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1.
Einstein (Sao Paulo) ; 18: eAO4858, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31851225

RESUMO

OBJECTIVE: To develop and validate the content of a tool aimed to select patients with hypertension for pharmaceutical care, based on identification of individuals in greater need of attention. METHODS: The tool was developed and assessed for face and content validity, which was carried out in three stages. Phase I consisted of comprehensive literature review, which prompted the development of the first version of the tool. Phase II consisted of validation by an expert panel. Phase III consisted of a pilot study with hypertensive patients and preparation of the final version of the instrument. RESULTS: Literature review yielded 30 studies, out of which 13 factors associated with hypertension and cardiovascular disease control and complications were selected. Once the initial version of the tool named INSAF-HAS was obtained, four expert meetings were held, each leading to instrument improvement until a final consensus was reached. In the pilot study, INSAF-HAS was applied to 30 patients with a diagnosis of hypertension for applicability pretest; adjustments were made and the final version of INSAF-HAS obtained. CONCLUSION: The INSAF-HAS tool developed in this study has face and content validity, and may contribute to the selection of patients with hypertension in greater need of pharmaceutical care services.


Assuntos
Anti-Hipertensivos/uso terapêutico , Hipertensão/tratamento farmacológico , Seleção de Pacientes , Assistência Farmacêutica/normas , Inquéritos e Questionários/normas , Doenças Cardiovasculares/etiologia , Progressão da Doença , Feminino , Humanos , Hipertensão/complicações , Masculino , Projetos Piloto , Reprodutibilidade dos Testes , Fatores de Risco
4.
J Manag Care Spec Pharm ; 25(10): 1073-1077, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31556829

RESUMO

Estimating medication adherence through the use of pharmacy claims-based adherence calculations such as medication possession ratio (MPR) and proportion of days covered (PDC) plays a significant role in specialty pharmacy practice. Although MPR and PDC are frequently used in clinical practice, calculation methodologies vary, making meaningful comparisons of adherence rates difficult. In addition, MPR and PDC are increasingly used by insurance companies, pharmacies, accrediting bodies, and drug manufacturers to demonstrate quality differences or clinical benefit across the specialty pharmacy industry. Therefore, recognizing the source and effect of calculation variability is necessary to fully understand reported adherence results. This article highlights the challenges in standardizing adherence methodologies, minimum methodology considerations that should be reported with MPR and PDC results, and key elements to consider when interpreting and applying adherence results. Further, recommendations are provided to promote a more consistent description of calculation methods and to aid pharmacies in adherence measure analysis, interpretation, and application to practice, with a focus on specialty pharmacy programs. A detailed description of methodology as outlined in this article must be provided to ensure reproducibility, external validation, and scientific rigor. In the absence of standardization, specialty pharmacies should be prudent in their use of adherence calculations as a clinical benchmarking tool or comparative quality indicator with outside organizations. Furthermore, specialty pharmacies should consider using current adherence measure calculations to identify and provide targeted interventions to patients with potential adherence problems and strive to better demonstrate ties between adherence measures and direct clinical and cost outcomes. DISCLOSURES: No outside funding supported the writing of this article. Anguiano is a speaker and research consultant for United Therapeutics. The other authors have nothing to disclose.


Assuntos
Benchmarking/normas , Adesão à Medicação/estatística & dados numéricos , Assistência Farmacêutica/normas , Farmácias/normas , Benchmarking/estatística & dados numéricos , Assistência Farmacêutica/estatística & dados numéricos , Farmácias/estatística & dados numéricos , Indicadores de Qualidade em Assistência à Saúde/normas , Indicadores de Qualidade em Assistência à Saúde/estatística & dados numéricos , Reprodutibilidade dos Testes
5.
Am J Health Syst Pharm ; 76(9): 599-607, 2019 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-31361829

