Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 513
Filtrar
1.
J Oncol Pharm Pract ; 26(1): 141-145, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31132937

RESUMO

INTRODUCTION: All guidelines necessitate wearing personal protective equipment during dispensing of oral anticancer drugs. This study aims to measure the degree of contamination on the press-through-package strips of oral anticancer drugs in Japan. METHOD: Surface contamination of the external packaging of anticancer drugs was examined by performing wipe tests at four hospitals and two community pharmacies. The following commercially available drugs were examined: Xeloda®, TS-1®, and methotrexate tablets and SA-1® and Rheumatrex® capsules. RESULTS: The wipe tests' results revealed that the contamination levels of Xeloda® and TS-1® tablets and SA-1® capsules were within their detection limits. In some facilities, the contamination levels on the press-through-package strips of Rheumatrex® capsules were 3.27 × 10-1, which is close to its detection limit. However, across all facilities, the contamination level of methotrexate tablets was above its detection limit. CONCLUSION: The results of this study suggested that adherence to oral anticancer drugs may not occur during manufacture or transportation. However, it may be due to the presence of pollutants in the facilities. Prevention of pollution in facilities might eliminate the need to wear personal protective equipment during dispensing of oral anticancer drugs.


Assuntos
Antineoplásicos/administração & dosagem , Contaminação de Medicamentos/prevenção & controle , Embalagem de Medicamentos/métodos , Contaminação de Equipamentos/prevenção & controle , Exposição Ocupacional/prevenção & controle , Antineoplásicos/análise , Embalagem de Medicamentos/normas , Monitoramento Ambiental/métodos , Monitoramento Ambiental/normas , Humanos , Japão/epidemiologia , Exposição Ocupacional/normas , Farmácias/normas
2.
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
3.
Medicina (Kaunas) ; 55(9)2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31454896

RESUMO

Background and objectives: Extemporaneous preparations are pharmaceutical preparations individually prepared for a specific patient or patient group, but also high-risk products accompanied by doubts regarding their safety and quality. Legislation regulating the compounding of extemporaneous preparations is not harmonized among European countries. This problem is partially resolved by Resolution CM/Res(2016)1 on quality and safety assurance requirements for medicinal products prepared in pharmacies for the special needs of patients. In order to understand the relevance of extemporaneous compounding in Latvia and the fulfillment of the abovementioned resolution's requirements, it is essential to get information about the volume and breakdown of sales of extemporaneous medicinal products in community pharmacies. The purpose of this survey is to identify the sales volume of extemporaneous preparations in community pharmacies in Latvia in 2017 by analyzing unpublished data of the State Agency of Medicines (SAM), as well as comparing Latvian laws with the requirements of the resolution. Materials and Methods: A separate Microsoft Excel spreadsheet was prepared for each statistical region in order to summarize the unpublished information of SAM on the turnover of extemporaneous preparations in 2017 in all Latvian statistical regions. In order to compare the regulatory framework in Latvia with the resolution, the Latvian Pharmaceutical Law and the Cabinet of Ministers Regulations regulating prescription, compounding and control of extemporaneous preparations in community pharmacies were analyzed. Results: Only 280 of 384 pharmacies submitted a report of sales of extemporaneous preparations for 2017 to the SAM. These pharmacies represented all Latvian statistical regions. Extemporaneous preparations were mostly sold in Riga (78.93%). The Latvian regulation does not include all paragraphs of the resolution. Most of the paragraphs of the resolution are described in Latvian regulatory enactments only partially. Conclusions: The total number of compounding pharmacies evidence that the service is needed. Latvian example highlights a necessity for European Union countries to compare their national legislation with the requirements of the resolution's last version and, if necessary, implement relevant amendments.


