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1.
Res Social Adm Pharm ; 16(4): 583-586, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32081569

RESUMO

The 2019-nCoV infection that is caused by a novel strain of coronavirus was first detected in China in the end of December 2019 and declared a public health emergency of international concern by the World Health Organization on January 30, 2020. Community pharmacists in one of the first areas that had confirmed cases of the viral infection, Macau, joined the collaborative force in supporting the local health emergency preparedness and response arrangements. This paper aimed to improve the understanding of community pharmacists' role in case of 2019-CoV outbreak based on the practical experiences in consultation with the recommendations made by the International Pharmaceutical Federation on the Coronavirus 2019-nCoV outbreak.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Máscaras/provisão & distribução , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle , Saúde Pública , Betacoronavirus , Surtos de Doenças , Emergências , Monitoramento Epidemiológico , Humanos , Higiene , Macau/epidemiologia , Educação de Pacientes como Assunto , Farmacêuticos
2.
BMC Health Serv Res ; 20(1): 99, 2020 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-32041591

RESUMO

BACKGROUND: People transitioning from hospital- to community-based care are at increased risk of experiencing medication problems that can lead to adverse drug events and poor health outcomes. Community pharmacists provide medication expertise and support during care transitions yet are not routinely included in communications between hospitals and other primary health care providers. The PhaRmacy COMmunication ParTnership (PROMPT) intervention facilitates medication management by optimizing information sharing between pharmacists across care settings. This developmental evaluation sought to assess the feasibility and acceptability of implementing the PROMPT intervention, and to explore how contextual factors influenced its implementation. METHODS: PROMPT was implemented for 14 weeks (January-April, 2018) in the general internal medicine units at two teaching hospitals in Toronto, Canada. PROMPT featured two contact points between hospital and community pharmacists around patient discharge: (1) faxing an enhanced discharge prescription and discharge summary to a patient's community pharmacy and (2) a follow-up phone call from the hospital pharmacist to the community pharmacist. Our mixed-method evaluation involved electronic patient records, process measures using tracking forms, telephone surveys and semi-structured interviews with participating community and hospital pharmacists. RESULTS: The intervention involved 45 patients with communication between 12 hospital and 45 community pharmacists. Overall, the intervention had challenges with feasibility. Issues with fidelity included challenges with the medical discharge summary being available at the time of faxing and hospital pharmacists' difficulties with incorporating novel elements of the program into their existing practices. However, both community and hospital pharmacists recognized the potential benefits to patient care that PROMPT offered, and both groups proposed recommendations for further improvements. Suggestions included enhancing hospital staffing and resources. CONCLUSION: Improving intraprofessional collaboration, through interventions such as PROMPT, positions pharmacists as leaders of medication management services across care settings and has the potential to improve patient care; however, more co-design work is needed to enhance the intervention and its fidelity.


Assuntos
Comunicação , Serviços Comunitários de Farmácia/organização & administração , Relações Interprofissionais , Farmacêuticos/psicologia , Serviço de Farmácia Hospitalar/organização & administração , Cuidado Transicional/organização & administração , Idoso , Idoso de 80 Anos ou mais , Canadá , Feminino , Pesquisa sobre Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Pesquisa Qualitativa , Inquéritos e Questionários
3.
Pharm. pract. (Granada, Internet) ; 17(3): 0-0, jul.-sept. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-188112

RESUMO

Background: Skin cancer incidence is increasing alarmingly, despite current efforts trying to improve its early detection. Community pharmacists have proven success in implementing screening protocols for a number of diseases because of their skills and easy access. Objective: To evaluate the prevalence of skin cancer risk factors and the photoprotection habits with a questionnaire in community pharmacy users. Methods: A research group consisting of pharmacists and dermatologists conducted a descriptive cross-sectional study to assess photoprotection habits and skin cancer risk factors by using a validated questionnaire in 218 community pharmacies in Barcelona from May 23rd to June 13th 2016. All participants received health education on photoprotection and skin cancer prevention. Patients with ≥1 skin cancer risk factor were referred to their physician, as they needed further screening of skin cancer. Results: A total of 5,530 participants were evaluated. Of those, only 20.2% participants had received a total body skin examination for skin cancer screening in the past by a physician and 57.1% reported using a SPF 50+ sunscreen. 53.9% participants presented ≥1 skin cancer risk factor: 11.8% participants reported having skin cancer familial history and 6.2% reported skin cancer personal history; pharmacists found ≥10 melanocytic nevi in 43.8% participants and chronically sun-damaged skin in 21.4%. Lesions suspicious for melanoma were reported in 10.9% of the participants and urgent dermatological evaluation was recommended. Conclusions: Pharmacists can detect people with skin cancer risk factors amongst their users. This intervention can be considered in multidisciplinary strategies of skin cancer screening