RESUMO

PURPOSE: This study investigates the use of a canopy-connected recirculating class II type A2 biological safety cabinet (BSC) as an alternative to the B2 when preparing volatile, sterile compounded preparations. Selection of the appropriate BSC for processes that use subgram levels of volatile chemicals is difficult due to a lack of quantitative containment evidence by cabinet type. There is a perception that hazardous compounding must be done in a B2 cabinet due to the potential for vapors, and this study seeks to challenge that perception. METHODS: In total, 5 tests, 3 prequalification tests and 2 containment capability tests, were conducted on a single cabinet of each type at sterile compounding pharmacies. Prequalification tests were performed to verify that each BSC was operating properly. Each cabinet was certified to NSF-ANSI 49-2016, particle counted per ISO 14644-1:1999, and subjected to a qualitative video smoke study. Once these tests confirmed the expected working conditions, 2 containment capability tests were conducted. The containment testing included tracer gas testing per ASHRAE 110:2016 section 8.1.1 through 8.1.13, and cyclophosphamide sampling during sterile compounding of the drug material. RESULTS: Both cabinets passed all the prequalification tests. During the ASHRAE tracer gas testing the A2 cabinet was able to contain a tracer gas 92% to 160% as effectively as the B2 cabinet depending on the position of the gas ejection. During sterile compounding the airborne cyclophosphamide sampling captured samples of less than 1.0 ng at all locations for both the A2 and B2 cabinets. CONCLUSION: The data generated from this study demonstrate that use of an A2 for hazardous compounding can provide a comparable level of safety for the environment, users, and product while having less stringent airflow requirements relative to a B2. The simpler requirements for an A2 make them an appealing alternative as they have the potential to reduce the overall operating costs associated with a compounding pharmacy while maintaining safe levels of containment.


Assuntos
Contenção de Riscos Biológicos/instrumentação , Composição de Medicamentos/instrumentação , Assistência Farmacêutica/normas , Antineoplásicos Alquilantes/análise , Contenção de Riscos Biológicos/normas , Ciclofosfamida/análise , Composição de Medicamentos/normas , Contaminação de Equipamentos/prevenção & controle , Substâncias Perigosas/análise , Humanos
6.
Am J Health Syst Pharm ; 76(9): 608-612, 2019 Apr 17.
Artigo em Inglês | MEDLINE | ID: mdl-31361831

RESUMO

PURPOSE: The attainment of fundamental research skills to create and disseminate new knowledge is imperative for the advancement of pharmacy practice. Research training is an important component of postgraduate residency training; however, the traditional model of performing residency research has several limitations that have hindered the ability of residents to complete high-quality research projects. Therefore, our institution developed and implemented the flipped residency research model with the 2013-2014 pharmacy practice residency class. SUMMARY: The flipped residency research model modifies the research timeline to better align research activities with residents' abilities at specific time points during the year. In the 4 years following implementation of the flipped residency research model, our institution found improvements in a number of areas pertaining to the research process compared with an evaluation of the 7 years prior to implementation. A decrease in the number of reviews required from institutional review boards was observed, resulting in improved institutional review board efficiency. The flipped residency research model also addressed limitations surrounding manuscript development and submission, as demonstrated by an improved publication rate. Additionally, residents who participated in the flipped residency research model self-reported increased comfort with research-related abilities associated with study design, implementation, manuscript development and submission, and biostatistics. CONCLUSION: The modified research timeline of the flipped residency research model better aligns research activities with resident experiences and abilities. This realignment has translated to demonstrable impact in the success of residency projects and dissemination of results. Research is needed to investigate the impact of the flipped residency research model on longer term scholarly success.


Assuntos
Pesquisa em Farmácia/educação , Residências em Farmácia/métodos , Estudantes de Farmácia , Humanos , Modelos Educacionais , Assistência Farmacêutica/normas , Competência Profissional , Pesquisadores/normas
7.
Am J Health Syst Pharm ; 76(12): 874-887, 2019 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-31361855

RESUMO

PURPOSE: Pharmacists are accountable for medication-related services provided to patients. As payment models transition from reimbursement for volume to reimbursement for value, pharmacy departments must demonstrate improvements in patient care outcomes and quality measure performance. The transition begins with an awareness of quality measures for which pharmacists and pharmacy personnel can demonstrate accountability across the continuum of care. The objective of the Pharmacy Accountability Measures (PAM) Work Group is to identify measures for which pharmacy departments can and should assume accountability. SUMMARY: The National Quality Forum (NQF) Quality Positioning System (QPS) was queried for NQF-endorsed medication-related measures. Included measures were curated into a data set of 6 therapeutic categories: antithrombotic safety, cardiovascular control, glucose control, pain management, behavioral health, and antimicrobial stewardship. Subject matter expert (SME) panels assigned to each area analyzed each measure according to a predetermined ranking system developed by the PAM Work Group. Measures remaining after SME review were disseminated during a public comment period for review and ballot. Over 1,000 measures are captured in the NQF QPS; 656 of the measures were found to be endorsed and medication use related or impacted by medication management services. A single reviewer categorized 140 measures into therapeutic categories for SME review; the remaining measures were unrelated to those clinical domains. The SME groups identified 28 measures for inclusion. CONCLUSION: An understanding of the endorsed quality measures available for public reporting programs provides an opportunity for pharmacists to demonstrate accountability for performance, thus improving quality and safety and demonstrating value of care provided.


