PubMed · 1494469
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R M Neil, C A Schroeder. 1992. Evaluation research within the human caring framework.. https://pubmed.ncbi.nlm.nih.gov/1494469/
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A system for exchanging patient information among hospital, long-term-care (LTC), and ambulatory care pharmacies is described, and the influence of that system on pharmacist interventions is reported. Study sites consisted of three ambulatory care pharmacies, one LTC pharmacy, and one hospital in a small Midwestern city. Meetings were held by clinicians, the investigators, and hospital administrators to plan the information-exchange system. From January through June 1996, patients admitted to the hospital were checked to see if they came from a participating (source) pharmacy; if so, they were randomly assigned to experimental and control groups. The hospital requested preadmission information from the source pharmacy for experimental group patients and did not do so for control patients. After the information arrived, the hospital pharmacists could use it to identify and document drug therapy problems. When an experimental group patient was discharged, the hospital sent information to the appropriate source pharmacy. A total of 156 patients were enrolled in the study. Complete information transfer occurred for 75% of experimental group patients. Significantly more experimental group patients than control patients had at least one in-hospital pharmacist intervention recorded. Similarly, in the ambulatory care pharmacies (but not the LTC pharmacy) significantly more interventions per patient were documented for the experimental group. Hospital and ambulatory care pharmacists documented more interventions for patients about whom information had been supplied than for patients for whom that information had not been supplied. No difference in intervention rates was observed for LTC pharmacists, who were already being supplied information by the LTC facilities about patients discharged from the hospital.
A survey for assessing ongoing patient satisfaction with ambulatory care pharmaceutical services was developed for and tested in a veterans population; acquiescence response to survey items and desire for potential future services were measured. A questionnaire based on key aspects of patient satisfaction described in the literature was distributed to 1451 patients visiting an ambulatory care pharmacy prescription-pickup window during five consecutive days in 1994. Patients were asked about current services and the desirability of potential future services. Patients indicated their responses to statements about current services. Acquiescence response (the tendency to agree with statements regardless of content) was measured by using matched pairs of contradictory statements. The response rate was 48.3%. Patients' mean +/- S.D. overall satisfaction with current services was 3.7 +/- 1.1. The responses of 72.0% of patients exhibited no contradictions. The potential new service wanted most by respondents was availability of a pharmacist to talk with patients by telephone; seeing a pharmacist in the clinic instead of a physician for drug-related problems was wanted least by respondents. Veterans responding to a survey of satisfaction with ambulatory care pharmaceutical services had a low tendency to agree with statements regardless of content. The survey can be used to assess veterans' ongoing satisfaction.
A national survey of pharmacist-managed anticoagulation clinics was conducted to determine how pharmacists are trained to provide care in such clinics. In June 1996 a survey was mailed to 177 pharmacist-managed anticoagulation clinics in the United States. A total of 128 surveys were returned (response rate, 72%). One hundred ten surveys representing 42 states and a variety of institutions were usable. Twenty-five (23%) of the 110 clinics offered an anticoagulation training program for their pharmacists. Most training programs had both didactic and experiential components and had been in existence for one to five years. Thirty-two (29%) of the 110 responding clinics had at least one pharmacist who had completed the ASHP Research and Education Foundation's Anticoagulation Service Traineeship. Twenty-three of the 25 clinics with a training program required successful completion of the program before a pharmacist could practice in the clinic. The overall quality of pharmacists' performance was regularly assessed by 22 of the 25 clinics. Most pharmacist-managed anticoagulation clinics in the United States do not offer formal training in anticoagulation therapy to pharmacists who practice in that setting.