Search PubMedSearch

Biomedical subjects

S N Almond

Publications and source records attributed to S N Almond.

2 recordsLinked to original sources

Pharmacist-managed diabetes education service.

A pharmacist-managed education service for diabetes patients is described. Clinical pharmacists in three ambulatory-care centers provide diabetes-patient education based on guidelines developed and approved by the pharmacy, therapeutics, and standing orders committee. Patients are referred by their primary health-care provider; they receive individualized information concerning the pathophysiology and therapy of diabetes mellitus and instruction in self-care methods. A questionnaire completed by the patient before the initial visit aids the pharmacist in assessing the patient's educational needs, developing an individualized teaching program, and establishing long- and short-range treatment goals. The pharmacist spends one hour with the patient for the initial visit and 15 minutes for subsequent visits; patient charges are $15 for the initial visit and $7.50 for further teaching sessions. Records maintained by the pharmacist enable primary-care providers to follow the patient's progress and anticipate problems. Patients return for periodic assessment of their progress. Patient teaching by pharmacists has been provided and reimbursed in this ambulatory-care setting for 10 years. The pharmacist-educators' responsibilities include assessment, planning, instruction, and follow-up.

Diabetes Mellitus

Pharmacist-managed allergy desensitization program.

A pharmacist-managed immunotherapy program for ambulatory atopic patients is described. Pharmacists in a network of three health centers recommended that they assume management of the allergy desensitization program when they recognized problems with the existing program. Guidelines for the immunotherapy service were developed and approved by the pharmacy, therapeutics, and standing orders committee. Patients, already tested by an allergist, are referred to the pharmacists for the administration of their immunotherapy. Under the guidelines for the program, pharmacists collect and record the patients' history, assess the patients' knowledge of allergy desensitization, administer the allergens, examine the injection site, question the patients about symptoms, and initiate treatment of local and systemic reactions. A physician is available for consultation and for treatment of life-threatened adverse reactions. Following any reaction, the pharmacist adjusts the next antigen dose accordingly. Typical charges for these services are $10-15 for the first visit, and $3.50 for subsequent visits. The pharmacists spend about 30 minutes of their time for the initial visits, and 10 minutes for subsequent visits. The time spent by physicians is negligible, and there is no charge for their consultations. Patients under the care of the pharmacists rarely wait more than 15 minutes for an appointment. This service has been well accepted by patients, physicians, and mid-level practitioners. Pharmacists are using their knowledge and skills to provide a direct patient-care service, and they are being reimbursed for a nondispensing activity.

Allergens