Assuntos
Conduta do Tratamento Medicamentoso/organização & administração , Assistência Farmacêutica/organização & administração , Garantia da Qualidade dos Cuidados de Saúde/normas , /economia , Humanos , Conduta do Tratamento Medicamentoso/economia , Conduta do Tratamento Medicamentoso/normas , Assistência Farmacêutica/economia , Assistência Farmacêutica/normas , Farmacêuticos/economia , Farmacêuticos/organização & administração , Farmacêuticos/psicologia , /normas , Papel Profissional/psicologia , Garantia da Qualidade dos Cuidados de Saúde/economia , Reembolso de Incentivo/economia , Reembolso de Incentivo/normas , Responsabilidade Social , Estados Unidos
8.
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
9.
Int J Clin Pharm ; 41(4): 1012-1020, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31093940

RESUMO

Background Oral anticoagulation therapy has proven beneficial impact on the prevention of thromboembolic events. However, the use of antocoagulatns also increases the risk of bleeds. To maximize the benefits and minimize the risks of the treatment, guidance on appropriate use of oral anticoagulants is essential. An international guideline describing relevant components and requirements for pharmaceutical care for patients receiving a therapy woth oral antocoagulants would increase the quality of care. However, recommendations on pharmaceutical care for patients on anticoagulation is lacking. Objective This study aims to develop an interprofessional guideline to support patients in their use of oral anticoagulation therapy. Method Two systematic literature searches were performed on existing guidelines on the management and interventions to improve-oral anticoagulant use, to generate possible recommendations. Subsequently, an international expert panel with 26 pharmacists with extensive experience in clinical and/or scientific work on anticoagulation from a total of 22 European and 4 non-European countries was constituted. With this (geographically well distributed) expert panel, a four-round internet-based Delphi technique was conducted to reach consensus on their relevance. Items were ranked on a 1-10 scale of agreement. A median agreement score of ≥ 7.5 was considered the threshold for consensus. Levels of importance were rated on a 1-3 scale. Setting A global network of 26 pharmacists specialized in oral antocoagulation therapy. Main outcome measure Development of inter-professional guideline. Results After the four Delphi rounds 18 guideline recommendations were formulated. Consensus of opinion was achieved for all recommendations (median agreement: 8.5-10.0), whereas mean levels of importance were between 1.1 and 2.0 (SD: 0.2-0.7). The following domains were rated as most important targets for improving the care around oral anticoagulation: 'INR-monitoring', 'Transfer of care between health care settings', 'Adherence to medication', 'Patient communication and engagement', and 'Medication reconciliation and medication review'. Conclusion The 18 recommendations included in this guideline provide the base for optimization of anticoagulation care across different countries/healthcare systems. Future work involves translating the guideline recommendations into clinical practice. Once implemented, the recommendations of the guideline will support health care providers with the pharmaceutical care for patients on, oral anticoagulation which will improve the effective and safe use of these medicines.


Assuntos
Anticoagulantes/uso terapêutico , Técnica Delfos , Guias como Assunto/normas , Assistência Farmacêutica/normas , Administração Oral , Anticoagulantes/administração & dosagem , Consenso , Humanos , Internacionalidade
10.
Int J Clin Pharm ; 41(3): 711-718, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31020600