Assuntos
Controle de Medicamentos e Entorpecentes/tendências , Preparações Farmacêuticas/economia , Controle de Medicamentos e Entorpecentes/legislação & jurisprudência , Fidelidade a Diretrizes/normas , Humanos , Letônia , Segurança do Paciente/normas , Segurança do Paciente/estatística & dados numéricos , Preparações Farmacêuticas/normas , Farmácias/economia , Farmácias/normas , Farmácias/estatística & dados numéricos , Inquéritos e Questionários
5.
BMC Health Serv Res ; 19(1): 186, 2019 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-30898124

RESUMO

BACKGROUND: Worldwide community pharmacies are shifting their role in the healthcare system from simple medication dispensers to health care providers. High levels of satisfaction with pharmacy services were found in previous studies. This study has two main goals. The primary goal is to describe the levels of satisfaction and knowledge regarding pharmacy services in Portugal. The secondary goal is to explore the perceptions and the utilisation of pharmacy services by the Portuguese. This statement includes exploring the impact of a set of variables on both perceptions and uses of pharmacies in regard to services that are currently offered as well as to new services that may be provided in the future. METHODS: A face-to-face survey of closed-ended questions was applied to a nationwide representative sample of the Portuguese population in September 2015. The sample was weighted based on population distribution across regions, habitat, age and gender. Data analysis comprises descriptive statistics and Multiple Correspondence Analysis to explore different typologies of respondent's orientation toward community pharmacy. RESULTS: A total of 1114 interviews comprised the study. Of the respondents, 36% used the pharmacy as a first resource when seeking to treat a minor ailment, and 54% reported that they use the pharmacy as a first resource when seeking answers about medicines. Of those who visited their pharmacy at least once in the previous year, 94% were either globally satisfied or very satisfied. The level of acknowledgement of pharmacy services' was also high among the Portuguese. Of the participants, 29% considered there could be more services available in pharmacies that are currently provided by other health care facilities. The construction of a typology of orientations towards community pharmacy practice resulted in three outcome groups: "Motivated" (63%), those with a connection to a pharmacy; "Settled" (23%), mainly those who had a pharmacy nearby; and "Demobilised" (14%), those who are weakly tied to a pharmacy. CONCLUSIONS: The vast majority of the Portuguese population has a strong positive attitude towards their community pharmacy, as expressed by the high levels of satisfaction with, and positive evaluation of, the pharmacy's services.


Assuntos
Serviços Comunitários de Farmácia/normas , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Serviços Comunitários de Farmácia/estatística & dados numéricos , Assistência à Saúde/estatística & dados numéricos , Utilização de Instalações e Serviços , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Percepção , Farmácias/normas , Farmácias/estatística & dados numéricos , Portugal , Opinião Pública , Inquéritos e Questionários , Adulto Jovem
6.
Farm. comunitarios (Internet) ; 11(1): 5-13, mar. 2019. graf, tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-186868

RESUMO

Introducción: La adherencia al tratamiento en enfermedades crónicas como la diabetes mellitus (DM) es de vital importancia. El incumplimiento está directamente implicado en el aumento del número de medicamentos prescritos en enfermos crónicos y es una de las causas más importantes de fracaso de los tratamientos. Objetivos: Evaluar en la farmacia comunitaria la prevalencia de no adherencia al tratamiento en DM tipo 2 mediante la realización del cuestionario MMAS-8. Material y métodos: Estudio observacional transversal realizado en mayo y junio de 2018. Se seleccionaron pacientes mayores de 45 años, en tratamiento con hipoglucemiantes. Se midió la adherencia farmacoterapéutica mediante la administración del cuestionario (MMAS-8) según la puntuación obtenida en el test y la percepción que tienen sobre su tratamiento. Resultados: Participaron 64 pacientes, 29 (45,3%) mujeres y 35 (54,7) hombres. Las mujeres tenían 65,5 años de edad media (DE=15,3) y los hombres 65,6 años (DE=12,3). La puntuación media del test de MMAS-8 fue de 6,2±2,1, no encontrando diferencias significativas entre sexos. Se encontró que el número de pacientes con baja adherencia fueron 21 (32,8%), con media adherencia 19 (29,7%) y con alta adherencia 24 (37,5%). No se encontró relación entre el porcentaje de adherencia al tratamiento con el sexo, edad, nivel de estudios y condición laboral. La creencia de que el tratamiento mejora la enfermedad y que los medicamentos prescritos son los adecuados aumenta la adherencia. Conclusiones: El cuestionario MMAS-8 se ha mostrado como una herramienta rápida y sencilla para la evaluación de la adherencia del tratamiento en la farmacia comunitaria


