Implementation of flu vaccination in community pharmacies: Understanding the barriers and enablers.

Improving influenza vaccination coverage has been, and still remains a challenge internationally. There are now many examples where countries have pursued a pharmacist-led influenza vaccination service in order to enhance vaccination coverage of at-risk populations. England, Portugal and the United States are successful examples where their experience implementing this service can now be explored retrospectively and learnt from. This review aims to provide evidence to help overcome barriers to commissioning and implementation of such services in countries new to the experience. Implementation is influenced by differing regulatory frameworks underpinning the provision of pharmacist-led influenza vaccination, methods of remuneration, training, and operating procedures. Practical aspects such as the facilities required, how patient records are maintained and how patients and other healthcare professionals are engaged also have an impact. These examples illustrate how community pharmacists can be trained to deliver influenza vaccinations safely, and coupled with their accessibility and convenience, can provide a complementary service to that already provided by family doctors and nurses to deliver influenza vaccinations for the benefit of patients.

A self-management program for adult asthma. Part II: Cost-benefit analysis.

BACKGROUND: We performed a cost-benefit analysis of a previously described self-management program for adult asthma. METHODS: Direct and indirect cost data from 47 subjects who participated in the self-management program were analyzed. In particular, costs incurred by the subjects 1 year before participation were compared with costs incurred 1 year after participation. RESULTS: The cost-benefit analysis indicated that the program was beneficial, reducing the cost of asthma to each patient by $475.29. The benefit came primarily from reductions in hospital admissions (reduced from $18,488 to $1538) and income lost as a result of asthma (reduced from $11,593 to $4589). The asthma self-management program cost $208.33 per patient. Comparison of the program cost with the program benefit produced a 1:2.28 cost-benefit ratio, demonstrating that the program more than paid for itself. CONCLUSION: A self-management program for adult asthma effectively reduced the cost associated with asthma. The findings are especially salient because the subjects' asthma was generally under good medical control when they participated in the program. The savings were therefore not the result of improved medical treatment; medical treatment was a controlled parameter, not a variable, in the self-management study. The self-management program for adult asthma was cost-beneficial.

Symptom perception and self-management in childhood asthma.

Asthma self-management, an increasingly important component of the treatment of pediatric asthma, entails accurate perception of respiratory symptoms. This review summarizes what is known about symptom perception in both adults and children. The literature on visceral autonomic perception, laboratory studies of respiratory perception, and clinical work with asthmatic patients is reviewed.

Research review: computer tools for health information management at a substance abuse treatment agency.

The process of computerizing the Quantitative and Qualitative Record Analysis functions in a Joint Commission on Accreditation of Healthcare Organizations (JCAHO) accredited substance abuse treatment facility is presented. Consultants analyzed the manual Quantitative and Qualitative systems, assessed computer resources, and developed and installed computerized systems. The computer programs produce uniform reports used by the agency's various monitoring and evaluation committees. The programs significantly reduced the amount of personnel and consultant time devoted to these tasks. During the first year of operation, this reduction in time saved the agency $3,900.