RESUMO

Background Atopic dermatitis affects 10-20% of the children worldwide. Unfortunately not all patients who receive treatment have optimal treatment outcomes. Objective To assess the view of parents and pharmacy staff in order to optimize pharmaceutical care for young atopic dermatitis patients. Setting Community pharmacies in the Netherlands. Method We first held an expert panel meeting to determine experts' views on treatment of atopic dermatitis and their suggestions for areas of improvement. This input was used to develop the interview guide. We conducted telephone interviews with parents of children (aged 0-12 years) with atopic dermatitis and face-to-face interviews with pharmacy staff members. All interviews were audiotaped and transcribed verbatim. Transcripts were coded using qualitative data analysis software. Codes were used to identify themes. Main outcome measure Perspectives of parents of young atopic dermatitis patients and pharmacy staff about treatment. Results We interviewed 29 parents and 18 pharmacy staff members. Many parents mentioned fear of steroid adverse effects, with intentional nonadherence as a consequence, and difficulties with the application of topical treatment. Pharmacy employees also mentioned to encounter these issues. Some employees themselves expressed concerns towards use of steroids. Most parents were satisfied with the information they received; however, they need more practical lifestyle advices, e.g. about bathing or clothing. Both pharmacists and pharmacy technicians mentioned that technicians often lack knowledge to support patients optimally in correct medication use. Conclusion Parents' perceptions about topical corticosteroids might negatively influence treatment outcomes. Pharmacy staff has an important role to inform parents of children with eczema on the appropriate use of topical corticosteroids and emollients. Counseling should not be influenced by their own prejudices about topical corticosteroids. Close collaboration between primary care providers should ensure that parents receive uniform messages.


Assuntos
Atitude do Pessoal de Saúde , Dermatite Atópica/tratamento farmacológico , Pais , Assistência Farmacêutica/normas , Farmacêuticos/normas , Administração Tópica , Corticosteroides/administração & dosagem , Criança , Pré-Escolar , Dermatite Atópica/epidemiologia , Dermatite Atópica/psicologia , Feminino , Humanos , Lactente , Recém-Nascido , Entrevistas como Assunto/métodos , Entrevistas como Assunto/normas , Masculino , Países Baixos/epidemiologia , Pais/psicologia , Farmacêuticos/psicologia
11.
Am J Health Syst Pharm ; 76(10): 646-653, 2019 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-30873537

RESUMO

PURPOSE: The optimal health care delivery models for providing services to patients with infections caused by hepatitis C virus (HCV) remain unknown. Pharmacist involvement may be a key component of optimal HCV care delivery. We examined the comparative effectiveness of a pharmacist-managed HCV clinic versus a pharmacist-assisted HCV clinic. METHODS: This retrospective cohort study used electronic health record data on patients ≥18 years old initiating HCV treatment at a pharmacist-managed clinic or a pharmacist-assisted clinic within a single health-system between January 2015 and June 2017. Outcomes included treatment completion, sustained virologic response 12 weeks following treatment completion (SVR-12), and dispensation of direct-acting antiviral agents at the institution-based specialty pharmacy. Inverse probability of treatment-weighted (IPTW) logistic regression models were used to compare outcomes between the 2 clinic models. RESULTS: A total of 127 patients initiated HCV treatment therapy: 64 patients from the pharmacist-managed clinic and 63 patients from the pharmacist-assisted clinic. The cohort had a mean age of 55 years, was 51% male, and 68% white. In IPTW analyses, there was no difference in treatment completion (odds ratio [OR], 1.1; 95% confidence interval [CI], 0.1-13.8; p = 0.93), achievement of sustained virologic response at 12 months (SVR-12) (OR, 1.0; 95% CI, 0.2-4.5; p = 0.62), or use of institution-based specialty pharmacy (OR, 0.6; 95% CI, 0.2-1.7; p = 0.33) between pharmacist-managed and pharmacist-assisted clinics. CONCLUSION: There were no significant differences in outcomes between patients receiving care at the pharmacist-managed HCV clinic and the pharmacist-assisted clinic. Given the frequency of SVR-12 achieved in both groups, both pharmacist-managed and pharmacist-assisted clinic models may be reasonable alternatives for providing outpatient HCV care.


Assuntos
Antivirais/uso terapêutico , Benchmarking , Assistência à Saúde , Hepatite C/tratamento farmacológico , Assistência Farmacêutica/normas , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Instituições de Assistência Ambulatorial , Antivirais/provisão & distribução , Estudos de Coortes , Feminino , Humanos , Masculino , Registros Médicos , Pessoa de Meia-Idade , Modelos Teóricos , Estudos Retrospectivos , Rhode Island
12.
Am J Pharm Educ ; 83(1): 7210, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30894776

RESUMO

Recently, scientific publishing has experienced an expansion of journals and publishers whose primary goal is profit and whose peer review process is virtually non-existent. These "predatory" or "opportunistic" journals pose a threat to the credibility and integrity of legitimate scientific literature, and quality science. Unfortunately, many scientists choose to publish in these journals and/or serve on their editorial boards, either due to ease of rapid publication or naivety. Here, we highlight the extensive use of predatory publications or editorial board involvement by applicants applying for a faculty position in the Pharmaceutical Sciences department at the Bill Gatton College of Pharmacy at East Tennessee State University. We caution search committees at other pharmacy schools to thoroughly examine applicant curricula vitarum (CVs) for predatory publishing.


