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1.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-fiocruz-SI | ID: lis-LISBR1.1-46754

RESUMO

Aula sobre atenção à saúde indígena.


Assuntos
Assistência Farmacêutica , Saúde de Populações Indígenas , Capacitação em Serviço
2.
Sr Care Pharm ; 34(7): 444-448, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31383055

RESUMO

Medical mission trips help meet the needs of underserved populations in the United States and abroad. As the medication experts, pharmacists play an important role in providing pharmacy services during these trips. Students can serve as pharmacist extenders by applying the knowledge, skills, and values learned in the classroom to reach more patients in resourcelimited settings. This paper describes the experience of the Gregory School of Pharmacy in sponsoring faithbased domestic and international medical missions. We believe that medical missions not only benefit those in need, but also foster professional growth and provide an opportunity for participants to develop a servantleadership mindset. Unlike the traditional leader, the servant-leader shares power, puts the needs of others first, and helps people develop and perform as highly as possible.


Assuntos
Missões Médicas , Assistência Farmacêutica , Farmácia , Estudantes de Farmácia , Humanos , Farmacêuticos
3.
Sr Care Pharm ; 34(7): 464-472, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31383058

RESUMO

OBJECTIVE: The primary objective was to evaluate prescribing of potentially inappropriate medications (PIMs) as defined by the Beers criteria in outpatient clinics with and without mandatory pharmacy medication reviews. DESIGN: Retrospective electronic medical chart review at a single academic Veterans Affairs (VA) medical center. SETTING: Home-based primary care (HBPC) and geriatric primary care. PATIENTS: Patients were included if they were 65 years of age or older at the time of enrollment and newly enrolled with an initial visit to HBPC or geriatric primary care between January 2015 and September 2015. Charts were included if patients received at least one follow-up visit with their primary care provider within 13 months of the initial visit. An additional inclusion criterion for HBPC patients was the documentation of at least one follow-up medication review by a clinical pharmacist within 13 months of the initial mandatory chart review. A total of 30 patients were included in both groups. INTERVENTIONS: Mandatory pharmacy medication reviews compared with usual care (no formal pharmacy review). MAIN OUTCOME MEASURE: Mean change in PIMs prescribed in both groups. RESULTS: The mean number of PIMs at initial and final visits was 0.4 unit per patient in HBPC. In geriatric primary care, the mean number of PIMs at the initial visit was 0.4 unit per patient, which increased at the final visit to 0.6 unit per patient. CONCLUSION: No change in PIMs was observed in the HBPC group, while an increase was observed in geriatric primary care.


Assuntos
Assistência Farmacêutica , Atenção Primária à Saúde , Veteranos , Idoso , Humanos , Lista de Medicamentos Potencialmente Inapropriados , Estudos Retrospectivos
5.
Yakugaku Zasshi ; 139(7): 963-968, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-31257253

RESUMO

In 2006, four-year pharmacist training courses in Japanese pharmacy schools were extended to a six-year course. Around that time, I participated in a committee related to pharmacy education reform within the Ministry of Education, Culture, Sports, Science and Technology. I also joined the pharmacist division of the medical council of the Ministry of Health, Labour and Welfare, to reform the national pharmacist examination system. In addition, I was part of the Pharmacy Education Council responsible for developing the contents of the new six-year curriculum, especially for clinical training. In the process, I had the opportunity to interact with many pharmacists and pharmacy educators. Following my transfer from the Pharmaceutical University Division to the Hospital Pharmacy Division in 2007, I participated in multidisciplinary collaborative education [inter professional work (IPW)/inter professional education (IPE)] for students in the disciplines of medicine, nursing, clinical laboratory examination, physiotherapy, occupational therapy, and pharmacy. This gave me an opportunity to apply this multidisciplinary experience to pharmacy education. "IPW", beyond the so-called "team medical care", is becoming an increasingly important concept in the medical field. Since all pharmacists are members of a team dedicated to patient-centered care, it is necessary to strengthen collaborative education, which will lead to an overall improvement in medical care. I believe that education is fundamental in all fields, and especially so in medical care. Pharmacy education needs radical reforms to increase its potency and to augment the value of pharmacists in the medical field.


