virtual worlds (3DVWs) as an instructional tool for clinical pharmacy teaching. Semi-structured interviews were carried out with Master of Science in Pharmacy students who had participated in communicative exercises in a 3DVW. Interviews were digitally recorded, transcribed and analyzed using thematic analysis. More than half of the students were positive to using 3DVWs for educational purposes and see the advantages of having a setting where communication can be practiced in an authentic but ‘safe’ environment available online. However, many students also reported technical difficulties in using the 3DVW which impacted negatively on the learning experience. Perceived ease of use and usefulness of 3DVWs appears to play an important role for students. The students’ level of engagement relates to not only their computer skills, but also to the value they place on 3DVWs as an instructional tool. PMID:28970417

European pharmacy students' experience with virtual patient technology.

PubMed

Cavaco, Afonso Miguel; Madeira, Filipe

2012-08-10

To describe how virtual patients are being used to simulate real-life clinical scenarios in undergraduate pharmacy education in Europe. One hundred ninety-four participants at the 2011 Congress of the European Pharmaceutical Students Association (EPSA) completed an exploratory cross-sectional survey instrument. Of the 46 universities and 23 countries represented at the EPSA Congress, only 12 students from 6 universities in 6 different countries reported having experience with virtual patient technology. The students were satisfied with the virtual patient technology and considered it more useful as a teaching and learning tool than an assessment tool. Respondents who had not used virtual patient technology expressed support regarding its potential benefits in pharmacy education. French and Dutch students were significantly less interested in virtual patient technology than were their counterparts from other European countries. The limited use of virtual patients in pharmacy education in Europe suggests the need for initiatives to increase the use of virtual patient technology and the benefits of computer-assisted learning in pharmacy education.

Outcomes, costs and stakeholders' perspectives associated with the incorporation of community pharmacy services into the National Health Insurance System in Thailand: a systematic review.

PubMed

Asayut, Narong; Sookaneknun, Phayom; Chaiyasong, Surasak; Saramunee, Kritsanee

2018-02-01

Identify costs, outcomes and stakeholders' perspectives associated with incorporation of community pharmacy services into the Thai National Health Insurance System and their values to all stakeholders. Using a combination of search terms, a comprehensive literature search was performed using the Thai Journal Citation Index Centre, Health System Research Institute database, PubMed and references from recent reviews. Identified studies were published between January 2000 and December 2014. The review included publications in English and Thai on primary research undertaken in community pharmacies associated with the National Health Insurance System. Two independent authors performed study selection, data extraction and quality assessment. The literature search yielded 251 titles, with 18 satisfying the inclusion criteria. Clinical outcomes of community pharmacy services included control and reduction in blood pressure and blood sugar, improved adherence to medications, an increase in acceptance of interventions, and an increase in healthy behaviours. Thirty-three percentage of those at risk of diabetes and hypertension achieved normal blood sugar and blood pressure levels after being followed for 2-6 months by a community pharmacist. The cost of collaborative screening by community pharmacies and primary care units was US$ 4.5. Diabetes management costs were US$ 5.1-30.7. Community pharmacists reported high satisfaction rates. Stakeholders' perspectives revealed support for the community pharmacists' roles and the inclusion of community pharmacies as partners with the National Health Insurance System. Community pharmacy services improved outcomes for diabetic and hypertensive patients. This review supports the feasibility of incorporating community pharmacies into the Thai National Health System. © 2017 Royal Pharmaceutical Society.

Legal and organisational innovation in the Italian pharmacy system: commercial vs public interest.

PubMed

Santuari, Alceste

2017-10-01

Pharmacy services are undoubtedly an important part of primary care. Pharmacists are entrepreneurs and simultaneously they are entrusted with a public mission in the health care sector. Pharmacies then reflect a contrast between a commercial/economic objective and public interest, which is to be identified with citizens' universal right to health care services. This is the reason why in Italy, as in many other EU countries, pharmacies supply their services according to a prior authorisation granted by public authorities. In common with many EU countries, this authorisation is secured according to a demographic criterion. It is only by means of these licensed pharmacies that citizens can buy drugs under medical prescription. Accordingly, the health system is to be driven by public interest, which has yet to prove how competing interests may be regulated in serving health needs. In the light of EU law, the article advocates for an innovative legal and organisational tool whereby to organise the Italian pharmacy system in order to combine economic consideration and public benefit.

[Effects of pharmacy market deregulation regarding patient-centred drug care in Germany from a health economics perspecitve].

PubMed

Rumm, R; Böcking, W

2013-03-01

This article analyses the impact of a potential deregulation Germany's pharmacy market by allowing foreign ownership of pharmacies and removing the limit of the number pharmacies that can be owned by a pharmacist. Based on a mathematical model and empirical values of foreign countries, scenarios for the German market are calculated and the impact on all participants of the health care system analysed. The key outcomes are:- A deregulation would enables the creation of pharmacy chains- In all simulated scenarios the total number of pharmacies would drastically grow- The increased pharmacy density improves patient centred drug care- The competition among pharmacies increases and leads to the closure of many independently owned and operated pharmacies. © Georg Thieme Verlag KG Stuttgart · New York.

Mapping private pharmacies and their characteristics in Ujjain district, Central India

PubMed Central

2011-01-01

Background In India, private pharmacies are ubiquitous yet critical establishments that facilitate community access to medicines. These are often the first points of treatment seeking in parts of India and other low income settings around the world. The characteristics of these pharmacies including their location, drug availability, human resources and infrastructure have not been studied before. Given the ubiquity and popularity of private pharmacies in India, such information would be useful to harness the potential of these pharmacies to deliver desirable public health outcomes, to facilitate regulation and to involve in initiatives pertaining to rational drug use. This study was a cross sectional survey that mapped private pharmacies in one district on a geographic information system and described relevant characteristics of these units. Methods This study of pharmacies was a part of larger cross sectional survey carried out to map all the health care providers in Ujjain district (population 1.9 million), Central India, on a geographic information system. Their location vis-à-vis formal providers of health services were studied. Other characteristics like human resources, infrastructure, clients and availability of tracer drugs were also surveyed. Results A total 475 private pharmacies were identified in the district. Three-quarter were in urban areas, where they were concentrated around physician practices. In rural areas, pharmacies were located along the main roads. A majority of pharmacies simultaneously retailed medicines from multiple systems of medicine. Tracer parenteral antibiotics and injectable steroids were available in 83.7% and 88.7% pharmacies respectively. The proportion of clients without prescription was 39.04%. Only 11.58% of staff had formal pharmacist qualifications. Power outages were a significant challenge. Conclusion This is the first mapping of pharmacies & their characteristics in India. It provides evidence of the urban dominance and close relationship between healthcare provider location and pharmacy location. The implications of this relationship are discussed. The study reports a lack of qualified staff in the presence of a high proportion of clients attending without a prescription. The study highlights the need for the better implementation of regulation. Besides facilitating regulation & partnerships, the data also provides a sampling frame for future interventional studies on these pharmacies. PMID:22204447

21 CFR 1301.27 - Separate registration by retail pharmacies for installation and operation of automated dispensing...

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Separate registration by retail pharmacies for....27 Separate registration by retail pharmacies for installation and operation of automated dispensing systems at long term care facilities. (a) A retail pharmacy may install and operate automated dispensing...

21 CFR 1301.27 - Separate registration by retail pharmacies for installation and operation of automated dispensing...

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Separate registration by retail pharmacies for....27 Separate registration by retail pharmacies for installation and operation of automated dispensing systems at long term care facilities. (a) A retail pharmacy may install and operate automated dispensing...

21 CFR 1301.27 - Separate registration by retail pharmacies for installation and operation of automated dispensing...

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Separate registration by retail pharmacies for....27 Separate registration by retail pharmacies for installation and operation of automated dispensing systems at long term care facilities. (a) A retail pharmacy may install and operate automated dispensing...

21 CFR 1301.27 - Separate registration by retail pharmacies for installation and operation of automated dispensing...

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Separate registration by retail pharmacies for....27 Separate registration by retail pharmacies for installation and operation of automated dispensing systems at long term care facilities. (a) A retail pharmacy may install and operate automated dispensing...

21 CFR 1301.27 - Separate registration by retail pharmacies for installation and operation of automated dispensing...

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Separate registration by retail pharmacies for....27 Separate registration by retail pharmacies for installation and operation of automated dispensing systems at long term care facilities. (a) A retail pharmacy may install and operate automated dispensing...

Pharmacy Law and Pharmacy Administration in the New Zealand B.Pharm Curriculum.

ERIC Educational Resources Information Center

Coville, Peter F.

1993-01-01

The role of pharmacy law and management in New Zealand's system of undergraduate pharmacy education is discussed. The areas of pharmaceutical sciences and pharmaceutical practice are seen as distinct but complementary and intersecting. The challenge is for educators to determine how to fit them into an already crowded curriculum. (MSE)

International Mentoring Programs: Leadership Opportunities to Enhance Worldwide Pharmacy Practice.

PubMed

Ubaka, Chukwuemeka; Brechtelsbauer, Erich; Goff, Debra A

2017-07-01

Health-system and community pharmacy practice in the United States is experiencing transformational change; however, this transformation is lagging in the international arena. As a result, efforts are being made to provide support and education to the international pharmacy leaders and practitioners. This article describes one effort, the Mandela Washington Fellows Program, and suggests areas where pharmacy leaders can be involved to help advance the practice of pharmacy on an international level. The Mandela Washington Fellows Program for young Africa leaders consists of a US-Africa pharmacy-mentoring program identified ranging from educational opportunities to collaboration for implementation of patient care programs. The specifics of the mentoring program include daily meetings, clinic and ward rounds, round table discussions with mentors, and visits to various hospital care systems. Lessons were learned and strategies for sustaining the program are discussed. These types of programs represent leadership opportunities that may not be apparent to most pharmacy directors, but expanding their view to helping international pharmacists expand their practice only strengthens the professional goal of providing patient-centered pharmacy services.

Application of Kanban System on a hospital pharmacy.

PubMed

Mitka, Eleftheria

2015-01-01

This is a brief overview of principles, views and methods, of the Kanban System for the pharmacy of a general hospital. The main goal is the reduction of stores managed by the pharmacy, as well as improvement of the mode of operation. Solutions to problems, such as inadequate storage space, the delay in serving patients or clinics and the expiration of various pharmaceutical formulations, stored for so long time, are provided. The philosophy behind the Kanban procurement System and specifically its applicability to a pharmacy underperforming in terms of efficiency, in Greece, are described. Based on the analysis of stock requirement, item stock prices and demand, it is concluded that a significant percentage of the stocked drugs can be procured using the Kanban System. Significant cost savings and operational advantages following the Kanban System will take place. The challenging endeavor is the analysis, design and application of a system that supports the proposed procurement method. Hospital pharmacies in Greece and in other countries that face an economic crisis may largely benefit after using the Kanban System.

Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia

PubMed Central

El.Mahalli, Azza; El-Khafif, Sahar H.; Yamani, Wid

2016-01-01

The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended. PMID:26903780

Assessment of Pharmacy Information System Performance in Three Hospitals in Eastern Province, Saudi Arabia.

PubMed

El Mahalli, Azza; El-Khafif, Sahar H; Yamani, Wid

2016-01-01

The pharmacy information system is one of the central pillars of a hospital information system. This research evaluated a pharmacy information system according to six aspects of the medication process in three hospitals in Eastern Province, Saudi Arabia. System administrators were interviewed to determine availability of functionalities. Then, system users within the hospital were targeted to evaluate their level of usage of these functionalities. The study was cross-sectional. Two structured surveys were designed. The overall response rate of hospital users was 31.7 percent. In all three hospitals studied, the electronic health record is hybrid, implementation has been completed and the system is running, and the systems have computerized provider order entry and clinical decision support. Also, the pharmacy information systems are integrated with the electronic health record, and computerized provider order entry and almost all prescribing and transcription functionalities are available; however, drug dispensing is a mostly manual process. However, the study hospitals do not use barcode-assisted medication administration systems to verify patient identity and electronically check dose administration, and none of them have computerized adverse drug event monitoring that uses the electronic health record. The numbers of users who used different functionalities most or all of the time was generally low. The highest frequency of utilization was for patient administration records (56.8 percent), and the lowest was for linkage of the pharmacy information system to pharmacy stock (9.1 percent). Encouraging users to use different functionalities was highly recommended.

Assessing the Value of Online Learning and Social Media in Pharmacy Education.

PubMed

Hamilton, Leslie A; Franks, Andrea; Heidel, R Eric; McDonough, Sharon L K; Suda, Katie J

2016-08-25

Objective. To assess student preferences regarding online learning and technology and to evaluate student pharmacists' social media use for educational purposes. Methods. An anonymous 36-question online survey was administered to third-year student pharmacists enrolled in the Drug Information and Clinical Literature Evaluation course. Results. Four hundred thirty-one students completed the survey, yielding a 96% response rate. The majority of students used technology for academic activities, with 90% using smart phones and 91% using laptop computers. Fifty-eight percent of students also used social networking websites to communicate with classmates. Conclusion. Pharmacy students frequently use social media and some online learning methods, which could be a valuable avenue for delivering or supplementing pharmacy curricula. The potential role of social media and online learning in pharmacy education needs to be further explored.

Assessment of drug information resource preferences of pharmacy students and faculty

PubMed Central

Hanrahan, Conor T.; Cole, Sabrina W.

2014-01-01

A 39-item survey instrument was distributed to faculty and students at Wingate University School of Pharmacy to assess student and faculty drug information (DI) resource use and access preferences. The response rate was 81% (n = 289). Faculty and professional year 2 to 4 students preferred access on laptop or desktop computers (67% and 75%, respectively), followed by smartphones (27% and 22%, respectively). Most faculty and students preferred using Lexicomp Online for drug information (53% and 74%, respectively). Results indicate that DI resources use is similar between students and faculty; laptop or desktop computers are the preferred platforms for accessing drug information. PMID:24860270

The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study

PubMed Central

Franklin, Bryony Dean; Reynolds, Matthew; Sadler, Stacey; Hibberd, Ralph; Avery, Anthony J; Armstrong, Sarah J; Mehta, Rajnikant; Boyd, Matthew J; Barber, Nick

2014-01-01

Objectives To compare prevalence and types of dispensing errors and pharmacists’ labelling enhancements, for prescriptions transmitted electronically versus paper prescriptions. Design Naturalistic stepped wedge study. Setting 15 English community pharmacies. Intervention Electronic transmission of prescriptions between prescriber and pharmacy. Main outcome measures Prevalence of labelling errors, content errors and labelling enhancements (beneficial additions to the instructions), as identified by researchers visiting each pharmacy. Results Overall, we identified labelling errors in 5.4% of 16 357 dispensed items, and content errors in 1.4%; enhancements were made for 13.6%. Pharmacists also edited the label for a further 21.9% of electronically transmitted items. Electronically transmitted prescriptions had a higher prevalence of labelling errors (7.4% of 3733 items) than other prescriptions (4.8% of 12 624); OR 1.46 (95% CI 1.21 to 1.76). There was no difference for content errors or enhancements. The increase in labelling errors was mainly accounted for by errors (mainly at one pharmacy) involving omission of the indication, where specified by the prescriber, from the label. A sensitivity analysis in which these cases (n=158) were not considered errors revealed no remaining difference between prescription types. Conclusions We identified a higher prevalence of labelling errors for items transmitted electronically, but this was predominantly accounted for by local practice in a single pharmacy, independent of prescription type. Community pharmacists made labelling enhancements to about one in seven dispensed items, whether electronically transmitted or not. Community pharmacists, prescribers, professional bodies and software providers should work together to agree how items should be dispensed and labelled to best reap the benefits of electronically transmitted prescriptions. Community pharmacists need to ensure their computer systems are promptly updated to help reduce errors. PMID:24742778

The effect of the electronic transmission of prescriptions on dispensing errors and prescription enhancements made in English community pharmacies: a naturalistic stepped wedge study.

PubMed

Franklin, Bryony Dean; Reynolds, Matthew; Sadler, Stacey; Hibberd, Ralph; Avery, Anthony J; Armstrong, Sarah J; Mehta, Rajnikant; Boyd, Matthew J; Barber, Nick

2014-08-01

To compare prevalence and types of dispensing errors and pharmacists' labelling enhancements, for prescriptions transmitted electronically versus paper prescriptions. Naturalistic stepped wedge study. 15 English community pharmacies. Electronic transmission of prescriptions between prescriber and pharmacy. Prevalence of labelling errors, content errors and labelling enhancements (beneficial additions to the instructions), as identified by researchers visiting each pharmacy. Overall, we identified labelling errors in 5.4% of 16,357 dispensed items, and content errors in 1.4%; enhancements were made for 13.6%. Pharmacists also edited the label for a further 21.9% of electronically transmitted items. Electronically transmitted prescriptions had a higher prevalence of labelling errors (7.4% of 3733 items) than other prescriptions (4.8% of 12,624); OR 1.46 (95% CI 1.21 to 1.76). There was no difference for content errors or enhancements. The increase in labelling errors was mainly accounted for by errors (mainly at one pharmacy) involving omission of the indication, where specified by the prescriber, from the label. A sensitivity analysis in which these cases (n=158) were not considered errors revealed no remaining difference between prescription types. We identified a higher prevalence of labelling errors for items transmitted electronically, but this was predominantly accounted for by local practice in a single pharmacy, independent of prescription type. Community pharmacists made labelling enhancements to about one in seven dispensed items, whether electronically transmitted or not. Community pharmacists, prescribers, professional bodies and software providers should work together to agree how items should be dispensed and labelled to best reap the benefits of electronically transmitted prescriptions. Community pharmacists need to ensure their computer systems are promptly updated to help reduce errors. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Market factors and the availability of community pharmacies.

PubMed

Doucette, W R; Brooks, J M; Sorofman, B A; Wong, H

1999-07-01

The purpose of this study was to examine the relationships between the availability of community pharmacies and 4 types of market factors. A composite data set was created that linked, at the county level, data on: (1) type and number of pharmacies; (2) population characteristics; (3) payer variables; (4) health care system factors; and (5) competitive factors. In this exploratory study, secondary data were used to assess the association between the availability of community pharmacies and the influence of market factors. To assess the market influences on availability of community pharmacies, 2 regressions were performed. In 1 model, the number of community pharmacies per 10,000 population was the dependent variable, whereas the dependent variable in the other regression was the proportion of independently owned community pharmacies. The independent variables in each regression were the market factors--population characteristics, payer variables, health care system factors, and competitive variables. Squared terms were included for 8 of 15 market factors to account for nonlinearities in the relationships. Multiple market factors were correlated with both the number of community pharmacies and the proportion of independently owned pharmacies in an area. Several of the relationships were not linear and changed direction within the range of data. Counties with either a low or a high percentage of elderly people had fewer pharmacies and a lower proportion of independently owned pharmacies compared with counties with a moderate percentage of elderly people. Counties that were scarcely or highly rural had fewer community pharmacies but a higher proportion of independently owned pharmacies than counties that were moderately rural. Areas with a greater percentage of the population earning less than the poverty level had more pharmacies, especially independently owned ones. Fewer community pharmacies were found in areas with higher health maintenance organization penetration rates. The number of hospital admissions was positively associated with the number of pharmacies but negatively associated with the proportion of independently owned pharmacies. The availability of community pharmacies varies across the country. In light of the trend toward fewer independently owned pharmacies, potential problems in accessing pharmacy services could develop in certain areas, including those that are highly rural and those with a high percentage of people earning less than the poverty level. Future research and policy issues are identified.

Exploring consumer understanding and preferences for pharmacy quality information

PubMed Central

Shiyanbola, Olayinka O.; Mort, Jane R.

2014-01-01

Objective: To describe consumer understanding of pharmacy quality measures and consumer preferences for pharmacy quality information. Methods: Semi-structured focus group design was combined with survey methods. Adults who filled prescription medications for self-reported chronic illnesses at community pharmacies discussed their understanding of Pharmacy Quality Alliance approved quality measures. Questions examined preference of pharmacy quality information rating systems (e.g. stars versus percentages) and desired data display/formats. During the focus group, participants completed a survey examining their understanding of each pharmacy quality measure. All focus group discussions were transcribed verbatim. Data were analyzed using thematic analysis and descriptive statistics. Results: Thirty-four individuals participated (mean age= 62.85; SD=16.05). Participants were unfamiliar with quality measures information and their level of understanding differed for each quality measure. Surveys indicated 94.1% understood “Drug-Drug Interactions” and “Helping Patients Get Needed Medications” better than other measures (e.g., 76.5% understood “Suboptimal Treatment of Hypertension in Patients with Diabetes”). Qualitative analysis indicated participants preferred an overall pharmacy rating for quick access and use. However, participants also wanted quality measures information displayed by health conditions. Participants favored comparison of their pharmacy to city data instead of state data. Most participants liked star ratings better than percentages, letter grades, or numerical ratings. Conclusions: Individuals who have a chronic illness and regularly use community pharmacies are interested in pharmacy quality measures. However, specific quality measures were not understood by some participants. Participants had specific preferences for the display of pharmacy quality information which will be helpful in the design of appropriate quality report systems. PMID:25580169

Survey to assess the role of pharmacy technicians and nonpharmacist staff in the operation of research pharmacies.

PubMed

Siden, Rivka; Tamer, Helen R; Skyles, Amy J; Dolan, Christopher S; Propes, Denise J; Redic, Kimberly

2014-11-01

Results of a survey assessing trends and innovations in the use of pharmacy technicians and other nonpharmacist staff in the research pharmacy setting are reported. A Web-based survey was distributed to Internet communities of members of the American Society of Health-System Pharmacists and the University Health-System Consortium involved in investigational drug research and related practice areas. The survey collected data on the characteristics of institutions with pharmacy department staff dedicated to such research activities and the participation of pharmacists, technicians, and other staff in key areas of research pharmacy operations. Survey responses from 51 institutions were included in the data analysis. Overall, the reported distribution of assigned responsibility for most evaluated research pharmacy tasks reflected traditional divisions of pharmacist and technician duties, with technicians performing tasks subject to a pharmacist check or pharmacists completing tasks alone. However, some institutions reported allowing technicians to perform a number of key tasks without direct pharmacist supervision, primarily in the areas of inventory management and sponsor monitoring and auditing; almost half of the surveyed institutions reported technician involvement in teaching activities. In general, the reported use of "tech-check-tech" arrangements in research pharmacies was very limited. Some responding institutions reported the innovative use of nonpharmacist staff (e.g., paid interns, students and residents on rotation). Although the majority of research pharmacy tasks related to direct patient care are performed by or under the direct supervision of pharmacists, a variety of other essential tasks are typically assigned to pharmacy technicians and other nonpharmacist staff. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

[Globalization and its impact on pharmacy services in the Slovak Republic].

PubMed

Malovecká, Ivona; Minarovič, Igor; Mináriková, Daniela; Lehocká, Lubica; Snopková, Miroslava; Foltán, Viliam

2014-02-01

Public pharmacies are excellent medical facilities having the largest number of contacts with patients. They are the facilities of the first and last contact with the health care system for the patient. Public pharmacies are unique and easily accessible places in the health care system with a high proficiency in the provision of pharmaceutical care and highly qualified medical staff. The aim of this paper was to determine geographical-demographic situation, the legal form of the ownership of public pharmacies, and the owner share of pharmacists on the capital of public pharmacies in Slovakia. The number on of providers of pharmaceutical care depends on the population at the level of regions, districts, towns and villages with differing tightness of binding. The most common legal form of the provider of pharmaceutical care in Slovakia in public pharmacies were limited companies with 73.6% share, a sole proprietor - pharmacist had 23.9%, and public limited companies had 1.3%. In the branches of public pharmacies the limited companies had 73.4% share, a sole proprietor - pharmacist had 26%, public limited companies had 1%. The owner share of the pharmacist on the capital in public pharmacies was 50.4%, and in the branches of public pharmacies it was 66%, owned by a sole proprietor or limited company.

Nontraditional Career Opportunities for Pharmacists

PubMed Central

Bai, Sandra; Hertig, John B.; Weber, Robert J.

2016-01-01

The changing landscape of health care mirrors that of health-system pharmacy, with pharmacists' scope of practice and provider status being the most significant changes. This creates new roles and opportunities; many of these roles are considered to be nontraditional in today's practice. This article reviews some new roles for pharmacy leaders that provide different career options and pathways. Nontraditional career opportunities discussed include expanded consulting roles in pricing analytics and drug pricing programs (contracting, 340B programs), pharmacogenomics patient consult services and clinics, specialty drug pharmacies, and compounding pharmacy services. To continue to develop high-performing pharmacy departments, pharmacy directors should recognize these roles and ensure they are clearly defined and managed. With the advent of these nontraditional opportunities, pharmacy departments can further expand their ability to provide advanced patient-centered pharmacy services. PMID:28057956

Physicians as Executives: Opportunities and Strategies for Health-System Pharmacy Leaders

PubMed Central

Harvin, Andre; Griffith, Niesha; Weber, Robert J.

2014-01-01

To deal with the pressures in health care that stress clinical excellence and profitability, health systems are increasingly recruiting physician executives or physicians in leadership and management positions. Physicians occupy less than 5% of all hospital leadership positions, but there is an apparent increase in the recruitment of physician executives. With the growth in the number of physician executives, pharmacy leaders must capitalize on their existing clinical relationship and apply it to health care leadership and management. By focusing on developing an executive presence, by clearly describing a patient-centered strategy and vision for pharmacy, and by nurturing the existing clinical relationships, the pharmacy director can work with physician executives to promote patient-centered pharmacy services. PMID:25477571

Portfolio use and practices in US colleges and schools of pharmacy.

PubMed

Skrabal, Maryann Z; Turner, Paul D; Jones, Rhonda M; Tilleman, Jennifer A; Coover, Kelli L

2012-04-10

To identify the prevalence of portfolio use in US pharmacy programs, common components of portfolios, and advantages of and limitations to using portfolios. A cross-sectional electronic survey instrument was sent to experiential coordinators at US colleges and schools of pharmacy to collect data on portfolio content, methods, training and resource requirements, and benefits and challenges of portfolio use. Most colleges and schools of pharmacy (61.8%) use portfolios in experiential courses and the majority (67.1%) formally assess them, but there is wide variation regarding content and assessment. The majority of respondents used student portfolios as a formative evaluation primarily in the experiential curriculum. Although most colleges and schools of pharmacy have a portfolio system in place, few are using them to fulfill accreditation requirements. Colleges and schools need to carefully examine the intended purpose of their portfolio system and follow-through with implementation and maintenance of a system that meets their goals.

Impact of an automated dispensing system in outpatient pharmacies.

PubMed

Humphries, Tammy L; Delate, Thomas; Helling, Dennis K; Richardson, Bruce

2008-01-01

To evaluate the impact of an automated dispensing system (ADS) on pharmacy staff work activities and job satisfaction. Cross-sectional, retrospective study. Kaiser Permanente Colorado (KPCO) outpatient pharmacies in September 2005. Pharmacists and technicians from 18 outpatient pharmacies. All KPCO outpatient pharmacists (n = 136) and technicians (n = 160) were surveyed regarding demographics and work activities and pharmacist job satisfaction. Work activities and job satisfaction were compared between pharmacies with and without ADS. Historical prescription purchase records from ADS pharmacies were assessed for pre-ADS to post-ADS changes in productivity. Self-reported pharmacy staff work activities and pharmacist job satisfaction. Pharmacists who responded to the demographic questionnaire (n = 74) were primarily women (60%), had a bachelor's degree in pharmacy (68%), and had been in practice for 10 years or more (53%). Responding technicians (n = 72) were predominantly women (80%) with no postsecondary degree (90%) and fewer than 10 years (68%) in practice. Pharmacists in ADS pharmacies who responded to the work activities questionnaire (n = 50) reported equivalent mean hours spent in patient care activities and filling medication orders compared with non-ADS pharmacists (n = 33; P > 0.05). Similarly, technicians in ADS pharmacies who responded to the work activities questionnaire (n = 64) reported equivalent mean hours spent in filling medication orders compared with non-ADS technicians (n = 38; P > 0.05). An equivalent proportion of ADS pharmacists reported satisfaction with their current job compared with non-ADS pharmacies (P > 0.05). Mean productivity did not increase appreciably after automation (P >0.05). By itself, installing an ADS does not appear to shift pharmacist work activities from dispensing to patient counseling or to increase job satisfaction. Shifting pharmacist work activities from dispensing to counseling and monitoring drug therapy outcomes may be warranted in ADS pharmacies.

Evaluating an online pharmaceutical education system for pharmacy interns in critical care settings.

PubMed

Yeh, Yu-Ting; Chen, Hsiang-Yin; Cheng, Kuei-Ju; Hou, Ssu-An; Yen, Yu-Hsuan; Liu, Chien-Tsai

2014-02-01

Incorporating electronic learning (eLearning) system into professional experimental programs such as pharmacy internships is a challenge. However, none of the current systems can fully support the unique needs of clinical pharmacy internship. In this study we enhanced a commercial eLearning system for clinical pharmacy internship (The Clinical Pharmacy Internship eLearning System, CPIES). The KAP questionnaire was used to evaluate the performance of group A with the traditional teaching model and group B with the CPIES teaching model. The CPIES teaching model showed significant improvement in interns' knowledge and practice (p = 0.002 and 0.031, respectively). The traditional teaching model only demonstrated significant improvement in practice (p = 0.011). Moreover, professionalism, such as attitudes on cooperating with other health professionals, is developed by learning from a good mentor. The on-line teaching and traditional teaching methods should undoubtedly be blended in a complete teaching model in order to improve learners' professional knowledge, facilitate correct attitude, and influence good practice. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Simplifying ART cohort monitoring: can pharmacy stocks provide accurate estimates of patients retained on antiretroviral therapy in Malawi?

PubMed

Tweya, Hannock; Feldacker, Caryl; Ben-Smith, Anne; Harries, Anthony D; Komatsu, Ryuichi; Jahn, Andreas; Phiri, Sam; Tassie, Jean-Michel

2012-07-20

Routine monitoring of patients on antiretroviral therapy (ART) is crucial for measuring program success and accurate drug forecasting. However, compiling data from patient registers to measure retention in ART is labour-intensive. To address this challenge, we conducted a pilot study in Malawi to assess whether patient ART retention could be determined using pharmacy records as compared to estimates of retention based on standardized paper- or electronic based cohort reports. Twelve ART facilities were included in the study: six used paper-based registers and six used electronic data systems. One ART facility implemented an electronic data system in quarter three and was included as a paper-based system facility in quarter two only. Routine patient retention cohort reports, paper or electronic, were collected from facilities for both quarter two [April-June] and quarter three [July-September], 2010. Pharmacy stock data were also collected from the 12 ART facilities over the same period. Numbers of ART continuation bottles recorded on pharmacy stock cards at the beginning and end of each quarter were documented. These pharmacy data were used to calculate the total bottles dispensed to patients in each quarter with intent to estimate the number of patients retained on ART. Information for time required to determine ART retention was gathered through interviews with clinicians tasked with compiling the data. Among ART clinics with paper-based systems, three of six facilities in quarter two and four of five facilities in quarter three had similar numbers of patients retained on ART comparing cohort reports to pharmacy stock records. In ART clinics with electronic systems, five of six facilities in quarter two and five of seven facilities in quarter three had similar numbers of patients retained on ART when comparing retention numbers from electronically generated cohort reports to pharmacy stock records. Among paper-based facilities, an average of 13 4 hours was needed to calculate patient retention for cohort reporting using patient registers as compared to 2.25 hours using pharmacy stock cards. The numbers of patients retained on ART as estimated using pharmacy stock records were largely similar to estimates based on either paper registers or electronic data system. Furthermore, less time and staff effort was needed to estimate ART patient retention using pharmacy stock records versus paper-based registers. Reinforcing ARV stock management may improve the precision of estimates.

Pharmacy in a New Frontier - The First Five Years at the Johnson Space Center Pharmacy

NASA Technical Reports Server (NTRS)

Bayuse, Tina

2008-01-01

A poster entitled "Space Medicine - A New Role for Clinical Pharmacists" was presented in December 2001 highlighting an up-and-coming role for pharmacists at the Johnson Space Center (JSC) in Houston, Texas. Since that time, the operational need for the pharmacy profession has expanded with the administration s decision to open a pharmacy on site at JSC to complement the care provided by the Flight Medicine and Occupational Medicine Clinics. The JSC Pharmacy is a hybrid of traditional retail and hospital pharmacy and is compliant with the ambulatory care standards set forth by the Joint Commission. The primary charge for the pharmacy is to provide medication management for JSC. In addition to providing ambulatory care for both clinics, the pharmacists also practice space medicine. A pharmacist had been involved in the packing of both the Space Shuttle and International Space Station Medical Kits before the JSC Pharmacy was established; however, the role of the pharmacist in packing medical kits has grown. The pharmacists are now full members of the operations team providing consultation for new drug delivery systems, regulations, and patient safety issues. As the space crews become more international, so does the drug information provided by the pharmacists. This presentation will review the journey of the JSC Pharmacy as it celebrated its five year anniversary in April of 2008. The implementation of the pharmacy, challenges to the incorporation of the pharmacy into an existing health-care system, and the current responsibilities of a pharmacist at the Johnson Space Center will be discussed.

Pharmaceutical care in community pharmacies: practice and research in Sweden.

PubMed

Westerlund, Lo Tommy; Björk, H Thony

2006-06-01

To describe the organization and delivery of community pharmacy and medical care, as well as pharmaceutical care practice and research, in Sweden. The Swedish retail pharmacy system of 800 community pharmacies and nearly 80 hospital pharmacies is unique in that it is organized into one single, government-owned chain, known as Apoteket AB. The pharmacy staff consists of pharmacists, prescriptionists, and pharmacy technicians. Some activities related to pharmaceutical care have been directed toward specific patient groups during annual theme campaigns. In the past few years, there has been a growing emphasis on the identification, resolution, and documentation of drug-related problems (DRPs) in Swedish pharmacy practice. A classification system for documenting DRPs and pharmacy interventions was developed in 1995 and incorporated into the software of all community pharmacies in 2001. A national DRP database (SWE-DRP) was established in 2004 to collect and analyze DRPs and interventions on a nationwide basis. Recently, a new counseling technique composed of key questions to facilitate the detection of DRPs has been tested successfully. Patient medication profiles are kept in 160 pharmacies, and a new national register of drugs dispensed to patients became available in 2006. Most pharmaceutical care studies in Sweden have focused on DRPs and resulting pharmacy interventions. Swedish community pharmacy DRP work is in the international forefront but there is a potential for further developing cognitive services, given the beneficial organization of the country's pharmacies into one single pharmacy chain. The introduction of patient medication profiles has been both late and slow and has only had a marginal effect on pharmaceutical care practice so far. The universities do not appear to have any desire to influence the practice of pharmacy and could potentially take on a more active role in preparing pharmacy students for patient-oriented services. Current threats to pharmaceutical care practice and research include organizational changes, budget cuts, and reduced manpower of Apoteket AB. The identification, resolution, and documentation of DRPs are central to community pharmacy practice in Sweden, resulting in a number of research studies. A national DRP database, patient medication profiles, and a new national register of drugs dispensed to patients provide opportunities for growth in pharmaceutical care practice and research in the country.

48 CFR 22.1102 - Definition.

Code of Federal Regulations, 2010 CFR

2010-10-01

... through prolonged study. Examples of these professions include accountancy, actuarial computation, architecture, dentistry, engineering, law, medicine, nursing, pharmacy, the sciences (such as biology...

Referral of tuberculosis symptomatic clients from private pharmacies to public sector clinics for diagnosis and treatment in Cambodia.

PubMed

Bell, Carolyn A; Ilomäki, Jenni; Pichenda, Koeut; Duncan, Gregory J; Saini, Bandana

2015-04-01

Cambodia is one of the 22 countries with a high burden of tuberculosis (TB). People often first seek treatment for cough and other TB symptoms through private pharmacies. The National Tuberculosis Programme trained willing private sector pharmacies to refer TB symptomatic clients to their closest public sector clinic for diagnosis and treatment. The study objective was to investigate factors associated with referral of TB symptomatic clients from pharmacies to public sector clinics in Phnom Penh, Cambodia. Face-to-face structured interviews were conducted with staff from a stratified random sample of 180 private pharmacies in Phnom Penh in 2012. Trained interviewers were Khmer speakers. Logistic regression was used to compute odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with self-reported referral during the previous 3 months. Fifty (29.6%) pharmacies reported that they had referred 125 clients (range 1-10) to public sector clinics during the previous 3 months. In total, 164 (96.5%) pharmacies reported that they always referred all TB symptomatic clients to DOTS (directly observed treatment, short course) clinics. More than 6-year participation in the programme (OR 5.23, 95% CI 1.93-14.18) and willingness to always continue referring (OR 12.24, 95% CI 11.61-93.10) were associated with referral of one or more clients in the previous 3 months. Referral to the client's closest clinic was negatively associated with referral (OR 0.45, 95% CI 0.23-0.99). Pharmacies' ongoing commitment to the Referral Programme was strongly associated with referral. Increased advocacy among the high number of non-referring pharmacies may improve programme performance. Factors negatively associated with referral may need investigation. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

Pharmacy workers' perceptions and acceptance of bar-coded medication technology in a pediatric hospital.

PubMed

Holden, Richard J; Brown, Roger L; Scanlon, Matthew C; Karsh, Ben-Tzion

2012-01-01

The safety benefits of bar-coded medication-dispensing and administration (BCMA) technology depend on its intended users favorably perceiving, accepting, and ultimately using the technology. (1) To describe pharmacy workers' perceptions and acceptance of a recently implemented BCMA system and (2) to model the relationship between perceptions and acceptance of BCMA. Pharmacists and pharmacy technicians at a Midwest U.S. pediatric hospital were surveyed following the hospital's implementation of a BCMA system. Twenty-nine pharmacists' and 10 technicians' self-reported perceptions and acceptance of the BCMA system were analyzed, supplemented by qualitative observational and free-response survey data. Perception-acceptance associations were analyzed using structural models. The BCMA system's perceived ease of use was rated low by pharmacists and moderate by pharmacy technicians. Both pharmacists and technicians perceived that the BCMA system was not useful for improving either personal job performance or patient care. Pharmacy workers perceived that individuals important to them encouraged BMCA use. Pharmacy workers generally intended to use BCMA but reported low satisfaction with the system. Perceptions explained 72% of the variance in intention to use BCMA and 79% of variance in satisfaction with BCMA. To promote their acceptance and use, BCMA and other technologies must be better designed and integrated into the clinical work system. Key steps to achieving better design and integration include measuring clinicians' acceptance and elucidating perceptions and other factors that shape acceptance. Copyright © 2012 Elsevier Inc. All rights reserved.

Preventing dispensing errors by alerting for drug confusions in the pharmacy information system—A survey of users

PubMed Central

Campmans, Zizi; van Rhijn, Arianne; Dull, René M.; Santen-Reestman, Jacqueline; Taxis, Katja

2018-01-01

Introduction Drug confusion is thought to be the most common type of dispensing error. Several strategies can be implemented to reduce the risk of medication errors. One of these are alerts in the pharmacy information system. Objective To evaluate the experiences of pharmacists and pharmacy technicians with alerts for drug name and strength confusion. Methods In May 2017, a cross-sectional survey of pharmacists and pharmacy technicians was performed in community pharmacies in the Netherlands using an online questionnaire. Results Of the 269 respondents, 86% (n = 230) had noticed the alert for drug name confusion, and 26% (n = 67) for drug strength confusion. Of those 230, 9% (n = 20) had experienced that the alert had prevented dispensing the wrong drug. For drug strength confusion, this proportion was 12% (n = 8). Respondents preferred to have an alert for drug name and strength confusion in the pharmacy information system. ‘Alert fatigue’ was an important issue, so alerts should only be introduced for frequent confusions or confusions with serious consequences. Conclusion Pharmacists and pharmacy technicians were positive about having alerts for drug confusions in their pharmacy information system and experienced that alerts contributed to the prevention of dispensing errors. To prevent alert fatigue, it was considered important not to include all possible confusions as a new alert: the potential contribution to the prevention of drug confusion should be weighed against the risk of alert fatigue. PMID:29813099

Comparison of medication safety effectiveness among nine critical access hospitals.

PubMed

Cochran, Gary L; Haynatzki, Gleb

2013-12-15

The rates of medication errors across three different medication dispensing and administration systems frequently used in critical access hospitals (CAHs) were analyzed. Nine CAHs agreed to participate in this prospective study and were assigned to one of three groups based on similarities in their medication-use processes: (1) less than 10 hours per week of onsite pharmacy support and no bedside barcode system, (2) onsite pharmacy support for 40 hours per week and no bedside barcode system, and (3) onsite pharmacy support for 40 or more hours per week with a bedside barcode system. Errors were characterized by severity, phase of origination, type, and cause. Characteristics of the medication being administered and a number of best practices were collected for each medication pass. Logistic regression was used to identify significant predictors of errors. A total of 3103 medication passes were observed. More medication errors originated in hospitals that had onsite pharmacy support for less than 10 hours per week and no bedside barcode system than in other types of hospitals. A bedside barcode system had the greatest impact on lowering the odds of an error reaching the patient. Wrong dose and omission were common error types. Human factors and communication were the two most frequently identified causes of error for all three systems. Medication error rates were lower in CAHs with 40 or more hours per week of onsite pharmacy support with or without a bedside barcode system compared with hospitals with less than 10 hours per week of pharmacy support and no bedside barcode system.

Medication adherence communications in community pharmacies: A naturalistic investigation.

PubMed

Rickles, Nathaniel M; Young, Gary J; Hall, Judith A; Noland, Carey; Kim, Ayoung; Peterson, Conner; Hong, Mina; Hale, John

2016-03-01

To describe the extent of pharmacy detection and monitoring of medication non-adherence, and solutions offered to improve adherence. Participants were 60 residents of the Boston area who had a generic chronic medication with 30 day supplies from their usual pharmacy. Participants received a duplicate prescription which they filled at a different pharmacy. For 5 months, participants alternated between the two pharmacies, creating gaps in their refill records at both pharmacies but no gaps in their medication adherence. Participants followed a scripted protocol and after each pharmacy visit reported their own and the pharmacy staff's behavior. Across 78 unique community pharmacies and 260 pharmacy visits, pharmacies were inconsistent and inadequate in asking if participants had questions, discussing the importance of adherence, providing adequate consultations with new medication, and detecting and intervening on non-adherence. Insurers rarely contacted the participants about adherence concerns. There is a need for more structured intervention systems to ensure pharmacists are consistently and adequately educating patients and detecting/managing potential medication non-adherence. The present study calls for more attention to building infrastructure in pharmacy practice that helps pharmacists more consistently identify, monitor, and intervene on medication adherence. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Tobacco and alcohol sales in community pharmacies: policy statements from U.S. professional pharmacy associations.

PubMed

Corelli, Robin L; Chai, Tiffany; Karic, Alda; Fairman, Melinda; Baez, Karina; Hudmon, Karen Suchanek

2014-01-01

To characterize the extent to which state and national professional pharmacy associations have implemented formal policies addressing the sale of tobacco and alcohol products in community pharmacies. To determine existence of tobacco and alcohol policies, national professional pharmacy associations (n = 10) and state-level pharmacy associations (n = 86) affiliated with the American Pharmacists Association (APhA) and/or the American Society of Health-System Pharmacists (ASHP) were contacted via telephone and/or e-mail, and a search of the association websites was conducted. Of 95 responding associations (99%), 14% have a formal policy opposing the sale of tobacco products in pharmacies and 5% have a formal policy opposing the sale of alcohol in pharmacies. Of the associations representing major tobacco-producing states, 40% have a formal policy against tobacco sales in pharmacies, significantly more than the 8% of non-tobacco state associations with such policies. Among national professional pharmacy associations, only APhA and ASHP have formal policy statements opposing the sale of both tobacco and alcohol in pharmacies. Most state-level professional pharmacy associations affiliated with these two national organizations have no formal policy statement or position.

The Guide to Better Hospital Computer Decisions

PubMed Central

Dorenfest, Sheldon I.

1981-01-01

A soon-to-be-published major study of hospital computer use entitled “The Guide to Better Hospital Computer Decisions” was conducted by my firm over the past 2½ years. The study required over twenty (20) man years of effort at a cost of over $300,000, and the six (6) volume final report provides more than 1,000 pages of data about how hospitals are and will be using computerized medical and business information systems. It describes the current status and future expectations for computer use in major application areas, such as, but not limited to, finance, admitting, pharmacy, laboratory, data collection and hospital or medical information systems. It also includes profiles of over 100 companies and other types of organizations providing data processing products and services to hospitals. In this paper, we discuss the need for the study, the specific objectives of the study, the methodology and approach taken to complete the study and a few major conclusions.

Comparison of self-reported professional competency across pharmacy education programs: a survey of Thai pharmacy graduates enrolled in the public service program

PubMed Central

Sumpradit, Nithima; Suttajit, Siritree; Hunnangkul, Saowalak; Wisaijohn, Thunthita; Putthasri, Weerasak

2014-01-01

Introduction Thai pharmacy education consists of two undergraduate programs, a 5-year Bachelor of Science in Pharmacy (BScPsci and BScPcare) degree and a 6-year Doctor of Pharmacy (Pharm D). Pharmacy students who wish to serve in the public sector need to enroll in the public service program. This study aims to compare the perception of professional competency among new pharmacy graduates from the three different pharmacy programs available in 2013 who enrolled in the public service program. Methods A cross-sectional survey was conducted among new pharmacy graduates in 2013 using a self-administered, structured, close-ended questionnaire. The questionnaire consisted of respondents’ characteristics and perception of professional competencies. The competency questions consisted of 13 items with a 5-point scale. Data collection was conducted during Thailand’s annual health professional meeting on April 2, 2013 for workplace selection of pharmacy graduates. Results A total of 266 new pharmacy graduates responded to the questionnaire (response rate 49.6%). There were no significant differences in sex and admission modes across the three pharmacy programs. Pharm D graduates reported highest competency in acute care services, medication reconciliation services, and primary care services among the other two programs. BScPsci graduates reported more competence in consumer health protection and herbal and alternative medicines than BScPcare graduates. There were significant differences in three competency domains: patient care, consumer protection and community health services, and drug review and information, but no significant differences in the health administration and communication domain among three pharmacy programs. Conclusion Despite a complete change into a 6-year Pharm D program in 2014, pharmacy education in Thailand should continue evolving to be responsive to the needs of the health system. An annual survey of new pharmacy graduates should be continued, to monitor changes of professional competency across different program tracks and other factors which may influence their contribution to the health service system. Likewise, a longitudinal monitoring of their competencies in the graduate cohort should be conducted. PMID:25337000

Comparison of self-reported professional competency across pharmacy education programs: a survey of Thai pharmacy graduates enrolled in the public service program.

PubMed

Sumpradit, Nithima; Suttajit, Siritree; Hunnangkul, Saowalak; Wisaijohn, Thunthita; Putthasri, Weerasak

2014-01-01

Thai pharmacy education consists of two undergraduate programs, a 5-year Bachelor of Science in Pharmacy (BScPsci and BScPcare) degree and a 6-year Doctor of Pharmacy (Pharm D). Pharmacy students who wish to serve in the public sector need to enroll in the public service program. This study aims to compare the perception of professional competency among new pharmacy graduates from the three different pharmacy programs available in 2013 who enrolled in the public service program. A cross-sectional survey was conducted among new pharmacy graduates in 2013 using a self-administered, structured, close-ended questionnaire. The questionnaire consisted of respondents' characteristics and perception of professional competencies. The competency questions consisted of 13 items with a 5-point scale. Data collection was conducted during Thailand's annual health professional meeting on April 2, 2013 for workplace selection of pharmacy graduates. A total of 266 new pharmacy graduates responded to the questionnaire (response rate 49.6%). There were no significant differences in sex and admission modes across the three pharmacy programs. Pharm D graduates reported highest competency in acute care services, medication reconciliation services, and primary care services among the other two programs. BScPsci graduates reported more competence in consumer health protection and herbal and alternative medicines than BScPcare graduates. There were significant differences in three competency domains: patient care, consumer protection and community health services, and drug review and information, but no significant differences in the health administration and communication domain among three pharmacy programs. Despite a complete change into a 6-year Pharm D program in 2014, pharmacy education in Thailand should continue evolving to be responsive to the needs of the health system. An annual survey of new pharmacy graduates should be continued, to monitor changes of professional competency across different program tracks and other factors which may influence their contribution to the health service system. Likewise, a longitudinal monitoring of their competencies in the graduate cohort should be conducted.

Managing Minor Ailments; The Public's Preferences for Attributes of Community Pharmacies. A Discrete Choice Experiment.

PubMed

Porteous, Terry; Ryan, Mandy; Bond, Christine; Watson, Margaret; Watson, Verity

2016-01-01

Demand for health services continues to rise. Greater use of community pharmacy services instead of medical services for minor ailments could help relieve pressure on healthcare providers in high-cost settings. Community pharmacies are recognised sources of treatment and advice for people wishing to manage these ailments. However, increasing the public's use of pharmacy services may depend on attributes of pharmacies and their staff. This study aimed to determine the general public's relative preferences for community pharmacy attributes using a discrete choice experiment (DCE). A UK-wide DCE survey of the general public was conducted using face-to-face computer-assisted personal interviews. Attributes and levels for the DCE were informed by a literature review and a cohort study of community pharmacy customers. The context for the experiment was a minor ailment scenario describing flu-like symptoms. The DCE choice sets described two hypothetical community pharmacy services; respondents were asked to choose which (if either) of the two pharmacies they would prefer to help them manage symptoms. Data from 1,049 interviews were analysed using an error components logit model. Willingness to pay (WTP), a monetary measure of benefit, was estimated for the different attribute levels. When seeking help or treatment for flu-like symptoms, respondents most valued a pharmacy service that would improve their understanding and management of symptoms (WTP = £6.28), provided by staff who are trained (WTP (pharmacist) = £2.63: WTP(trained assistant) = £3.22), friendly and approachable (WTP = £3.38). Waiting time, pharmacy location and availability of parking also contributed to respondents' preferences. WTP for a service comprising the best possible combination of attributes and levels was calculated as £55.43. Attributes of a community pharmacy and its staff may influence people's decisions about which pharmacy they would visit to access treatment and advice for minor ailments. In line with the public's preferences, offering community pharmacy services that help people to better understand and manage symptoms, are provided promptly by trained staff who are friendly and approachable, and in a local setting with easy access to parking, has the potential to increase uptake amongst those seeking help to manage minor ailments. In this way it may be possible to shift demand away from high-cost health services and make more efficient use of scarce public resources.

What is known about community pharmacy supply of naloxone? A scoping review.

PubMed

Nielsen, Suzanne; Van Hout, Marie Claire

2016-06-01

There is growing evidence that expanded supply of take-home naloxone to prevent opioid overdose deaths is needed. Potential routes for expansion of naloxone provision include through community pharmacies. The aim of this scoping review is to establish what is known about community pharmacy supply of naloxone, in light of unique challenges and opportunities present in pharmacy settings. A scoping review methodology was employed using the six stage iterative process advocated by Arksey and O'Malley (2005) and Levac et al. (2010). Searches used key words and terms such as 'naloxone'; 'overdose prevention/drug overdose/opiate overdose'; 'community/retail pharmacy'; 'pharmacist/pharmacy/community pharmacy/pharmaceutical services'; 'professional practice/role'; 'community care'; attitude of health personnel'; 'training/supply/cost'. Appropriate search terms were selected for each database. After initial exploratory searches, comprehensive searches were conducted with Cochrane Database of Systematic Reviews, Medline, Medline in Process, Embase, PsycINFO and CINAHL. Eligibility criteria centered on whether studies broadly described supply of naloxone in community pharmacy or had content relating to community pharmacy supply. The search identified 95 articles, of which 16 were related to pharmacy supply of naloxone. Five themes were presented after initial review of the data and consultation with the project Expert Group, and are; 'Pharmacists Perceptions of Naloxone: Facilitators and Barriers', 'Patient Populations: Identification and Recruitment', 'Supply Systems and Cost', 'Legal Issues', and 'Training of Pharmacists and Community Pharmacy Naloxone Recipients'. Findings from this scoping review suggest that community pharmacy based supply of take-home naloxone warrants the community pharmacy based route for distribution of take home naloxone provision warrants further consideration and development. Existing strengths include a range of established supply models, and training curricula, few direct concerns regarding legal liability of pharmacists in the supply of naloxone (once legal supply systems have been established) and the wide range of potential identifiable patient populations, which include pain patients that may not be in contact with existing naloxone supply programmes. Copyright © 2016 Elsevier B.V. All rights reserved.

Preventing Large-Scale Controlled Substance Diversion From Within the Pharmacy

PubMed Central

Martin, Emory S.; Dzierba, Steven H.; Jones, David M.

2013-01-01

Large-scale diversion of controlled substances (CS) from within a hospital or heath system pharmacy is a rare but growing problem. It is the responsibility of pharmacy leadership to scrutinize control processes to expose weaknesses. This article reviews examples of large-scale diversion incidents and diversion techniques and provides practical strategies to stimulate enhanced CS security within the pharmacy staff. Large-scale diversion from within a pharmacy department can be averted by a pharmacist-in-charge who is informed and proactive in taking effective countermeasures. PMID:24421497

The use of wireless laptop computers for computer-assisted learning in pharmacokinetics.

PubMed

Munar, Myrna Y; Singh, Harleen; Belle, Donna; Brackett, Carolyn C; Earle, Sandra B

2006-02-15

To implement computer-assisted learning workshops into pharmacokinetics courses in a doctor of pharmacy (PharmD) program. Workshops were designed for students to utilize computer software programs on laptop computers to build pharmacokinetic models to predict drug concentrations resulting from various dosage regimens. In addition, students were able to visualize through graphing programs how altering different parameters changed drug concentration-time curves. Surveys were conducted to measure students' attitudes toward computer technology before and after implementation. Finally, traditional examinations were used to evaluate student learning. Doctor of pharmacy students responded favorably to the use of wireless laptop computers in problem-based pharmacokinetic workshops. Eighty-eight percent (n = 61/69) and 82% (n = 55/67) of PharmD students completed surveys before and after computer implementation, respectively. Prior to implementation, 95% of students agreed that computers would enhance learning in pharmacokinetics. After implementation, 98% of students strongly agreed (p < 0.05) that computers enhanced learning. Examination results were significantly higher after computer implementation (89% with computers vs. 84% without computers; p = 0.01). Implementation of wireless laptop computers in a pharmacokinetic course enabled students to construct their own pharmacokinetic models that could respond to changing parameters. Students had greater comprehension and were better able to interpret results and provide appropriate recommendations. Computer-assisted pharmacokinetic techniques can be powerful tools when making decisions about drug therapy.

The Use of Wireless Laptop Computers for Computer-Assisted Learning in Pharmacokinetics

PubMed Central

Munar, Myrna Y.; Singh, Harleen; Belle, Donna; Brackett, Carolyn C.; Earle, Sandra B.

2006-01-01

Objective To implement computer-assisted learning workshops into pharmacokinetics courses in a doctor of pharmacy (PharmD) program. Design Workshops were designed for students to utilize computer software programs on laptop computers to build pharmacokinetic models to predict drug concentrations resulting from various dosage regimens. In addition, students were able to visualize through graphing programs how altering different parameters changed drug concentration-time curves. Surveys were conducted to measure students’ attitudes toward computer technology before and after implementation. Finally, traditional examinations were used to evaluate student learning. Assessment Doctor of pharmacy students responded favorably to the use of wireless laptop computers in problem-based pharmacokinetic workshops. Eighty-eight percent (n = 61/69) and 82% (n = 55/67) of PharmD students completed surveys before and after computer implementation, respectively. Prior to implementation, 95% of students agreed that computers would enhance learning in pharmacokinetics. After implementation, 98% of students strongly agreed (p < 0.05) that computers enhanced learning. Examination results were significantly higher after computer implementation (89% with computers vs. 84% without computers; p = 0.01). Conclusion Implementation of wireless laptop computers in a pharmacokinetic course enabled students to construct their own pharmacokinetic models that could respond to changing parameters. Students had greater comprehension and were better able to interpret results and provide appropriate recommendations. Computer-assisted pharmacokinetic techniques can be powerful tools when making decisions about drug therapy. PMID:17136147

Enactment of mandatory pharmacy technician certification in Kansas.

PubMed

Lucas, Amber; Massey, Lindsay; Gill, Taylor; Burger, Gregory; Little, Jeff D

2016-02-01

The successful enactment of mandatory pharmacy technician certification in Kansas is described. In 2004, Kansas began requiring registration of all pharmacy technicians with the state board of pharmacy. Registration identified individuals working as pharmacy technicians but did not require any specific education or certification. In September 2012, the Kansas Board of Pharmacy created a task force of key stakeholders including pharmacists from multiple areas of practice, the University of Kansas School of Pharmacy, organizational leaders from the Kansas Council of Health-System Pharmacists (KCHP) and Kansas Pharmacists Association, and professional lobbyists. The goals of this task force were to research practices of technician certification in other states and to make recommendations to the state board of pharmacy on how Kansas could accomplish mandatory technician certification. The task force outlined the steps needed to achieve legislation that could be supported by the members. These topics included the creation of a technician trainee category, grandfathering certain technicians who had been practicing for a designated period of time, state board-approved exemptions, training requirements, age and education requirements, continuing-education requirements, and pharmacist:technician ratio. The recommendations were finalized at the August 2013 Kansas Pharmacy Summit, and the proposed legislation was introduced and passed during the 2014 legislative session. KCHP members learned many valuable lessons about advocacy and the legislative process with this initiative, including building relationships, working with legislators, and working with other professional organizations. The formation of a task force led to the successful passage of a bill granting the Kansas Board of Pharmacy the authority to issue regulations regarding mandatory pharmacy technician certification. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Global sale of tobacco products and electronic nicotine delivery systems in community pharmacies.

PubMed

Hudmon, Karen Suchanek; Elkhadragy, Nervana; Kusynová, Zuzana; Besançon, Luc; Brock, Tina Penick; Corelli, Robin L

2017-12-01

To estimate the proportion of countries/territories that allow sales of tobacco products and electronic nicotine delivery systems (ENDS) in community pharmacies. International Pharmaceutical Federation (FIP) member organisations were contacted by email and asked to respond to a two-item survey assessing whether their country/territory allowed sales of (a) tobacco products and (b) ENDS in community pharmacies. Of 95 countries/territories contacted, responses were received from 60 (63.2%). Seven countries (11.7%) reported that tobacco products were sold in community pharmacies, and 11 countries (18.3%) reported that ENDS were sold in community pharmacies. Among the FIP member organisations, there are few countries that allow the sale of tobacco products and ENDS in community pharmacies, with ENDS being more likely than tobacco products to be sold. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Pharmacy-based distribution system for enteral nutrition products.

PubMed

Craig, S A; Paulson, M F

1985-12-01

A hospital pharmacy department's implementation of enteral nutrition product distribution and its proposal for an enteral nutrition product admixture service are described. Responsibility for the distribution of enteral nutrition formulations was transferred from the central distribution department to the pharmacy after problems with inventory control, billing procedures, and inappropriate administration of enteral nutrition products were recognized by personnel from the central-distribution area and nutrition services. After additional problems were identified using a multi-disciplinary approach, the pharmacy department implemented an enteral nutrition product distribution system and developed an enteral nutrition product formulary. A proposal was developed for a pharmacy-based enteral nutrition admixture service, but implementation of this service was deferred because data from a cost-effectiveness evaluation and random bacteriologic monitoring did not justify adding the service. Pharmacy-based distribution and formulary control of enteral nutrition products alleviated problems with inaccurate patient charges and accumulation of stock on the nursing units. Pharmacists at this hospital hope to develop an enteral nutrition product admixture program that will result in cost savings for the institution.

Pharmacy workers’ perceptions and acceptance of bar coded medication technology in a pediatric hospital

PubMed Central

Holden, Richard J.; Brown, Roger L.; Scanlon, Matthew C.; Karsh, Ben-Tzion

2012-01-01

Background The safety benefits of bar-coded medication dispensing and administration technology (BCMA) depend on its intended users favorably perceiving, accepting, and ultimately using the technology. Objectives (1) To describe pharmacy workers’ perceptions and acceptance of a recently implemented BCMA system and (2) to model the relationship between perceptions and acceptance of BCMA. Methods Pharmacists and pharmacy technicians at a Midwest US pediatric hospital were surveyed following the hospital’s implementation of a BCMA system. Twenty-nine pharmacists and ten technicians’ self-reported perceptions and acceptance of the BCMA system were analyzed, supplemented by qualitative observational and free-response survey data. Perception-acceptance associations were analyzed using structural models. Results The BCMA system’s perceived ease of use was rated low by pharmacists and moderate by pharmacy technicians. Both pharmacists and technicians perceived that the BCMA system was not useful for improving either personal job performance or patient care. Pharmacy workers perceived that individuals important to them encouraged BMCA use. Pharmacy workers generally intended to use BCMA but reported low satisfaction with the system. Perceptions explained 72% of the variance in intention to use BCMA and 79% of variance in satisfaction with BCMA. Conclusions To promote their acceptance and use, BCMA and other technologies must be better designed and integrated into the clinical work system. Key steps to achieving better design and integration include measuring clinicians’ acceptance and elucidating perceptions and other factors that shape acceptance. PMID:22417887

Portfolio Use and Practices in US Colleges and Schools of Pharmacy

PubMed Central

Turner, Paul D.; Jones, Rhonda M.; Tilleman, Jennifer A.; Coover, Kelli L.

2012-01-01

Objectives. To identify the prevalence of portfolio use in US pharmacy programs, common components of portfolios, and advantages of and limitations to using portfolios. Methods. A cross-sectional electronic survey instrument was sent to experiential coordinators at US colleges and schools of pharmacy to collect data on portfolio content, methods, training and resource requirements, and benefits and challenges of portfolio use. Results. Most colleges and schools of pharmacy (61.8%) use portfolios in experiential courses and the majority (67.1%) formally assess them, but there is wide variation regarding content and assessment. The majority of respondents used student portfolios as a formative evaluation primarily in the experiential curriculum. Conclusions. Although most colleges and schools of pharmacy have a portfolio system in place, few are using them to fulfill accreditation requirements. Colleges and schools need to carefully examine the intended purpose of their portfolio system and follow-through with implementation and maintenance of a system that meets their goals. PMID:22544963

Description and analysis of hospital pharmacies in Madagascar.

PubMed

Ratsimbazafimahefa, H R; Sadeghipour, F; Trouiller, P; Pannatier, A; Allenet, B

2018-05-01

Madagascar's health care system has operated without formal hospital pharmacies for more than two decades. The gradual integration of pharmacists in public hospitals since 2012 will allow the structuring of this field. This study was conducted to characterize the current situation regarding all aspects relating to the general functioning of hospital pharmacies and the services provided. This qualitative research used semi-structured interviews. Interviewees' perceptions about the general organization and functioning of hospital pharmacies and details on services provided were collected. The 16 interviewees were Ministry of Health staff members involved in hospital pharmacy, hospital directors, medical staff members and hospital pharmacy managers. Interviews were recorded, translated into French if conducted in Malagasy, and fully transcribed. Verbatim transcripts were coded according to the themes of hospital pharmacy and topical content analysis was performed. The principal issue perceived by interviewees was the heterogeneity of the system in terms of technical and financing management, with a main impact on the restocking of pharmaceutical products. The drug supply chain is not under control: no internal procedure has been established for the selection of pharmaceutical products, the quantification of needs is complex, stock management is difficult to supervise, a standard prescription protocol is lacking, dispensing is performed by unqualified staff, no pharmaceutical preparation is manufactured in the hospitals and administration occurs without pharmaceutical support. Progressive structuring of efficient hospital pharmacy services using the Basel statements for the future of hospital pharmacy is urgently needed to improve health care in Madagascar. Copyright © 2017 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Community pharmacy incident reporting: a new tool for community pharmacies in Canada.

PubMed

Ho, Certina; Hung, Patricia; Lee, Gary; Kadija, Medina

2010-01-01

Incident reporting offers insight into a variety of intricate processes in healthcare. However, it has been found that medication incidents are under reported in the community pharmacy setting. The Community Pharmacy Incident Reporting (CPhIR) program was created by the Institute for Safe Medication Practices Canada specifically for incident reporting in the community pharmacy setting in Canada. The initial development of key elements for CPhIR included several focus-group teleconferences with pharmacists from Ontario and Nova Scotia. Throughout the development and release of the CPhIR pilot, feedback from pharmacists and pharmacy technicians was constantly incorporated into the reporting program. After several rounds of iterative feedback, testing and consultation with community pharmacy practitioners, a final version of the CPhIR program, together with self-directed training materials, is now ready to launch. The CPhIR program provides users with a one-stop platform to report and record medication incidents, export data for customized analysis and view comparisons of individual and aggregate data. These unique functions allow for a detailed analysis of underlying contributing factors in medication incidents. A communication piece for pharmacies to share their experiences is in the process of development. To ensure the success of the CPhIR program, a patient safety culture must be established. By gaining a deeper understanding of possible causes of medication incidents, community pharmacies can implement system-based strategies for quality improvement and to prevent potential errors from occurring again in the future. This article highlights key features of the CPhIR program that will assist community pharmacies to improve their drug distribution system and, ultimately, enhance patient safety.

Use of pharmacy delivery robots in intensive care units.

