Pharmaceutical Care (pharmaceutical + care)

Distribution by Scientific Domains

Selected Abstracts

Drug-related problems in elderly general practice patients receiving pharmaceutical care

Elaine Lau Research fellow
Objective To describe the types of drug-related problems identified by pharmacists providing pharmaceutical care to elderly patients in the primary care or general medicine setting, and the impact of their recommendations on drug-related outcomes. Methods Searches of the MEDLINE, EMBASE, CINAHL, HealthSTAR, and International Pharmaceutical Abstracts electronic databases from 1990 to 2002 were conducted and a manual search of references from retrieved articles and references on file was performed. Large (n> 100) randomised, controlled studies comparing the provision of pharmaceutical care to usual care in seniors in primary care or general medicine settings were included. Two reviewers evaluated articles based on inclusion criteria and extracted data from the intervention arm of each study, resolving discrepancies by consensus. Nine original articles were included for analysis. Key findings The mean number of drug-related problems (DRPs) identified per patient was 3.2 and the mean number of recommendations made per patient was 3.3. The most common DRP identified was not taking/receiving a prescribed drug appropriately (35.2%, range 4.7,49.3%). The most common recommendations made involved patient education (37.2%, range 4.6,48.2%). Implementation rates were generally high for all types of recommendations, with the highest being for provision of patient education (81.6%). The small number of studies available examining measures of drug utilisation and costs, health services utilisation, and patient outcomes produced inconsistent results, making it difficult to draw conclusions. Conclusions Substantial numbers and a wide range of DRPs were identified by pharmacists who provided pharmaceutical care to seniors in the primary care and general medicine setting. Pharmacists' drug-therapy recommendations were well accepted; however, further study is needed to determine the impact of these recommendations on health-related outcomes. [source]

Community pharmacists' identification of natural health product/drug interactions in older persons

Ruby E. Grymonpre professor
ABSTRACT Objective To document the prevalence and significance of potential natural health products (NHPs)/prescribed drug interactions in a sample of older adults; to determine whether community pharmacists detected these drug interactions; and to characterise users and non-users of NHPs. Setting The project involved 15 community pharmacists providing pharmaceutical care to 213 non-institutionalised older adults. Method The study was a subanalysis of a prospective, non-randomised, before-and-after trial of the provision of pharmaceutical care. Pharmacists documented each time medication-specific information or advice was provided to subjects. The numbers and types of NHPs that clients reported taking and the number of potentially significant NHP/prescribed drug interactions were determined. Whether pharmacists identified such drug interactions and made the necessary interventions were also documented. Results Forty-two NHPs were reported 96 times by 49 (23%) clients, most commonly glucosamine (n = 10), garlic (n = 10), prune juice (n = 9), and Ginkgo biloba (n = 6). There was a total of 446 possible NHP/prescribed drug combinations in the 49 clients, of which 53 (12%) were considered to be of potential clinical significance. Of these 53 combinations, three pharmacists identified four (8%) potential interactions in three different patients. Although gender, mean age and number of reported medical conditions did not differ between users and non-users of NHPs, users reported taking fewer prescribed drugs compared with non-users (5.0 3.2 vs 6.0 2.9, respectively, P = 0.043) and more non-prescribed drugs (4.2 2.5 vs 2.1 2.0, respectively, P < 0.0001). Conclusion The reported prevalence of NHP and the potential for NHP/prescribed drug interactions in our sample of older adults were high. Pharmacists providing pharmaceutical care did not commonly identify potentially significant NHP/prescribed drug interactions. [source]

Physician-pharmacist collaborative care for dyslipidemia patients: Knowledge and skills of community pharmacists

Julie Villeneuve MSc Pharmacist, Study Coordinator
Abstract Introduction: In a physician-pharmacist collaborative-care (PPCC) intervention, community pharmacists were responsible for initiating lipid-lowering pharmacotherapy and adjusting the medication dosage. They attended a 1-day interactive workshop supported by a treatment protocol and clinical and communication tools. Afterwards, changes in pharmacists' knowledge, their skills, and their satisfaction with the workshop were evaluated. Methods: In a descriptive study nested in a clinical trial, pharmacists assigned to the PPCC intervention (n = 58) completed a knowledge questionnaire before and after the workshop. Their theoretical skills were evaluated with the use of a vignette approach (n = 58) after the workshop and their practical skills were assessed by direct observation with study patients (n = 28). Results: The mean (SD) overall knowledge score was 45.8% (12.1%) before the workshop; it increased significantly to 89.3% (8.3%) afterwards (mean difference: 43.5%; 95% CI: 40.3%,46.7%). All the pharmacists had an overall theoretical-skill score of at least 80%, the minimum required to apply the PPCC in the trial. From 92.9% to 100% of the pharmacists' interventions with study patients complied with the treatment protocol. Discussion: In primary care, a short continuing-education program based on a specific treatment protocol and clinical tools is necessary and probably sufficient to prepare pharmacists to provide advanced pharmaceutical care. [source]