Home About us Contact
|
Home About us Contact | ||
|
|
||
Pharmacist Interventions (pharmacist + intervention)
Selected AbstractsIs hospital admission a sufficiently sensitive outcome measure for evaluating medication review services?INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2007A descriptive analysis of admissions within a randomised controlled trial Objective The aims of the study were: to describe and assess hospital admissions occurring during a randomised controlled trial (RCT) of a pharmacist-led medication review service; to describe the admissions in terms of emergency status and main cause; to estimate the potential contribution of pharmaceutical care issues (PCIs) to admission; and to assess the proportion of admissions that could be influenced by a pharmacist intervention. Setting Within the context of a RCT of pharmacists providing medication review for 332 elderly patients living at home, taking at least four repeat medicines, carried out in one region of Scotland. Method Hospital data were obtained for all admissions occurring during the 9-month period studied, summarised and evaluated by two independent medical reviewers for the contribution of PCIs to admission. Two pharmacists assessed the extent to which PCIs were preventable by pharmacist intervention. Key findings Approximately two-thirds of the 77 admissions were unplanned, and two-thirds were to medical wards. Only 17 (22%) of all admissions were considered to be related to PCIs and 10 (13%) possibly preventable by pharmacist intervention. Although the majority of surgical admissions were considered to be unrelated to PCIs (26/29), both unplanned and planned medical admissions were related to PCIs. One of these occurred as a direct result of the pharmacist's recommendation. Conclusion The overall numbers of hospital admissions, medical admissions and unplanned admissions may not be sufficiently sensitive outcome measures for evaluating the impact of pharmacist interventions. Consideration could be given to developing categories of admission that are related to medicines or are likely to be preventable as more relevant measures. Including more details of hospital admissions in future studies may be useful. [source] Development of protocols for the provision of headache and back-pain treatments in Maltese community pharmaciesINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 5 2009Elaine Vella Abstract Objective The purpose of this study was to draw up two protocols designed to help Maltese pharmacists care for consumers seeking treatment for headache and back pain and to subsequently use the protocols to assess pharmacists' management of the named conditions. Method The setting was a sample of 10 of the 207 community pharmacies in Malta. Two flow-chart protocols for headache and back-pain management were developed from various reference sources. The protocols were first tested in a community pharmacy for practicality and applicability in a pilot study. In nine other pharmacies chosen at random the pharmacists' manner of addressing 10 headache and 10 back-pain cases in each pharmacy was compared with that recommended in the protocols. Consumers who visited the pharmacy to fill a prescription, to purchase a named product or for advice on how to deal with symptoms were included in the study. Key findings Of the 212 pharmacist interventions assessed, cases where pharmacists responded to symptoms were managed with the highest average compliance (57%) whereas cases in which the consumer asked for a product by name were managed with an average compliance with the protocols of 46%. Cases in which consumers presented at the pharmacy with a prescription were managed with an average compliance of 55%. Conclusions Protocols may be used as a means of measuring the impact of the intervention of community pharmacists in patient care. The findings suggest a lack of advice given to consumers presenting at the pharmacy to request a named product. [source] Is hospital admission a sufficiently sensitive outcome measure for evaluating medication review services?INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2007A descriptive analysis of admissions within a randomised controlled trial Objective The aims of the study were: to describe and assess hospital admissions occurring during a randomised controlled trial (RCT) of a pharmacist-led medication review service; to describe the admissions in terms of emergency status and main cause; to estimate the potential contribution of pharmaceutical care issues (PCIs) to admission; and to assess the proportion of admissions that could be influenced by a pharmacist intervention. Setting Within the context of a RCT of pharmacists providing medication review for 332 elderly patients living at home, taking at least four repeat medicines, carried out in one region of Scotland. Method Hospital data were obtained for all admissions occurring during the 9-month period studied, summarised and evaluated by two independent medical reviewers for the contribution of PCIs to admission. Two pharmacists assessed the extent to which PCIs were preventable by pharmacist intervention. Key findings Approximately two-thirds of the 77 admissions were unplanned, and two-thirds were to medical wards. Only 17 (22%) of all admissions were considered to be related to PCIs and 10 (13%) possibly preventable by pharmacist intervention. Although the majority of surgical admissions were considered to be unrelated to PCIs (26/29), both unplanned and planned medical admissions were related to PCIs. One of these occurred as a direct result of the pharmacist's recommendation. Conclusion The overall numbers of hospital admissions, medical admissions and unplanned admissions may not be sufficiently sensitive outcome measures for evaluating the impact of pharmacist interventions. Consideration could be given to developing categories of admission that are related to medicines or are likely to be preventable as more relevant measures. Including more details of hospital admissions in future studies may be useful. [source] Clinical medication review by a pharmacist of elderly people living in care homes: pharmacist interventionsINTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 2 2007David P Alldred research clinical pharmacist Objectives To describe the rate and nature of pharmacist interventions following clinical medication review of elderly people living in care