PubMed

Summerfield, Marc R; Seagull, F Jacob; Vaidya, Neelesh; Xiao, Yan

2011-01-01

The use of pharmacy delivery robots in an institution's intensive care units was evaluated. In 2003, the University of Maryland Medical Center (UMMC) began a pilot program to determine the logistic capability and functional utility of robotic technology in the delivery of medications from satellite pharmacies to patient care units. Three satellite pharmacies currently used the robotic system. Five data sources (electronic robot activation records, logs, interviews, surveys, and observations) were used to assess five key aspects of robotic delivery: robot use, reliability, timeliness, cost minimization, and acceptance. A 19-item survey using a 7-point Likert-type scale was developed to determine if pharmacy delivery robots changed nurses' perception of pharmacy service. The components measured included general satisfaction, reliability, timeliness, stat orders, services, interaction with pharmacy, and status tracking. A total of 23 pre-implementation, 96 post-implementation, and 30 two-year follow-up surveys were completed. After implementation of the robotic delivery system, time from fax to label, order preparation time, and idle time for medications to be delivered decreased, while nurses' general satisfaction with the pharmacy and opinion of the reliability of pharmacy delivery significantly increased. Robotic delivery did not influence the perceived quality of delivery service or the timeliness of orders or stat orders. Robot reliability was a major issue for the technician but not for pharmacists, who did not have as much interaction with the devices. By considering the needs of UMMC and its patients and matching them with available technology, the institution was able to improve the medication-use process and timeliness of medication departure from the pharmacy.

Disruptive innovation in community pharmacy - Impact of automation on the pharmacist workforce.

PubMed

Spinks, Jean; Jackson, John; Kirkpatrick, Carl M; Wheeler, Amanda J

Pharmacy workforce planning has been relatively static for many decades. However, like all industries, health care is exposed to potentially disruptive technological changes. Automated dispensing systems have been available to pharmacy for over a decade and have been applied to a range of repetitive technical processes which are at risk of error, including record keeping, item selection, labeling and dose packing. To date, most applications of this technology have been at the local level, such as hospital pharmacies or single-site community pharmacies. However, widespread implementation of a more centralized automated dispensing model, such as the 'hub and spoke' model currently being debated in the United Kingdom, could cause a 'technology shock,' delivering industry-wide efficiencies, improving medication accessibility and lowering costs to consumers and funding agencies. Some of pharmacists' historical roles may be made redundant, and new roles may be created, decoupling pharmacists to a certain extent from the dispensing and supply process. It may also create an additional opportunity for pharmacists to be acknowledged and renumerated for professional services that extend beyond the dispensary. Such a change would have significant implications for the organization and funding of community pharmacy services as well as pharmacy workforce planning. This paper discusses the prospect of centralized automated dispensing systems and how this may impact on the pharmacy workforce. It concludes that more work needs to be done in the realm of pharmacy workforce planning to ensure that the introduction of any new technology delivers optimal outcomes to consumers, insurers and the pharmacy workforce. Copyright © 2016 Elsevier Inc. All rights reserved.

Perceived importance and self-assessment of the skills of Canada's health-system pharmacy managers.

PubMed

Axworthy, Sheri; MacKinnon, Neil J

2002-06-01

The relationship between the perceived importance of managerial skills and self-assessed proficiency in each skill among health-system pharmacy managers in Canada was examined, and the demographic characteristics associated with pharmacy managers who lack these skills were analyzed. Surveys were mailed to 514 health-system pharmacy managers in Canada in July 2000. The survey listed 61 specific managerial skills, under seven general categories. The respondents were asked to rate the level of importance that each of the skills had in their job and rate their proficiency in each skill. Ratings were based on a five-point Likert scale ranging from very high importance or skill level to very low importance or skill level. The response rate was 52.7%. Of the 61 specific managerial skills considered, the majority of respondents identified "Demonstrating ethical conduct" as both the most important skill and their greatest strength. "Understand the operating principles of managed care" was viewed as the least important skill, while "Participating in the implementation of a marketing program" was respondents' greatest weakness. There were significant differences in the mean self-assessed skill levels of the respondents according to their educational background, size of the institution in which they work, and years of managerial experience. Health-system pharmacy managers with a master of business administration degree had a significantly higher overall mean perceived skill level than managers in all other "Education" categories. Managers with a bachelor of science degree in pharmacy had a significantly lower overall mean perceived skill level than those with a bachelor of science degree in pharmacy plus "other" degrees, while managers employed in institutions of 500 or more inpatient beds had a significantly higher overall self-rated mean skill level than managers employed in institutions of 51-100 inpatient beds. A national survey of health-system pharmacy managers in Canada revealed a pressing need for better training in managerial skills for these pharmacists.

Principles and methods of managerial cost-accounting systems.

PubMed

Suver, J D; Cooper, J C

1988-01-01

An introduction to cost-accounting systems for pharmacy managers is provided; terms are defined and examples of specific applications are given. Cost-accounting systems determine, record, and report the resources consumed in providing services. An effective cost-accounting system must provide the information needed for both internal and external reports. In accounting terms, cost is the value given up to secure an asset. In determining how volumes of activity affect costs, fixed costs and variable costs are calculated; applications include pricing strategies, cost determinations, and break-even analysis. Also discussed are the concepts of direct and indirect costs, opportunity costs, and incremental and sunk costs. For most pharmacy department services, process costing, an accounting of intermediate outputs and homogeneous units, is used; in determining the full cost of providing a product or service (e.g., patient stay), job-order costing is used. Development of work-performance standards is necessary for monitoring productivity and determining product costs. In allocating pharmacy department costs, a ratio of costs to charges can be used; this method is convenient, but microcosting (specific identification of the costs of products) is more accurate. Pharmacy managers can use cost-accounting systems to evaluate the pharmacy's strategies, policies, and services and to improve budgets and reports.

An assessment of pharmacists' readiness for paperless labeling: a national survey.

PubMed

Ho, Yun-Xian; Chen, Qingxia; Nian, Hui; Johnson, Kevin B

2014-01-01

To assess the state of readiness for the adoption of paperless labeling among a nationally representative sample of pharmacies, including chain pharmacies, independent retail pharmacies, hospitals, and other rural or urban dispensing sites. Both quantitative and qualitative analyses were used to analyze responses to a cross-sectional survey disseminated to American Pharmacists Association pharmacists nationwide. The survey assessed factors related to pharmacists' attitudinal readiness (ie, perceptions of impact) and pharmacies' structural readiness (eg, availability of electronic resources, internet access) for the paperless labeling initiative. We received a total of 436 survey responses (6% response rate) from pharmacists representing 44 US states and territories. Across the spectrum of settings we studied, pharmacists had work access to computers, printers, fax machines and access to the internet or intranet. Approximately 79% of respondents believed that the initiative would improve the adequacy of drug information available in their work site and 95% believed it would either not change (33%) or would improve (62%) communication to patients. Overall, respondents' comments supported advancing the initiative; however, some comments revealed reservations regarding corporate or pharmacy buy-in, success of implementation, and ease of adoption. This is the first nationwide study to report about pharmacists' perspectives on paperless labeling. In general, pharmacists believe they are ready and that their pharmacies are well equipped for the transition to paperless labeling. Further exploration of perspectives from product label manufacturers and corporate pharmacy offices is needed to understand fully what will be necessary to complete this transition.

Using Free Computational Resources to Illustrate the Drug Design Process in an Undergraduate Medicinal Chemistry Course

ERIC Educational Resources Information Center

Rodrigues, Ricardo P.; Andrade, Saulo F.; Mantoani, Susimaire P.; Eifler-Lima, Vera L.; Silva, Vinicius B.; Kawano, Daniel F.

2015-01-01

Advances in, and dissemination of, computer technologies in the field of drug research now enable the use of molecular modeling tools to teach important concepts of drug design to chemistry and pharmacy students. A series of computer laboratories is described to introduce undergraduate students to commonly adopted "in silico" drug design…

Availability of information on renal function in Dutch community pharmacies.

PubMed

Koster, Ellen S; Philbert, Daphne; Noordam, Michelle; Winters, Nina A; Blom, Lyda; Bouvy, Marcel L

2016-08-01

Background Early detection and monitoring of impaired renal function may prevent drug related problems. Objective To assess the availability of information on patient's renal function in Dutch community pharmacies, for patients using medication that might need monitoring in case of renal impairment. Methods Per pharmacy, 25 patients aged ≥65 years using at least one drug that requires monitoring, were randomly selected from the pharmacy information system. For these patients, information on renal function [estimated glomerular filtration rate (eGFR)], was obtained from the pharmacy information system. When absent, this information was obtained from the general practitioner (GP). Results Data were collected for 1632 patients. For 1201 patients (74 %) eGFR values were not directly available in the pharmacy, for another 194 patients (12 %) the eGFR value was not up-to-date. For 1082 patients information could be obtained from the GP, resulting in 942 additional recent eGFR values. Finally, recent information on renal function was available for 72 % (n = 1179) of selected patients. Conclusion In patients using drugs that require renal monitoring, information on renal function is often unknown in the pharmacy. For the majority of patients this information can be retrieved from the GP.

JSC Pharmacy Services for Remote Operations

NASA Technical Reports Server (NTRS)

Stoner, Paul S.; Bayuse, Tina

2005-01-01

The Johnson Space Center Pharmacy began operating in March of 2003. The pharmacy serves in two main capacities: to directly provide medications and services in support of the medical clinics at the Johnson Space Center, physician travel kits for NASA flight surgeon staff, and remote operations, such as the clinics in Devon Island, Star City and Moscow; and indirectly provide medications and services for the International Space Station and Space Shuttle medical kits. Process changes that occurred and continued to evolve in the advent of the installation of the new JSC Pharmacy, and the process of stocking medications for each of these aforementioned areas will be discussed. Methods: The incorporation of pharmacy involvement to provide services for remote operations and supplying medical kits was evaluated. The first step was to review the current processes and work the JSC Pharmacy into the existing system. The second step was to provide medications to these areas. Considerations for the timeline of expiring medications for shipment are reviewed with each request. The third step was the development of a process to provide accountability for the medications. Results: The JSC Pharmacy utilizes a pharmacy management system to document all medications leaving the pharmacy. Challenges inherent to providing medications to remote areas were encountered. A process has been designed to incorporate usage into the electronic medical record upon return of the information from these remote areas. This is an evolving program and several areas have been identified for further improvement.

Providing Formative Feedback From a Summative Computer-aided Assessment

PubMed Central

Sewell, Robert D. E.

2007-01-01

Objectives To examine the effectiveness of providing formative feedback for summative computer-aided assessment. Design Two groups of first-year undergraduate life science students in pharmacy and neuroscience who were studying an e-learning package in a common pharmacology module were presented with a computer-based summative assessment. A sheet with individualized feedback derived from each of the 5 results sections of the assessment was provided to each student. Students were asked via a questionnaire to evaluate the form and method of feedback. Assessment The students were able to reflect on their performance and use the feedback provided to guide their future study or revision. There was no significant difference between the responses from pharmacy and neuroscience students. Students' responses on the questionnaire indicated a generally positive reaction to this form of feedback. Conclusions Findings suggest that additional formative assessment conveyed by this style and method would be appreciated and valued by students. PMID:17533442

A System Approach to Navy Medical Education and Training. Appendix 40. Competency Curricula for Pharmacy Assistant and Pharmacy Technician.

DTIC Science & Technology

1974-08-31

Procedures and techniques for compounding syrups, collodion, waters, spirits, liniments Use and maintenance of automatic liquid prepacker IIi [ o [ I... liniments , glycerites, elixirs Use and maintenance of automatic liquid prepacker 31 J ] Competency: PHARMACY TECHNICIAN (PHT) Unit II: Compounding

Specialty pharmaceuticals care management in an integrated health care delivery system with electronic health records.

PubMed

Monroe, C Douglas; Chin, Karen Y

2013-05-01

The specialty pharmaceuticals market is expanding more rapidly than the traditional pharmaceuticals market. Specialty pharmacy operations have evolved to deliver selected medications and associated clinical services. The growing role of specialty drugs requires new approaches to managing the use of these drugs. The focus, expectations, and emphasis in specialty drug management in an integrated health care delivery system such as Kaiser Permanente (KP) can vary as compared with more conventional health care systems. The KP Specialty Pharmacy (KP-SP) serves KP members across the United States. This descriptive account addresses the impetus for specialty drug management within KP, the use of tools such as an electronic health record (EHR) system and process management software, the KP-SP approach for specialty pharmacy services, and the emphasis on quality measurement of services provided. Kaiser Permanente's integrated system enables KP-SP pharmacists to coordinate the provision of specialty drugs while monitoring laboratory values, physician visits, and most other relevant elements of the patient's therapy. Process management software facilitates the counseling of patients, promotion of adherence, and interventions to resolve clinical, logistic, or pharmacy benefit issues. The integrated EHR affords KP-SP pharmacists advantages for care management that should become available to more health care systems with broadened adoption of EHRs. The KP-SP experience may help to establish models for clinical pharmacy services as health care systems and information systems become more integrated.

A qualitative assessment of a community pharmacy cognitive pharmaceutical services program, using a work system approach.

PubMed

Chui, Michelle A; Mott, David A; Maxwell, Leigh

2012-01-01

Although lack of time, trained personnel, and reimbursement have been identified as barriers to pharmacists providing cognitive pharmaceutical services (CPS) in community pharmacies, the underlying contributing factors of these barriers have not been explored. One approach to better understand barriers and facilitators to providing CPS is to use a work system approach to examine different components of a work system and how the components may impact care processes. The goals of this study were to identify and describe pharmacy work system characteristics that pharmacists identified and changed to provide CPS in a demonstration program. A qualitative approach was used for data collection. A purposive sample of 8 pharmacists at 6 community pharmacies participating in a demonstration program was selected to be interviewed. Each semistructured interview was audio recorded and transcribed, and the text was analyzed in a descriptive and interpretive manner by 3 analysts. Themes were identified in the text and aligned with 1 of 5 components of the Systems Engineering Initiative for Patient Safety (SEIPS) work system model (organization, tasks, tools/technology, people, and environment). A total of 21 themes were identified from the interviews, and 7 themes were identified across all 6 interviews. The organization component of the SEIPS model contained the most (n=10) themes. Numerous factors within a pharmacy work system appear important to enable pharmacists to provide CPS. Leadership and foresight by the organization to implement processes (communication, coordination, planning, etc.) to facilitate providing CPS was a key finding across the interviews. Expanding technician responsibilities was reported to be essential for successfully implementing CPS. To be successful in providing CPS, pharmacists must be cognizant of the different components of the pharmacy work system and how these components influence providing CPS. Copyright © 2012 Elsevier Inc. All rights reserved.

A qualitative assessment of a community pharmacy cognitive pharmaceutical services program, using a work system approach

PubMed Central

Chui, Michelle A.; Mott, David A.; Maxwell, Leigh

2012-01-01

Background Although lack of time, trained personnel, and reimbursement have been identified as barriers to pharmacists providing cognitive pharmaceutical services (CPS) in community pharmacies, the underlying contributing factors of these barriers have not been explored. One approach to better understand barriers and facilitators to providing CPS is to use a work system approach to examine different components of a work system and how the components may impact care processes. Objectives The goals of this study were to identify and describe pharmacy work system characteristics that pharmacists identified and changed to provide CPS in a demonstration program. Methods A qualitative approach was used for data collection. A purposive sample of 8 pharmacists at 6 community pharmacies participating in a demonstration program was selected to be interviewed. Each semistructured interview was audio recorded and transcribed, and the text was analyzed in a descriptive and interpretive manner by 3 analysts. Themes were identified in the text and aligned with 1 of 5 components of the Systems Engineering Initiative for Patient Safety (SEIPS) work system model (organization, tasks, tools/technology, people, and environment). Results A total of 21 themes were identified from the interviews, and 7 themes were identified across all 6 interviews. The organization component of the SEIPS model contained the most (n = 10) themes. Numerous factors within a pharmacy work system appear important to enable pharmacists to provide CPS. Leadership and foresight by the organization to implement processes (communication, coordination, planning, etc.) to facilitate providing CPS was a key finding across the interviews. Expanding technician responsibilities was reported to be essential for successfully implementing CPS. Conclusions To be successful in providing CPS, pharmacists must be cognizant of the different components of the pharmacy work system and how these components influence providing CPS. PMID:21824822

Knowledge-Centric Management of Business Rules in a Pharmacy

NASA Astrophysics Data System (ADS)

Puustjärvi, Juha; Puustjärvi, Leena

A business rule defines or constraints some aspect of the business. In healthcare sector many of the business rules are dictated by law or medical regulations, which are constantly changing. This is a challenge for the healthcare organizations. Although there is available several commercial business rule management systems the problem from pharmacies point of view is that these systems are overly geared towards the automation and manipulation of business rules, while the main need in pharmacies lies in easy retrieving of business rules within daily routines. Another problem is that business rule management systems are isolated in the sense that they have their own data stores that cannot be accessed by other information systems used in pharmacies. As a result, a pharmacist is burdened by accessing many systems inside a user task. In order to avoid this problem we have modeled business rules as well as their relationships to other relevant information by OWL (Web Ontology Language) such that the ontology is shared among the pharmacy's applications. In this way we can avoid the problems of isolated applications and replicated data. The ontology also encourages pharmacies business agility, i.e., the ability to react more rapidly to the changes required by the new business rules. The deployment of the ontology requires that stored business rules are annotated by appropriate metadata descriptions, which are presented by RDF/XML serialization format. However, neither the designer nor the pharmacists are burdened by RDF/XML format as there are sophisticated graphical editors that can be used.

Creating a performance appraisal template for pharmacy technicians using the method of equal-appearing intervals.

PubMed

Desselle, Shane P; Vaughan, Melissa; Faria, Thomas

2002-01-01

To design a highly quantitative template for the evaluation of community pharmacy technicians' job performance that enables managers to provide sufficient feedback and fairly allocate organizational rewards. Two rounds of interviews with two convenience samples of community pharmacists and pharmacy technicians were conducted. The interview in phase 1 was qualitative, and responses were used to design the second interview protocol. During the phase 2 interviews, a new group of respondents ranked technicians' job responsibilities, identified through the initial interviewees' responses, using scales the researchers had designed using an interval-level scaling technique called equal-appearing intervals. Chain and independent pharmacies. Phase 1-20 pharmacists and 20 technicians from chain and independent pharmacies; phase 2-20 pharmacists and 9 technicians from chain and independent pharmacies. Ratings of the importance of technician practice functions and corresponding responsibilities. Weights were calculated for each practice function. A weighted list of practice functions was developed, and this may serve as a performance evaluation template. Customer service-related activities were judged by pharmacists and technicians alike to be the most important technician functions. Many pharmacies either lack formal performance appraisal systems or fail to implement them properly. Technicians may desire more consistent feedback from pharmacists and value information that may lead to organizational rewards. Using a weighted, behaviorally anchored performance appraisal system may help pharmacists and pharmacy managers meet these demands.

Financial performance of the teaching pharmacies in Isfahan: an economic evaluation

PubMed Central

Sabzghabaee, A.M.; Etebari, M.; Sajjadi, H.; Badri, Sh.; Hosseini-Biuki, S.M.; Sheikhaboumasoudi, R.

2009-01-01

Teaching pharmacies are amongst the important cornerstones of a healthcare system for drug supplying, pharmacy education and pharmacy practice research. Assessment of the Iranian healthcare system costs shows that after personnel charges, drug outlay is the second expensive factor. This great financial mass requires integral audit and management in order to provide costumers satisfaction in addition to financial viability. Teaching pharmacies are required to realize financial viability as well as providing several educational and drug servicing goals, which makes microeconomic analysis important. The aim of this study was to evaluate the financial performance of the teaching pharmacies affiliated with the Isfahan University of Medical Sciences (with the abrreviated names as: SHM, ISJ, AZH for the confidentialiy of the financial data). This is a descriptive and cross-sectional study done in 2008. The target pharmacies of this study were all the 3 teaching pharmacies affiliated with the Isfahan University of Medical Sciences. The data collecting template was prepared using the standard scientific methods according to the goals of this research The goals also nominated necessary items needed in economic profit evaluation. The data collection template was completed by reference to the teaching pharmacies financial documents and reports, used as a base for calculating the total income and the total costs in 2007-2008 financial year. The difference between these two balances showed the value of profits or loss. The profit/cost ratio was also calculated, using the proportion of the total income to the total costs. The collected data was statistically analyzed using the Excel software (Microsoft 2007). For the financial year 2007-2008, the difference between the total income and the total costs was -831.6 million Rials (excess costs to income) for the SHM pharmacy, + 25.4 billion Rials for the ISJ pharmacy and -429.5 million Rials for the AZH pharmacy. According to our findings there is a strong requirement to improve the financial performance of all the three teaching pharmacies while maintaining a high standardard of teaching and educational affairs. PMID:21589804

Financial performance of the teaching pharmacies in Isfahan: an economic evaluation.

PubMed

Sabzghabaee, A M; Etebari, M; Sajjadi, H; Badri, Sh; Hosseini-Biuki, S M; Sheikhaboumasoudi, R

2009-07-01

Teaching pharmacies are amongst the important cornerstones of a healthcare system for drug supplying, pharmacy education and pharmacy practice research. Assessment of the Iranian healthcare system costs shows that after personnel charges, drug outlay is the second expensive factor. This great financial mass requires integral audit and management in order to provide costumers satisfaction in addition to financial viability. Teaching pharmacies are required to realize financial viability as well as providing several educational and drug servicing goals, which makes microeconomic analysis important. The aim of this study was to evaluate the financial performance of the teaching pharmacies affiliated with the Isfahan University of Medical Sciences (with the abrreviated names as: SHM, ISJ, AZH for the confidentialiy of the financial data). This is a descriptive and cross-sectional study done in 2008. The target pharmacies of this study were all the 3 teaching pharmacies affiliated with the Isfahan University of Medical Sciences. The data collecting template was prepared using the standard scientific methods according to the goals of this research The goals also nominated necessary items needed in economic profit evaluation. The data collection template was completed by reference to the teaching pharmacies financial documents and reports, used as a base for calculating the total income and the total costs in 2007-2008 financial year. The difference between these two balances showed the value of profits or loss. The profit/cost ratio was also calculated, using the proportion of the total income to the total costs. The collected data was statistically analyzed using the Excel software (Microsoft 2007). For the financial year 2007-2008, the difference between the total income and the total costs was -831.6 million Rials (excess costs to income) for the SHM pharmacy, + 25.4 billion Rials for the ISJ pharmacy and -429.5 million Rials for the AZH pharmacy. According to our findings there is a strong requirement to improve the financial performance of all the three teaching pharmacies while maintaining a high standardard of teaching and educational affairs.

Managing Minor Ailments; The Public’s Preferences for Attributes of Community Pharmacies. A Discrete Choice Experiment

PubMed Central

Ryan, Mandy; Bond, Christine; Watson, Margaret

2016-01-01

Background Demand for health services continues to rise. Greater use of community pharmacy services instead of medical services for minor ailments could help relieve pressure on healthcare providers in high-cost settings. Community pharmacies are recognised sources of treatment and advice for people wishing to manage these ailments. However, increasing the public’s use of pharmacy services may depend on attributes of pharmacies and their staff. This study aimed to determine the general public’s relative preferences for community pharmacy attributes using a discrete choice experiment (DCE). Method A UK-wide DCE survey of the general public was conducted using face-to-face computer-assisted personal interviews. Attributes and levels for the DCE were informed by a literature review and a cohort study of community pharmacy customers. The context for the experiment was a minor ailment scenario describing flu-like symptoms. The DCE choice sets described two hypothetical community pharmacy services; respondents were asked to choose which (if either) of the two pharmacies they would prefer to help them manage symptoms. Data from 1,049 interviews were analysed using an error components logit model. Willingness to pay (WTP), a monetary measure of benefit, was estimated for the different attribute levels. Results When seeking help or treatment for flu-like symptoms, respondents most valued a pharmacy service that would improve their understanding and management of symptoms (WTP = £6.28), provided by staff who are trained (WTP (pharmacist) = £2.63: WTP(trained assistant) = £3.22), friendly and approachable (WTP = £3.38). Waiting time, pharmacy location and availability of parking also contributed to respondents’ preferences. WTP for a service comprising the best possible combination of attributes and levels was calculated as £55.43. Conclusion Attributes of a community pharmacy and its staff may influence people’s decisions about which pharmacy they would visit to access treatment and advice for minor ailments. In line with the public’s preferences, offering community pharmacy services that help people to better understand and manage symptoms, are provided promptly by trained staff who are friendly and approachable, and in a local setting with easy access to parking, has the potential to increase uptake amongst those seeking help to manage minor ailments. In this way it may be possible to shift demand away from high-cost health services and make more efficient use of scarce public resources. PMID:27031588

Design and implementation of a cost-accounting system in hospital pharmacy.

PubMed

Gouveia, W A; Anderson, E R; Decker, E L; Backer, K

1988-03-01

The design and implementation of a cost-accounting system in a hospital pharmacy department is described. Pharmacy resource use (labor, drugs, supplies, and overhead), or pharmacy's intermediate products, was clearly defined in terms of dosage forms (10 groupings representing variable labor and supplies) and drug products (more than 100 categories that incorporate cost and volume of use for 3000 line items). Costs were defined as variable or nonvariable (fixed), based on whether they were related to a specific medication order. Labor was divided into variable and fixed components. Time standards were developed using time and motion studies. Variable labor hours were determined as follows: specified hours (the volume of each dosage form multiplied by the standard time for each dosage form); nonspecified hours (time not directly associated with production); hours worked (specified plus nonspecified hours); and hours paid (hours worked plus sick leave and vacation). A standard cost for each drug product was based on the weighted average of volume and cost of the individual line items. The total drug budget was constructed by multiplying the standard cost for each drug product times the projected volume for each drug product. The pharmacy budget was developed by calculating the number and mix of pharmacy products used in association with the projected number and type of cases for the fiscal year. The monthly pharmacy budget reports were assembled with data from the payroll, billing, and cost-accounting systems.(ABSTRACT TRUNCATED AT 250 WORDS)

Informal learning processes in support of clinical service delivery in a service-oriented community pharmacy.

PubMed

Patterson, Brandon J; Bakken, Brianne K; Doucette, William R; Urmie, Julie M; McDonough, Randal P

The evolving health care system necessitates pharmacy organizations' adjustments by delivering new services and establishing inter-organizational relationships. One approach supporting pharmacy organizations in making changes may be informal learning by technicians, pharmacists, and pharmacy owners. Informal learning is characterized by a four-step cycle including intent to learn, action, feedback, and reflection. This framework helps explain individual and organizational factors that influence learning processes within an organization as well as the individual and organizational outcomes of those learning processes. A case study of an Iowa independent community pharmacy with years of experience in offering patient care services was made. Nine semi-structured interviews with pharmacy personnel revealed initial evidence in support of the informal learning model in practice. Future research could investigate more fully the informal learning model in delivery of patient care services in community pharmacies. Copyright © 2016 Elsevier Inc. All rights reserved.

Evaluating and selecting an information system, Part 1.

PubMed

Neal, T

1993-01-01

Initial steps in the process of evaluating and selecting a computerized information system for the pharmacy department are described. The first step in the selection process is to establish a steering committee and a project committee. The steering committee oversees the project, providing policy guidance, making major decisions, and allocating budgeted expenditures. The project committee conducts the departmental needs assessment, identifies system requirements, performs day-to-day functions, evaluates vendor proposals, trains personnel, and implements the system chosen. The second step is the assessment of needs in terms of personnel, workload, physical layout, and operating requirements. The needs assessment should be based on the department's mission statement and strategic plan. The third step is the development of a request for information (RFI) and a request for proposal (RFP). The RFI is a document designed for gathering preliminary information from a wide range of vendors; this general information is used in deciding whether to send the RFP to a given vendor. The RFP requests more detailed information and gives the purchaser's exact specifications for a system; the RFP also includes contractual information. To help ensure project success, many institutions turn to computer consultants for guidance. The initial steps in selecting a computerized pharmacy information system are establishing computerization committees, conducting a needs assessment, and writing an RFI and an RFP. A crucial early decision is whether to seek a consultant's expertise.

Ensuring continuing fitness to practice in the pharmacy workforce: Understanding the challenges of revalidation.

PubMed

Schafheutle, Ellen Ingrid; Hassell, Karen; Noyce, Peter R

2013-01-01

Revalidation is about assuring that health practitioners remain up to date and fit to practice, and demonstrating that they continue to meet the requirements of their professional regulator. To critically discuss issues that need to be considered when designing a system of revalidation for pharmacy professionals. Although providing international context, the article focuses in particular on Great Britain (GB), where both pharmacists (Phs) and pharmacy technicians (PTs) are regulated. Following a brief historical overview, the article draws on emerging evidence in context. Revalidation may involve discrete periodic assessment or a continuous process of assessment against clearly identified standards. The evolving scope of pharmacy practice involves increasingly clinical roles and also practitioners in nonpatient-facing roles. The potential risk to patients and the public may require consideration. Although revalidation, or systems for recertification/relicensure, exist in numerous jurisdictions, most center on the collection of continuing education credits; continuous professional development and reflective practice are increasingly found. Revalidation may involve assessment of other sources, such as appraisals or monitoring visits. Existing revalidation systems are coordinated centrally, but particularly in larger jurisdictions, like GB, where approximately 67,000 pharmacy professionals are regulated, some responsibility may need to be devolved. This would require engagement with employers and contracting organizations to ensure suitability and consistency. Existing systems, such as company appraisals, are unfit for the assessment of fitness to practice owing to a focus on organizational/business targets. Certain groups of pharmacy professionals may pose particular challenges, such as self-employed locums, pharmacy owners, those working in different sectors, or returning after a break. To ensure proportionality, it must be considered whether the same standards and/or sources of evidence should apply to all pharmacy professionals, either dependent on whether they are patient facing, their scope of practice, or whether Phs and PTs should be treated differently. Copyright © 2013 Elsevier Inc. All rights reserved.

Taking the pulse of Internet pharmacies.

PubMed

Yang, Z; Peterson, R T; Huang, L

2001-01-01

Like most businesses, online pharmacy companies will only be successful if they make sure customers are satisfied with the service they receive. But what attributes of service quality lead to satisfaction and dissatisfaction? This study identified 19 Internet pharmacy service quality dimensions in three categories: (1) product cost and availability, (2) customer service, and (3) the online information system. Our analysis uncovered attributes that tend to determine consumer satisfaction and points out ways to improve overall service quality in the Internet pharmacy arena.

Pharmacy Information Systems in Teaching Hospitals: A Multi-dimensional Evaluation Study.

PubMed

Kazemi, Alireza; Rabiei, Reza; Moghaddasi, Hamid; Deimazar, Ghasem

2016-07-01

In hospitals, the pharmacy information system (PIS) is usually a sub-system of the hospital information system (HIS). The PIS supports the distribution and management of drugs, shows drug and medical device inventory, and facilitates preparing needed reports. In this study, pharmacy information systems implemented in general teaching hospitals affiliated to medical universities in Tehran (Iran) were evaluated using a multi-dimensional tool. This was an evaluation study conducted in 2015. To collect data, a checklist was developed by reviewing the relevant literature; this checklist included both general and specific criteria to evaluate pharmacy information systems. The checklist was then validated by medical informatics experts and pharmacists. The sample of the study included five PIS in general-teaching hospitals affiliated to three medical universities in Tehran (Iran). Data were collected using the checklist and through observing the systems. The findings were presented as tables. Five PIS were evaluated in the five general-teaching hospitals that had the highest bed numbers. The findings showed that the evaluated pharmacy information systems lacked some important general and specific criteria. Among the general evaluation criteria, it was found that only two of the PIS studied were capable of restricting repeated attempts made for unauthorized access to the systems. With respect to the specific evaluation criteria, no attention was paid to the patient safety aspect. The PIS studied were mainly designed to support financial tasks; little attention was paid to clinical and patient safety features.

Comparison on Human Resource Requirement between Manual and Automated Dispensing Systems.

PubMed

Noparatayaporn, Prapaporn; Sakulbumrungsil, Rungpetch; Thaweethamcharoen, Tanita; Sangseenil, Wunwisa

2017-05-01

This study was conducted to compare human resource requirement among manual, automated, and modified automated dispensing systems. Data were collected from the pharmacy department at the 2100-bed university hospital (Siriraj Hospital, Bangkok, Thailand). Data regarding the duration of the medication distribution process were collected by using self-reported forms for 1 month. The data on the automated dispensing machine (ADM) system were obtained from 1 piloted inpatient ward, whereas those on the manual system were the average of other wards. Data on dispensing, returned unused medication, and stock management processes under the traditional manual system and the ADM system were from actual activities, whereas the modified ADM system was modeled. The full-time equivalent (FTE) of each model was estimated for comparison. The result showed that the manual system required 46.84 FTEs of pharmacists and 132.66 FTEs of pharmacy technicians. By adding pharmacist roles on screening and verification under the ADM system, the ADM system required 117.61 FTEs of pharmacists. Replacing counting and filling medication functions by ADM has decreased the number of pharmacy technicians to 55.38 FTEs. After the modified ADM system canceled the return unused medication process, FTEs requirement for pharmacists and pharmacy technicians decreased to 69.78 and 51.90 FTEs, respectively. The ADM system decreased the workload of pharmacy technicians, whereas it required more time from pharmacists. However, the increased workload of pharmacists was associated with more comprehensive patient care functions, which resulted from the redesigned work process. Copyright © 2017. Published by Elsevier Inc.

[Problems encountered by hospital pharmacists with information systems: Analysis of exchanges within social networks].

PubMed

Charpiat, B; Mille, F; Fombeur, P; Machon, J; Zawadzki, E; Bobay-Madic, A

2018-05-21

The development of information systems in French hospitals is mandatory. The aim of this work was to analyze the content of exchanges carried out within social networks, dealing with problems encountered with hospital pharmacies information systems. Messages exchanged via the mailing list of the Association pour le Digital et l'Information en Pharmacie and abstracts of communications presented at hospital pharmacists trade union congresses were analyzed. Those referring to information systems used in hospital pharmacies were selected. From March 2015 to June 2016, 122 e-mails sent by 80 pharmacists concerned information systems. From 2002 to 2016, 45 abstracts dealt with this topic. Problems most often addressed in these 167 documents were "parameterization and/or functionalities" (n=116), interfaces and complexity of the hospital information systems (n=52), relationship with health information technologies vendors and poor reactivity (n=32), additional workload (n=32), ergonomics (n=30), insufficient user training (n=22). These problems are interdependent, lead to errors and in order to mitigate their consequences, they compel pharmacy professionals to divert a significant amount of working hours to the detriment of pharmaceutical care and dispensing and preparing drugs. Hospital pharmacists are faced with many problems of insecurity and inefficiency generated by information systems. Researches are warranted to determine their cost, specify their deleterious effects on care and identify the safest information systems. Copyright © 2018 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.

Student Experiences of Engaged Enquiry in Pharmacy Education: Digital Natives or Something Else?

ERIC Educational Resources Information Center

Ellis, Robert A.; Bliuc, Ana-Maria; Goodyear, Peter

2012-01-01

This article reports on research into the student experience of enquiry in two tasks in a university pharmacy course. Students were required to investigate through a field trip how a community pharmacy operated to meet customer needs and the requirements of the Health System in which it operated. Students were also required to investigate…

Impact of the Pharmacy Practice Model Initiative on Clinical Pharmacy Specialist Practice.

PubMed

Jacobi, Judith; Ray, Shaunta'; Danelich, Ilya; Dodds Ashley, Elizabeth; Eckel, Stephen; Guharoy, Roy; Militello, Michael; O'Donnell, Paul; Sam, Teena; Crist, Stephanie M; Smidt, Danielle

2016-05-01

This paper describes the goals of the American Society of Health-System Pharmacists' Pharmacy Practice Model Initiative (PPMI) and its recommendations for health-system pharmacy practice transformation to meet future patient care needs and elevate the role of pharmacists as patient care providers. PPMI envisions a future in which pharmacists have greater responsibility for medication-related outcomes and technicians assume greater responsibility for product-related activities. Although the PPMI recommendations have elevated the level of practice in many settings, they also potentially affect existing clinical pharmacists, in general, and clinical pharmacy specialists, in particular. Moreover, although more consistent patient care can be achieved with an expanded team of pharmacist providers, the role of clinical pharmacy specialists must not be diminished, especially in the care of complex patients and populations. Specialist practitioners with advanced training and credentials must be available to model and train pharmacists in generalist positions, residents, and students. Indeed, specialist practitioners are often the innovators and practice leaders. Negotiation between hospitals and pharmacy schools is needed to ensure a continuing role for academic clinical pharmacists and their contributions as educators and researchers. Lessons can be applied from disciplines such as nursing and medicine, which have developed new models of care involving effective collaboration between generalists and specialists. Several different pharmacy practice models have been described to meet the PPMI goals, based on available personnel and local goals. Studies measuring the impact of these new practice models are needed. © 2016 Pharmacotherapy Publications, Inc.

What constitutes an effective community pharmacy?--development of a preliminary model of organizational effectiveness through concept mapping with multiple stakeholders.

PubMed

Scahill, S L; Harrison, J; Carswell, P

2010-08-01

To develop a multi-constituent model of organizational effectiveness for community pharmacy. Using Concept Systems software, a project with 14 stakeholders included a three stage process: (i) face to face brainstorming to generate statements describing what constitutes an effective community pharmacy, followed by (ii) statement reduction and approval by participants, followed by (iii) sorting of the statements into themes with rating of each statement for importance. Primary care in a government-funded, national health care system. A multi-constituent group representing policy-makers and health care providers including; community pharmacy, professional pharmacy organizations, primary health care funders and policy-makers, general practitioners and general practice support organizations. Statement clusters included: 'has safe and effective workflows', 'contributes to the safe use of medicines', 'manages human resources and has leadership', 'has a community focus', 'is integrated within primary care', 'is a respected innovator', 'provides health promotion and preventative care', 'communicates and advocates'. These clusters fit into a quadrant model setting stakeholder focus against role development. The poles of stakeholder focus are 'internal capacity' and 'social utility'. The poles of role development are labelled 'traditional safety roles' and 'integration and innovation'. Organizational effectiveness in community pharmacy includes the internal and external focus of the organization and role development. Our preliminary model describes an effective community pharmacy and provides a platform for investigation of the factors that may influence the organizational effectiveness of individual community pharmacies now and into the future.

The status of Iranian hospital pharmacies according to age-friendly pharmacies criteria

PubMed Central

Bastani, Peivand; Marzaleh, Milad Ahmadi; Dehghani, Mina; Falahatzadeh, Maryam; Rahmati, Elahe; Tahernezhad, Ali

2017-01-01

Due to the increasing elderly population and the subsequent increase in their need for medication and more referrals to the pharmacy, this study was conducted to investigate the Iranian hospital pharmacies in terms of age-friendliness criteria. This was a cross-sectional study conducted in 2017. The study population included 3 metropolitan hospital pharmacies selected through clustered sampling, and all their 67 pharmacies were included by census. Data collection tool was a reliable researcher-made checklist (t = 0.85, α = 0.9) Data analysis was performed using Kruskal–Wallis test and Mann–Whitney test through SPSS version 24. The results in these three cities showed that only two pharmacies were in a high level of age-friendly. The relationship between type of pharmacy and the final score of age-friendly situation in these cities showed no significant relationship. There was no significant relationship among the average of the final score of the age-friendly situation in three studied cities. Due to the increasing elderly population and the aging society, readiness of Iranian hospital pharmacies to provide services to the elderly will be one of the most challenging issues in the long term. With proper legislation and policies on health-care systems, especially pharmacies, physical and psychological problems in elderly can be reduced in the future. Furthermore, with advancing toward age-friendly pharmacies, the community can be empower and become ready encountering elderly problems. PMID:29184842

Expanded Roles for Pharmacy Technicians in the Medication Reconciliation Process: A Qualitative Review

PubMed Central

Ham, YoungYoon; Gerrity, Theresa M.

2017-01-01

Background: Collection of a complete and accurate medication history is an essential component of the medication reconciliation process. The role of pharmacy technicians in supporting medication reconciliation has been the subject of recent interest. Purpose: The purpose of this article is to review the existing literature on pharmacy technician involvement in the medication reconciliation process and to summarize outcomes on the quality and accuracy of pharmacy technician–collected medication histories. Method: A literature review was conducted using MEDLINE and Academic Search Premier (1948 – April 2015). Results: Sixteen papers were identified, with 12 containing a formal evaluation of outcomes. Three were purely descriptive, and 9 compared the pharmacy technician's performance to pharmacists, nurses, physicians, and/or interdisciplinary teams. Studies used a variety of endpoints, but they demonstrated similar or improved outcomes by engaging pharmacy technicians. Evidence demonstrates that trained pharmacy technicians are able to gather medication histories with similar completeness and accuracy to other health care professionals. Conclusion: The use of pharmacy technicians may be a viable strategy for developing and expanding medication reconciliation processes with appropriate supervision. Future efforts should focus on evaluating the impact of expanded roles for pharmacy technicians in the health care system; assessing the need for standardization of pharmacy technician education, training, and certification; and obtaining clarification from state pharmacy boards regarding these expanded roles. PMID:28179740

Evaluation of a Hepatitis C Patient Management Program at a University Specialty Pharmacy.

PubMed

Zaepfel, Michelle; Cristofaro, Lisa; Trawinski, Allison; McCarthy, Katharine; Rightmier, Elizabeth; Khadem, Tina

2017-04-01

The University of Rochester (UR) Specialty Pharmacy hepatitis C patient management program offers a unique advantage of being integrated within the same health system as the University of Rochester Medical Center (URMC) Gastroenterology and Hepatology division. The primary purpose of this study was to assess treatment success through the incidence of achieving a sustained virological response (SVR) in patients served by the UR Specialty Pharmacy versus other nonintegrated pharmacies. This was a single-center retrospective cohort study in adult patients of URMC Gastroenterology and Hepatology prescribed hepatitis C treatment between January 1, 2014, and July 15, 2015. The incidence of SVR, adherence, delay in therapy initiation, early treatment discontinuation, rate of attainment of viral load measurement post-therapy completion, and predictors associated with treatment outcome were assessed. A total of 414 patients were prescribed hepatitis C virus treatment during the study period; 137 did not initiate therapy. The rate of SVR was 93% among patients at the UR Specialty Pharmacy and 89% at nonintegrated pharmacies ( P = 0.357). Adherence to therapy was 100% and 97% at the UR Specialty Pharmacy and nonintegrated pharmacies, respectively ( P = 0.046). The UR Specialty Pharmacy was associated with a 93% SVR rate and significantly greater adherence compared with nonintegrated pharmacies. Larger studies are needed to determine if a significant difference in SVR exists between integrated and nonintegrated pharmacies. This study provides a framework for other institutions to justify developing integrated hepatitis C specialty pharmacy services and evaluate their success.

Utilization of Pharmacy Technicians to Increase the Accuracy of Patient Medication Histories Obtained in the Emergency Department

PubMed Central

Pisupati, Radhika; Nerenberg, Steven F.

2016-01-01

Purpose: The purpose of this study is to determine the accuracy of a pharmacy technician–collected medication history pilot program in the emergency department. This was completed by reviewing all elements of the technician activity by direct observation and by verifying the technician-collected medication list through a second phone call by a pharmacist to the outpatient pharmacy. Methods: This was a retrospective, single-center study conducted from March to April 2015. Four certified pharmacy technicians were trained by a postgraduate year 1 (PGY1) pharmacy practice resident on how to collect, verify, and accurately enter medication histories into the electronic medical record. Accuracy of pharmacy technician–collected medication histories was verified by a pharmacist through observation of their patient interviews, review of technician-completed medication history forms, and by contacting the patient's outpatient pharmacy. Results: The pharmacy technician–completed medication histories resulted in an absolute risk reduction of errors of 50% and a relative risk reduction of errors of 77% (p < .001) in comparison to medication histories collected by non-pharmacy personnel. Conclusion: With high accuracy rates, pharmacy technicians proved to be a valuable asset to the medication history process and can enhance patient safety during care transitions. The results of this study further support the Pharmacy Practice Model Initiative vision to advance the pharmacy technician role to improve the process of medication history taking and reconciliation within the health care system. PMID:27303094

Self-Reported Digital Literacy of the Pharmacy Workforce in North East Scotland

PubMed Central

MacLure, Katie; Stewart, Derek

2015-01-01

In their day-to-day practice, pharmacists, graduate (pre-registration) pharmacists, pharmacy technicians, dispensing assistants and medicines counter assistants use widely available office, retail and management information systems alongside dedicated pharmacy management and electronic health (ehealth) applications. The ability of pharmacy staff to use these applications at home and at work, also known as digital literacy or digital competence or e-skills, depends on personal experience and related education and training. The aim of this research was to gain insight into the self-reported digital literacy of the pharmacy workforce in the North East of Scotland. A purposive case sample survey was conducted across NHS Grampian in the NE of Scotland. Data collection was based on five items: sex, age band, role, pharmacy experience plus a final question about self-reported digital literacy. The study was conducted between August 2012 and March 2013 in 17 community and two hospital pharmacies. With few exceptions, pharmacy staff perceived their own digital literacy to be at a basic level. Secondary outcome measures of role, age, gender and work experience were not found to be clear determinants of digital literacy. Pharmacy staff need to be more digitally literate to harness technologies in pharmacy practice more effectively and efficiently. PMID:28975912

Are patient's simply unaware? A cross-sectional study of website promotion of community pharmacy adherence-related services in Tennessee.

PubMed

Hohmeier, Kenneth C; Borja-Hart, Nancy

Medication adherence rates can impact patient outcomes, quality of life, and health care costs. Community pharmacists who offer adherence-related services are well positioned to bolster medication adherence rates. One means for patients to learn more about these services is through the pharmacy's website. However, the prevalence of pharmacies' promotion of adherence services through the internet is unknown. The present study aimed to quantify the online promotion of pharmacies' adherence-related services. This was a cross-sectional, observational study of websites representing licensed community pharmacies. One-hundred and sixty-nine community pharmacy websites, representing 1161 of community pharmacies in Tennessee (U.S. State), were included in the observational analysis. The most commonly promoted adherence-related service was online refills (81.1%). Auto refill, medication synchronization, and packaging systems were promoted on <20% pharmacy websites. Types of promoted adherence services differed between chain and independent pharmacy websites. Despite 67% of pharmacies offering adherence-related services, only a fraction of them promote these services online. Patient awareness represents a hidden and often unaddressed variable in increasing adherence. Future studies should investigate whether increasing website promotion of these services would increase service use, and potentially improve adherence rates. Copyright © 2015 Elsevier Inc. All rights reserved.

Selecting a Clinical Intervention Documentation System for an Academic Setting

PubMed Central

Andrus, Miranda; Hester, E. Kelly; Byrd, Debbie C.

2011-01-01

Pharmacists' clinical interventions have been the subject of a substantial body of literature that focuses on the process and outcomes of establishing an intervention documentation program within the acute care setting. Few reports describe intervention documentation as a component of doctor of pharmacy (PharmD) programs; none describe the process of selecting an intervention documentation application to support the complete array of pharmacy practice and experiential sites. The process that a school of pharmacy followed to select and implement a school-wide intervention system to document the clinical and financial impact of an experiential program is described. Goals included finding a tool that allowed documentation from all experiential sites and the ability to assign dollar savings (hard and soft) to all documented interventions. The paper provides guidance for other colleges and schools of pharmacy in selecting a clinical intervention documentation system for program-wide use. PMID:21519426

Selecting a clinical intervention documentation system for an academic setting.

PubMed

Fox, Brent I; Andrus, Miranda; Hester, E Kelly; Byrd, Debbie C

2011-03-10

Pharmacists' clinical interventions have been the subject of a substantial body of literature that focuses on the process and outcomes of establishing an intervention documentation program within the acute care setting. Few reports describe intervention documentation as a component of doctor of pharmacy (PharmD) programs; none describe the process of selecting an intervention documentation application to support the complete array of pharmacy practice and experiential sites. The process that a school of pharmacy followed to select and implement a school-wide intervention system to document the clinical and financial impact of an experiential program is described. Goals included finding a tool that allowed documentation from all experiential sites and the ability to assign dollar savings (hard and soft) to all documented interventions. The paper provides guidance for other colleges and schools of pharmacy in selecting a clinical intervention documentation system for program-wide use.

Prototype of a Questionnaire and Quiz System for Supporting Increase of Health Awareness During Wait Time in Dispensing Pharmacy

NASA Astrophysics Data System (ADS)

Toda, Takeshi; Chen, Poa-Min; Ozaki, Shinya; Ideguchi, Naoko; Miyaki, Tomoko; Nanbu, Keiko; Ikeda, Keiko

For quit-smoking clinic and its campaign, there was a need for pharmacists to investigate pediatric patient's parent consciousness to tobacco harm utilizing wait time in a pediatric dispensing pharmacy. In this research, we developed the questionnaire and quiz total system using the tablet for user interface, in which people can easily answer the questionnaire/quiz and quickly see the total results on the spot in order to enhance their consciousness to the tobacco harm. The system also provides their tobacco dependence level based on the questionnaire results and some advice for their health and dietary habits due to the tobacco dependence level. From a field trial with one hundred four examinees in the pediatric dispensing pharmacy, the user interface was useful compared to conventional questionnaire form. The system could enhance their consciousness to tobacco harm and make their beneficial use of waiting time in dispensing pharmacy. Some interesting suggestions for improvement and new services were also obtained.

A collaborative approach to residency preparation programming for pharmacy students.

PubMed

Rider, Shyla K; Oeder, Jessica L; Nguyen, Trang T; Rodis, Jennifer L

2014-06-01

An innovative program to help pharmacy students navigate the residency application and interview process is described, including results of a survey evaluating the program's impact. The Ohio State University (OSU) chapter of the Student Society of Health-System Pharmacy (SSHP) collaborated with OSU College of Pharmacy faculty members, pharmacists from OSU Wexner Medical Center and surrounding areas, and current pharmacy residents to provide programming to equip pharmacy students with skills to succeed as residency candidates. The programming has four components: Curriculum Vitae (CV) Critique, Mock Residency Interviews, Residency 101, and Midyear to Match (M-M), a six-part series that provides guidance on the Residency Showcase at the American Society of Health-System Pharmacists (ASHP) Midyear Clinical Meeting, Match day (the annual matching process coordinated by ASHP), and the post-Match "scramble," in which unmatched applicants compete for unfilled residency slots. In an online survey conducted by the SSHP chapter after the 2012-13 residency year, 26 of 57 survey respondents indicated they had pursued a residency. Twenty respondents reported success in the Match (a rate 15% higher than the national average), with 9 reporting acceptance by their first-choice residency site. The mock interview program was rated as the most useful (a mean score of 4.8 on a 5-point scale), followed by the M-M series (mean score, 4.6). Collaborative programming coordinated by the OSU chapter of SSHP was offered to pharmacy students to improve preparation for the residency application and interview process. The program was well received by participants. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Challenges to counseling customers at the pharmacy counter--why do they exist?

PubMed

Kaae, Susanne; Traulsen, Janine Morgall; Nørgaard, Lotte Stig

2012-01-01

Challenges to engage pharmacy customers in medicine dialogues at the counter have been identified comprising a new and extended clinical role for pharmacists in the health care system. This article seeks to expand understanding of factors involved in successful interaction at the pharmacy counter between customers and pharmacy staff to develop their relationship further. Practical challenges to customer encounters experienced by community pharmacists are discussed using theory from the field of mainly inter-relational communication and particular studies on pharmacy communication. Preconceived expectation of customers, the type of question asked by pharmacy staff, and differences in perception of illness and medicines between staff and customers are discussed. Both staff and customer influence the outcome of attempts by pharmacy staff to engage customers in dialogue about their medicine use through a complex mechanism of interaction. It is recommended that practitioners and researchers begin to distinguish, both theoretically and practically, between the content of a conversation and the underlying relationship when exploring and further developing the therapeutic relationship between pharmacy personnel and customers. Copyright © 2012 Elsevier Inc. All rights reserved.

History of the pharmacies in the town of Aleşd, Bihor county

PubMed Central

PAŞCA, MANUELA BIANCA; GÎTEA, DANIELA; MOISA, CORINA

2013-01-01

In 1848 pharmacist Horváth Mihály established the first pharmacy in Aleşd, called Speranţa (Remény). Following the brief history of this pharmacy we will notice that in 1874 the pharmacy comes into the possession of Kocsiss József. In 1906 the personal rights of the pharmacy are transcribed to Kocsiss Béla, and since 1938 the his son, Kocsiss Dezső, pharmacist, became the new owner. In 1949 the pharmacy was nationalized and became the property of the Pharmaceutical Office Oradea, the pharmacy got the name Farmacia nr. 22 of Aleşd, and continued its activity throughout the whole communist period. Starting with the year 1991 it entered into private system as Angefarm, as the property of Mermeze Gheorghe, pharmacist, and from 2003 until now works under the name Vitalogy 3, as the property of Ghitea Sorin. A second pharmacy, Sfântul Anton was founded in 1937 by pharmacist Herceg Dobreanu Atena, which however had no continuity during the communist period. PMID:26527963

Consumer willingness to pay for pharmacy services: An updated review of the literature.

PubMed

Painter, Jacob T; Gressler, Laura; Kathe, Niranjan; Slabaugh, S Lane; Blumenschein, Karen

2018-02-02

Quantifying the value of pharmacy services is imperative for the profession as it works to establish an expanded role within evolving health care systems. The literature documents the work that many have contributed toward meeting this goal. To date, however, the preponderance of evidence evaluates the value of pharmacist services to third-party payers; few published studies address the value that consumers place on these services. In 1999, a review of studies that used the contingent valuation method to value pharmacy services was published. The objective of this manuscript is to provide an update of that review. Relevant studies published in the English language were identified searching MEDLINE, ECONLIT and International Pharmaceutical Abstracts databases from January 1999 to November 2017. Only studies that specifically elicited willingness to pay for a community pharmacist provided service from actual or potential consumers were included. Thirty-one studies using the contingent valuation method to value pharmacy services were identified using the search strategy outlined. These studies included surveys in different demographic and geographic populations and valuing various pharmacy services. Improving the quality of studies using contingent valuation to value pharmacy services will aid the profession in marketing pharmacy services to consumers, and may assist practitioners who wish to implement various pharmacy services in their practice settings. A limited number of studies have been conducted, but the quality of contingent valuation studies valuing pharmacist services is improving. Understanding the pharmacy services that consumers value, and understanding the level of their monetary willingness to pay for those services will be crucial as the profession continues to work toward establishing a sustainable and economically viable role within the evolving health care systems. Copyright © 2018. Published by Elsevier Inc.

Effect of Technological Changes in Information Transfer on the Delivery of Pharmacy Services.

ERIC Educational Resources Information Center

Barker, Kenneth N.; And Others

1989-01-01

Personal computer technology has arrived in health care. Specific technological advances are optical disc storage, smart cards, voice recognition, and robotics. This paper discusses computers in medicine, in nursing, in conglomerates, and with patients. Future health care will be delivered in primary care centers, medical supermarkets, specialized…

Assessment of Computer-Mediated Module Intervention in a Pharmacy Calculations Course

ERIC Educational Resources Information Center

Bell, Edward C.; Fike, David S.; Liang, Dong; Lockman, Paul R.; McCall, Kenneth L.

2017-01-01

Computer module intervention is the process of exposing students to a series of discrete exercises for the purpose of strengthening students' familiarity with conceptual material. The method has been suggested as a remedy to student under-preparedness. This study was conducted to determine the effectiveness of module intervention in improving and…

Computer-Based Exercises To Supplement the Teaching of Stereochemical Aspects of Drug Action.

ERIC Educational Resources Information Center

Harrold, Marc W.

1995-01-01

At the Duquesne University (PA) school of pharmacy, five self-paced computer exercises using a molecular modeling program have been implemented to teach stereochemical concepts. The approach, designed for small-group learning, has been well received and found effective in enhancing students' understanding of the concepts. (Author/MSE)

Evaluation of DILearn: An Interactive Computer-Assisted Learning Program for Drug Information.

ERIC Educational Resources Information Center

Tunget, Cynthia L.; And Others

1993-01-01

Use of an interactive computer-assisted learning program to teach basic skills in obtaining drug information was investigated with 26 doctoral pharmacy students and a control group of 25 students receiving lecture instruction. Findings indicated no significant differences in short-term retention of drug information between groups and that students…

Review of nuclear pharmacy practice in hospitals

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kawada, T.K.; Tubis, M.; Ebenkamp, T.

1982-02-01

An operational profile for nuclear pharmacy practice is presented, and the technical and professional role of nuclear pharmacists is reviewed. Key aspects of nuclear pharmacy practice in hospitals discussed are the basic facilities and equipment for the preparation, quality control, and distribution of radioactive drug products. Standards for receiving, storing, and processing radioactive material are described. The elements of a radiopharmaceutical quality assurance program, including the working procedures, documentation systems, data analysis, and specific control tests, are presented. Details of dose preparation and administration and systems of inventory control for radioactive products are outlined.

Strategic planning for clinical services: St. Joseph Hospital and Health Care Center.

PubMed

Linggi, A; Pelham, L D

1986-09-01

A pharmacy department at a 340-bed community hospital based its strategic plan for developing patient-oriented services on a sound drug distribution system, a credible work-measurement program, and fiscal responsibility. In 1982 the department of pharmacy and i.v. therapy implemented a strategic plan for improving pharmaceutical services. The plan involved developing goals and objectives for the department; marketing the department's services and fiscal management to hospital administrators, medical staff, and nursing staff; building teamwork among the pharmacy staff; and improving the drug distribution system before instituting clinical services. Hiring of additional pharmacy staff was justified on the basis of work-measurement data. By adjusting staffing levels every two weeks based on work-measurement data, the department increased the efficiency of drug distribution activities; the pharmacy also implemented cost-saving programs like selection of therapeutic alternates and formulary restrictions. The savings were then reinvested in labor-intensive patient-oriented pharmaceutical services. A staff development program using staff pharmacists as preceptors expanded the breadth and depth of pharmacists' clinical skills. The planning efforts were successful because the needs of hospital administrators, the pharmacy department, and staff members were addressed.

Lessons learned from a pharmacy practice model change at an academic medical center.

PubMed

Knoer, Scott J; Pastor, John D; Phelps, Pamela K

2010-11-01

The development and implementation of a new pharmacy practice model at an academic medical center are described. Before the model change, decentralized pharmacists responsible for order entry and verification and clinical specialists were both present on the care units. Staff pharmacists were responsible for medication distribution and sterile product preparation. The decentralized pharmacists handling orders were not able to use their clinical training, the practice model was inefficient, and few clinical services were available during evenings and weekends. A task force representing all pharmacy department roles developed a process and guiding principles for the model change, collected data, and decided on a model. Teams consisting of decentralized pharmacists, decentralized pharmacy technicians, and team leaders now work together to meet patients' pharmacy needs and further departmental safety, quality, and cost-saving goals. Decentralized service hours have been expanded through operational efficiencies, including use of automation (e.g., computerized provider order entry, wireless computers on wheels used during rounds with physician teams). Nine clinical specialist positions were replaced by five team leader positions and four pharmacists functioning in decentralized roles. Additional staff pharmacist positions were shifted into decentralized roles, and the hospital was divided into areas served by teams including five to eight pharmacists. Technicians are directly responsible for medication distribution. No individual's job was eliminated. The new practice model allowed better alignment of staff with departmental goals, expanded pharmacy hours and services, more efficient medication distribution, improved employee engagement, and a staff succession plan.

An assessment of pharmacists’ readiness for paperless labeling: a national survey

PubMed Central

Ho, Yun-Xian; Chen, Qingxia; Nian, Hui; Johnson, Kevin B

2014-01-01

Objective To assess the state of readiness for the adoption of paperless labeling among a nationally representative sample of pharmacies, including chain pharmacies, independent retail pharmacies, hospitals, and other rural or urban dispensing sites. Methods Both quantitative and qualitative analyses were used to analyze responses to a cross-sectional survey disseminated to American Pharmacists Association pharmacists nationwide. The survey assessed factors related to pharmacists’ attitudinal readiness (ie, perceptions of impact) and pharmacies’ structural readiness (eg, availability of electronic resources, internet access) for the paperless labeling initiative. Results We received a total of 436 survey responses (6% response rate) from pharmacists representing 44 US states and territories. Across the spectrum of settings we studied, pharmacists had work access to computers, printers, fax machines and access to the internet or intranet. Approximately 79% of respondents believed that the initiative would improve the adequacy of drug information available in their work site and 95% believed it would either not change (33%) or would improve (62%) communication to patients. Overall, respondents’ comments supported advancing the initiative; however, some comments revealed reservations regarding corporate or pharmacy buy-in, success of implementation, and ease of adoption. Conclusions This is the first nationwide study to report about pharmacists’ perspectives on paperless labeling. In general, pharmacists believe they are ready and that their pharmacies are well equipped for the transition to paperless labeling. Further exploration of perspectives from product label manufacturers and corporate pharmacy offices is needed to understand fully what will be necessary to complete this transition. PMID:23523874

Pharmacy Customers’ Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland

PubMed Central

Timonen, Johanna; Ahonen, Riitta

2018-01-01

Background One of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers. Objective The aim of this study was to investigate Finnish pharmacy customers’ (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions. Methods Questionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community pharmacies across Finland in autumn 2015. Customers’ experiences were explored with 10 structured questions. The data were stored in SPSS for Windows and subjected to descriptive analysis, chi-square, Fisher exact, Kolmogorov-Smirnov, the Mann-Whitney U, and Kruskal-Wallis tests. Results Completed questionnaires were returned by 1288 customers, a response rate of 44.19% (1288/2913). The majority of the respondents did not encounter any problems during pharmacy visits (1161/1278, 90.85%) and were informed about the current status of their ePrescriptions after their medication was dispensed (1013/1276, 79.44%). Over half of the respondents had usually received a patient instruction sheet from their physician (752/1255, 59.92%), and nearly all of them regarded its content as clear (711/724, 98.2%). Half of the respondents had renewed their ePrescriptions through the pharmacy (645/1281, 50.35%), and one-third of them had acted on behalf of someone else with ePrescriptions (432/1280, 33.75%). Problems were rarely encountered in the renewal process (49/628, 7.8%) or when acting on behalf of another person (25/418, 6.0%) at the pharmacy. The most common way of keeping up to date with ePrescriptions was to ask at the pharmacy (631/1278, 49.37%). The vast majority of the respondents were satisfied with ePrescriptions as a whole (1221/1274, 95.84%). Conclusions Finnish pharmacy customers are satisfied with the recently implemented nationwide ePrescription system. They seldom have any difficulties purchasing medicines, renewing their ePrescriptions, or acting on behalf of someone else at the pharmacy. Customers usually keep up to date with their ePrescriptions by asking at the pharmacy. However, some customers are unaware of the practices or have difficulty keeping up to date with the status of their ePrescriptions. The provision of relevant information and assistance by health care professionals is therefore required to promote customers’ adoption of the ePrescription system. PMID:29475826

Pharmacy Customers' Experiences With Electronic Prescriptions: Cross-Sectional Survey on Nationwide Implementation in Finland.

PubMed

Lämsä, Elina; Timonen, Johanna; Ahonen, Riitta

2018-02-23

One of the forerunners in electronic health, Finland has introduced electronic prescriptions (ePrescriptions) nationwide by law. This has led to significant changes for pharmacy customers. Despite the worldwide ambition to develop ePrescription services, there are few reports of nationally adopted systems and particularly on the experiences of pharmacy customers. The aim of this study was to investigate Finnish pharmacy customers' (1) experiences with purchasing medicines with ePrescriptions; (2) experiences with renewing ePrescriptions and acting on behalf of someone else at the pharmacy; (3) ways in which customers keep up to date with their ePrescriptions; and (4) overall satisfaction with ePrescriptions. Questionnaires were distributed to 2913 pharmacy customers aged ≥18 years purchasing prescription medicines for themselves with an ePrescription in 18 community pharmacies across Finland in autumn 2015. Customers' experiences were explored with 10 structured questions. The data were stored in SPSS for Windows and subjected to descriptive analysis, chi-square, Fisher exact, Kolmogorov-Smirnov, the Mann-Whitney U, and Kruskal-Wallis tests. Completed questionnaires were returned by 1288 customers, a response rate of 44.19% (1288/2913). The majority of the respondents did not encounter any problems during pharmacy visits (1161/1278, 90.85%) and were informed about the current status of their ePrescriptions after their medication was dispensed (1013/1276, 79.44%). Over half of the respondents had usually received a patient instruction sheet from their physician (752/1255, 59.92%), and nearly all of them regarded its content as clear (711/724, 98.2%). Half of the respondents had renewed their ePrescriptions through the pharmacy (645/1281, 50.35%), and one-third of them had acted on behalf of someone else with ePrescriptions (432/1280, 33.75%). Problems were rarely encountered in the renewal process (49/628, 7.8%) or when acting on behalf of another person (25/418, 6.0%) at the pharmacy. The most common way of keeping up to date with ePrescriptions was to ask at the pharmacy (631/1278, 49.37%). The vast majority of the respondents were satisfied with ePrescriptions as a whole (1221/1274, 95.84%). Finnish pharmacy customers are satisfied with the recently implemented nationwide ePrescription system. They seldom have any difficulties purchasing medicines, renewing their ePrescriptions, or acting on behalf of someone else at the pharmacy. Customers usually keep up to date with their ePrescriptions by asking at the pharmacy. However, some customers are unaware of the practices or have difficulty keeping up to date with the status of their ePrescriptions. The provision of relevant information and assistance by health care professionals is therefore required to promote customers' adoption of the ePrescription system. ©Elina Lämsä, Johanna Timonen, Riitta Ahonen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 23.02.2018.