Assuntos
Currículo/tendências , Educação em Farmácia/tendências , Comunicação Interdisciplinar , Assistência Farmacêutica/tendências , Humanos , Japão , Equipe de Assistência ao Paciente/tendências
6.
Sr Care Pharm ; 34(6): 370-383, 2019 Jun 01.
Artigo em Inglês | MEDLINE | ID: mdl-31164184

RESUMO

OBJECTIVE: To analyze the long-term utilization of an on-site consultant pharmacist referral service at a home health care (HHC) agency (HHA) and the medication-related problems in the homebound patients served.
DESIGN: A retrospective, descriptive study reporting the pharmacist's role in providing pharmaceutical care to patients referred by HHC clinicians from 2009 through 2015.
SETTING: A nonprofit HHA in Spokane, Washington, that has utilized a consultant pharmacist service for more than 20 years as part of an academic partnership with Washington State University.
PARTICIPANTS: All patients referred to the pharmacy team were eligible for inclusion in the data analysis.
INTERVENTIONS: Pharmacists provided comprehensive medication management via telephone calls, home visits, and communication with HHA clinicians to resolve clinician-referred problems.
MAIN OUTCOMES: Reason for referral, modality of resolution, number and type of medication-related problems, prescriber response rate.
RESULTS: Of 1,263 referrals, the pharmacy team resolved the case by visiting 421 patients, calling 261 patients, and collaborating with the clinician team for 323 patients; 258 patients declined or were lost to follow-up. The most common problems were the need for education (37%), adverse drug effect (18.8%), and nonadherence (18.4%). The pharmacy team contacted the prescriber 209 times with a 58.4% rate of partial or full acceptance of pharmacy recommendations (nonresponses were counted as not accepted). An additional 265 prescriber contacts were planned to be done by either the patient or HHC clinician.
CONCLUSION: Consultant pharmacists can play an integral role as part of an interdisciplinary HHC team to resolve medication-related problems.


Assuntos
Assistência Farmacêutica , Farmacêuticos , Consultores , Humanos , Estudos Retrospectivos
7.
BMC Health Serv Res ; 19(1): 422, 2019 Jun 25.
Artigo em Inglês | MEDLINE | ID: mdl-31238950

RESUMO

BACKGROUND: Medication non-adherence is a major contributor to poor outcomes in diabetes. Previous research has shown an association between use of mail order pharmacy delivery and better medication adherence, but little is known about the barriers and facilitators to mail order pharmacy use in diabetes patients. This qualitative study examined factors related to mail order pharmacy use versus traditional "brick and mortar" pharmacies to refill prescriptions. METHODS: We conducted four 90-min focus groups in 2016 among 28 diabetes patients in the Hawaii and Northern California regions of Kaiser Permanente, a large integrated health care delivery system. We queried participants on their preferred mode for refilling prescriptions and perceived barriers and facilitators of mail order pharmacy use. One researcher independently coded each focus group transcript, with two of these transcripts double-coded by a second researcher to promote reliability. We employed thematic analysis guided by the Capability, Opportunity, Motivation, and Behavior (COM-B) framework using NVivo 11 software. RESULTS: A total of 28 diabetes patients participated. Participants' average age was 64.1 years; 57% were female; and racial/ethnic backgrounds included Asian/Native Hawaiian/Pacific Islander (36%), Black/African-American (21%) Hispanic/Latino (7%), and non-Hispanic White (36%). Analysis uncovered 26 themes related to the decision to use mail order pharmacy, with each theme representing a barrier or facilitator mapped to the COM-B framework. Most themes (20/26) fell into the COM-B category of 'Opportunity.' Opportunity barriers to mail order pharmacy use included unpredictability of medication delivery date, concerns about mail security, and difficulty coordinating refill orders for multiple prescriptions. In contrast, facilitators included greater access and convenience (e.g., no need to wait in line or arrange transportation) compared to traditional pharmacies. Motivational facilitators to mail order pharmacy use included receiving a pharmacy benefit plan incentive of a free one-month supply of prescriptions. CONCLUSIONS: This study found that while patients with diabetes may benefit from mail order pharmacy use, they perceive numerous barriers to using the service. These findings will inform the design of interventions and quality improvement initiatives to increase mail order pharmacy use, which in turn may improve medication adherence and outcomes in diabetes patients, across health care systems.