No disponible


Assuntos
Humanos , Serviços Comunitários de Farmácia/organização & administração , Neoplasias Cutâneas/epidemiologia , Proteção Radiológica/estatística & dados numéricos , Protetores Solares/farmacocinética , Radiação Solar/efeitos adversos , Detecção Precoce de Câncer/métodos , Estudos Transversais , Fatores de Risco , Variação Biológica da População
4.
Am J Health Syst Pharm ; 76(14): 1079-1085, 2019 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-31415687

RESUMO

PURPOSE: To describe the development of a collaborative community-academic postgraduate year 1 pharmacy residency program in San Diego that provides a hybrid experience of opportunities in community practice, ambulatory care, and teaching. SUMMARY: Residency training programs are being developed to better match the evolving role of the community pharmacist. In 2016, the University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences partnered with Ralphs Pharmacy, a division of the Kroger Co., to launch a 1-year community residency to develop community-based pharmacists with diverse patient care, leadership, and education skills. Learning experiences include pharmacy operations, clinical services focusing on chronic disease management and education, teaching, and practice-based research. Training settings include community pharmacy, corporate pharmacy, ambulatory care, and academia. Graduates are prepared to work in these settings as well as capitalize on advanced training opportunities, including postgraduate year 2 residencies and professional certifications. The program has been successfully accredited, and graduates have completed the program: one completed a postgraduate year 2 residency, and both have obtained a management or clinical pharmacist position. CONCLUSION: An innovative community-academic residency program preparing postgraduate year 1 learners for careers in community-based pharmacy, corporate, ambulatory care, and academic settings was developed, with positive preliminary outcomes.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Educação de Pós-Graduação em Farmácia/organização & administração , Residências em Farmácia/organização & administração , Desenvolvimento de Programas , Universidades/organização & administração , Acreditação , California , Centros Comunitários de Saúde/organização & administração , Humanos , Colaboração Intersetorial , Aprendizagem , Farmacêuticos , Corporações Profissionais/organização & administração , Ensino
5.
J Manag Care Spec Pharm ; 25(9): 995-1000, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31456493

RESUMO

The shift to a value-based health care system has incentivized providers to implement strategies that improve population health outcomes while minimizing downstream costs. Given their accessibility and expanded clinical care models, community pharmacists are well positioned to join interdisciplinary care teams to advance efforts in effectively managing the health of populations. In this Viewpoints article, we discuss the expanded role of community pharmacists and potential barriers limiting the uptake of these services. We then explore strategies to integrate, leverage, and sustain these services in a value-based economy. Although community pharmacists have great potential to improve population health outcomes because of their accessibility and clinical interventions that have demonstrated improved outcomes, pharmacists are not recognized as merit-based incentive eligible providers and, as a result, may be underutilized in this role. Additional barriers include lack of formal billing codes, which limits patient access to services such as hormonal contraception; fragmentation of Medicare, which prevents alignment of medical and pharmaceutical costs; and continued fee-for-service payment models, which do not incentivize quality. Despite these barriers, there are several opportunities for continued pharmacist involvement in new care models such as patient-centered medical homes (PCMH), accountable care organizations, and other value-based payment models. Community pharmacists integrated within PCMHs have demonstrated improved hemoglobin A1c, blood pressure control, and immunization rates. Likewise, other integrated, value-based models that used community pharmacists to provide medication therapy management services have reported a positive return on investment in overall health care costs. To uphold these efforts and effectively leverage community pharmacist services, we recommend the following: (a) recognition of pharmacists as providers to facilitate full participation in performance-based models, (b) increased integration of pharmacists in emerging delivery and payment models with rapid cycle testing to further clarify the role and value of pharmacists, and (c) enhanced collaborative relationships between pharmacists and other providers to improve interdisciplinary care. DISCLOSURES: This article was funded by the National Association of Chain Drug Stores. The authors have no potential conflicts of interest to report.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Serviços Comunitários de Farmácia/normas , Conduta do Tratamento Medicamentoso/organização & administração , Conduta do Tratamento Medicamentoso/normas , Farmacêuticos/organização & administração , Farmacêuticos/normas , Organizações de Assistência Responsáveis/organização & administração , Organizações de Assistência Responsáveis/normas , Redução de Custos/normas , Planos de Pagamento por Serviço Prestado/normas , Custos de Cuidados de Saúde/normas , Humanos , Medicare/organização & administração , Medicare/normas , Equipe de Assistência ao Paciente/organização & administração , Equipe de Assistência ao Paciente/normas , Atenção Primária à Saúde/organização & administração , Atenção Primária à Saúde/normas , Papel Profissional , Estados Unidos
6.
Am J Health Syst Pharm ; 76(6): 360-365, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-31361840