Hospital survival strategies for the 1980s.

PubMed

Bonney, R S

1983-09-01

Survival strategies for hospitals and hospital pharmacy departments are presented, and one hospital's development into a health-services system is described. Financial and competitive pressures are forcing institutions to develop new strategies for survival. The primary institutional strategy is diversification--both horizontal and vertical. Diversification can assist in the hospital's growth, increase its asset and revenue bases, and lead to the development of a health-care delivery system. Marketing to physicians and developing information systems are also critical strategies under a prospective payment system. Institutions will need to know the cost of providing care for specific diagnosis-related groups. Strategies must be employed to develop incentives to reduce inpatient acute-care services and to increase productivity. Physicians should be involved in all of the institutional strategies. Strategies for the pharmacy department are basically the same. Pharmacy departments should develop programs to reduce drug use (especially antibiotic use) and information systems that show the actual cost of providing services by diagnosis. The major corporate restructuring and diversification efforts of one hospital are described. The future of hospitals and pharmacy departments will depend on the successful application of the strategies discussed.

BC Medication Management Project

PubMed Central

Henrich, Natalie; Tsao, Nicole; Gastonguay, Louise; Lynd, Larry

2015-01-01

Background: The BC Medication Management Project (BCMMP) was developed by the BC Ministry of Health and the BC Pharmacy Association. This pilot project ran from September 2010 to January 2012. Pharmacists reviewed patients’ medication histories, discussed best use of medications, provided education and monitored for adverse effects, developed a plan to deal with medication issues and created a best possible medication history. Methods: To evaluate the experience of participating in the BCMMP, challenges and strengths of the project and the alignment of these experiences with the overarching goals, focus groups and interviews were conducted with 6 stakeholder groups. Themes were compared within and across stakeholder type and descriptively analyzed. Results: A total of 88 people participated in the focus groups/interviews. Pharmacists stated that providing BCMMP services was professionally satisfying and concurred with patients that the service did benefit them. However, participating in the BCMMP was not seen as financially sustainable by pharmacy owners, and there were concerns about patient selection. Physicians expressed concerns about increased workload associated with the BCMMP, for which they were not compensated. The computer system and burden of documentation were identified as the greatest problems. Conclusions: The BCMMP pilot project was enthusiastically received by pharmacists and patients who felt that it benefited patients and moved the pharmacy profession in a positive direction. It was widely felt that the BCMMP could be successful and sustainable if the identified challenges are addressed. PMID:25983759

Development of a pharmacy resident rotation to expand decentralized clinical pharmacy services.

PubMed

Hill, John D; Williams, Jonathan P; Barnes, Julie F; Greenlee, Katie M; Cardiology, Bcps-Aq; Leonard, Mandy C

2017-07-15

The development of a pharmacy resident rotation to expand decentralized clinical pharmacy services is described. In an effort to align with the initiatives proposed within the ASHP Practice Advancement Initiative, the department of pharmacy at Cleveland Clinic, a 1,400-bed academic, tertiary acute care medical center in Cleveland, Ohio, established a goal to provide decentralized clinical pharmacy services for 100% of patient care units within the hospital. Patient care units that previously had no decentralized pharmacy services were evaluated to identify opportunities for expansion. Metrics analyzed included number of medication orders verified per hour, number of pharmacy dosing consultations, and number of patient discharge counseling sessions. A pilot study was conducted to assess the feasibility of this service and potential resident learning opportunities. A learning experience description was drafted, and feedback was solicited regarding the development of educational components utilized throughout the rotation. Pharmacists who were providing services to similar patient populations were identified to serve as preceptors. Staff pharmacists were deployed to previously uncovered patient care units, with pharmacy residents providing decentralized services on previously covered areas. A rotating preceptor schedule was developed based on geographic proximity and clinical expertise. An initial postimplementation assessment of this resident-driven service revealed that pharmacy residents provided a comparable level of pharmacy services to that of staff pharmacists. Feedback collected from nurses, physicians, and pharmacy staff also supported residents' ability to operate sufficiently in this role to optimize patient care. A learning experience developed for pharmacy residents in a large medical center enabled the expansion of decentralized clinical services without requiring additional pharmacist full-time equivalents. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Forging a novel provider and payer partnership in Wisconsin to compensate pharmacists for quality-driven pharmacy and medication therapy management services.

PubMed

Trapskin, Kari; Johnson, Curtis; Cory, Patrick; Sorum, Sarah; Decker, Chris

2009-01-01

To describe the Wisconsin Pharmacy Quality Collaborative (WPQC), a quality-based network of pharmacies and payers with the common goals of improving medication use and safety, reducing health care costs for payers and patients, and increasing professional recognition and compensation for pharmacist-provided services. Wisconsin between 2006 and 2009. Community (independent, chain, and health-system) pharmacies and private and public health care payers/purchasers with support from the McKesson Corporation. This initiative aligns incentives for pharmacies and payers through implementation of 12 quality-based pharmacy requirements as conditions of pharmacy participation in a practice-advancement pilot. Payers compensate network pharmacies that meet the quality-based requirements for two levels of pharmacy professional services (level 1, intervention-based services; level 2, comprehensive medication review and assessment services). The pilot project is designed to measure the following outcomes: medication-use quality improvements, frequency and types of services provided, drug therapy problems, patient safety, cost savings, identification of factors that facilitate pharmacist participation, and patient satisfaction. The Pharmacy Society of Wisconsin created the WPQC network, which consists of 53 pharmacies, 106 trained pharmacists, 45 student pharmacists, 6 pharmacy technicians, and 2 initial payers. A quality assurance process is followed approximately quarterly to audit the 12 network quality requirements. An evaluation of this collaboration is being conducted. This program demonstrates that collaboration among payers and pharmacists is possible and can result in the development of an incentive-aligned program that stresses quality patient care, standardized services, and professional service compensation for pharmacists. This combination of a quality-based credentialing process with a professional services reimbursement schedule is unique and has the promise to enhance the ambulatory pharmacy practice model.

The impact of medication synchronization on quality care criteria in an independent community pharmacy.

PubMed

Hinson, Jessica L; Garofoli, Gretchen K; Elswick, Betsy M

To determine the impact of a comprehensive medication synchronization program in an independent community pharmacy by (1) evaluating changes in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and (2) examining the change in monthly prescription volume. Independent community pharmacy in Morgantown, WV. Waterfront Family Pharmacy is a single-location independent community pharmacy located in Morgantown, WV. The pharmacy consists of four full-time pharmacists and is the primary practice site for one community pharmacy PGY-1 resident. The pharmacy provides a variety of clinical services, including vaccine administration, medication therapy management, and diabetes education services. In September 2014, Waterfront Family Pharmacy started a comprehensive medication synchronization program. Change in Electronic Quality Improvement Platform for Plans and Pharmacies (EQuIPP) scores and change in monthly prescription volume. At the end of 6 months there was improvement in all targeted EQuIPP scores. There was a 7% improvement in proportion of days covered (PDC) for cholesterol-reducing agents, a 9.5% improvement in PDC for oral glycemic agents, a 1.2% improvement in PDC for renin-angiotensin system antagonists, and a 1.8% reduction in the use of high-risk medications in the elderly. There was also an average increase in monthly prescription volume of 4.8% over the first 6 months after the implementation of the comprehensive medication synchronization program. The implementation of a comprehensive medication synchronization program in an independent community pharmacy may result in benefits including improved EQuIPP scores and increased prescription volume. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

E-prescribing errors in community pharmacies: exploring consequences and contributing factors.

PubMed

Odukoya, Olufunmilola K; Stone, Jamie A; Chui, Michelle A

2014-06-01

To explore types of e-prescribing errors in community pharmacies and their potential consequences, as well as the factors that contribute to e-prescribing errors. Data collection involved performing 45 total hours of direct observations in five pharmacies. Follow-up interviews were conducted with 20 study participants. Transcripts from observations and interviews were subjected to content analysis using NVivo 10. Pharmacy staff detected 75 e-prescription errors during the 45 h observation in pharmacies. The most common e-prescribing errors were wrong drug quantity, wrong dosing directions, wrong duration of therapy, and wrong dosage formulation. Participants estimated that 5 in 100 e-prescriptions have errors. Drug classes that were implicated in e-prescribing errors were antiinfectives, inhalers, ophthalmic, and topical agents. The potential consequences of e-prescribing errors included increased likelihood of the patient receiving incorrect drug therapy, poor disease management for patients, additional work for pharmacy personnel, increased cost for pharmacies and patients, and frustrations for patients and pharmacy staff. Factors that contribute to errors included: technology incompatibility between pharmacy and clinic systems, technology design issues such as use of auto-populate features and dropdown menus, and inadvertently entering incorrect information. Study findings suggest that a wide range of e-prescribing errors is encountered in community pharmacies. Pharmacists and technicians perceive that causes of e-prescribing errors are multidisciplinary and multifactorial, that is to say e-prescribing errors can originate from technology used in prescriber offices and pharmacies. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

E-Prescribing Errors in Community Pharmacies: Exploring Consequences and Contributing Factors

PubMed Central

Stone, Jamie A.; Chui, Michelle A.

2014-01-01

Objective To explore types of e-prescribing errors in community pharmacies and their potential consequences, as well as the factors that contribute to e-prescribing errors. Methods Data collection involved performing 45 total hours of direct observations in five pharmacies. Follow-up interviews were conducted with 20 study participants. Transcripts from observations and interviews were subjected to content analysis using NVivo 10. Results Pharmacy staff detected 75 e-prescription errors during the 45 hour observation in pharmacies. The most common e-prescribing errors were wrong drug quantity, wrong dosing directions, wrong duration of therapy, and wrong dosage formulation. Participants estimated that 5 in 100 e-prescriptions have errors. Drug classes that were implicated in e-prescribing errors were antiinfectives, inhalers, ophthalmic, and topical agents. The potential consequences of e-prescribing errors included increased likelihood of the patient receiving incorrect drug therapy, poor disease management for patients, additional work for pharmacy personnel, increased cost for pharmacies and patients, and frustrations for patients and pharmacy staff. Factors that contribute to errors included: technology incompatibility between pharmacy and clinic systems, technology design issues such as use of auto-populate features and dropdown menus, and inadvertently entering incorrect information. Conclusion Study findings suggest that a wide range of e-prescribing errors are encountered in community pharmacies. Pharmacists and technicians perceive that causes of e-prescribing errors are multidisciplinary and multifactorial, that is to say e-prescribing errors can originate from technology used in prescriber offices and pharmacies. PMID:24657055

Comparison of indexing times among articles from medical, nursing, and pharmacy journals.

PubMed

Rodriguez, Ryan W

2016-04-15

Results of an analysis of the times to indexing of articles published in medical, nursing, and pharmacy journals are reported. MEDLINE data were retrieved for articles published in selected general practice medical, nursing, and pharmacy journals and entered into the PubMed system in 2012 and 2013. Collected data included PubMed entry date, date of indexing with Medical Subject Headings (MeSH) terms, and publication characteristics. Survival analysis was performed to assess the primary outcome of time to indexing. Cox proportional hazards models were developed to assess the effect of healthcare discipline and source journal on the primary outcome. Data were collected for 19,259 articles, of which 78.7%, 12.6%, and 8.7% originated from medical, nursing, and pharmacy journals, respectively. For medical, pharmacy, and nursing journals, 97.8%, 90.8%, and 50.1% of articles, respectively, were indexed within one year of PubMed entry; the corresponding median (interquartile range) times to indexing were 52 (20-68), 186 (150-246), and 252 (168-301) days. Unadjusted hazard ratios derived from Cox models indicated that indexing within one year was significantly less likely for articles published in pharmacy or nursing journals versus medical journals and for articles from all evaluated journals versus a designated reference publication (New England Journal of Medicine). Analysis of major medical, nursing, and pharmacy journals found that articles from nursing and pharmacy journals were indexed with MeSH terms more slowly than articles from medical journals. Journal identity was significantly associated with time to indexing. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The need for PGY2-trained clinical pharmacy specialists.

PubMed

Ragucci, Kelly R; O'Bryant, Cindy L; Campbell, Kristin Bova; Buck, Marcia L; Dager, William E; Donovan, Jennifer L; Emerson, Kayleigh; Gubbins, Paul O; Haight, Robert J; Jackevicius, Cynthia; Murphy, John E; Prohaska, Emily

2014-06-01

The American College of Clinical Pharmacy and other stakeholder organizations seek to advance clinical pharmacist practitioners, educators, and researchers. Unfortunately, there remains an inadequate supply of residency-trained clinical specialists to meet the needs of our health care system, and nonspecialists often are called on to fill open specialist positions. The impact of clinical pharmacy specialists on pharmacotherapy outcomes in both acute care and primary care settings demonstrates the value of these specialists. This commentary articulates the need for postgraduate year two (PGY2)-trained clinical specialists within the health care system by discussing various clinical and policy rationales, interprofessional support, economic justifications, and their impact on quality of care and drug safety. The integrated practice model that has grown out of the American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) could threaten the growth and development of future clinical specialists. Therefore, the ways in which PGY2-trained clinical pharmacist specialists are deployed in the PPMI require further consideration. PGY2 residencies provide education and training opportunities that cannot be achieved in traditional professional degree programs or postgraduate year one residencies. These specialists are needed to provide direct patient care to complex patient populations and to educate and train pharmacy students and postgraduate residents. Limitations to training and hiring PGY2-trained clinical pharmacy specialists include site capacity limitations and lack of funding. A gap analysis is needed to define the extent of the mismatch between the demand for specialists by health care systems and educational institutions versus the capacity to train clinical pharmacists at the specialty level. © 2014 Pharmacotherapy Publications, Inc.

Implementation of an i.v.-compounding robot in a hospital-based cancer center pharmacy.

PubMed

Yaniv, Angela W; Knoer, Scott J

2013-11-15

The implementation of a robotic device for compounding patient-specific chemotherapy doses is described, including a review of data on the robot's performance over a 13-month period. The automated system prepares individualized i.v. chemotherapy doses in a variety of infusion bags and syringes; more than 50 drugs are validated for use in the machine. The robot is programmed to recognize the physical parameters of syringes and vials and uses photographic identification, barcode identification, and gravimetric measurements to ensure that the correct ingredients are compounded and the final dose is accurate. The implementation timeline, including site preparation, logistics planning, installation, calibration, staff training, development of a pharmacy information system (PIS) interface, and validation by the state board of pharmacy, was about 10 months. In its first 13 months of operation, the robot was used to prepare 7384 medication doses; 85 doses (1.2%) found to be outside the desired accuracy range (±4%) were manually modified by pharmacy staff. Ongoing system monitoring has identified mechanical and materials-related problems including vial-recognition failures (in many instances, these issues were resolved by the system operator and robotic compounding proceeded successfully), interface issues affecting robot-PIS communication, and human errors such as the loading of an incorrect vial or bag into the machine. Through staff training, information technology improvements, and workflow adjustments, the robot's throughput has been steadily improved. An i.v.-compounding robot was successfully implemented in a cancer center pharmacy. The robot performs compounding tasks safely and accurately and has been integrated into the pharmacy's workflow.

The future of health-system pharmacy: opportunities and challenges in practice model change.

PubMed

Zellmer, William A

2012-04-01

Key factors outside of health-system pharmacy that will shape this sector of the profession in the coming years are (1) the national economy, (2) national politics, (3) the debt of the federal government, (4) global megatrends (including terrorism and economic globalization), (5) health care reform, and (6) trends in the development and use of medicines. These factors will translate into payment cutbacks to hospitals, expanded mandates to improve the quality of health care, increased focus on patient-centered care, more team-based care, and a higher degree of integration across the range of health care settings and providers. In this environment, pharmacists in hospitals and other health systems will have rich opportunities to help improve patient care and institutional sustainability by continuing to move from order-fulfillment and product-preparation functions toward team leadership of drug therapy management. The American Society of Health-System Pharmacists Pharmacy Practice Model Initiative (PPMI) was created to encourage hospital and health-system practice leaders to examine how they deploy their resources (ie, pharmacist time, technician time, and technology) to ensure that the efforts of the pharmacy department are aligned with the most urgent needs of patients and institutions. Key recommendations of the PPMI and evidence about gaps in the provision of drug therapy management services are presented. It is important for every pharmacist and pharmacy technician in health-system practice to understand the imperatives for changing the profession's practice model and to actively pursue appropriate changes in that model.

Hazardous Materials Pharmacies - A Vital Component of a Robust P2 Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

McCarter, S.

2006-07-01

Integrating pollution prevention (P2) into the Department of Energy Integrated Safety Management (ISM) - Environmental Management System (EMS) approach, required by DOE Order 450.1, leads to an enhanced ISM program at large and complex installations and facilities. One of the building blocks to integrating P2 into a comprehensive environmental and safety program is the control and tracking of the amounts, types, and flow of hazardous materials used on a facility. Hazardous materials pharmacies (typically called HazMarts) provide a solid approach to resolving this issue through business practice changes that reduce use, avoid excess, and redistribute surplus. If understood from conceptmore » to implementation, the HazMart is a powerful tool for reducing pollution at the source, tracking inventory storage, controlling usage and flow, and summarizing data for reporting requirements. Pharmacy options can range from a strict, single control point for all hazardous materials to a virtual system, where the inventory is user controlled and reported over a common system. Designing and implementing HazMarts on large, diverse installations or facilities present a unique set of issues. This is especially true of research and development (R and D) facilities where the chemical use requirements are extensive and often classified. There are often multiple sources of supply; a wide variety of chemical requirements; a mix of containers ranging from small ampoules to large bulk storage tanks; and a wide range of tools used to track hazardous materials, ranging from simple purchase inventories to sophisticated tracking software. Computer systems are often not uniform in capacity, capability, or operating systems, making it difficult to use a server-based unified tracking system software. Each of these issues has a solution or set of solutions tied to fundamental business practices. Each requires an understanding of the problem at hand, which, in turn, requires good communication among all potential users. A key attribute to a successful HazMart is that everybody must use the same program. That requirement often runs directly into the biggest issue of all... institutional resistance to change. To be successful, the program has to be both a top-down and bottom-up driven process. The installation or facility must set the policy and the requirement, but all of the players have to buy in and participate in building and implementing the program. Dynamac's years of experience assessing hazardous materials programs, providing business case analyses, and recommending and implementing pharmacy approaches for federal agencies has provided us with key insights into the issues, problems, and the array of solutions available. This paper presents the key steps required to implement a HazMart, explores the advantages and pitfalls associated with a HazMart, and presents some options for implementing a pharmacy or HazMart on complex installations and R and D facilities. (authors)« less

Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia.

PubMed

Ali Jadoo, Saad Ahmed; Aljunid, Syed Mohamed; Nur, Amrizal Muhammad; Ahmed, Zafar; Van Dort, Dexter

2015-02-10

The service weight is among several issues and challenges in the implementation of case-mix in developing countries, including Malaysia. The aim of this study is to develop the Malaysian Diagnosis Related Group (MY-DRG) case-mix pharmacy service weight in University Kebangsaan Malaysia-Medical Center (UKMMC) by identifying the actual cost of pharmacy services by MY-DRG groups in the hospital. All patients admitted to UKMMC in 2011 were recruited in this study. Combination of Step-down and Bottom-up costing methodology has been used in this study. The drug and supplies cost; the cost of staff; the overhead cost; and the equipment cost make up the four components of pharmacy. Direct costing approach has been employed to calculate Drugs and supplies cost from electronic-prescription system; and the inpatient pharmacy staff cost, while the overhead cost and the pharmacy equipments cost have been calculated indirectly from MY-DRG data base. The total pharmacy cost was obtained by summing the four pharmacy components' cost per each MY-DRG. The Pharmacy service weight of a MY-DRG was estimated by dividing the average pharmacy cost of the investigated MY-DRG on the average of a specified MY-DRG (which usually the average pharmacy cost of all MY-DRGs). Drugs and supplies were the main component (86.0%) of pharmacy cost compared o overhead cost centers (7.3%), staff cost (6.5%) and pharmacy equipments (0.2%) respectively. Out of 789 inpatient MY-DRGs case-mix groups, 450 (57.0%) groups were utilized by the UKMMC. Pharmacy service weight has been calculated for each of these 450 MY-DRGs groups. MY-DRG case-mix group of Lymphoma & Chronic Leukemia group with severity level three (C-4-11-III) has the highest pharmacy service weight of 11.8 equivalents to average pharmacy cost of RM 5383.90. While the MY-DRG case-mix group for Circumcision with severity level one (V-1-15-I) has the lowest pharmacy service weight of 0.04 equivalents to average pharmacy cost of RM 17.83. A mixed approach which is based partly on top-down and partly on bottom up costing methodology has been recruited to develop MY-DRG case-mix pharmacy service weight for 450 groups utilized by the UKMMC in 2011.

Safety culture in a pharmacy setting using a pharmacy survey on patient safety culture: a cross-sectional study in China.

PubMed

Jia, P L; Zhang, L H; Zhang, M M; Zhang, L L; Zhang, C; Qin, S F; Li, X L; Liu, K X

2014-06-30

To explore the attitudes and perceptions of patient safety culture for pharmacy workers in China by using a Pharmacy Survey on Patient Safety Culture (PSOPSC), and to assess the psychometric properties of the translated Chinese language version of the PSOPSC. Cross-sectional study. Data were obtained from 20 hospital pharmacies in the southwest part of China. We performed χ(2) test to explore the differences on pharmacy staff in different hospital and qualification levels and countries towards patient safety culture. We also computed descriptive statistics, internal consistency coefficients and intersubscale correlation analysis, and then conducted an exploratory factor analysis. A test-retest was performed to assess reproducibility of the items. A total of 630 questionnaires were distributed of which 527 were responded to validly (response rate 84%). The positive response rate for each item ranged from 37% to 90%. The positive response rate on three dimensions ('Teamwork', 'Staff Training and Skills' and 'Staffing, Work Pressure and Pace') was higher than that of Agency for Healthcare Research and Quality (AHRQ) data (p<0.05). There was a statistical difference in the perception of patient safety culture at different hospital and qualification levels. The internal consistency of the total survey was comparatively satisfied (Cronbach's α=0.89). The results demonstrated that among the pharmacy staffs surveyed in China, there was a positive attitude towards patient safety culture in their organisations. Identifying perspectives of patient safety culture from pharmacists in different hospital and qualification levels are important, since this can help support decisions about action to improve safety culture in pharmacy settings. The Chinese translation of the PSOPSC questionnaire (V.2012) applied in our study is acceptable. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Does deregulation in community pharmacy impact accessibility of medicines, quality of pharmacy services and costs? Evidence from nine European countries.

PubMed

Vogler, Sabine; Habimana, Katharina; Arts, Danielle

2014-09-01

To analyse the impact of deregulation in community pharmacy on accessibility of medicines, quality of pharmacy services and costs. We analysed and compared community pharmacy systems in five rather deregulated countries (England, Ireland, the Netherlands, Norway, Sweden) and four rather regulated countries (Austria, Denmark, Finland, Spain). Data were collected by literature review, a questionnaire survey and interviews. Following a deregulation, several new pharmacies and dispensaries of Over-the-Counter (OTC) medicines tended to be established, predominantly in urban areas. Unless prevented by regulation, specific stakeholders, e.g. wholesalers, were seen to gain market dominance which limited envisaged competition. There were indications for an increased workload for pharmacists in some deregulated countries. Economic pressure to increase the pharmacy turnover through the sale of OTC medicines and non-pharmaceuticals was observed in deregulated and regulated countries. Prices of OTC medicines were not found to decrease after a deregulation in pharmacy. Access to pharmacies usually increases after a deregulation but this is likely to favour urban populations with already good accessibility. Policy-makers are recommended to take action to ensure equitable accessibility and sustainable competition in a more deregulated environment. No association between pharmaceutical expenditure and the extent of regulation/deregulation appears to exist. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Life in a Fishbowl: Accountability and Integrity in Pharmacy Leadership

PubMed Central

Haumschild, Ryan J.; Weber, Robert J.

2014-01-01

The Director’s Forum is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems by providing practical information on various leadership topics. Pharmacists are bound to practice in the best interest of the patient and are obligated to act with integrity and in an ethical manner. Pharmacy directors and their leadership staff are additionally bound to manage their department with integrity. Staff often scrutinize the pharmacy director’s actions, giving the director a feeling of “life in a fishbowl.” Every action of the leader is judged in the context of personal integrity or their individual commitment to moral, spiritual, and ethical values. The objective of this article is to describe how a pharmacy leader manages this responsibility. This article addresses the pharmacy leader’s obligations to act with integrity, reviews key integrity concerns in pharmacy leadership, and provides guidance for leading and managing in the context of ethics and integrity. Pharmacy directors must always be aware that they are open to both department and public scrutiny if they do not conduct themselves in a professional manner. Being accountable for their actions and maintaining a high standard of integrity, leaders can keep the focus of their departments on the goal of patient-centered pharmacy services. PMID:25477587

A national survey of clinical pharmacy services in county hospitals in China.

PubMed

Yao, Dongning; Xi, Xiaoyu; Huang, Yuankai; Hu, Hao; Hu, Yuanjia; Wang, Yitao; Yao, Wenbing

2017-01-01

Clinical pharmacy is not only a medical science but also an elaborate public health care system firmly related to its subsystems of education, training, qualification authentication, scientific research, management, and human resources. China is a developing country with a tremendous need for improvements in the public health system, including the clinical pharmacy service system. The aim of this research was to evaluate the infrastructure and personnel qualities of clinical pharmacy services in China. Public county hospitals in China. A national survey of clinical pharmacists in county hospitals was conducted. It was sampled through a stratified sampling strategy. Responses were analyzed using descriptive and inferential statistics. The main outcome measures include the coverage of clinical pharmacy services, the overall staffing of clinical pharmacists, the software and hardware of clinical pharmacy services, the charge mode of clinical pharmacy services, and the educational background, professional training acquisition, practical experience, and entry path of clinical pharmacists. The overall coverage of clinical pharmacy services on both the department scale (median = 18.25%) and the patient scale (median = 15.38%) does not meet the 100% coverage that is required by the government. In 57.73% of the sample hospitals, the staffing does not meet the requirement, and the size of the clinical pharmacist group is smaller in larger hospitals. In addition, 23.4% of the sample hospitals do not have management rules for the clinical pharmacists, and 43.1% do not have rational drug use software, both of which are required by the government. In terms of fees, 89.9% of the sample hospitals do not charge for the services. With regard to education, 8.5% of respondents are with unqualified degree, and among respondents with qualified degree, 37.31% are unqualified in the major; 43% of respondents lack the clinical pharmacist training required by the government. Most respondents (93.5%) have a primary or medium professional title. The median age and work seniority of respondents are 31 and four years, respectively. Only 18.5% of respondents chose this occupation by personal consideration or willingness. The main findings in this research include the overall low coverage of clinical pharmacy services, the low rate of clinical pharmacy service software, hardware, and personnel as well as a wide variance in educational training of pharmacists at county hospitals.

Inclusion of oral-systemic health in predoctoral/undergraduate curricula of pharmacy, nursing, and medical schools around the world: a preliminary study.

PubMed

Hein, Casey; Schönwetter, Dieter J; Iacopino, Anthony M

2011-09-01

There is increasing evidence that oral health is a critical component of overall health and that poor oral health may lead to initiation or exacerbation of chronic inflammatory diseases/conditions and adverse pregnancy outcomes. Added to this is an increasing awareness that among non-dental health care professions curricula (e.g., medicine, nursing, pharmacy, and allied health) there is an apparent lack of information regarding the interrelationships between oral health and overall health or recognition of the significance of oral health in achieving and sustaining general health outcomes. This study explored the amount of information related to oral-systemic science currently being taught in the predoctoral/undergraduate professional curricula of pharmacy, nursing, and medical schools in English-speaking universities around the world. The Oral-Systemic Health Educational Curriculum Survey was circulated online to associate or academic deans at medical, nursing, and pharmacy schools in universities across Canada, the United States, Europe, Asia, Australia, and New Zealand. The survey found that 53.7 percent of the respondents ranked the inclusion of oral-systemic science as somewhat important, 51.2 percent reported no or limited requirements to incorporate oral health education within their curricula, and 59.6 percent rated their current curricula in oral-systemic health as inadequate. The majority of students in these programs are not being instructed to examine the mouth, nor are they being taught how to perform an oral examination. Despite growing awareness of emerging evidence of oral-systemic relationships and recommendations that all health care providers should contribute to enhancing oral health, this knowledge base appears to be substantially deficient in the curricula of pharmacy, nursing, and medical students in many universities. This study provides the first formal documentation that the curricula of non-dental health care professions, specifically in medicine, nursing, and pharmacy, do not contain adequate content related to oral-systemic health.

Short Communication: Perception and attitude of pharmacy students towards learning tools.

PubMed

Ali, Fatima Ramzan; Hassan, Fouzia; Hasan, Sm Farid; Israr, Fouzia; Shafiq, Yusra; Arshad, Hafiz Muhammad

2015-11-01

Use of technology in education has increased worldwide. Teaching methodologies are shifting from traditional classroom lectures to e-learning and computer-based learning. Pakistani students are also now fathoming necessity of acquiring tools for strengthening their knowledge and skills. The objective of present study was to analyze the shifting trends (perception and attitudes) of Pakistani Pharmacy students towards learning tools. A survey based study conducted on 296 students from various years of Pharmacy, studying in a state owned university, Karachi, Pakistan. This study was initially piloted and Cronbach's-alpha was computed for evaluation of internal consistency of questionnaire (for perception; 0.660, for attitude; 0.777 respectively). Data was computed by SPSS, version 16 (Crosstab) and Chisquare (P=0.05). Most of the students strongly agreed (53%; χ² =495;P<0.05) that introducing technology will improve learning; books are reliable reading source (53%; χ² =437.23; P<0.05) or book-reading is essential (50%; χ² =360.36; P<0.05) while others disagreed that they only study from class lectures (31%; χ² =17.22; P<0.05); not take classes (41%; χ² =48.21; P<0.05); have used software (44%; χ² =46.54; P<0.05). Majority of the students agreed on incorporating technology to improve learning. Other factors such as unavailability and expenditure of books influenced their ability to learn. This study might assist policy makers in developing policies that could improve learning.

The Impact of Computer Supported Collaborative Learning on Internship Outcomes of Pharmacy Students

ERIC Educational Resources Information Center

Timmers, S.; Valcke, M.; de Mil, K.; Baeyens, W. R. G.

2008-01-01

This article focuses on an evaluation of the impact of an innovative instructional design of internships in view of a new integrated pharmaceutical curriculum. A key innovative element was the implementation of a computer-supported collaborative learning environment. Students were, as part of their formal curriculum, expected to work in a…

Implementation of a web-based medication tracking system in a large academic medical center.

PubMed

Calabrese, Sam V; Williams, Jonathan P

2012-10-01

Pharmacy workflow efficiencies achieved through the use of an electronic medication-tracking system are described. Medication dispensing turnaround times at the inpatient pharmacy of a large hospital were evaluated before and after transition from manual medication tracking to a Web-based tracking process involving sequential bar-code scanning and real-time monitoring of medication status. The transition was carried out in three phases: (1) a workflow analysis, including the identification of optimal points for medication scanning with hand-held wireless devices, (2) the phased implementation of an automated solution and associated hardware at a central dispensing pharmacy and three satellite locations, and (3) postimplementation data collection to evaluate the impact of the new tracking system and areas for improvement. Relative to the manual tracking method, electronic medication tracking allowed the capture of far more data points, enabling the pharmacy team to delineate the time required for each step of the medication dispensing process and to identify the steps most likely to involve delays. A comparison of baseline and postimplementation data showed substantial reductions in overall medication turnaround times with the use of the Web-based tracking system (time reductions of 45% and 22% at the central and satellite sites, respectively). In addition to more accurate projections and documentation of turnaround times, the Web-based tracking system has facilitated quality-improvement initiatives. Implementation of an electronic tracking system for monitoring the delivery of medications provided a comprehensive mechanism for calculating turnaround times and allowed the pharmacy to identify bottlenecks within the medication distribution system. Altering processes removed these bottlenecks and decreased delivery turnaround times.

Congruence of Self-Reported Medications With Pharmacy Prescription Records In Low-Income Older Adults

PubMed Central

Caskie, Grace I. L.; Willis, Sherry L.

2013-01-01

Purpose This study examined the congruence of self-reported medications with computerized pharmacy records. Design and Methods Pharmacy records and self-reported medications were obtained for 294 members of a state pharmaceutical assistance program who also participated in ACTIVE, a clinical trial on cognitive training in nondemented elderly persons. The average age of the sample participants was 74.5 years (range = 65–91); 87.8% were females. Results Congruence between self-report and pharmacy data was generally high. Self-reports omitted drug classes in the pharmacy records less often than the pharmacy records did not include self-reported drug classes. The percentage of individuals with perfect agreement between self-reports and pharmacy records varied from 49% for major drug classes to 81 % for specific cardiovascular and central nervous system drugs. Within a drug class, agreement tended to be higher for individuals without a prescription in that class. Poorer health was consistently related to poorer self-report of medications. Implications Self-reported medications are most likely to be congruent with pharmacy records for drugs prescribed for more serious conditions, for more specific classes of drugs, and for healthier individuals. PMID:15075414

The Central Endocrine Glands: Intertwining Physiology and Pharmacy

PubMed Central

2007-01-01

The initial courses in didactic pharmacy curriculum are designed to provide core scientific knowledge and develop learning skills that are the basis for highly competent application and practice of pharmacy. Commonly, students interpret this scientific base as ancillary to the practice of pharmacy. Physiology courses present a natural opportunity for the instructor to introduce basic pharmaceutical principles that form the foundation of pharmacological application early in the professional curriculum. Human Physiology I is the first of a 2-course physiology sequence that pharmacy students take upon matriculating into Midwestern University College of Pharmacy-Glendale. The endocrine physiology section of this course is designed to emphasize the regulatory and compensatory nature of this system in maintaining homeostasis, but also includes aspects of basic pharmaceutical principles. In this way the dependency of physiology and pharmacy upon one another is accentuated. The lecture format and content described in this manuscript focus on the central endocrine glands and illustrates their vital role in normal body function, compensatory responses to disease states, and their components as pharmacotherapy targets. The integration of these pharmaceutical principles at the introductory level supports an environment that can alleviate any perceived disparity between science foundation and practical application in the profession of pharmacy. PMID:17998993

Medication Incidents Related to Automated Dose Dispensing in Community Pharmacies and Hospitals - A Reporting System Study

PubMed Central

Cheung, Ka-Chun; van den Bemt, Patricia M. L. A.; Bouvy, Marcel L.; Wensing, Michel; De Smet, Peter A. G. M.

2014-01-01

Introduction Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. Methods The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR) reporting system were selected and characterized independently by two researchers. Main Outcome Measures Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. Results From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4%) incidents from community pharmacies and 11,428 (75.6%) incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8%) were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2%) were related to ADD than in hospitals (41/11,428 = 0.4%). The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. Conclusion A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an incident. PMID:25058321

Medication incidents related to automated dose dispensing in community pharmacies and hospitals--a reporting system study.

PubMed

Cheung, Ka-Chun; van den Bemt, Patricia M L A; Bouvy, Marcel L; Wensing, Michel; De Smet, Peter A G M

2014-01-01

Automated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR) reporting system were selected and characterized independently by two researchers. Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4%) incidents from community pharmacies and 11,428 (75.6%) incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8%) were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2%) were related to ADD than in hospitals (41/11,428 = 0.4%). The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an incident.

Challenges of standardized continuous quality improvement programs in community pharmacies: the case of SafetyNET-Rx.

PubMed

Boyle, Todd A; MacKinnon, Neil J; Mahaffey, Thomas; Duggan, Kellie; Dow, Natalie

2012-01-01

Research on continuous quality improvement (CQI) in community pharmacies lags in comparison to service, manufacturing, and various health care sectors. As a result, very little is known about the challenges community pharmacies face when implementing CQI programs in general, let alone the challenges of implementing a standardized and technologically sophisticated one. This research identifies the initial challenges of implementing a standardized CQI program in community pharmacies and how such challenges were addressed by pharmacy staff. Through qualitative interviews, a multisite study of the SafetyNET-Rx CQI program involving community pharmacies in Nova Scotia, Canada, was performed to identify such challenges. Interviews were conducted with the CQI facilitator (ie, staff pharmacist or technician) in 55 community pharmacies that adopted the SafetyNET-Rx program. Of these 55 pharmacies, 25 were part of large national corporate chains, 22 were part of banner chains, and 8 were independent pharmacies. A total of 10 different corporate chains and banners were represented among the 55 pharmacies. Thematic content analysis using well-established coding procedures was used to explore the interview data and elicit the key challenges faced. Six major challenges were identified, specifically finding time to report, having all pharmacy staff involved in quality-related event (QRE) reporting, reporting apprehensiveness, changing staff relationships, meeting to discuss QREs, and accepting the online technology. Challenges were addressed in a number of ways including developing a manual-online hybrid reporting system, managers paying staff to meet after hours, and pharmacy managers showing visible commitment to QRE reporting and learning. This research identifies key challenges to implementing CQI programs in community pharmacies and also provides a starting point for future research relating to how the challenges of QRE reporting and learning in community pharmacies change over time. Copyright © 2012 Elsevier Inc. All rights reserved.

Modernizing an ambulatory care pharmacy in a large multi-clinic institution.

PubMed

Miller, R F; Herrick, J D

1979-03-01

The steps involved in modernizing an outdated outpatient pharmacy, including the functional planning process, development of a work-flow pattern which makes the patient an integral part of the system, budget considerations and evaluation of the new pharmacy, are described. Objectives of the modernization were to: (1) provide a facility conductive to efficient and high quality services to the ambulatory patient; (2) provide an attractive and comfortable area for patients and staff; (3) provide a work flow which keeps the patient in the system and allows the pharmacist time for instruction and patient education; and (4) establish a patient medication record system. After one year of operation, average overall prescription volume increased by 50%, while average waiting time declined by 74%. Facility and procedural changes allowed the pharmacist to substantially increase patient counseling activity. The application of functional planning and facility design to the renovation and restructuring of an outpatient pharmacy allowed pharmacists to provide efficient, patient-oriented service.

Perception of community pharmacists towards the barriers to enhanced pharmacy services in the healthcare system of Dubai: a quantitative approach.

PubMed

Rayes, Ibrahim K; Hassali, Mohamed A; Abduelkarem, Abduelmula R

2015-01-01

In many developing countries, pharmacists are facing many challenges while they try to enhance the quality of services provided to patients approaching community pharmacies. To explore perception of community pharmacists in Dubai regarding the obstacles to enhanced pharmacy services using a part of the results from a nation-wide quantitative survey. A questionnaire was distributed to 281 full-time licensed community pharmacists in Dubai. The questionnaire had 5 inter-linked sections: demographic information, information about the pharmacy, interaction with physicians, pharmacists' current professional role, and barriers to enhanced pharmacy services. About half of the respondents (45.4%, n=90) agreed that pharmacy clients under-estimate them and 52.5% (n=104) felt the same by physicians. About 47.5% (n=94) of the respondents felt that they are legally unprotected against profession's malpractice. Moreover, 64.7% (n=128) stated that pharmacy practice in Dubai turned to be business-focused. In addition, 76.8% (n=252) found that one of the major barriers to enhanced pharmacy services is the high business running cost. Pharmacists screened tried to prove that they are not one of the barriers to optimized pharmacy services as 62.7% (n=124) disagreed that they lack appropriate knowledge needed to serve community and 67.7% (n=134) gave the same response when asked whether pharmacy staff lack confidence when treating consumers or not. Although being well established within the community, pharmacists in Dubai negatively perceived their own professional role. They stated that there are number of barriers which hinder optimized delivery of pharmacy services like under-estimation by pharmacy clients and other healthcare professionals, pressure to make sales, and high running cost.

Perception of community pharmacists towards the barriers to enhanced pharmacy services in the healthcare system of Dubai: a quantitative approach

PubMed Central

Rayes, Ibrahim K.; Hassali, Mohamed A.; Abduelkarem, Abduelmula R.

2014-01-01

Background: In many developing countries, pharmacists are facing many challenges while they try to enhance the quality of services provided to patients approaching community pharmacies. Objective: To explore perception of community pharmacists in Dubai regarding the obstacles to enhanced pharmacy services using a part of the results from a nation-wide quantitative survey. Methods: A questionnaire was distributed to 281 full-time licensed community pharmacists in Dubai. The questionnaire had 5 inter-linked sections: demographic information, information about the pharmacy, interaction with physicians, pharmacists’ current professional role, and barriers to enhanced pharmacy services. Results: About half of the respondents (45.4%, n=90) agreed that pharmacy clients under-estimate them and 52.5% (n=104) felt the same by physicians. About 47.5% (n=94) of the respondents felt that they are legally unprotected against profession’s malpractice. Moreover, 64.7% (n=128) stated that pharmacy practice in Dubai turned to be business-focused. In addition, 76.8% (n=252) found that one of the major barriers to enhanced pharmacy services is the high business running cost. Pharmacists screened tried to prove that they are not one of the barriers to optimized pharmacy services as 62.7% (n=124) disagreed that they lack appropriate knowledge needed to serve community and 67.7% (n=134) gave the same response when asked whether pharmacy staff lack confidence when treating consumers or not. Conclusions: Although being well established within the community, pharmacists in Dubai negatively perceived their own professional role. They stated that there are number of barriers which hinder optimized delivery of pharmacy services like under-estimation by pharmacy clients and other healthcare professionals, pressure to make sales, and high running cost. PMID:26131039

Pharmacy executive leadership issues and associated skills, knowledge, and abilities.

PubMed

Meadows, Andrew B; Maine, Lucinda L; Keyes, Elizabeth K; Pearson, Kathy; Finstuen, Kenn

2005-01-01

To identify challenges that current and future pharmacy executives are facing or will face in the future and to define what skills, knowledge, and abilities (SKAs) are required to successfully negotiate these challenges. Delphi method for executive decision making. Civilian pharmacy profession. 110 pharmacists who graduated from the GlaxoSmithKline Executive Management Program for Pharmacy Leaders. Two iterations of the Delphi method for executive decision making separated by an expert panel content analysis. Round 1--participants were asked to identify five major issues they believed to be of greatest importance to pharmacy leaders in the next 5-10 years and name specific SKAs that might be needed by future leaders to successfully deal with those issues. An expert panel reviewed the issues, classified issues into specific domains, and titled each domain. Round 2-participants rated the SKAs on a 7-point scale according to their individual assessment of importance in each domain. For Delphi rounds 1 and 2, response rates were 21.8% and 18.2%, respectively. More than 100 total issue statements were identified. The expert panel sorted the issues into five domains: management and development of the pharmacy workforce, pharmacy finance, total quality management of work-flow systems, influences on the practice of pharmacy, and professional pharmacy leadership. Five of the top 15 SKAs-and all four highest ranked items--came from the professional pharmacy leadership domain, including ability to see the big picture, ability to demonstrate the value of pharmacy services, ability to lead and manage in an ethical manner, and skills for influencing an organization's senior leadership. Through successful integration of communication skills, critical thinking, and problem solving techniques, future public-sector pharmacy executives will be better equipped to effectively position their organizations and the profession for the challenges that lie ahead.

Utilization of community pharmacy space to enhance privacy: a qualitative study.

PubMed

Hattingh, H Laetitia; Emmerton, Lynne; Ng Cheong Tin, Pascale; Green, Catherine

2016-10-01

Community pharmacists require access to consumers' information about their medicines and health-related conditions to make informed decisions regarding treatment options. Open communication between consumers and pharmacists is ideal although consumers are only likely to disclose relevant information if they feel that their privacy requirements are being acknowledged and adhered to. This study sets out to explore community pharmacy privacy practices, experiences and expectations and the utilization of available space to achieve privacy. Qualitative methods were used, comprising a series of face-to-face interviews with 25 pharmacists and 55 pharmacy customers in Perth, Western Australia, between June and August 2013. The use of private consultation areas for certain services and sensitive discussions was supported by pharmacists and consumers although there was recognition that workflow processes in some pharmacies may need to change to maximize the use of private areas. Pharmacy staff adopted various strategies to overcome privacy obstacles such as taking consumers to a quieter part of the pharmacy, avoiding exposure of sensitive items through packaging, lowering of voices, interacting during pharmacy quiet times and telephoning consumers. Pharmacy staff and consumers regularly had to apply judgement to achieve the required level of privacy. Management of privacy can be challenging in the community pharmacy environment, and on-going work in this area is important. As community pharmacy practice is increasingly becoming more involved in advanced medication and disease state management services with unique privacy requirements, pharmacies' layouts and systems to address privacy challenges require a proactive approach. © 2015 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

Will there be a pharmacy leadership crises? An ASHP Foundation Scholar-in-residence report.

PubMed

White, Sara J

2005-04-15

Health-system pharmacy directors, managers, practitioners, students, and employers were surveyed to assess the situation of current and future leaders in pharmacy and generate recommendations for preventing shortages. Online surveys were sent to pharmacy directors, pharmacy middle managers, current pharmacy practitioners pharmacy students, and employers recruiting for management positions using ASHP's membership and CareerPharm databases. Directors, managers, and practitioners were asked about their job satisfaction and future plans. The trends in demographics and attitudes toward the balance between family and work were assessed among directors, managers, practitioners, and students. Employers were asked about their perceived ease of filling managerial positions. While most pharmacy directors and middle managers were satisfied with their current positions, 80% of directors and 77% of middle managers anticipated leaving their jobs in the next decade. Men comprised 72% of directors, 50% of middle managers, 62% of practitioners, and 21% of pharmacy students. The majority of pharmacy students and practitioners reported being married to a working spouse and having children and expressed a desire to balance their personal life with their career. The top reasons cited by students and practitioners for not seeking leadership positions were having to give up clinical practice and competing responsibilities. More than half of employers felt it was more difficult to recruit managers now than it was three years ago. A significant gap in pharmacy leadership in the next 5-10 years is expected, as well as a shift in work force composition and attitude. Mentoring and residencies are important methods of fostering new leaders in the profession.

Pharmacist and physician perspectives on diabetes service delivery within community pharmacies in Indonesia: a qualitative study.

PubMed

Wibowo, Yosi; Sunderland, Bruce; Hughes, Jeffery

2016-05-01

To explore perspectives of physicians and pharmacists on diabetes service delivery within community pharmacies in Indonesia. In depth interviews were conducted with 10 physicians and 10 community pharmacists in Surabaya, Indonesia, using a semi-structured interview guide. Nvivo version 9 was used to facilitate thematic content analysis to identify barriers/facilitators for community pharmacists to provide diabetes services. The identified themes indicating barriers/facilitators for diabetes service delivery within Indonesian community pharmacies included: (1) pharmacist factors - i.e. positive views (facilitator) and perceived lack of competence (barrier); (2) pharmacist-physician relationships - i.e. physicians' lack of support and accessibility (barriers); (3) pharmacist-patient relationships - i.e. perceived patients' lack of support and accessibility (barriers); (4) pharmacy environment - i.e. business orientation (barrier), lack of staff and poor pharmacist availability (barriers), and availability of supporting resources, such as counselling areas/rooms, procedures/protocols and IT systems for labelling and patient records (facilitators); and (5) external environment - i.e. a health system to support pharmacist roles, remuneration, marketing and professional assistance (facilitators). Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, Ikatan Apoteker Indonesia (Indonesian Pharmacists Association) and Ikatan Dokter Indonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities. © 2015 Royal Pharmaceutical Society.

Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management.

PubMed

Gregório, João; Russo, Giuliano; Lapão, Luís Velez

2016-01-01

The current financial crisis is pressing health systems to reduce costs while looking to improve service standards. In this context, the necessity to optimize health care systems management has become an imperative. However, little research has been conducted on health care and pharmaceutical services cost management. Pharmaceutical services optimization requires a comprehensive understanding of resources usage and its costs. This study explores the development of a time-driven activity-based costing (TDABC) model, with the objective of calculating the cost of pharmaceutical services to help inform policy-making. Pharmaceutical services supply patterns were studied in three pharmacies during a weekday through an observational study. Details of each activity's execution were recorded, including time spent per activity performed by pharmacists. Data on pharmacy costs was obtained through pharmacies' accounting records. The calculated cost of a dispensing service in these pharmacies ranged from €3.16 to €4.29. The cost of a counseling service when no medicine was supplied ranged from €1.24 to €1.46. The cost of health screening services ranged from €2.86 to €4.55. The presented TDABC model gives us new insights on management and costs of community pharmacies. This study shows the importance of cost analysis for health care services, specifically on pharmaceutical services, in order to better inform pharmacies' management and the elaboration of pharmaceutical policies. Copyright © 2016 Elsevier Inc. All rights reserved.

Program for developing leadership in pharmacy residents.

PubMed

Fuller, Patrick D

2012-07-15

An innovative, structured approach to incorporating leadership development activities into pharmacy residency training is described. The American Society of Health-System Pharmacists (ASHP) has called for increased efforts to make leadership development an integral component of the training of pharmacy students and new practitioners. In 2007, The Nebraska Medical Center (TNMC) took action to systematize leadership training in its pharmacy residency programs by launching a new Leadership Development Series. Throughout the residency year, trainees at TNMC participate in a variety of activities: (1) focused group discussions of selected articles on leadership concepts written by noted leaders of the past and present, (2) a two-day offsite retreat featuring trust-building exercises and physical challenges, (3) a self-assessment designed to help residents identify and use their untapped personal strengths, (4) training on the effective application of different styles of communication and conflict resolution, and (5) education on the history and evolution of health-system pharmacy, including a review and discussion of lectures by recipients of ASHP's Harvey A. K. Whitney Award. Feedback from residents who have completed the series has been positive, with many residents indicating that it has stimulated their professional growth and helped prepared them for leadership roles. A structured Leadership Development Series exposes pharmacy residents to various leadership philosophies and principles and, through the study of Harvey A. K. Whitney Award lectures, to the thoughts of past and present pharmacy leaders. Residents develop an increased self-awareness through a resident fall retreat, a StrengthsFinder assessment, and communication and conflict-mode assessment tools.

Using an integrated information system to reduce interruptions and the number of non-relevant contacts in the inpatient pharmacy at tertiary hospital.

PubMed

Binobaid, Saleh; Almeziny, Mohammed; Fan, Ip-Shing

2017-07-01

Patient care is provided by a multidisciplinary team of healthcare professionals intended for high-quality and safe patient care. Accordingly, the team must work synergistically and communicate efficiently. In many hospitals, nursing and pharmacy communication relies mainly on telephone calls. In fact, numerous studies have reported telephone calls as a source of interruption for both pharmacy and nursing operations; therefore, the workload increases and the chance of errors raises. This report describes the implementation of an integrated information system that possibly can reduce telephone calls through providing real-time tracking capabilities and sorting prescriptions urgency, thus significantly improving traceability of all prescriptions inside pharmacy. The research design is based on a quasi-experiment using pre-post testing using the continuous improvement approach. The improvement project is performed using a six-step method. A survey was conducted in Prince Sultan Military Medical City (PSMMC) to measure the volume and types of telephone calls before and after implementation to evaluate the impact of the new system. Beforehand of the system implementation, during the two-week measurement period, all pharmacies received 4466 calls and the majority were follow-up calls. Subsequently of the integrated system rollout, there was a significant reduction ( p  > 0.001) in the volume of telephone calls to 2630 calls; besides, the calls nature turned out to be more professional inquiries ( p  > 0.001). As a result, avoidable interruptions and workload were decreased.

Development of a community pharmacy program in Iran with a focus on Logbook application

PubMed Central

Farsaei, Shadi

2016-01-01

Objective: Community pharmacy educational program needs to be completed because of gradual transition in pharmacist responsibilities from traditional roles such as dispensing and compounding medications to give professional patient-based care. To further develop the community pharmacy program, this study was designed to involve Logbook in pharmacy training courses. Methods: For this study, at first, Logbook for community pharmacy practice was designed to develop educational program of this course in Isfahan University of Medical Sciences. Thereafter, in a 6-month prospective study, this Logbook was incorporated to the pharmacy practice course of Doctor of Pharmacy (PharmD) educational program, and students’ feedbacks were gained after final examination to improve the Logbook accordingly. Students described their opinions about different sections of this program as unnecessary, necessary, and necessary with revision. Findings: A total of 65 PharmD students were included in this study. More than 90% of the students gave complete answers to the evaluation of this pharmacy training program. The results showed that more than 70% of students considered this program of pharmacy training was necessary (with or without revisions) in PharmD courses. They recommended more time to be included for prescription reading and analyses during these courses. Conclusion: Developing pharmacy training program by using Logbook which was presented in this study was considered necessary and efficient for PharmD students. However, it is a prototype system, and we are committed to using initial students and preceptors’ feedbacks to improve Logbook in future courses. PMID:26985437

Mapping the terrain: A conceptual schema for a mental health medication support service in community pharmacy

PubMed Central

Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J

2015-01-01

Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Results: Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. Conclusion: The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole. PMID:26770802

Competence in metered dose inhaler technique among community pharmacy professionals in Gondar town, Northwest Ethiopia: Knowledge and skill gap analysis.

PubMed

Belachew, Sewunet Admasu; Tilahun, Fasil; Ketsela, Tirsit; Achaw Ayele, Asnakew; Kassie Netere, Adeladlew; Getnet Mersha, Amanual; Befekadu Abebe, Tamrat; Melaku Gebresillassie, Begashaw; Getachew Tegegn, Henok; Asfaw Erku, Daniel

2017-01-01

When compared to systemic administration, if used correctly inhalers deliver a smaller enough percent of the drug right to the site of action in the lungs, with a faster onset of effect and with reduced systemic availability that minimizes adverse effects. However, the health professionals' and patients' use of metered dose inhaler is poor. This study was aimed to explore community pharmacy professionals' (pharmacists' and druggists') competency on metered dose inhaler (MDI) technique. A cross sectional study was employed on pharmacy professionals working in community drug retail outlets in Gondar town, northwest Ethiopia from March to May 2017. Evaluation tool was originally taken and adapted from the National Asthma Education and Prevention Programmes of America (NAEPP) step criteria for the demonstration of a metered dose inhaler to score the knowledge/proficiency of using the inhaler. Among 70 community pharmacy professionals approached, 62 (32 pharmacists and 30 druggists/Pharmacy technicians) completed the survey with a response rate of 85.6%. Only three (4.8%) respondents were competent by demonstrating the vital steps correctly. Overall, only 13 participants got score seven or above, but most of them had missed the essential steps which included steps 1, 2, 5, 6, 7 or 8. There was a significant difference (P = 0.015) in competency of demonstrating adequate inhalational technique among respondents who took training on basic inhalational techniques and who did not. This study shown that, community pharmacy professionals' competency of MDI technique was very poor. So as to better incorporate community pharmacies into future asthma illness management and optimize the contribution of pharmacists, interventions would emphasis to improve the total competence of community pharmacy professionals through establishing and providing regular educational programs.

Impact of Environmental Factors on Differences in Quality of Medication Use: An Insight for the Medicare Star Rating System.

PubMed

Desai, Vibha; Nau, David; Conklin, Mark; Heaton, Pamela C

2016-07-01

The Medicare star ratings system incentivizes health plan sponsors based on their performance across a measurement system that contains quality measures related to medication use. As health plan sponsors seek to further engage their network providers, specifically network pharmacies, to improve performance on these measures, it is important to consider the effect of environmental factors on the performance of network pharmacies. To determine the effect of environmental factors on pharmacy quality as measured by (a) medication adherence for noninsulin diabetes medications, (b) medication adherence for renin angiotensin receptor antagonists (RASA), (c) medication adherence for cholesterol medications (statins), and (d) use of high-risk medications (HRM) in the elderly. The EQuIPP database, which contains performance information for pharmacies for a nationwide sample of Medicare beneficiaries, was used for this analysis. Environmental factors included regions or characteristics of a community or county. County-level data was obtained from the Area Health Resource Files, a resource product available from the Health Resources & Service Administration. A logistic regression model was developed with performance as the dependent variable and regions and environmental factors as independent variables. Performance and county characteristics, such as proportion of patients in an age group, race, income, or number of outpatient visits, were classified as high and low based on a median cutoff of nationwide performance scores. A total of 28,950 pharmacies were included in this analysis. For most measures, the proportion of low-performing pharmacies was significantly higher in the East South Central, Mid-Atlantic, Mountain, Pacific, and West South Central regions. Pharmacies in counties with high median income, high proportion of elderly population (aged > 84 years), high proportion of elderly patients who were white or Hispanic, high proportion of elderly males, and high proportion of elderly urban patients were less likely to have low performance, whereas those with high proportion of elderly African Americans and high density of independent pharmacies were more likely to have low performance (P < 0.05-0.0001). This study found that environmental characteristics of a region, including pharmacy and sociodemographic characteristics, explained regional variation in quality measures related to medication use for patient populations served by pharmacies. This evaluation serves to further inform the discussion regarding case-mix adjustment of quality measures and provides information that may be important to further refine intervention strategies for pharmacies and pharmacists who serve certain regional populations. Additionally, pharmacies in greatest need of support for quality improvement may be those who serve populations that are predominantly low income and elderly African American. Desai's postdoctoral fellowship was funded by Pharmacy Quality Solutions for conducting this study and writing the manuscript. Nau and Conklin are employed by Pharmacy Quality Solutions. An earlier version of this research was presented as a poster at the Annual Meeting of the Academy of Managed Care Pharmacy; San Diego, CA; April 7-10, 2015. Study concept and design were contributed by Conklin, Nau, Desai, and Heaton. Desai and Conklin took the lead in data collection, assisted by Nau and Heaton. The manuscript was primarily written by Desai and Heaton, with assistance from Conklin and Nau. All authors contributed to data interpretation and manuscript revision.

Telemedicine and telepharmacy: current status and future implications.

PubMed

Angaran, D M

1999-07-15

Uses of telemedicine are described and potential roles for pharmacists are discussed. Telemedicine has been defined as "the use of electronic information and communications technologies to provide and support health care when distance separates the participants." Technologies included in telemedicine are videoconferencing, telephones, computers, the Internet, fax, radio, and television. Telepharmacy has the same basic definition but refers to pharmaceutical care provision. Although the videotelemedicine market is expected to grow considerably, lack of reimbursement and high costs are continuing obstacles. Pharmacy is using video-conferencing for education, training, and management purposes. The telephone has changed from a dial-and-talk instrument to a multimedia access tool. Medical devices are being attached to telephone lines to provide remote monitoring and therapy, and call centers are providing medication counseling, prior authorization, refill authorization, and formulary compliance monitoring. Although the Internet has quickly become a star performer, utilization by health care lags behind that of other industries. The Internet-fueled empowerment of consumers and their expectations for speed, access, and convenience are creating more unmet expectations of the traditional health care system. Pharmacy has both organizational and individual practitioner Web sites, but it is online drugstores that are attracting most attention. Potential benefits of telemedicine include improved access to care, greater efficiency in diagnosis and treatment, higher productivity, and market positioning for the coming century. Telemedicine will tax the economic, regulatory, legal, ethical, and clinical care expertise of the entire health care system. Studies of the effectiveness, cost, and societal implications of telemedicine are needed, along with practice models and standards, training programs, and solutions to regulatory, licensing, and legal questions. Securing reimbursement for cognitive services remains a problem for telemedicine and telepharmacy. Telemedicine presents profound opportunities and challenges to pharmacy and other health care professions.

Improving the review of standard operating procedures: a novel electronic system for compounding pharmacies.

PubMed

Brensel, Robert; Brensel, Scott; Ng, Amy

2013-01-01

Since the New England Compounding Center disaster in 2012, the importance of following correct procedures during every phase of customized pharmacy has been a focus of governmental interest and action as well as public scrutiny. Many pharmacies rely on the rote review of standard operating procedures to ensure that staff members understand and follow protocols that ensure the safety and potency of all compounds prepared, but that approach to continuing education can be cumbersome and needlessly time-consuming. In addition, documenting and retrieving evidence of employee competence can be difficult. In this article, we describe our use of online technology to improve our methods of educating staff about the full range of standard operating procedures that must be followed in our pharmacy. The system we devised and implemented has proven to be effective, easy to update and maintain, very inexpensive, and user friendly. Its use has reduced the time previously required for a read-over review of standard operating procedures from 30 or 40 minutes to 5 or 10 minutes in weekly staff meetings, and we can now easily document and access proof of employees' comprehension of that content. It is our hope that other small compounding pharmacies will also find this system of online standard operating procedure review helpful.

Medication order communication using fax and document-imaging technologies.

PubMed

Simonian, Armen I

2008-03-15

The implementation of fax and document-imaging technology to electronically communicate medication orders from nursing stations to the pharmacy is described. The evaluation of a commercially available pharmacy order imaging system to improve order communication and to make document retrieval more efficient led to the selection and customization of a system already licensed and used in seven affiliated hospitals. The system consisted of existing fax machines and document-imaging software that would capture images of written orders and send them from nursing stations to a central database server. Pharmacists would then retrieve the images and enter the orders in an electronic medical record system. The pharmacy representatives from all seven hospitals agreed on the configuration and functionality of the custom application. A 30-day trial of the order imaging system was successfully conducted at one of the larger institutions. The new system was then implemented at the remaining six hospitals over a period of 60 days. The transition from a paper-order system to electronic communication via a standardized pharmacy document management application tailored to the specific needs of this health system was accomplished. A health system with seven affiliated hospitals successfully implemented electronic communication and the management of inpatient paper-chart orders by using faxes and document-imaging technology. This standardized application eliminated the problems associated with the hand delivery of paper orders, the use of the pneumatic tube system, and the printing of traditional faxes.

Performance of retail pharmacies in low- and middle-income Asian settings: a systematic review

PubMed Central

Miller, Rosalind; Goodman, Catherine

2016-01-01

In low- and middle-income countries (LMIC) in Asia, pharmacies are often patients’ first point of contact with the health care system and their preferred channel for purchasing medicines. Unfortunately, pharmacy practice in these settings has been characterized by deficient knowledge and inappropriate treatment. This paper systematically reviews both the performance of all types of pharmacies and drug stores across Asia’s LMIC, and the determinants of poor practice, in order to reflect on how this could best be addressed. Poor pharmacy practice in Asia appears to have persisted over the past 30 years. We identify a set of inadequacies that occur at key moments throughout the pharmacy encounter, including: insufficient history taking; lack of referral of patients who require medical attention; illegal sale of a wide range of prescription only medicines without a prescription; sale of medicines that are either clinically inappropriate and/or in doses that are outside of the therapeutic range; sale of incomplete courses of antibiotics; and limited provision of information and counselling. In terms of determinants of poor practice, first knowledge was found to be necessary but not sufficient to ensure correct management of patients presenting at the pharmacy. This is evidenced by large discrepancies between stated and actual practice; little difference in the treatment behaviour of less and more qualified personnel and the failure of training programmes to improve practice to a satisfactory level. Second, we identified a number of profit maximizing strategies employed by pharmacy staff that can be linked to poor practices. Finally, whilst the research is relatively sparse, the regulatory environment appears to play an important role in shaping behaviour. Future efforts to improve the situation may yield more success than historical attempts, which have tended to concentrate on education, if they address the profit incentives faced by pharmacy personnel and the regulatory system. PMID:26962123

Performance of retail pharmacies in low- and middle-income Asian settings: a systematic review.

PubMed

Miller, Rosalind; Goodman, Catherine

2016-03-08

In low- and middle-income countries (LMIC) in Asia, pharmacies are often patients' first point of contact with the health care system and their preferred channel for purchasing medicines. Unfortunately, pharmacy practice in these settings has been characterized by deficient knowledge and inappropriate treatment. This paper systematically reviews both the performance of all types of pharmacies and drug stores across Asia's LMIC, and the determinants of poor practice, in order to reflect on how this could best be addressed. Poor pharmacy practice in Asia appears to have persisted over the past 30 years. We identify a set of inadequacies that occur at key moments throughout the pharmacy encounter, including: insufficient history taking; lack of referral of patients who require medical attention; illegal sale of a wide range of prescription only medicines without a prescription; sale of medicines that are either clinically inappropriate and/or in doses that are outside of the therapeutic range; sale of incomplete courses of antibiotics; and limited provision of information and counselling. In terms of determinants of poor practice, first knowledge was found to be necessary but not sufficient to ensure correct management of patients presenting at the pharmacy. This is evidenced by large discrepancies between stated and actual practice; little difference in the treatment behaviour of less and more qualified personnel and the failure of training programmes to improve practice to a satisfactory level. Second, we identified a number of profit maximizing strategies employed by pharmacy staff that can be linked to poor practices. Finally, whilst the research is relatively sparse, the regulatory environment appears to play an important role in shaping behaviour. Future efforts to improve the situation may yield more success than historical attempts, which have tended to concentrate on education, if they address the profit incentives faced by pharmacy personnel and the regulatory system. © The Author 2016. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal.

PubMed

Gyawali, Sudesh; Rathore, Devendra Singh; Adhikari, Kishor; Shankar, Pathiyil Ravi; K C, Vikash Kumar; Basnet, Suyog

2014-04-28

Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The 'Current Index of Medical Specialties' was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. Community pharmacies in Pokhara offer a wide range of services including, but not limited to, drug dispensing, counseling, dressing of wounds, and administering injections. However, the lack of qualified staff and adequate infrastructure may be compromising the quality of the services offered. Therefore, the health authorities should take the necessary measures to upgrade the qualifications of the personnel and to improve the infrastructure for the sake of good pharmacy practice and the safer use of injections.