Background: The treatment adherence in chronic diseases such as diabetes mellitus is of vital importance. Noncompliance is directly implicated in the increase of the prescribed drugs number in chronic patients and is one of the most important causes of treatment failure. Objectives: To evaluate in the community pharmacy the prevalence of non-adherence to treatment in type 2 diabetes mellitus by completing the MMAS-8 questionnaire. Methods: Cross-sectional observational study conducted in May and June 2018. Patients older than 45 years were selected, in treatment with hypoglycemic agents. Pharmacotherapeutic adherence was measured by administering the questionnaire (MMAS-8) according to the score obtained in the test and the perception they have of their treatment. Results: 64 patients participated, 29 (45.3%) women and 35 (54.7) men. Women ware 65.5 years of age (SD = 15.3) and men 65.6 years (SD = 12.3). The mean score of the MMAS-8 test was 6.2±2.1, not finding significant differences between sexes. It was found that the number of patients with low adherence was 21 (32.8%), with medium adherence 19 (29.7%) and with high adherence 24 (37.5%). No relation was found between the percentage of adherence to treatment with sex, age, level of education and work condition. The belief that the treatment improves the disease and that the prescribed medications are adequate, increases adherence. Conclusions: The MMAS-8 questionnaire has been shown as a quick and simple tool for evaluating the adherence of the treatment in the community pharmacy


Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Cooperação e Adesão ao Tratamento , Farmácias/normas , Hipoglicemia/tratamento farmacológico , Comercialização de Produtos , Hipertensão/epidemiologia , Farmácias/organização & administração , Inquéritos e Questionários , Percepção , Hipoglicemiantes/administração & dosagem , Estudos Transversais , Hipoglicemiantes/uso terapêutico
8.
PLoS One ; 14(2): e0211567, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30759124

RESUMO

BACKGROUND: As the burden of noncommunicable diseases grows, access to safe medical therapy is increasing in importance. The aim of this study was to develop a method for evaluating the quality of antihypertensive drugs and to examine whether this prevalence varies by socioeconomic variables. METHODS: We conducted a cross-sectional survey of registered pharmacies in 6 local government areas (LGAs) in Lagos State, Nigeria. In each LGA, we sampled 17 pharmacies from a list of all registered pharmacies derived from the Pharmacists Council of Nigeria. We assessed drug quality based on (1) the level of active pharmaceutical ingredients (APIs), which identified falsely labeled drug samples; and (2) the amount of impurities, which revealed substandard drug samples in accordance with the international pharmacopoeia guidelines. Good-quality drugs met specifications for both API and impurity. RESULTS: Of the 102 drug samples collected, 30 (29.3%) were falsely labeled, 76 (74.5%) were substandard,78 (76.5%) were of poor quality and 24 (23.5%) were of good quality.Among the falsely labeled drugs, 2 samples met standards set for purity while 28 did not. Among the 76 substandard drug samples, 28 were also falsely labeled. Of the falsely labeled drugs, 17 (56.7%) came from LGAs with low socioeconomic status, and 40 (52.6%) of the substandard drug samples came from LGAs with high socioeconomic status. Most of the good-quality drug samples, 14 (58.3%), were from LGAs with low socioeconomic status. Eighteen (60%) of the falsely labeled samples, 37 (48.7%) of the substandard samples, and 15 (62.5%) of the good-quality drug samples were from manufacturers based in Asia. The average price was 375.67 Nigerian naira (NGN) for falsely labeled drugs, 383.33 NGN for substandard drugs, and 375.67 NGN for good-quality drugs. The prevalence of falsely labeled and substandard drug samples did not differ by LGA-level socioeconomic status (P = .39) or region of manufacturer (P = .24); however, there was a trend for a difference by price (P = .06). CONCLUSION: The prevalence of falsely labeled and substandard drug samples was high in Lagos. Treatment of noncommunicable diseases in this setting will require efforts to monitor and assure drug quality.