RESUMO

PURPOSE: This study evaluated employee perceptions of safety culture in 9 health-system-owned community pharmacies using a safety culture survey before and after implementation of a Pharmacy Services Call Center (PSCC) designed to reduce distractions through reduction of phone volume related to refills and prescription readiness. METHODS: The Agency for Healthcare Research and Quality (AHRQ) Community Pharmacy Survey on Patient Safety Culture (CPSPSC) was used to collect employee safety culture perceptions pre-post PSCC implementation. A percent positive score (PPS) was calculated for each of 11 CPSPSC composite questions and for 1 overall rating of patient safety question based on AHRQ-suggested analytic procedures. Pre-post PSCC implementation, PPSs were compared using a chi-square test. RESULTS: Overall, the lowest composite PPS (Staffing, Work Pressure, and Pace) and the highest composite PPS (Patient Counseling) ranked the same in both survey periods. Of the nine PSCC pharmacies, statistically significant (p < 0.05) PPS improvements occurred in 4 composites including Teamwork (11.9%), Communication About Mistakes (18%), Staff Training and Skills (20.6%), and Staffing, Work Pressure, and Pace (11.8%). PSCC pharmacies also reported a 9.3% (NS) improvement in overall rating of pharmacy patient safety post PSCC implementation. Separate analysis of pharmacist responses was consistent with pharmacy level results, but technician results differed slightly in overall rating of safety perceptions. CONCLUSION: Presence of the PSCC appeared to increase pharmacy employees' perceptions of safety culture in the community pharmacies, an integral part of overall patient safety.


Assuntos
Atitude do Pessoal de Saúde , Call Centers/organização & administração , Serviços Comunitários de Farmácia/organização & administração , Segurança do Paciente , Gestão da Segurança , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Aconselhamento/organização & administração , Implementação de Plano de Saúde , Humanos , Erros de Medicação/prevenção & controle , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Técnicos em Farmácia/psicologia , Técnicos em Farmácia/estatística & dados numéricos , Avaliação de Programas e Projetos de Saúde , Inquéritos e Questionários/estatística & dados numéricos , Estados Unidos , United States Agency for Healthcare Research and Quality , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
7.
Am J Health Syst Pharm ; 76(6): 353-359, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-31361842

RESUMO

PURPOSE: The process and methods used in an impact assessment of a centralized pharmacy call center on community pharmacy employee patient safety climate perceptions, telephone distractions/interruptions, and prescription filling efficiency are described. SUMMARY: A broad-based team designed a multi-faceted, pre-post call center implementation analysis that included multiple change assessment measures. First, yearly administration of the Agency for Healthcare Research and Quality Community Pharmacy Survey on Patient Safety Culture was used to assess patient safety climate based on employee perceptions of a safe working environment and potential for errors due to interruptions and distractions. Evaluative measures of staff workload that assessed telephone interference with prescription filling activities pre and 3 months post implementation included (1) the NASA Task Load Index, (2) multi-tasking observations through shadowing of pharmacists and technicians to count number of interruptions/distractions per prescription "touched," and (3) self-reported work sampling to assess proportional time estimates of clinical, professional, and technical activities. Finally, pharmacy efficiency and prescription filling capacity were assessed using operational measures (prescriptions filled, patients served, phone call volume changes, prescription rework counting). Data analysis included summary statistics, Student's t-test, and chi-square analysis, as appropriate, in addition to assessing convergence and agreement among measures. Every evaluative method showed a positive outcome from call center implementation, although individual pharmacies may have accrued greater benefit from call reduction than others. CONCLUSION: Multiple analysis methods can be used to evaluate the impact of workflow changes.


Assuntos
Call Centers/organização & administração , Serviços Comunitários de Farmácia/organização & administração , Erros de Medicação/prevenção & controle , Segurança do Paciente , Centros Médicos Acadêmicos/organização & administração , Centros Médicos Acadêmicos/estatística & dados numéricos , Serviços Comunitários de Farmácia/estatística & dados numéricos , Prescrições de Medicamentos/estatística & dados numéricos , Eficiência Organizacional/estatística & dados numéricos , Implementação de Plano de Saúde , Humanos , Auditoria Administrativa/estatística & dados numéricos , Comportamento Multitarefa , Farmacêuticos/organização & administração , Farmacêuticos/psicologia , Farmacêuticos/estatística & dados numéricos , Técnicos em Farmácia/organização & administração , Técnicos em Farmácia/psicologia , Técnicos em Farmácia/estatística & dados numéricos , Papel Profissional/psicologia , Avaliação de Programas e Projetos de Saúde , Gestão da Segurança/organização & administração , Inquéritos e Questionários/estatística & dados numéricos , Telefone , Estados Unidos , United States Agency for Healthcare Research and Quality , Carga de Trabalho/psicologia , Carga de Trabalho/estatística & dados numéricos
8.
Am J Health Syst Pharm ; 76(13): 980-990, 2019 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-31361883