A Real Time Interface Between a Computerized Physician Order Entry System and the Computerized ICU Medication Administration Record

PubMed Central

Chen, Jeannie; Shabot, M. Michael; LoBue, Mark

2003-01-01

Prior attempts to interface ICU Clinical Information Systems (CIS) to Pharmacy systems have been less than successful. The major problem is that in ICUs, medications frequently have to be administered and charted in the CIS Medication Administration Record (MAR) before pharmacists can enter them into the Pharmacy system. When the Pharmacy system belatedly sends medication orders to the CIS MAR, this may create duplicate entries for medications that ICU nurses have had to enter manually to chart doses actually given. The authors have implemented a real time interface between a Computerized Physician Order Entry (CPOE) system and a CIS operating in ten ICUs that solves this problem. The interface transfers new medication orders including order details and alerts directly to the CIS Medication Administration Record (MAR), where they are immediately available for nurse charting. PMID:14728315

Assessment of students' ability to incorporate a computer into increasingly complex simulated patient encounters.

PubMed

Ray, Sarah; Valdovinos, Katie

Pharmacy students should be exposed to and offered opportunities to practice the skill of incorporating a computer into a patient interview in the didactic setting. Faculty sought to improve retention of student ability to incorporate computers into their patient-pharmacist communication. Students were required to utilize a computer to document clinical information gathered during a simulated patient encounter (SPE). Students utilized electronic worksheets and were evaluated by instructors on their ability to effectively incorporate a computer into a SPE using a rubric. Students received specific instruction on effective computer use during patient encounters. Students were then re-evaluated by an instructor during subsequent SPEs of increasing complexity using standardized rubrics blinded from the students. Pre-instruction, 45% of students effectively incorporated a computer into a SPE. After receiving instruction, 67% of students were effective in their use of a computer during a SPE of performing a pharmaceutical care assessment for a patient with chronic obstructive pulmonary disease (COPD) (p < 0.05 compared to pre-instruction), and 58% of students were effective in their use of a computer during a SPE of retrieving a medication list and social history from a simulated alcohol-impaired patient (p = 0.087 compared to pre-instruction). Instruction can improve pharmacy students' ability to incorporate a computer into SPEs, a critical skill in building and maintaining rapport with patients and improving efficiency of patient visits. Complex encounters may affect students' ability to utilize a computer appropriately. Students may benefit from repeated practice with this skill, especially with SPEs of increasing complexity. Copyright © 2016 Elsevier Inc. All rights reserved.

Impact of Multiple Pharmacy Use on Medication Adherence and Drug-drug Interactions in Older Adults with Medicare Part D

PubMed Central

Marcum, Zachary A.; Driessen, Julia; Thorpe, Carolyn T.; Gellad, Walid F.; Donohue, Julie M.

2014-01-01

Objective To assess the association between multiple pharmacy use and medication adherence and potential drug-drug interactions (DDIs) among older adults. Design, Setting, and Participants Cross-sectional propensity score-weighted analysis of 2009 claims data from a nationally representative sample of 926,956 Medicare Part D beneficiaries aged >65 continuously enrolled in fee-for-service Medicare and Part D that year, and filled >1 prescription at a community/retail or mail order pharmacy. Multiple pharmacy use was defined as concurrent (overlapping time periods) or sequential use (non-overlapping time periods) of >2 pharmacies in the year. Measurements Medication adherence was calculated using a proportion of days covered ≥0.80 for eight therapeutic categories (β-blockers, renin angiotensin system antagonists, calcium channel blockers, statins, sulfonylureas, biguanides [i.e., metformin], thiazolidinediones, and dipeptidyl peptidase-IV inhibitors). Potential DDIs arising from use of certain drugs across a broad set of classes were defined as the concurrent filling of two interacting drugs. Results Overall, 38.1% of the sample used multiple pharmacies. Those using multiple pharmacies (both concurrently and sequentially) consistently had higher adjusted odds of non-adherence (ranging from 1.10 to 1.31, p<0.001) across all chronic medication classes assessed after controlling for socio-demographic, health status and access to care factors, compared to single pharmacy users. The adjusted predicted probability of exposure to a DDI was also slightly higher for those using multiple pharmacies concurrently (3.6%) compared to single pharmacy users (3.2%, AOR 1.11, 95% CI 1.08–1.15) but lower in individuals using multiple pharmacies sequentially (2.8%, AOR 0.85, 95% CI 0.81–0.91). Conclusions Filling prescriptions at multiple pharmacies was associated with lower medication adherence across multiple chronic medications, and a small but statistically significant increase in DDIs among concurrent pharmacy users. PMID:24521363

Applications of a Pharmacokinetic Simulation Program in Pharmacy Courses.

ERIC Educational Resources Information Center

Ingram, D.; And Others

1979-01-01

Presents a multicompartment model which illustrates aspects of drug absorption, distribution, and elimination in the human body for a course in pharmacokinetics. The course work consists of the interpretation of computer generated simulated data. (Author/CMV)

Dual Degree Programs at the University of Kentucky College of Pharmacy

PubMed Central

Senft, Sandra L.; Thompson, Chad

2008-01-01

The rapid growth and evolution of the pharmacy profession has created a wide array of opportunities for graduating pharmacists beyond traditional community pharmacy or hospital practice. Management and leadership positions in federal and state healthcare agencies, pharmaceutical companies, hospitals, retail pharmacies, academia and managed care organizations increasingly require the pharmaceutical knowledge obtained through a doctor of pharmacy (PharmD) degree combined with financial, organizational, and management skills. In these innovative positions, pharmacists are being called upon to assume responsibilities as executives and administrators in systems providing pharmacist care services to patients. To endow students with knowledge and skills required to perform the duties required in these decision-making positions, the University of Kentucky College of Pharmacy has established 3 joint degree programs: the PharmD/Master of Business Administration (PharmD/MBA), PharmD/Master of Public Administration (PharmD/MPA), and PharmD/Master of Science in Economics (PharmD/MS). This paper describes these joint degree programs. PMID:18322574

Uncertainty and Motivation to Seek Information from Pharmacy Automated Communications.

PubMed

Bones, Michelle; Nunlee, Martin

2018-05-28

Pharmacy personnel often answer telephones to respond to pharmacy customers (subjects) who received messages from automated systems. This research examines the communication process in terms of how users interact and engage with pharmacies after receiving automated messages. No study has directly addressed automated telephone calls and subjects' interactions. The purpose of this study is to test the interpersonal communication (IC) process of uncertainty in subjects in receipt of automated telephone calls ATCs from pharmacies. Subjects completed a survey of validated scales for Satisfaction (S); Relevance (R); Quality (Q); Need for Cognitive Closure (NFC). Relationships between S, R, Q, NFC, and subject preference to ATCs were analyzed to determine whether subjects contacting pharmacies display information seeking behavior. Results demonstrated that seeking information occurs if subjects: are dissatisfied with the content of the ATC; perceive that the Q of ATC is high and like receiving the ATC, or have a high NFC and do not like receiving ATCs. Other interactions presented complexities amongst uncertainty and tolerance of NFC within the IC process.

A Blueprint for Pharmacy Benefit Managers to Increase Value

PubMed Central

Shrank, William H.; Porter, Michael E.; Jain, Sachin H.; Choudhry, Niteesh K.

2009-01-01

Pharmacy benefit managers (PBMs) have a unique opportunity to promote health and generate value in the healthcare system. Today, PBMs are largely evaluated on their ability to control costs rather than improve health. Pharmacy benefit managers should be evaluated along 3 dimensions in which they can increase value: (1) use of cost-effective medications, (2) timely initiation of appropriate medication therapy, and (3) adherence to that therapy. Value creation requires the development of integrated data systems, stronger partnerships with patients and physicians, and improved measurement and reporting of results. Incentives for PBMs to promote value should drive innovation and improve health outcomes. PMID:19284805

Effect of attitudes and perceptions of independent community pharmacy owners/managers on the comprehensiveness of strategic planning.

PubMed

Harrison, Donald L

2006-01-01

To assess the attitudes and perceptions of independent community pharmacy owners/managers about the comprehensiveness of strategic planning conducted for their pharmacies. Cross-sectional study. United States. Nationwide random sample of 1,250 owners/managers of independent community pharmacies. Mailed survey. Comprehensiveness of strategic planning conducted; components used in the strategic planning process. Attitudes and perceptions of owners/managers of independent community pharmacies toward strategic planning. A total of 527 (42.1%) usable questionnaires were returned. Of the 141 (26.8%) respondents who indicated that they conduct strategic planning, most components of the process were used. However, only 78 (55.3%) of those respondents conducted a review of pharmacy systems, and only 60 (42.6%) periodically evaluated implemented strategies. Approximately 88% of the variance in comprehensiveness was accounted for by 12 variables identified as significantly associated with the comprehensiveness of strategic planning conducted by owners/managers of independent community pharmacies. These included factors such as favorable cost-benefit relationship, impact of the Medicare Modernization Act of 2003, and remaining competitive in the pharmacy marketplace. While a minority of the survey population, respondents who reported conducting strategic planning used a reasonably comprehensive process. Further, several variables were identified as significant factors associated with comprehensiveness of strategic planning conducted.

Knowledge, Attitudes, and Usage of Apitherapy for Disease Prevention and Treatment among Undergraduate Pharmacy Students in Lithuania

PubMed Central

Trumbeckaite, Sonata; Dauksiene, Jurgita; Bernatoniene, Jurga; Janulis, Valdimaras

2015-01-01

Traditional medicine therapies are historically used worldwide for disease prevention and treatment purposes. Apitherapy is part of the traditional medicine based on bee product use. Complementary medicine practices which incorporate use of some traditional herbal, mineral, or animal kind substances very often are discussed with pharmacy professionals because these products are often sold in pharmacies as dietary supplements. This study is aimed at determining the attitude, knowledge, and practices of apitherapy among undergraduated pharmacy students (Master of Pharmacy) who already have a pharmacy technician diploma and from 1 to 20 years of practice working in a community pharmacy as pharmacy assistants. A method of questionnaire was chosen. The questions about attitudes, experience, knowledge, and practices for disease prevention and treatment of different bee products, their safety, and informational sources were included. Respondents shared opinion that use of bee product is part of the traditional medicine. Most of them had experience on honey product use for treatment and disease prevention for themselves and their family members (62%) although the need of more evidence based information was expressed. The most known bee products were honey, propolis, and royal jelly. They are widely used for enhancing the immune system and prevention of respiratory tract infection. PMID:26697094

Knowledge, Attitudes, and Usage of Apitherapy for Disease Prevention and Treatment among Undergraduate Pharmacy Students in Lithuania.

PubMed

Trumbeckaite, Sonata; Dauksiene, Jurgita; Bernatoniene, Jurga; Janulis, Valdimaras

2015-01-01

Traditional medicine therapies are historically used worldwide for disease prevention and treatment purposes. Apitherapy is part of the traditional medicine based on bee product use. Complementary medicine practices which incorporate use of some traditional herbal, mineral, or animal kind substances very often are discussed with pharmacy professionals because these products are often sold in pharmacies as dietary supplements. This study is aimed at determining the attitude, knowledge, and practices of apitherapy among undergraduated pharmacy students (Master of Pharmacy) who already have a pharmacy technician diploma and from 1 to 20 years of practice working in a community pharmacy as pharmacy assistants. A method of questionnaire was chosen. The questions about attitudes, experience, knowledge, and practices for disease prevention and treatment of different bee products, their safety, and informational sources were included. Respondents shared opinion that use of bee product is part of the traditional medicine. Most of them had experience on honey product use for treatment and disease prevention for themselves and their family members (62%) although the need of more evidence based information was expressed. The most known bee products were honey, propolis, and royal jelly. They are widely used for enhancing the immune system and prevention of respiratory tract infection.

[Analysis of supplying situation in pharmacies. I. Supply with medicaments and health appliances from the viewpoint of pharmacies and distributors].

PubMed

Macesková, B; Vyhnalíková, J

2007-01-01

The paper describes the contemporary methods of ordering, their demands for time, and positive and negative aspects. The results of the analysis of the data from pharmacies were compared with the data found by analyzing the data provided by the distributor. The methodology of the paper includes: a questionnaire survey, the method of the autopicture, and an analysis of archival data from pharmacies and distributors. The most frequent response to the question concerning the number of supplying wholesale distributors is two (38.1% of pharmacies) and three (33.3 % of pharmacies); pharmacies receive supplies from them most frequently three times a day (28.1% of pharmacies). 61.9 % of pharmacies compile the orders intuitively, 38.1% of them use the possibilities of the automatic proposal of the order using a PC system. 66.6% of pharmacies utilize modem ordering whose advantages are rapidity (493%), time availability (41.2%), a list of confirmed preparations (28.5 %), and financial advantageousness (23.8 %). The average time of ordering amounts to 21 min a day for telephone orders and 4 min a day for modem orders, the average proportion in the use of the individual methods of ordering is 59.1% to 40.9% of items to the benefit of modem orders. A concrete pharmacy was selected to demonstrate the effect of changes resulting from the transition from exclusively telephonic ordering to prevalently modem ordering; saved time period amounted to 62.5 % (from 14.4 s to 5.4 s per 1 ordered item). The analysis of distributors' data reveals an increase in the share of the items and packages ordered via modem (from 22.2%, and 20.6%, respectively, in the year 2000, to 54.5% and 49.8%, respectively, in the year 2004).

Cross-Sectoral Partnerships: A Case Study of the Best Practices Used by CVS/Pharmacy in Developing Partnerships with the Public Workforce Development System in Minnesota

ERIC Educational Resources Information Center

Jacobsen, Nancy M.

2009-01-01

This dissertation explores the private-public sector partnership between CVS/pharmacy and the federal/state workforce development system in Minnesota. The study describes how CVS creates partnerships with the federal/state system of one-stop career centers and other partners in the workforce development arena such as community or faith-based…

Classification of medication incidents associated with information technology.

PubMed

Cheung, Ka-Chun; van der Veen, Willem; Bouvy, Marcel L; Wensing, Michel; van den Bemt, Patricia M L A; de Smet, Peter A G M

2014-02-01

Information technology (IT) plays a pivotal role in improving patient safety, but can also cause new problems for patient safety. This study analyzed the nature and consequences of a large sample of IT-related medication incidents, as reported by healthcare professionals in community pharmacies and hospitals. The medication incidents submitted to the Dutch central medication incidents registration (CMR) reporting system were analyzed from the perspective of the healthcare professional with the Magrabi classification. During classification new terms were added, if necessary. The principal source of the IT-related problem, nature of error. Additional measures: consequences of incidents, IT systems, phases of the medication process. From March 2010 to February 2011 the CMR received 4161 incidents: 1643 (39.5%) from community pharmacies and 2518 (60.5%) from hospitals. Eventually one of six incidents (16.1%, n=668) were related to IT; in community pharmacies more incidents (21.5%, n=351) were related to IT than in hospitals (12.6%, n=317). In community pharmacies 41.0% (n=150) of the incidents were about choosing the wrong medicine. Most of the erroneous exchanges were associated with confusion of medicine names and poor design of screens. In hospitals 55.3% (n=187) of incidents concerned human-machine interaction-related input during the use of computerized prescriber order entry. These use problems were also a major problem in pharmacy information systems outside the hospital. A large sample of incidents shows that many of the incidents are related to IT, both in community pharmacies and hospitals. The interaction between human and machine plays a pivotal role in IT incidents in both settings.

21 CFR 1307.11 - Distribution by dispenser to another practitioner or reverse distributor.

Code of Federal Regulations, 2014 CFR

2014-04-01

... distributions that a registered retail pharmacy makes to automated dispensing systems at long term care facilities for which the retail pharmacy also holds registrations do not count toward the 5 percent limit in...

21 CFR 1307.11 - Distribution by dispenser to another practitioner or reverse distributor.

Code of Federal Regulations, 2012 CFR

2012-04-01

... distributions that a registered retail pharmacy makes to automated dispensing systems at long term care facilities for which the retail pharmacy also holds registrations do not count toward the 5 percent limit in...

21 CFR 1307.11 - Distribution by dispenser to another practitioner or reverse distributor.

Code of Federal Regulations, 2011 CFR

2011-04-01

... distributions that a registered retail pharmacy makes to automated dispensing systems at long term care facilities for which the retail pharmacy also holds registrations do not count toward the 5 percent limit in...

21 CFR 1307.11 - Distribution by dispenser to another practitioner or reverse distributor.

Code of Federal Regulations, 2013 CFR

2013-04-01

... distributions that a registered retail pharmacy makes to automated dispensing systems at long term care facilities for which the retail pharmacy also holds registrations do not count toward the 5 percent limit in...

Pharmacy Dashboard: An Innovative Process for Pharmacy Workload and Productivity.

PubMed

Kinney, Ashley; Bui, Quyen; Hodding, Jane; Le, Jennifer

2017-03-01

Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy. Methods: Long Beach Memorial Hospital (462 adult beds) and Miller Children's and Women's Hospital of Long Beach (combined 324 beds) are tertiary not-for-profit, community-based hospitals that are served by one CIVAS pharmacy. Metrics to evaluate the effectiveness of CIVAS were developed and implemented on a dashboard in real-time from March 2013 to March 2014. Results: The metrics that were designed and implemented to evaluate the effectiveness of CIVAS were quality and value, financial resilience, and the department's people and culture. Using a dashboard that integrated these metrics, the accuracy of manufacturing defect-free products was ≥99.9%, indicating excellent quality and value of CIVAS. The metric for financial resilience demonstrated a cost savings of $78,000 annually within pharmacy by eliminating the outsourcing of products. People and value metrics on the dashboard focused on standard work, with an overall 94.6% compliance to the workflow. Conclusion: A unique dashboard that incorporated metrics to monitor 3 important areas was successfully implemented to improve the effectiveness of CIVAS pharmacy. These metrics helped pharmacy to monitor progress in real-time, allowing attainment of production goals and fostering continuous quality improvement through LEAN work.

Pharmacy Dashboard: An Innovative Process for Pharmacy Workload and Productivity

PubMed Central

Bui, Quyen; Hodding, Jane; Le, Jennifer

2017-01-01

Background: Innovative approaches, including LEAN systems and dashboards, to enhance pharmacy production continue to evolve in a cost and safety conscious health care environment. Furthermore, implementing and evaluating the effectiveness of these novel methods continues to be challenging for pharmacies. Objective: To describe a comprehensive, real-time pharmacy dashboard that incorporated LEAN methodologies and evaluate its utilization in an inpatient Central Intravenous Additives Services (CIVAS) pharmacy. Methods: Long Beach Memorial Hospital (462 adult beds) and Miller Children's and Women's Hospital of Long Beach (combined 324 beds) are tertiary not-for-profit, community-based hospitals that are served by one CIVAS pharmacy. Metrics to evaluate the effectiveness of CIVAS were developed and implemented on a dashboard in real-time from March 2013 to March 2014. Results: The metrics that were designed and implemented to evaluate the effectiveness of CIVAS were quality and value, financial resilience, and the department's people and culture. Using a dashboard that integrated these metrics, the accuracy of manufacturing defect-free products was ≥99.9%, indicating excellent quality and value of CIVAS. The metric for financial resilience demonstrated a cost savings of $78,000 annually within pharmacy by eliminating the outsourcing of products. People and value metrics on the dashboard focused on standard work, with an overall 94.6% compliance to the workflow. Conclusion: A unique dashboard that incorporated metrics to monitor 3 important areas was successfully implemented to improve the effectiveness of CIVAS pharmacy. These metrics helped pharmacy to monitor progress in real-time, allowing attainment of production goals and fostering continuous quality improvement through LEAN work. PMID:28439134

A Survey of Pharmacy Education in Thailand.

PubMed

Chanakit, Teeraporn; Low, Bee Yean; Wongpoowarak, Payom; Moolasarn, Summana; Anderson, Claire

2014-11-15

To explore the current status of pharmacy education in Thailand. The International Pharmaceutical Federation of the World Health Organization's (FIP-WHO) Global Survey of Pharmacy Schools was used for this study. The survey instrument was distributed to the deans of the 19 faculties (colleges) of pharmacy in Thailand. More than half the colleges have been in existence less than 20 years, and the government owns 80% of them. There were 2 paths of admission to study pharmacy: direct admission and central admission system. The doctor of pharmacy (PharmD) programs can be divided into 4 types. Approximately 60% of all teaching staff holds a doctoral degree. Regarding the work balance among teaching staff, around 60% focus on teaching activities, 20% focus on research, and less than 20% focus on patient care services concurrent with real practice teaching. The proportion of student time dedicated to theory, practice, and research in PharmD programs is 51.5%, 46.7%, and 1.8%, respectively. Sites owned by the colleges or by others were used for student training. Colleges followed the Office of the National Education Standards' Internal Quality Assurance (IQA) and External Quality Assurance (EQA), and the Pharmacy Council's Quality Assessment (ONESQA). This study provides a picture of the current status of curriculum, teaching staff, and students in pharmacy education in Thailand. The curriculum was adapted from the US PharmD program with the aim of meeting the country's needs and includes industrial pharmacy and public health tracks as well as clinical tracks. However, this transition in pharmacy education in Thailand needs to be monitored and evaluated.

Competition among pharmacies and the typology of services delivered: The Portuguese case.

PubMed

Martins, Lurdes; Queirós, Sónia

2015-05-01

To analyze the impact of individual and market characteristics (such as competition) on the typology of services delivered by a community pharmacy after a recent Portuguese pro-competitive regulatory change. In this paper, market concentration indices are used to identify market competition groups in the sample. These competition groups are then described with regard to the typology of services on offer by pharmacies within the group. Finally, a system of structural equations is estimated to verify if the decision of a pharmacy to offer or not to offer each of the studied pharmaceutical services is affected by local market regulated competition. In some cases, pharmacies belonging to different competition groups do not present significant differences in terms of the typology of services on offer, but according to our regressions, it seems that vaccines and medicines administration services, pharmaceutical care programmes and medicines management programmes are more likely to be offered in pharmacies located in higher competitive markets. These are also urban areas, in which there is already easy access to products sold in pharmacies, and to health services in general. Access to additional pharmacy services may in some cases increase as market competition increases. Thus, pro-competitive regulatory measures may have led to an asymmetric distribution of pharmacy services across the country, favouring more competitive urban marketplaces. If policy-makers are interested in a more symmetrical distribution of pharmacies services all over the country, they are recommended to take action to ensure equitable access to these services. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Quality-improvement initiatives focused on enhancing customer service in the outpatient pharmacy.

PubMed

Poulin, Tenley J; Bain, Kevin T; Balderose, Bonnie K

2015-09-01

The development and implementation of quality-improvement initiatives to enhance customer service in an outpatient pharmacy of a Veterans Affairs (VA) medical center are described. Historically low customer service satisfaction rates with the outpatient pharmacy at the Philadelphia Veterans Affairs Medical Center prompted this quality-improvement project. A three-question survey was designed to be easily and quickly administered to veterans in the outpatient pharmacy waiting area. Using 5-point Likert scale, veterans were asked to rate (1) their overall experience with the outpatient pharmacy service and (2) their satisfaction with the customer service provided by the pharmacy department. They were also asked how they thought the pharmacy department could improve its customer service. After receiving feedback from the survey, several quality-improvement initiatives were developed. The initiatives were categorized as environmental, personnel, communicative, and technological. For each initiative, one or more tasks were developed and the initiatives were subsequently implemented over eight months. After each task was completed, veterans were surveyed to measure the impact of the change. A total of 79 veterans were surveyed before the implementation of the quality-improvement initiatives, and 49% and 68% rated their experience with the outpatient pharmacy and customer service favorably, respectively. Twenty-five veterans were surveyed after the implementation of numerous quality-improvement interventions, with 44% and 72% rating their experience with the outpatient pharmacy and customer service favorably. Customer service satisfaction with an outpatient pharmacy service at a VA medical center was enhanced through the implementation of various quality-improvement initiatives. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Consultant's Playbook: A Survey of Pharmacy Consultant Experiences Among Hospitals In the University HealthSystem Consortium.

PubMed

Hicks, Dave; McCarthy, Bryan; Fanikos, John; Emamifar, Amir; Nedved, Andrea; Thompson, Bruce; Bender, Fred; McMahon, Patrick

2013-10-01

Our team surveyed a group of pharmacy directors to learn about their experiences with pharmacy consultants so that the directors might be able to use their consulting resources in a more effective manner. In May 2012, the University HealthSystem Consortium (UHC) Pharmacy Council Financial Performance Committee developed an electronic survey that collectively measured the characteristics, goals, and methodology of historical pharmacy consultant engagements and level of satisfaction. After e-mailing the initial electronic survey, we conducted follow-up telephone interviews with respondents from July through November 2012. These interviews were designed to include questions about expected outcomes, recommendations for evaluation processes, timelines for implementing the recommendations, consultants' expenses, and insights gained. A total of 23 pharmacy directors responded to the initial electronic survey; their organizations had engaged at least one consultant within the previous 5 years. Data were collected for 28 consultant engagements. Subsequent telephone interviews were conducted with 20 of the 23 pharmacy directors (87%) who completed the initial electronic survey, accounting for 25 of the 28 consultant engagements (89%). Cost reduction along with revenue enhancement was most often the focus of these engagements. These engagements were also mainly within the scope of an organization-wide effort initiated by the executive board or executive team. Consultant experiences varied greatly in terms of (1) the degree to which assistance was provided to the organization, (2) benchmarking methodologies and resources, and (3) timelines for implementing the consultants' recommendations. In general, most respondents rated their consultant experience as positive and were able to provide "pearls of wisdom" or lessons learned.

Skills and knowledge of informatics, and training needs of hospital pharmacists in Thailand: A self-assessment survey.

PubMed

Chonsilapawit, Teeraporn; Rungpragayphan, Suang

2016-10-01

Because hospital pharmacists have to deal with large amounts of health information and advanced information technology in practice, they must possess adequate skills and knowledge of informatics to operate efficiently. However, most current pharmacy curricula in Thailand barely address the principles and skills concerned with informatics, and Thai pharmacists usually acquire computer literacy and informatics skills through personal-interest training and self-study. In this study, we aimed to assess the skills and knowledge of informatics and the training needs of hospital pharmacists in Thailand, in order to improve curricular and professional development. A self-assessment postal survey of 73 questions was developed and distributed to the pharmacy departments of 601 hospitals throughout the country. Practicing hospital pharmacists were requested to complete and return the survey voluntarily. Within the 3 months of the survey period, a total of 805 out of 2002 surveys were returned. On average, respondents rated themselves as competent or better in the skills of basic computer operation, the Internet, information management, and communication. Understandably, they rated themselves at novice level for information technology and database design knowledge/skills, and at advanced beginner level for project, risk, and change management skills. Respondents believed that skills and knowledge of informatics were highly necessary for their work, and definitely needed training. Thai hospital pharmacists were confident in using computers and the Internet. They realized and appreciated their lack of informatics knowledge and skills, and needed more training. Pharmacy curricula and training should be developed accordingly. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Pharmacist-led Tdap vaccination of close contacts of neonates in a women's hospital.

PubMed

Mills, Brittany; Fensterheim, Leonard; Taitel, Michael; Cannon, Adam

2014-01-16

Pertussis can cause severe illness and death in infants. Immunization of family members with the tetanus toxoid, reduced diphtheria toxoids, and acellular pertussis (Tdap) vaccine can decrease risk of pertussis infection among infants. A community pharmacy on a women's hospital campus implemented a Tdap vaccination pilot program. To investigate the rate of Tdap vaccination among close contacts of neonates in a women's hospital pharmacy and to assess the impact of a coordinated pharmacy and hospital Tdap vaccination program. The intervention entailed education from hospital staff who explained the risks of pertussis, advocated the benefits of vaccination, and encouraged family members to be vaccinated. In the on-site clinic or in the pharmacy, pharmacists administered vaccine to eligible patients. Rates of Tdap vaccinations in the intervention pharmacy with in-hospital vaccination were compared to comparison pharmacies without Tdap interventions. In the pre-study period (December 2008-November 2010), there were 31 Tdap vaccinations administered at the intervention pharmacy (mean=1.3/month); during the study period (December 2010-November 2012), 2045 Tdap vaccinations were administered (mean=85.2/month). In four comparison hospital-campus pharmacies, there were 77 vaccinations (mean=0.8/month) during the pre-study period and 817 vaccinations (mean=8.5/month) during the study period. There were 155 vaccinations administered in 44 area-community pharmacies (mean=0.1/month) during the pre-study period and 2930 (mean=2.8/month) during the study period. The intervention pharmacy had the highest average monthly rate of change in Tdap volume from pre-study to study period (83.9), compared to comparison hospital-campus pharmacies (7.7, p<.001) and area-community pharmacies (2.7, p<.001). During the study period, the estimated Tdap vaccination coverage per live births was 8.1% in the intervention pharmacy versus 5.5% in the comparison hospital-campus pharmacies (p<.001). Tdap vaccination rates increased after implementation of the intervention program. This project illustrates how health systems and community pharmacists can collaborate to improve patient care. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

Overview of the hospital formulary systems in Hong Kong. Princess Margaret Hospital as a baseline.

PubMed

Chang, S; Wong, J W; Wong, C W; Chiu, H C; Raymond, K

1997-12-01

To investigate the popularity of formulary systems in all Hong Kong hospitals and to compare these with the newly introduced formulary system in a major government hospital, the Princess Margaret Hospital (PMH), as the baseline. Questionnaire and selected interviews by pharmacy students. All hospital pharmacies in Hong Kong. Department managers (directors of pharmacy services) of hospital pharmacies. The popularity of the hospitals' formulary systems and their formulary decision-making strategies. Calculations of cost savings of the new formulary system in PMH and a comparison of the PMH system with the US standards were also made. Among 38 responding hospitals, 35 (92%) had a formulary handbook and 21 (55.3%) claimed to have a formulary system. The evaluation processes and formulary decision-making procedures were found to be inadequate because basic components in drug evaluation (e.g., standardized criteria for drug evaluation) were not used regularly. However, the formulary system in PMH was found to be comparable with the US standards. Substantial cost savings were made through rejection of less cost-effective drugs by the Formulary Subcommittee in PMH. In general, comprehensive formulary systems are still not popular in Hong Kong. This may be due to insufficient staffing and lack of administrative and physicians' support. The new formulary system in PMH can be used as a model to develop a successful formulary system in which hospital pharmacists can prove their expertise for the benefit of both hospitals and patients in Hong Kong.

Impact of automated telephone messaging on zoster vaccination rates in community pharmacies.

PubMed

Hess, Rick

2013-01-01

To measure the impact of an automated outbound telephone messaging system on herpes zoster (HZ) vaccinations among older adults in the community pharmacy setting. Randomized controlled trial. 16 grocery store chain community pharmacies in Georgia and Tennessee, between December 2006 and May 2007. Adults 60 years or older who filled at least one prescription at a participating study pharmacy. A 30-second automated outbound telephone message was delivered to patient households monthly during the first week of March through May 2007. The message advertised that older adults should speak with their pharmacist about the risk for HZ and the availability of a new vaccine. HZ vaccinations based on pharmacy profile records. After 3 months, 146 and 46 vaccinations were administered to older adults among the study cohort populations, translating into HZ vaccination rates of 2.60% and 0.72% at intervention and control pharmacies, respectively (odds ratio 3.69 [95% CI 2.64-5.15], P < 0.001). Use of an automated outbound telephone messaging tool to inform older adults about their risk for HZ and the availability of a vaccine significantly improved vaccination rates in the community pharmacy setting.

[Cooperation of medical and pharmaceutical sciences between private and national universities to educate professionals in the fields of drug development and rational pharmacotherapy].

PubMed

Iwakawa, Seigo

2012-01-01

Cooperation in education and research in medical and pharmaceutical sciences between Kobe Pharmaceutical University and Kobe University was started in 2008 for training professionals in drug development and rational pharmacotherapy. Initially, we started a two-year pharmacy residency program. Our pharmacy residents can attend lectures at our universities, and they also help pharmacist preceptors educate undergraduate pharmacy students in practical training. As curricula for cooperative education of pharmacy, nursing and medical students, we developed two new elective subjects (early exposure to clinical training for first year students and IPW (inter-professional work) seminar for fifth year pharmacy students) to learn about the roles of health care professionals in a medical team. Cooperative research between faculty members and graduate students is also in progress. For faculty and staff developments, invited lectures by clinical pharmacy and medical professors from the United States on the clinical education system in pharmacy and medicine in the United States have been held. This systematic cooperation will contribute to the promotion of a new curriculum for inter-professional education in the health-science fields.

Acceptance of clinical decision support surveillance technology in the clinical pharmacy.

PubMed

English, Dan; Ankem, Kalyani; English, Kathleen

2017-03-01

There are clinical and economic benefits to incorporating clinical decision support systems (CDSSs) in patient care interventions in the clinical pharmacy setting. However, user dissatisfaction and resistance to HIT can prevent optimal use of such systems, particularly when users employ system workarounds and overrides. The present study applied a modified version of the unified theory of acceptance and use of technology (UTAUT) to evaluate the disposition and satisfaction with CDSS among clinical pharmacists who perform surveillance to identify potential medication therapy interventions on patients in the hospital setting. A survey of clinical pharmacists (N = 48) was conducted. Partial least squares (PLS) regression was used to analyze the influence of the UTAUT-related variables on behavioral intention and satisfaction with CDSS among clinical pharmacists. While behavioral intention did not predict actual use of HIT, facilitating conditions had a direct effect on pharmacists' use of CDSS. Likewise, satisfaction with CDSS was found to have a direct effect on use, with more satisfied users being less inclined to employ workarounds or overrides of the system. Based on the findings, organizational structures that facilitate CDSS use and user satisfaction affect the extent to which pharmacy and health care management maximize use in the clinical pharmacy setting.

Customer assessment of long-term care pharmacy provider services.

PubMed

Clark, Thomas R

2008-09-01

Assess performance of long-term care pharmacy providers on key services offered to nursing facilities. Cross-sectional; nursing facility team. Random phone survey of nursing facility team members. 485 nursing facility team members (practicing in nursing facilities, interacting with > or = 1 consultant pharmacist); 46 members excluded, unable to identify facility's pharmacy provider. Directors of nursing, medical directors, and administrators were asked to rate long-term care pharmacy provider performance of eight commonly offered pharmacy services. All groups evaluated pharmacy provider performance of these services using a five-point scale. Results are broken down by employer type. Average rating for eight pharmacy services was 3.64. Top two services: "Labeling medications accurately" ranked in top 1-2 services for all groups (combined rating of 3.97) and "Provides medication administration system" ranked in top 1-3 services for all groups (combined rating of 3.95). One service, "Provides educational inservices," ranked lowest for all groups (combined rating of 3.54). In general, when looking at the eight services in combination for all providers, all services were ranked between Good and Very Good (average score of 3.64). Therefore, while the pharmacy provider is performing above average for these services, there is room for improvement in all of these services. These results can be used as a benchmark. Detailed data results and sample surveys are available online at www.ascp.com/supplements. These surveys can be used by the pharmacy provider to solicit assessments from their own facilities on these services.

A national survey on the current status of informatics residency education in pharmacy.

PubMed

Blash, Anthony; Saltsman, Connie L; Steil, Condit

2017-11-01

Upon completion of their post-graduate training, pharmacy informatics residents need to be prepared to interact with clinical and technology experts in the new healthcare environment. This study describes pharmacy informatics residency programs within the United States. Preliminary information for all pharmacy informatics residency programs was accessed from program webpages. An email was sent out to programs asking them to respond to a six-item questionnaire. This questionnaire was designed to elicit information on attributes of the program, behaviors of the preceptors and residents, and attitudes of the residency directors. Of 22 pharmacy informatics residencies identified, nineteen (86%) participated. Twenty (91%) were second post-graduate year (PGY2) residencies. Ten (45%) were accredited by the American Society of Health-System Pharmacists (ASHP), while eight (36%) were candidates for accreditation. Hospital (17/22, 77%) and administrative offices (3/22, 14%) were the predominant training sites for pharmacy informatics residents. Large institutions were the predominant training environment for the pharmacy informatics resident, with 19 of 22 (86%) institutions reporting a licensed bed count of 500 or more. The median (range) number of informatics preceptors at a site was six to eight. Regarding barriers to pharmacy informatics residency education, residency directors reported that residents did not feel prepared based on the limited availability of curricular offerings. In the United States, relatively few residencies are explicitly focused on pharmacy informatics. Most of these are accredited and hospital affiliated, especially with large institutions (>500 beds). Copyright © 2017 Elsevier Inc. All rights reserved.

Community pharmacy owners' views of star ratings and performance measurement: In-depth interviews.

PubMed

Teeter, Benjamin S; Fox, Brent I; Garza, Kimberly B; Harris, Stanley G; Nau, David P; Owensby, Justin K; Westrick, Salisa C

2016-01-01

The star rating system implemented by Medicare has the potential to positively affect patient health and may have financial implications for community pharmacies. Learning from owners of community pharmacies with high performance on these quality measures may help us to identify and further understand factors contributing to their success. This study described high-performing community pharmacy owners' current awareness and knowledge of star ratings, attitudes toward star ratings and performance measurement, and initiatives being offered in pharmacies that aim to improve the quality of care. Qualitative interviews with owners of independent community pharmacies were conducted in Spring 2015. Fifteen community pharmacies with high performance on the star rating measures were invited to participate. Recruitment did not end until the saturation point had been reached. All interviews were transcribed verbatim. Interview data were analyzed with the use of ATLAS.ti by 2 coders trained in thematic analysis. Krippendorf's alpha was calculated to assess intercoder reliability. Ten high-performing pharmacy owners participated. Analysis identified 8 themes, which were organized into the following categories: 1) current awareness and knowledge (i.e., superficial or advanced knowledge); 2) attitudes toward star ratings (positive perceptions, skeptical of performance rewards, and lack a feeling of control); and 3) pharmacy initiatives (personal patient relationships, collaborative employee relationships, and use of technology). Intercoder reliability was good overall. Interviews with high-performing pharmacies suggested that awareness of the star rating measures, overall positive attitudes toward the star ratings, the relationships that pharmacy owners have with their patients and their employees, and the use of technology as a tool to enhance patient care may contribute to high performance on the star rating measures. Future research is needed to determine if and how these constructs are associated with pharmacy performance in a larger population. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

From A to Z: Medication Cost-Management Strategies for Disproportionate Share Hospitals

PubMed Central

Henry, Andrea; Erowele, Goldina Ikezuagu; Ndefo, Uche Anadu; Milton-Brown, Jackie; Anassi, Enock; Green, Wendy; Alvidrez, Adriana; Okpara, Alphonsus U.

2011-01-01

Background Harris County Hospital District, Houston, TX, is a publicly funded hospital system that provides care to residents of Harris County with a need-based payment system. The Harris County Hospital District pharmacy department, with a drug budget of more than $75 million in fiscal year 2010, utilizes a closed formulary system that is managed by the Formulary Management and Pharmacoeconomics Service, along with the medical staff. This service is comprised of clinical pharmacists whose goal is to provide a comprehensive, safe, and cost-effective formulary. Objective To describe the unique formulary management process at a county hospital system and what makes this process cost-effective, which may benefit pharmacy departments in institutions serving an indigent patient population. Summary The Harris County Hospital District drug formulary is overseen by the Pharmacy & Therapeutics committee, which is supported by 5 therapeutic subcommittees, including antimicrobials, cardiovascular, general formulary, central nervous system, and oncology. The Pharmacy & Therapeutics Committee consists of a medical staff committee that is supported by clinical pharmacists, who serve as the facilitators of these 5 subcommittees. Their responsibilities include the provision of drug information for formulary decisions, providing parameters to govern the use of certain medications, communicating changes to the formulary, conducting class reviews and medication utilization evaluations, coordinating annual pharmaceutical bids, reviewing and writing medication use policies and procedures, facilitating the use of cost-effective medications, and monitoring the use of medications in the hospital system. Conclusion The processes incorporated by Harris County Hospital District in its formulary management are cost-effective and may be beneficial to other pharmacy departments, especially those institutions that serve an indigent patient population and are interested in cost-effective management strategies. PMID:25126349

Pharmacist-initiated hepatitis C virus screening in a community pharmacy to increase awareness and link to care at the medical center.

PubMed

Isho, Nadine Y; Kachlic, Marlowe Djuric; Marcelo, Jennifer Chan; Martin, Michelle T

To describe the design and implementation of a pharmacist-led hepatitis C virus (HCV) screening and education program in a community pharmacy with a protocol for linkage to care at the affiliated hepatology clinic for patients born between 1945 and 1965. Outpatient pharmacy affiliated with the University of Illinois Hospital and Health Sciences System. The community pharmacist resident conducted the HCV screening at the health system-based community pharmacy. Community pharmacists provided patients with HCV screening and education while patients waited for their prescriptions to be ready or upon appointment. Patients were given a questionnaire before and after HCV education to assess the impact of pharmacist-provided education on patient knowledge. A protocol was developed to link patients with a positive HCV antibody test result to care with a hepatologist for confirmatory testing at a follow-up appointment at the medical center. Investigators assessed the feasibility of providing the screening and education, recorded the number of patients screened, and recorded the differences in the questionnaire responses before and after education. Pharmacist-led HCV screening services were implemented successfully at the community pharmacy. All patients had a negative antibody result; therefore, linkage to care at the medical center, although available, was not necessary. The self-reported posttest HCV knowledge scores were significantly higher than pretest scores. This article outlines the methodology for providing a multidisciplinary HCV screening, education, and referral program in a community pharmacy affiliated with a medical center. Pharmacist-initiated HCV screening in a community pharmacy can assist with identifying patients at risk for HCV infection and provide patients with linkage to care in the health system. This report may encourage community pharmacists to conduct future prospective trials to evaluate clinical and economic outcomes of community-based HCV screenings. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Data analyst technician: an innovative role for the pharmacy technician.

PubMed

Ervin, K C; Skledar, S; Hess, M M; Ryan, M

2001-10-01

The development of an innovative role for the pharmacy technician is described. The role of the pharmacy technician was based on a needs assessment and the expertise of the pharmacy technician selected. Initial responsibilities of the technician included chart reviews, benchmarking surveys, monthly financial impact analysis, initiative assessment, and quality improvement reporting. As the drug-use and disease-state management (DUDSM) program expanded, pharmacist activities increased, requiring the expansion of data analyst technician (DAT) duties. These new responsibilities included participation in patient assessment, data collection and interpretation, and formulary enforcement. Most recently, technicians' expanded duties include maintenance of a physician compliance profiling database, quality improvement reporting and graphing, active role in patient risk assessment and database management for adult vaccination, and support of financial impact monitoring for other institutions within the health system. This pharmacist-technician collaboration resulted a threefold increase in patient assessments completed per day. In addition, as the DUDSM program continues to expand across the health system, an increase in DAT resources from 0.5 to 1.0 full-time equivalent was obtained. The role of the DAT has increased the efficiency of the DUDSM program and has provided an innovative role for the pharmacy technician.

Racial differences in acquisition of syringes from pharmacies under conditions of legal but restricted sales.

PubMed

Costenbader, Elizabeth C; Zule, William A; Coomes, Curtis C

2010-09-01

Injecting drug users (IDUs) are at increased risk of acquiring and transmitting HIV and other bloodborne pathogens through the multi-person use of syringes. Although research has shown that increased access to syringes through syringe exchange programs (SEPs) is an effective strategy to reduce risky injection practices many areas of the United States still do not have SEPs. In the absence of SEPs, legislation allowing pharmacies over-the-counter sales of syringes has also been shown to reduce syringe sharing. The success of pharmacy sales however is limited by other legal stipulations, such as drug paraphernalia laws, which in turn may contribute to fear among IDUs about being caught purchasing and carrying syringes. Between 2003 and 2006, 851 out-of-treatment IDUs were recruited using street outreach in the Raleigh-Durham (North Carolina) area. Data were collected using audio-computer assisted interview (ACASI) technology. Multiple logistic regression analyses were performed to assess factors associated with purchasing syringes from pharmacies. In our study sample, African-American IDUs were one-fifth as likely as white IDUs to report pharmacies as their primary source of syringes. Given the absence of syringe exchange programs and the relatively high prevalence of HCV and HIV among IDUs in the Raleigh-Durham area, the limited use of pharmacies as a source of syringes among African-American IDUs in this study sample is problematic. The study findings support the need for effective multilevel interventions to increase access to clean needles in this population, as well as for policy interventions, such as legalization of SEPs and elimination of penalties for carrying syringes, to reduce harm and eliminate the health threats posed by receptive syringe sharing. Copyright 2010 Elsevier B.V. All rights reserved.

Pharmacy practice and injection use in community pharmacies in Pokhara city, Western Nepal

PubMed Central

2014-01-01

Background Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. Methods A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. Results Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The ‘Current Index of Medical Specialties’ was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. Conclusions Community pharmacies in Pokhara offer a wide range of services including, but not limited to, drug dispensing, counseling, dressing of wounds, and administering injections. However, the lack of qualified staff and adequate infrastructure may be compromising the quality of the services offered. Therefore, the health authorities should take the necessary measures to upgrade the qualifications of the personnel and to improve the infrastructure for the sake of good pharmacy practice and the safer use of injections. PMID:24774195

Implementation of a pharmacy automation system (robotics) to ensure medication safety at Norwalk hospital.

PubMed

Bepko, Robert J; Moore, John R; Coleman, John R

2009-01-01

This article reports an intervention to improve the quality and safety of hospital patient care by introducing the use of pharmacy robotics into the medication distribution process. Medication safety is vitally important. The integration of pharmacy robotics with computerized practitioner order entry and bedside medication bar coding produces a significant reduction in medication errors. The creation of a safe medication-from initial ordering to bedside administration-provides enormous benefits to patients, to health care providers, and to the organization as well.

[Comparative analysis of impact factor and h-index for pharmacology journals].

PubMed

Bador, Pascal; Lafouge, Thierry

2010-01-01

Using the strictly same parameters (identical two publication years (2004-2005) and identical one-year citation window (2006)), impact factor (IF) 2006 was compared with h-index 2006 for one sample of "pharmacology and pharmacy" journals computed from the ISI Web of Science. For this sample, the IF and the h-index rankings of the journals are very different. The correlation coefficient between the IF and the h-index is low for "pharmacology and pharmacy" journals. The IF and h-index can be completely complementary when evaluating journals of the same scientific discipline. 2010 Société Française de Pharmacologie et de Thérapeutique.

["Hormone bomb": risks of emergency contraception from the perspective of pharmacy attendants in Rio de Janeiro, Brazil].

PubMed

Brandão, Elaine Reis; Cabral, Cristiane da Silva; Ventura, Miriam; Paiva, Sabrina Pereira; Bastos, Luiza Lena; Oliveira, Naira Villas Boas Vidal de; Szabo, Iolanda

2016-09-19

This study focused on views towards emergency contraception among pharmacy attendants in Greater Metropolitan Rio de Janeiro, Brazil. The empirical material came from a socio-anthropological study with 20 semi-structured interviews of pharmacy attendants of both sexes (8 females and 12 males). The interviews showed negative views of emergency contraception, emphasizing its potential health risks. Interviews considered emergency contraception a "hormone bomb" that can harm the female reproductive organs and other organ systems. The pharmacy attendants highlighted the risks of "uncontrolled" or "indiscriminate" use, especially by adolescents and young women. Since they considered it "dangerous" to women's bodies, they assigned the responsibility for orientation and counseling on use of the method to gynecologists rather than to pharmacists. The article discusses the need to expand the public debate on emergency contraception in Brazil to include pharmacists and pharmacy attendants, in addition to health professionals in general and teachers.

Education of Pharmacists in Canada

PubMed Central

Ensom, Mary H.H.

2008-01-01

In Canada, the education of pharmacists is built upon a foundation of strong, research-intensive publicly funded universities and a universal health-care system that balances government and private financing for prescription medications. The evolution of pharmacy education and practice in Canada has laid the foundation for a variety of emerging trends related to expanded roles for pharmacists, increasing interprofessional collaboration for patient-centered care, and emergence of pharmacy technicians as a soon-to-be regulated professional group in parts of the country. Current challenges include the need to better integrate internationally educated pharmacists within the domestic workforce and tools to ensure continuous professional development and maintenance of competency of practitioners. Academic pharmacy is currently debating how best to manage the need to enhance the pharmacy curriculum to meet current and future skills needs, and whether a doctor of pharmacy (PharmD) degree ought to become the standard entry-to-practice qualification for pharmacists in Canada. PMID:19325948

Incorporating Health Information Technology and Pharmacy Informatics in a Pharmacy Professional Didactic Curriculum -with a Team-based Learning Approach.

PubMed

Hincapie, Ana L; Cutler, Timothy W; Fingado, Amanda R

2016-08-25

Objective. To incorporate a pharmacy informatics program in the didactic curriculum of a team-based learning institution and to assess students' knowledge of and confidence with health informatics during the course. Design. A previously developed online pharmacy informatics course was adapted and implemented into a team-based learning (TBL) 3-credit-hour drug information course for doctor of pharmacy (PharmD) students in their second didactic year. During a period of five weeks (15 contact hours), students used the online pharmacy informatics modules as part of their readiness assurance process. Additional material was developed to comply with the TBL principles. Online pre/postsurveys were administered to evaluate knowledge gained and students' perceptions of the informatics program. Assessment. Eighty-three second-year students (84% response rate) completed the surveys. Participants' knowledge of electronic health records, computerized physician order entry, pharmacy information systems, and clinical decision support was significantly improved. Additionally, their confidence significantly improved in terms of describing health informatics terminology, describing the benefits and barriers of using health information technology, and understanding reasons for systematically processing health information. Conclusion. Students responded favorably to the incorporation of pharmacy informatics content into a drug information course using a TBL approach. Students met the learning objectives of seven thematic areas and had positive attitudes toward the course after its completion.

Pharmacy and freedom.

PubMed

Cowen, D L

1984-03-01

The development of pharmacy in Western civilization has been influenced by ideas of individual liberty; the impact of these ideas is traced. For a short time during the French Revolution, individuals without qualifications could practice pharmacy, but abuses prompted return of regulation; from 1803, pharmacy was closely regulated by the state. Liberal thinking in 19th-century Britain left control of pharmacy mainly within the profession; regulation was definitive rather than restrictive. With the influence of Jacksonian Democracy and freedom of trade in the United States, there were no effective pharmacy regulations until the late 19th century and few educational requirements for licensure until the 1920s. In Germany, the old system of concessions and privileges was upset after World War II when any qualified pharmacist was allowed to open a shop wherever desired in the American-occupied zone; the courts upheld this policy as the basis for establishment of pharmacies in West Germany. Liberty in dispensing drugs has been limited out of concern for the well-being of individuals and of society as a whole. In Great Britain and the U.S., restrictions on dispensing antedated laws establishing qualifications for pharmacists. The history of pharmacy demonstrates that there are moral and social barriers to realization of the ideals of liberty. History also suggests that if pharmacists assume responsibilities that use their specialized training, they can defend against inroads by nonpharmacists.

Future-proofing the pharmacy profession in a hypercompetitive market.

PubMed

Singleton, Judith A; Nissen, Lisa M

2014-01-01

This paper highlights the hypercompetitive nature of the current pharmacy landscape in Australia and to suggest either a superior level of differentiation strategy or a focused differentiation strategy targeting a niche market as two viable, alternative business models to cost leadership for small, independent community pharmacies. A description of the Australian health care system is provided as well as background information on the current community pharmacy environment in Australia. The authors propose a differentiation or focused differentiation strategy based on cognitive professional services (CPS) which must be executed well and of a superior quality to competitors' services. Market research to determine the services valued by target customers and that they are willing to pay for is vital. To achieve the superior level of quality that will engender high patient satisfaction levels and loyalty, pharmacy owners and managers need to develop, maintain and clearly communicate service quality specifications to the staff delivering these services. Otherwise, there will be a proliferation of pharmacies offering the same professional services with no evident service differential. However, to sustain competitive advantage over the long-term, these smaller, independent community pharmacies will need to exploit a broad core competency base in order to be able to continuously introduce new sources of competitive advantage. With the right expertise, the authors argue that smaller, independent community pharmacies can successfully deliver CPS and sustain profitability in a hypercompetitive market. Copyright © 2014 Elsevier Inc. All rights reserved.

Is point of access to needles and syringes related to needle sharing? Comparing data collected from pharmacies and needle and syringe programs in south-east Sydney.

PubMed

Bryant, Joanne; Topp, Libby; Hopwood, Max; Iversen, Jenny; Treloar, Carla; Maher, Lisa

2010-07-01

The comprehensive needle and syringe distribution system in New South Wales is partly based on the premise that different points of access to injecting equipment may attract different groups of injecting drug users. This paper examines patterns of equipment acquisition and risk for blood-borne virus transmission among injecting drug users who use pharmacies and needle and syringe programs (NSP) in south-east Sydney. Clients obtaining injecting equipment from four NSP (n = 147) and eight pharmacies (n = 227) in 2006 voluntarily completed a self-administered questionnaire. Respondents were grouped into three categories based on their needle and syringe acquisition patterns: exclusive use of NSP, exclusive use of pharmacies and use of both. Although it was common for respondents to report using both pharmacies and NSP to obtain needles and syringes (57%), a proportion reported exclusive use of pharmacies (17%) and NSP (14%). Exclusive pharmacy users were more likely to have never received treatment for their drug use and the least likely to have had a recent test for hepatitis C. Compared with respondents who exclusively used NSP, respondents who exclusively used pharmacies were more likely to report receptive sharing of injecting equipment (adjusted odds ratio 5.9, 95% confidence interval 2.02-17.14), as were respondents who reported using both sources (adjusted odds ratio 5.8, 95% confidence interval 2.35-14.40). The high prevalence of receptive equipment sharing among pharmacy clients indicates a need to improve access to needles and syringes and ancillary equipment, possibly by including ancillary equipment at no cost in existing pre-packaged pharmacy products.

Using grey literature to prepare pharmacy students for an evolving healthcare delivery system.

PubMed

Happe, Laura E; Walker, Desiree'

2013-05-13

To assess the impact of using "grey literature" (information internally produced in print or electronic format by agencies such as hospitals, government, businesses, etc) rather than a textbook in a course on healthcare delivery systems on students' perception of the relevance of healthcare delivery system topics and their ability to identify credible sources of this information. A reading from the grey literature was identified and assigned to the students for each topic in the course. Pre- and post-course survey instruments were used for the assessment. Students reported healthcare delivery systems topics to be moderately relevant to the profession of pharmacy on both the pre- and post-course survey instruments. Students' knowledge of current and credible sources of information on healthcare delivery system topics significantly improved based on self-reports and scores on objective assessments (p<0.05). Assignment of grey literature in a course on healthcare delivery systems can be used to ensure that information in the pharmacy school curriculum is the most current and credible information available.

Economic Evaluation of Hospital and Community Pharmacy Services.

PubMed

Gammie, Todd; Vogler, Sabine; Babar, Zaheer-Ud-Din

2017-01-01

To review the international body of literature from 2010 to 2015 concerning methods of economic evaluations used in hospital- and community-based studies of pharmacy services in publicly funded health systems worldwide, their clinical outcomes, and economic effectiveness. The literature search was undertaken between May 2, 2015, and September 4, 2015. Keywords included "health economics" and "evaluation" "assessment" or "appraisal," "methods," "hospital" or "community" or "residential care," "pharmacy" or "pharmacy services" and "cost minimisation analysis" or "cost utility analysis" or "cost effectiveness analysis" or "cost benefit analysis." The databases searched included MEDLINE, PubMed, Google Scholar, Science Direct, Springer Links, and Scopus, and journals searched included PLoS One, PLoS Medicine, Nature, Health Policy, Pharmacoeconomics, The European Journal of Health Economics, Expert Review of Pharmacoeconomics and Outcomes Research, and Journal of Health Economics. Studies were selected on the basis of study inclusion criteria. These criteria included full-text original research articles undertaking an economic evaluation of hospital- or community-based pharmacy services in peer-reviewed scientific journals and in English, in countries with a publicly funded health system published between 2010 and 2015. 14 articles were included in this review. Cost-utility analysis (CUA) was the most utilized measure. Cost-minimization analysis (CMA) was not used by any studies. The limited use of cost-benefit analyses (CBAs) is likely a result of technical challenges in quantifying the cost of clinical benefits, risks, and outcomes. Hospital pharmacy services provided clinical benefits including improvements in patient health outcomes and reductions in adverse medication use, and all studies were considered cost-effective due to meeting a cost-utility (per quality-adjusted life year) threshold or were cost saving. Community pharmacy services were considered cost-effective in 8 of 10 studies. Economic evaluations of hospital and community pharmacy services are becoming increasingly commonplace to enable an understanding of which health care services provide value for money and to inform policy makers as to which services will be cost-effective in light of limited health care resources.

Use of a pharmacy technician to facilitate postfracture care provided by clinical pharmacy specialists.

PubMed

Irwin, Adriane N; Heilmann, Rachel M F; Gerrity, Theresa M; Kroner, Beverly A; Olson, Kari L

2014-12-01

The ability of a pharmacy technician to support the patient screening and documentation-related functions of a pharmacist-driven osteoporosis management service was evaluated. A two-phase prospective study was conducted within a large integrated health system to assess a pharmacy technician's performance in supporting a multisite team of clinical pharmacy specialists providing postfracture care. In phase I of the study, a specially trained pharmacy technician provided support to pharmacists at five participating medical offices, helping to identify patients requiring pharmacist intervention and, when applicable, collecting patient-specific clinical information from the electronic health record. In phase II of the study, the amount of pharmacist time saved through the use of technician support versus usual care was evaluated. The records of 127 patient cases were reviewed by the pharmacy technician during phase I of the study, and a pharmacist agreed with the technician's determination of the need for intervention in the majority of instances (92.9%). An additional 91 patient cases were reviewed by the technician in phase II of the research. With technician support, pharmacists spent less time reviewing cases subsequently determined as not requiring intervention (mean ± S.D., 5.0 ± 3.8 minutes per case compared with 5.2 ± 4.5 minutes under the usual care model; p = 0.78). In cases requiring intervention, technician support was associated with a reduction in the average pharmacist time spent on care plan development (13.5 ± 7.1 minutes versus 18.2 ± 16.6 minutes with usual care, p = 0.34). The study results suggest that a pharmacy technician can accurately determine if a patient is a candidate for pharmacist intervention and collect clinical information to facilitate care plan development. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Potential drug-drug interactions between anti-cancer agents and community pharmacy dispensed drugs.

PubMed

Voll, Marsha L; Yap, Kim D; Terpstra, Wim E; Crul, Mirjam

2010-10-01

To identify the prevalence of potential drug-drug interactions between hospital pharmacy dispensed anti-cancer agents and community pharmacy dispensed drugs. A retrospective cohort study was conducted on the haematology/oncology department of the internal medicine ward in a large teaching hospital in Amsterdam, the Netherlands. Prescription data from the last 100 patients treated with anti-cancer agents were obtained from Paracelsus, the chemotherapy prescribing system in the hospital. The community pharmacy dispensed drugs of these patients were obtained by using OZIS, a system that allows regionally linked pharmacies to call up active medication on any patient. Both medication lists were manually screened for potential drug-drug interactions by using several information sources on interactions, e.g. Pubmed, the Flockhart P450 table, Micromedex and Dutch reference books. Prevalence of potential drug-drug interactions between anti-cancer agents provided by the hospital pharmacy and drugs dispensed by the community pharmacy. Ninety-one patients were included in the study. A total of 31 potential drug-drug interactions were found in 16 patients, of which 15 interactions were clinically relevant and would have required an intervention. Of these interactions 1 had a level of severity ≥ D, meaning the potential drug-drug interaction could lead to long lasting or permanent damage, or even death. The majority of the interactions requiring an intervention (67%) had a considerable level of evidence (≥ 2) and were based on well-documented case reports or controlled interaction studies. Most of the potential drug-drug interactions involved the antiretroviral drugs (40%), proton pump inhibitors (20%) and antibiotics (20%). The anti-cancer drug most involved in the drug-drug interactions is methotrexate (33%). This study reveals a high prevalence of potential drug-drug interactions between anti-cancer agents provided by the hospital pharmacy and drugs dispensed by the community pharmacy. It shows us there is need for an optimal medication surveillance mechanism to detect potential drug-drug interactions between these two groups of medication, especially because of the high toxicity of anticancer drugs and thus the severe consequences these interactions can have for the patient.

Prevalence and determinants of pharmacy shopping behaviour.

PubMed

Buurma, H; Bouvy, M L; De Smet, P A G M; Floor-Schreudering, A; Leufkens, H G M; Egberts, A C G

2008-02-01

Discontinuity of care bears the risk of medication errors and poor clinical outcomes. Little is known about the continuity of care related to pharmacies. Therefore, we studied the prevalence and determinants of pharmacy shopping behaviour in the Netherlands. Beneficiaries from a Dutch pharmacy claims database who had visited two or more pharmacies in 2001 were indicated as 'shoppers' (n = 45 805). A random sample was taken from all the other beneficiaries who had received at least one prescription: 'non-shoppers' (n = 45 805). Shoppers were classified as light (all patients who visited more than one pharmacy at least once in 2001, except for patients defined as heavy or moderate shoppers), moderate (visited 3 or 4 pharmacies and had proportion of prescriptions elsewhere >10% and number of prescriptions elsewhere >10) or heavy (visited 5 or more pharmacies and had proportion of prescriptions elsewhere >10% and number of prescriptions elsewhere >10). Determinants of shopping behaviour were investigated as well as the association between any dispensing of Anatomical Therapeutic Chemical (ATC) classes of drugs and this behaviour. 10.8% beneficiaries were identified as shoppers: 98.8%'light shoppers', 1.0%'moderate shoppers' and 0.2%'heavy shoppers'. Female gender [odds ratio (OR)(adj) 1.2; 95% confidence interval (CI) 1.1-1.2], younger age (OR(adj) 1.7; 95%CI 1.7-1.8), the use of > or =3 drugs (OR(adj) 2.9; 95%CI 2.8-3.0) and visiting different kind of prescribers (OR(adj) 2.4; 95%CI 2.4-2.5) were associated with shopping behaviour. Shoppers more frequently received at least one prescription for systemic anti-infectives (51.7% vs. 30.8%; OR 2.4; 95%Cl 2.3-2.5) and for nervous system drugs (46.2% vs. 29.3%; OR 2.1; 95%Cl 2.0-2.1). Pharmacy shopping behaviour is limited in the Netherlands. However, it may put the patient at risk for unintentional problems, such as drug-drug interactions with anti-infectives. A small proportion of patients exhibit possibly intentional shopping behaviour with psychotropic drugs.

Student pharmacists' perceptions of community pharmacy residency programs.

PubMed

Datar, Manasi V; Holmes, Erin R; Adams, Alex J; Stolpe, Samuel F

2013-01-01

To compare penultimate-year (next-to-last) and final-year student pharmacists' perceptions of the educational value of community pharmacy residency programs (CPRPs) and to compare student pharmacists' perceptions of the educational value of CPRPs and health-system residency programs (HSRPs). A self-administered online survey was sent to administrators at 119 Accreditation Council for Pharmacy Education-accredited schools of pharmacy for ultimate distribution to penultimate- and final-year student pharmacists. The survey included demographic measures and a 20-item residency program "perceived value of skill development" scale developed for this study. 1,722 completed surveys were received and analyzed. Penultimate-year students attributed greater value to CPRPs more frequently than final-year students. Students more often attributed higher value to CPRPs for skills related to business management, practice management, and medication therapy management, while they attributed higher value to HSRPs for skills related to teaching, research, and clinical knowledge. The results of this study suggest students' perceived value of CPRPs may be related to their year of pharmacy school and the pharmacy practice skill in question.

How Two Small Pharmacy Schools' Competency Standards Compare with an International Competency Framework and How Well These Schools Prepare Students for International Placements.

PubMed

Hawboldt, John; Nash, Rose; FitzPatrick, Beverly

2017-03-06

International standards of pharmacy curricula are necessary to ensure student readiness for international placements. This paper explores whether curricula from two pharmacy programs, in Australia and Canada, are congruent with international standards and if students feel prepared for international placements. Nationally prescribed educational standards for the two schools were compared to each other and then against the International Pharmaceutical Federation (FIP) Global Competency Framework. Written student reflections complemented this analysis. Mapping results suggested substantial agreement between the FIP framework and Australia and Canada, with two gaps being identified. Moreover, the students felt their programs prepared them for their international placements. Despite differences in countries, pharmacy programs, and health-systems all students acclimatized to their new practice sites. Implications are that if pharmacy programs align well with FIP, pharmacists should be able to integrate and practise in other jurisdictions that also align with the FIP. This has implications for the mobility of pharmacy practitioners to countries not of their origin of training.

Using Six Sigma to reduce medication errors in a home-delivery pharmacy service.

PubMed

Castle, Lon; Franzblau-Isaac, Ellen; Paulsen, Jim

2005-06-01

Medco Health Solutions, Inc. conducted a project to reduce medication errors in its home-delivery service, which is composed of eight prescription-processing pharmacies, three dispensing pharmacies, and six call-center pharmacies. Medco uses the Six Sigma methodology to reduce process variation, establish procedures to monitor the effectiveness of medication safety programs, and determine when these efforts do not achieve performance goals. A team reviewed the processes in home-delivery pharmacy and suggested strategies to improve the data-collection and medication-dispensing practices. A variety of improvement activities were implemented, including a procedure for developing, reviewing, and enhancing sound-alike/look-alike (SALA) alerts and system enhancements to improve processing consistency across the pharmacies. "External nonconformances" were reduced for several categories of medication errors, including wrong-drug selection (33%), wrong directions (49%), and SALA errors (69%). Control charts demonstrated evidence of sustained process improvement and actual reduction in specific medication error elements. Establishing a continuous quality improvement process to ensure that medication errors are minimized is critical to any health care organization providing medication services.