Assuntos
Anti-Hipertensivos/normas , Nifedipino/normas , Farmácias/normas , Controle de Qualidade , Anti-Hipertensivos/uso terapêutico , Comércio , Estudos Transversais , Humanos , Nifedipino/uso terapêutico , Nigéria , Doenças não Transmissíveis/tratamento farmacológico , Fatores Socioeconômicos
9.
Endocr J ; 66(3): 233-239, 2019 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-30726787

RESUMO

This study was conducted to assess quality of counseling provided to type 2 diabetic patients. For this cross-sectional study, a simulated patient method was applied in 562 selected community pharmacies of Punjab, Pakistan. A scenario for the metformin oral therapy was developed that illustrates direct counseling for adult diabetic patients. Counseling and communication skills were also assessed. Descriptive statistics and chi-square tests were used for analysis. Only 29.4% of simulated patients received medication counseling directly; 47.6% received it on request. About 32.8% of clients were referred to a physician without counseling. The most frequently provided information was dietary instruction (94.8%) and dose of therapy (84.5%). Only one quarter (25.3%) of simulated patients were asked about disease duration and similar rate (25.0%) was found for discussions of special warnings. The side effects, drug storage, drug-drug interactions and duration of therapy were ignored. Minimal information was provided about other medication during therapy (0.2%) and effect of medicine withdrawal (2.7%). About 59.5% simulated patients were instructed for compliance to medication. Counseling to type 2 diabetic patients in Pakistani community pharmacies is not very satisfactory. Pharmacies' staff have little focus on counseling. Professional training of staff could improve counseling and communication skills.


Assuntos
Aconselhamento/normas , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Farmácias/normas , Adulto , Feminino , Pesquisas sobre Serviços de Saúde , Humanos , Masculino , Paquistão , Qualidade da Assistência à Saúde
10.
J Oncol Pharm Pract ; 25(1): 85-93, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29592766

RESUMO

PURPOSE: The primary aim was to determine if dispensing of cyclophosphamide tablets resulted in accumulated residue on pharmacy counting tools during a simulated outpatient dispensing process. Secondary objectives included determining if cyclophosphamide contamination exceeded a defined threshold level of 1 ng/cm2 and if a larger number of prescriptions dispensed resulted in increased contamination. METHODS: Mock prescriptions of 40 cyclophosphamide 50 mg tablets were counted on clean trays in three scenarios using a simulated outpatient pharmacy after assaying five cleaned trays as controls. The three scenarios consisted of five simulated dispensings of one, three, or six prescriptions dispensed per scenario. Wipe samples of trays and spatulas were collected and assayed for all trays, including the five clean trays used as controls. Contamination was defined as an assayed cyclophosphamide level at or above 0.001 ng/cm2 and levels above 1 ng/cm2 were considered sufficient to cause risk of human uptake. Mean contamination for each scenario was calculated and compared using one-way analysis of variance. P-values of < 0.05 implied significance. RESULTS: Mean cyclophosphamide contamination on trays used to count one, three, and six cyclophosphamide prescriptions was 0.51 ± 0.10 (p=0.0003), 1.02 ± 0.10 (p < 0.0001), and 1.82 ± 0.10 ng/cm2 (p < 0.0001), respectively. Control trays did not show detectable cyclophosphamide contamination. Increasing the number of prescriptions dispensed from 1 to 3, 1 to 6, and 3 to 6 counts increased contamination by 0.51 ± 0.15 (p = 0.0140), 1.31 + 0.15 (p < 0.0001), and 0.80 ± 0.15 ng/cm2 (p = 0.0004), respectively. CONCLUSION: Dispensing one or more prescriptions of 40 cyclophosphamide 50 mg tablets contaminates pharmacy counting tools, and an increased number of prescriptions dispensed correlates with increased level of contamination. Counting out three or more prescriptions leads to trays having contamination that surpasses the threshold at which worker exposure may be increased. Pharmacies should consider devoting a separate tray to cyclophosphamide tablets, as cross-contamination could occur with other drugs and the efficacy of decontamination methods is unclear. Employee exposure could be minimized with the use of personal protective equipment, environmental controls, and cleaning trays between uses. Future investigation should assess the extent of drug powder dispersion, the effects of various cleaning methods, and the potential extent of contamination with different oral cytotoxic drugs.