Assuntos
Docentes/normas , Revisão da Pesquisa por Pares/normas , Publicações/normas , Editoração/normas , Educação em Farmácia/normas , Humanos , Publicações Periódicas como Assunto , Assistência Farmacêutica/normas , Farmácia/normas , Faculdades de Farmácia/normas , Universidades/normas
13.
Ann Pharm Fr ; 77(3): 222-231, 2019 May.
Artigo em Francês | MEDLINE | ID: mdl-30670297

RESUMO

OBJECTIVES: In order to prevent medication errors during patient's care pathway, all transition steps must be secured. The main objective of this study was to assess the interest of medication review at hospital discharge on the sustainability of therapeutic optimizations made during hospitalisation in a geriatric population. MATERIAL AND METHODS: This was a three months prospective, single-centre study performed in an acute geriatric unit of a university hospital. All patients hospitalized during the study were included. They were divided in two groups: the securing pathway (SP) group with admission reconciliation, step 3 prescription analysis (according to the French Society of clinical pharmacy) and medication review at hospital discharge were compared to the not concerned group (NSP) with only a step 2 (according to the French Society of clinical pharmacy) prescriptions analysis. The Medication Regimen Complexity Index was used to quantify the complexity of medication regimens. RESULTS: In total, 53 patients of the SP group and 44 patients of the NSP group got the benefit of whole clinical pharmaceutical activities put in places. The average medications on discharge's drug prescription is lower in SP group (SP 8.4±3.4 medications and NSP 9.6±3.2 medications, P=0.06). The discharge's drug prescription complexity index is lower in SP group compared to NSP group (SP 27.9±9.8 and NSP 32.7±11.5, P=0.02). The same trend is observed 30 days post discharge. CONCLUSION: A medication review at hospital discharge reduces the subsequent drug prescription's complexity score. This multidisciplinary dynamic makes easier the communication between health care professionals and contributes to strengthen the city-hospital link.


Assuntos
Assistência Farmacêutica/normas , Idoso , Prescrições de Medicamentos/normas , Feminino , Humanos , Masculino , Erros de Medicação/prevenção & controle , Reconciliação de Medicamentos , Alta do Paciente , Farmacêuticos , Serviço de Farmácia Hospitalar , Estudos Prospectivos
14.
Int J Clin Pharm ; 41(1): 244-250, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30610541

RESUMO

Background Many tools exist to document drug-related problems (DRP), such as the Pharmaceutical Care Network Europe (PCNE) classification. However, none have been adapted and published for French-speaking Belgian community pharmacies. Settings French-speaking Belgian Community pharmacies. Objective The objective was to translate and adapt the PCNE V6.2 classification to the Belgian pharmacy practice and legal setting and to assess the content validity, daily use and inter-rater reliability of this classification. Main Outcome Measure Validation of the French-language adapted PCNE v6.2 classification in Belgium. Method The first step translated and adapted the PCNE V6.2 classification to the Belgian setting. Thereafter academic and community pharmacists evaluated the content validity, which involved six criteria and concerned the instruction manual (clarity, helpfulness) and the registration form (representativeness, logical design, completeness and uniqueness). The next step was the DRP collection, using the PCNE tool daily. Compliance with the instructions and the time needed to solve a DRP were evaluated. Finally, the inter-rater reliability was evaluated by comparing DRP codings done by pharmacist volunteers. Results The classification was translated into French and adapted by adding 16 items. The classification showed a high content validity for the academics and the community pharmacists. A total of 109 DRP forms were coded, with an average resolution time of 5 min. Regarding the inter-rater reliability, 74 tool items out of the set of 83 showed high consistency in coding. Conclusion This study showed that the tool adaptation to a French-speaking Belgian context was reliable and has adequate validity for daily use.