Assuntos
Diabetes Mellitus/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Assistência Farmacêutica/estatística & dados numéricos , Serviços Postais/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , California , Feminino , Grupos Focais , Hawaii , Humanos , Masculino , Adesão à Medicação/estatística & dados numéricos , Pessoa de Meia-Idade , Pesquisa Qualitativa
8.
Wiad Lek ; 72(5 cz 2): 1126-1130, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31175757

RESUMO

OBJECTIVE: Introduction: Military pharmacy has always been a priority, being widely supported by the state with any social order. Field pharmacy development has always been considered a national safety factor. After creation of the numerous military commands and improvement of medical conditions relating to preserving and restoring the military men health, the importance of development of pharmacy as a science has only been increasing. The object of the study in this article is development of Ukrainian pharmacy as illustrated by the Poltava region example. The aim: The study is research of the pharmacy development and its influence on to the neighbor fields within the Poltava region. PATIENTS AND METHODS: Material and methods: systemic approach, historical and dialectical methods, methods of theoretical and empirical learning. CONCLUSION: Conclusions: The Lubny pharmacy was the basis for the military pharmaceutical service in Ukraine and triggered foundation of private pharmacies in the Poltava region. Also, the Lubny pharmacy had effected on the development of pharmaceutical service and industrial agricultural cultivation of medical plants in Ukraine.


Assuntos
Militares , Assistência Farmacêutica , Farmácias , Farmácia , Ucrânia
9.
Manag Care ; 28(4): 33-34, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31188122

RESUMO

The annual pharmacy costs for single tablet regimens were $6,100 less compared with regimens involving multiple pills, at least among HIV patients who were taking the medicines as intended, according to an Express Scripts analysis. On average, the company found that health plans could save about $4,160 per patient per year.


Assuntos
Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Fármacos Anti-HIV/administração & dosagem , Fármacos Anti-HIV/economia , HIV , Humanos , Adesão à Medicação , Assistência Farmacêutica/economia
10.
Gan To Kagaku Ryoho ; 46(Suppl 1): 90-92, 2019 May.
Artigo em Japonês | MEDLINE | ID: mdl-31189866

RESUMO

Medical advances have made it possible to save lives of children with severe refractory diseases. As a result, the number of children who need continuous medical care at home has increased. However, there are concerns that many pharmacies are not actively involved in, because the dispensing fee does not match their prescriptions, which are very complicated and contain some high-risk medicines. We analyzed the burden of dispensing prescribed medicines so that we can quantitatively discuss from prescription contents. The essence of the burden of a pharmacy regarding home medical care for children is to cover the transportation of heavy pharmaceuticals and the combination of multiple medication including high-risk medicines and lack of pediatric drug formulations with the efforts of the on-site pharmacist. It became clear that the pharmacist's objective work supports pediatric pharmacotherapy.