Pharmacy education in India: strategies for a better future.

PubMed

Jishnu, V; Gilhotra, Rm; Mishra, Dn

2011-10-01

In this world of specialization and globalization the pharmacy education in India is suffering from serious backdrops and flaws. There is an urgent need to initiate an academic exercise aimed at attaining revamping of curriculum, keeping in pace with current and emerging trends in the field of pharmacy. Unfortunately all these years, enough emphasis was not laid on strengthening the components of Community Pharmacy, Hospital and Clinical pharmacy, while designing curriculum at diploma and degree levels of teaching. The curriculum followed by almost all universities in India are no were up to the world standards and students are still getting the 20-30 yrs older compounding practical exposure in labs during the graduation level. The article emphasises the concept of innovation ecosystems and quality management. Application of TQM to the educational system improves the present situation. The counseling system which serves to be the gateway of the students for entry into the profession should be brought under the scanner. Introducing specializations at the graduation level will result in professional expertise and excellence. Education is a customer focused industry and every student should be capable of evaluating themselves for continuously improving their quality and professionalism. Teacher focused mastery learning should give away to student focused smart learning. An educational institution should provide the student with a stress-free atmosphere for learning and developing his intellectual capabilities. Every college should have a counseling centre to address the problems of students in their academic and personal life. An emphasis on the concept of quality teacher is included. Revival of the pharmacy education in India is the need of the hour which in turn will pave the way for the up gradation of the pharmacy profession in the country.

Clinical support role for a pharmacy technician within a primary care resource center.

PubMed

Fera, Toni; Kanel, Keith T; Bolinger, Meghan L; Fink, Amber E; Iheasirim, Serah

2018-02-01

The creation of a clinical support role for a pharmacy technician within a primary care resource center is described. In the Primary Care Resource Center (PCRC) Project, hospital-based care transition coordination hubs staffed by nurses and pharmacist teams were created in 6 independent community hospitals. At the largest site, patient volume for targeted diseases challenged the ability of the PCRC pharmacist to provide expected elements of care to targeted patients. Creation of a new pharmacy technician clinical support role was implemented as a cost-effective option to increase the pharmacist's efficiency. The pharmacist's work processes were reviewed and technical functions identified that could be assigned to a specially trained pharmacy technician under the direction of the PCRC pharmacist. Daily tasks performed by the pharmacy technician included maintenance of the patient roster and pending discharges, retrieval and documentation of pertinent laboratory and diagnostic test information from the patient's medical record, assembly of patient medication education materials, and identification of discrepancies between disparate systems' medication records. In the 6 months after establishing the PCRC pharmacy technician role, the pharmacist's completion of comprehensive medication reviews (CMRs) for target patients increased by 40.5% ( p = 0.0223), driven largely by a 42.4% ( p < 0.0001) decrease in the time to complete each chart review. The addition of a pharmacy technician to augment pharmacist care in a PCRC team extended the reach of the pharmacist and allowed more time for the pharmacist to engage patients. Technician support enabled the pharmacist to complete more CMRs and reduced the time required for chart reviews. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Pharmacy Education in India: Strategies for a Better Future

PubMed Central

Jishnu, V; Gilhotra, RM; Mishra, DN

2011-01-01

In this world of specialization and globalization the pharmacy education in India is suffering from serious backdrops and flaws. There is an urgent need to initiate an academic exercise aimed at attaining revamping of curriculum, keeping in pace with current and emerging trends in the field of pharmacy. Unfortunately all these years, enough emphasis was not laid on strengthening the components of Community Pharmacy, Hospital and Clinical pharmacy, while designing curriculum at diploma and degree levels of teaching. The curriculum followed by almost all universities in India are no were up to the world standards and students are still getting the 20-30 yrs older compounding practical exposure in labs during the graduation level. The article emphasises the concept of innovation ecosystems and quality management. Application of TQM to the educational system improves the present situation. The counseling system which serves to be the gateway of the students for entry into the profession should be brought under the scanner. Introducing specializations at the graduation level will result in professional expertise and excellence. Education is a customer focused industry and every student should be capable of evaluating themselves for continuously improving their quality and professionalism. Teacher focused mastery learning should give away to student focused smart learning. An educational institution should provide the student with a stress-free atmosphere for learning and developing his intellectual capabilities. Every college should have a counseling centre to address the problems of students in their academic and personal life. An emphasis on the concept of quality teacher is included. Revival of the pharmacy education in India is the need of the hour which in turn will pave the way for the up gradation of the pharmacy profession in the country. PMID:22224042

[Preventive measures for drug addiction in the middle scale hospital--our challenge for ideal drug management system in the operating rooms].

PubMed

Nakasuji, Masato; Tanaka, Masuji; Imanaka, Norie; Kawashima, Hiroko; Asada, Akira

2007-09-01

Drug addiction of doctors has become social problems recently due to inappropriate drug management system in the operating theater. It goes without saying that we must behave ourselves as doctors. In addition, current drug management system should be improved and all drugs stocked in the operating theater should be counted by pharmacists after surgery. Kansai Denryoku Hospital with four hundred beds started new drug management system in December 2005. Drug sets for each surgical patient in the cart are delivered from the pharmacy every morning. A drug set is carried to the each operating room by an anesthesiologist or a nurse and they write down administered drugs in the document after surgery. Pharmacists collect the drug cart the following morning and check each drug set and document in the pharmacy. All drugs can not be carried out from the operating theater without permission, and anesthesiologists and nurses do not have to spend too much time on drug management. Extra one hour is needed for pharmacists to check the drug set in the pharmacy. We consider that our new drug management system can substitute a satellite pharmacy, which is recognized currently as ideal drug management system in the operating theater, in the middle scale hospitals without enough pharmacists assigned exclusively to the operating theater.

A joint inventory policy under permissible delay in payment and stochastic demand (Case study: Pharmacy Department of Pariaman Hospital)

NASA Astrophysics Data System (ADS)

Jonrinaldi, Primadi, M. Yugo; Hadiguna, Rika Ampuh

2017-11-01

Inventory cannot be avoided by organizations. One of them is a hospital which has a functional unit to manage the drugs and other medical supplies such as disposable and laboratory material. The unit is called Pharmacy Department which is responsible to do all of pharmacy services in the hospital. The current problem in Pharmacy Department is that the level of drugs and medical supplies inventory is too high. Inventory is needed to keep the service level to customers but at the same time it increases the cost of holding the items, so there should be a policy to keep the inventory on an optimal condition. To solve such problem, this paper proposes an inventory policy in Pharmacy Department of Pariaman Hospital. The inventory policy is determined by using Economic Order Quantity (EOQ) model under condition of permissible delay in payment for multiple products considering safety stock to anticipate stochastic demand. This policy is developed based on the actual condition of the system studied where suppliers provided a certain period to Pharmacy Department to complete the payment of the order. Based on implementation using software Lingo 13.0, total inventory cost of proposed policy of IDR 137,334,815.34 is 37.4% lower than the total inventory cost of current policy of IDR 219,511,519.45. Therefore, the proposed inventory policy is applicable to the system to minimize the total inventory cost.

Linked electronic medication systems in community pharmacies for preventing pseudoephedrine diversion: a review of international practice and analysis of results in Australia.

PubMed

Berbatis, Constantine G; Sunderland, Vivian Bruce; Dhaliwal, Satvinder S

2009-11-01

Pseudoephedrine is a precursor often diverted into the illegal manufacture of amphetamine type substances (ATS). The aim of this study was to evaluate the effectiveness of a linked electronic medication recording system (LEMS) established in Australian pharmacies in 2005 for preventing the diversion of pseudoephedrine. The number of illegal ATS laboratories detected in each jurisdiction of Australia from 1996-1997 to 2004-2005 were analysed by linear regression nationally and by each jurisdiction. The statistical significance of seizures in 2005-2006 was based on the comparison of the observed value to the 95% prediction confidence intervals calculated from the historical data for each jurisdiction and nationally. Pharmacies in Queensland commenced an LEMS in late 2005 to minimise retail pseudoephedrine diversion. The number of ATS laboratories seized in 2005-2006 in Queensland was significantly lower (P < 0.05) than predicted by historical data. For all other jurisdictions and nationally the totals of laboratories seized in 2005-2006 were not significantly different from predicted values. The significant decline in ATS illegal laboratories seized in Queensland in 2005-2006 suggests the effective use of LEMS in pharmacies to minimise pseudoephedrine diversion. In order to evaluate a national LEMS, more frequent data on numbers of linked pharmacies, ATS laboratories seized and indicators of pseudoephedrine sales and misuse are required. Testing the use of LEMS by pharmacies for preventing the diversion of other medicines seems appropriate.

Acceptance of direct physician access to a computer-based patient record in a managed care setting.

PubMed

Dewey, J B; Manning, P; Brandt, S

1993-01-01

Kaiser Permanente Mid-Atlantic States has developed a fully integrated outpatient information system which currently runs on an IBM ES9000 on a VM platform written in MUMPS. The applications include Lab, Radiology, Transcription, Appointments. Pharmacy, Encounter tracking, Hospitalizations, Referrals, Phone Advice, Pap tracking, Problem list, Immunization tracking, and Patient demographics. They are department specific and require input and output from a dumb terminal. We have developed a physician's work station to access this information using PC compatible computers running Microsoft Windows and a custom Microsoft Visual Basic 2.0 environment which draws from these 14 applications giving the physician a comprehensive view of all electronic medical records. Through rapid prototyping, voluntary participation, formal training and gradual implementation we have created an enthusiastic response. 95% of our physician PC users access the system each month. The use ranges from 0.2 to 3.0 screens of data viewed per patient visit. This response continues to drive the process toward still greater user acceptance and further practice enhancement.

A European community pharmacy-based survey to investigate patterns of prescription fraud through identification of falsified prescriptions.

PubMed

Lapeyre-Mestre, Maryse; Gony, Mireille; Carvajal, Alfonso; Macias, Diego; Conforti, Anita; D'Incau, Paola; Heerdink, Rob; Van der Stichele, Robert; Bergman, Ulf

2014-01-01

To identify prescription drugs involved in falsified prescriptions in community pharmacies in 6 European countries. A cross-sectional survey among 2,105 community pharmacies in Belgium, France, Italy, the Netherlands, Spain and Sweden was carried out to collect all suspect prescription forms. For each reported drug, the number of reported falsified prescriptions per thousand inhabitants was estimated. A falsification ratio was calculated by dividing the number of reports by the number of defined daily doses per 1,000 inhabitants per day for this drug, computed from national sale or reimbursement data. On 862 prescription forms, benzodiazepines (zolpidem, bromazepam, alprazolam), buprenorphine (as an opioid maintenance drug) and tramadol were the most frequently reported. Depending on their level of use in each country, methylphenidate, morphine and flunitrazepam presented the highest falsification ratios, particularly in Spain, Belgium and France. Stimulants, opioids and some benzodiazepines were the most frequently reported drugs in this survey on falsified prescriptions, but differences between countries were observed. © 2014 S. Karger AG, Basel.

[Introduction of active learning and student readership in teaching by the pharmaceutical faculty].

PubMed

Sekiguchi, Masaki; Yamato, Ippei; Kato, Tetsuta; Torigoe, Kojyun

2005-07-01

We have introduced improvements and new approaches into our teaching methods by exploiting 4 active learning methods for pharmacy students of first year. The 4 teaching methods for each lesson or take home assignment are follows: 1) problem-based learning (clinical case) including a student presentation of the clinical case, 2) schematic drawings of the human organs, one drawing done in 15-20 min during the week following a lecture and a second drawing done with reference to a professional textbook, 3) learning of professional themes in take home assignments, and 4) short test in order to confirm the understanding of technical terms by using paper or computer. These improvements and new methods provide active approaches for pharmacy students (as opposed to passive memorization of words and image study). In combination, they have proven to be useful as a learning method to acquire expert knowledge and to convert from passive learning approach to active learning approach of pharmacy students in the classroom.

Simplified methods of determining treatment retention in Malawi: ART cohort reports vs. pharmacy stock cards.

PubMed

Chan, A K; Singogo, E; Changamire, R; Ratsma, Y E C; Tassie, J-M; Harries, A D

2012-06-21

Rapid scale-up of antiretroviral therapy (ART) has challenged the health system in Malawi to monitor large numbers of patients effectively. To compare two methods of determining retention on treatment: quarterly ART clinic data aggregation vs. pharmacy stock cards. Between October 2010 and March 2011, data on ART outcomes were extracted from monitoring tools at five facilities. Pharmacy data on ART consumption were extracted. Workload for each method was observed and timed. We used intraclass correlation and Bland-Altman plots to compare the agreeability of both methods to determine treatment retention. There is wide variability between ART clinic cohort data and pharmacy data to determine treatment retention due to divergence in data at sites with large numbers of patients. However, there is a non-significant trend towards agreeability between the two methods (intraclass correlation coefficient > 0.9; P > 0.05). Pharmacy stock card monitoring is more time-efficient than quarterly ART data aggregation (81 min vs. 573 min). In low-resource settings, pharmacy records could be used to improve drug forecasting and estimate ART retention in a more time-efficient manner than quarterly data aggregation; however, a necessary precondition would be capacity building around pharmacy data management, particularly for large-sized cohorts.

Residency Program Directors' View on the Value of Teaching.

PubMed

Korte, Catherine; Smith, Andrew; Pace, Heather

2016-08-01

There is no standardization for teaching activities or a requirement for residency programs to offer specific teaching programs to pharmacy residents. This study will determine the perceived value of providing teaching opportunities to postgraduate year 1 (PGY-1) pharmacy residents in the perspective of the residency program director. The study will also identify the features, depth, and breadth of the teaching experiences afforded to PGY-1 pharmacy residents. A 20-question survey was distributed electronically to 868 American Society of Health-System Pharmacists-accredited PGY-1 residency program directors. The survey was completed by 322 program directors. Developing pharmacy educators was found to be highly valued by 57% of the program directors. Advertisement of teaching opportunities was found to be statistically significant when comparing program directors with a high perceived value for providing teaching opportunities to program demographics. Statistically significant differences were identified associating development of a teaching portfolio, evaluation of Advanced Pharmacy Practice Experiences students, and delivery of didactic lectures with program directors who highly value developing pharmacy educators. Future residency candidates interested in teaching or a career in academia may utilize these findings to identify programs that are more likely to value developing pharmacy educators. The implementation of a standardized teaching experience among all programs may be difficult. © The Author(s) 2015.

The role of information technology in the development of community pharmacy services: visions and strategic views of international experts.

PubMed

Westerling, Anna M; Haikala, Veikko; Airaksinen, Marja

2011-12-01

Community pharmacy's strategic vision has been to extend practice responsibilities beyond dispensing and provide patient care services. Few studies have evaluated the strategic and long-term development of information technology (IT) systems to support this vision. The objective of this study was to explore international experts' visions and strategic views on IT development needs in relation to service provision in community pharmacies. Semistructured interviews were conducted with a purposive sample of 14 experts from 8 countries in 2007-2008. These experts had expertise in the development of community pharmacy services and IT. The interviews were content analyzed using a constant comparison approach and a SWOT (strengths, weaknesses, opportunities, threats) analysis was undertaken. Most of the experts shared the vision for community pharmacy adopting a patient care orientation; supported by IT-based documentation, new technological solutions, access to information, and shared patient data. Opportunities to achieve this vision included IT solutions, professional skills, and interprofessional collaboration. Threats included costs, pharmacists' attitude, and the absence of IT solutions. Those responsible for IT development in community pharmacy sector should create long-term IT development strategies that are in line with community pharmacy service development strategies. Copyright © 2011 Elsevier Inc. All rights reserved.

Social Media As a Leadership Tool for Pharmacists

PubMed Central

Toney, Blake; Goff, Debra A.; Weber, Robert J.

2015-01-01

The profession of pharmacy is currently experiencing transformational change in health system practice models with pharmacists’ provider status. Gaining buy-in and support of stakeholders in medicine, nursing, and other advocates for patient care is critical. To this end, building momentum to advance the profession will require experimentation with and utilization of more efficient ways to disseminate relevant information. Traditional methods to communicate can be inefficient and painstakingly slow. Health care providers are turning to social media to network, connect, engage, educate, and learn. Pharmacy leaders can use social media as an additional tool in the leadership toolkit. This article of the Director’s Forum shows how social media can assist pharmacy leaders in further developing patient-centered pharmacy services. PMID:26448676

Pharmacy participation and claim characteristics in the Wisconsin Medicaid Pharmaceutical Care Program from 1996 to 2007.

PubMed

Look, Kevin A; Mott, David A; Leedham, Robert K; Kreling, David H; Hermansen-Kobulnicky, Carol J

2012-03-01

Under the 1995 Wisconsin Act 27, the biennial budget, Wisconsin Medicaid was required to develop an incentive-based pharmacy payment system for pharmaceutical care (PC) services. Started on July 1, 1996, the Wisconsin Medicaid Pharmaceutical Care Program (WMPCP) is the longest currently ongoing Medicaid program to compensate pharmacists for nondispensing services. The program reimburses pharmacies for providing PC services that increase patient compliance or prevent potential adverse drug problems by paying an enhanced PC dispensing fee. Pharmacists can bill for PC services provided to Wisconsin Medicaid fee-for-service and SeniorCare (i.e., state prescription drug assistance program for low-income seniors) beneficiaries. To examine trends in (a) the number of pharmacies participating in the WMPCP and the intensity of participation among participating pharmacies; and (b) frequencies of reason, action, result, and level-of-service (time) codes associated with PC service claims from July 1, 1996, through June 30, 2007, which represents Wisconsin state fiscal years (SFYs) 1997 through 2007. A retrospective, longitudinal, and descriptive research design was used to analyze all paid claims for PC services provided to Wisconsin Medicaid fee-for-service and SeniorCare recipients during SFYs 1997 through 2007. The total number of paid PC claims and the average number of claims paid per pharmacy were examined to determine trends in pharmacy participation. Mean annual reimbursement amounts for PC per claim and per pharmacy were calculated. Reason, action, result, and level-of-service (time) codes that appeared in the claims were grouped into categories and analyzed to characterize the total number of claims paid overall and per SFY. During the study period, one-half (n = 601) of the approximately 1,200 licensed pharmacies in the state of Wisconsin were paid for a claim through the WMPCP. However, intensity of participation in the WMPCP was low, with 57% of all participating pharmacies being paid for 10 or fewer PC claims and 19% paid for only 1 PC claim over the 11-year study period. The growth in claims per year coupled with smaller growth in the number of participating pharmacies resulted in a trend of growth in the mean number of claims per participating pharmacy in the program. The proportion of total WMPCP claims accounted for by the top 10 pharmacies with the highest volume of PC claims varied from 46.6% to 80.2% per year. Patient behaviors (e.g., early or late refills) and drug use issues/problems (e.g., patient complaints or symptoms) were the most common reasons for pharmacists to provide PC services (62% of all PC claims), although drug choice reasons (e.g., product selection opportunity) were more common after 2004. The majority (55.1%) of PC services took 15 minutes or less of pharmacists' time. The total dollar amount paid to pharmacies for PC services was $876,822 between SFYs 1997 and 2007, with an overall mean of $1,459 paid per participating pharmacy. Trends in pharmacy participation and claims volume showed growth, albeit limited, in PC program participation with a majority of paid claims dealing with patient behaviors and drug use issues or problems that consumed a small amount of pharmacists' time (15 minutes or less). The intensity of participation (claims per pharmacy) increased over time, suggesting that some pharmacies may have developed effective systems for participating and successfully submitting claims to WMPCP for enhanced dispensing fees. Further evaluation of the impact and implications of this program for patients, pharmacists, and the state is needed to gauge overall program success and provide evidence or guidance for continued or expanded PC initiatives.

Health system informatics.

PubMed

Felkey, B G

1997-02-01

The application of informatics in a health system in general and to pharmacy in particular is discussed. Informatics is the use of information technology to enhance the quality of care, facilitate accountability, and assist in cost containment. Tying the pieces of health care into a seamless system using informatics principles yields a more rational approach to caregiving. A four-layer hierarchy of information systems can be found in any health system: layer 1, the foundational layer formed by a transaction-processing system; 2, the management information system; 3, decision support; and 4, advanced informatics applications such as expert systems. Other industries appear to be ahead of health care in investing in informatics applications. Pharmacy is one of the key health care professions that must adopt informatics. A stepwise structure for pharmacy informatics has been proposed; it consists of establishing a relationship with the patient, establishing a database, listing and ranking problems, choosing among alternatives, and planning and monitoring. Informatics should be approached by determining where the department is going strategically. Informatics standards will be needed. Pharmacists will need to use informatics to enhance their worth on the health care team and to improve patient care.

Opportunities for Health System Pharmacies in Patient Care

PubMed Central

Felkey, Bill G.; Fox, Brent I.

2015-01-01

It’s been said that the best hospital stay is the one that doesn’t occur. Certainly, Hospital Pharmacy’s readers know that we are still working toward a completely safe health care delivery experience. In this installment, medication errors experienced during a hospital stay bring to light opportunities for health system pharmacies to create new points of engagement with their patients and increase patients’ involvement in their care. PMID:26445911

Providing an integrated clinical data view in a hospital information system that manages multimedia data.

PubMed

Dayhoff, R E; Maloney, D L; Kenney, T J; Fletcher, R D

1991-01-01

The VA's hospital information system, the Decentralized Hospital Computer Program (DHCP), is an integrated system based on a powerful set of software tools with shared data accessible from any of its application modules. It includes many functionally specific application subsystems such as laboratory, pharmacy, radiology, and dietetics. Physicians need applications that cross these application boundaries to provide useful and convenient patient data. One of these multi-specialty applications, the DHCP Imaging System, integrates multimedia data to provide clinicians with comprehensive patient-oriented information. User requirements for cross-disciplinary image access can be studied to define needs for similar text data access. Integration approaches must be evaluated both for their ability to deliver patient-oriented text data rapidly and their ability to integrate multimedia data objects. Several potential integration approaches are described as they relate to the DHCP Imaging System.

Providing an integrated clinical data view in a hospital information system that manages multimedia data.

PubMed Central

Dayhoff, R. E.; Maloney, D. L.; Kenney, T. J.; Fletcher, R. D.

1991-01-01

The VA's hospital information system, the Decentralized Hospital Computer Program (DHCP), is an integrated system based on a powerful set of software tools with shared data accessible from any of its application modules. It includes many functionally specific application subsystems such as laboratory, pharmacy, radiology, and dietetics. Physicians need applications that cross these application boundaries to provide useful and convenient patient data. One of these multi-specialty applications, the DHCP Imaging System, integrates multimedia data to provide clinicians with comprehensive patient-oriented information. User requirements for cross-disciplinary image access can be studied to define needs for similar text data access. Integration approaches must be evaluated both for their ability to deliver patient-oriented text data rapidly and their ability to integrate multimedia data objects. Several potential integration approaches are described as they relate to the DHCP Imaging System. PMID:1807651

Physiotherapy and pharmacy students perception of educational environment in a medical university from Pakistan.

PubMed

Memon, Aamir Raoof; Ali, Bahadur; Kiyani, Mubin Mustafa; Ahmed, Imran; Memon, Attiq-Ur-Rehman; Feroz, Jam

2018-01-01

To assess and compare the perceptions of the educational environment between physiotherapy and pharmacy students in a public-sector medical university. This cross-sectional study was conducted at the Peoples University of Medical and Health Sciences for Women, Nawabshah, Pakistan, and comprised undergraduate physiotherapy and pharmacy students. The Dundee Ready Educational Environment Measure questionnaire was used to assess the perceptions of students about their educational environment. Global and subscale scores were computed and compared between the respondents. P<0.05 was considered statistically significant. Of the 300 questionnaires, 281(93.66%) were returned duly filled in. The overall mean global score was 127.2±16.0. For physiotherapy students, the mean global score was 124.9±14.0 while it was 131.7±18.9 for pharmacy students (p=0.16). The domain scores were comparable for both specialties (p>0.05). There was no significance difference in the global and domain scores for preclinical and clinical years in the students (p>0.05). However, in the physiotherapy students, the global and domain scores for Dundee Ready Educational Environment Measure were significantly lower in clinical than preclinical students (p<0.05) except for students' social self-perception (p>0.05). Students were overall positive about their educational environment.

Sale of fluoroquinolones in northern Tanzania: a potential threat for fluoroquinolone use in tuberculosis treatment.

PubMed

van den Boogaard, Jossy; Semvua, Hadija H; Boeree, Martin J; Aarnoutse, Rob E; Kibiki, Gibson S

2010-01-01

Fluoroquinolones have a potential role in shortening tuberculosis (TB) treatment duration. They are currently used in the treatment of other infections. This has raised concerns about development of mycobacterial resistance. The current study evaluates the sale of fluoroquinolones (among other antibacterials) in Moshi, Tanzania, a country with one of the highest burdens of TB in the world. Trained pharmacy assistants registered the sale of fluoroquinolones during February and March 2009 to outpatients in Moshi in all 14 pharmacies that are authorized to sell antibacterials for systemic use. The sale of all antibacterials of the Anatomical Therapeutic Chemical (ATC) J01 class was expressed in defined daily doses (DDDs) per 1000 inhabitants per day (DID). The availability of fluoroquinolones in drug outlets that are not authorized to sell antibacterials for systemic use was assessed in 15 randomly selected outlets in Moshi. The sale of antibacterials to outpatients in Moshi by authorized pharmacies was 4.99 DID. The sale of fluoroquinolones was 0.62 DID (12% of total antibacterial sales). Ciprofloxacin was available in all 15 unauthorized drug outlets. The substantial sales of fluoroquinolones by authorized pharmacies and the wide availability of fluoroquinolones in unauthorized drug outlets in Moshi constitute a challenge to the use of fluoroquinolones in TB treatment in Tanzania. Control of antibacterial use in Tanzania requires the implementation of surveillance systems for antibacterial use and resistance, and adequate restriction of antibacterial sales to authorized pharmacies only.

Integrating Data From the UK National Reporting and Learning System With Work Domain Analysis to Understand Patient Safety Incidents in Community Pharmacy.

PubMed

Phipps, Denham L; Tam, W Vanessa; Ashcroft, Darren M

2017-03-01

To explore the combined use of a critical incident database and work domain analysis to understand patient safety issues in a health-care setting. A retrospective review was conducted of incidents reported to the UK National Reporting and Learning System (NRLS) that involved community pharmacy between April 2005 and August 2010. A work domain analysis of community pharmacy was constructed using observational data from 5 community pharmacies, technical documentation, and a focus group with 6 pharmacists. Reports from the NRLS were mapped onto the model generated by the work domain analysis. Approximately 14,709 incident reports meeting the selection criteria were retrieved from the NRLS. Descriptive statistical analysis of these reports found that almost all of the incidents involved medication and that the most frequently occurring error types were dose/strength errors, incorrect medication, and incorrect formulation. The work domain analysis identified 4 overall purposes for community pharmacy: business viability, health promotion and clinical services, provision of medication, and use of medication. These purposes were served by lower-order characteristics of the work system (such as the functions, processes and objects). The tasks most frequently implicated in the incident reports were those involving medication storage, assembly, or patient medication records. Combining the insights from different analytical methods improves understanding of patient safety problems. Incident reporting data can be used to identify general patterns, whereas the work domain analysis can generate information about the contextual factors that surround a critical task.

Detection of adverse drug reactions among ordinary users of liraglutide on the occasion of drug dispensing in the community pharmacy setting.

PubMed

Christensen, Søren Troels; Bjerrum, Ole Jannik

2013-12-01

Postmarketing studies of drugs forms an essential part of safety surveillance. In particular, this concerns new drugs as safety information of these by large rests on randomized clinical studies conducted on a limited number of subjects before licensing. Pharmacists in community pharmacies are in a unique position for detection of user experienced adverse drug reactions (ADRs) in relation to drug dispensing. The study reports from a research initiative exploring prompt and proactive ADR detection of liraglutide and reporting facilitated by pharmacy students undertaking internship in a community pharmacy in Denmark. Nineteen pharmacy students undertaking regular 6 months' internship--eighth semester--in a Danish community pharmacy participated in the data collection. Before the data collection, students attended an interactive training seminar addressing ADRs in general, organ symptoms, diagnostic classification, and pharmacovigilance systems. Pharmacy students approached recurrent drug users purchasing liraglutide. Participating users were asked about experienced ADRs linked to liraglutide use. Reported ADRs were collected and analyzed. Sixty-two liraglutide users participated in the study, of whom, 38 reported 84 ADRs possibly linked to liraglutide usage. Nausea was by far the most reported ADR followed by decreased appetite, diarrhea, fatigue, and abdominal pain (upper). The reported ADRs are in accordance with previously reported ADRs. The study has demonstrated the feasibility of community pharmacy driven pharmacovigilance. The study supports the thesis that community pharmacists in the future may play a proactive and prominent role in patient-centered pharmacovigilance.

State prescription drug price Web sites: how useful to consumers?

PubMed

Tu, Ha T; Corey, Catherine G

2008-02-01

To aid consumers in comparing prescription drug costs, many states have launched Web sites to publish drug prices offered by local retail pharmacies. The current push to make retail pharmacy prices accessible to consumers is part of a much broader movement to increase price transparency throughout the health-care sector. Efforts to encourage price-based shopping for hospital and physician services have encountered widespread concerns, both on grounds that prices for complex services are difficult to measure and compare accurately and that quality varies substantially across providers. Experts agree, however, that prescription drugs are much easier to shop for than other, more complex health services. However, extensive gaps in available price information--the result of relying on Medicaid data--seriously hamper the effectiveness of state drug price-comparison Web sites, according to a new study by the Center for Studying Health System Change (HSC). An alternative approach--requiring pharmacies to submit price lists to the states--would improve the usefulness of price information, but pharmacies typically oppose such a mandate. Another limitation of most state Web sites is that price information is restricted to local pharmacies, when online pharmacies, both U.S. and foreign, often sell prescription drugs at substantially lower prices. To further enhance consumer shopping tools, states might consider expanding the types of information provided, including online pharmacy comparison tools, lists of deeply discounted generic drugs offered by discount retailers, and lists of local pharmacies offering price matches.

The broad field of forensic pharmacy.

PubMed

Anderson, Peter D

2012-02-01

Forensic pharmacy is application of the sciences of drugs to legal issues. Forensic pharmacists engage in work relating to litigation, the regulatory process, and the criminal justice system. Forensic pharmacy overlaps with many other forensic fields. Pharmacists hold a variety of positions with local, state, and federal governments. Many pharmacists do freelance work as forensic litigation consultants. A forensic pharmacist can be a valuable resource in legal cases relating to malpractice, adverse drug reactions, drunk and drugged driving, health care fraud, poisoning, and numerous other types of civil and criminal cases.

Rewards and advancements for clinical pharmacists.

PubMed

Goodwin, S Diane; Kane-Gill, Sandra L; Ng, Tien M H; Melroy, Joel T; Hess, Mary M; Tallian, Kimberly; Trujillo, Toby C; Vermeulen, Lee C

2010-01-01

The American College of Clinical Pharmacy charged the Clinical Practice Affairs Committee to review and update the College's 1995 White Paper, "Rewards and Advancements for Clinical Pharmacy Practitioners." Because of the limited data on the present state of rewards and advancements for clinical pharmacists, an online survey of "front-line" clinical pharmacists and pharmacy managers was conducted (1126 total respondents, 14% response rate). The resulting White Paper discusses motivators and existing systems of rewards and advancements for clinical pharmacists, as well as perceived barriers to implementation of these systems. Clinical pharmacists reported work-life balance, a challenging position, and opportunities for professional advancement as the most important factors for career success. At the time of the survey, financial rewards appeared not to be a major motivator for clinical pharmacists. Managers underestimated the importance that clinical pharmacists place on work-life balance and favorable work schedules. Although almost two thirds of the clinical pharmacists surveyed had not developed a professional development plan, 84% indicated an interest in career planning. Both clinical pharmacists and managers rated the lack of a clear reward and advancement structure as the most important barrier to effective systems of rewards and advancements. Pharmacy managers and administrators are encouraged to develop effective systems of rewards and advancements for clinical pharmacists that positively impact patient care and the institution's mission; these systems will benefit the clinical pharmacist, the health care institution, and the patient.

Implementation and Student Assessment of Intranet-Based Learning Resources.

ERIC Educational Resources Information Center

Sosabowski, Michael H.; Herson, Katie; Lloyd, Andrew W.

1998-01-01

The University of Brighton (England) pharmacy and biomedical sciences school developed an institutional intranet providing course information, Internet links, lecture notes, links to computer-assisted instructional packages, and worksheets. Electronic monitoring of usage and subsequent questionnaire-based evaluation showed the intranet to be a…

Evaluation of a hybrid paper-electronic medication management system at a residential aged care facility.

PubMed

Elliott, Rohan A; Lee, Cik Yin; Hussainy, Safeera Y

2016-06-01

Objectives The aims of the study were to investigate discrepancies between general practitioners' paper medication orders and pharmacy-prepared electronic medication administration charts, back-up paper charts and dose-administration aids, as well as delays between prescribing, charting and administration, at a 90-bed residential aged care facility that used a hybrid paper-electronic medication management system. Methods A cross-sectional audit of medication orders, medication charts and dose-administration aids was performed to identify discrepancies. In addition, a retrospective audit was performed of delays between prescribing and availability of an updated electronic medication administration chart. Medication administration records were reviewed retrospectively to determine whether discrepancies and delays led to medication administration errors. Results Medication records for 88 residents (mean age 86 years) were audited. Residents were prescribed a median of eight regular medicines (interquartile range 5-12). One hundred and twenty-five discrepancies were identified. Forty-seven discrepancies, affecting 21 (24%) residents, led to a medication administration error. The most common discrepancies were medicine omission (44.0%) and extra medicine (19.2%). Delays from when medicines were prescribed to when they appeared on the electronic medication administration chart ranged from 18min to 98h. On nine occasions (for 10% of residents) the delay contributed to missed doses, usually antibiotics. Conclusion Medication discrepancies and delays were common. Improved systems for managing medication orders and charts are needed. What is known about the topic? Hybrid paper-electronic medication management systems, in which prescribers' orders are transcribed into an electronic system by pharmacy technicians and pharmacists to create medication administration charts, are increasingly replacing paper-based medication management systems in Australian residential aged care facilities. The accuracy and safety of these systems has not been studied. What does this paper add? The present study identified discrepancies between general practitioners' orders and pharmacy-prepared electronic medication administration charts, back-up paper medication charts and dose-administration aids, as well as delays between ordering, charting and administering medicines. Discrepancies and delays sometimes led to medication administration errors. What are the implications for practitioners? Facilities that use hybrid systems need to implement robust systems for communicating medication changes to their pharmacy and reconciling prescribers' orders against pharmacy-generated medication charts and dose-administration aids. Fully integrated, paperless medication management systems, in which prescribers' electronic medication orders directly populate an electronic medication administration chart and are automatically communicated to the facility's pharmacy, could improve patient safety.

Integration of outpatient infectious diseases clinic pharmacy services and specialty pharmacy services for patients with HIV infection.

PubMed

Gilbert, Elise M; Gerzenshtein, Lana

2016-06-01

The integration of specialty pharmacy services and existing outpatient clinical pharmacy services within an infectious diseases (ID) clinic to optimize the care of patients with human immunodeficiency virus (HIV) infection is described. The management of HIV-infected patients is a highly specialized area of practice, often requiring use of complex medication regimens for reduction of HIV-associated morbidity and mortality prophylaxis and treatment of opportunistic infections, and prevention of HIV transmission. To maximize the effectiveness and safety of treatment with antiretroviral agents and associated pharmacotherapies, an interdisciplinary team is often involved in patient care. At Chicago-based Northwestern Medicine (NM), the outpatient ID clinic has long worked with an interdisciplinary care team including physicians, clinical pharmacists, nurses, and social workers to care for patients with HIV infection. In April 2014, specialty pharmacy services for patients with HIV infection were added to the NM ID clinic's care model to help maintain continuity of care and enhance patient follow-up. The care model includes well-defined roles for clinical pharmacists, pharmacy residents and students on rotation, and licensed pharmacy technicians. Specialty pharmacy services, including medication education, prescription fulfillment, assistance with medication access (e.g., navigation of financial assistance programs, completion of prior-authorization requests), and treatment monitoring, allow for closed-loop medication management of the HIV-infected patient population. Integration of specialty pharmacy services with the interdisciplinary care provided in the outpatient NM ID clinic has enhanced continuity of care for patients with HIV infection in terms of prescription filling, medication counseling, and adherence monitoring. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The future of pharmacy practice research - Perspectives of academics and practitioners from Australia, NZ, United Kingdom, Canada and USA.

PubMed

Babar, Zaheer-Ud-Din; Scahill, Shane; Nagaria, Raveena Amee; Curley, Louise E

2018-01-11

Healthcare is under significant pressure with the explosion of long term conditions, shift in worldwide demographics and is evolving through advances in technology. Aligned with this is the changing role of pharmacy from the traditional dispenser of medicines to having (in addition) a more advanced clinical role. This study aimed to understand what the pharmacy practice research agenda might look like from the viewpoint of pharmacy academics and practitioners across five high-income countries. Qualitative methods were used, and thirty one-hour interviews were undertaken with practitioners and academics from five economically advanced countries. These nations have comparable socio-economic status but differing health systems and include; Australia, Canada, New Zealand, United Kingdom and United States of America. Six key informants were chosen from each country, three academics and three community pharmacists. A general inductive analysis was undertaken to analyse the most common and recurring themes. These themes of research were based around current community pharmacy practice issues and the enablers to changing the profession. Specific areas pharmacy practice could be more involved with included long term health conditions. Some community pharmacists also believed that research into the impact of professional standards and policy change would be beneficial. The findings of this research suggest that current pharmacy practice research methods are sufficient, but need to be used more effectively. Participants identified a wide range of issues within community pharmacy practice. Academics largely focused on how research can be utilised in the community and how to implement findings to ensure sustainability of pharmacy practice research. Issues that community pharmacists would like to research are related to the current practice model, such as allocating time to provide patient-focused services in addition to managing a business. Copyright © 2018 Elsevier Inc. All rights reserved.

Email medication counseling services provided by Finnish community pharmacies.

PubMed

Pohjanoksa-Mäntylä, Marika K; Kulovaara, Heidi; Bell, J Simon; Enäkoski, Marianne; Airaksinen, Marja S

2008-12-01

The importance of email as a mode of communication between medication users and pharmacists is likely to increase. However, little is known about the email medication counseling practices of community pharmacies. To determine the prevalence of email medication counseling services in Finland and to assess the accuracy and comprehensiveness of responses by pharmacies providing the opportunity for email medication counseling to inquiries related to use of antidepressants. An inventory was made of all Finnish community pharmacies that provided the opportunity for email medication counseling. Data related to the accuracy and comprehensiveness of responses were collected, using a virtual pseudo-customer method with 3 scenarios related to common concerns of patients on antidepressants. Two inquiries were emailed to each pharmacy that provided the opportunity for email medication counseling in January and February 2005. The responses were content analyzed by 2 researchers, using a prestructured scoring system. Almost one-third (30%, n = 182) of Finnish community pharmacies maintained a working Web site, and 94% of those provided the opportunity for email medication counseling. An online "ask-the-pharmacist" service was offered by 13% (n = 23) of the pharmacies with a Web site. Pharmacies responded to 54% of the email inquiries sent by the virtual pseudo-customers. The response rate and the content score ratio between mean and maximum scores varied among the scenarios. The content score ratio was highest for the scenarios concerning the adverse effects of fluoxetine (0.53, n = 55) and interactions with mirtazapine (0.52, n = 63) and lowest for the scenario related to sexual dysfunction and weight gain associated with citalopram (0.38, n = 52). Community pharmacies are potential providers of email medication counseling services. However, more attention should be directed to responding to consumer inquiries and to the content of these responses.

Social and economic value of Portuguese community pharmacies in health care.

PubMed

Félix, Jorge; Ferreira, Diana; Afonso-Silva, Marta; Gomes, Marta Vargas; Ferreira, César; Vandewalle, Björn; Marques, Sara; Mota, Melina; Costa, Suzete; Cary, Maria; Teixeira, Inês; Paulino, Ema; Macedo, Bruno; Barbosa, Carlos Maurício

2017-08-29

Community pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal. The social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: "with service" versus "without service". It is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (M€), including 342.1 M€ in non-remunerated pharmaceutical services and 448.1 M€ in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 M€: 120.3 M€ in non-remunerated services and 24.5 M€ in potential savings with health resource consumption. Community pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society.

Impact of Computerized Provider Order Entry on Pharmacist Productivity

PubMed Central

Hatfield, Mark D.; Cox, Rodney; Mhatre, Shivani K.; Flowers, W. Perry

2014-01-01

Abstract Purpose: To examine the impact of computerized provider order entry (CPOE) implementation on average time spent on medication order entry and the number of order actions processed. Methods: An observational time and motion study was conducted from March 1 to March 17, 2011. Two similar community hospital pharmacies were compared: one without CPOE implementation and the other with CPOE implementation. Pharmacists in the central pharmacy department of both hospitals were observed in blocks of 1 hour, with 24 hours of observation in each facility. Time spent by pharmacists on distributive, administrative, clinical, and miscellaneous activities associated with order entry were recorded using time and motion instrument documentation. Information on medication order actions and order entry/verifications was obtained using the pharmacy network system. Results: The mean ± SD time spent by pharmacists per hour in the CPOE pharmacy was significantly less than the non-CPOE pharmacy for distributive activities (43.37 ± 7.75 vs 48.07 ± 8.61) and significantly greater than the non-CPOE pharmacy for administrative (8.58 ± 5.59 vs 5.72 ± 6.99) and clinical (7.38 ± 4.27 vs 4.22 ± 3.26) activities. The CPOE pharmacy was associated with a significantly higher number of order actions per hour (191.00 ± 82.52 vs 111.63 ± 25.66) and significantly less time spent (in minutes per hour) on order entry and order verification combined (28.30 ± 9.25 vs 36.56 ± 9.14) than the non-CPOE pharmacy. Conclusion: The implementation of CPOE facilitated pharmacists to allocate more time to clinical and administrative functions and increased the number of order actions processed per hour, thus enhancing workflow efficiency and productivity of the pharmacy department. PMID:24958959

Prevalence of unclaimed prescriptions at military pharmacies.

PubMed

Esposito, Dominick; Schone, Eric; Williams, Thomas; Liu, Su; CyBulski, Karen; Stapulonis, Rita; Clusen, Nancy

2008-01-01

Prescriptions that are ordered by physicians but not picked up by patients represent a potential quality improvement opportunity in health systems. Previous research has demonstrated that anywhere from as little as 0.28% to as much as 30.0% of prescriptions are unclaimed, and that 0.45% to 22.0% of patients fail to claim prescriptions. In the Military Health System (MHS), prescriptions filled at military pharmacies are dispensed with no copayment, providing an opportunity to examine the factors that contribute to unclaimed prescriptions other than out-of-pocket cost. To estimate the prevalence of unclaimed prescriptions in the MHS, investigate reasons for unclaimed prescriptions, and compare self-reported noncompliance, defined as the failure to pick up at least 1 prescription in a 12-month period, with evidence from an administrative database of prescription orders and dispensings. Research methods included pharmacy staff interviews at 6 military pharmacies, a telephone survey of beneficiaries who filled prescriptions at these pharmacies, descriptive analysis of survey data, and comparison of administrative pharmacy data with self-reported survey data. Beneficiary interviews, conducted from May through July 2004, covered background characteristics, medical conditions, and unclaimed prescriptions, relying on 12 months of recall regarding noncompliance. Interviews with pharmacy staff covered day-to-day operations, factors that alleviate or exacerbate noncompliance, and the burden that noncompliance places on pharmacies. Administrative data from the Pharmacy Data Transaction Service (pharmacy claims) and Composite Health Care System (CHCS: prescription orders and dispensings) databases were used to select a random sample for the beneficiary survey. Survey respondents' CHCS data were matched to their responses to determine the degree of agreement between self-reports and administrative data. Pharmacy interviews were completed with 30 staff members at 6 military pharmacies, and telephone interviews were completed with 1,214 beneficiaries (60.6% response rate). Beneficiary respondents filled an average of 7 prescriptions in the 5 months approximately surrounding the survey administration time frame (from March to July 2004). More than half (56.8%) of respondents were female, and nearly 60.6% were retired military or their dependents. Among all respondents at all study pharmacies, 8.0% reported failing to claim at least 1 prescription during the prior 12 months. Among survey respondents deemed compliant by CHCS data, 93.8% correctly identified themselves as compliant. However, among patients identified as noncompliant using CHCS data, only 16.0% selfidentified as noncompliant. The administrative data were not concordant with self-report data: of 105 survey respondents identifying themselves as noncompliant in the prior year and matched to administrative data (CHCS), only 58.1% were noncompliant per administrative data, and of 1,065 selfidentifying as compliant, only 61.1% were compliant per administrative data. The most common reasons cited by respondents for not picking up their prescriptions were: no perceived need for the prescription (18.5% of the noncompliant), forgot to pick it up (17.3%), the prescription was not in stock (14.8%), long wait time (11.1%), the prescription was not yet available (10.5%), was out of town (9.9%), and was too busy to pick up the prescription (6.2%). Factors associated with unclaimed prescriptions were: younger age, active duty military status, lower educational levels, and the absence of certain chronic medical conditions (i.e., no claims for cardiovascular medications, no self-reported arthritis). The present study's survey findings of an 8.0% selfreported noncompliance rate fall in the midrange of noncompliance rates reported in previous literature: between 0.45% and 22.0% in nonmilitary populations. Although reported reasons for noncompliance were generally consistent with those identified in previously published studies, they were only partially consistent with previous military pharmacy literature, which also found that patients did not know they had a prescription waiting or had some of the prescribed medicine at home. Concordance between measures of noncompliance, comparing administrative data with patient self-report based on 12-month recall, was poor.

A review of countries' pharmacist-patient communication legal requirements on prescription medications and alignment with practice: Comparison of Nordic countries.

PubMed

Svensberg, Karin; Sporrong, Sofia Kälvemark; Björnsdottir, Ingunn

2015-01-01

Pharmacist-patient communication around prescription medications can optimize treatment outcomes. Society's expectations of pharmacist-patient communication around medications can be expressed in legislation, economic incentives, and authority control. In this study, the Nordic countries of Denmark, Finland, Iceland, Norway and Sweden provide the legislative examples and can be used as a platform to discuss how society's expectations, professional visions, and practice are aligning. The overall aim of this study was to describe society's expectations of pharmacist-patient communication around medications as expressed by the state in Nordic legislation, economic incentives and authority control. Additionally, this study describes how the states govern Nordic pharmacists in different pharmacy systems. A legal review was performed using online legislative databases. Regulating authorities were contacted to gather supplementary information. Thereafter, a qualitative document analysis was conducted. The Nordic countries regulate staff-patient communication by using broad laws. The legislation's main focus during dispensing is information on the use of medications, but also generic substitution and pricing. Pharmacies should have internal routines for this in place. Pharmacists' obligation to keep a journal on advice given during dispensing is ambiguously regulated. The economic incentives for communication on prescription medication during dispensing are included in the general pharmacy mark-up. Today's authority control focuses on the pharmacy management and appears to primarily evaluate structure indicators of communication, for example, if there is a routine method of counseling available. Various countries throughout the world differ in their requirements for pharmacy staff to communicate on the use of medicines during dispensing. The Nordic countries all require such communication, which aligns with professional visions. Regardless of the pharmacy system, the states let the employer and pharmacy professions carry out it in practice with apparently little state involvement, thus showing trust in the profession and employers. However, since Nordic communication studies show deviation from the legislation, there are reasons to reevaluate and discuss the legislation, the economic incentives and the control system. Copyright © 2015 Elsevier Inc. All rights reserved.

Pharmacy clients' attitudes to expanded pharmacist prescribing and the role of agency theory on involved stakeholders.

PubMed

Hoti, Kreshnik; Hughes, Jeffery; Sunderland, Bruce

2011-02-01

To examine the views of regular pharmacy clients on pharmacist prescribing and employ agency theory in considering the relationship between the stakeholders involved. Computer assisted telephone interviews were conducted with 400 pharmacy clients recruited around Australia. Potential respondents were identified using a random number generation function in Microsoft Excel. Data were analysed with SPSS version 17 using one-way analysis of variance, principal component analysis and linear regression. The relationships between the main stakeholders involved were explored using agency theory. A total of 1153 answered calls recruited 400 consenting pharmacy clients. Most respondents (71%) trusted pharmacists adopting an expanded role in prescribing, however the majority (66%) supported this only after a diagnosis had been made by a doctor. Those who accepted pharmacist diagnosing and prescribing preferred that this was limited to pain management and antibiotics. Most respondents (64%) considered that expanded pharmacist prescribing would improve their access to prescription medicines, although those over 65 years of age were less supportive than younger respondents. Factors which contributed positively to clients' perception of trust in an expanded prescribing role for pharmacists were identified, and improved access to medicines was found to be the strongest predictor (P < 0.0001). Most pharmacy clients trusted pharmacists adopting an expanded prescribing role, but preferred that this was limited to doctors performing the initial diagnosis. Agency theory would conceptualize the introduction of pharmacist prescribers, as disrupting the principal (patient) agent (doctor) relationship. Its introduction would best be facilitated by careful change management. © 2011 The Authors. IJPP © 2011 Royal Pharmaceutical Society.

Assessment of pharmacy students' communication competence using the Roter Interaction Analysis System during objective structured clinical examinations.

PubMed

Kubota, Yoshie; Yano, Yoshitaka; Seki, Susumu; Takada, Kaori; Sakuma, Mio; Morimoto, Takeshi; Akaike, Akinori; Hiraide, Atsushi

2011-04-11

To determine the value of using the Roter Interaction Analysis System during objective structured clinical examinations (OSCEs) to assess pharmacy students' communication competence. As pharmacy students completed a clinical OSCE involving an interview with a simulated patient, 3 experts used a global rating scale to assess students' overall performance in the interview, and both the student's and patient's languages were coded using the Roter Interaction Analysis System (RIAS). The coders recorded the number of utterances (ie, units of spoken language) in each RIAS category. Correlations between the raters' scores and the number and types of utterances were examined. There was a significant correlation between students' global rating scores on the OSCE and the number of utterances in the RIAS socio-emotional category but not the RIAS business category. The RIAS proved to be a useful tool for assessing the socio-emotional aspect of students' interview skills.

[Computer-aided prescribing: from utopia to reality].

PubMed

Suárez-Varela Ubeda, J; Beltrán Calvo, C; Molina López, T; Navarro Marín, P

2005-05-31

To determine whether the introduction of computer-aided prescribing helped reduce the administrative burden at primary care centers. Descriptive, cross-sectional design. Torreblanca Health Center in the province of Seville, southern Spain. From 29 October 2003 to the present a pilot project involving nine pharmacies in the basic health zone served by this health center has been running to evaluate computer-aided prescribing (the Receta XXI project) with real patients. All patients on the center's list of patients who came to the center for an administrative consultation to renew prescriptions for medications or supplies for long-term treatment. Total number of administrative visits per patient for patients who came to the center to renew prescriptions for long-term treatment, as recorded by the Diraya system (Historia Clinica Digital del Ciudadano, or Citizen's Digital Medical Record) during the period from February to July 2004. Total number of the same type of administrative visits recorded by the previous system (TASS) during the period from February to July 2003. The mean number of administrative visits per month during the period from February to July 2003 was 160, compared to a mean number of 64 visits during the period from February to July 2004. The reduction in the number of visits for prescription renewal was 60%. Introducing a system for computer-aided prescribing significantly reduced the number of administrative visits for prescription renewal for long-term treatment. This could help reduce the administrative burden considerably in primary care if the system were used in all centers.

Impact of regulation of Community Pharmacies on efficiency, access and equity. Evidence from the UK and Spain.

PubMed

Lluch, Maria; Kanavos, Panos

2010-05-01

In this paper, we focus on regulatory restrictions on Community Pharmacies and whether these have an impact on efficiency, access and equity and thus in the delivery of services community pharmacists provide to patients. Primary data collection through semi-structured interviews and secondary data collection through literature review have been used with a particular focus on Spain (a country where Community Pharmacy is strictly regulated) and the UK (a country where Community Pharmacy is considered liberalised by EU standards). The findings indicate that improved pharmacy operational efficiency is the result of appropriate incentive structures, ownership liberalisation and OTC price freedom as is the case in the UK. Equity and access seem to be better achieved by establishing geographic, demographic or needs-based criteria to open new pharmacies (as is the case in Spain). In sum, there are useful lessons for both countries: the UK could look into the policies applied in Spain that increase access and equity whilst Spain could adopt some of the policies from the UK to increase efficiency in the system. Copyright (c) 2009 Elsevier Ireland Ltd. All rights reserved.

Electronic Inventory Systems and Barcode Technology: Impact on Pharmacy Technical Accuracy and Error Liability

PubMed Central

Oldland, Alan R.; May, Sondra K.; Barber, Gerard R.; Stolpman, Nancy M.

2015-01-01

Purpose: To measure the effects associated with sequential implementation of electronic medication storage and inventory systems and product verification devices on pharmacy technical accuracy and rates of potential medication dispensing errors in an academic medical center. Methods: During four 28-day periods of observation, pharmacists recorded all technical errors identified at the final visual check of pharmaceuticals prior to dispensing. Technical filling errors involving deviations from order-specific selection of product, dosage form, strength, or quantity were documented when dispensing medications using (a) a conventional unit dose (UD) drug distribution system, (b) an electronic storage and inventory system utilizing automated dispensing cabinets (ADCs) within the pharmacy, (c) ADCs combined with barcode (BC) verification, and (d) ADCs and BC verification utilized with changes in product labeling and individualized personnel training in systems application. Results: Using a conventional UD system, the overall incidence of technical error was 0.157% (24/15,271). Following implementation of ADCs, the comparative overall incidence of technical error was 0.135% (10/7,379; P = .841). Following implementation of BC scanning, the comparative overall incidence of technical error was 0.137% (27/19,708; P = .729). Subsequent changes in product labeling and intensified staff training in the use of BC systems was associated with a decrease in the rate of technical error to 0.050% (13/26,200; P = .002). Conclusions: Pharmacy ADCs and BC systems provide complementary effects that improve technical accuracy and reduce the incidence of potential medication dispensing errors if this technology is used with comprehensive personnel training. PMID:25684799

Electronic inventory systems and barcode technology: impact on pharmacy technical accuracy and error liability.

PubMed

Oldland, Alan R; Golightly, Larry K; May, Sondra K; Barber, Gerard R; Stolpman, Nancy M

2015-01-01

To measure the effects associated with sequential implementation of electronic medication storage and inventory systems and product verification devices on pharmacy technical accuracy and rates of potential medication dispensing errors in an academic medical center. During four 28-day periods of observation, pharmacists recorded all technical errors identified at the final visual check of pharmaceuticals prior to dispensing. Technical filling errors involving deviations from order-specific selection of product, dosage form, strength, or quantity were documented when dispensing medications using (a) a conventional unit dose (UD) drug distribution system, (b) an electronic storage and inventory system utilizing automated dispensing cabinets (ADCs) within the pharmacy, (c) ADCs combined with barcode (BC) verification, and (d) ADCs and BC verification utilized with changes in product labeling and individualized personnel training in systems application. Using a conventional UD system, the overall incidence of technical error was 0.157% (24/15,271). Following implementation of ADCs, the comparative overall incidence of technical error was 0.135% (10/7,379; P = .841). Following implementation of BC scanning, the comparative overall incidence of technical error was 0.137% (27/19,708; P = .729). Subsequent changes in product labeling and intensified staff training in the use of BC systems was associated with a decrease in the rate of technical error to 0.050% (13/26,200; P = .002). Pharmacy ADCs and BC systems provide complementary effects that improve technical accuracy and reduce the incidence of potential medication dispensing errors if this technology is used with comprehensive personnel training.

Experience with a pharmacy technician medication history program.

PubMed

Cooper, Julie B; Lilliston, Michelle; Brooks, DeAnne; Swords, Bruce

2014-09-15

The implementation and outcomes of a pharmacy technician medication history program are described. An interprofessional medication reconciliation team, led by a clinical pharmacist and a clinical nurse specialist, was charged with implementing a new electronic medication reconciliation system to improve compliance with medication reconciliation at discharge and capture compliance-linked reimbursement. The team recommended that the pharmacy department be allocated new pharmacy technician full-time-equivalent positions to assume ownership of the medication history process. Concurrent with the implementation of this program, a medication history standard was developed to define rules for documentation of what a patient reports he or she is actually taking. The standard requires a structured interview with the patient or caregiver and validation with outside sources as indicated to determine which medications to document in the medication history. The standard is based on four medication administration category rules: scheduled, as-needed, short-term, and discontinued medications. The medication history standard forms the core of the medication history technician training and accountability program. Pharmacy technicians are supervised by pharmacists, using a defined accountability plan based on a set of medical staff approved rules for what medications comprise a best possible medication history. Medication history accuracy and completeness rates have been consistently over 90% and rates of provider compliance with medication reconciliation rose from under 20% to 100% since program implementation. A defined medication history based on a medication history standard served as an effective foundation for a pharmacy technician medication history program, which helped improve provider compliance with discharge medication reconciliation. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Development of a Pharmacy Technician-Driven Program to Improve Vaccination Rates at an Academic Medical Center.

PubMed

Hill, John D; Anderegg, Sammuel V; Couldry, Rick J

2017-10-01

Background: Influenza and pneumococcal disease contribute substantially to the burden of preventable disease in the United States. Despite quality measures tied to immunization rates, health systems have struggled to achieve these targets in the inpatient setting. Pharmacy departments have had success through implementation of pharmacist standing order programs (SOP); however, these initiatives are labor-intensive and have not resulted in 100% immunization rates. Objective: The objective of this study was to evaluate a pilot utilizing pharmacy technician interventions, in combination with a nursing SOP, to improve vaccination rates of hospitalized patients for influenza and pneumococcal disease. Methods: A process was developed for pharmacy technicians to identify patients who were not previously screened or immunized during the weekend days on the Cardiovascular Progressive Care unit at the University of Kansas Health-System. Targeted pharmacy technician interventions consisted of phone call reminders and face-to-face discussions with nursing staff. The primary study outcome was the change in immunization compliance rates between the control and intervention groups. Results: Influenza vaccine rates showed a statistically significant increase from 72.2% (52 of 72) of patients during the control group to 92.9% (65 of 70, P = .001) of patients during the intervention group. A pneumococcal vaccination rate of 81.3% (61 of 75) was observed in the control group, compared with 84.3% (59 of 70) of patients in the intervention group ( P = .638). Conclusion: An improvement in inpatient influenza immunization rates can be achieved through targeted follow-up performed by pharmacy technicians, in combination with a nursing-driven SOP.

Innovations in Medication Preparation Safety and Wastage Reduction: Use of a Workflow Management System in a Pediatric Hospital.

PubMed

Davis, Stephen Jerome; Hurtado, Josephine; Nguyen, Rosemary; Huynh, Tran; Lindon, Ivan; Hudnall, Cedric; Bork, Sara

2017-01-01

Background: USP <797> regulatory requirements have mandated that pharmacies improve aseptic techniques and cleanliness of the medication preparation areas. In addition, the Institute for Safe Medication Practices (ISMP) recommends that technology and automation be used as much as possible for preparing and verifying compounded sterile products. Objective: To determine the benefits associated with the implementation of the workflow management system, such as reducing medication preparation and delivery errors, reducing quantity and frequency of medication errors, avoiding costs, and enhancing the organization's decision to move toward positive patient identification (PPID). Methods: At Texas Children's Hospital, data were collected and analyzed from January 2014 through August 2014 in the pharmacy areas in which the workflow management system would be implemented. Data were excluded for September 2014 during the workflow management system oral liquid implementation phase. Data were collected and analyzed from October 2014 through June 2015 to determine whether the implementation of the workflow management system reduced the quantity and frequency of reported medication errors. Data collected and analyzed during the study period included the quantity of doses prepared, number of incorrect medication scans, number of doses discontinued from the workflow management system queue, and the number of doses rejected. Data were collected and analyzed to identify patterns of incorrect medication scans, to determine reasons for rejected medication doses, and to determine the reduction in wasted medications. Results: During the 17-month study period, the pharmacy department dispensed 1,506,220 oral liquid and injectable medication doses. From October 2014 through June 2015, the pharmacy department dispensed 826,220 medication doses that were prepared and checked via the workflow management system. Of those 826,220 medication doses, there were 16 reported incorrect volume errors. The error rate after the implementation of the workflow management system averaged 8.4%, which was a 1.6% reduction. After the implementation of the workflow management system, the average number of reported oral liquid medication and injectable medication errors decreased to 0.4 and 0.2 times per week, respectively. Conclusion: The organization was able to achieve its purpose and goal of improving the provision of quality pharmacy care through optimal medication use and safety by reducing medication preparation errors. Error rates decreased and the workflow processes were streamlined, which has led to seamless operations within the pharmacy department. There has been significant cost avoidance and waste reduction and enhanced interdepartmental satisfaction due to the reduction of reported medication errors.

Identifying perceptions of academic reform in pharmacy using a four-frame organizational change model.

PubMed

Bajis, Dalia; Chaar, Betty; Basheti, Iman A; Moles, Rebekah

2017-11-10

In an ever-changing environment, pharmacy education is in the race to catch up and excel to produce competent pharmacists. Examining academic institutions, including schools of pharmacy, their internal systems and framework, it seems appropriate to view these institutions using multiple lenses. Bolman and Deal conceptualized a method to examine organizations using four constructs (structural, human resource, political, and symbolic). The Eastern Mediterranean Region (EMR), with deep-rooted pharmacy education and practice was the setting for this research. To explore factors affecting academic reform in undergraduate pharmacy education in the EMR from stakeholders' and students' perspectives; and to apply Bolman and Deal's four-frame organizational change model to explore how these issues might be viewed. A multiple-method approach was employed and involved collecting, analyzing and integrating qualitative semi-structured interview data with open-ended questions in a survey. Cross-sector stakeholder sample from various EMR countries was recruited and interviewed. Final year pharmacy students from one school of pharmacy in Jordan were surveyed. Emergent themes were indicative that academic reform was addressed by all frames of the Bolman and Deal model. Structural and political frames received substantial weighing pointing to the importance of curricular reform, collaboration and leadership. A need for skillful and role-model teaching academic staff was highlighted, and in harmony with the human resource frame. Issues within the symbolic frame were readily apparent in the data and spanned the other three frames in relation to heritage, customs and cultural barriers. Issues pertinent to academic reform in pharmacy were presented. Viewing change in pharmacy schools from multiple perspectives highlighted the need for structural changes to pharmacy programs, human resource management, political will, leadership, and collaboration. The importance of understanding cultural aspects of organizations is critical as it is these that provide identity to any organization and help reformers better manage change. Copyright © 2017 Elsevier Inc. All rights reserved.

Provision of menstrual regulation with medication among pharmacies in three municipal districts of Bangladesh: a situation analysis.

PubMed

Huda, Fauzia Akhter; Mahmood, Hassan Rushekh; Alam, Anadil; Ahmmed, Faisal; Karim, Farzana; Sarker, Bidhan Krishna; Al Haque, Nafis; Ahmed, Anisuddin

2018-02-01

The objective was to assess the provision of the combination of mifepristone-misoprostol for menstrual regulation (MR) in randomly selected urban pharmacies in Bangladesh. We conducted a cross-sectional survey among 553 pharmacy workers followed by 548 mystery client visits to the same pharmacies in 3 municipal districts during July 2014-December 2015. The survey found that 99% of pharmacy workers visited had knowledge of MR procedures but only two-thirds (67%) could state the legal time limit correctly; they mentioned misoprostol (86%) over mifepristone-misoprostol combination (78%) as a procedure of MR with medication (MRM); 36% reported knowing the recommended dosage of mifepristone-misoprostol combination; 70% reported providing information on effectiveness of the medicines; 50% reported recommending at least one follow-up visit to them; 63% reported explaining possible complications of using the medications; and 47% reported offering any post-MR contraception to their clients. In contrast, mystery client visits found that the mifepristone-misoprostol combination (69%) was suggested over misoprostol (51%) by the pharmacy workers; 54% provided the recommended dosage of mifepristone-misoprostol combination; 42% provided information on its effectiveness; 12% recommended at least one follow-up visit; 11% counseled on possible complications; and only 5% offered post-MR contraceptives to the mystery clients. We found knowledge gaps regarding recommended dosage for MRM and inconsistent practice in informing women on effectiveness, follow-up visits, possible complications and provision of post-MR contraceptives among the pharmacy workers, particularly during the mystery client visits. Pharmacy workers in Bangladesh need to be trained on legal time limits for MR services provision, on providing accurate information on disbursed medicine, and on proper referral mechanisms. A strong monitoring and regulatory system for pharmacy provision of MRM in pharmacies should be established. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

OVERSEER: An Expert System Monitor for the Psychiatric Hospital

PubMed Central

Bronzino, Joseph D.; Morelli, Ralph A.; Goethe, John W.