Assuntos
Serviços Comunitários de Farmácia/normas , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/classificação , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Multilinguismo , Assistência Farmacêutica/normas , Tradução , Bélgica/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Humanos , Farmacêuticos/normas , Reprodutibilidade dos Testes
16.
J Oncol Pharm Pract ; 25(1): 148-162, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28841099

RESUMO

PURPOSE: A survey of guidelines and current practices was conducted to examine the safe handling procedures for antineoplastic and other hazardous drugs that are used in 24 countries including the Americas, Europe, the Mideast, Far East, and Australia. METHODS: Subject experts were asked to complete a brief survey regarding safe handling guidelines and practices for hazardous drugs in their countries. Questions addressed practices for handling monoclonal antibodies, the use of closed-system transfer devices, medical surveillance practices, and measurements of compliance with existing guidelines. RESULTS: Responses from 37 subject experts representing 24 countries revealed considerable variation in the content and scope of safe handling guidelines and pharmacy practices among the participating countries. Guidelines in the majority of countries used the term "cytotoxics," while others referred to "hazardous" or "antineoplastic" drugs. The International Society of Oncology Pharmacy Practice standard was cited by six countries, and five cited the National Institute for Occupational Safety and Health Alert. Others cited international guidelines other than International Society of Oncology Pharmacy Practice, or they have created their own guidelines. Approximately half reported that their guidelines were mandatory under federal, state, or provincial legislation. Only 11 countries reported that monoclonal antibodies were covered in their guidelines. Closed-system drug-transfer devices are widely used, but were not specifically recommended in four countries, while one country required their use. Medical surveillance programs are in place in 20 countries, but only in The Netherlands is surveillance mandatory. Nine countries reported that they have completed recent updates or revisions of guidelines, and the measures for their adoption have been initiated. CONCLUSIONS: Although the overall goals in the participating countries were similar, the approaches taken to assure safe handling of hazardous drugs varied considerably in some cases.


Assuntos
Antineoplásicos/efeitos adversos , Guias como Assunto/normas , Internacionalidade , Exposição Ocupacional/normas , Farmácias/normas , Inquéritos e Questionários , Austrália , Europa (Continente) , Extremo Oriente , Substâncias Perigosas/efeitos adversos , Pessoal de Saúde , Humanos , Oriente Médio , Exposição Ocupacional/prevenção & controle , Saúde do Trabalhador/normas , Assistência Farmacêutica/normas , Farmácia/métodos , Farmácia/normas , Equipamentos de Proteção/normas , Estados Unidos
17.
Pharm. care Esp ; 21(3): 159-178, 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-185110

RESUMO

Introducción: La dermatitis atópica es una enfermedad inflamatoria y crónica de la piel que afecta en gran medida a la calidad de vida de los pacientes de la padecen. Objetivo: Evaluar la eficacia de la atención farmacéutica en pacientes con dermatitis atópica diagnosticada, valorando su impacto sobre la sintomatología y la adherencia al tratamiento. Métodos: Se realizó un estudio experimental longitudinal prospectivo en 50 pacientes con dermatitis atópica no controlada, llevando a cabo una actuación farmacéutica individualizada basada en tres estrategias: educación sanitaria, seguimiento farmacoterapéutico, e intervención sobre el cuidado dermocosmético. Se evaluó la sintomatología y la adherencia al tratamiento farmacológico de cada paciente, y su evolución tras la intervención. Resultados: Los datos obtenidos se analizaron mediante el test estadístico de McNemar, confirmando que el 79,17% de los pacientes graves y el 92,30% de los casos moderados mejoraron significativamente tras la intervención. El valor obtenido del estadístico (Z=3,49) indicó que las variables intervención farmacéutica y mejora del paciente no eran independientes, siendo la primera la causa de la segunda. Al inicio del estudio, el 42% de los pacientes eran incumplidores, mientras que al final del mismo sólo el 23,81% lo eran. Conclusión: Este estudio demuestra que la atención farmacéutica, y más concretamente el seguimiento farmacoterapéutico, son herramientas útiles y necesarias para reducir la sintomatología y mejorar la calidad de vida de los pacientes con dermatitis atópica