Assuntos
Assistência Farmacêutica , Farmácias , Criança , Assistência à Saúde , Visita Domiciliar , Humanos , Farmacêuticos
11.
Int Braz J Urol ; 45(3): 435-448, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31038864

RESUMO

OBJECTIVES: Prostate cancer is the most common and fatal cancer amongst Brazilian males. The quality of prostate cancer care in Brazil was systematically reviewed and compared to United Kingdom (UK) National Institute for Health and Care Excellence (NICE) guidelines, which are considered an international benchmark in care, to determine any treatment gaps in Brazilian practice. MATERIALS AND METHODS: A systematic review of Brazilian and UK literature was undertaken. Additionally, quality of life scores was measured using a FACT-P questionnaire of 36 prostate cancer patients attending the Farmácia Universitária da Universidade de São Paulo (FARMUSP). These scores were compared against NICE care measures for patient safety, clinical effi cacy and quality of life indicators determined by either quantitative or qualitative methods. Key fi ndings: The quality of prostate cancer care in Brazil was considered good when compared to NICE guidelines. However, FACT-P data strongly indicated a poor understanding of treatment received by Brazilian patients and that their mental health needs were not being met. CONCLUSIONS: NICE quality statements that address the holistic needs of patients should be implemented into Brazilian outpatient care plans. Addressing the non-medical concerns of patients may improve quality of life and can be easily rolled-out through existing Brazilian pharmacy services at no fi nancial cost to the Brazilian Unifi ed Health System (SUS).


Assuntos
Assistência Ambulatorial/normas , Assistência Farmacêutica/normas , Neoplasias da Próstata/tratamento farmacológico , Garantia da Qualidade dos Cuidados de Saúde/métodos , Qualidade de Vida , Brasil , Lista de Checagem/normas , Humanos , Masculino , Padrões de Referência , Inquéritos e Questionários/normas , Reino Unido
12.
BMC Health Serv Res ; 19(1): 328, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118096

RESUMO

BACKGROUND: Prescription connects physician, patient and community pharmacy personnel who can help in understanding prescribing pattern. The present study was aimed to get an insight of viewpoints of all members involved in progression of events from prescription to drug purchase, i.e., physician, patient and medical-store personals regarding the prescription pattern in Pakistan. METHODS: Therefore, a cross-sectional study was conducted in four provinces and capital territory (Islamabad) of Pakistan to evaluate the perception of physicians, patients and medical stores/pharmacy personnel of the prescribing trends in Pakistan. RESULTS: Response rate was higher from Punjab and lower in Sindh. Responses of 981 walk-in patients with 393 physicians and 618 medical stores/pharmacies were received and statistically evaluated. The majority of physicians, patients and pharmacists/medical store personnel considered the medicines of multinational manufacturers as more effective. Physicians considered their prescribing cost-effective. However, majority of patients as well as pharmacists/medical store personnel strongly disagreed or disagreed with this notion that physicians prescribe cheap medicines. Furthermore, physicians and patients reported that medicines of local companies were not as effective as the medicines of multinational manufacturers, which were contrary to what pharmacists thought. Majority of physicians disagreed that their prescribing was under the influence of medical stores in their vicinity. The response of most of the patients (40.5%) was in line with that of physicians whereas 32% pharmacist/medical store personnel agreed. Nearly half of the physicians strongly agreed or agreed that patients demand medicines of multinational companies. Contrarily, a majority of patients and medical store personnel denied that patients demand for the medicines of multinational manufacturers. CONCLUSION: The study highlighted that there was a need to develop policy guidelines at the level of Federal Government and Drug Regulatory Authority of Pakistan in connection with prescribing practices to reduce the variation in perception of key stakholders involved in drug use process.


Assuntos
Atitude do Pessoal de Saúde , Atitude Frente a Saúde , Prescrições de Medicamentos/estatística & dados numéricos , Padrões de Prática Médica/tendências , Adolescente , Adulto , Idoso , Comportamento do Consumidor , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão , Percepção , Assistência Farmacêutica/estatística & dados numéricos , Farmácias/estatística & dados numéricos , Farmacêuticos/psicologia , Médicos/psicologia , Adulto Jovem
13.
J Manag Care Spec Pharm ; 25(5): 538-543, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31039066