1988-01-01

In order to improve patient care, comply with regulatory guidelines and decrease potential liability, psychiatric hospitals and clinics have been searching for computer systems to monitor the management and treatment of patients. This paper describes OVERSEER: a knowledge based system that monitors the treatment of psychiatric patients in real time. Based on procedures and protocols developed in the psychiatric setting, OVERSEER monitors the clinical database and issues alerts when standard clinical practices are not followed or when laboratory results or other clinical indicators are abnormal. Written in PROLOG, OVERSEER is designed to interface directly with the hospital's database, and, thereby utilizes all available pharmacy and laboratory data. Moreover, unlike the interactive expert systems developed for the psychiatric clinic, OVERSEER does not require extensive data entry by the clinician. Consequently, the chief benefit of OVERSEER's monitoring approach is the unobtrusive manner in which it evaluates treatment and patient responses and provides information regarding patient management.

A Computer Program for the Management of Prescription-Based Problems.

ERIC Educational Resources Information Center

Cotter, Patricia M.; Gumtow, Robert H.

1991-01-01

The Prescription Management Program, a software program using Apple's HyperCard on a MacIntosh, was developed to simplify the creation, storage, modification, and general management of prescription-based problems. Pharmacy instructors may customize the program to serve their individual teaching needs. (Author/DB)

[Role of researchers and employees of the Military Medical Academy in development of the system of military medical supply].

PubMed

Miroshnichenko, Iu V; Kononov, V N; Perfil'ev, A B

2013-12-01

The Military Medical Academy has been solving theoretical and practical issues, concerning development of military medical supply, for 215 years. At different time periods and according to needs of military medicine and pharmacy researches and employees of the Academy aimed efforts to: development of the theory and practice of medical supply organization, regulatory basis of the system of medical supply, development of new samples of medical equipment, development of medicine manufacturing technologies and methods of quality control, researches in the area of medicine radiochemistry, forensic chemistry and toxicology, herbal and mineral water analysis and etc. At the present time there are the following education programs at the Academy: "Pharmacy", magister program "Management of medical supply", program for resident physicians "Management and economics of pharmacy".

[Technology to improve adherence in community pharmacy: a literature review].

PubMed

Staessen, J

2015-03-01

Drug-related problems are very common and they need some specific attention. Improper use of medication as well as poor adherence leads to side effects, interaction, increased healthcare costs,... What technologies can be used in community pharmacies to improve drug adherence? Articles were found in scientific databases Pubmed, Embase and CINAHL using a fixed search strategy. In this review 21 studies were included. The different technologies were compared with each other. Reminders using sms or smartphone were the most effective. There are already plenty of reminder systems (SMS, Email, internet, smartphone) and practical tools (medication dispensers, MEMS) available in community pharmacies. A major hurdle is the lack of the infrastructure. There needs to be invested in systems were patients are confronted with their own drug use.

Ensuring the Safety of Sterile Admixtures Prepared Outside of the Institution

PubMed Central

Eberts, Matthew W.; Cecere, David A.; Mark, Scott

2013-01-01

Director’s Forum is designed to guide pharmacy leaders in establishing patient-centered services in hospitals and health systems. This article provides an overview of outsourcing sterile products and discusses tools that pharmacy leaders can use to ensure the safety of the medications dispensed in their institution. PMID:24421470

Health Services: Clinical. Pharmacy Aide. Instructor's Manual. Competency-Based Education.

ERIC Educational Resources Information Center

Cave, Julie; And Others

This instructor's manual consists of materials for use in presenting a course in the occupational area of pharmacy aide. Included in the first part of the guide are a program master sequence; a master listing of instructional materials, equipment, and supplies; an overview of the competency-based vocational education (CBVE) system; and guidelines…

The Poison Control Center--Its Role

ERIC Educational Resources Information Center

Manoguerra, Anthony S.

1976-01-01

Poison Control Centers are being utilized by more schools of pharmacy each year as training sites for students. This paper discusses what such a center is, its services, changes anticipated in the poison center system in the next several years and how they may influence pharmacy education, specifically as it relates to clinical toxicology.…

A Just Culture Approach to Managing Medication Errors.

PubMed

Rogers, Erin; Griffin, Emily; Carnie, William; Melucci, Joseph; Weber, Robert J

2017-04-01

Medication errors continue to be a concern of health care providers and the public, in particular how to prevent harm from medication mistakes. Many health care workers are afraid to report errors for fear of retribution including the loss of professional licensure and even imprisonment. Most health care workers are silent, instead of admitting their mistake and discussing it openly with peers. This can result in further patient harm if the system causing the mistake is not identified and fixed; thus self-denial may have a negative impact on patient care outcomes. As a result, pharmacy leaders, in collaboration with others, must put systems in place that serve to prevent medication errors while promoting a "Just Culture" way of managing performance and outcomes. This culture must exist across disciplines and departments. Pharmacy leaders need to understand how to classify behaviors associated with errors, set realistic expectations, instill values for staff, and promote accountability within the workplace. This article reviews the concept of Just Culture and provides ways that pharmacy directors can use this concept to manage the degree of error in patient-centered pharmacy services.

Global Practices of Interprofessional Education (IPE) and Relevant International Activities.

PubMed

Arakawa, Naoko

2017-01-01

Activities related to interprofessional education (IPE) vary between countries according to local and national health needs and systems. The International Pharmaceutical Federation (FIP) Education Initiative endeavors to provide a global vision in IPE by the sharing of experiences and gathering of evidence collaboratively to facilitate country-level initiatives. The purpose of this paper is to contribute to the further development of IPE activities in pharmacy in Japan through sharing global perspectives and activities related to IPE. FIP Education Initiative published the Interprofessional Education in a Pharmacy Context: Global Report in September 2015, which marked a milestone in the growing recognition of IPE in pharmacy globally. The paper shared global and regional perspectives and experiences in IPE in pharmacy, both from the report and FIP activities. This paper can be seen as a snapshot of IPE-related international activities, which enables gaps and challenges in implementing IPE activities in Japan to be identified. This paper provides an opportunity to explore global trends and initiatives regarding IPE, and to consider how to form and implement IPE specifically based on Japanese health needs and systems.

Development of a pharmacy student research program at a large academic medical center.

PubMed

McLaughlin, Milena M; Skoglund, Erik; Bergman, Scott; Scheetz, Marc H

2015-11-01

A program to promote research by pharmacy students created through the collaboration of an academic medical center and a college of pharmacy is described. In 2009, Midwestern University Chicago College of Pharmacy and Northwestern Memorial Hospital (NMH) expanded their existing partnership by establishing a program to increase opportunities for pharmacy students to conduct clinical-translational research. All professional year 1, 2, or 3 students at the college, as well as professional year 4 students on rotation at NMH, can participate in the program. Central to the program's infrastructure is the mentorship of student leads by faculty- and hospital-based pharmacists. The mentors oversee the student research projects and guide development of poster presentations; student leads mentor junior students and assist with orientation and training activities. Publication of research findings in the peer-reviewed literature is a key program goal. In the first four years after program implementation, participation in a summer research program grew nearly 10-fold (mainly among incoming professional year 2 or 3 students, and student poster presentations at national pharmacy meetings increased nearly 20-fold; the number of published research articles involving student authors increased from zero in 2009 to three in 2012 and two in 2013. A collaborative program between an academic medical center and a college of pharmacy has enabled pharmacy students to conduct research at the medical center and has been associated with increases in the numbers of poster presentations and publications involving students. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The 'third class' of medications: Sales and purchasing behavior are associated with pharmacist only and pharmacy medicine classifications in Australia.

PubMed

Emmerton, Lynne

2009-01-01

Nonprescription (over-the-counter) medications in Australia are classified as Pharmacist Only Medicines, Pharmacy Medicines, or unscheduled medications. This report characterizes these medication classifications using key sales and purchasing behavior variables. Descriptive, nonexperimental, cross-sectional study. 15 pharmacies in southeast Queensland, Australia, with data recorded over 36 hours per pharmacy in mid-August, 2006. Eligible purchasers (n = 3,470 medication purchases) of all nonprescription medications (including nutritional supplements). Researchers documented details of all observed nonprescription medication sales and interviewed all available patients following the transaction. Incidence of product-related consultation, products purchased (brand, dosage form, classification), and purchasing behavior data (including previous purchase, intended use, intended user, and intention to purchase a particular brand). More restrictive classification of the purchased medication was significantly (P < 0.01) associated with younger purchasers, purchase of a single nonprescription medication, intent to self-use the medication, intent to purchase a particular brand, repeat purchase, brand-switching interventions by pharmacy staff, pharmacy staff influence on first-time purchases, and observed consultation by pharmacists. Legislative compliance issues were identified: Pharmacists consulted in only 54.7% of Pharmacist Only Medicine sales and 13 cases (1.7% of observed sales) occurred in which Pharmacist Only and Pharmacy Medicines had been sourced from publicly accessible areas of the store. Pharmacist Only Medicines received greater levels of professional involvement during their sale than Pharmacy Medicines and unscheduled medications, despite higher levels of product familiarity among patients. To optimize the benefits of this classification system, emphasis on professional guidelines is recommended.

An overview of service quality of continuous positive airway pressure services in Australian pharmacies.

PubMed

Hanes, Carissa A; Wong, Keith K H; Saini, Bandana

2014-01-01

Little is known about CPAP services offered in the Australian primary care pharmacy setting, despite the potential influence of service quality on patient adherence. The objective of this study was to provide an overview on a nationwide scale of the range and quality of CPAP and sleep apnoea-related services in Australian pharmacies. A paper-based questionnaire was developed and mailed to all pharmacies in Australia that currently provide CPAP services (as identified by manufacturer's distributor lists or Internet search). A point system was devised to score participants on the quality of their CPAP service. Pharmacies were rated against a list of 23 criteria that were determined by consensus, with one point allocated for each criterion met, allowing for a maximum score of 23. The study response rate was 55% (110/199), and representation was obtained from all eight Australian states and territories. The mean number of criteria met (total score) for pharmacies was 15.7 ± 3.4 (15.7/23 = 68.3%; score range 2-22). Variability was evident in the range of services offered. Eighty-seven per cent of respondents believed that pharmacies supplying CPAP should adhere to a formalized set of professional guidelines. The accessibility of pharmacies may make them a valuable venue for CPAP service provision. However, models of care to guide practice and standardize the variability in services are required. Implementation of such models could improve patient access to quality treatment in the primary care setting. © 2013 The Authors. Respirology © 2013 Asian Pacific Society of Respirology.

Service provision in the wake of a new funding model for community pharmacy.

PubMed

Smith, Alesha J; Scahill, Shane L; Harrison, Jeff; Carroll, Tilley; Medlicott, Natalie J

2018-05-02

Recently, New Zealand has taken a system wide approach providing the biggest reform to New Zealand community pharmacy for 70 years with the aim of providing more clinically orientated patient centred services through a new funding model. The aim of this study was to understand the types of services offered in New Zealand community pharmacies since introduction of the new funding model, what the barriers are to providing these services. A survey of all community pharmacies were undertaken between August, 2014 and February, 2015. Basic descriptive statistics were completed and group comparisons were made using the chi squared test with significance set at p < 0.05. 528 responses were received. Education and advice on prescription and non-prescription medicines were the two top listed services provided. There were no significant differences in service provision between rural and metro based pharmacies. Many pharmacies were considering introducing new patient centred services. Four of the top ten frequently provided services have no public funding attached. Costs and staff availability are the most common barriers to undertake services, more predominantly in patient centred services. This study was the first to provide an evaluation of service provision in response to a new funding model for New Zealand Community Pharmacies. A broad range of services are being undertaken in New Zealand community pharmacies including patient-centred services. A number of barriers to service provision were identified. This study provides a baseline for the current levels of service provision upon which future studies can compare to and evaluate any changes in service provision with differing funding models going forward.

Completeness of patient records in community pharmacies post-discharge after in-patient medication reconciliation: a before-after study.

PubMed

Karapinar-Çarkıt, Fatma; van Breukelen, Ben R L; Borgsteede, Sander D; Janssen, Marjo J A; Egberts, Antoine C G; van den Bemt, Patricia M L A

2014-08-01

Transfer of discharge medication related information to community pharmacies could improve continuity of care. This requires for community pharmacies to accurately update their patient records when new information is transferred. An instruction manual that specifies how to document information regarding medication changes and clinical information (i.e. allergies/contraindications) could support community pharmacies. To explore the effect of instruction manuals sent to community pharmacies on completeness of their patient records. A before-after study was performed (July 2009-August 2010) in the St Lucas Andreas Hospital, a general teaching hospital in Amsterdam, The Netherlands. Patients discharged from the cardiology and respiratory ward were included consecutively. The intervention consisted of a training session for community pharmacies regarding documentation problems and faxing an instruction manual to community pharmacies specifying how to document discharge information in their information system. Usual care consisted of faxing a discharge medication overview to community pharmacies without additional instructions. Two weeks after discharge the medication records of community pharmacies were collected by fax. These were compared with the initial discharge overviews regarding completeness of medication changes (i.e. explicit explanation that medication had been changed) and clinical information documentation. MAIN OUTCOME MEASURE OUTCOMES: were the number and percentage of completely documented medication changes (either needing to be dispensed or not) and clinical information items. The sample size was calculated at 107 patients per measurement period. Multivariable logistic regression was used for analysis. Two hundred and eighteen patients (112 before-106 after) were included. Completeness of medication changes documentation increased marginally after the intervention (46.6 vs 56.3 %, adjusted Odds Ratio 1.4 [95 % confidence interval 1.07-1.83]). Documentation increased when medication was actually dispensed by the community pharmacy. No significant improvements were seen for allergy and contraindication documentation. The intervention is insufficient to increase the completeness of documentation by community pharmacies as marginal improvements were achieved. Future studies should evaluate whether electronic infrastructures may help in achieving updated medication records to improve continuity of pharmaceutical care.

Improving pharmacy practice through public health programs: experience from Global HIV/AIDS initiative Nigeria project.

PubMed

Oqua, Dorothy; Agu, Kenneth Anene; Isah, Mohammed Alfa; Onoh, Obialunamma U; Iyaji, Paul G; Wutoh, Anthony K; King, Rosalyn C

2013-01-01

The use of medicines is an essential component of many public health programs (PHPs). Medicines are important not only for their capacity to treat and prevent diseases. The public confidence in healthcare system is inevitably linked to their confidence in the availability of safe and effective medicines and the measures for ensuring their rational use. However, pharmacy services component receives little or no attention in most public health programs in developing countries. This article describes the strategies, lessons learnt, and some accomplishments of Howard University Pharmacists and Continuing Education (HU-PACE) Centre towards improving hospital pharmacy practice through PHP in Nigeria. In a cross-sectional survey, 60 hospital pharmacies were randomly selected from 184 GHAIN-supported health facilities. The assessment was conducted at baseline and repeated after at least 12 months post-intervention using a study-specific instrument. Interventions included engagement of stakeholders; provision of standards for infrastructural upgrade; development of curricula and modules for training of pharmacy personnel; provision of job aids and tools amongst others. A follow-up hands-on skill enhancement based on identified gaps was conducted. Chi-square was used for inferential statistics. All reported p-values were 2-tailed at 95% confidence interval. The mean duration of service provision at post-intervention assessment was 24.39 (95% CI, 21.70-27.08) months. About 16.7% of pharmacies reported been trained in HIV care at pre-intervention compared to 83.3% at post-intervention. The proportion of pharmacies with audio-visual privacy for patient counseling increased significantly from 30.9% at pre-intervention to 81.4% at post-intervention. Filled prescriptions were cross-checked by pharmacist (61.9%) and pharmacy technician (23.8%) before dispensing at pre-intervention compared to pharmacist (93.1%) and pharmacy technician (6.9%) at post intervention. 40.0% of pharmacies reported tracking consumption of drugs at pre-intervention compared to 98.3% at post-intervention; while 81.7% of pharmacies reported performing periodic stock reconciliation at pre-intervention compared to 100.0% at post-intervention. 36.5% of pharmacies were observed providing individual counseling on medication use to patients at pre-intervention compared to 73.2% at post-intervention; and 11.7% of pharmacies had evidence of monitoring and reporting of suspected adverse drug reaction at pre-intervention compared to 73.3% at post-intervention. The institution of access to patients' clinical information by pharmacists in all pharmacies at post-intervention was a paradigm shift. Through public health program, HU-PACE created an enabling environment and improved capacity of pharmacy personnel for quality HIV/AIDS and TB services. This has contributed in diverse ways to better monitoring of patients on pharmacotherapy by pharmacists through access of pharmacists to patients' clinical information.

A Primer on Audience Response Systems: Current Applications and Future Considerations

PubMed Central

Robinson, Evan

2008-01-01

Audience response systems (ARSs) are an increasingly popular tool in higher education for promoting interactivity, gathering feedback, preassessing knowledge, and assessing students' understanding of lecture concepts. Instructors in numerous disciplines are realizing the pedagogical value of these systems. Actual research on ARS usage within pharmacy education is sparse. In this paper, the health professions literature on uses of ARSs is reviewed and a primer on the issues, benefits, and potential uses within pharmacy education is presented. Future areas of educational research on ARS instructional strategies are also suggested. PMID:19002277

Comparison and alignment of an academic medical center's strategic goals with ASHP initiatives.

PubMed

Engels, Melanie J; Chaffee, Bruce W; Clark, John S

2015-12-01

An academic medical center's strategic goals were compared and aligned with the 2015 ASHP Health-System Pharmacy Initiative and the Pharmacy Practice Model Initiative (PPMI). The department's pharmacy practice model steering committee identified potential solutions to narrow prioritized gaps using a modified nominal group technique and a multivoting dot technique. Five priority solutions were identified and assigned to work groups to develop business plans, which included admission medication history and reconciliation for high-risk patients and those with complex medication regimens, pharmacist provision of discharge counseling to high-risk patients and those with complex medication regimens, improved measurement and reporting of the impact of PPMI programs on patient outcomes, implementation of a departmentwide formalized peer review and evaluation process, and the greeting of every patient at some time during his or her visit by a pharmacy team member. Stakeholders evaluated the business plans based on feasibility, financial return on investment, and anticipated safety enhancements. The solution that received the highest priority ranking and was subsequently implemented was "improved measurement and reporting of the impact of PPMI programs on patient outcomes." A defined process was followed for identifying gaps among current practices at an academic medical center and the 2015 ASHP Health-System Pharmacy Initiative and the PPMI. A key priority to better document the impact of pharmacists on patient care was identified for our department by using a nominal group technique brainstorming process and a multivoting dot technique and creating standardized business plans for five potential priority projects. Copyright © 2015 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Clinical pharmacists: The major support to Indian healthcare system in near future

PubMed Central

Deshpande, Prasanna R.; Vantipalli, Raghuram; Chaitanya Lakshmi, C. H.; Rao, E. Jagadeswara; Regmi, Bishnu; Ahad, Abdul; Nirojini, P. Sharmila

2015-01-01

Pharmacy practice is still in the initial stages of development in India, but launching of Doctor of Pharmacy (PharmD) study program has brought serious discussions about clinical pharmacy in the country. As the profession is in budding stage in the country, the patients, physicians, nurses, other healthcare providers, recruiters in pharmaceutical industries, prospective students, and their parents have numerous questions about this profession and study course. The objective of this article is to create awareness about clinical pharmacy services (CPS) and to introduce the role of clinical pharmacists (CPs). After reading this article, one will know about the usefulness of CPs in the Indian healthcare system against the current flaws in the system. The article describes the role of CPs in the hospitals, in research, in pharmaceutical/contract research companies, in community service and it also tells about the related myths and facts. Prospective job opportunities for CPs, present challenges and the possible solutions are elaborated as well. In conclusion, CPs are going to be the major support to the Indian healthcare system in near future; the reasons being (1) CPS are beneficial in many ways to improve healthcare; CPS have already proved their importance in western countries (2) India was never officially and efficiently exposed to CPS; so launching of CPS shall revolutionize the country's healthcare scenario. PMID:26229349

Perceptions of pharmacy students, faculty members, and administrators on the use of technology in the classroom.

PubMed

DiVall, Margarita V; Hayney, Mary S; Marsh, Wallace; Neville, Michael W; O'Barr, Stephen; Sheets, Erin D; Calhoun, Larry D

2013-05-13

To gather and evaluate the perceptions of students, faculty members, and administrators regarding the frequency and appropriateness of classroom technology use. Third-year pharmacy students and faculty members at 6 colleges and schools of pharmacy were surveyed to assess their perceptions about the type, frequency, and appropriateness of using technology in the classroom. Upper-level administrators and information technology professionals were also interviewed to ascertain overall technology goals and identify criteria used to adopt new classroom technologies. Four hundred sixty-six students, 124 faculty members, and 12 administrators participated in the survey. The most frequently used and valued types of classroom technology were course management systems, audience response systems, and lecture capture. Faculty members and students agreed that faculty members appropriately used course management systems and audience response systems. Compared with their counterparts, tech-savvy, and male students reported significantly greater preference for increased use of classroom technology. Eighty-six percent of faculty members reported having changed their teaching methodologies to meet student needs, and 91% of the students agreed that the use of technology met their needs. Pharmacy colleges and schools use a variety of technologies in their teaching methods, which have evolved to meet the needs of the current generation of students. Students are satisfied with the appropriateness of technology, but many exhibit preferences for even greater use of technology in the classroom.

Perceptions of Pharmacy Students, Faculty Members, and Administrators on the Use of Technology in the Classroom

PubMed Central

DiVall, Margarita V.; Hayney, Mary S; Marsh, Wallace; Neville, Michael W.; O’Barr, Stephen; Sheets, Erin D.; Calhoun, Larry D.

2013-01-01

Objectives. To gather and evaluate the perceptions of students, faculty members, and administrators regarding the frequency and appropriateness of classroom technology use. Methods. Third-year pharmacy students and faculty members at 6 colleges and schools of pharmacy were surveyed to assess their perceptions about the type, frequency, and appropriateness of using technology in the classroom. Upper-level administrators and information technology professionals were also interviewed to ascertain overall technology goals and identify criteria used to adopt new classroom technologies. Results. Four hundred sixty-six students, 124 faculty members, and 12 administrators participated in the survey. The most frequently used and valued types of classroom technology were course management systems, audience response systems, and lecture capture. Faculty members and students agreed that faculty members appropriately used course management systems and audience response systems. Compared with their counterparts, tech-savvy, and male students reported significantly greater preference for increased use of classroom technology. Eighty-six percent of faculty members reported having changed their teaching methodologies to meet student needs, and 91% of the students agreed that the use of technology met their needs. Conclusions. Pharmacy colleges and schools use a variety of technologies in their teaching methods, which have evolved to meet the needs of the current generation of students. Students are satisfied with the appropriateness of technology, but many exhibit preferences for even greater use of technology in the classroom. PMID:23716743

Infrastructure of pharmacies of the primary health care in the Brazilian Unified Health System: Analysis of PNAUM - Services data.

PubMed

Leite, Silvana Nair; Manzini, Fernanda; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mário; Farias, Mareni Rocha

2017-11-13

To characterize the infrastructure of the primary health care pharmacies of the Brazilian Unified Health System, aiming at humanizing the offered services. This is a cross-sectional study, of quantitative approach, from data obtained in the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos - Serviços, 2015 (PNAUM - National Survey on Access, Use and Promotion of Rational Use of Medicines - Services, 2015). Information on 1,175 pharmacies/dispensing units were gathered from direct observation and assessment of dispensing units installations conducted by trained researchers who used a standardized form. The analyzed variables refer to the physical structure of pharmacies or medicine dispensing units of the health units under research. The pharmacy area was greater than 14 m2 in 40.3% of the sampled units, highlighting those from Midwest (56.9%) and Southeast (56.2%) regions and those of Northeast, with only 23.3%. About 80.2% units had waiting rooms with chairs for patients, 31.8% of them had dispensing areas inferior to 5m2, while in 46.2% these areas were superior to 10m2. Bars were found in service counters in 23.8% of health units, thus separating the patient from the professional; 44.1% had internet access. In most units, the area of medicine storage had no refrigerator or freezer for their exclusive storage and 13.7% had a specific room for pharmaceutical consultation. Aiming at achieving care humanization and improving working conditions for professionals, the structuring of the environment of pharmacy services is necessary. This would contribute to the better qualification of pharmacy services, comprising more than medicine delivery. Data on the Northeast region indicated less favorable conditions to the development of adequate dispensing services. Based on the panorama pointed out, we suggest the expansion of stimulus concerning the physical structure of pharmaceutical services, considering regional specificities.

Organizational readiness for change: Preceptor perceptions regarding early immersion of student pharmacists in health-system practice.

PubMed

Sanders, Kimberly A; Wolcott, Michael D; McLaughlin, Jacqueline E; D'Ostroph, Amanda; Shea, Christopher M; Pinelli, Nicole R

To examine preceptors' perceptions regarding readiness for change pre- and post-implementation of a pilot early immersion program engaging student pharmacists in direct patient care. Student pharmacists enrolled in the second professional year of a Doctor of Pharmacy degree program completed a four-week health-system introductory pharmacy practice experience (IPPE) which was modified to include direct patient care roles in operational (drug preparation and dispensing) and clinical (comprehensive medication management) pharmacy environments. Pharmacy preceptors with direct oversight for program implementation completed a pre/post Organizational Readiness for Implementing Change (ORIC) survey and a 50-min interview or focus group post-experience. The ORIC survey evaluates two dimensions of organizational readiness for change - change commitment and change efficacy. Additional items assessed included implementation needs, support, and perceived value of the change. ORIC survey constructs were compared before and after the experience. Interviews and focus groups were audio recorded, transcribed, and evaluated by constant comparative analysis. A mixed methods approach was used to triangulate findings and develop greater understanding of the ORIC survey results. Twenty pharmacy preceptors (37 ± 8 years of age, 60% female, 65% clinical pharmacist position, 70% prior preceptor experience) participated in the study. There were no significant changes in pre/post survey constructs, except for a decline in the perception of organizational change commitment (p < 0.001). Sub-analyses indicated the decline was associated with items assessing individual dedication and individual commitment to the change (p < 0.05 for both). Primary emerging themes from interviews included concerns about implementation requirements, contextual factors of the experience that affected implementation, and varying perceptions about the value of early immersion across preceptor roles. As pharmacy curricula immerse student pharmacists in practice earlier in their education, pharmacy departments can utilize the ORIC survey to identify preceptors' commitment and concerns to support the necessary changes for student pharmacist engagement. Copyright © 2017 Elsevier Inc. All rights reserved.

Implementation of a formulary management process.

PubMed

Karel, Lauren I; Delisle, Dennis R; Anagnostis, Ellena A; Wordell, Cindy J

2017-08-15

The application of lean methodology in an initiative to redesign the formulary maintenance process at an academic medical center is described. Maintaining a hospital formulary requires clear communication and coordination among multiple members of the pharmacy department. Using principles of lean methodology, pharmacy department personnel within a multihospital health system launched a multifaceted initiative to optimize formulary management systemwide. The ongoing initiative began with creation of a formulary maintenance redesign committee consisting of pharmacy department personnel with expertise in informatics, automation, purchasing, drug information, and clinical pharmacy services. The committee met regularly and used lean methodology to design a standardized process for management of formulary additions and deletions and changes to medications' formulary status. Through value stream analysis, opportunities for process and performance improvement were identified; staff suggestions on process streamlining were gathered during a series of departmental kaizen events. A standardized template for development and dissemination of monographs associated with formulary additions and status changes was created. In addition, a shared Web-based checklist was developed to facilitate information sharing and timely initiation and completion of tasks involved in formulary status changes, and a permanent formulary maintenance committee was established to monitor and refine the formulary management process. A clearly defined, standardized process within the pharmacy department was developed for tracking necessary steps in enacting formulary changes to encourage safe and efficient workflow. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

The role of pharmacists in developing countries: the current scenario in Pakistan

PubMed Central

Azhar, Saira; Hassali, Mohamed Azmi; Ibrahim, Mohamed Izham Mohamed; Ahmad, Maqsood; Masood, Imran; Shafie, Asrul Akmal

2009-01-01

During the past few years, the pharmacy profession has expanded significantly in terms of professional services delivery and now has been recognized as an important profession in the multidisciplinary provision of health care. In contrast to the situation in developed countries, pharmacists in developing countries are still underutilized and their role as health care professionals is not deemed important by either the community or other health care providers. The aim of this paper is to highlight the role of pharmacists in developing countries, particularly in Pakistan. The paper draws on the literature related to the socioeconomic and health status of Pakistan's population, along with background on the pharmacy profession in the country in the context of the current directions of health care. The paper highlights the current scenario and portrays the pharmacy profession in Pakistan. It concludes that although the pharmacy profession in Pakistan is continuously evolving, the health care system of Pakistan has yet to recognize the pharmacist's role. This lack of recognition is due to the limited interaction of pharmacists with the public. Pharmacists in Pakistan are concerned about their present professional role in the health care system. The main problem they are facing is the shortage of pharmacists in pharmacies. Moreover, their services are focused towards management more than towards customers. For these reasons, the pharmacist's role as a health care professional is not familiar to the public. PMID:19594916

Minimizing human error in radiopharmaceutical preparation and administration via a bar code-enhanced nuclear pharmacy management system.

PubMed

Hakala, John L; Hung, Joseph C; Mosman, Elton A

2012-09-01

The objective of this project was to ensure correct radiopharmaceutical administration through the use of a bar code system that links patient and drug profiles with on-site information management systems. This new combined system would minimize the amount of manual human manipulation, which has proven to be a primary source of error. The most common reason for dosing errors is improper patient identification when a dose is obtained from the nuclear pharmacy or when a dose is administered. A standardized electronic transfer of information from radiopharmaceutical preparation to injection will further reduce the risk of misadministration. Value stream maps showing the flow of the patient dose information, as well as potential points of human error, were developed. Next, a future-state map was created that included proposed corrections for the most common critical sites of error. Transitioning the current process to the future state will require solutions that address these sites. To optimize the future-state process, a bar code system that links the on-site radiology management system with the nuclear pharmacy management system was proposed. A bar-coded wristband connects the patient directly to the electronic information systems. The bar code-enhanced process linking the patient dose with the electronic information reduces the number of crucial points for human error and provides a framework to ensure that the prepared dose reaches the correct patient. Although the proposed flowchart is designed for a site with an in-house central nuclear pharmacy, much of the framework could be applied by nuclear medicine facilities using unit doses. An electronic connection between information management systems to allow the tracking of a radiopharmaceutical from preparation to administration can be a useful tool in preventing the mistakes that are an unfortunate reality for any facility.

Use of Computer-Assisted Instruction to Review Microbiology and Antimicrobial Agents.

ERIC Educational Resources Information Center

Carver, Peggy L.; And Others

1991-01-01

A study assessed the effectiveness of a microcomputer-assisted instructional program using graphics, color, and text in simulations to enhance pharmacy students' knowledge of microbiology and antimicrobial agents. Results indicated high short- and long-term retention of information presented and higher levels of knowledge and comprehension among…

Supply chain optimization at an academic medical center.

PubMed

Labuhn, Jonathan; Almeter, Philip; McLaughlin, Christopher; Fields, Philip; Turner, Benjamin

2017-08-01

A successful supply chain optimization project that leveraged technology, engineering principles, and a technician workflow redesign in the setting of a growing health system is described. With continued rises in medication costs, medication inventory management is increasingly important. Proper management of central pharmacy inventory and floor-stock inventory in automated dispensing cabinets (ADCs) can be challenging. In an effort to improve control of inventory costs in the central pharmacy of a large academic medical center, the pharmacy department implemented a supply chain optimization project in collaboration with the medical center's inhouse team of experts on process improvement and industrial engineering. The project had 2 main components: (1) upgrading and reconfiguring carousel technology within an expanded central pharmacy footprint to generate accurate floor-stock inventory replenishment reports, which resulted in efficiencies within the medication-use system, and (2) implementing a technician workflow redesign and algorithm to right-size the ADC inventory, which decreased inventory stockouts (i.e., incidents of depletion of medication stock) and improved ADC user satisfaction. Through a multifaceted approach to inventory management, the number of stockouts per month was decreased and ADC inventory was optimized, resulting in a one-time inventory cost savings of $220,500. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Impact of electronic order management on the timeliness of antibiotic administration in critical care patients.

PubMed

Cartmill, Randi S; Walker, James M; Blosky, Mary Ann; Brown, Roger L; Djurkovic, Svetolik; Dunham, Deborah B; Gardill, Debra; Haupt, Marilyn T; Parry, Dean; Wetterneck, Tosha B; Wood, Kenneth E; Carayon, Pascale

2012-11-01

To examine the effect of implementing electronic order management on the timely administration of antibiotics to critical-care patients. We used a prospective pre-post design, collecting data on first-dose IV antibiotic orders before and after the implementation of an integrated electronic medication-management system, which included computerized provider order entry (CPOE), pharmacy order processing and an electronic medication administration record (eMAR). The research was performed in a 24-bed adult medical/surgical ICU in a large, rural, tertiary medical center. Data on the time of ordering, pharmacy processing and administration were prospectively collected and time intervals for each stage and the overall process were calculated. The overall turnaround time from ordering to administration significantly decreased from a median of 100 min before order management implementation to a median of 64 min after implementation. The first part of the medication use process, i.e., from order entry to pharmacy processing, improved significantly whereas no change was observed in the phase from pharmacy processing to medication administration. The implementation of an electronic order-management system improved the timeliness of antibiotic administration to critical-care patients. Additional system changes are required to further decrease the turnaround time. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The potential dual use of online pharmacies.

PubMed

Letkiewicz, Sławomir; Górski, Andrzej

2010-03-01

The technological advances of the 20th century resulted in the creation of the Internet and its introduction into everyday life on a global scale. The Internet provides access to information and the sale and purchase of goods. Medications are also subject to trade. Their sale is conducted by online pharmacies and their global turnover amounts to hundreds of billions of dollars. Medications ordered over the Internet are sent by mail all over the world. Considering the events of recent years, we cannot exclude the risk of a terrorist attack through online pharmacies. Terrorists can establish such companies, legally or illegally, or acquire ones already existing. Parcels, which are highly trusted by the customers of online pharmacies, can, for example, be contaminated with dangerous materials. The sale of online medications in the international system is potentially dangerous and requires international regulation.

Drug Information Education in Doctor of Pharmacy Programs

PubMed Central

Wang, Fei; Troutman, William G.; Seo, Teresa; Peak, Amy; Rosenberg, Jack M.

2006-01-01

Objective To characterize pharmacy program standards and trends in drug information education. Methods A questionnaire containing 34 questions addressing general demographic characteristics, organization, and content of drug information education was distributed to 86 colleges and schools of pharmacy in the United States using a Web-based survey system. Results Sixty colleges responded (73% response rate). All colleges offered a campus-based 6-year first-professional degree PharmD program. Didactic drug information was a required course in over 70% of these schools. Only 51 of the 60 colleges offered an advanced pharmacy practice experience (APPE) in drug information, and 62% of these did so only on an elective basis. Conclusion Although almost all of the PharmD programs in the US include a required course in drug information, the majority do not have a required APPE in this important area. PMID:17136172

New workers' compensation legislation: expected pharmaceutical cost savings.

PubMed

Wilson, Leslie; Gitlin, Matthew

2005-10-01

California Workers' Compensation (WC) system costs are under review. With recently approved California State Assembly Bill (AB) 749 and Senate Bill (SB) 228, an assessment of proposed pharmaceutical cost savings is needed. A large workers' compensation database provided by the California Workers' Compensation Institute (CWCI) and Medi-Cal pharmacy costs obtained from the State Drug Utilization Project are utilized to compare frequency, costs and savings to Workers' Compensation in 2002 with the new pharmacy legislation. Compared to the former California Workers' Compensation fee schedule, the newly implemented 100% Medi-Cal fee schedule will result in savings of 29.5% with a potential total pharmacy cost savings of $125 million. Further statistical analysis demonstrated that a large variability in savings across drugs could not be controlled with this drug pricing system. Despite the large savings in pharmaceuticals, inconsistencies between the two pharmaceutical payment systems could lead to negative incentives and uncertainty for long-term savings. Proposed alternative pricing systems could be considered. However, pain management implemented along with other cost containment strategies could more effectively reduce overall drug spending in the workers' compensation system.

Evaluation of community pharmacy service mix: evidence from the 2004 National Pharmacist Workforce Study.

PubMed

Doucette, William R; Kreling, David H; Schommer, Jon C; Gaither, Caroline A; Mott, David A; Pedersen, Craig A

2006-01-01

To describe the mix of pharmacy services being offered in different types of community pharmacy practices and to identify factors associated with a community pharmacy offering pharmacy services. Cross-sectional study. Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies). Pharmacists practicing full-time or part-time who worked in community pharmacies and responded to the 2004 National Pharmacist Workforce Survey. Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled pharmacists and supplemental surveys that included workplace questions for a selected subsample of pharmacists. Type and frequency of pharmacy services being offered in a community pharmacy, including dispensing and product-related services (e.g., specialty compounding), and pharmacist care services (e.g., immunizations, smoking cessation, health screening, medication therapy management, wellness screening, nutritional support, and disease management services). Four pharmacist care services were reported as being offered at more than 10% of community pharmacy practices: immunizations, smoking cessation, health screening, and diabetes management. The number of pharmacist care services offered at a community pharmacy was positively associated with having at least three pharmacists on duty, innovativeness of the pharmacy, status as an independent pharmacy, and status as a supermarket pharmacy. More than one half of the community pharmacy practices did not offer any of the eight pharmacist care services included in a pharmacy service index. Pharmacy services were reported at relatively few community pharmacies, and were associated with pharmacy innovativeness, pharmacist staffing levels, and pharmacy setting. Some community pharmacies are offering pharmacy services as part of their business strategy, while others are dedicated to dispensing services. Continued study of pharmacy service availability in community pharmacies is needed to improve our understanding of our capacity to deliver such services, including medication therapy management services.

Pharmacy staff characteristics associated with support for pharmacy-based HIV-testing in pharmacies participating in the New York State Expanded Access Syringe Exchange Program

PubMed Central

Amesty, Silvia; Blaney, Shannon; Crawford, Natalie D.; Rivera, Alexis V.; Fuller, Crystal

2013-01-01

Objective To determine support of in-pharmacy HIV-testing among pharmacy staff and the individual-level characteristics associated with in-pharmacy HIV testing support. Design Descriptive, nonexperimental, cross-sectional study. Setting New York City (NYC) during January 2008 to March 2009. Intervention 131 pharmacies registered in the Expanded Syringe Access Program (ESAP) completed a survey. Participants 480 pharmacy staff, including pharmacists, owners/managers, and technicians/clerks. Main outcome measures Support of in-pharmacy HIV testing. Results Support of in-pharmacy HIV testing is high among pharmacy staff (79.4%). Pharmacy staff that supported in-pharmacy vaccinations were significantly more likely to support in-pharmacy HIV testing. Pharmacy staff that think that selling syringes to IDUs causes the community to be littered with dirty syringes were significantly less likely to support in-pharmacy HIV testing. Conclusion Support for in-pharmacy HIV testing is high among our sample of ESAP pharmacy staff actively involved in non-prescription syringe sales. These findings suggest that active ESAP pharmacy staff may be amenable to providing HIV counseling and testing to injection drug users and warrants further investigation. PMID:22825227

Exploring relationships among pharmacy service use, patronage motives, and patient satisfaction.

PubMed

Patterson, Brandon J; Doucette, William R; Urmie, Julie M; McDonough, Randal P

2013-01-01

To describe and identify significant relationships among pharmacy service use, general and service-specific patient satisfaction, pharmacy patronage motives, and marketing awareness in a service-oriented, independent community pharmacy. Cross-sectional study. Midwest United States during May through July 2011. Stratified random sample of 500 participants. Self-reported questionnaire mailed to participants. Patient satisfaction, pharmacy service use, patronage motives, marketing awareness, and demographics. Study participants were mostly satisfied with the pharmacy services on global and service-specific measures. Patronage motives of relationships, pharmacy atmosphere, and quality previous experience were associated with increased pharmacy service use at the study pharmacy, while a unique service patronage motivation was associated with decreased pharmacy service use at the study pharmacy. Participants citing pharmacy atmosphere and personnel competency as patronage motives did not use pharmacies other than the study pharmacy more often, whereas participants citing unique services as a patronage motive used pharmacies other than the study pharmacy more often. Direct marketing awareness increased pharmacy service awareness but not use. Offering unique services may not be enough to bring in patients loyal to all services provided in a pharmacy. Pharmacists should focus on developing strong relationships with patients and conveying competence when delivering appropriate, quality pharmacy services in a professional pharmacy atmosphere.

Impact of pharmacy worker training and deployment on access to essential medicines and health outcomes in Malawi: protocol for a cluster quasi-experimental evaluation.

PubMed

Lubinga, Solomon J; Jenny, Alisa M; Larsen-Cooper, Erin; Crawford, Jessica; Matemba, Charles; Stergachis, Andy; Babigumira, Joseph B

2014-10-11

Access to essential medicines is core to saving lives and improving health outcomes of people worldwide, particularly in the low- and middle-income countries. Having a trained pharmacy workforce to manage the supply chain and safely dispense medicines is critical to ensuring timely access to quality pharmaceuticals and improving child health outcomes. This study measures the impact of an innovative pharmacy assistant training program in the low-income country of Malawi on access to medicines and health outcomes. We employ a cluster quasi-experimental design with pre-and post-samples and decision analytic modeling to examine access to and the use of medicines for malaria, pneumonia, and diarrhea for children less than 5 years of age. Two intervention districts, with newly trained and deployed pharmacy assistants, and two usual care comparison districts, matched on socio-economic, geographic, and health-care utilization indicators, were selected for the study. A baseline household survey was conducted in March 2014, prior to the deployment of pharmacy assistants to the intervention district health centers. Follow-up surveys are planned at 12- and 24-months post-deployment. In addition, interviews are planned with caregivers, and time-motion studies will be conducted with health-care providers at the health centers to estimate costs and resources use. This impact evaluation is designed to provide data on the effects of a novel pharmacy assistant program on pharmaceutical systems performance, and morbidity and mortality for the most common causes of death for children under five. The results of this study should contribute to policy decisions about whether and how to scale up the health systems strengthening workforce development program to have the greatest impact on the supply chain and health outcomes in Malawi.

Using link analysis to explore the impact of the physical environment on pharmacist tasks.

PubMed

Lester, Corey A; Chui, Michelle A

2016-01-01

National community pharmacy organizations have been redesigning pharmacies to better facilitate direct patient care. However, evidence suggests that changing the physical layout of a pharmacy prior to understanding how the environment impacts pharmacists' work may not achieve the desired benefits. This study describes an objective method to understanding how the physical layout of the pharmacy may affect how pharmacists perform tasks. Link analysis is a systems engineering method used to describe the influence of the physical environment on task completion. This study used a secondary data set of field notes collected from 9 h of direct observation in one mass-merchandise community pharmacy in the U.S. State, Wisconsin. A node is an individual location in the environment. A link is the movement between two nodes. Tasks were inventoried and task themes identified. The mean, minimum, and maximum number of links needed to complete each task were then determined and used to construct a link table. A link diagram is a graphical display showing the links in conjunction with the physical layout of the pharmacy. A total of 92 unique tasks were identified resulting in 221 links. Tasks were sorted into five themes: patient care activities, insurance issues, verifying prescriptions, filling prescriptions, and other. Insurance issues required the greatest number of links with a mean of 4.75. Verifying prescriptions and performing patient care were the most commonly performed tasks with 36 and 30 unique task occurrences, respectively. Link analysis provides an objective method for identifying how a pharmacist interacts with the physical environment to complete tasks. This method provides designers with useful information to target interventions to improve the effectiveness of pharmacist work. Analysis beyond link analysis should be considered for large scale system redesign. Copyright © 2015 Elsevier Inc. All rights reserved.

Faculty and student expectations and perceptions of e-mail communication in a campus and distance doctor of pharmacy program.

PubMed

Foral, Pamela A; Turner, Paul D; Monaghan, Michael S; Walters, Ryan W; Merkel, Jennifer J; Lipschultz, Jeremy H; Lenz, Thomas L

2010-12-15

To examine faculty members' and students' expectations and perceptions of e-mail communication in a dual pathway pharmacy program. Three parallel survey instruments were administered to campus students, distance students, and faculty members, respectively. Focus groups with students and faculty were conducted. Faculty members perceived themselves as more accessible and approachable by e-mail than either group of students did. Campus students expected a shorter faculty response time to e-mail and for faculty members to be more available than did distance students. E-mail is an effective means of computer-mediated communication between faculty members and students and can be used to promote a sense of community and inclusiveness (ie, immediacy), especially with distant students.

[Chickenpox case estimation in acyclovir pharmacy survey and early bioterrorism detection].

PubMed

Sugawara, Tamie; Ohkusa, Yasushi; Kawanohara, Hirokazu; Taniguchi, Kiyosu; Okabe, Nobuhiko

2011-11-01

Early potential health hazards and bioterrorism threats require early detection. Smallpox cases caused by terrorist could, for example, be treated by prescribing acyclovir to those having fever and vesicle exanthema diagnosed as chicken pox. We have constructed real-time pharmacy surveillance scenarios using information technology (IT) to monitor acyclovir prescription. We collected the number of acyclovir prescriptions from 5138 pharmacies using the Application Server Provider System (ASP) to estimate the number of cases. We then compared the number of those given acyclovir under 15 years old from pharmacy surveillance and sentinel surveillance for chickenpox under the Infection Disease Control Law. The estimated number of under 15 years old prescribed acyclovir in pharmacy surveillance resembled sentinel surveillance results and showed a similar seasonal chickenpox pattern. The correlation coefficient was 0.8575. The estimated numbers of adults, older than 15 but under 65 years old, and elderly, older than 65, prescribed acyclovir showed no clear seasonal pattern. Pharmacy surveillance for acyclovir identified the baseline and can be used to detect unusual chickenpox outbreak. Bioterrorism attack could potentially be detected using smallpox virus when acyclovir prescription for adults suddenly increases without outbreaks in children or the elderly. This acyclovir prescription monitoring such as an application is, to our knowledge, the first of its kind anywhre.

Predicting tobacco sales in community pharmacies using population demographics and pharmacy type.

PubMed

Hickey, Lisa M; Farris, Karen B; Peterson, N Andrew; Aquilino, Mary L

2006-01-01

To determine whether the population demographics of the location of pharmacies were associated with tobacco sales in pharmacies, when controlling for pharmacy type. Retrospective analysis. Iowa. All retailers in Iowa that obtained tobacco licenses and all pharmacies registered with the Iowa Board of Pharmacy in 2003. MAIN OUTCOME MEASURE AND INTERVENTIONS: Percentage of pharmacies selling tobacco (examined by pharmacy type using chi-square analysis); median income and distribution of race/ethnicity in the county for pharmacies that did or did not sell tobacco (t tests); predictors of whether a pharmacy sold tobacco (logistic regression using the independent variables county-level demographic variables and pharmacy characteristics). County gender composition, race/ethnicity make-up, and income levels were different for tobacco-selling and -nonselling pharmacies. Logistic regression showed that whether a pharmacy sold tobacco was strongly dependent on the type of pharmacy; compared with independent pharmacies (of which only 5% sold tobacco products), chain pharmacies were 34 times more likely to sell tobacco products, mass merchandiser outlets were 47 times more likely to stock these goods, and grocery stores were 378 times more likely to do so. Pharmacies selling tobacco were more likely to be located in counties with significantly higher numbers of multiracial groups. The best predictor of whether an Iowa pharmacy sells tobacco products is type of pharmacy. In multivariable analyses, population demographics of the county in which pharmacies were located were generally not predictive of whether a pharmacy sold tobacco.

Notification of real-time clinical alerts generated by pharmacy expert systems.

PubMed Central

Miller, J. E.; Reichley, R. M.; McNamee, L. A.; Steib, S. A.; Bailey, T. C.

1999-01-01

We developed and implemented a strategy for notifying clinical pharmacists of alerts generated in real-time by two pharmacy expert systems: one for drug dosing and the other for adverse drug event prevention. Display pagers were selected as the preferred notification method and a concise, yet readable, format for displaying alert data was developed. This combination of real-time alert generation and notification via display pagers was shown to be efficient and effective in a 30-day trial. PMID:10566374

Statistics in the pharmacy literature.

PubMed

Lee, Charlene M; Soin, Herpreet K; Einarson, Thomas R

2004-09-01

Research in statistical methods is essential for maintenance of high quality of the published literature. To update previous reports of the types and frequencies of statistical terms and procedures in research studies of selected professional pharmacy journals. We obtained all research articles published in 2001 in 6 journals: American Journal of Health-System Pharmacy, The Annals of Pharmacotherapy, Canadian Journal of Hospital Pharmacy, Formulary, Hospital Pharmacy, and Journal of the American Pharmaceutical Association. Two independent reviewers identified and recorded descriptive and inferential statistical terms/procedures found in the methods, results, and discussion sections of each article. Results were determined by tallying the total number of times, as well as the percentage, that each statistical term or procedure appeared in the articles. One hundred forty-four articles were included. Ninety-eight percent employed descriptive statistics; of these, 28% used only descriptive statistics. The most common descriptive statistical terms were percentage (90%), mean (74%), standard deviation (58%), and range (46%). Sixty-nine percent of the articles used inferential statistics, the most frequent being chi(2) (33%), Student's t-test (26%), Pearson's correlation coefficient r (18%), ANOVA (14%), and logistic regression (11%). Statistical terms and procedures were found in nearly all of the research articles published in pharmacy journals. Thus, pharmacy education should aim to provide current and future pharmacists with an understanding of the common statistical terms and procedures identified to facilitate the appropriate appraisal and consequential utilization of the information available in research articles.

[Proceedings of clinical pharmacy research with the cooperation of community and hospital pharmacist and pharmacy school].

PubMed

Hirotani, Yoshihiko

2007-11-01

The new pharmaceutical education system starts in Japan, those constructions are performed at a lot of universities aiming at the execution of a common examination and the clinical training, and the workshop for directive pharmacists have been held actively since last year. Moreover, various educational lectures, open lectures, and the training lectures for on-site pharmacist's upskilling are carried out. However, a technical training and the lecture for research approach that supports the pharmacist in a pharmaceutical clinical research are little at the chance to learn the research methods. Now, many joint researches with university initiative or a university is performed, and the institution of presentation inexperience at academic society also exists in terms of a regional element, a staff arrangement side, etc, and also when the continuation is difficult, it looks mostly. It is necessary that the teacher of pharmacy school almost arranged in the whole country support positively a clinical research by the nearby pharmacist, and also it seems that a clinical teacher's role is large in the cooperation of pharmacy school and the medical institution. Moreover, in order to elucidate the scientific basis (mechanism) of a problem suggestion in the clinical spot, basic research in a pharmacy school is also required. We always need to advance a pharmaceutical clinical research by considering the basic research by pharmacy school in medical institution, considering clinical research by medical institution in pharmacy school, while cooperating mutually. In this article, I show how to advance pharmaceutical clinical research.

The paradox of pharmacy: A profession's house divided.

PubMed

Brown, Daniel

2012-01-01

To describe the paradox in pharmacy between the vision of patient care and the reality of community pharmacy practice and to explore how integrated reimbursement for the retail prescription and linking cognitive patient care services directly to prescription processing could benefit the profession. A dichotomy exists between what many pharmacists do and what they've been trained to do. Pharmacy leaders have formulated a vision for pharmacists to become more involved in direct patient care. All graduates now receive PharmD-level training, and some leaders call for requirements of postgraduate residency training and board certification for pharmacists who provide patient care. How such requirements would relate to community pharmacy practice is unclear. The retail prescription remains the primary link between the pharmacist and the health care consumer. Cognitive services, such as medication therapy management (MTM), need to be integrated into the standard workflow of community pharmacies so as to become a natural extension of the professional services rendered in the process of filling a prescription. Current prescription fees are not sufficient to support legitimate professional services. A proposed integrated pricing system for retail prescriptions includes a $15 professional fee that is scaled upward for value-added services, such as MTM. Pharmacy includes a diversity of practice that has historically been a source of division. For pharmacists to reach their potential as patient care providers, the various factions within the profession must forge a unified vision of the future that addresses all realms of practice.

Analysis of PGY-1 Pharmacy Resident Candidate Letters of Recommendation at an Academically Affiliated Residency Program.

PubMed

McLaughlin, Milena M; Masic, Dalila; Gettig, Jacob P

2018-04-01

Letters of recommendation (LORs) are a critical component for differentiating among similarly qualified pharmacy residency candidates. These letters contain information that is difficult to ascertain from curricula vitae and pharmacy school transcripts. LOR writers may use any words or phrases appropriate for each candidate as there is no set framework for LORs. The objective of this study was to characterize descriptive themes in postgraduate year 1 (PGY-1) pharmacy residency candidates' LORs and to examine which themes of PGY-1 pharmacy residency candidates' LORs are predictive of an interview invitation at an academically affiliated residency program. LORs for candidates from the Pharmacy Online Residency Centralized Application System (PhORCAS) from 2013 and 2014 for the Midwestern University PGY-1 Pharmacy Residency were analyzed. LOR characteristics and descriptive themes were collected. All scores for candidate characteristics and overall PhORCAS recommendation were also recorded. A total of 351 LORs for 111 candidates from 2013 (n = 47 candidates) and 2014 (n = 64 candidates) were analyzed; 36 (32.4%) total candidates were offered an interview. Themes that were identified as predictors of an interview included a higher median (interquartile range) number of standout words (3 words [1.3-4] vs 3.8 words [2.5-5.5], P < .01) and teaching references (3.7 words [2.7-6] vs 5.7 words [3.7-7.8], P = .01). For this residency program, standout words and teaching references were important when offering interviews.

A Formalized Teaching, Practice, and Research Partnership with the Veterans Affairs North Texas Health Care System: A Model for Advancing Academic Partnerships

PubMed Central

Foslein-Nash, Cynthia; Singh, Dilpreet K.; Zeiss, Robert A.; Sanders, Karen M.; Patry, Roland; Leff, Richard

2009-01-01

In 1999, the Texas Tech University Health Sciences Center School of Pharmacy expanded its Dallas/Fort Worth presence by creating a regional campus for pharmacy students in their third and fourth years (P3 and P4 years) of the program. This expansion was driven by the need for additional practice sites. The VANTHCS was an obvious choice for the school due to the similarity of missions for clinical practice, education, and research. The VANTHCS and pharmacy school renovated a 4,000 square foot building, which includes classrooms, conference rooms, a student lounge, and faculty offices (expanded to 8,000 square feet in 2003). To date, the school has invested $1 million in the building. From a practice perspective, VANTHCS purchases faculty professional services from the school to augment its clinical specialist staff. These professional practice contracts provide VANTHCS with 12 additional clinical pharmacy specialists serving 50% of their time in multiple specialty areas. The collaboration has also allowed for expansion of clinical teaching, benefitting both institutions. In addition to the pharmacy student interns on P3 and P4 practice experiences, the collaboration allows for 8 to 10 postgraduate pharmacy residents to train with VANTHCS clinical specialists and school faculty members each year. The VANTHCS/pharmacy school collaboration has clearly enhanced the ability of both institutions to exceed their teaching, research, and practice goals in a cost-effective manner. PMID:20221334

Web vulnerability study of online pharmacy sites.

PubMed

Kuzma, Joanne

2011-01-01

Consumers are increasingly using online pharmacies, but these sites may not provide an adequate level of security with the consumers' personal data. There is a gap in this research addressing the problems of security vulnerabilities in this industry. The objective is to identify the level of web application security vulnerabilities in online pharmacies and the common types of flaws, thus expanding on prior studies. Technical, managerial and legal recommendations on how to mitigate security issues are presented. The proposed four-step method first consists of choosing an online testing tool. The next steps involve choosing a list of 60 online pharmacy sites to test, and then running the software analysis to compile a list of flaws. Finally, an in-depth analysis is performed on the types of web application vulnerabilities. The majority of sites had serious vulnerabilities, with the majority of flaws being cross-site scripting or old versions of software that have not been updated. A method is proposed for the securing of web pharmacy sites, using a multi-phased approach of technical and managerial techniques together with a thorough understanding of national legal requirements for securing systems.

Disparities in Access to Over-the-Counter Nicotine Replacement Products in New York City Pharmacies

PubMed Central

Cabral, Lisa; Maantay, Juliana; Peprah, Dorothy; Lounsbury, David; Maroko, Andrew; Murphy, Mary; Shelley, Donna

2009-01-01

Objectives. We surveyed the availability of tobacco products and nonprescription nicotine replacement therapy (NRT) in pharmacies in New York City, stratified by the race, ethnicity, and socioeconomic status (SES) of the surrounding neighborhoods to determine whether disparities in availability existed. Methods. Surveyors visited a random sample of retail pharmacies to record the availability of tobacco products and nonprescription NRT. We used census data and geographic information systems analysis to determine the SES of each neighborhood. We used logistic modeling to explore relations between SES and the availability of NRT and tobacco products. Results. Of 646 pharmacies sampled, 90.8% sold NRT and 46.9% sold cigarettes. NRT and cigarettes were slightly more available in pharmacies in neighborhoods with a higher SES. NRT was more expensive in poorer neighborhoods. Conclusions. Small disparities existed in access to nonprescription NRT and cigarettes. The model did not adequately account for cigarette access, because of availability from other retail outlets. These results may explain some of the excess prevalence of cigarette use in low-SES areas. PMID:19638596

Specialty pharmacies and other restricted drug distribution systems: financial and safety considerations for patients and health-system pharmacists.

PubMed

Kirschenbaum, Bonnie E

2009-12-15

To discuss the role of restricted drug distribution systems in the implementation of risk evaluation and mitigation strategies (REMS), health-system pharmacists' concerns associated with the use of specialty pharmacies and other restricted drug distribution systems, reimbursement policies for high-cost specialty drugs, supply chain models for traditional and specialty drugs, and emerging trends in the management of and reimbursement for specialty pharmaceuticals. Restricted drug distribution systems established by pharmaceutical manufacturers, specialty pharmacies, or other specialty suppliers may be a component of REMS, which are required by the Food and Drug Administration for the management of known or potential serious risks from certain drugs. Concerns of health-system pharmacists using specialty suppliers include access to pharmaceuticals, operational challenges, product integrity, financial implications, continuity of care, and patient safety. An ambulatory care patient taking a specialty drug product from home to a hospital outpatient clinic or inpatient setting for administration, a practice known as "brown bagging," raises concerns about product integrity and institutional liability. An institution's finances, tolerance for liability, and ability to skillfully manage the processes involved often determine its choice between an approach that prohibits brown bagging but is costly and one that permits the practice under certain conditions and is less costly. The recent shift from a traditional supply chain model to a specialty pharmacy supply chain model for high-cost pharmaceuticals has the potential to increase pharmaceutical costs for health systems. A dialogue is needed between health-system pharmacists and group purchasing organizations to address the latter's role in mitigating the financial implications of this change and to help clarify the safety issues. Some health plans have shifted part of the cost of expensive drugs to patients by establishing a fourth tier of drugs with a large copayment based on a substantial percentage of the cost of the drug. The number and cost of specialty drugs are expected to increase in the future. New approaches and reimbursement models are emerging to manage the high cost of new pharmaceuticals. Health-system pharmacists can improve drug safety and manage costs by collaborating with group purchasing organizations, establishing policies for brown bagging, and making efforts to reconcile drug therapy provided in different settings through traditional drug channels and specialty pharmacies or other restricted drug distribution systems.

Exploring safety systems for dispensing in community pharmacies: focusing on how staff relate to organizational components.

PubMed

Harvey, Jasmine; Avery, Anthony J; Ashcroft, Darren; Boyd, Matthew; Phipps, Denham L; Barber, Nicholas

2015-01-01

Identifying risk is an important facet of a safety practice in an organization. To identify risk, all components within a system of operation should be considered. In clinical safety practice, a team of people, technologies, procedures and protocols, management structure and environment have been identified as key components in a system of operation. To explore risks in relation to prescription dispensing in community pharmacies by taking into account relationships between key components that relate to the dispensing process. Fifteen community pharmacies in England with varied characteristics were identified, and data were collected using non-participant observations, shadowing and interviews. Approximately 360 hours of observations and 38 interviews were conducted by the team. Observation field notes from each pharmacy were written into case studies. Overall, 52,500 words from 15 case studies and interview transcripts were analyzed using thematic and line-by-line analyses. Validation techniques included multiple data collectors co-authoring each case study for consensus, review of case studies by members of the wider team including academic and practicing community pharmacists, and patient safety experts and two presentations (internally and externally) to review and discuss findings. Risks identified were related to relationships between people and other key components in dispensing. This included how different levels of staff communicated internally and externally, followed procedures, interacted with technical systems, worked with management, and engaged with the environment. In a dispensing journey, the following categories were identified which show how risks are inextricably linked through relationships between human components and other key components: 1) dispensing with divided attention; 2) dispensing under pressure; 3) dispensing in a restricted space or environment; and, 4) managing external influences. To identify and evaluate risks effectively, an approach that includes understanding relationships between key components in dispensing is required. Since teams of people in community pharmacies are a key dispensing component, and therefore part of the operational process, it is important to note how they relate to other components in the environment within which they operate. Pharmacies can take the opportunity to reflect on the organization of their systems and review in particular how they can improve on the four key categories identified. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

How to enhance public health service utilization in community pharmacy?: general public and health providers' perspectives.

PubMed

Saramunee, Kritsanee; Krska, Janet; Mackridge, Adam; Richards, Jacqueline; Suttajit, Siritree; Phillips-Howard, Penelope

2014-01-01

Community pharmacists (PHs) in England are increasingly providing a range of public health services. However, the general public view pharmacists as drug experts and not experts in health, and therefore, services may be underutilized. To explore experiences and views of 4 groups of participants, the general public, PHs, general practitioners (GPs), and other stakeholders (STs) on pharmacy-based public health services, and identify potential factors affecting service use. The study was undertaken in a locality of North West England. Three focus groups were conducted with the general public (n=16), grouped by socioeconomic status. Fourteen semistructured interviews were undertaken with PHs (n=9), GPs (n=2), and STs (n=3). Discussions/interviews were audio recorded, transcribed verbatim, and analyzed thematically. All 4 groups of participants agreed that community pharmacies are a good source of advice on medicines and minor ailments but were less supportive of public health services. Six factors were identified affecting utilization of pharmacy services: community pharmacy environment, pharmacist and support staff, service publicity, general public, GP services, and health care system and policies. Crucial obstacles that could inhibit service utilization are perceptions of both the general public and other health providers toward pharmacists' competencies, privacy and confidentiality in pharmacies, high dispensing workload, and inadequate financial support. Networking between local health professionals could enhance confidence in service delivery, general awareness, and thus utilization. Community pharmacy has the potential to deliver public health services, although the impact on public health may be limited. Addressing the factors identified could help to increase utilization and impact of pharmacy public health services. Copyright © 2014 Elsevier Inc. All rights reserved.

Do higher-priced generic medicines enjoy a competitive advantage under reference pricing?

PubMed

Puig-Junoy, Jaume

2012-11-01

In many countries with generic reference pricing, generic producers and distributors compete by means of undisclosed discounts offered to pharmacies in order to reduce acquisition costs and to induce them to dispense their generic to patients in preference over others. The objective of this article is to test the hypothesis that under prevailing reference pricing systems for generic medicines, those medicines sold at a higher consumer price may enjoy a competitive advantage. Real transaction prices for 179 generic medicines acquired by pharmacies in Spain have been used to calculate the discount rate on acquisition versus reimbursed costs to pharmacies. Two empirical hypotheses are tested: the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical presentations for which there are more generic competitors; and, the discount rate at which pharmacies acquire generic medicines is higher for those pharmaceutical forms for which the consumer price has declined less in relation to the consumer price of the brand drug before generic entry (higher-priced generic medicines). An average discount rate of 39.3% on acquisition versus reimbursed costs to pharmacies has been observed. The magnitude of the discount positively depends on the number of competitors in the market. The higher the ratio of the consumer price of the generic to that of the brand drug prior to generic entry (i.e. the smaller the price reduction of the generic in relation to the brand drug), the larger the discount rate. Under reference pricing there is intense price competition among generic firms in the form of unusually high discounts to pharmacies on official ex-factory prices reimbursed to pharmacies. However, this effect is highly distorting because it favours those medicines with a higher relative price in relation to the brand price before generic entry.

Certification, Accreditation, and Credentialing for 503A Compounding Pharmacies.

PubMed

Pritchett, Jon; McCrory, Gary; Kraemer, Cheri; Jensen, Brenda; Allen, Loyd V

2018-01-01

The terms certification, accreditation, and credentialing are often used interchangeably when they apply to compounding-pharmacy qualifications, but they are not synonymous. The reasons for obtaining each, the requirements for each, and the benefits of each differ. Achieving such distinctions can negatively or positively affect the status of a pharmacy among peers and prescribers as well as a pharmacy's relationships with third-party payors. Changes in the third-party payor industry evolve constantly and, we suggest, will continue to do so. Compounding pharmacists must be aware of those changes to help ensure success in a highly competitive marketplace. To our knowledge at the time of this writing, there is no certification program for compounding pharmacists, although pharmacy technicians can achieve certification and may be required to do so by the state in which they practice (a topic beyond the scope of this article). For that reason, we primarily address accreditation and credentialing for 503A compounding pharmacies. In this article, the evolution of the third-party payment system for compounds is reviewed; the definitions of certification, accreditation, and credentialing are examined; and the benefits and recognition of obtaining accredited or credentialed status are discussed. Suggestions for selecting an appropriate agency that offers accreditation or credentialing, preparing for and undergoing an onsite survey, responding to findings, and maintaining a pharmacy practice that enables a successful survey outcome are presented. The personal experience of author CK during accreditation and credentialing is discussed, as is the role of a consultant (author BJ) in helping compounders prepare for the survey process. A list of agencies that offer accreditation and credentialing for compounding pharmacies is included for easy reference. Copyright© by International Journal of Pharmaceutical Compounding, Inc.