Assuntos
Ciclofosfamida , Contaminação de Medicamentos/prevenção & controle , Contaminação de Equipamentos/prevenção & controle , Exposição Ocupacional , Farmácias/normas , Ciclofosfamida/efeitos adversos , Ciclofosfamida/análise , Descontaminação/métodos , Descontaminação/normas , Monitoramento Ambiental/métodos , Humanos , Determinação de Necessidades de Cuidados de Saúde , Exposição Ocupacional/análise , Exposição Ocupacional/prevenção & controle , Assistência Farmacêutica/organização & administração , Melhoria de Qualidade
11.
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
12.
J Oncol Pharm Pract ; 25(1): 172-178, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28942722

RESUMO

BACKGROUND AND OBJECTIVES: Current productivity assessment models lack the ability to measure the quality of pharmacy services through workload validation. The goal of our efforts was to create a model to more accurately assess workload at multiple outpatient infusion centers. METHOD: Current procedural terminology codes were identified as representative of the key drivers of pharmacy workload. Fourteen current procedural terminology codes representing medication orders were selected and categorized into eight distinctive groups associated with varying amounts of pharmacy workload. A three-month average of current procedural terminology volumes were calculated and used to create a workload baseline. RESULTS: Our study found a usable productivity assessment and coefficient to compare relevant clinical workload across outpatient oncology sites. The current procedural terminology codes were readily retrievable from our system electronic medical record. By assigning activities, e.g. clinical review, verification, barcoding, batch preparation, we were able to compute a workload and then adjust staffing to achieve a median coefficient across sites. DISCUSSION: This study evaluated the use of administration current procedural terminology codes for an outpatient oncology productivity model. Based upon our analysis, it can be successfully used to determine workload for pharmacists and technicians across variable locations. We believe it is the first study to demonstrate a productivity model for this setting.


Assuntos
Assistência Ambulatorial/normas , Antineoplásicos/administração & dosagem , Benchmarking/normas , Farmacêuticos/normas , Serviço de Farmácia Hospitalar/normas , Carga de Trabalho/normas , Assistência Ambulatorial/métodos , Instituições de Assistência Ambulatorial/normas , Benchmarking/métodos , Humanos , Infusões Intravenosas , Farmácias/normas , Serviço de Farmácia Hospitalar/métodos
13.
BMC Health Serv Res ; 18(1): 874, 2018 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-30458844

RESUMO

BACKGROUND: An interprofessional medication adherence program (IMAP) for chronic patients was developed and successfully implemented in the community pharmacy of the Department of ambulatory care and community medicine (Lausanne, Switzerland). This study assesses the capacity of a physician and a nurse at the infectious diseases service of a public hospital and of community pharmacists in the Neuchâtel area (Switzerland) to implement the IMAP in their practice. METHODS: Mixed method, prospective, observational study. Quantitative and qualitative analyses of the implementation process were conducted following the RE-AIM model (reach, effectiveness, adoption, implementation and maintenance). RESULTS: Implementation started in November 2014. One physician, one nurse, and five pharmacists agreed to participate. Healthcare professionals perceived the benefits of the program and were motivated to implement it in their practice (adoption). Seventeen patients were included in the program; 13 refused to participate. The inclusion of naïve HIV patients was easier than the inclusion of experienced patients with difficult psychosocial issues (reach). Pharmacists were engaged in reinforcing patient medication adherence in 25% of interviews (effectiveness). Key facilitators expressed by healthcare professionals were patient inclusion by the physician and the nurse instead of the pharmacist and the organisation of regular meetings between all stakeholders. In contrast, the encountered barriers were the lack of time and resources, the lack of team uptake, and the lack of adoption by senior managers (implementation). Interviewed patients were all satisfied with this new program, encouraging healthcare professionals to scale it up. Structural changes allowed the hospital and one pharmacy to enter the maintenance stage (maintenance). CONCLUSION: The research team and collaboration between all professionals involved played an important role in this implementation. However, the dissemination of such a program to a larger scale and for the long term requires financial and structural resources as well as transitional external support.