RESUMO

Managed care organizations are growing more sophisticated in their ability to analyze data. There are increasing numbers of data analysts at managed care organizations, as well as more types of real-time, or "live," data available. These data range from pharmacy claims and enrollment files to medical claims, medical records, and linkages to external data. Moreover, the data are often curated in a way that allows for easier data analysis. Using these data, managed care residents are often required to perform a project to evaluate a utilization management policy or clinical program. Yet, there is a lack of guidance specific to managed care organizations on how to conduct such a research study using "live" claims data. This Viewpoint article provides a primer for managed care residents and other managed care professionals who are seeking to use data to help inform decisions on how to manage their beneficiaries' health and costs. DISCLOSURES: There was no funding source for this manuscript. Hung reports a grant from the Agency for Healthcare Research and Quality and personal fees from Blue Cross Blue Shield Association, outside the submitted work. Gedey, Groeneweg, and Jay have nothing to disclose.


Assuntos
Revisão da Utilização de Seguros/normas , Programas de Assistência Gerenciada/organização & administração , Assistência Farmacêutica/organização & administração , Pesquisa em Farmácia/métodos , Projetos de Pesquisa , Interpretação Estatística de Dados , Humanos , Internato e Residência , Programas de Assistência Gerenciada/economia , Assistência Farmacêutica/economia , Pesquisa em Farmácia/normas , Estados Unidos
14.
J Manag Care Spec Pharm ; 25(5): 526-531, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31039067

RESUMO

Health care payment models that reward value over volume have the potential to improve patient care and control rising costs. These payment models are increasingly being implemented by a range of care delivery providers in the United States. Integrated delivery networks (IDNs)-systems of providers and sites (e.g., group practices and hospitals) that care for and provide health care services and health insurance plans to patients in a specific region or market-present special opportunities and challenges for value-based care and represent an important sector for the advancement of value-based models. Successful implementation of value-based agreements in IDNs requires a range of complex capabilities, including advanced data analytics, population health management solutions, comprehensive care management, and successful patient engagement. To address these and other operational issues, the Academy of Managed Care Pharmacy convened a stakeholder forum on November 13-14, 2018, in Baltimore, MD. Forum attendees addressed topics including (a) the current delivery of value-based care in IDNs; (b) opportunities and barriers to implementing pharmaceutical value-based agreements; (c) recommendations for IDNs to reach the full potential of value-based agreements; and (d) opportunities for collaborations among managed care organizations, accountable care organizations, and IDNs to improve health care outcomes. Thought leaders with a wide range of backgrounds attended the forum, including those representing patients, payers, providers, government, and biopharmaceutical companies. The forum was sponsored by Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Genentech, Lilly, MedImpact, Merck, National Pharmaceutical Council, Novo Nordisk, Pharmaceutical Research and Manufacturers of America, Takeda, and Xcenda. This proceedings document presents common themes and comments from individual participants at the forum, which are not necessarily endorsed by all attendees, nor should they be construed to reflect group consensus. DISCLOSURES: This AMCP Partnership Forum and the development of this proceedings document were supported by Amgen, Boehringer Ingelheim, Bristol-Myers Squibb, Genentech, Lilly, MedImpact, Merck, National Pharmaceutical Council, Novo Nordisk, Pharmaceutical Research and Manufacturers of America, Takeda, and Xcenda.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Assistência Farmacêutica/organização & administração , Seguro de Saúde Baseado em Valor/organização & administração , Prestação Integrada de Cuidados de Saúde/métodos , Custos de Cuidados de Saúde , Humanos , Assistência Farmacêutica/economia , Estados Unidos , Seguro de Saúde Baseado em Valor/economia
15.
Int J Pharm Compd ; 23(3): 192-199, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31085787

RESUMO

Polycystic ovary syndrome (Stein- Leventhal syndrome) is a common endocrinopathologic condition in reproductive- age women in the U.S. Patients with that disease are not faced with treatment choices for a single medical entity; they must manage a constellation of comorbid conditions that compromise their overall health and diminish their quality of life. The combinations of those disorders are unique to each patient. As a result, the safest and most effective therapeutic approach often requires precision pharmacy: the use of compounded therapies that, unlike commercially manufactured medications, can be precisely adjusted to meet individual needs and modified as therapeutic requirements change. In this article, the manifestations of polycystic ovary syndrome are reviewed, several common concomitant conditions are discussed, therapeutic interventions are suggested, and compounded formulations are provided.