Prevalence and characteristics of pharmacies owned and operated by schools of pharmacy in the United States.

PubMed

Nathan, Joseph P; Grossman, Sara; Zerilli, Tina; Pace, Adam

2018-02-01

To identify schools/colleges of pharmacy that own and operate a pharmacy and to gather key details about such pharmacies. Schools of pharmacy (n = 134) in the United States were contacted to determine whether they own and operate a pharmacy. Schools identified as having a pharmacy were subsequently sent an online questionnaire to solicit information about school and pharmacy characteristics. Eighteen (13.4%) schools reported owning and operating at least one pharmacy; of these, 14 (77.8%) responded to the questionnaire. The provision of education was a goal for all pharmacies. Pharmacy services were provided to students, faculty/staff, and community members (85.7%, 78.6%, and 50%, respectively). Student pharmacists were regularly involved in the operations of 13 (92.9%) pharmacies, largely as part of their introductory and advanced pharmacy practice experiences and/or as paid employees. Few schools of pharmacy in the United States own and operate a pharmacy. These pharmacies primarily serve as teaching and learning venues and provide services to the campus community and/or the community at large. Copyright © 2017 Elsevier Inc. All rights reserved.

A national examination of pharmacy-based immunization statutes and their association with influenza vaccinations and preventive health.

PubMed

McConeghy, Kevin W; Wing, Coady

2016-06-24

A series of state-level statute changes have allowed pharmacists to provide influenza vaccinations in community pharmacies. The study aim was to estimate the effects of pharmacy-based immunization statutes changes on per capita influenza vaccine prescriptions, adult vaccination rates, and the utilization of other preventive health services. A quasi-experimental study that compares vaccination outcomes over time before and after states allowed pharmacy-based immunization. Measures of per capita pharmacy prescriptions for influenza vaccines in each state came from a proprietary pharmacy prescription database. Data on adult vaccination rates and preventive health utilization were studied using multiple waves of the Behavioral Risk Factor Surveillance System (BRFSS). The primary outcomes were changes in per capita influenza vaccine pharmacy prescriptions, adult vaccination rates, and preventive health interventions following changes. Between 2007 and 2013, the number of influenza vaccinations dispensed in community pharmacies increased from 3.2 to 20.9 million. After one year, adopting pharmacist immunization statutes increased per capita influenza vaccine prescriptions by an absolute difference (AD) of 2.6% (95% CI: 1.1-4.2). Adopting statutes did not lead to a significant absolute increase in adult vaccination rates (AD 0.9%, 95% CI: -0.3, 2.2). There also was no observed difference in adult vaccination rates among adults at high-risk of influenza complications (AD 0.8%, 95% CI: -0.2, 1.8) or among standard demographic subgroups. There also was no observed difference in the receipt of preventive health services, including routine physician office visits (AD -1.9%, 95% CI: -4.9, 1.1). Pharmacists are providing millions of influenza vaccines as a consequence of immunization statutes, but we do not observe significant differences in adult influenza vaccination rates. The main gains from pharmacy-based immunization may be in providing a more convenient way to obtain an important health service. Published by Elsevier Ltd.

[NPT (near patient test) in the pharmacy: document and practice guidelines 2008].

PubMed

Stuard, S; Cesarone, M R; Belcaro, G; Ledda, A; Cornelli, U; Di Renzo, A; Grossi, M G; Pellegrini, L; Gizzi, G; Vinciguerra, G; Dugall, M; Corsi, M; Ippolito, E; Di Palma, T; Zulli, C; Del Boccio, G

2008-10-01

NPT tests in the pharmacy. Blood testing can be made with NPT (near patient testing) directly in the pharmacy. Most tests can be made with a single drop of blood (i.e. from a finger) and results are comparable with results from blood test obtained with standard vein blood samples. NPT is basically used for: 1 - evaluating the risk of a disease. 2 evaluating or confirming the presence of a disease. 3 to manage and monitor treatments. The social role of the pharmacy in NPT (particularly in cardiovascular screening) is very important as the pharmacy is an institution with capillary diffusion in the territory. The pharmacy often constitutes an important, first-level consultancy point for the population, particularly where health institutions are far away (small villages) or not easily accessible. Rules for NPT. Guidelines for NPT testing in the pharmacy have been proposed and discussed in a consensus meeting (Spoleto, 2007). NPT guidelines suggest operating management and technical procedures and indicate prospective lines of action defining new roles for the pharmacy. Coagulation tests can be now made in the pharmacy at a very low cost and with an efficacy comparable to blood tests obtained with a vein sample. Results can be read in seconds. This test is also available for personal use and home testing. NPT: The Clinical Study. The evaluation of the results of a clinical study (patients with venous thrombosis/pulmonary embolisation, patients with fibrillation and patients with artificial cardiac valves) indicates that costing is very favourable for NPT which may reduce costs and improve management of many clinical conditions and their monitoring. Training and control systems help NPT testing to be reliable and useful to screen and manage most clinical and risk conditions. The clinical study also shows the positive correlation between NPT tests and standard' tests. In conclusion NPT tests are now very reliable and cost-effective and can be used for screening, diagnosis and to monitor treatments.

Projection of future pharmacy service fees using the dispensing claims in hospital and clinic outpatient pharmacies: national health insurance database between 2006 and 2012.

PubMed

Ha, Dongmun; Song, Inmyung; Lee, Eui-Kyung; Shin, Ju-Young

2018-05-03

Predicting pharmacy service fees is crucial to sustain the health insurance budget and maintain pharmacy management. However, there is no evidence on how to predict pharmacy service fees at the population level. This study compares the status of pharmacy services and constructs regression model to project annual pharmacy service fees in Korea. We conducted a time-series analysis by using sample data from the national health insurance database from 2006 and 2012. To reflect the latest trend, we categorized pharmacies into general hospital, special hospital, and clinic outpatient pharmacies based on the major source of service fees, using a 1% sample of the 2012 data. We estimated the daily number of prescriptions, pharmacy service fees, and drugs costs according to these three types of pharmacy services. To forecast pharmacy service fees, a regression model was constructed to estimate annual fees in the following year (2013). The dependent variable was pharmacy service fees and the independent variables were the number of prescriptions and service fees per pharmacy, ratio of patients (≥ 65 years), conversion factor, change of policy, and types of pharmacy services. Among the 21,283 pharmacies identified, 5.0% (1064), 4.6% (974), and 77.5% (16,340) were general hospital, special hospital, and clinic outpatient pharmacies, respectively, in 2012. General hospital pharmacies showed a higher daily number of prescriptions (111.9), higher pharmacy service fees ($25,546,342), and higher annual drugs costs ($215,728,000) per pharmacy than any other pharmacy (p <  0.05). The regression model to project found the ratio of patients aged 65 years and older and the conversion factor to be associated with an increase in pharmacy service fees. It also estimated the future rate of increase in pharmacy service fees to be between 3.1% and 7.8%. General hospital outpatient pharmacies spent more on annual pharmacy service fees than any other type of pharmacy. The forecast of annual pharmacy service fees in Korea was similar to that of Australia, but not that of the United Kingdom.

Assessment of Pharmacy Students' Communication Competence Using the Roter Interaction Analysis System During Objective Structured Clinical Examinations

PubMed Central

Kubota, Yoshie; Seki, Susumu; Takada, Kaori; Sakuma, Mio; Morimoto, Takeshi; Akaike, Akinori; Hiraide, Atsushi

2011-01-01

Objective To determine the value of using the Roter Interaction Analysis System during objective structured clinical examinations (OSCEs) to assess pharmacy students' communication competence. Methods As pharmacy students completed a clinical OSCE involving an interview with a simulated patient, 3 experts used a global rating scale to assess students' overall performance in the interview, and both the student's and patient's languages were coded using the Roter Interaction Analysis System (RIAS). The coders recorded the number of utterances (ie, units of spoken language) in each RIAS category. Correlations between the raters' scores and the number and types of utterances were examined. Results There was a significant correlation between students' global rating scores on the OSCE and the number of utterances in the RIAS socio-emotional category but not the RIAS business category. Conclusions The RIAS proved to be a useful tool for assessing the socio-emotional aspect of students' interview skills. PMID:21655397

A novel drug management system in the Febuxostat versus Allopurinol Streamlined Trial: A description of a pharmacy system designed to supply medications directly to patients within a prospective multicenter randomised clinical trial.

PubMed

Rogers, Amy; Flynn, Robert Wv; McDonnell, Patrick; Mackenzie, Isla S; MacDonald, Thomas M

2016-12-01

Trials of investigational medicinal products are required to adhere to strict guidelines with regard to the handling and supply of medication. Information technology offers opportunities to approach clinical trial methodology in new ways. This report summarises a novel pharmacy system designed to supply trial medications directly to patients by post in the Febuxostat versus Allopurinol Streamlined Trial. A bespoke web-based software package was designed to facilitate the direct supply of trial medications to Febuxostat versus Allopurinol Streamlined Trial participants from a pharmacy based in the Medicines Monitoring Unit, University of Dundee. To date, 65,467 packs of medication have been dispensed using the system to 3978 patients. Up to 238 packs per day have been dispensed. The Medicines Monitoring Unit Febuxostat versus Allopurinol Streamlined Trial drug management system is an effective method of administering the complex drug supply requirements of a large-scale clinical trial with advantages over existing arrangements. A low rate of loss to follow-up in the Febuxostat versus Allopurinol Streamlined Trial may be attributable to the drug management system. © The Author(s) 2016.

Reflecting on patient-centred care in pharmacy through an illness narrative.

PubMed

Dowse, Ros

2015-08-01

Patient-centred care (PCC) is rapidly adopting a central position in discussions on the quality of healthcare, with patient-centredness deemed essential to transforming the healthcare system. PCC speaks to the quality of patient-provider relationships and has been defined as an approach to providing care that is respectful of and responsive to individual patient preferences, needs, and values, while ensuring that patient values guide all clinical decisions. However its place within pharmacy practice is unclear and is as yet undefined, particularly in relation to pharmaceutical care. Through my personal illness narrative, I briefly explore the visibility and evidence of PCC in the pharmacy literature as well as from personal experience of pharmacy care, and find it lacking. I conclude that an integrated, seamless understanding of PCC and the use of shared language within the health professions is essential in successful teamwork with both the patient and with other health professions.

Pharmacy access to ulipristal acetate in Hawaii: is a prescription enough?

PubMed

Bullock, Holly; Steele, Sarah; Kurata, Nicole; Tschann, Mary; Elia, Jennifer; Kaneshiro, Bliss; Salcedo, Jennifer

2016-05-01

To determine pharmacy availability of ulipristal acetate (UPA) and compare to availability of levonorgestrel-containing emergency contraceptive pills (LNG-ECPs). We conducted an observational population-based study utilizing a telephone-based secret shopper methodology. Researchers called all 198 unique retail pharmacies in Hawaii on December 2013-June 2014, representing themselves as patients and physicians. Only 2.6% of pharmacies had UPA immediately available, though 22.8% reported ability to order UPA. In contrast, 82.4% reported immediate availability of LNG-ECPs. No significant difference in availability was reported to patients and physicians. Availability of UPA is limited and significantly lower compared to LNG-ECPs. The study period did overlap with a change in distributor for UPA, likely capturing some disruption of the supply chain. Systems-based interventions are needed to address barriers to obtaining UPA. Copyright © 2015 Elsevier Inc. All rights reserved.

The project shift: a form of participative management and staffing.

PubMed

Puckett, F

1991-11-01

North Colorado Medical Center is a 326 bed primary and tertiary care medical center serving northeastern Colorado and southwestern Nebraska. The pharmacy department provides 24-hour-a-day clinical and distributive services to both inpatients and outpatients with a staff of 1 clinical pharmacy coordinator, 10 pharmacists (excluding pharmacy manager), and 11 technicians. Rather than rely on one assistant manager, the pharmacy manager involves all interested staff pharmacists in various administrative, clinical, and distributive projects. These project (P) shifts are scheduled 8-hour shifts with minimal or no drug distribution duties. This staffing system and form of participative management has been used since 1983 and has been successful in achieving three objectives: it provides assistance to the manager in achieving certain departmental objectives; it provides job variety and professional growth/satisfaction for staff pharmacists; and it provides flexible and readily available source of pharmacists to meet personal leave days (vacation, illness, time off) needs.

Inventory information approval system certification and flexible spending account purchases.

PubMed

Shuey, Brandon; Williams, La Vonn A

2010-01-01

There is no question that 2009 was a year of change within the pharmacy industry. Several new requirements were implemented, including the need for an Inventory Information Approval System for accepting flexible spending or health reimbursement account cords. Some pharmacies relied on the 90% exemption rule, which is discussed within this article, or an alternative method to avoid the expense of a point of sale. However, with flexible spending or health reimbursement account card participation expected to reach 85% in 2010, now bay be the time for compounding pharmacists to weigh the pros and cons of Inventory Information Approval System certification.

A pilot study to evaluate a community pharmacy-based monitoring system to identify adverse drug reactions associated with paediatric medicines use.

PubMed

Tobaiqy, Mansour; Stewart, Derek; Helms, Peter J; Bond, Christine; Lee, Amanda Jane; Bateman, Nick; McCaig, Dorothy; McLay, James

2010-06-01

Current pharmacovigilance systems are limited by spontaneous reporting of adverse drug reactions (ADRs), lack of a denominator, and lower than expected reporting rates. The aim of our study was to undertake a formal pilot evaluation of a community pharmacy-led ADR monitoring system. The setting was community pharmacies in five Health Boards areas of Scotland. Subjects were parents, guardians, or children presenting prescriptions for children 16 years and under prescribed serotonin specific reuptake inhibitors (SSRI), anticonvulsants, or medicines for the treatment of attention deficit hyperactivity disorder (ADHD). All pharmacies (n = 827) were invited to participate. Over a 3-month period they were asked to identify prescriptions for targeted medicines and give out an ADR questionnaire. Questionnaire content included child demography, duration of medicine use, indication, perceived ADRs, and their description and severity. The study was approved by the North of Scotland Research Ethics Committee. Seventy-two community pharmacists (8.7%) agreed to take part. Two hundred and twenty-nine questionnaires were distributed and 55 (24%) completed and returned by parents. Forty-one questionnaires related to ADHD medications, 13 to anticonvulsants, and 1 to an SSRI. Thirty questionnaires reported 44 possible ADRs, 19 of which were related to methylphenidate. The proposed ADR monitoring system identified expected ADRs thus demonstrating face and content validity for our approach. However the process was limited by low community pharmacist participation rates and low questionnaire return rates.

Integrating Bar-Code Medication Administration Competencies in the Curriculum: Implications for Nursing Education and Interprofessional Collaboration.

PubMed

Angel, Vini M; Friedman, Marvin H; Friedman, Andrea L

This article describes an innovative project involving the integration of bar-code medication administration technology competencies in the nursing curriculum through interprofessional collaboration among nursing, pharmacy, and computer science disciplines. A description of the bar-code medication administration technology project and lessons learned are presented.

Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan

PubMed Central

2010-01-01

Background Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. Methods We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007). Results Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with < US $25,000 due to governmental resource-sharing. The network operated at break-even profit, leaving little room to lower medicine prices and mark-ups. Medicine mark-ups needed for sustainability were greater than originally envisioned by network administration. In 2005, 55%, 35%, and 10% of the network's top 50 products revealed mark-ups of < 50%, 50-99% and > 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of < 50% and 50-99%, respectively; while 35% of products revealed mark-ups > 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Conclusion Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals. Health systems researchers must document the positive and negative financial experiences of pharmacy initiatives to inform future projects and advance access to medicines goals. PMID:20626904

Balancing medicine prices and business sustainability: analyses of pharmacy costs, revenues and profit shed light on retail medicine mark-ups in rural Kyrgyzstan.

PubMed

Waning, Brenda; Maddix, Jason; Soucy, Lyne

2010-07-13

Numerous not-for-profit pharmacies have been created to improve access to medicines for the poor, but many have failed due to insufficient financial planning and management. These pharmacies are not well described in health services literature despite strong demand from policy makers, implementers, and researchers. Surveys reporting unaffordable medicine prices and high mark-ups have spurred efforts to reduce medicine prices, but price reduction goals are arbitrary in the absence of information on pharmacy costs, revenues, and profit structures. Health services research is needed to develop sustainable and "reasonable" medicine price goals and strategic initiatives to reach them. We utilized cost accounting methods on inventory and financial information obtained from a not-for-profit rural pharmacy network in mountainous Kyrgyzstan to quantify costs, revenues, profits and medicine mark-ups during establishment and maintenance periods (October 2004-December 2007). Twelve pharmacies and one warehouse were established in remote Kyrgyzstan with < US $25,000 due to governmental resource-sharing. The network operated at break-even profit, leaving little room to lower medicine prices and mark-ups. Medicine mark-ups needed for sustainability were greater than originally envisioned by network administration. In 2005, 55%, 35%, and 10% of the network's top 50 products revealed mark-ups of < 50%, 50-99% and > 100%, respectively. Annual mark-ups increased dramatically each year to cover increasing recurrent costs, and by 2007, only 19% and 46% of products revealed mark-ups of < 50% and 50-99%, respectively; while 35% of products revealed mark-ups > 100%. 2007 medicine mark-ups varied substantially across these products, ranging from 32% to 244%. Mark-ups needed to sustain private pharmacies would be even higher in the absence of government subsidies. Pharmacy networks can be established in hard-to-reach regions with little funding using public-private partnership, resource-sharing models. Medicine prices and mark-ups must be interpreted with consideration for regional costs of business. Mark-ups vary dramatically across medicines. Some mark-ups appear "excessive" but are likely necessary for pharmacy viability. Pharmacy financial data is available in remote settings and can be used towards determination of "reasonable" medicine price goals. Health systems researchers must document the positive and negative financial experiences of pharmacy initiatives to inform future projects and advance access to medicines goals.

Antibiotic distribution channels in Thailand: results of key-informant interviews, reviews of drug regulations and database searches.

PubMed

Sommanustweechai, Angkana; Chanvatik, Sunicha; Sermsinsiri, Varavoot; Sivilaikul, Somsajee; Patcharanarumol, Walaiporn; Yeung, Shunmay; Tangcharoensathien, Viroj

2018-02-01

To analyse how antibiotics are imported, manufactured, distributed and regulated in Thailand. We gathered information, on antibiotic distribution in Thailand, in in-depth interviews - with 43 key informants from farms, health facilities, pharmaceutical and animal feed industries, private pharmacies and regulators- and in database and literature searches. In 2016-2017, licensed antibiotic distribution in Thailand involves over 700 importers and about 24 000 distributors - e.g. retail pharmacies and wholesalers. Thailand imports antibiotics and active pharmaceutical ingredients. There is no system for monitoring the distribution of active ingredients, some of which are used directly on farms, without being processed. Most antibiotics can be bought from pharmacies, for home or farm use, without a prescription. Although the 1987 Drug Act classified most antibiotics as "dangerous drugs", it only classified a few of them as prescription-only medicines and placed no restrictions on the quantities of antibiotics that could be sold to any individual. Pharmacists working in pharmacies are covered by some of the Act's regulations, but the quality of their dispensing and prescribing appears to be largely reliant on their competences. In Thailand, most antibiotics are easily and widely available from retail pharmacies, without a prescription. If the inappropriate use of active pharmaceutical ingredients and antibiotics is to be reduced, we need to reclassify and restrict access to certain antibiotics and to develop systems to audit the dispensing of antibiotics in the retail sector and track the movements of active ingredients.

Expanding the clinical role of community pharmacy: A qualitative ethnographic study of medication reviews in Ontario, Canada.

PubMed

Patton, Sarah J; Miller, Fiona A; Abrahamyan, Lusine; Rac, Valeria E

2018-03-01

Medication reviews by community pharmacists are an increasingly common strategy to improve medication management for chronic conditions, and are part of wider efforts to make more effective use of community-based health professionals. To identify opportunities to optimize the medication review program in Ontario, Canada, we explored how providers and clients interpret and operationalize medication reviews within everyday community pharmacy practice. We conducted a qualitative ethnographic study at four pharmacies in Ontario, Canada, including non-participant observation of provider and client activities and interactions with specific attention to medication reviews, as well as brief ethnographic interviews with providers and clients, and in-depth, semi-structured interviews with providers. We report on 72h of field research, observation of 178 routine pharmacist-client interactions and 29 medication reviews, 62 brief ethnographic interviews with providers and clients, and 7 in-depth, semi-structured interviews with providers. We found that medication reviews were variably conducted across the dimensions of duration, provider type, location, and interaction style, and that local contexts and system-wide developments influence their meaning and practice. Medication reviews are exemplary of policy efforts to enhance the role of community pharmacies within health systems and the scope of practice of pharmacists as healthcare professionals. Our study highlights the importance of the local structure of community pharmacy practice and the clinical aspirations of pharmacists in the delivery of medication reviews. Copyright © 2017 Elsevier B.V. All rights reserved.

Prototyping with AIDA for a hospital pharmacy system.

PubMed

Molenaar, G C; Boon, W M

1987-01-01

The CENTRASYS system for the Hospital Pharmacy, developed as part of a research project of the Department of Medical Informatics is described. The role of AIDA, a fourth-generation software package, as a prototyping tool is discussed. It is concluded that AIDA facilitates prototyping and is also very suitable as a vehicle for systems in operation. It is further concluded that prototyping is of great help in the developmental phase of a project, but that great care has to be taken during evaluation of the prototypes: minimize the number of test sites and try to avoid that users become dependent on the system, because every prototype needs further tuning before it really becomes an operational system.

Comparison of prescription reimbursement methodologies in Japan and the United States.

PubMed

Akaho, Eiichi; MacLaughlin, Eric J; Takeuchi, Yoshikazu

2003-01-01

To compare methods of prescription reimbursement in Japan and the United States. Data were obtained through interviews and a search of the pharmacy literature using MEDLINE, International Pharmaceutical Abstracts, the Iowa Drug Information Service, and the Internet. Search terms were pharmacy, dispensing fee, reimbursement, prescriptions, Japan, United States, and average wholesale price (AWP). A comprehensive search was done (i.e., no year limits were observed). Performed manually by the authors. The reimbursement systems for prescriptions differ widely between Japan and the United States. The reimbursement system in the United States is fairly straightforward and easy to understand; it is generally based on product cost (e.g., AWP minus a percentage) plus a small dispensing fee. The system in Japan is extremely complex. Reimbursement formulae have four components, including fees for professional dispensing, drug cost, counseling and administration, and medication supplies and devices. Additionally, various adjustments to the final amount are made based on dosage form, length of therapy, number of prescriptions dispensed by the pharmacy per month, and when the prescription is filled (e.g., after hours, on Sundays or holidays). In Japan, each pharmacist is limited to filling 40 prescriptions per day, but each "prescription" can involve several medication orders, making it difficult to compare Japanese pharmacists' workloads with those of their counterparts in the United States. In addition, Japanese pharmacists are provided remuneration for providing various cognitive services, such as taking a patient history, counseling a patient, consulting with a physician, and identifying drug-related problems. Japan and the United States have very different methods of reimbursing pharmacists for dispensing prescriptions, each with positive and negative features. Based on the features of pharmacy reimbursement systems in each country, perhaps the optimal pharmacy practice system would have workload limits that reflect safety standards and amount of support staff available, provide a fair and standardized method for determining drug cost, are relatively straightforward, pay for cognitive services, and provide care for all of citizens through of some type of national health care system.

Pharmacy-level barriers to implementing expedited partner therapy in Baltimore, Maryland.

PubMed

Qin, Jennifer Z; Diniz, Clarissa P; Coleman, Jenell S

2018-05-01

Addressing record high rates of Chlamydia trachomatis incidence in the United States requires the utilization of effective strategies, such as expedited partner therapy, to reduce reinfection and further transmission. Expedited partner therapy, which can be given as a prescription or medication, is a strategy to treat the sexual partners of index patients diagnosed with a sexually transmitted infection without prior medical evaluation of the partners. There are multiple steps in the prescription-expedited partner therapy cascade, and we sought to identify pharmacy-level barriers to implementing prescription-expedited partner therapy for Chlamydia trachomatis treatment. We used spatial analysis and ArcGIS, a geographic information system, to map and assess geospatial access to pharmacies within Baltimore, MD, neighborhoods with the highest rates of Chlamydia trachomatis (1180.25-4255.31 per 100,000 persons). Expedited partner therapy knowledge and practices were collected via a telephone survey of pharmacists employed at retail pharmacies located in these same neighborhoods. Cost of antibiotic medication in US dollars was collected. Census tracts with the highest Chlamydia trachomatis incidence rates had lower median pharmacy density than other census tracts (26.9 per 100,000 vs 31.4 per 100,000, P < .001). We identified 25 pharmacy deserts. Areas defined as pharmacy deserts had larger proportions of black and Hispanic or Latino populations compared with non-Hispanic whites (93.1% vs 6.3%, P < .001) and trended toward higher median Chlamydia trachomatis incidence rates (1170.0 per 100,000 vs 1094.5 per 100,000, P = .110) than non-pharmacy desert areas. Of the 52 pharmacies identified, 96% (50 of 52) responded to our survey. Less than a fifth of pharmacists (18%, 9 of 50) were aware of expedited partner therapy for Chlamydia trachomatis. Most pharmacists (59%, 27 of 46) confirmed they would fill an expedited partner therapy prescription. The cost of a single dose of azithromycin (1 g) ranged from 5.00 to 39.99 US dollars (median, 30 US dollars). Limited geographic access to pharmacies, lack of pharmacist awareness of expedited partner therapy, and wide variation in expedited partner therapy medication cost are potential barriers to implementing prescription-expedited partner therapy. Although most Baltimore pharmacists were unaware of expedited partner therapy, they were generally receptive to learning about and filling expedited partner therapy prescriptions. This finding suggests the need for wide dissemination of educational material targeted to pharmacists. In areas with limited geographic access to pharmacies, expedited partner therapy strategies that do not depend on partners physically accessing a pharmacy merit consideration. Copyright © 2018 Elsevier Inc. All rights reserved.

Implementation of an advanced clinical and administrative hospital information system.

PubMed

Vegoda, P R; Dyro, J F

1986-01-01

Over the last six years since University Hospital opened, the University Hospital Information System (UHIS) has continued to evolve to what is today an advanced administrative and clinical information system. At University Hospital UHIS is the way of conducting business. A wide range of patient care applications are operational including Patient Registration, ADT for Inpatient/Outpatient/Emergency Room visits, Advanced Order Entry/Result Reporting, Medical Records, Lab Automated Data Acquisition/Quality Control, Pharmacy, Radiology, Dietary, Respiratory Therapy, ECG, EEG, Cardiology, Physical/Occupational Therapy and Nursing. These systems and numerous financial systems have been installed in a highly tuned, efficient computer system. All applications are real-time, on-line, and data base oriented. Each system is provided with multiple data security levels, forward file recovery, and dynamic transaction backout of in-flight tasks. Sensitive medical information is safeguarded by job function passwords, identification codes, need-to-know master screens and terminal keylocks. University Hospital has an IBM 3083 CPU with five 3380 disk drives, four dual density tape drives, and a 3705 network controller. The network of 300 terminals and 100 printers is connected to the computer center by an RF broadband cable. The software is configured around the IBM/MVS operating system using CICS as the telecommunication monitor, IMS as the data base management system and PCS/ADS as the application enabling tool. The most extensive clinical system added to UHIS is the Physiological Monitoring/Patient Data Management System with serves 92 critical care beds. In keeping with the Hospital's philosophy of integrated computing, the PMS/PDMS with its network of minicomputers was linked to the UHIS system. In a pilot program, remote access to UHIS through the IBM personal computer has been implemented in several physician offices in the local community, further extending the communications horizons of University Hospital's Information System. The implications of remote access to PDMS through the IBM PC emulating a Siemens Model 420 Patient Data Management Terminal are being examined.

Factors influencing the current practice of self-medication consultations in Eastern Indonesian community pharmacies: a qualitative study.

PubMed

Brata, Cecilia; Fisher, Colleen; Marjadi, Brahmaputra; Schneider, Carl R; Clifford, Rhonda M

2016-05-13

Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.

Availability of snacks, candy and beverages in hospital, community clinic and commercial pharmacies.

PubMed

Whitehouse, Anne; Simon, Anna; French, Simone A; Wolfson, Julian

2012-06-01

The purpose of the present study was to measure the availability of energy-dense foods and sugar-sweetened beverages in pharmacies and to examine differences by pharmacy type and presence of a food policy. Trained research staff visited pharmacies (n 37) to measure shelf space and variety of snacks, candy and sugar-sweetened beverages available within 10 ft (3·05 m) of the pharmacy register. Community clinic, hospital and commercial pharmacies in Minneapolis, MN, USA. Employees were interviewed regarding pharmacy food policies. Approximately 60 % of pharmacies had foods and/or sugar-sweetened beverages available for purchase within 10 ft (3·05 m) of the pharmacy register. Total shelf space (P = 0·02) and variety (P = 0·0003) differed significantly by pharmacy type and were greatest among community clinic pharmacies. Over half of pharmacies had no food policy (58·3 %). Pharmacies with food policies were less likely to have foods/beverages available within 10 ft (3·05 m) of the pharmacy register than pharmacies with no food policies (P = 0·03). Candy, snacks and sugar-sweetened beverages are highly available in the pharmacy environment. Presence of a policy is associated with less food availability within 10 ft (3·05 m) of the pharmacy register and represents an important potential intervention strategy.

Pharmacists' Attitudes and Perceived Barriers to Human Papillomavirus (HPV) Vaccination Services.

PubMed

Hastings, Tessa J; Hohmann, Lindsey A; McFarland, Stuart J; Teeter, Benjamin S; Westrick, Salisa C

2017-08-07

Use of non-traditional settings such as community pharmacies has been suggested to increase human papillomavirus (HPV) vaccination uptake and completion rates. The objectives of this study were to explore HPV vaccination services and strategies employed by pharmacies to increase HPV vaccine uptake, pharmacists' attitudes towards the HPV vaccine, and pharmacists' perceived barriers to providing HPV vaccination services in community pharmacies. A pre-piloted mail survey was sent to 350 randomly selected community pharmacies in Alabama in 2014. Measures included types of vaccines administered and marketing/recommendation strategies, pharmacists' attitudes towards the HPV vaccine, and perceived system and parental barriers. Data analysis largely took the form of descriptive statistics. 154 pharmacists completed the survey (response rate = 44%). The majority believed vaccination is the best protection against cervical cancer (85.3%), HPV is a serious threat to health for girls (78.8%) and boys (55.6%), and children should not wait until they are sexually active to be vaccinated (80.1%). Perceived system barriers included insufficient patient demand (56.5%), insurance plans not covering vaccination cost (54.8%), and vaccine expiration before use (54.1%). Respondents also perceived parents to have inadequate education and understanding about HPV infection (86.6%) and vaccine safety (78.7%). Pharmacists have positive perceptions regarding the HPV vaccine. Barriers related to system factors and perceived parental concerns must be overcome to increase pharmacist involvement in HPV vaccinations.

Positioning a Paediatric Compounded Non-Sterile Product Electronic Repository (pCNPeRx) within the Health Information Technology Infrastructure

PubMed Central

Parrish, Richard H.

2015-01-01

Numerous gaps in the current medication use system impede complete transmission of electronically identifiable and standardized extemporaneous formulations as well as a uniform approach to medication therapy management (MTM) for paediatric patients. The Pharmacy Health Information Technology Collaborative (Pharmacy HIT) identified six components that may have direct importance for pharmacy related to medication use in children. This paper will discuss key positions within the information technology infrastructure (HIT) where an electronic repository for the medication management of paediatric patients’ compounded non-sterile products (pCNP) and care provision could be housed optimally to facilitate and maintain transmission of e-prescriptions (eRx) from initiation to fulfillment. Further, the paper will propose key placement requirements to provide for maximal interoperability of electronic medication management systems to minimize disruptions across the continuum of care. PMID:28970375

A summer pharmacy camp for high school students as a pharmacy student recruitment tool.

PubMed

Myers, Tristan L; DeHart, Renee M; Dunn, Eddie B; Gardner, Stephanie F

2012-05-10

To determine the effectiveness of a summer pharmacy camp on participants' pursuit of enrollment in doctor of pharmacy degree programs. All participants (n = 135) in a pharmacy camp at the University of Arkansas for Medical Sciences (UAMS) College of Pharmacy from 2007-2010 were invited to complete an anonymous online survey instrument. Seventy-three students completed the survey instrument (54% response rate). Ninety-six percent of pharmacy camp participants said that they would recommend pharmacy camp to a friend, and 76% planned to apply or had applied to doctor of pharmacy degree program. Seven of the camp participants had enrolled in the UAMS College of Pharmacy. The pharmacy summer camp at UAMS is effective in maintaining high school students' interest in the profession of pharmacy. Continued use of the pharmacy camp program as a recruitment tool is warranted; however, additional research on this topic is needed.

A clinical database management system for improved integration of the Veterans Affairs Hospital Information System.

PubMed

Andrews, R D; Beauchamp, C

1989-12-01

The Department of Veterans Affairs (VA) Decentralized Hospital Computer Program (DHCP) contains data modules derived from separate ancillary services (e.g., Lab, Pharmacy and Radiology). It is currently difficult to integrate information between the modules. A prototype is being developed aimed at integrating ancillary data by storing clinical data oriented to the patient so that there is easy interaction of data from multiple services. A set of program utilities provides for user-defined functions of decision support, queries, and reports. Information can be used to monitor quality of care by providing feedback in the form of reports, and reminders. Initial testing has indicated the prototype's design and implementation are feasible (in terms of space requirements, speed, and ease of use) in outpatient and inpatient settings. The design, development, and clinical use of this prototype are described.

Fall prevention in central coast community pharmacies.

PubMed

Stuart, Gina M; Kale, Helen L

2018-04-19

Fall injuries among people aged 65 years and over (older people) cause substantial health decline and cost to the health system. In 2009 in New South Wales, 25.6% of older people fell in the previous year, and 10.7% (32 000) were hospitalised. Pharmacists are trusted professionals, who interact extensively with older people and have potential to augment fall prevention in pharmacies. This brief report describes how professional development improved pharmacist's knowledge and confidence in fall prevention, encouraged implementation of fall prevention plans and facilitated the provision of brief fall prevention interventions for older clients, after identification of fall risk. In 2014, pharmacists from all Central Coast pharmacies (n = 76) were invited to free, continuing professional development (CPD) in fall prevention. It provided education and resources to identify clients' fall risk, conduct brief fall prevention interventions and implement fall prevention health promotion plans (FPHPP). Pharmacists completed written: Baseline and post-workshop questionnaires to assess changes in pharmacist's knowledge and confidence, and existing fall prevention in pharmacies. Logs of client fall risk and brief fall prevention interventions offered to clients. Four-month follow-up questionnaires to assess implementation of FPHPPs and pharmacy practice changes. Pharmacists representing 36% of pharmacies participated. At four-month follow-up, 67% had implemented FPHPPs, and 62% delivered brief interventions determined by client fall risk. Fall prevention in pharmacies can be augmented through locally provided CPD tailored for pharmacists. SO WHAT?: This model could increase fall prevention reach. It is transferable to settings where health professionals provide services to older adults and require reregistration through professional development. © 2018 Australian Health Promotion Association.

Design and short-term impact of an event to promote careers in clinical pharmacy.

PubMed

Ray, Sarah; Ticcioni, Andrew; Mueller, Robert; Battaglia, Jessica

2018-03-01

There is a role for local pharmacy organizations to promote clinical pharmacy and increase awareness to both potential and current pharmacy students. The Greater Milwaukee College of Clinical Pharmacy (GMCCP) chapter sought to promote clinical pharmacy amongst current and prospective pharmacy students to increase the knowledge, awareness, and interest in clinical pharmacy. Subcommittee members designed programming to introduce the basics of clinical pharmacy. Students from three schools of pharmacy and more than 40 colleges in the region were invited to the event. Didactic and discussion-based content was developed. Pharmacists from GMCCP were solicited as presenters, along with a current pharmacy student and resident. Participants were asked to complete pre-event and post-event surveys to assess their awareness of and interest in clinical pharmacy. Volunteer pharmacists were also surveyed after the event. Twenty-eight individuals attended the event. Nineteen students completed both the pre- and post-survey. The comparison between median score pre- and post-event was analyzed with the Wilcoxon Signed-Rank test. Students' awareness and knowledge of clinical pharmacy improved after attending the event. Students' interest in a career in clinical pharmacy also increased after attending the event. Nine of the thirteen volunteer breakout session pharmacists (69%) responded to the post-event survey. The majority strongly agreed that participants were interested in learning about their area of practice and asked meaningful questions appropriate for their area of practice. The Exploring Careers in Clinical Pharmacy event increased awareness of clinical pharmacy career choices available within the profession of pharmacy. Local, regional, and national pharmacy organizations may consider utilizing the diverse talent of their membership and collaborate with colleges of pharmacy or other organizations to impact the knowledge, awareness, and interest in clinical pharmacy as a future career choice for pre-pharmacy and current pharmacy students. Copyright © 2017 Elsevier Inc. All rights reserved.

Is Neighborhood Access to Health Care Provision Associated with Individual-Level Utilization and Satisfaction?

PubMed Central

Hiscock, Rosemary; Pearce, Jamie; Blakely, Tony; Witten, Karen

2008-01-01

Objective To explore whether travel time access to the nearest general practitioner (GP) surgery (which is equivalent to U.S. primary care physician [PCP] office) and pharmacy predicts individual-level health service utilization and satisfaction. Data Sources GP and pharmacy addresses were obtained from the New Zealand Ministry of Health in 2003 and merged with a geographic boundaries data set. Travel times derived from these data were appended to the 2002/03 New Zealand Health Survey (N = 12,529). Study Design Multilevel logistic regression was used to model the relationship between travel time access and five health service outcomes: GP consultation, blood pressure test, cholesterol test, visit to pharmacy, and satisfaction with latest GP consultation. Data Collection/Extraction Travel times between each census meshblock centroid and the nearest GP and pharmacy were calculated using Geographical Information System. Principal Findings When travel times were long, blood pressure tests were less likely in urban areas (odds ratio [OR] 0.75 [0.59–0.97]), GP consultations were less likely in rural centers (OR 0.42 [0.22–0.78]) and pharmacy visits were less likely in highly rural areas (OR 0.36 [0.13–0.99]). There was some evidence of lower utilization in rural areas. Conclusions Locational access to GP surgeries and pharmacies appears to sometimes be associated with health service use but not satisfaction. PMID:18671752

45 CFR 156.295 - Prescription drug distribution and cost reporting.

Code of Federal Regulations, 2012 CFR

2012-10-01

... prescriptions that were provided under the QHP through retail pharmacies compared to mail order pharmacies, and... drugs dispensed, broken down by pharmacy type, which includes an independent pharmacy, supermarket pharmacy, or mass merchandiser pharmacy that is licensed as a pharmacy by the State and that dispenses...

45 CFR 156.295 - Prescription drug distribution and cost reporting.

Code of Federal Regulations, 2014 CFR

2014-10-01

... prescriptions that were provided under the QHP through retail pharmacies compared to mail order pharmacies, and... drugs dispensed, broken down by pharmacy type, which includes an independent pharmacy, supermarket pharmacy, or mass merchandiser pharmacy that is licensed as a pharmacy by the State and that dispenses...

45 CFR 156.295 - Prescription drug distribution and cost reporting.

Code of Federal Regulations, 2013 CFR

2013-10-01

... prescriptions that were provided under the QHP through retail pharmacies compared to mail order pharmacies, and... drugs dispensed, broken down by pharmacy type, which includes an independent pharmacy, supermarket pharmacy, or mass merchandiser pharmacy that is licensed as a pharmacy by the State and that dispenses...

Pharmacy students' perceptions of natural science and mathematics subjects.

PubMed

Prescott, Julie; Wilson, Sarah Ellen; Wan, Kai-Wai

2014-08-15

To determine the level of importance pharmacy students placed on science and mathematics subjects for pursuing a career in pharmacy. Two hundred fifty-four students completed a survey instrument developed to investigate students' perceptions of the relevance of science and mathematics subjects to a career in pharmacy. Pharmacy students in all 4 years of a master of pharmacy (MPharm) degree program were invited to complete the survey instrument. Students viewed chemistry-based and biology-based subjects as relevant to a pharmacy career, whereas mathematics subjects such as physics, logarithms, statistics, and algebra were not viewed important to a career in pharmacy. Students' experience in pharmacy and year of study influenced their perceptions of subjects relevant to a pharmacy career. Pharmacy educators need to consider how they can help students recognize the importance of scientific knowledge earlier in the pharmacy curriculum.

End-preparation assessments and tests for compounded sterile preparations.

PubMed

McElhiney, Linda F

2013-01-01

Outsourcing has become a necessity to obtain sterile products that are currently on backorder. Because of the expense of outsourcing sterile compounding, pharmacy leadership in health systems are now considering the option of insourcing and batch preparing compounded sterile preparations, which can be a viable option for a health system. It can significantly decrease drug-spending costs, and the pharmacy has a complete record of the compounding process. The key to preparing high-quality, safe, sterile preparations and meeting United States Pharmacopeia standards is end-preparation assessments and tests.

Faculty and Student Expectations and Perceptions of E-mail Communication in a Campus and Distance Doctor of Pharmacy Program

PubMed Central

Turner, Paul D.; Monaghan, Michael S.; Walters, Ryan W.; Merkel, Jennifer J.; Lipschultz, Jeremy H.; Lenz, Thomas L.

2010-01-01

Objective To examine faculty members' and students' expectations and perceptions of e-mail communication in a dual pathway pharmacy program. Methods Three parallel survey instruments were administered to campus students, distance students, and faculty members, respectively. Focus groups with students and faculty were conducted. Results Faculty members perceived themselves as more accessible and approachable by e-mail than either group of students did. Campus students expected a shorter faculty response time to e-mail and for faculty members to be more available than did distance students. Conclusion E-mail is an effective means of computer-mediated communication between faculty members and students and can be used to promote a sense of community and inclusiveness (ie, immediacy), especially with distant students. PMID:21436932

Pharmacy patronage: identifying key factors in the decision making process using the determinant attribute approach.

PubMed

Franic, Duska M; Haddock, Sarah M; Tucker, Leslie Tootle; Wooten, Nathan

2008-01-01

To use the determinant attribute approach, a research method commonly used in marketing to identify the wants of various consumer groups, to evaluate consumer pharmacy choice when having a prescription order filled in different pharmacy settings. Cross sectional. Community independent, grocery store, community chain, and discount store pharmacies in Georgia between April 2005 and April 2006. Convenience sample of adult pharmacy consumers (n = 175). Survey measuring consumer preferences on 26 attributes encompassing general pharmacy site features (16 items), pharmacist characteristics (5 items), and pharmacy staff characteristics (5 items). 26 potential determinant attributes for pharmacy selection. 175 consumers were surveyed at community independent (n = 81), grocery store (n = 44), community chain (n = 27), or discount store (n = 23) pharmacy settings. The attributes of pharmacists and staff at all four pharmacy settings were shown to affect pharmacy patronage motives, although consumers frequenting non-community independent pharmacies were also motivated by secondary convenience factors, e.g., hours of operation, and prescription coverage. Most consumers do not perceive pharmacies as merely prescription-distribution centers that vary only by convenience. Prescriptions are not just another economic good. Pharmacy personnel influence pharmacy selection; therefore, optimal staff selection and training is likely the greatest asset and most important investment for ensuring pharmacy success.

Oil Pharmacy at the Thermal Protection System Facility

NASA Image and Video Library

2017-08-08

An overall view of the Oil Pharmacy operated under the Test and Operations Support Contract, or TOSC. The facility consolidated storage and distribution of petroleum products used in equipment maintained under the contract. This included standardized naming, testing processes and provided a central location for distribution of oils used in everything from simple machinery to the crawler-transporter and cranes in the Vehicle Assembly Building.

Infrastructure of pharmacies of the primary health care in the Brazilian Unified Health System: Analysis of PNAUM – Services data

PubMed Central

Leite, Silvana Nair; Manzini, Fernanda; Álvares, Juliana; Guerra, Augusto Afonso; Costa, Ediná Alves; Acurcio, Francisco de Assis; Guibu, Ione Aquemi; Costa, Karen Sarmento; Karnikowski, Margô Gomes de Oliveira; Soeiro, Orlando Mário; Farias, Mareni Rocha

2017-01-01

ABSTRACT OBJECTIVE To characterize the infrastructure of the primary health care pharmacies of the Brazilian Unified Health System, aiming at humanizing the offered services. METHODS This is a cross-sectional study, of quantitative approach, from data obtained in the Pesquisa Nacional de Acesso, Utilização e Promoção do Uso Racional de Medicamentos – Serviços, 2015 (PNAUM – National Survey on Access, Use and Promotion of Rational Use of Medicines – Services, 2015). Information on 1,175 pharmacies/dispensing units were gathered from direct observation and assessment of dispensing units installations conducted by trained researchers who used a standardized form. The analyzed variables refer to the physical structure of pharmacies or medicine dispensing units of the health units under research. RESULTS The pharmacy area was greater than 14 m2 in 40.3% of the sampled units, highlighting those from Midwest (56.9%) and Southeast (56.2%) regions and those of Northeast, with only 23.3%. About 80.2% units had waiting rooms with chairs for patients, 31.8% of them had dispensing areas inferior to 5m2, while in 46.2% these areas were superior to 10m2. Bars were found in service counters in 23.8% of health units, thus separating the patient from the professional; 44.1% had internet access. In most units, the area of medicine storage had no refrigerator or freezer for their exclusive storage and 13.7% had a specific room for pharmaceutical consultation. CONCLUSION Aiming at achieving care humanization and improving working conditions for professionals, the structuring of the environment of pharmacy services is necessary. This would contribute to the better qualification of pharmacy services, comprising more than medicine delivery. Data on the Northeast region indicated less favorable conditions to the development of adequate dispensing services. Based on the panorama pointed out, we suggest the expansion of stimulus concerning the physical structure of pharmaceutical services, considering regional specificities. PMID:29160456

[The participation of hospital pharmacy services in enteral nutrition].

PubMed

Hidalgo, F J; Bermejo, T; de Juana, P; Delgado, E; García, D

1995-01-01

We present the results of a study done in the departments of hospital pharmacy of our country with the aim of knowing their participation in the use and clinical follow up of patients with enteral nutrition. 293 questionnaires were sent out, and 121 were filled out and returned (41.3%). The responses were classified into three groups, according to the number of hospital beds, considering > or = 1000 (large), 500-1000 (medium), and < or = 500 (small). The data were analyzed by means of a statistical program (R-Sigma Horus). 79% (68) of the small hospitals have a unitary dose drug dispensation system, and the Enteral Nutrition was distributed through this system in 53% (50) of them; only 29% (27) of them have a stock of these preparations on the wards. 93% (14) and 65% (54) of the large and small hospitals respectively, prefer the use of enteral nutrition as opposed to parenteral nutrition. 85% (11) of the large hospitals have protocols for the use of enteral nutrition, this being 62% (10) and 59% (47) in medium and small hospitals. The committees for artificial nutrition are present in 75% of the large hospitals, in addition to which, in 66% of these there is a nutritional support team. A pharmacist from the department of pharmacy participates in both multidisciplinary groups. If it is necessary to manipulate the enteral nutrition preparations, in 30% of the departments of pharmacy of the smaller hospitals, this is centralized, being done by personnel of the department itself; in 59% of them (19) there is a specific area for the elaboration, which is not the case in large hospitals. Drugs are mixed with the enteral nutrition in 25% (1), 12% (1), and 9% (4) of the large, medium and small hospitals respectively. There is great, active participation of the hospital pharmacists in the activities of the multidisciplinary nutritional support systems, although at the present time, the involvement of the departments of pharmacy in the centralization of the manipulation of the enteral nutrition is reduced. It is necessary therefore, to implement the development of enteral nutrition programs with a quality guarantee from the departments of pharmacy.

21 CFR 1304.05 - Records of authorized central fill pharmacies and retail pharmacies.

Code of Federal Regulations, 2010 CFR

2010-04-01

... 21 Food and Drugs 9 2010-04-01 2010-04-01 false Records of authorized central fill pharmacies and retail pharmacies. 1304.05 Section 1304.05 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF... fill pharmacies and retail pharmacies. (a) Every retail pharmacy that utilizes the services of a...

21 CFR 1304.05 - Records of authorized central fill pharmacies and retail pharmacies.

Code of Federal Regulations, 2011 CFR

2011-04-01

... 21 Food and Drugs 9 2011-04-01 2011-04-01 false Records of authorized central fill pharmacies and retail pharmacies. 1304.05 Section 1304.05 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF... fill pharmacies and retail pharmacies. (a) Every retail pharmacy that utilizes the services of a...

21 CFR 1304.05 - Records of authorized central fill pharmacies and retail pharmacies.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 9 2014-04-01 2014-04-01 false Records of authorized central fill pharmacies and retail pharmacies. 1304.05 Section 1304.05 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF... fill pharmacies and retail pharmacies. (a) Every retail pharmacy that utilizes the services of a...

21 CFR 1304.05 - Records of authorized central fill pharmacies and retail pharmacies.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 9 2012-04-01 2012-04-01 false Records of authorized central fill pharmacies and retail pharmacies. 1304.05 Section 1304.05 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF... fill pharmacies and retail pharmacies. (a) Every retail pharmacy that utilizes the services of a...

21 CFR 1304.05 - Records of authorized central fill pharmacies and retail pharmacies.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 9 2013-04-01 2013-04-01 false Records of authorized central fill pharmacies and retail pharmacies. 1304.05 Section 1304.05 Food and Drugs DRUG ENFORCEMENT ADMINISTRATION, DEPARTMENT OF... fill pharmacies and retail pharmacies. (a) Every retail pharmacy that utilizes the services of a...

Pharmacy specialists' attitudes toward pharmaceutical service quality at community pharmacies.

PubMed

Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas

2010-01-01

The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic aspects as compared to those working at pharmacies with fewer specialists. Men evaluated both pharmacotherapeutic and socioeconomic aspects worse than women. The evaluation of pharmaceutical service quality did not differ by pharmacy location. Two dimensions of pharmaceutical service quality were determined. According to Lithuanian pharmacy specialists, the quality of pharmacotherapeutic aspects at community pharmacies was worse than that of socioeconomic aspects. The evaluation of the quality of pharmaceutical service significantly differed according to the specialists' sex, age, qualification, and type and size of pharmacies.

Identification of losses to follow-up in a community-based antiretroviral therapy clinic in South Africa using a computerized pharmacy tracking system.

PubMed

Nglazi, Mweete D; Kaplan, Richard; Wood, Robin; Bekker, Linda-Gail; Lawn, Stephen D

2010-11-15

High rates of loss to follow-up (LTFU) are undermining rapidly expanding antiretroviral treatment (ART) services in sub-Saharan Africa. The intelligent dispensing of ART (iDART) is an open-source electronic pharmacy system that provides an efficient means of generating lists of patients who have failed to pick-up medication. We determined the duration of pharmacy delay that optimally identified true LTFU. We conducted a retrospective cross-sectional study of a community-based ART cohort in Cape Town, South Africa. We used iDART to identify groups of patients known to be still enrolled in the cohort on the 1st of April 2008 that had failed to pick-up medication for periods of ≥ 6, ≥ 12, ≥ 18 and ≥ 24 weeks. We defined true LTFU as confirmed failure to pick up medication for 3 months since last attendance. We then assessed short-term and long-term outcomes using a prospectively maintained database and patient records. On the date of the survey, 2548 patients were registered as receiving ART but of these 85 patients (3.3%) were found to be true LTFU. The numbers of individuals (proportion of the cohort) identified by iDART as having failed to collect medication for periods of ≥ 6, ≥ 12, ≥ 18 and ≥ 24 weeks were 560 (22%), 194 (8%), 117 (5%) and 80 (3%), respectively. The sensitivities of these pharmacy delays for detecting true LTFU were 100%, 100%, 62.4% and 47.1%, respectively. The corresponding specificities were 80.7%, 95.6%, 97.4% and 98.4%. Thus, the optimal delay was ≥ 12 weeks since last attendance at this clinic (equivalent to 8 weeks since medication ran out). Pharmacy delays were also found to be significantly associated with LTFU and death one year later. The iDART electronic pharmacy system can be used to detect patients potentially LTFU and who require recall. Using a short a cut-off period was too non-specific for LTFU and would require the tracing of very large numbers of patients. Conversely prolonged delays were too insensitive. Of the periods assessed, a ≥ 12 weeks delay appeared optimal. This system requires prospective evaluation to further refine its utility.

Identification of losses to follow-up in a community-based antiretroviral therapy clinic in South Africa using a computerized pharmacy tracking system

PubMed Central

2010-01-01

Background High rates of loss to follow-up (LTFU) are undermining rapidly expanding antiretroviral treatment (ART) services in sub-Saharan Africa. The intelligent dispensing of ART (iDART) is an open-source electronic pharmacy system that provides an efficient means of generating lists of patients who have failed to pick-up medication. We determined the duration of pharmacy delay that optimally identified true LTFU. Methods We conducted a retrospective cross-sectional study of a community-based ART cohort in Cape Town, South Africa. We used iDART to identify groups of patients known to be still enrolled in the cohort on the 1st of April 2008 that had failed to pick-up medication for periods of ≥ 6, ≥ 12, ≥ 18 and ≥ 24 weeks. We defined true LTFU as confirmed failure to pick up medication for 3 months since last attendance. We then assessed short-term and long-term outcomes using a prospectively maintained database and patient records. Results On the date of the survey, 2548 patients were registered as receiving ART but of these 85 patients (3.3%) were found to be true LTFU. The numbers of individuals (proportion of the cohort) identified by iDART as having failed to collect medication for periods of ≥6, ≥12, ≥18 and ≥24 weeks were 560 (22%), 194 (8%), 117 (5%) and 80 (3%), respectively. The sensitivities of these pharmacy delays for detecting true LTFU were 100%, 100%, 62.4% and 47.1%, respectively. The corresponding specificities were 80.7%, 95.6%, 97.4% and 98.4%. Thus, the optimal delay was ≥12 weeks since last attendance at this clinic (equivalent to 8 weeks since medication ran out). Pharmacy delays were also found to be significantly associated with LTFU and death one year later. Conclusions The iDART electronic pharmacy system can be used to detect patients potentially LTFU and who require recall. Using a short a cut-off period was too non-specific for LTFU and would require the tracing of very large numbers of patients. Conversely prolonged delays were too insensitive. Of the periods assessed, a ≥12 weeks delay appeared optimal. This system requires prospective evaluation to further refine its utility. PMID:21078148

The Roles of Pharmacy Schools in Bridging the Gap Between Law and Practice.

PubMed

Adams, Alex J; Dering-Anderson, Allison; Klepser, Michael E; Klepser, Donald

2018-05-01

Progressive pharmacy laws do not always lead to progressive pharmacy practice. Progressive laws are necessary, but not sufficient for pharmacy services to take off in practice. Pharmacy schools can play critical roles by working collaboratively with community pharmacies to close the gap between law and practice. Our experiences launching pharmacy-based point-of-care testing services in community pharmacy settings illustrate some of the roles schools can play, including: developing and providing standardized training, developing template protocols, providing workflow support, sparking collaboration across pharmacies, providing policy support, and conducting research.

Impact of pharmacists providing immunizations on adolescent influenza immunization.

PubMed

Robison, Steve G

2016-01-01

To determine if the Oregon law change in 2011 to allow pharmacists to immunize adolescents 11 to 17 years of age increased influenza immunizations or changed existing immunization venues. With the use of Oregon's ALERT Immunization Information System (IIS), 2 measures of impact were developed. First, the change in adolescent age 11-17 influenza immunizations before (2007-2010) and after (2011-2014) the pharmacy law change was evaluated against a reference cohort (aged 7-10) not affected by the law. Community pharmacies were also compared with other types of influenza immunization sites within one of the study influenza seasons (2013-2014). From 2007 to 2014, adolescent influenza immunizations at community pharmacies increased from 36 to 6372 per year. After the 2011 pharmacy law change, adolescents aged 11 to 17 were more likely to receive an influenza immunization compared with the reference population (odds ratio, 1.21; 95% CI, 1.19-1.22). Analysis of the 2013-2014 influenza season suggests that community pharmacies immunized a different population of adolescents than other providers. The 2011 change in Oregon law allowed pharmacists to increase the total of influenza immunizations given to adolescents. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Innovation in clinical pharmacy practice and opportunities for academic--practice partnership.

PubMed

Gubbins, Paul O; Micek, Scott T; Badowski, Melissa; Cheng, Judy; Gallagher, Jason; Johnson, Samuel G; Karnes, Jason H; Lyons, Kayley; Moore, Katherine G; Strnad, Kyle

2014-05-01

Clinical pharmacy has a rich history of advancing practice through innovation. These innovations helped to mold clinical pharmacy into a patient-centered discipline recognized for its contributions to improving medication therapy outcomes. However, innovations in clinical pharmacy practice have now waned. In our view, the growth of academic–practice partnerships could reverse this trend and stimulate innovation among the next generation of pioneering clinical pharmacists. Although collaboration facilitates innovation,academic institutions and health care systems/organizations are not taking full advantage of this opportunity. The academic–practice partnership can be optimized by making both partners accountable for the desired outcomes of their collaboration, fostering symbiotic relationships that promote value-added clinical pharmacy services and emphasizing continuous quality improvement in the delivery of these services. Optimizing academic–practice collaboration on a broader scale requires both partners to adopt a culture that provides for dedicated time to pursue innovation, establishes mechanisms to incubate ideas, recognizes where motivation and vision align, and supports the purpose of the partnership. With appropriate leadership and support, a shift in current professional education and training practices, and a commitment to cultivate future innovators, the academic–practice partnership can develop new and innovative practice advancements that will improve patient outcomes.

Assessing experiential education factors contributing to a PGY1 residency match: Pharmacy residency program director and comparative student survey.

PubMed

Prisco, Jennifer L; Hritcko, Philip M; Feret, Brett; Yorra, Mark L; Todd, Noreen E; Kim Tanzer; Basile, Cathy; Bonaceto, Kara; Morelli, Rita; Carace, Nicole; Szumita, Andrew

2018-02-01

To compare and contrast experiential education perceptions of pharmacy residency program directors (RPDs) and doctor of pharmacy students in their last year of the curriculum for residency application considerations. The New England Regional Departments of Experiential Education (NERDEE) consortium developed a 17-question survey to assess residency factors, including those related to experiential education. The survey was dispersed to advanced pharmacy practice experience (APPE) students from six colleges/schools of pharmacy and RPDs nationwide. Students have different values on experiential preferences compared to RPDs. Sample findings include internal medicine and specialty clinical elective experiences prior to American Society of Health-System Pharmacists (ASHP) Midyear were extremely important to important for students, while RPDs viewed these experiences as somewhat important at best (p < 0.02). The majority of RPDs (67%) have no APPE schedule preference, while most students (77%) feel that certain APPE schedules may influence acceptance into residency. Based on findings, information outlined can be used to dispel and/or validate common beliefs held by students regarding experiential factors that help or hinder a successful postgraduate year 1 (PGY1) residency match. Copyright © 2017 Elsevier Inc. All rights reserved.

Perception of community pharmacists toward their current professional role in the healthcare system of Dubai, United Arab Emirates.

PubMed

Rayes, Ibrahim Khalid; Hassali, Mohamed Azmi; Abduelkarem, Abduelmula R

2015-07-01

The new paradigm to pharmacy profession has changed the focus of pharmacists from product-centered to patient-oriented. This change has brought new set of beliefs and assumptions on the way services should be delivered to pharmacy clients. The main aim of this study was to explore the perception of community pharmacists on their current professional role in Dubai. Key findings show that community pharmacists are more directed toward business than patients. They almost dispense all categories of medicines over-the-counter without the need of prescriptions. However, a new trend of pharmacists in Dubai is to provide enhanced pharmacy services such as consultation to patients upon request.

Building a Web-based drug ordering system for hospitals: from requirements engineering to prototyping.

PubMed

Hübner, U; Klein, F; Hofstetter, J; Kammeyer, G; Seete, H

2000-01-01

Web-based drug ordering allows a growing number of hospitals without pharmacy to communicate seamlessly with their external pharmacy. Business process analysis and object oriented modelling performed together with the users at a pilot hospital resulted in a comprehensive picture of the user and business requirements for electronic drug ordering. The user requirements were further validated with the help of a software prototype. In order to capture the needs of a large number of users CAP10, a new method making use of pre-built models, is proposed. Solutions for coping with the technical requirements (interfacing the business software at the pharmacy) and with the legal requirements (signing the orders) are presented.

Pharmacy Students’ Perceptions of Natural Science and Mathematics Subjects

PubMed Central

Wilson, Sarah Ellen; Wan, Kai-Wai

2014-01-01

Objective. To determine the level of importance pharmacy students placed on science and mathematics subjects for pursuing a career in pharmacy. Method. Two hundred fifty-four students completed a survey instrument developed to investigate students’ perceptions of the relevance of science and mathematics subjects to a career in pharmacy. Pharmacy students in all 4 years of a master of pharmacy (MPharm) degree program were invited to complete the survey instrument. Results. Students viewed chemistry-based and biology-based subjects as relevant to a pharmacy career, whereas mathematics subjects such as physics, logarithms, statistics, and algebra were not viewed important to a career in pharmacy. Conclusion. Students’ experience in pharmacy and year of study influenced their perceptions of subjects relevant to a pharmacy career. Pharmacy educators need to consider how they can help students recognize the importance of scientific knowledge earlier in the pharmacy curriculum. PMID:25147390

Customer interest in and experience with various types of pharmacy counselling - a qualitative study.

PubMed

Kaae, Susanne; Traulsen, Janine M; Nørgaard, Lotte S

2014-12-01

Despite pharmacists' extensive knowledge in the optimization of patients' medical treatments, community pharmacies are still fighting to earn patients' trust with respect to medicinal counselling at the counter. The aim was to investigate how patients perceive pharmacy counselling at the present time, in order to develop the patient-pharmacy relationship for the benefit of both patients and pharmacies. Short semi-structured interviews were carried out with pharmacy customers by pharmacy internship students. One hundred and eight customers in 35 independent pharmacies across Denmark were interviewed during the spring of 2011. Customers were interviewed about their expectations of pharmacies in general and their experiences with medical counselling in particular. Customers perceive community pharmacies very differently in terms of both expectations of and positive experiences with counselling. They appear to be in favour of pharmacy counselling with respect to over-the-counter medicine and first-time prescription medicine in contrast to refills. Customers find it difficult to express the health-care role of pharmacies even when experiencing and appreciating it. Lack of appreciation of pharmacy counselling for refill prescription medicine and the difficulty in defining the role of pharmacies might stem from the difficulties that customers have in understanding medicine and thus the role of counselling services with respect to medicine. The pharmacy staff does not seem to realize these barriers. For pharmacies to encourage customer interest in pharmacy counselling, the staff should start taking the identified barriers into account when planning communication strategies. © 2012 John Wiley & Sons Ltd.

Incremental Effect of the Addition of Prescriber Restrictions on a State Medicaid's Pharmacy-Only Patient Review and Restriction Program.

PubMed

Keast, Shellie L; Pham, Timothy; Teel, Ashley; Nesser, Nancy J

2017-08-01

Patient review and restriction programs (PRRPs), used by state Medicaid programs to limit potential abuse and misuse of opioids and related controlled medications, often restrict members to a single pharmacy for controlled medications. While most states use a restricted pharmacy access model, not all states include restricted prescriber access. Oklahoma Medicaid (MOK) added a restricted prescriber access feature to its PRRP in July 2014. To evaluate the incremental effect that the addition of a prescriber restriction to MOK's pharmacy-only PRRP had on the pharmacy and resource utilization of the enrolled members. MOK members with at least 6 months of enrollment in the pharmacy-only PRRP were restricted to a maximum of 3 prescribers for controlled substances in July 2014 and were identified as "cases." Using a propensity score method, cases were matched to controls from the MOK non-PRRP enrolled population based on demographics and baseline health care utilization. Data from January 1, 2014, through December 31, 2014, were evaluated. Each member's monthly health care resource utilization, defined in terms of medical and pharmacy costs, prescription counts, and opioid use per member per month (PMPM), was analyzed. A difference-indifferences (DID) regression estimated the change in resource utilization following the July 2014 policy change. This study included 378 controls and 126 cases after propensity matching. No differences were noted for daily morphine equivalents, benzodiazepine prescriptions, or maintenance prescriptions. There were decreases in mean PMPM use for both groups for short-acting opioid (SAO) claims (P < 0.001), overall opioid claims (P = 0.007 for controls and P < 0.001 for cases), prescribers (P = 0.01 for controls and P < 0.001 for cases), and number of pharmacies for cases (P < 0.001). DID analyses indicated that cases had a larger decrease in mean SAO claims (difference: -0.15, 95% CI: -0.25 to -0.04, P = 0.008); prescribers (difference: -0.25, 95% CI: -0.36 to -0.15, P < 0.001); and pharmacies (difference: -0.20, 95% CI: -0.28 to -0.13, P < 0.001) relative to controls. The difference for overall opioid claims was greater for cases than controls but did not reach statistical significance (difference: -0.12, 95% CI: -0.25 to 0.00, P = 0.050). Although there was no evidence that overall opioid claims were affected, the addition of prescriber restrictions may have resulted in an incremental change to SAO, prescriber, and pharmacy use in the PRPP population. Use of PRRPs may be an effective tool in reducing inappropriate use of prescription opioids within payer systems. The question remains whether these changes result in long-term changes to behavior outside the payer system. Future research into the effects of PRRPs on patient behavior beyond the payer system is needed. No outside funding supported this research. All authors disclose either employment by the Oklahoma Health Care Authority or contractual work for this employer. In addition, Keast discloses unrelated funding through unrestricted research grants from Gilead Sciences and Purdue Pharma. Study concept and design were contributed by Keast and Pham, along with Teel and Nesser. Keast and Pham collected the data, along with Teel, and data interpretation was provided by Keast and Pham, with assistance from Teel and Nesser. The manuscript was written primarily by Keast, along with Pham and Teel, and revised by all the authors.