RESUMO

PURPOSE: Complementary health approaches including the use of dietary supplements (DS) such as vitamin, mineral, nutritional, and herbal supplements are popular in the United States. Beyond a statement issued by the American Society of Health-System Pharmacists (ASHP) in 2004, knowledge about the role of pharmacists related to DS use is largely unknown. The objectives of this study were to identify pharmacists' and other key stakeholders' perceptions and opinions about assuming roles that ensure the appropriate and safe use of DS. METHODS: A grounded theory approach involving in-depth, semi-structured key informant audio-recorded phone interviews with 12 practicing pharmacists and 10 key stakeholders were conducted. Key themes were identified using open coding, grouping, and categorizing. RESULTS: Participants believed the majority of their patients self-select and purchase DS from a pharmacy, often in conjunction with conventional medicines, and reported concerns about the regulatory standards, efficacy, and safety of DS. Despite acknowledging their ethical and professional responsibilities regarding DS, as identified by the ASHP statement and other sources, the majority of pharmacists are not expecting their profession to adopt these in the near future because of multiple barriers. CONCLUSIONS: There is a substantial disconnect between awareness of DS use and pharmacists adopting professional responsibilities regarding DS. The barriers identified are multifaceted, indicating the need for a joint effort from key stakeholders in developing a coordinated approach to supporting pharmacists in their practice efforts to ensure the appropriate and safe use of DS.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Suplementos Nutricionais/efeitos adversos , Educação de Pacientes como Assunto/organização & administração , Farmacêuticos/organização & administração , Papel Profissional , Atitude do Pessoal de Saúde , Comportamento do Consumidor , Estudos Transversais , Feminino , Teoria Fundamentada , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Farmacêuticos/psicologia , Participação dos Interessados , Estados Unidos
10.
Am J Health Syst Pharm ; 76(15): 1150-1157, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31201774

RESUMO

PURPOSE: The development and dissemination of a specialty pharmacy service to optimize fingolimod therapy management are described. SUMMARY: Fingolimod was the first oral therapy developed to counter relapsing-remitting multiple sclerosis. Pharmacovigilance measures and individualized support are strongly recommended due to associated safety concerns. The Fingolimod Patient Support Program (F-PSP) was developed and disseminated within a community pharmacy network. The F-PSP aims to ensure responsible use of fingolimod and patient empowerment by promoting medication adherence and patient safety through a person-centered and integrated care approach. It complements basic pharmacy services through 2 interventions: medication adherence support and pharmacovigilance tailored to fingolimod. The adherence intervention combines motivational interviewing with longitudinal electronic medication adherence monitoring. The pharmacovigilance component consists of informing patients of fingolimod recommendations, reminding patients of recommended medical tests, and tracking and monitoring symptoms, especially those of potential serious adverse fingolimod reactions. A secure Web platform guides the pharmacist in conducting interviews and enables collection of patient-reported outcome data. A transition care pharmacist proposes program participation to all patients initiated on fingolimod, performs enrollment, and coordinates transfers to patient-designated community pharmacies for ongoing care. CONCLUSION: The F-PSP enables support of individual patients, and also provides real-world data, helping to bridge the gap between practice and research. The F-PSP is intended to be a generic model of a specialty pharmacy service that is transferable to any other healthcare context, specialty drug or disease.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Cloridrato de Fingolimode/uso terapêutico , Conduta do Tratamento Medicamentoso/organização & administração , Esclerose Múltipla Recidivante-Remitente/tratamento farmacológico , Transferência de Pacientes/organização & administração , Administração Oral , Redes Comunitárias/organização & administração , Prestação Integrada de Cuidados de Saúde/organização & administração , Feminino , Humanos , Adesão à Medicação/psicologia , Entrevista Motivacional , Educação de Pacientes como Assunto , Segurança do Paciente , Farmacêuticos/organização & administração , Farmacovigilância , Desenvolvimento de Programas , Suíça
11.
Expert Opin Drug Saf ; 18(8): 745-752, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31232612

RESUMO

Objectives: Adverse drug reactions (ADRs) are a pervasive global problem, and its management is integral to patient safety and healthcare quality. Pharmacists play a pivotal role in monitoring and reporting ADRs, which has a direct impact on patient care. The aim of this study was to identify potential factors that facilitate pharmacists in community and hospital settings to report ADRs. Methods: A cross-sectional, online survey using a validated questionnaire was administered to pharmacists working in community and hospital pharmacies in Saudi Arabia. Results: 1,717 community and 153 hospital pharmacists participated in this study. Only 10.2% and 26.8% of community and hospital pharmacists, respectively, admitted ever reporting an ADR. The most reported factors that may facilitate ADRs reporting have included ongoing improvements in therapeutic knowledge about ADRs, attending educational programs with continuous medical education credits, the seriousness of the experienced ADRs and accessibility to patients' medical profile. The impact of peers by seeing colleagues reporting ADRs and ADRs due to herbal or traditional medicine were the least important factors reported by pharmacists. Conclusion: The study identified factors that can effectively address the under-reporting of ADRs by pharmacists. A multi-stakeholder, multi-pronged approach of ADR reporting is needed to develop greater awareness of this issue among pharmacists.