Assuntos
Assistência Farmacêutica , Síndrome do Ovário Policístico , Feminino , Humanos , Qualidade de Vida
16.
BMC Health Serv Res ; 19(1): 207, 2019 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-30935394

RESUMO

BACKGROUND: In 2016, Oregon became the first of eight states to allow pharmacists to directly prescribe hormonal contraception (HC), including the pill, patch, or ring, without a clinic visit. In the two years following this policy change, the majority of ZIP codes across the state of Oregon had a pharmacist certified to prescribe HC. METHODS: We will utilize complementary methodologies to evaluate the effect of this policy change on convenient access to contraception (cost, supply dispensed), safety, contraceptive continuation and unintended pregnancy rates. We will conduct a prospective clinical cohort study to directly measure the impact of provider type on contraceptive continuation and to understand who is accessing hormonal contraception directly from pharmacists. We will concurrently conduct a retrospective analysis using medical claims data to evaluate the state-level effect of the policy. We will examine contraceptive continuation rates, incident pregnancy, and safety measures. The combination of these methodologies allows us to examine key woman-level factors, such as pregnancy intention and usual place of care, while also estimating the impact of the pharmacist prescription policy at the state level. DISCUSSION: Pharmacist prescription of HC is emerging nationally as a strategy to reduce unintended pregnancy. This study will provide data on the effect of this practice on convenient access to care, contraceptive safety and continuation rates.


Assuntos
Anticoncepcionais Femininos , Prescrições de Medicamentos , Legislação de Medicamentos , Farmacêuticos/legislação & jurisprudência , Feminino , Acesso aos Serviços de Saúde , Humanos , Oregon , Assistência Farmacêutica/legislação & jurisprudência , Gravidez , Taxa de Gravidez , Gravidez não Planejada , Estudos Prospectivos , Projetos de Pesquisa , Estudos Retrospectivos
17.
San Salvador; s.n; abr. 2019. 66 p. graf, tab, ilus.
Tese em Espanhol | LILACS | ID: biblio-1007277

RESUMO

OBJETIVO: Caracterizar la atención farmacéutica en pacientes poli medicados con enfermedades crónicas no transmisibles, del Hospital Nacional Especializado Rosales, atendidos en la farmacia especializada del MINSAL. Agosto 2017 - Agosto 2018. METODOLOGÍA: Se realizó un estudio descriptivo de corte transversal; La muestra fue 378 expedientes de pacientes diagnosticados con Enfermedades Crónicas no Transmisibles, con seguimiento en el área de atención farmacéutica; Se diseñó una matriz para recolectar la información y facilitar su análisis haciendo uso de frecuencias de variables múltiples de SPSS. RESULTADOS: el 40% de las edades estaban en el rango de 66 años o más, el sexo femenino predominó con el 69%, más del 50% de los participantes estaban solteros, la ocupación más frecuente del estudio, fue ama de casa con un 43%, el 56% de las personas sabían leer, pero no habían realizado estudios de nivel básico, Las características personales fueron el PRM que predominó en el estudio con un 39% de los casos, la educación en medidas no farmacológicas fue la intervención que más se realizó de parte de los profesionales farmacéuticos con un 50% del total de casos, y el 71% de los casos reportados logró una mejoría en el control de su presión arterial con el seguimiento farmacoterapéutico. CONCLUSIONES: Se encontró que las características personales son el problema relacionado con la medicación más frecuente en pacientes con Enfermedades Crónicas no Transmisibles, la educación en medidas no farmacológicas es la intervención que más se realiza en atención farmacéutica y los logros en pacientes se evidenciaron en un mejor control de la presión arterial