Introduction: Atopic dermatitis is an inflammatory and chronic skin disease that greatly affects the quality of life of patients suffering from it. Objective: To evaluate the efficacy of pharmaceutical care in patients with diagnosed atopic dermatitis, assessing its impact on symptomatology and adherence to treatment. Methods: A prospective longitudinal experimental study was conducted in 50 patients with uncontrolled atopic dermatitis, and an individualized pharmaceutical action was carried out based on three strategies: health education, pharmacotherapeutic follow-up, and intervention on the dermocosmetic routine. The symptomatology and adherence to the pharmacological treatment of each patient, and their evolution after the intervention were evaluated. Results: The data obtained were analyzed by means of the McNemar statistical test, confirming that 79.17% of the serious patients and 92.30% of the moderate cases improved significantly after the intervention. The value obtained from the statistic (Z = 3.49) indicated that the variables pharmaceutical intervention and patient improvement were not independent, the former being the cause of the latter. At the beginning of the study, 42% of the patients were noncompliant, while at the end of the study only 23.81% were noncompliant. Conclusion: This study demonstrates that pharmaceutical care, and more specifically pharmacotherapy follow-up, are useful and necessary tools to reduce symptomatology and improve the quality of life of patients with atopic dermatitis


Assuntos
Humanos , Assistência Farmacêutica/normas , Dermatite Atópica/tratamento farmacológico , Cooperação e Adesão ao Tratamento , Estudos Prospectivos , Estudos Longitudinais , Qualidade de Vida , Índice de Gravidade de Doença , Entrevistas como Assunto , Resultado do Tratamento
18.
Curr Pharm Teach Learn ; 10(12): 1616-1623, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30527828

RESUMO

BACKGROUND AND PURPOSE: Concept mapping is an active learning tool associated with meaningful learning. In the pharmacy education literature, most evaluations of concept mapping focused solely on students' perceptions of mapping without evaluating its effectiveness on students' ability to apply the information learned. This article describes an evaluation of the effectiveness of group concept mapping during advanced pharmacy practice experiences (APPEs) by evaluating both application of the knowledge gained and students' reflections on the process. EDUCATIONAL ACTIVITY AND SETTING: Ambulatory care APPE students created group concept maps on pain management based on provided focus questions during a single session. Students completed pre-session and post-session tests comprised of the same multiple-choice questions that were derived from chapters on pain within licensure exam preparatory books. Additionally, students completed a survey after the group concept mapping session that assessed their thoughts on concept mapping. FINDINGS: Most students (92%) reported that concept mapping was an effective approach to learning, though there was not a statistically significant improvement in scores on the multiple-choice test. More than half (55%) of the students indicated the greatest gain in individual learning when actively discussing pain treatment related concepts amongst their group during concept map creation. Over 40% of students identified misconceptions related to pain management. SUMMARY: Using group concept mapping as a framework for discussions led to student integration of both concrete and abstract patient care concepts with individualized awareness of learning.


Assuntos
Formação de Conceito , Processos Grupais , Assistência Farmacêutica/normas , Educação em Farmácia/métodos , Avaliação Educacional/métodos , Humanos , Assistência Farmacêutica/tendências , Aprendizagem Baseada em Problemas/métodos , Avaliação de Programas e Projetos de Saúde/métodos , Inquéritos e Questionários
19.
BMC Health Serv Res ; 18(1): 934, 2018 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-30514376

RESUMO

BACKGROUND: Access to quality hypertension care is often poor in sub-Saharan Africa. Some community pharmacies offer hypertension monitoring services, with and without involvement of medical doctors. To directly connect pharmacy staff and cardiologists a care model including a mobile application (mHealth) for remote patient monitoring was implemented and pilot tested in Lagos, Nigeria. Pharmacists provided blood pressure measurements and counselling. Cardiologists enrolled patients in the pilot program and remotely monitored them, for which patients paid a monthly fee. We evaluated the feasibility of this care model at five private community pharmacies. Outcome measures were retention in care, blood pressure change, quality of care, and patients' and healthcare providers' satisfaction with the care model. METHODS: Patients participated in the care model's pilot at one of the five pharmacies for approximately 6-8 months from February 2016. We conducted structured patient interviews and blood pressure measurements at pilot entry and exit, and used exports of the mHealth-application, in-depth interviews and focus group discussions with patients, pharmacists and cardiologists. RESULTS: Of 336 enrolled patients, 236 (72%) were interviewed at pilot entry and exit. According to the mHealth data 71% returned to the pharmacy after enrollment, with 3.3 months (IQR: 2.2-5.4) median duration of activity in the mHealth-application. Patients self-reported more visits than recorded in the mHealth data. Pharmacists mentioned use of paper records, understaffing, the application not being user-friendly, and patients' unwillingness to pay as reasons for underreporting. Mean systolic blood pressure decreased 9.9 mmHg (SD: 18). Blood pressure on target increased from 24 to 56% and an additional 10% had an improved blood pressure at endline, however this was not associated with duration of mHealth activity. Patients were satisfied because of accessibility, attention, adherence and information provision. CONCLUSION: Patients, pharmacists and cardiologists adopted the care model, albeit with gaps in mHealth data. Most patients were satisfied, and their mean blood pressure significantly reduced. Usage of the mHealth application, pharmacy incentives, and a modified financing model are opportunities for improvement. In addition, costs of implementation and availability of involved healthcare providers need to be investigated before such a care model can be further implemented.