Evaluate the ability of clinical decision support systems (CDSSs) to improve clinical practice.

PubMed

Ajami, Sima; Amini, Fatemeh

2013-01-01

Prevalence of new diseases, medical science promotion and increase of referring to health care centers, provide a good situation for medical errors growth. Errors can involve medicines, surgery, diagnosis, equipment, or lab reports. Medical errors can occur anywhere in the health care system: In hospitals, clinics, surgery centers, doctors' offices, nursing homes, pharmacies, and patients' homes. According to the Institute of Medicine (IOM), 98,000 people die every year from preventable medical errors. In 2010 from all referred medical error records to Iran Legal Medicine Organization, 46/5% physician and medical team members were known as delinquent. One of new technologies that can reduce medical errors is clinical decision support systems (CDSSs). This study was unsystematic-review study. The literature was searched on evaluate the "ability of clinical decision support systems to improve clinical practice" with the help of library, books, conference proceedings, data bank, and also searches engines available at Google, Google scholar. For our searches, we employed the following keywords and their combinations: medical error, clinical decision support systems, Computer-Based Clinical Decision Support Systems, information technology, information system, health care quality, computer systems in the searching areas of title, keywords, abstract, and full text. In this study, more than 100 articles and reports were collected and 38 of them were selected based on their relevancy. The CDSSs are computer programs, designed for help to health care careers. These systems as a knowledge-based tool could help health care manager in analyze evaluation, improvement and selection of effective solutions in clinical decisions. Therefore, it has a main role in medical errors reduction. The aim of this study was to express ability of the CDSSs to improve

Stakeholder analysis for the development of a community pharmacy service aimed at preventing cardiovascular disease.

PubMed

Franco-Trigo, L; Hossain, L N; Durks, D; Fam, D; Inglis, S C; Benrimoj, S I; Sabater-Hernández, D

Participatory approaches involving stakeholders across the health care system can help enhance the development, implementation and evaluation of health services. These approaches may be particularly useful in planning community pharmacy services and so overcome challenges in their implementation into practice. Conducting a stakeholder analysis is a key first step since it allows relevant stakeholders to be identified, as well as providing planners a better understanding of the complexity of the health care system. The main aim of this study was to conduct a stakeholder analysis to identify those individuals and organizations that could be part of a leading planning group for the development of a community pharmacy service (CPS) to prevent cardiovascular disease (CVD) in Australia. An experienced facilitator conducted a workshop with 8 key informants of the Australian health care system. Two structured activities were undertaken. The first explored current needs and gaps in cardiovascular care and the role of community pharmacists. The second was a stakeholder analysis, using both ex-ante and ad-hoc approaches. Identified stakeholders were then classified into three groups according to their relative influence on the development of the pharmacy service. The information gathered was analyzed using qualitative content analysis. The key informants identified 46 stakeholders, including (1) patient/consumers and their representative organizations, (2) health care providers and their professional organizations and (3) institutions and organizations that do not directly interact with patients but organize and manage the health care system, develop and implement health policies, pay for health care, influence funding for health service research or promote new health initiatives. From the 46 stakeholders, a core group of 12 stakeholders was defined. These were considered crucial to the service's development because they held positions that could drive or inhibit progress. Secondary results of the workshop included: a list of needs and gaps in cardiovascular care (n = 6), a list of roles for community pharmacists in cardiovascular prevention (n = 12) and a list of potential factors (n = 7) that can hinder the integration of community pharmacy services into practice. This stakeholder analysis provided a detailed picture of the wide range of stakeholders across the entire health care system that have a stake in the development of a community pharmacy service aimed at preventing CVD. Of these, a core group of key stakeholders, with complementary roles, can then be approached for further planning of the service. The results of this analysis highlight the relevance of establishing multilevel stakeholder groups for CPS planning. Copyright © 2016 Elsevier Inc. All rights reserved.

Optimizing EEMCO guidance for the assessment of dry skin (xerosis) for pharmacies.

PubMed

Kang, B C; Kim, Y E; Kim, Y J; Chang, M J; Choi, H D; Li, K; Shin, W G

2014-02-01

People with dry skin (xerosis) are common in community pharmacies, but there is no consistent guidance for community pharmacists to evaluate and alleviate dry skin. Through evaluating any difference of the clinical scoring systems of EEMCO guidance between a dermatologist and pharmacists and the efficacy of moisturizers for the treatment of dry skin recommended by community pharmacists, we aim to validate a dry skin guidance through the help of community pharmacists. These results provide insight into how community pharmacists can help patients with dry skin. The clinical scoring systems of EEMCO guidance used in this study comprised analog scales, the overall dry skin score (ODS), and the specific symptom sum score (SRRC) system. All pictures of the dry skin scored by pharmacists were visually evaluated by a dermatologist. The efficacy of the moisturizers was determined by the difference of the scales on day 0 and on day 28. In this study, 387 patients with dry skin from 157 community pharmacies were evaluated by pharmacists. Visual scale with divisions, ODS and SRRC that were evaluated by pharmacists on day 0 and day 28 were moderately reliable by a dermatologist. All parameters of dry skin were significantly improved by the moisturizers which were recommended by community pharmacists on day 28. Visual scale, ODS and SRRC can be generally measured to evaluate dry skin in community pharmacies with moderate degree of reliability. This finding has possible applications for investigating the assessment of the community pharmacists on clinical scoring system of dry skin and moisturizers. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Development of a standardized Intranet database of formulation records for nonsterile compounding, Part 2.

PubMed

Haile, Michael; Anderson, Kim; Evans, Alex; Crawford, Angela

2012-01-01

In part 1 of this series, we outlined the rationale behind the development of a centralized electronic database used to maintain nonsterile compounding formulation records in the Mission Health System, which is a union of several independent hospitals and satellite and regional pharmacies that form the cornerstone of advanced medical care in several areas of western North Carolina. Hospital providers in many healthcare systems require compounded formulations to meet the needs of their patients (in particular, pediatric patients). Before a centralized electronic compounding database was implemented in the Mission Health System, each satellite or regional pharmacy affiliated with that system had a specific set of formulation records, but no standardized format for those records existed. In this article, we describe the quality control, database platform selection, description, implementation, and execution of our intranet database system, which is designed to maintain, manage, and disseminate nonsterile compounding formulation records in the hospitals and affiliated pharmacies of the Mission Health System. The objectives of that project were to standardize nonsterile compounding formulation records, create a centralized computerized database that would increase healthcare staff members' access to formulation records, establish beyond-use dates based on published stability studies, improve quality control, reduce the potential for medication errors related to compounding medications, and (ultimately) improve patient safety.

Teaching and learning curriculum programs: recommendations for postgraduate pharmacy experiences in education.

PubMed

Wright, Eric A; Brown, Bonnie; Gettig, Jacob; Martello, Jay L; McClendon, Katie S; Smith, Kelly M; Teeters, Janet; Ulbrich, Timothy R; Wegrzyn, Nicole; Bradley-Baker, Lynette R

2014-08-01

Recommendations for the development and support of teaching and learning curriculum (TLC) experiences within postgraduate pharmacy training programs are discussed. Recent attention has turned toward meeting teaching- and learning-related educational outcomes through a programmatic process during the first or second year of postgraduate education. These programs are usually coordinated by schools and colleges of pharmacy and often referred to as "teaching certificate programs," though no national standards or regulation of these programs currently exists. In an effort to describe the landscape of these programs and to develop a framework for their basic design and content, the American Association of Colleges of Pharmacy Pharmacy Practice Section's Task Force on Student Engagement and Involvement, with input from the American Society of Health-System Pharmacists, reviewed evidence from the literature and conference proceedings and considered author experience and expertise over a two-year period. The members of the task force created and reached consensus on a policy statement and 12 recommendations to guide the development of best practices of TLC programs. The recommendations address topics such as the value of TLC programs, program content, teaching and learning experiences, feedback for participants, the development of a teaching portfolio, the provision of adequate resources for TLC programs, programmatic assessment and improvement, program transparency, and accreditation. TLC programs provide postgraduate participants with valuable knowledge and skills in teaching applicable to the practitioner and academician. Postgraduate programs should be transparent to candidates and seek to ensure the best experiences for participants through systematic program implementation and assessments. Copyright © 2014 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Antibiotic distribution channels in Thailand: results of key-informant interviews, reviews of drug regulations and database searches

PubMed Central

Chanvatik, Sunicha; Sermsinsiri, Varavoot; Sivilaikul, Somsajee; Patcharanarumol, Walaiporn; Yeung, Shunmay; Tangcharoensathien, Viroj

2018-01-01

Abstract Objective To analyse how antibiotics are imported, manufactured, distributed and regulated in Thailand. Methods We gathered information, on antibiotic distribution in Thailand, in in-depth interviews – with 43 key informants from farms, health facilities, pharmaceutical and animal feed industries, private pharmacies and regulators– and in database and literature searches. Findings In 2016–2017, licensed antibiotic distribution in Thailand involves over 700 importers and about 24 000 distributors – e.g. retail pharmacies and wholesalers. Thailand imports antibiotics and active pharmaceutical ingredients. There is no system for monitoring the distribution of active ingredients, some of which are used directly on farms, without being processed. Most antibiotics can be bought from pharmacies, for home or farm use, without a prescription. Although the 1987 Drug Act classified most antibiotics as “dangerous drugs”, it only classified a few of them as prescription-only medicines and placed no restrictions on the quantities of antibiotics that could be sold to any individual. Pharmacists working in pharmacies are covered by some of the Act’s regulations, but the quality of their dispensing and prescribing appears to be largely reliant on their competences. Conclusion In Thailand, most antibiotics are easily and widely available from retail pharmacies, without a prescription. If the inappropriate use of active pharmaceutical ingredients and antibiotics is to be reduced, we need to reclassify and restrict access to certain antibiotics and to develop systems to audit the dispensing of antibiotics in the retail sector and track the movements of active ingredients. PMID:29403113

Identifying opportunities to advance practice at a large academic medical center using the ASHP Ambulatory Care Self-Assessment Tool.

PubMed

Martirosov, Amber Lanae; Michael, Angela; McCarty, Melissa; Bacon, Opal; DiLodovico, John R; Jantz, Arin; Kostoff, Diana; MacDonald, Nancy C; Mikulandric, Nancy; Neme, Klodiana; Sulejmani, Nimisha; Summers, Bryant B

2018-05-29

The use of the ASHP Ambulatory Care Self-Assessment Tool to advance pharmacy practice at 8 ambulatory care clinics of a large academic medical center is described. The ASHP Ambulatory Care Self-Assessment Tool was developed to help ambulatory care pharmacists assess how their current practices align with the ASHP Practice Advancement Initiative. The Henry Ford Hospital Ambulatory Care Advisory Group (ACAG) opted to use the "Practitioner Track" sections of the tool to assess pharmacy practices within each of 8 ambulatory care clinics individually. The responses to self-assessment items were then compiled and discussed by ACAG members. The group identified best practices and ways to implement action items to advance ambulatory care practice throughout the institution. Three recommended action items were common to most clinics: (1) identify and evaluate solutions to deliver financially viable services, (2) develop technology to improve patient care, and (3) optimize the role of pharmacy technicians and support personnel. The ACAG leadership met with pharmacy administrators to discuss how action items that were both feasible and deemed likely to have a medium-to-high impact aligned with departmental goals and used this information to develop an ambulatory care strategic plan. This process informed and enabled initiatives to advance ambulatory care pharmacy practice within the system. The ASHP Ambulatory Care Self-Assessment Tool was useful in identifying opportunities for practice advancement in a large academic medical center. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Elevating pharmacists' scope of practice through a health-system clinical privileging process.

PubMed

Jordan, Trisha A; Hennenfent, Joel A; Lewin, John J; Nesbit, Todd W; Weber, Robert

2016-09-15

The privileging of pharmacists for clinical activities and the impact that privileging has on enhancing the scope of pharmacy practice in health systems are reviewed. Health-system pharmacists or pharmacy leaders must gain a thorough understanding of the credentialing and privileging process as they broaden their scope of practice. Clinical privileging affords an expanded scope of practice that is recognized at the institutional level and formally elevates the pharmacist to that of a nonphysician provider. The installation of privileging processes is expected to take many months to complete for individual institutions and should begin now in anticipation of provider status. Model institutions, including Truman Medical Centers, Johns Hopkins Hospital, and The Ohio State University Wexner Medical Center, are highlighted in this article and provide their individual approach to clinical privileging that can be applied to other institutions. The development and evaluation of these programs have given valuable insight into how this individual approach translates to health systems across the country and how the pharmacy profession can continue to unite to convey the value of pharmacists in improving patient care. In preparation for the potential approval of pharmacist provider status across the United States, it is essential that pharmacists are privileged by the medical staff at their respective institution. Clinical privileges must be strategically developed with a focus on cost and quality aims and meeting the needs of patients. Implementation and maintenance of high-performing pharmacy privileging programs require both successful leadership and management skills and an understanding of the interprofessional nature of healthcare. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

Medication errors room: a simulation to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication-use system.

PubMed

Daupin, Johanne; Atkinson, Suzanne; Bédard, Pascal; Pelchat, Véronique; Lebel, Denis; Bussières, Jean-François

2016-12-01

The medication-use system in hospitals is very complex. To improve the health professionals' awareness of the risks of errors related to the medication-use system, a simulation of medication errors was created. The main objective was to assess the medical, nursing and pharmacy staffs' ability to identify errors related to the medication-use system using a simulation. The secondary objective was to assess their level of satisfaction. This descriptive cross-sectional study was conducted in a 500-bed mother-and-child university hospital. A multidisciplinary group set up 30 situations and replicated a patient room and a care unit pharmacy. All hospital staff, including nurses, physicians, pharmacists and pharmacy technicians, was invited. Participants had to detect if a situation contained an error and fill out a response grid. They also answered a satisfaction survey. The simulation was held during 100 hours. A total of 230 professionals visited the simulation, 207 handed in a response grid and 136 answered the satisfaction survey. The participants' overall rate of correct answers was 67.5% ± 13.3% (4073/6036). Among the least detected errors were situations involving a Y-site infusion incompatibility, an oral syringe preparation and the patient's identification. Participants mainly considered the simulation as effective in identifying incorrect practices (132/136, 97.8%) and relevant to their practice (129/136, 95.6%). Most of them (114/136; 84.4%) intended to change their practices in view of their exposure to the simulation. We implemented a realistic medication-use system errors simulation in a mother-child hospital, with a wide audience. This simulation was an effective, relevant and innovative tool to raise the health care professionals' awareness of critical processes. © 2016 John Wiley & Sons, Ltd.

Shifting tasks from pharmacy to non-pharmacy personnel for providing antiretroviral therapy to people living with HIV: a systematic review and meta-analysis.

PubMed

Mbeye, Nyanyiwe Masingi; Adetokunboh, Olatunji; Negussie, Eyerusalem; Kredo, Tamara; Wiysonge, Charles Shey

2017-08-29

Lay people or non-pharmacy health workers with training could dispense antiretroviral therapy (ART) in resource-constrained countries, freeing up time for pharmacists to focus on more technical tasks. We assessed the effectiveness of such task-shifting in low-income and middle-income countries. We conducted comprehensive searches of peer-reviewed and grey literature. Two authors independently screened search outputs, selected controlled trials, extracted data and resolved discrepancies by consensus. We performed random-effects meta-analysis and assessed certainty of evidence using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Three studies with 1993 participants met the inclusion criteria, including two cluster trials conducted in Kenya and Uganda and an individually randomised trial conducted in Brazil. We found very low certainty evidence regarding mortality due to the low number of events. Therefore, we are uncertain whether there is a true increase in mortality as the effect size suggests, or a reduction in mortality between pharmacy and non-pharmacy models of dispensing ART (risk ratio (RR) 1.86, 95% CI 0.44 to 7.95, n=1993, three trials, very low certainty evidence). There may be no differences between pharmacy and non-pharmacy models of dispensing ART on virological failure (risk ratio (RR) 0.92, 95% CI 0.73 to 1.15, n=1993, three trials, low certainty evidence) and loss to follow-up (RR 1.13, 95% CI 0.68 to 1.91, n=1993. three trials, low certainty evidence). We found some evidence that costs may be reduced for the patient and health system when task-shifting is undertaken. The low certainty regarding the evidence implies a high likelihood that further research may find the effects of the intervention to be substantially different from our findings. If resource-constrained countries decide to shift ART dispensing and distribution from pharmacy to non-pharmacy personnel, this should be accompanied by robust monitoring and impact evaluation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Quality indicators to compare accredited independent pharmacies and accredited chain pharmacies in Thailand.

PubMed

Arkaravichien, Wiwat; Wongpratat, Apichaya; Lertsinudom, Sunee

2016-08-01

Background Quality indicators determine the quality of actual practice in reference to standard criteria. The Community Pharmacy Association (Thailand), with technical support from the International Pharmaceutical Federation, developed a tool for quality assessment and quality improvement at community pharmacies. This tool has passed validity and reliability tests, but has not yet had feasibility testing. Objective (1) To test whether this quality tool could be used in routine settings. (2) To compare quality scores between accredited independent and accredited chain pharmacies. Setting Accredited independent pharmacies and accredited chain pharmacies in the north eastern region of Thailand. Methods A cross sectional study was conducted in 34 accredited independent pharmacies and accredited chain pharmacies. Quality scores were assessed by observation and by interviewing the responsible pharmacists. Data were collected and analyzed by independent t-test and Mann-Whitney U test as appropriate. Results were plotted by histogram and spider chart. Main outcome measure Domain's assessable scores, possible maximum scores, mean and median of measured scores. Results Domain's assessable scores were close to domain's possible maximum scores. This meant that most indicators could be assessed in most pharmacies. The spider chart revealed that measured scores in the personnel, drug inventory and stocking, and patient satisfaction and health promotion domains of chain pharmacies were significantly higher than those of independent pharmacies (p < 0.05). There was no statistical difference between independent pharmacies and chain pharmacies in the premise and facility or dispensing and patient care domains. Conclusion Quality indicators developed by the Community Pharmacy Association (Thailand) could be used to assess quality of practice in pharmacies in routine settings. It is revealed that the quality scores of chain pharmacies were higher than those of independent pharmacies.

Nonprescription naloxone and syringe sales in the midst of opioid overdose and hepatitis C virus epidemics: Massachusetts, 2015.

PubMed

Stopka, Thomas J; Donahue, Ashley; Hutcheson, Marguerite; Green, Traci C

To determine the prevalence of nonprescription naloxone and sterile syringe sales, factors associated with nonprescription sales, geospatial access to nonprescription naloxone and syringe-selling pharmacies, and targets for potential interventions. Cross-sectional study. Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to nonprescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease hepatitis C virus transmission, respectively. We completed brief telephone surveys with 809 of 1042 retail pharmacies across Massachusetts (response rate = 77.6%) during 2015 to assess experience with nonprescription sales of naloxone and sterile syringes. Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes or no) for nonprescription sales and nonprescription syringe sales (yes or no). We conducted multivariable regression analyses and created maps using a geographic information system to identify factors associated with nonprescription sales of naloxone and sterile syringes, and to improve our understanding of geospatial access to pharmacy-based naloxone and syringe sales. More than 97% of pharmacies reported selling sterile syringes without requiring a prescription, and 45% of pharmacies reported stocking and selling naloxone. Factors associated with nonprescription sales included hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to nonprescription sale of sterile syringes is widespread, whereas geospatial access to naloxone is limited. Training to understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists. Access to sterile syringes through nonprescription sales is strong across Massachusetts, and although more than 350 pharmacies (45%) reported stocking and selling naloxone to prevent opioid overdose deaths, there is much room for improvement in access and training among pharmacy staff members. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Non-Prescription Naloxone and Syringe Sales in the Midst of Opioid Overdose and Hepatitis C Virus Epidemics: Massachusetts, 2015

PubMed Central

Stopka, Thomas J.; Donahue, Ashley; Hutcheson, Marguerite; Green, Traci C.

2017-01-01

Objectives To determine the prevalence of non-prescription naloxone and sterile syringe sales, factors associated with non-prescription sales, geospatial access to non-prescription naloxone and syringe selling pharmacies, and targets for potential interventions. Design Cross-sectional study. Setting and Participants Massachusetts has experienced steep increases in reported opioid overdoses and hepatitis C virus (HCV) cases in the past decade. Pharmacists have the potential to play a substantial role in increasing access to non-prescription naloxone and sterile syringes, which can reverse opioid overdoses and decrease HCV transmission, respectively. We completed brief telephone surveys with 809 of 1,042 retail pharmacies across Massachusetts (response rate=77.6%) during 2015 to assess experience with non-prescription sales of naloxone and sterile syringes. Outcome Measures Our primary outcomes were the stocking and selling of naloxone in the pharmacy (yes/no) for non-prescription sales, and non-prescription syringe sales (yes/no). We conducted multivariable regression analyses and created maps using a geographic information system (GIS) to identify factors associated with non-prescription sales of naloxone and sterile syringes, and to improve our understanding geospatial access to pharmacy-based naloxone and syringe sales. Results Over 97% of pharmacies reported selling sterile syringes without requiring a prescription and 45% of pharmacies reported stocking and selling naloxone. Factors associated with non-prescription sales included: hours of operation, experience with and interest in harm reduction activities, and presence in an opioid overdose hotspot. Geographic access to non-prescription sale of sterile syringes is wide-spread, while geospatial access to naloxone is more limited. Training to better understand the benefits, applications, and distribution needs of naloxone is of interest to surveyed pharmacists. Conclusion Access to sterile syringes through non-prescription sales is strong across Massachusetts and, while over 350 pharmacies (45%) reported stocking and selling naloxone to prevent opioid overdose deaths, there is much room for improvement in access, and training among pharmacy staff. PMID:28189540

[Changes of medico-pharmaceutical profession and private practice from the late 19th century to the early 20th century: ebb and flow of western pharmacies and clinics attached to pharmacy].

PubMed

Lee, Heung-Ki

2010-12-31

This article examined i) how traditional medico-pharmaceutical custom from the late 19th century influenced such changes, ii) how medical laws of Daehan Empire and early colonial period influenced the differentiation of medico-pharmaceutical profession, and iii) what the responses of medico-pharmaceutical professionals were like, and arrived at following conclusions. First, in late Chosun, there was a nationwide spread of pharmacies (medicine room, medicine store) as general medical institutions in charge of prescription and medication as well as diagnosis. Therefore, Koreans' perception of Western medicine was not very different from that of traditional pharmacy. Second, Western pharmacies were established by various entities including oriental doctors, Western doctors and drug manufacturers.Their business ranged from medical consultation, prescription, medication and drug manufacture. This was in a way the extension of traditional medico-pharmaceutical custom, which did not draw a sharp line between medical and pharmaceutical practices. Also, regulations on medical and pharmaceutical business of Daehan Empire did not distinguish oriental and Western medicine. Third, clinics attached to pharmacy began to emerge after 1908, as some Western pharmacies that had grown their business based on selling medicine began to hire doctors trained in Western medicine. This trend resulted from Government General's control over medico-pharmaceutical business that began in 1908, following a large-scale dismissal of army surgeons trained in medical schools in 1907. Fourth, as specialization increased within medico-pharmaceutical business following the colonial medical law in early 1910s, such comprehensive business practices as Western pharmacy disappeared and existing businesses were differentiated into dealers of medical ingredients, drug manufacturer, patent medicine businessmen and herbalists. And private practice gradually became the general trend by establishment of medical system with doctors at the pinnacle and spread of modern Western medicine, and support of capitalists.

The provision of emergency contraception in Kinshasa's private sector pharmacies: experiences of mystery clients.

PubMed

Hernandez, Julie H; Mbadu, Muanda Fidèle; Garcia, Mélissa; Glover, Annie

2018-01-01

Recent programmatic and research efforts on addressing gaps in health systems of low-income countries increasingly see task shifting, i.e. the provision of healthcare by non-medically trained personnel, as a possible solution to increase the availability of specific services and commodities. In Kinshasa, private-sector pharmacies are the primary and preferred provider of family planning (FP) methods, and thus constitute a potential resource for expanding access to specific contraceptives. The objective of this study is to explore selected pharmacies' readiness to serve women seeking emergency contraception (EC). This study used a mystery client (MC) methodology to visit 73 pharmacies in Kinshasa, Democratic Republic of Congo (DRC). Trained interviewers posed as novice EC users and asked specific questions to evaluate the pharmacy staff's technical knowledge of EC and their attitudes towards EC clients. The results of the MC visit were recorded immediately after the MC left the pharmacy. Findings indicate that more than two-thirds of EC providers were knowledgeable about EC dosage, timeframe, and side effects, and 90% were deemed helpful towards novice EC users. Rare but glaring misconceptions about EC timeframe (20% of providers) and long-term side effects (4% of providers), as well as frequent stock-out (22%) and cost issues highlight priorities for programmatic improvements. As new service delivery strategies are explored to complement the uneven network of health structures in DRC, this study suggests that, given proper training and integration in FP programming, private-sector pharmacies have the potential to meet specific contraceptive needs for women living in Kinshasa. Private pharmacies included in study sample in Kinshasa (DRC) have adequate family planning (FP) service skills to provide clients with emergency contraceptive pills. These higher-end outlets constitute an opportunity for expanding access to FP, although, under total market approaches, a more diverse range of drugs shops should be investigated. Copyright © 2017 The Author(s). Published by Elsevier Inc. All rights reserved.

Cost-effectiveness of ward-based pharmacy care in surgical patients: protocol of the SUREPILL (Surgery & Pharmacy In Liaison) study.

PubMed

de Boer, Monica; Ramrattan, Maya A; Kiewiet, Jordy J S; Boeker, Eveline B; Gombert-Handoko, Kim B; van Lent-Evers, Nicolette A E M; Kuks, Paul F; Dijkgraaf, Marcel G W; Boermeester, Marja A; Lie-A-Huen, Loraine

2011-03-07

Preventable adverse drug events (pADEs) are widely known to be a health care issue for hospitalized patients. Surgical patients are especially at risk, but prevention of pADEs in this population is not demonstrated before. Ward-based pharmacy interventions seem effective in reducing pADEs in medical patients. The cost-effectiveness of these preventive efforts still needs to be assessed in a comparative study of high methodological standard and also in the surgical population. For these aims the SUREPILL (Surgery & Pharmacy in Liaison) study is initiated. A multi-centre controlled trial, with randomisation at ward-level and preceding baseline assessments is designed. Patients admitted to the surgical study wards for elective surgery with an expected length of stay of more than 48 hours will be included. Patients admitted to the intervention ward, will receive ward-based pharmacy care from the clinical pharmacy team, i.e. pharmacy practitioners and hospital pharmacists. This ward-based pharmacy intervention includes medication reconciliation in consultation with the patient at admission, daily medication review with face-to-face contact with the ward doctor, and patient counselling at discharge. Patients admitted in the control ward, will receive standard pharmaceutical care.The primary clinical outcome measure is the number of pADEs per 100 elective admissions. These pADEs will be measured by systematic patient record evaluation using a trigger tool. Patient records positive for a trigger will be evaluated on causality, severity and preventability by an independent expert panel. In addition, an economic evaluation will be performed from a societal perspective with the costs per preventable ADE as the primary economic outcome. Other outcomes of this study are: severity of pADEs, number of patients with pADEs per total number of admissions, direct (non-)medical costs and indirect non-medical costs, extra costs per prevented ADE, number and type of pharmacy interventions, length of hospital stay, complications registered in a national complication registration system for surgery, number of readmissions within three months after initial admission (follow-up), quality of life and number of non-institutionalized days during follow-up. This study will assess the cost-effectiveness of ward-based pharmacy care on preventable adverse drug events in surgical patients from a societal perspective, using a comparative study design. Netherlands Trial Register (NTR): NTR2258.

Identifying high risk medications causing potential drug-drug interactions in outpatients: A prescription database study based on an online surveillance system.

PubMed

Toivo, T M; Mikkola, J A V; Laine, K; Airaksinen, M

2016-01-01

Drug-drug interactions (DDIs) are a significant cause for adverse drug events (ADEs). DDIs are often predictable and preventable, but their prevention and management require systematic service development. Most DDI studies focus on interaction rates in hospitalized patients. Less is known of DDIs in outpatients, particularly how community pharmacists could contribute to DDI management by applying their surveillance systems for identifying high-risk medications. The study was related to the implementation of the first online DDI surveillance system in Finnish community pharmacies. The goal was to demonstrate how community pharmacies can utilize their prospective surveillance system 1) for identifying high risk medications causing potential DDIs in outpatients, 2) for collaborative service development with local physicians, and 3) for academic risk management research purposes. All DDI alerts given by the online surveillance system were collected during a one-month period in 16 out of 17 University Pharmacy outlets in Finland, covering approximately 10% of the national outpatient prescription volume. The surveillance system was based on the FASS database, which categorizes DDIs into four classes (A-D) according to their clinical significance. Potential drug-drug DDIs were analyzed for 276,891 dispensed community pharmacy prescriptions. Potential DDIs were associated with 10.8%, or 31,110 of these prescriptions. Clinically significant interaction alerts categorized as FASS classes D (most severe, should be avoided) and C (clinically significant but controllable) were associated with 0.5% and 7.0% of the prescriptions, respectively. Methotrexate and warfarin had the highest risk of causing potentially serious (class D) interactions. These interaction alerts were most frequently between methotrexate and NSAIDs and warfarin and NSAIDs. In general, NSAIDs were the most commonly interacting drugs in this study. This study demonstrates that community pharmacies can actively contribute to DDI risk management and systematically use their surveillance systems for identifying patients having clinically significant DDIs. The findings also indicate that the majority of potentially serious interactions in outpatients involve a limited number of drugs, particularly NSAIDs, warfarin and methotrexate. Further research should focus on community pharmacists' involvement in DDI risk management in collaboration with local health care providers. Copyright © 2015 Elsevier Inc. All rights reserved.

The prescription pickup lag, an automatic prescription refill program, and community pharmacy operations.

PubMed

Lester, Corey A; Chui, Michelle A

2016-01-01

To determine the effect of an automatic prescription refill program on the prescription pickup lag in community pharmacy. A post-only quasi-experimental design comparing automatic and manual refill prescription cohorts for each of the 3 Centers for Medicare and Medicaid medication adherence metrics. A 29-store community pharmacy chain in the Midwest. Community-dwelling patients over the age of 65 years receiving prescription medications included in the statin, renin-angiotensin-aldosterone system antagonist, or non-insulin diabetes adherence metrics. An automatic prescription refill program that initiated prescription refills on a standardized, recurrent basis, eliminating the need for patients to phone in or drop off prescription refills. The prescription pickup lag, defined as the number of days between a prescription being adjudicated in the pharmacy and the prescription being picked up by the patient. A total of 37,207 prescription fills were examined. There were 20.5%, 22.4%, and 23.3% of patients enrolled in the automatic prescription refill program for the statin, renin-angiotensin-aldosterone system antagonist, and diabetes adherence metrics, respectively. Prescriptions in the automatic prescription refill cohorts experienced a median pickup lag of 7 days compared with 1 day for the manual refill prescriptions. 35.2% of all manual refill prescriptions had a pickup lag of 0 days compared with 13% for automatic refills. However, 15.4% of automatic prescription refills had a pickup lag of greater than 14 days, compared with 4.8% of manual refills. Prescriptions in the automatic prescription refill programs were associated with a significantly longer amount of time in the pharmacy before being picked up by the patient. This increased pickup lag may contribute positively by smoothing out workload demands of pharmacy staff, but may contribute negatively owing to an increased amount of rework and greater inventory requirements. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

Multiple pharmacy use and types of pharmacies used to obtain prescriptions.

PubMed

Look, Kevin A; Mott, David A

2013-01-01

To evaluate trends and patterns in the prevalence of multiple pharmacy use (MPU) and to describe the number and types of pharmacies used by multiple pharmacy users from 2003 to 2009. Retrospective, cross-sectional, descriptive study. United States from 2003 to 2009. 89,941 responses to the Medical Expenditure Panel Survey over 7 years. Analysis of respondent pharmacy use behaviors. Annual use of more than one pharmacy and number and types of pharmacies used. MPU among patients using medications increased significantly during the study period (from 36.4% [95% CI 35.2-37.6] in 2003 to 43.2% [41.9-44.4] in 2009)-a relative increase of 18.7% ( P = 0.01). Multiple pharmacy users used between 2 and 17 different pharmacies per year to obtain prescription medications. Although approximately 70% of multiple pharmacy users used only two pharmacies, the proportion using three or more pharmacies increased from 24.1% (22.5-25.7) in 2003 to 29.1% (27.4-30.8) in 2009. Mail service pharmacy use had the largest relative increase among multiple pharmacy users during the study period (27.2%), and MPU was nearly twice as high (75%) among mail service users compared with non-mail service users. MPU is common on a national level and has increased greatly in recent years. Patient use of pharmacies that have the potential to share medication information electronically is low among multiple pharmacy users, suggesting increased workload for pharmacists and potential medication safety concerns. This has important implications for pharmacists, as it potentially impedes their ability to maintain accurate medication profiles for patients.

Rural pharmacy in Canada: pharmacist training, workforce capacity and research partnerships.

PubMed

Soon, Judith A; Levine, Marc

2011-09-01

To characterize rural health care and pharmacy recruitment and retention issues explored in Canadian pharmacy strategic guidelines and Canadian Faculties of Pharmacy curricula; compare the availability of pharmacy workforce across Canadian jurisdictions; and identify models for potential collaborations between universities and rural pharmacies in the North. Review of Canadian pharmacy strategic documents, Canadian Faculty of Pharmacy websites, Canadian pharmacy workforce data and relevant literature based on the search terms to identify university-rural community pharmacy initiatives. Three recent Canadian pharmacy strategic documents do not directly address issues related to rural and northern pharmacy practice, with recruitment and retention mentioned only in Canadian Pharmacists Association documents. Few Canadian Faculties of Pharmacy provide curricula on rural and northern health care issues or discuss rural recruitment and retention during training, with barriers to experiential rural practicums impeding placements. An innovative new partnership between the University of Waterloo School of Pharmacy and Gateway Rural Health Research Institute has the potential to enhance rural education, pharmacy services and community-based research. The number of pharmacists per 100,000 population in northern regions of British Columbia and the territories is low when compared with other Canadian provinces. In Australia, a model of university-rural pharmacy collaboration has been developed that may have the potential to inform future Canadian initiatives. Development of a coordinated, multifaceted approach involving universities, pharmacy professional associations and community-based research organizations in rural and northern regions of the country has the potential to enhance pharmacist education, practice recruitment, practice retention and community-based health outcomes research.

Merchandising of cigarettes in San Francisco pharmacies: 27 years later.

PubMed

Eule, B; Sullivan, M K; Schroeder, S A; Hudmon, K S

2004-12-01

To estimate changes since 1976 in the proportion of San Francisco pharmacies that sell cigarettes and to characterise the advertising of cigarettes and the merchandising of non-prescription nicotine replacement therapy (NRT) products in these retail establishments. 100 randomly selected San Francisco pharmacies were visited in 2003. Pharmacies were characterised based on the sale of cigarettes, advertising for cigarettes, and the merchandising of non-prescription NRT products. In 2003, 61% of pharmacies sold cigarettes, a significant decrease compared to 89% of pharmacies selling cigarettes in 1976 (p < 0.001); 84% of pharmacies selling cigarettes also displayed cigarette advertising. Non-prescription NRT products were stocked by 78% of pharmacies, and in 55% of pharmacies selling cigarettes, the NRT products were stocked immediately adjacent to the cigarettes. Since 1976, there has been a decline in the overall proportion of pharmacies in San Francisco that sell cigarettes yet most pharmacies, particularly traditional chain pharmacies, continue to merchandise the primary known risk factor for death in the USA.

Merchandising of cigarettes in San Francisco pharmacies: 27 years later

PubMed Central

Eule, B; Sullivan, M; Schroeder, S; Hudmon, K

2004-01-01

Objective: To estimate changes since 1976 in the proportion of San Francisco pharmacies that sell cigarettes and to characterise the advertising of cigarettes and the merchandising of non-prescription nicotine replacement therapy (NRT) products in these retail establishments. Methods and setting: 100 randomly selected San Francisco pharmacies were visited in 2003. Pharmacies were characterised based on the sale of cigarettes, advertising for cigarettes, and the merchandising of non-prescription NRT products. Results: In 2003, 61% of pharmacies sold cigarettes, a significant decrease compared to 89% of pharmacies selling cigarettes in 1976 (p < 0.001); 84% of pharmacies selling cigarettes also displayed cigarette advertising. Non-prescription NRT products were stocked by 78% of pharmacies, and in 55% of pharmacies selling cigarettes, the NRT products were stocked immediately adjacent to the cigarettes. Conclusions: Since 1976, there has been a decline in the overall proportion of pharmacies in San Francisco that sell cigarettes yet most pharmacies, particularly traditional chain pharmacies, continue to merchandise the primary known risk factor for death in the USA. PMID:15564630

Public-private partnerships in the Canadian environment: options for hospital pharmacies.

PubMed

Uddin, Z; Bear, R A

1997-01-01

This brief report explores the direction being pursued by hospitals interested in outsourcing non-core activities within the pharmacy department. Private sector logistics companies are looking to position themselves in the drug product supply chain to facilitate seamless transfers of drug products, ordering information and payments between drug manufacturers and hospitals. Opportunities for implementing consolidated purchasing, unit dosing, just-in-time inventory and electronic commerce systems are discussed.

Publication Rates of Abstracts Presented at Five National Pharmacy Association Meetings

PubMed Central

Prohaska, Emily; Generali, Joyce; Zak, Kevin; Grauer, Dennis

2013-01-01

Background: Abstract presentations at professional meetings provide a medium for disseminating the findings of scholarly activity. Rates of abstract publication from various biomedical disciplines have been evaluated, with pharmacy noted to be lower than other specialties. Previous research on pharmacy abstract publication rates was conducted for a limited number of professional meetings but has not been assessed using Google Scholar. Objective: To determine the full publication rate of abstracts presented at the 2005 American College of Clinical Pharmacy (ACCP) Spring and Annual Meetings, American Pharmacists Association (APhA) Annual Meeting, and American Society of Health-System Pharmacists (ASHP) Summer and Midyear Clinical Meetings. Methods: Publication status was assessed for abstracts presented during the 2005 ACCP Spring and Annual Meetings, APhA Annual Meeting, and ASHP Summer and Midyear Clinical Meetings using PubMed and Google Scholar. Data collected included abstract category, study category, practice site, database(s) in which publication appeared, time in months to publication, publication type, and journal of publication. Results: Evaluation of 2,000 abstracts presented in 2005 revealed an overall full publication rate of 19.8% (n = 384). Nearly all pharmacy abstracts were published as manuscripts (98.4%; n=378) and indexed in PubMed and Google Scholar (91.9%; n = 353), although a significant percentage were indexed in Google Scholar only (7.8%; n = 30). The mean time to full publication was 16.8 months (SD ±11.9 months). Conclusions: Results were consistent with previously reported full publication rates of abstracts from pharmacy association meetings, indicating that abstracts presented at pharmacy meetings continue to have a lower full publication rate than other health disciplines. PMID:24421465

An Analytic Hierarchy Process-based Method to Rank the Critical Success Factors of Implementing a Pharmacy Barcode System.

PubMed

Alharthi, Hana; Sultana, Nahid; Al-Amoudi, Amjaad; Basudan, Afrah

2015-01-01

Pharmacy barcode scanning is used to reduce errors during the medication dispensing process. However, this technology has rarely been used in hospital pharmacies in Saudi Arabia. This article describes the barriers to successful implementation of a barcode scanning system in Saudi Arabia. A literature review was conducted to identify the relevant critical success factors (CSFs) for a successful dispensing barcode system implementation. Twenty-eight pharmacists from a local hospital in Saudi Arabia were interviewed to obtain their perception of these CSFs. In this study, planning (process flow issues and training requirements), resistance (fear of change, communication issues, and negative perceptions about technology), and technology (software, hardware, and vendor support) were identified as the main barriers. The analytic hierarchy process (AHP), one of the most widely used tools for decision making in the presence of multiple criteria, was used to compare and rank these identified CSFs. The results of this study suggest that resistance barriers have a greater impact than planning and technology barriers. In particular, fear of change is the most critical factor, and training is the least critical factor.

Prospective-pricing strategies for hospital and departmental effectiveness: the administrator's response.

PubMed

Van Etten, P

1985-10-01

The approach of the New England Medical Center toward case management and increased productivity, and the role of the pharmacy within this system, are described by a chief hospital administrator. External pressures that caused the hospital to alter its management style included changes in reimbursement, hospital overuse, increased competition, and a surplus of physicians. Variations in medical practice that affected admission rates, length of stay, and use of ancillary services existed because clinical and financial data had not been integrated, so clinicians had no information on the economic consequences of their decisions. The solution offered to this problem was to decentralize resource-use decisions to increase clinician accountability. The goal of the case-management system is to reduce the cost of intermediate product (e.g., laboratory tests) use through increased productivity. The system provides pharmacy with a new power base if pharmacists can reduce overall costs by influencing prescribers to use cost-effective therapies. Pharmacy can increase its influence within the institution by forming new relationships with administrators, physicians, and nurses that broaden its impact on cost.

Pharmacy staff perceptions and self-reported behaviors related to providing contraceptive information and counseling.

PubMed

Batra, Peter; Aquilino, Mary L; Farris, Karen B

2015-01-01

To evaluate pharmacy staff perspectives of a 2-year pharmacy intervention aimed at reducing unintended pregnancy in 18- to 30-year-old women. Pharmacy staff completed a 48-item, self-administered paper survey consisting of scaled and open-ended questions. 55 community pharmacies in 12 Iowa counties. All pharmacy staff participated, including pharmacists, pharmacy technicians, and other pharmacy employees. Online continuing education (CE) training was made available to all pharmacy staff. Promotional materials including posters, brochures, and shelf talkers were displayed in all of the pharmacies. Pharmacy staff perceptions and self-reported behaviors related to displaying posters, brochures, and shelf talkers in their pharmacies and providing contraceptive information and counseling to patients/customers. A total of 192 (43% return rate) pharmacy staff responded. Only 44% of respondents consistently provided contraceptive information and counseling, yet more than 90% felt that talking with patients/customers about contraceptives was easy, and more than 50% could do so privately. The study showed increased pharmacy staff desire to make this topic a priority. Community pharmacy staff can play a key role in educating and counseling young adult women about contraceptive health and pregnancy planning. This study indicates that staff are comfortable providing this service and that patients/customers are open to receiving guidance from pharmacists. However, pharmacy staff are missing additional opportunities to provide information and counseling. There is also a need for greater attention to provision of nonprescription contraceptive education.

The Use of Portfolios in US Pharmacy Schools

PubMed Central

Cumberland, Denise M.

2018-01-01

Objective. To conduct a review of the pharmacy literature on the use of portfolios in US pharmacy schools. Findings. This study provides examples of how pharmacy schools are using portfolios in various parts and across their curricula, however, assessment/outcome data is lacking. These examples can be used as a starting point for schools as they begin to design their own use of portfolios. Overall, students indicated that the use of portfolios is important in their professional development, but significant time is needed to complete. Summary. Things to consider when implementing a portfolio system include how it will be used, who will review it, and what resources will be needed to sustain the project. It is important for schools to consider these items at the start of the process to ensure the portfolio process that is created is useful for assessing the overall programmatic or course outcomes being proposed by their use. More scholarly work needs to be published on the use of portfolios. PMID:29692438

Innovative Advances in Connectivity and Community Pharmacist Patient Care Services: Implications for Patient Safety.

PubMed

Bacci, Jennifer L; Berenbrok, Lucas A

2018-06-07

The scope of community pharmacy practice has expanded beyond the provision of drug product to include the provision of patient care services. Likewise, the community pharmacist's approach to patient safety must also expand beyond prevention of errors during medication dispensing to include optimization of medications and prevention of adverse events throughout the entire medication use process. Connectivity to patient data and other healthcare providers has been a longstanding challenge in community pharmacy with implications for the delivery and safety of patient care. Here, we describe three innovative advances in connectivity in community pharmacy practice that enhance patient safety in the provision of community pharmacist patient care services across the entire medication use process. Specifically, we discuss the growing use of immunization information systems, quality improvement platforms, and health information exchanges in community pharmacy practice and their implications for patient safety. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study

PubMed Central

2012-01-01

Background The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. Method We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. Results In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three approaches community pharmacies used to appropriate procedures in practice. These were ‘technically oriented’, ‘improvising’ or ‘socially oriented’. Conclusion We offer a model of different work approaches community pharmacies use to dispense, which suggests that when adopting a core technical element such as the EPS2 system of dispensing there could be variations in its successful adoption. Technically oriented pharmacies might find it easiest to integrate a similar artefact into work practice although needs EPS2 to synchronise effectively with existing technologies. Pharmacies adopting an improvising-approach have the potential to improve how they organise dispensing through EPS2 although they will need to improve how they apply their operating procedures. Socially oriented pharmacies will need to dramatically adapt their approach to dispensing since they usually rely on few technical tools. PMID:23256484

The socio-technical organisation of community pharmacies as a factor in the Electronic Prescription Service Release Two implementation: a qualitative study.

PubMed

Harvey, Jasmine; Avery, Anthony J; Waring, Justin; Barber, Nick

2012-12-20

The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three approaches community pharmacies used to appropriate procedures in practice. These were 'technically oriented', 'improvising' or 'socially oriented'. We offer a model of different work approaches community pharmacies use to dispense, which suggests that when adopting a core technical element such as the EPS2 system of dispensing there could be variations in its successful adoption. Technically oriented pharmacies might find it easiest to integrate a similar artefact into work practice although needs EPS2 to synchronise effectively with existing technologies. Pharmacies adopting an improvising-approach have the potential to improve how they organise dispensing through EPS2 although they will need to improve how they apply their operating procedures. Socially oriented pharmacies will need to dramatically adapt their approach to dispensing since they usually rely on few technical tools.

Knowledge, Skills, and Resources for Pharmacy Informatics Education

PubMed Central

Fox, Brent I.; Flynn, Allen J.; Fortier, Christopher R.; Clauson, Kevin A.

2011-01-01

Pharmacy has an established history of technology use to support business processes. Pharmacy informatics education within doctor of pharmacy programs, however, is inconsistent, despite its inclusion as a requirement in the 2007 Accreditation Council for Pharmacy Education Standards and Guidelines. This manuscript describes pharmacy informatics knowledge and skills that all graduating pharmacy students should possess, conceptualized within the framework of the medication use process. Additionally, we suggest core source materials and specific learning activities to support pharmacy informatics education. We conclude with a brief discussion of emerging changes in the practice model. These changes are facilitated by pharmacy informatics and will inevitably become commonplace in our graduates’ practice environment. PMID:21829267

Knowledge, skills, and resources for pharmacy informatics education.

PubMed

Fox, Brent I; Flynn, Allen J; Fortier, Christopher R; Clauson, Kevin A

2011-06-10

Pharmacy has an established history of technology use to support business processes. Pharmacy informatics education within doctor of pharmacy programs, however, is inconsistent, despite its inclusion as a requirement in the 2007 Accreditation Council for Pharmacy Education Standards and Guidelines. This manuscript describes pharmacy informatics knowledge and skills that all graduating pharmacy students should possess, conceptualized within the framework of the medication use process. Additionally, we suggest core source materials and specific learning activities to support pharmacy informatics education. We conclude with a brief discussion of emerging changes in the practice model. These changes are facilitated by pharmacy informatics and will inevitably become commonplace in our graduates' practice environment.

Using queuing theory and simulation model to optimize hospital pharmacy performance.

PubMed

Bahadori, Mohammadkarim; Mohammadnejhad, Seyed Mohsen; Ravangard, Ramin; Teymourzadeh, Ehsan

2014-03-01

Hospital pharmacy is responsible for controlling and monitoring the medication use process and ensures the timely access to safe, effective and economical use of drugs and medicines for patients and hospital staff. This study aimed to optimize the management of studied outpatient pharmacy by developing suitable queuing theory and simulation technique. A descriptive-analytical study conducted in a military hospital in Iran, Tehran in 2013. A sample of 220 patients referred to the outpatient pharmacy of the hospital in two shifts, morning and evening, was selected to collect the necessary data to determine the arrival rate, service rate, and other data needed to calculate the patients flow and queuing network performance variables. After the initial analysis of collected data using the software SPSS 18, the pharmacy queuing network performance indicators were calculated for both shifts. Then, based on collected data and to provide appropriate solutions, the queuing system of current situation for both shifts was modeled and simulated using the software ARENA 12 and 4 scenarios were explored. Results showed that the queue characteristics of the studied pharmacy during the situation analysis were very undesirable in both morning and evening shifts. The average numbers of patients in the pharmacy were 19.21 and 14.66 in the morning and evening, respectively. The average times spent in the system by clients were 39 minutes in the morning and 35 minutes in the evening. The system utilization in the morning and evening were, respectively, 25% and 21%. The simulation results showed that reducing the staff in the morning from 2 to 1 in the receiving prescriptions stage didn't change the queue performance indicators. Increasing one staff in filling prescription drugs could cause a decrease of 10 persons in the average queue length and 18 minutes and 14 seconds in the average waiting time. On the other hand, simulation results showed that in the evening, decreasing the staff from 2 to 1 in the delivery of prescription drugs, changed the queue performance indicators very little. Increasing a staff to fill prescription drugs could cause a decrease of 5 persons in the average queue length and 8 minutes and 44 seconds in the average waiting time. The patients' waiting times and the number of patients waiting to receive services in both shifts could be reduced by using multitasking persons and reallocating them to the time-consuming stage of filling prescriptions, using queuing theory and simulation techniques.

Using Queuing Theory and Simulation Model to Optimize Hospital Pharmacy Performance

PubMed Central

Bahadori, Mohammadkarim; Mohammadnejhad, Seyed Mohsen; Ravangard, Ramin; Teymourzadeh, Ehsan

2014-01-01

Background: Hospital pharmacy is responsible for controlling and monitoring the medication use process and ensures the timely access to safe, effective and economical use of drugs and medicines for patients and hospital staff. Objectives: This study aimed to optimize the management of studied outpatient pharmacy by developing suitable queuing theory and simulation technique. Patients and Methods: A descriptive-analytical study conducted in a military hospital in Iran, Tehran in 2013. A sample of 220 patients referred to the outpatient pharmacy of the hospital in two shifts, morning and evening, was selected to collect the necessary data to determine the arrival rate, service rate, and other data needed to calculate the patients flow and queuing network performance variables. After the initial analysis of collected data using the software SPSS 18, the pharmacy queuing network performance indicators were calculated for both shifts. Then, based on collected data and to provide appropriate solutions, the queuing system of current situation for both shifts was modeled and simulated using the software ARENA 12 and 4 scenarios were explored. Results: Results showed that the queue characteristics of the studied pharmacy during the situation analysis were very undesirable in both morning and evening shifts. The average numbers of patients in the pharmacy were 19.21 and 14.66 in the morning and evening, respectively. The average times spent in the system by clients were 39 minutes in the morning and 35 minutes in the evening. The system utilization in the morning and evening were, respectively, 25% and 21%. The simulation results showed that reducing the staff in the morning from 2 to 1 in the receiving prescriptions stage didn't change the queue performance indicators. Increasing one staff in filling prescription drugs could cause a decrease of 10 persons in the average queue length and 18 minutes and 14 seconds in the average waiting time. On the other hand, simulation results showed that in the evening, decreasing the staff from 2 to 1 in the delivery of prescription drugs, changed the queue performance indicators very little. Increasing a staff to fill prescription drugs could cause a decrease of 5 persons in the average queue length and 8 minutes and 44 seconds in the average waiting time. Conclusions: The patients' waiting times and the number of patients waiting to receive services in both shifts could be reduced by using multitasking persons and reallocating them to the time-consuming stage of filling prescriptions, using queuing theory and simulation techniques. PMID:24829791

The Faculties of Pharmacy Schools Should Make an Effort to Network with Community Pharmacies.

PubMed

Matsushita, Ryo

2016-01-01

By law, medical faculties are mandated to have a designated partner hospital for the purposes of student practical training. In contrast, pharmacy faculties do not have such a legal requirement for student training in a community pharmacy setting. Nevertheless, there are several public and private universities that do have community pharmacies. However, there is no national university that has established both an educational hospital and a community pharmacy. When Kanazawa University (KU) established a graduate school with a clinical pharmacy course, the faculty of KU deemed it necessary to set up an independent community pharmacy for the purpose of practical training. Thus, in 2003, the Acanthus Pharmacy was set up as the first educational community pharmacy in Japan, managed by a nonprofit organization, with the permission of the Ishikawa Pharmaceutical Association and local community pharmacists. Since that time, Acanthus has managed a clinical pharmacy practice for students from both the undergraduate and graduate schools of KU. From 2006, the undergraduate pharmacy program was changed to a 6-year program, and the Acanthus Pharmacy has continued its roles in educating undergraduate pharmaceutical students, medical students, and as a site of early exposure for KU freshmen. From our experience, it is important to have a real clinical environment available to university pharmacy faculty and students, especially in training for community pharmacy practices.

Using the Consumer Experience with Pharmacy Services Survey as a quality metric for ambulatory care pharmacies: older adults' perspectives

PubMed Central

Shiyanbola, Olayinka O; Mott, David A; Croes, Kenneth D

2016-01-01

Objectives To describe older adults' perceptions of evaluating and comparing pharmacies based on the Consumer Experience with Pharmacy Services Survey (CEPSS), describe older adults' perceived importance of the CEPSS and its specific domains, and explore older adults' perceptions of the influence of specific CEPSS domains in choosing/switching pharmacies. Design Focus group methodology was combined with the administration of a questionnaire. The focus groups explored participants' perceived importance of the CEPSS and their perception of using the CEPSS to choose and/or switch pharmacies. Then, using the questionnaire, participants rated their perceived importance of each CEPSS domain in evaluating a pharmacy, and the likelihood of using CEPSS to switch pharmacies if their current pharmacy had low ratings. Descriptive and thematic analyses were done. Setting 6 semistructured focus groups were conducted in a private meeting room in a Mid-Western state in the USA. Participants 60 English-speaking adults who were at least 65 years, and had filled a prescription at a retail pharmacy within 90 days. Results During the focus groups, the older adults perceived the CEPSS to have advantages and disadvantages in evaluating and comparing pharmacies. Older adults thought the CEPSS was important in choosing the best pharmacies and avoiding the worst pharmacies. The perceived influence of the CEPSS in switching pharmacies varied depending on the older adult's personal experience or trust of other consumers' experience. Questionnaire results showed that participants perceived health/medication-focused communication as very important or extremely important (n=47, 82.5%) in evaluating pharmacies and would be extremely likely (n=21, 36.8%) to switch pharmacies if their pharmacy had low ratings in this domain. Conclusions The older adults in this study are interested in using patient experiences as a quality metric for avoiding the worst pharmacies. Pharmacists' communication about health and medicines is perceived important and likely to influence older adults' pharmacy selection. PMID:27231004

Factors affecting pharmacy engagement and pharmacy customer devotion in community pharmacy: A structural equation modeling approach.

PubMed

Nitadpakorn, Sujin; Farris, Karen B; Kittisopee, Tanattha

2017-01-01

The concept of customer engagement and devotion has been applied in various service businesses to keep the customers with business However, a limited number of studies were performed to examine the context of customer engagement and devotion in pharmacy business which focus on the impact of customer perceptions about pharmacists, perceived quality of pharmacy structure, medication price strategy on pharmacy engagement and pharmacy customer devotion in a pharmacy providing pharmaceutical care to the customers. This study aimed to assess a conceptual model depicting the relationships among customer perceptions about pharmacists, pharmacy quality structure, medication price, customer engagement, and customer devotion. And also aimed to assess and measure if there is a direct or indirect relationship between these factors. A quantitative study was conducted by using self-administered questionnaires. Two hundred and fifty three customers who regularly visited the pharmacy were randomly recruited from a purposively selected 30 community pharmacies in Bangkok. The survey was completed during February to April 2016. A structural equation model (SEM) was used to assess the direct and indirect relationships between constructs. A total of 253/300 questionnaires were returned for analysis, and the response rate was 84%. Only perceptions about pharmacist in customers receiving professional pharmacy services was statically significant regarding relationship with pharmacy engagement (beta=0.45). Concurrently, the model from empirical data fit with the hypothetical model (p-value = 0.06, adjusted chi-square (CMIN/DF)=1.16, Goodness of Fit Index (GFI)=0.93, Comparatively Fit Index (CFI)=0.99, and Root Mean Square Error Approximation (RMSEA)=0.03). The study confirmed the indirect positive influence of customer perceptions about pharmacist on pharmacy customer devotion in providing pharmacy services via pharmacy engagement It was customer perceptions about pharmacist that influenced customer retention, positive word of mouth and constructive advice to pharmacies, not quality of pharmacy structure and medication price. To create a long term impact on community pharmacy business, pharmacist is the key success factor.

Defining and classifying medical error: lessons for patient safety reporting systems.

PubMed

Tamuz, M; Thomas, E J; Franchois, K E

2004-02-01

It is important for healthcare providers to report safety related events, but little attention has been paid to how the definition and classification of events affects a hospital's ability to learn from its experience. To examine how the definition and classification of safety related events influences key organizational routines for gathering information, allocating incentives, and analyzing event reporting data. In semi-structured interviews, professional staff and administrators in a tertiary care teaching hospital and its pharmacy were asked to describe the existing programs designed to monitor medication safety, including the reporting systems. With a focus primarily on the pharmacy staff, interviews were audio recorded, transcribed, and analyzed using qualitative research methods. Eighty six interviews were conducted, including 36 in the hospital pharmacy. Examples are presented which show that: (1) the definition of an event could lead to under-reporting; (2) the classification of a medication error into alternative categories can influence the perceived incentives and disincentives for incident reporting; (3) event classification can enhance or impede organizational routines for data analysis and learning; and (4) routines that promote organizational learning within the pharmacy can reduce the flow of medication error data to the hospital. These findings from one hospital raise important practical and research questions about how reporting systems are influenced by the definition and classification of safety related events. By understanding more clearly how hospitals define and classify their experience, we may improve our capacity to learn and ultimately improve patient safety.

Randomized, community-based pharmacy intervention to expand services beyond sale of sterile syringes to injection drug users in pharmacies in New York City.

PubMed

Crawford, Natalie D; Amesty, Silvia; Rivera, Alexis V; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M

2013-09-01

Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful.

Is crime associated with over-the-counter pharmacy syringe sales? Findings from Los Angeles, California.

PubMed

Stopka, Thomas J; Geraghty, Estella M; Azari, Rahman; Gold, Ellen B; DeRiemer, Kathryn

2014-03-01

More than 50,000 new HIV infections occur annually in the United States. Injection drug users represent twelve percent of incident HIV infections each year. Pharmacy sales of over-the-counter (OTC) syringes have helped prevent HIV transmission among injection drug users in many states throughout the United States. However, concerns exist among some law enforcement officials, policymakers, pharmacists, and community members about potential links between OTC syringe sales and crime. We used a geographic information system and novel spatial and longitudinal analyses to determine whether implementation of pharmacy-based OTC syringe sales were associated with reported crime between January 2006 and December 2008 in Los Angeles Police Department Reporting Districts. We assessed reported crime pre- and post-OTC syringe sales initiation as well as longitudinal associations between crime and OTC syringe-selling pharmacies. By December 2008, 9.3% (94/1010) of Los Angeles Police Department Reporting Districts had at least one OTC syringe-selling pharmacy. Overall reported crime counts and reported crime rates decreased between 2006 and 2008 in all 1010 Reporting Districts. Using generalized estimating equations and adjusting for potential confounders, reported crime rates were negatively associated with OTC syringe sales (adjusted rate ratio: 0.89; 95% confidence interval: 0.81, 0.99). Our findings demonstrate that OTC pharmacy syringe sales were not associated with increases in reported crime in local communities in Los Angeles during 2006-2008. Copyright © 2014 Elsevier B.V. All rights reserved.

Recruitment of participants through community pharmacies for a pharmacogenetic study of antihypertensive drug treatment.

PubMed

van Wieren-de Wijer, Diane B M A; Maitland-van der Zee, Anke-Hilse; de Boer, Anthonius; Stricker, Bruno H Ch; Kroon, Abraham A; de Leeuw, Peter W; Bozkurt, O; Klungel, Olaf H

2009-04-01

To describe the design, recruitment and baseline characteristics of participants in a community pharmacy based pharmacogenetic study of antihypertensive drug treatment. Participants enrolled from the population-based Pharmaco-Morbidity Record Linkage System. We designed a nested case-control study in which we will assess whether specific genetic polymorphisms modify the effect of antihypertensive drugs on the risk of myocardial infarction. In this study, cases (myocardial infarction) and controls were recruited through community pharmacies that participate in PHARMO. The PHARMO database comprises drug dispensing histories of about 2,000,000 subjects from a representative sample of Dutch community pharmacies linked to the national registrations of hospital discharges. In total we selected 31010 patients (2777 cases and 28233 controls) from the PHARMO database, of whom 15973 (1871 cases, 14102 controls) were approached through their community pharmacy. Overall response rate was 36.3% (n = 5791, 794 cases, 4997 controls), whereas 32.1% (n = 5126, 701 cases, 4425 controls) gave informed consent to genotype their DNA. As expected, several cardiovascular risk factors such as smoking, body mass index, hypercholesterolemia, and diabetes mellitus were more common in cases than in controls. Furthermore, cases more often used beta-blockers and calcium-antagonists, whereas controls more often used thiazide diuretics, ACE-inhibitors, and angiotensin-II receptor blockers. We have demonstrated that it is feasible to select patients from a coded database for a pharmacogenetic study and to approach them through community pharmacies, achieving reasonable response rates and without violating privacy rules.

[What kind of ethical education for pharmacists is necessary? Can "the core curriculum model for pharmacology education" provide the needed guidance?].

PubMed

Matsuda, Jun

2009-07-01

Section A of "The core curriculum model for pharmacy education" (2002)- "Learning about Humanism"- outlines the educational contents for ethics in pharmaceutical departments. People who read this section are likely to conclude that the cultivation of human sensitivity is of prime importance in ethics education in pharmacy. However, if a pharmacist found herself or himself on the horns of a moral dilemma during clinical practice, she/he may discover that human sensitivity alone may not provide the answer. When searching for ethically appropriate conduct in concrete cases, both moral insight and good judgment are necessary. The main contents of ethics education in a pharmaceutical department should be instruction in the ethics of medicine and pharmacy and practical exercises in handling moral dilemmas that pharmacists might encounter in actual situations. "Humanism" implies not only humanitarianism but also anthropocentricism. Plants, animals, and ecological systems are considered to be objects of ethical concern in some contemporary ethics, such as L. Siep's "Concrete Ethics (Konkrete Ethik, 2004)". The pharmacist's job specifications require her or him to treat laboratory animals ethically and to have environmental consciousness. Humanism-based ethics are too narrow for pharmacy ethics. Pharmacy students should learn a more comprehensive ethics that covers social ethics, bioethics, and environmental ethics. Such ethics and moral training should be given, especially, both before and after long-term practical training in hospitals and pharmacies.

Complete-block scheduling for advanced pharmacy practice experiences.

PubMed

Hatton, Randy C; Weitzel, Kristin W

2013-12-01

An innovative approach to meeting increased student demand for advanced pharmacy practice experiences (APPEs) is described, including lessons learned during a two-year pilot project. To achieve more efficient allocation of preceptor resources, the University of Florida College of Pharmacy (UFCOP) adopted a new APPE rotation model in which 20 pharmacy students per year complete all required and elective APPEs at one practice site, an affiliated academic medical center. Relative to the prevailing model of experiential training for Pharm.D. students, the "complete-block scheduling" model offers a number of potential benefits to students, preceptors, and the pharmacy school. In addition to potentially reduced student housing expenses and associated conveniences, complete-block scheduling may enable (1) more efficient use of teaching resources, (2) increased collaboration among preceptors, (3) greater continuity and standardization of educational experiences, and (4) enhanced opportunities for students to engage in longer and more complex research projects. The single-site APPE rotation model also can provide value to the training site by enabling the extension of clinical pharmacy services; for example, UFCOP students perform anticoagulation monitoring and discharge medication counseling at the host institution. Despite logistical and other challenges encountered during pilot testing of the new scheduling model, the program has been well received by students and preceptors alike. Complete-block APPE scheduling is a viable model for some health systems to consider as a means of streamlining experiential education practices and helping to ensure high-quality clinical rotations for Pharm.D. students.