Assuntos
Sistemas de Notificação de Reações Adversas a Medicamentos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Farmacêuticos/estatística & dados numéricos , Adulto , Serviços Comunitários de Farmácia/organização & administração , Estudos Transversais , Feminino , Humanos , Masculino , Farmacovigilância , Serviço de Farmácia Hospitalar/organização & administração , Papel Profissional , Arábia Saudita , Inquéritos e Questionários
12.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184673

RESUMO

Objectives: To describe the drug therapy problems (DTPs) identified for patients enrolled in an Appointment Based Model (ABM) for medication synchronization, describe the pharmacist-delivered clinical interventions, and assess what patient characteristics are associated with the number of DTPs identified. Methods: A cross-sectional chart review of 1 month of pharmacist notes for telephone ABM encounters at one independent community pharmacy in the Midwest U.S. was performed for a systematic random sample of patients active in the program during September 2017. Included patients were 18 years and older and took one or more synchronized medications. Data included months in the program, gender, age, insurance type, refill interval, medications (synchronized and total), DTP category, and intervention category. Descriptive statistics were calculated, and a multiple linear regression tested the association between patient characteristics and the number of DTPs identified. Results: The study involved 209 subjects, 54% women, with a mean age of 69.5 years and. The average number of medications synchronized was 4.7, the mean total number of medications was 6.3, and mean length of time in the program was 20 months. The DTPs (n=334) identified included needs additional drug therapy (43.1%), inappropriate adherence (31.4%), unnecessary drug therapy (15.0%), and adverse drug reaction (9.6%). The regression showed age and number of medications was positively associated with number of DTPs identified, but months enrolled was not. Conclusions: This ABM approach identified several hundred DTPs with corresponding interventions within a one-month period, suggesting that ABMs have a significant potential to improve patient care. The data also suggest that pharmacist interventions within an ABM program are valuable beyond the first few fills as patients move into maintenance use of their medications, especially for patients of advancing age and polypharmacy


No disponible


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Monitoramento de Medicamentos/métodos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Adesão à Medicação/estatística & dados numéricos , Terapia Diretamente Observada/métodos , Estudos Retrospectivos , Avaliação de Eficácia-Efetividade de Intervenções , Papel Profissional , Serviços Comunitários de Farmácia/organização & administração
13.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-184676

RESUMO

Objectives: To investigate the view of the role of community pharmacy by selected stakeholders in local Danish communities. Methods: A mixed method approach combining qualitative and quantitative methods was used: observations at pharmacies, questionnaires for pharmacy staff and customers, and interviews with pharmacy owners, general practitioners (GPs) and politicians. Role theory was the theoretical foundation. Data was analyzed using directed content analysis and descriptive statistics. Results: Five Danish towns were visited, resulting in five pharmacist interviews, 48 questionnaire replies from pharmacy staff, 59 customer interviews, three GP interviews and four interviews with local politicians. All stakeholders found the pharmacy to have a medical focus, although to a differing degree. While pharmacy staff and GPs had the greatest knowledge and expectations regarding the pharmacy staff's level of medical knowledge, local politicians had the least. Pharmacy staff wanted to take on more responsibility. Customers generally considered the pharmacy part of the healthcare sector with a high level of knowledge on medications. GPs' attitudes appeared to be related to the amount of communication between GP office and pharmacy. Local politicians interviewed did not seem to be aware of the competencies within the pharmacy, but once informed were open to using the pharmacy as an integrated part of the local healthcare system. Conclusions: There was general consensus between stakeholder groups that medicine is the main area of focus at the pharmacy. However, investigated stakeholders did not appear to be aware of the full extent of the competencies within the pharmacy, and there was a general lack of consensus about the services the pharmacy should perform. If the competencies within the pharmacy are to be fully utilized, the pharmacy must not only tell but also show the local community what they can do


No disponible


Assuntos
Humanos , Serviços Comunitários de Farmácia/organização & administração , Papel Profissional , Dinamarca/epidemiologia , Conhecimentos, Atitudes e Prática em Saúde , Percepção Social , Pesquisa sobre Serviços de Saúde , Inquéritos e Questionários/estatística & dados numéricos , Participação da Comunidade/estatística & dados numéricos
14.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184677