Assuntos
Humanos , Farmácia , Serviço de Farmácia Hospitalar , Assistência Farmacêutica , Doenças não Transmissíveis , Saúde Pública , Epidemiologia Descritiva
18.
Yakugaku Zasshi ; 139(3): 405-410, 2019.
Artigo em Japonês | MEDLINE | ID: mdl-30828019

RESUMO

The 6-year education system for pharmacists was introduced in Japanese schools of pharmacy in 2006, after which a 4-year doctoral course system was established for advancing clinical pharmaceutical research. The roles of hospital pharmacists and community pharmacists have been expanded from drug dispensing to patient care. Clinical pharmacists practice patient care daily using evidence-based medicine and shared decision making. Clinical pharmacists also carry out research proactively for resolving clinical questions encountered in practice. The Japanese Society of Pharmaceutical Health Care and Sciences (JSPHCS) was established in June 1990, and its membership has expanded significantly. The society has over 12000 members including clinical pharmacists and those in pharmacies who participate in practice, research, and education. The JSPHCS functions as the main platform for pharmacy professionals. It holds annual meetings, publishes an academic journal, supports overseas study, and confers awards on exceptional individuals. It also authorizes JSPHCS-Certified Clinical Pharmacists, Board-Certified Oncology Pharmacists, and Board-Certified Pharmacotherapy Specialists. Recently, clinical pharmacy educational seminars and conferences for newly qualified pharmacists have been held to improve the quality of clinical research performed. Several subcommittees under the JSPHCS were newly established for promoting clinical pharmacy research. The mission of the JSPHCS is to promote clinical pharmacy research and systematize the evidence and information, thereby contributing to the healthcare of all.


Assuntos
Serviços Comunitários de Farmácia , Assistência Farmacêutica/organização & administração , Farmacêuticos , Serviço de Farmácia Hospitalar , Sociedades Farmacêuticas/organização & administração , Educação em Farmácia , Humanos , Japão , Papel Profissional , Pesquisa
19.
Med Care ; 57(4): 295-299, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30829940

RESUMO

RESEARCH OBJECTIVE: Pharmacists are an expensive and limited resource in the hospital and outpatient setting. A pharmacist can spend up to 25% of their day planning. Time spent planning is time not spent delivering an intervention. A readmission risk adjustment model has potential to be used as a universal outcome-based prioritization tool to help pharmacists plan their interventions more efficiently. Pharmacy-specific predictors have not been used in the constructs of current readmission risk models. We assessed the impact of adding pharmacy-specific predictors on performance of readmission risk prediction models. STUDY DESIGN: We used an observational retrospective cohort study design to assess whether pharmacy-specific predictors such as an aggregate pharmacy score and drug classes would improve the prediction of 30-day readmission. A model of age, sex, length of stay, and admission category predictors was used as the reference model. We added predictor variables in sequential models to evaluate the incremental effect of additional predictors on the performance of the reference. We used logistic regression to regress the outcomes on predictors in our derivation dataset. We derived and internally validated our models through a 50:50 split validation of our dataset. POPULATION STUDIED: Our study population (n=350,810) was of adult admissions at hospitals in a large integrated health care delivery system. PRINCIPAL FINDINGS: Individually, the aggregate pharmacy score and drug classes caused a nearly identical but moderate increase in model performance over the reference. As a single predictor, the comorbidity burden score caused the greatest increase in model performance when added to the reference. Adding the severity of illness score, comorbidity burden score and the aggregate pharmacy score to the reference caused a cumulative increase in model performance with good discrimination (c statistic, 0.712; Nagelkerke R, 0.112). The best performing model included all predictors: severity of illness score, comorbidity burden score, aggregate pharmacy score, diagnosis groupings, and drug subgroups. CONCLUSIONS: Adding the aggregate pharmacy score to the reference model significantly increased the c statistic but was out-performed by the comorbidity burden score model in predicting readmission. The need for a universal prioritization tool for pharmacists may therefore be potentially met with the comorbidity burden score model. However, the aggregate pharmacy score and drug class models still out-performed current Medicare readmission risk adjustment models. IMPLICATIONS FOR POLICY OR PRACTICE: Pharmacists have a great role in preventing readmission, and therefore can potentially use one of our models: comorbidity burden score model, aggregate pharmacy score model, drug class model or complex model (a combination of all 5 major predictors) to prioritize their interventions while exceeding Medicare performance measures on readmission. The choice of model to use should be based on the availability of these predictors in the health care system.