Assuntos
Infecções por HIV/tratamento farmacológico , Adesão à Medicação , Assistência Ambulatorial/normas , Atitude do Pessoal de Saúde , Competência Clínica/normas , Serviços Comunitários de Farmácia/normas , Feminino , Infecções por HIV/enfermagem , Pessoal de Saúde/normas , Recursos em Saúde/normas , Hospitais Públicos , Humanos , Relações Interprofissionais , Masculino , Enfermeiros de Saúde Comunitária/normas , Percepção , Farmácias/normas , Farmacêuticos/normas , Médicos/normas , Estudos Prospectivos , Suíça
14.
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
15.
Int J Pharm Compd ; 22(5): 387-398, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30384337

RESUMO

The individual attention devoted to preparing customized medications is the cornerstone of pharmaceutical compounding. Providing that level of care, however, entails exposure to drugs, airborne particulates, and fumes or vapors that can jeopardize the health of pharmacy staff and customers in the store. The responsibility of supplying protection against compounding-related contamination falls to the pharmacy owner, and the selection, use, and maintenance of compounding enclosures are essential to ensuring that safety. In this article, we discuss various types of those enclosures and their proper use in a variety of compounding settings. Figures and a Table describing models of interest to compounders are also presented. It is our hope that this information will provide a better understanding of the role of this essential equipment as a safeguard against exposure to airborne contaminants.


Assuntos
Poluição do Ar em Ambientes Fechados/prevenção & controle , Composição de Medicamentos/normas , Exposição Ocupacional/prevenção & controle , Humanos , Farmácias/normas , Ventilação/instrumentação
17.
Am J Pharm Educ ; 82(7): 6806, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30323395

RESUMO

The first tenet of the Code of Ethics for Pharmacists of the American Pharmacists Association describes the relationship between the pharmacist and the patient as a covenant. The central argument of this commentary is that the symbolic language of covenant, the metaphor used to describe the pharmacist-patient relationship, should be formally acknowledged as an ideal theory or concept. However, before committing to this ideal, there should be resonance with the realities of pharmacy practice. This commentary argues that the intimate nature of a covenantal relationship is not a good fit with most contexts in which pharmacists practice. The disconnection between the ideal of the covenantal relationship and context is important because codes of ethics apply regardless of context. By acknowledging the ideal of a covenantal relationship, transitional structures could then be developed to move the pharmacy profession toward this ideal.


Assuntos
Relações Profissional-Paciente , Educação em Farmácia/normas , Humanos , Assistência Farmacêutica/normas , Farmácias/normas , Farmacêuticos/psicologia , Papel Profissional/psicologia , Estados Unidos
18.
J Am Pharm Assoc (2003) ; 58(6): 652-658, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30170967