RESUMO

Background: Fever and pain are common conditions in the Australian healthcare setting. Whilst clinical guidelines provide important therapeutic recommendations, evidence suggests they are not always followed. Given that community pharmacy is one of the most frequently accessed primary healthcare services, it is important to understand the views and practices of community pharmacists in pain and fever. Objectives: To investigate the views and practices of Australian community pharmacists in pain and fever management, and their views on relevant clinical guidelines. Methods: A cross-sectional study of community pharmacists in Australia was conducted using a customised, anonymous, self-administered, online questionnaire between March and May 2018. To capture a broad range of demographics, pharmacists were recruited via local industry contacts and the Pharmaceutical Society newsletter, with further recruitment through snowball sampling. The main outcomes measured were pharmacists' views, practices and treatment recommendation of choice in pain and fever management, as well as views on clinical guidelines and training. Results: A total of 113 pharmacists completed the survey. In general, paracetamol (72%) was preferred as a recommendation over ibuprofen, and was the drug of choice for most mild to moderate pain and fever scenarios. Majority of pharmacists reported good knowledge of pain and fever management, however, only approximately half reported recent pain management training. Greater than 87% of pharmacists believe that clinical guidelines are useful in fever management, and 79% of pharmacists believe that following clinical guidelines is important in pain management. Conclusions: While most pharmacists recognise the importance of guidelines and demonstrated good pain and fever management, results suggests opportunities to promote additional education, upskilling, and research in this space to further optimise pain and fever management in the community


No disponible


Assuntos
Humanos , Serviços Comunitários de Farmácia/organização & administração , Febre/tratamento farmacológico , Manejo da Dor/métodos , Austrália/epidemiologia , Estudos Transversais , Antipiréticos/uso terapêutico , Analgésicos/uso terapêutico , Inquéritos e Questionários/estatística & dados numéricos , Papel Profissional
15.
Pharm. pract. (Granada, Internet) ; 17(2): 0-0, abr.-jun. 2019. tab
Artigo em Inglês | IBECS | ID: ibc-184685

RESUMO

Background: Hormonal contraceptive pills have evolved as a common form of contraception worldwide. Pharmacists play a vital role in providing safe and effective access to these medicines. In many developing countries such as the United Arab Emirates (UAE), these medicines are available to the general public without the presentation of a prescription which requires the pharmacist to shoulder responsibility by assessing and educating patients to assure their appropriate use. Objectives: To evaluate community pharmacists' current practice of dispensing and counseling on hormonal contraceptives. Methods: Simulated patient methodology was used in this study. A single simulated patient visited community pharmacies requesting an oral contraceptive as per a preplanned scenario. Information from the visits were recorded on a data collection form including: pharmacist assessing patient eligibility to take hormonal contraceptives, selecting the appropriate oral contraceptive, providing complete counseling on how to use the pill, adherence, missed dose handlings and side effects of the medication. The Pharmacist was prompted by the simulated patient to provide the information if they did not provide spontaneous counseling. The quality of pharmacists' counseling was rated and consequently coded as complete, incomplete or poor. Results: A total of 201 community pharmacies were visited. More than 92% of the pharmacists did not ask the simulated patient any question to assess their eligibility to use contraceptives. Twenty three pharmacists (11.4%) selected the proper product. One hundred seventeen (58.2%) of the pharmacists provided spontaneous counseling on how to use the pill, 17 of them had their counsel rated as complete, but none of the pharmacists provided spontaneous counseling regarding adherence or side effects of the medications. On prompting, 10 pharmacists (12%) provided complete counseling regarding how to use oral contraceptives, 14 pharmacists (7.0%) provided complete counseling on adherence and missing dose handling and five pharmacists (2.5%) provided complete counseling about expected side effects. Conclusions: Pharmacists' practice regarding hormonal contraceptive dispensing and counseling was suboptimal in this study. Areas needing intervention were related to pharmacist assessment of eligibility for oral contraceptive use, choice of optimal oral contraceptive for patient-specific co-morbidities and provision of adequate counseling regarding proper use, adherence and missed dose handlings


No disponible


Assuntos
Humanos , Anticoncepcionais/administração & dosagem , Aconselhamento Diretivo/organização & administração , Serviços Comunitários de Farmácia/organização & administração , Anticoncepcionais Orais Hormonais/administração & dosagem , Anticoncepção/métodos , Prática Profissional/tendências , Papel Profissional , Qualidade da Assistência à Saúde/tendências , Emirados Árabes Unidos/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle
16.
BMC Health Serv Res ; 19(1): 282, 2019 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-31053135