Assuntos
Comorbidade , Readmissão do Paciente/estatística & dados numéricos , Assistência Farmacêutica/estatística & dados numéricos , Risco Ajustado/estatística & dados numéricos , Índice de Gravidade de Doença , Idoso , Doença Crônica/terapia , Feminino , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Medicare , Avaliação de Resultados (Cuidados de Saúde)/estatística & dados numéricos , Estudos Retrospectivos , Risco Ajustado/métodos , Estados Unidos
20.
Saúde Soc ; 28(1): 287-298, jan.-mar. 2019.
Artigo em Português | LILACS | ID: biblio-991674

RESUMO

Resumo O trabalho teve como objetivo identificar a percepção de gestores públicos da assistência farmacêutica em esferas subnacionais e de gerentes técnicos de instâncias colegiadas do Sistema Único de Saúde sobre os reflexos do Programa Farmácia Popular do Brasil (PFPB), iniciativa exclusivamente federal, na gestão da assistência farmacêutica na atenção básica (Afab), de responsabilidade tripartite e operacionalizada pelos municípios. Entrevistaram-se gestores municipais, estaduais e gerentes técnicos do Conselho Nacional de Secretarias Municipais de Saúde e do Conselho Nacional de Secretários de Saúde. A análise do conteúdo considerou as categorias (1) desafios e avanços da Afab e do PFPB e (2) conexões entre a Afab e o PFPB. Houve visões divergentes sobre as relações entre Afab e PFPB, se concorrentes ou complementares. Ressaltou-se o contraste entre os crescentes investimentos no PFPB e sua estagnação na Afab, a sobreposição dos elencos, a migração de usuários e o papel do PFPB como alternativa de acesso, entre outros. A implementação centralizada do PFPB parece ter se dado com baixa articulação com as esferas subnacionais de gestão, gerando distintas e contraditórias interpretações sobre seu papel e objetivos para os municípios, considerando-se as diretrizes de descentralização da assistência farmacêutica.


Abstract This study aimed to identify the perception of public administrators from pharmaceutical services in subnational spheres, and of technical administrators from collegiate instances of the Brazilian National Health System on the impacts of the Farmácia Popular do Brasil Program (PFPB - Brazilian Popular Pharmacy Program), an exclusively federal initiative, in the administration of pharmaceutical services in primary health care (AFAB), of the responsibility of the three government levels and operationalized by the municipalities. Municipal, state and technical administrators from the National Council of Municipal Health Secretaries and from the National Council of Health Secretaries were interviewed. Content analysis considered the categories: (1) challenges and advances of AFAB and PFPB and (2) connections between AFAB and PFPB. There were different visions on the relations between them, either competing or complementing. The contrast between the growing investments in the PFPB and their stagnation in the AFAB, the overlapping of lists of medications, patient migration and the role of the PFPB as an access alternative, among others, were highlighted. The centralized implementation of the PFPB seems to have happened with poor articulation with subnational spheres of management, generating distinct and conflicting interpretations about the program's role and objectives for the municipalities, considering the decentralization guidelines of pharmaceutical services.


Assuntos
Humanos , Masculino , Feminino , Assistência Farmacêutica , Atenção Primária à Saúde , Gestão em Saúde , Federalismo , Política de Saúde
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