Assuntos
Hipertensão/tratamento farmacológico , Assistência Farmacêutica/normas , Telemedicina/normas , Atitude do Pessoal de Saúde , Pressão Sanguínea/fisiologia , Determinação da Pressão Arterial , Utilização de Instalações e Serviços , Estudos de Viabilidade , Feminino , Grupos Focais , Gastos em Saúde , Pessoal de Saúde , Humanos , Hipertensão/economia , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Aplicativos Móveis/estatística & dados numéricos , Nigéria , Satisfação do Paciente , Assistência Farmacêutica/economia , Assistência Farmacêutica/estatística & dados numéricos , Farmácias/economia , Farmácias/estatística & dados numéricos , Farmacêuticos , Médicos , Projetos Piloto , Estudos Prospectivos , Autorrelato , Telemedicina/economia , Telemedicina/estatística & dados numéricos
20.
BMC Health Serv Res ; 18(1): 884, 2018 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-30466436

RESUMO

BACKGROUND: Medication errors have been the largest component of medical errors threatening patient safety worldwide. Several international health bodies advocate measuring safety culture within healthcare organizations as an effective strategy for sustainable safety improvement. To the best of our knowledge, this is the first study conducted in a Middle Eastern country at the level of community pharmacy, to examine safety culture and to evaluate the extent to which patient safety is a strategic priority. METHODS: A descriptive cross-sectional study was conducted. The Pharmacy Survey on Patient Safety Culture (PSOPSC), developed by the Agency for Healthcare Research and Quality (AHRQ), was used to collect data. PSOPSC is a self-administered questionnaire which was previously tested for validity and reliability. The questionnaire was distributed among pharmacists who work in community pharmacies from the five governorates of Kuwait (Capital, Hawalli, Farwaniya, Jahra, and Ahmadi). The Statistical Package for Social Science (SPSS) software, version 24 was used for analysing data. RESULTS: A total of 255 community pharmacists from the five governorates were approached to participate in the study, of whom 253 returned a completed questionnaire, with the response rate of 99%. Results from the study showed that patient safety is a strategic priority in many aspects of patient safety standards at the level of community pharmacies. This was reflected by the high positive response rate (PRR) measures demonstrated in the domains of "Teamwork" (96.8%), "Organizational Learning-Continuous Improvement" (93.2%) and "Patient Counselling" (90.9%). On the other hand, the lowest PRR was given to the "Staffing, Work Pressure, and Pace" domain which scored 49.7%. CONCLUSIONS: Understanding community pharmacists' perspectives of patient safety culture within their organization is critical. It can help identify areas of strength and those that require improvement, which can help support decision about actions to improve patient safety. The current study showed that urgent attention should be given to the areas of weakness, mainly in the dimension of "Staffing, Work Pressure and Pace." The pharmacists pointed the need for adequate breaks between shifts and less distractible work environment to perform their jobs accurately.


Assuntos
Serviços Comunitários de Farmácia/normas , Segurança do Paciente , Farmacêuticos/normas , Padrões de Prática Médica/normas , Gestão da Segurança , Adulto , Idoso , Serviços Comunitários de Farmácia/organização & administração , Estudos Transversais , Assistência à Saúde , Feminino , Humanos , Kuweit , Masculino , Erros Médicos/prevenção & controle , Erros de Medicação/prevenção & controle , Pessoa de Meia-Idade , Assistência Farmacêutica/normas , Farmácias/normas , Reprodutibilidade dos Testes , Inquéritos e Questionários , Local de Trabalho/normas , Adulto Jovem
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