RESUMO

BACKGROUND: Pharmaceutical care is the pharmacist's contribution to the care of individuals to optimize medicines use and improve health outcomes. The primary tool of pharmaceutical care is medication review. Defining and classifying Drug-Related Problems (DRPs) is an essential pillar of the medication review. Our objectives were to perform a pilot of medication review in Hungarian community pharmacies, a DRP classification was applied for the first time. Also, our goal was the qualitative and quantitative description of the discovered DRPs, and of the interventions for their solution in order to prove the safety relevance of the service and to map out the competence limits of GPs and community pharmacists to drug therapy. METHODS: The project took place in Hungarian community pharmacies. The study was performed with patients taking vitamin K antagonist (VKA) and/or ACE inhibitor and NSAID simultaneously (ACEI-NSAID). 61 pharmacists and 606 patients participated in the project. Pharmacists reviewed the medication for 3 months and the classification of DRPs was performed (category of DRP1 - DRP6). Patient data were statistically analyzed. RESULTS: Patients consumed on average 7.9 ± 3.1 medications and other products. 571 DRPs were detected in 540 patients, averaging 1.06 DRPs per patient (SD = 1.07). The highest frequency category was DRP5 (non-quantitative safety problem; 51.0%). The most common root cause was an interaction (42.0%) and non-adherence (19.4%.). The most commonly used intervention was education (25.4%) and medication replacement by the pharmacist (20.1%). The changing of the frequency and dosage in any direction were negligible. CONCLUSIONS: Patients are struggling with many DRPs that can be assessed and categorized by this system and which remain unrecognizable without pharmacists. Further projects need to be developed to assist in the development of physician-pharmacist cooperation and the widespread dissemination of pharmaceutical care.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Uso de Medicamentos/estatística & dados numéricos , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/prevenção & controle , Farmacêuticos/organização & administração , Idoso , Estudos de Avaliação como Assunto , Feminino , Humanos , Hungria , Masculino , Auditoria Médica , Pessoa de Meia-Idade , Projetos Piloto , Pesquisa Qualitativa
17.
AIDS Patient Care STDS ; 33(5): 207-213, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31067124

RESUMO

The efficacy of pre-exposure prophylaxis (PrEP) to prevent HIV has been firmly established; however, the success of PrEP largely depends on access to care as well as high levels of medication adherence. One of the key areas of focus for the National HIV/AIDS Strategy for 2020 in the United States calls for full access to comprehensive PrEP services where appropriate and desired, with support for medication adherence. Despite advances and advocacy for PrEP since approval for adults in 2012, large rates of prescribing disparity exist among gender and race/ethnicity. In 2016, only 3.7% of all PrEP users were women and only 11.2% were black. As one of the most widely accessible health care resources, pharmacists are well positioned to improve patient understanding, promote medication adherence, provide key risk reduction counseling, and enhance PrEP efficacy. Pharmacists' knowledge and accessibility in nearly every urban and rural community can be leveraged as part of a comprehensive HIV prevention strategy to expand access to care and improve population health. As trusted health care professionals, pharmacists develop a strong rapport with patients and may be the key to address current disparities in PrEP prescribing patterns as well as serve as an essential liaison between patients and other members of the multi-disciplinary care team. The purpose of this review is to summarize available data on pharmacist involvement in various models of care providing PrEP services and to identify opportunities to maximize and expand the role of the pharmacist to improve access to PrEP.


Assuntos
Fármacos Anti-HIV/administração & dosagem , Serviços Comunitários de Farmácia/organização & administração , Infecções por HIV/prevenção & controle , Farmacêuticos/psicologia , Profilaxia Pré-Exposição/métodos , Adulto , Aconselhamento/métodos , Feminino , Infecções por HIV/tratamento farmacológico , Conhecimentos, Atitudes e Prática em Saúde , Acesso aos Serviços de Saúde , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Estados Unidos
18.
BMC Health Serv Res ; 19(1): 243, 2019 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-31014325

RESUMO

BACKGROUND: Redispensing unused medications that have been returned to outpatient pharmacies by patients may reduce waste and healthcare costs. However, little is known regarding the extra costs associated with this process, nor the price level of medications for which this is economically beneficial. The objective of this study was to assess costs associated with redispensing unused medications in the pharmacy and the price level at which redispensing becomes cost-beneficial. METHODS: A micro-costing study was conducted in four Dutch outpatient pharmacies for medications requiring room-temperature storage and requiring refrigeration. First, the pharmacy's necessary additional process steps and resources for redispensing were identified. Second, time required for each process step was simulated. Third, required resources were quantified by calculating labour, purchasing and overhead costs. Lastly, a model with different scenarios was constructed to calculate the price of a medication package at which redispensing becomes cost-beneficial. RESULTS: Three main additional process steps for redispensing were identified: (1) pack medications with product quality indicators before dispensing, (2) assess quality of medications returned to the pharmacy (temperature storage, package integrity, expiry date) and (3a) restock medications fulfilling quality criteria or (3b) dispose of medications not fulfilling criteria. Total time required for all steps up to restock one medication package was on average 5.3 (SD ±0.3) and 6.8 (SD ±0.3) minutes for medications stored at room-temperature and under refrigeration, respectively, and associated costs were €5.54 and €7.61. Similar outcomes were found if a medication package would ultimately be disposed of. The price level primarily depended upon the proportion of dispensed packages returned unused to the pharmacy and fulfilling the quality criteria: if 5% is returned, of which 60% fulfils quality criteria, the price level was €101 per package for medications requiring room-temperature storage and €215 per package for those requiring refrigeration. However, if 10% is returned, of which 60% fulfils the quality criteria, the price level decreases to €53 and €109, respectively (arbitrary proportions). CONCLUSIONS: Redispensing unused medications in the pharmacy is at least cost-beneficial if applied to expensive medications.