RESUMO

OBJECTIVE: The purpose of this study was to design, pilot, and evaluate a community "tech-check-tech" (TCT) program as a strategy for pharmacy practice advancement. SETTING: Community pharmacy with both mail order and outpatient pharmacy services. PRACTICE DESCRIPTION: The policies, technician training requirements, prescription eligibility requirements, and quality assurance measures necessary for the pilot were developed. The TCT workflows and procedures were integrated into the existing prescription dispensing framework at a pilot site. An analysis of pharmacist and technician checking accuracy was conducted with a 4-week data collection period for each role. To determine TCT technician accuracy, the TCT technician performed the first product verification check after the prescription was filled by a pharmacy staff member. If the TCT technician found an error, they documented the error and returned the prescription to the filling technician for correction. If the prescription was filled correctly, the TCT technician passed the prescription to a pharmacist for final verification. The pharmacist documented any incorrect prescriptions that the TCT technician verified. Pharmacist accuracy was measured through direct pharmacist observation. Direct observation was also used to measure and record pharmacist and technician prescription checking time. The data were then used to evaluate pharmacist time savings as a result of community TCT, while ensuring prescription dispensing accuracy. PRACTICE INNOVATION: TCT was piloted in a community pharmacy. EVALUATION: An analysis of pharmacist and technician checking accuracy was conducted with a 4-week data collection period for each role. To determine TCT technician accuracy, the TCT technician performed the first product verification check after the prescription was filled by pharmacy staff. If the TCT technician found an error, they documented the error and returned the prescription to the filling technician for correction. If filled correctly, the TCT technician passed the prescription to a pharmacist for final verification. The pharmacist documented any incorrect prescriptions that the TCT technician verified. Pharmacist accuracy was measured through direct pharmacist observation. Direct observation was also used to measure and record pharmacist and technician prescription checking time. This data was then used to evaluate pharmacist time savings as a result of community TCT, while ensuring prescription dispensing accuracy. RESULTS: A TCT workflow was piloted successfully in the community pharmacy setting. Technicians were at least as accurate as pharmacists, as validated with statistical analysis (99.95% [95% CI 99.89%-99.99%] versus 99.74% [95% CI 99.61%-99.87%]), and patient safety was maintained. Time studies allowed for the quantification of potential pharmacist time savings (23 days per year) resulting from the implementation of a community TCT program. CONCLUSION: This study demonstrates the feasibility of a TCT program in the community pharmacy setting.


Assuntos
Serviços Comunitários de Farmácia/normas , Técnicos em Farmácia/normas , Humanos , Erros de Medicação/prevenção & controle , Pacientes Ambulatoriais , Farmácias/normas , Farmacêuticos/normas , Farmácia/normas , Prescrições/normas , Papel Profissional , Fluxo de Trabalho
19.
Eur J Gen Pract ; 24(1): 223-228, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30257115

RESUMO

BACKGROUND: The incidence of anaphylaxis appears to be increasing worldwide with cases in the community outnumbering those in the hospital setting. General practice (GP) surgeries and pharmacies, based in the community, are often the first point of contact for many patients suffering from anaphylaxis. OBJECTIVES: To determine if studied GP surgeries and pharmacies have an anaphylaxis protocol on site and have access to an anaphylaxis kit; to explore GP's and pharmacists' personal experiences with management of anaphylaxis. METHODS: A cross-sectional, questionnaire-based study was performed examining anaphylaxis protocols in a sample of general practices and pharmacies from some counties in Ireland. This consisted of a sample from rural and urban settings. The study commenced in October 2014. RESULTS: Nineteen of 24 GPs (79%) and 9 (29%) pharmacies had an anaphylaxis protocol (P < 0.001). Twenty-four (100%) GP practices and 12 pharmacies (39%) surveyed had an anaphylaxis kit on site. Twelve GPs (50%) had treated a patient with anaphylaxis in the surgery while 8 (33%) had treated a patient in the community. One pharmacist (3%) had witnessed anaphylaxis in practice. Two pharmacies and one GP had been contacted by local businesses to alert them to a case of anaphylaxis. CONCLUSION: In contrast to national and international guidelines only 79% of GPs and 29% of pharmacies in this study from Ireland had an anaphylaxis protocol onsite.


Assuntos
Anafilaxia/tratamento farmacológico , Medicina Geral/normas , Farmácias/normas , Serviços de Saúde Rural/normas , Serviços Urbanos de Saúde/normas , Clorfeniramina/provisão & distribução , Protocolos Clínicos , Estudos Transversais , Tratamento de Emergência , Epinefrina/provisão & distribução , Feminino , Medicina Geral/instrumentação , Humanos , Irlanda , Masculino , Guias de Prática Clínica como Assunto , Esteroides/provisão & distribução , Inquéritos e Questionários
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA