Pharmacist knowledge of gout management: impact of an educational intervention.

BACKGROUND: Pharmacists play a key role in community gout education. We investigated pharmacist knowledge of gout management and developed an educational intervention which was assessed in a cohort of Irish pharmacists. METHODS: A ten-question questionnaire about gout management was developed to assess pharmacists' knowledge. A 14 min 26 s video educational intervention was co-designed by a rheumatologist, a pharmacist, and designer of pharmacy education resources. The effectiveness of this pharmacy-specific intervention was assessed using the same questionnaire in 53 pharmacists (25 in the intervention group; 28 in the control group). Contingency tables were used to analyse differences between groups. RESULTS: There were 173 pharmacist respondents to the initial survey; 35.3% answered that first-line therapy for gout involves a combination of a xanthine oxidase inhibitor (e.g., allopurinol) combined with a prophylactic agent (e.g., colchicine), and 28.9% of respondents answered that colchicine prophylaxis should be used when initiating urate-lowering therapy. Following the educational intervention, pharmacist's knowledge about gout management increased across many domains, including serum urate targets when using urate-lowering therapy (p = 0.006), use of colchicine prophylaxis (p = 0.011), and duration of colchicine use (p < 0.001). CONCLUSION: Gout management recommendations can be impeded if translation into pharmacy practice is neglected. Pharmacists are a valuable information resource for patients. Co-designing a brief education intervention with pharmacists is an effective, low-cost way to increase pharmacist knowledge on the management of gout.

Supply and demand: application of Lean Six Sigma methods to improve drug round efficiency and release nursing time.

OBJECTIVE: To improve efficiency, reduce interruptions and reduce the time taken to complete oral drug rounds. DESIGN: Lean Six Sigma methods were applied to improve drug round efficiency using a pre- and post-intervention design. SETTING: A 20-bed orthopaedic ward in a large teaching hospital in Ireland. PARTICIPANTS: Pharmacy, nursing and quality improvement staff. INTERVENTION(S): A multifaceted intervention was designed which included changes in processes related to drug trolley organization and drug supply planning. A communications campaign aimed at reducing interruptions during nurse-led during rounds was also developed and implemented. MAIN OUTCOME MEASURE(S): Average number of interruptions, average drug round time and variation in time taken to complete drug round. RESULTS: At baseline, the oral drug round took an average of 125 min. Following application of Lean Six Sigma methods, the average drug round time decreased by 51 min. The average number of interruptions per drug round reduced from an average of 12 at baseline to 11 following intervention, with a 75% reduction in drug supply interruptions. CONCLUSIONS: Lean Six Sigma methodology was successfully employed to reduce interruptions and to reduce time taken to complete the oral drug round.