Assuntos
Serviços Comunitários de Farmácia/economia , Custos de Cuidados de Saúde/estatística & dados numéricos , Recursos em Saúde/economia , Medicamentos sob Prescrição/economia , Gerenciamento de Resíduos/economia , Serviços Comunitários de Farmácia/organização & administração , Recursos em Saúde/organização & administração , Humanos
19.
Pharmazie ; 74(3): 186-190, 2019 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-30961687

RESUMO

Medication refill reminder services (MRRS), having the potential to support the detection of non-adherence and to promote periodic medication refilling by addressing forgetfulness, are not generally available in community pharmacy practice. Based on a new software module, a MRRS was developed. The acceptance of this service was tested in community pharmacies in Germany. Patients were recruited by trained pharmacy staff. Supported by the software, the pharmacies reminded patients to refill their prescription. After 7 months, the service was evaluated by patients and pharmacy staff. The pharmacy owners/managers were interviewed. Ten pharmacies applied the service to 148 patients, with 806 refill reminders for 391 drugs. Seventy-five patients (50.7%) chose to be reminded by a phone call, followed by text message (n=25), and email (n=18). Of all patients, 75 (50.7%) completed the paper-based questionnaire. Sixty-eight (90.7%) rated the service as good or very good and 54 (72.0%) felt more satisfied with their pharmacy. Sixty-four patients (85.3%) considered the service as supportive and wanted to continue. Thirty-nine pharmacy staff members (61.9%) answered the online questionnaire. Twenty-four (61.5%) stated that they found it difficult to use and apply the MRRS; twenty-six (66.6%) experienced technical problems. The service was rated good by 16 (41.0%) pharmacy staff members. They regarded the service helpful for some patients and wanted to continue after the end of the study. The majority of the ten interviewed pharmacy owners/managers expressed the opinion that the service was not very suitable for increasing customer loyalty and not cost-effective. Nevertheless, six (60.0%) of them wanted to continue using the service. The MRRS seems to be feasible, apart from technical difficulties. Patients rated the service as supportive, and the personal contact seems to be of high importance; most patients would like to continue the service. However, offering the service to patients turned out to be challenging in daily German community pharmacy practice.


Assuntos
Serviços Comunitários de Farmácia/organização & administração , Sistemas de Registro de Ordens Médicas , Farmácias/organização & administração , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Feminino , Alemanha , Humanos , Masculino , Adesão à Medicação , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Farmacêuticos , Farmácia , Inquéritos e Questionários , Adulto Jovem
20.
Int J Clin Pharm ; 41(2): 452-459, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31028598

RESUMO

Background Several effective mobile health (mHealth) interventions have been developed to support patients with their medication use, however hardly any is implemented in clinical practice. Process evaluations and user experiences are therefore important for further implementation. Objective To explore experiences, barriers, and facilitators of pharmacists and patients towards the use of the interactive ADolescent Adherence Patient Tool (ADAPT). In addition, the perceptions of pharmacists towards mHealth interventions in general were explored. Setting Dutch community pharmacies. Methods Pharmacists (N = 24) and adolescent asthma patients (N = 87; age 12-18) completed a questionnaire about the ADAPT intervention. Pharmacists who did not have access to the ADAPT intervention (N = 26) completed a questionnaire on their perceptions towards mHealth. Main outcome measure Experiences, barriers, and facilitators of pharmacists and patients. Results Most patients (78%) would recommend the ADAPT intervention to others, and thought that the pharmacy was the right place for mHealth aiming to support adherence (63%). The possibility to monitor asthma symptoms was highly appreciated by patients and pharmacists. Pharmacists were satisfied with ADAPT intervention (96%), and using the intervention was not time consuming (91%). The ADAPT intervention promoted contact with patients (74%) and facilitated the healthcare providing role of pharmacists (83%). Pharmacists who did not have access to the ADAPT intervention mentioned time constraints and funding as main barriers for using mHealth. Conclusion Pharmacists and patients perceived many beneficial effects and were positive about the the use of the interactive ADolescent Adherence Patient Tool (ADAPT) intervention. This study emphasizes opportunities for mHealth in improving the quality of care, which supports the need for further implementation in clinical practice.


Assuntos
Asma/psicologia , Atitude do Pessoal de Saúde , Serviços Comunitários de Farmácia/organização & administração , Adesão à Medicação/psicologia , Autogestão , Telemedicina/métodos , Adolescente , Criança , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Países Baixos , Papel Profissional , Inquéritos e Questionários
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