homes. Setting Care home residents aged 65+ years, prescribed at least one repeat medication, living in nursing, residential and mixed care homes for older people in Leeds, UK. Method Analysis of data from care home residents receiving clinical medication review in the intervention arm of a randomised controlled trial. Intervention outcomes for each medicine were evaluated for each resident. Key findings Three-hundred and thirty-one residents were randomised to receive a clinical medication review and 315 (95%) were reviewed by the study pharmacist; 256 (77%) residents had at least one recommendation made to the general practitioner. For the 2280 medicines prescribed, there were 672 medicine-related interventions: medicines for cardiovascular system (167 (25%)), nutrition and blood (121 (18%)), central nervous system (113 (17%)) and gastrointestinal conditions (86 (13%)) accounted for 487 (73%) of medicine-related interventions. There were 75 non-medicine-related interventions. The most common interventions were ,technical' (225 (30%)), ,test to monitor medicine' (161 (22%)), ,stop drug' (100 (13%)), ,test to monitor conditions' (75 (10%)), ,start drug' (76 (10%)), ,alter dose' (40 (5%)) and ,switch drug' (37 (5%)). Recommendations to stop a medicine were most common for CNS drugs (32 (32%)). The most common medicine to be recommended to be started was calcium and vitamin D (45 (59%)). Following a recommendation to test to monitor a medicine, 23 (14%) medicines required a change. Conclusions This study has demonstrated that clinical medication review by a pharmacist can identify medicine problems in approximately 80% of care home residents, requiring intervention in 1 in 4 of their prescribed medications. [source] Do researchers use pharmacists' communication as an outcome measure?INTERNATIONAL JOURNAL OF PHARMACY PRACTICE, Issue 4 2010A scoping review of pharmacist involvement in diabetes care Abstract Objectives, Pharmacy practice increasingly revolves around obtaining and interpreting information. We investigated whether and how pharmacy practice researchers design their studies in ways that acknowledge verbal communication between pharmacists and patients with diabetes. Methods, We conducted a scoping review of pharmacists' interventions with patients previously diagnosed as having diabetes with the aim of assessing how many used communication (quality and quantity) as an outcome measure. A scoping review identifies gaps in the literature and draws conclusions regarding the overall state of a research programme, but does not necessarily identify gaps in the quality of the studies reviewed. Quality assessment, therefore, was not conducted. MEDLINE, EMBASE, the Cochrane Library and International Pharmaceutical Abstracts were searched from 2003 to 2008 to identify relevant studies published in English. Reference lists of key studies were also scanned to identify additional studies. Randomized controlled trials and related studies of pharmacists verbal communication with diabetic patients were included. Key findings, Some 413 abstracts were identified through database and reference searching. Of these, 65 studies met abstract inclusion criteria and 16 studies met full-text inclusion criteria necessary for this review. The majority of included studies report on patients' health outcomes, beliefs about drugs, self-reported health-related quality-of-life scales or some combination of these measures as indicators of pharmacists' interventions. Nine studies included information on the duration of the initial interaction between pharmacists and patients with diabetes; 13 reported on the number of follow-up contacts with pharmacists, and seven studies indicated that pharmacists participating in interventions had received training in diabetes management or in patient-centred care. No studies included or evaluated transcripts of pharmacist,patient interactions. Summary, Results reveal a gap in the existing literature. In studies of diabetes, pharmacy practice researchers do not appear to consider the influence of pharmacists' communication skills on health outcomes. Future studies should be designed to incorporate a communication research component. [source] Prescribed medications and pharmacy interventions for acute respiratory tract infections in Swiss primary careJOURNAL OF CLINICAL PHARMACY & THERAPEUTICS, Issue 4 2009K. E. Hersberger PhD Summary Background and objectives:, Symptomatic medications are often not considered in clinical studies assessing interventions to reduce prescribing of antibiotics for acute respiratory tract infections (ARTI). Our study objectives were to examine prescribing patterns of antibiotics and symptomatic medications for ARTI in Swiss primary care and to monitor pharmacists' interventions during the prescription-dispensing process. Methods:, Medical records of 695 patients participating in a clinical trial which was designed to reduce use of antibiotics for ARTI in primary care, were linked to their prescriptions. Matching of prescribed and dispensed medications enabled the assessment of interventions by community pharmacists. Results:, On average, 2·4 different drugs were prescribed per patient (in total 142 antibiotics, 1599 symptomatic medications, and 56 non-ARTI-medication). Most patients (80%) were treated only with symptomatic medications. Most frequently prescribed symptomatic ARTI-medications were nasal decongestants (39%), cough suppressants (36%), and mucolytics (31%). Patients with prescribed antibiotics received significantly fewer symptomatic medications (odds ratio, 0·24; 95% confidence interval 0·16,0·37). Over 20% of prescriptions prompted at least one intervention by a pharmacist in the dispensing process. A discrepancy between prescribed and dispensed medications was seen in 19% of patients. Conclusions:, Prescription rates of antibiotics for ARTI in this trial were low and patients were treated mainly with non-antibiotic symptomatic medications. Efforts to reduce antibiotic prescribing may induce higher rates of use of medications for intensive symptomatic treatment. Considerable differences between prescribed and dispensed medications were noted. [source] Physician-pharmacist collaborative care for dyslipidemia patients: Knowledge and skills of community pharmacistsTHE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS, Issue 4 2009Julie 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] | ||||||||||