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PubMed2000

[Pharmacy in Canton Vaud during the period of radical domination: 1845-1945].

Between 1845 and 1945, major changes took place both in society and in pharmacy. These two dates represent important phases of mutation for the pharmacy profession. In 1845, university studies were about to become compulsory. Towards 1945, the prodigious development of patent medicines had been disconcerting the pharmaceutical community. In this time period, pharmacy had taken a more modern face: School of pharmacy was founded (1873), professional associations were being formed up and the first hospital pharmacy was established in 1882. Politically, this period of time was marked by the hegemony of the Radical party. Society was at a turning point. The expanding railway network and the development of industry in certain regions were influencing the implantation of pharmacies and their unequal distribution in the Canton. Based on archive documents, the different aspects of pharmacy in Canton Vaud at this epoch have been examined and analyzed. In particular, evolution of legislation and of professional training have been studied with reference to previous time periods or to the situation in other cantons of countries.The creation and development of professional associations has also been treated. One chapter is devoted to a brief description of the careers of more than one hundred pharmacists. The activities of the Cantonal Hospital pharmacy are also outlined, as well as the increase in the number of pharmacies within the context of economical growth in different regions of the Canton. Tables and addenda are used to support the discussions in the different chapters. This study should allow the present generation of pharmacists to have a better knowledge of the history of their profession and thus understand its evolution.

History of Pharmacy↗
PubMed1992

Female condom launched in UK.

The lone-awaited female condom, Femidom, is to be launched at the end of September by manufacturers Chartex. It is being welcomed by the FPA [Family Planning Association] and other family planning experts as a valuable addition to the existing range of contraceptive methods and as an alternative to the male condom in offering effective protection against sexually transmitted diseases including HIV. A lubricated, loose-fitting polyurethane sheath, Femidom is inserted into the vagina at any time before sex. An inner ring holds the condom in place beyond the pubic bone and an outer ring lies flat against the vulva. In addition to extending choice, it is under direct control of the woman. As FPA Director Doreen Massey puts it: "We have to face the fact that some women who want safer sex can't get their partners to use condoms. for the 1st time with Femidom, you can insist that if he won't use a condom, you'll use yours." In trails of self-selected couples, up to 2/3 of women and their partners found the product acceptable. a study at the Institute of Population Studies in Exeter showed that while some couples had initial misgivings about the condom's size and appearance, especially its visibility when in position, these often declined with repeated use. Researcher Dr. Nicholas Ford pointed out that if the female condom makes a woman feel unattractive, her partner's comments may well influence these feelings. Users' experience of insertion and the condom's comfort also improved with repeated use. While there are no large studies showing ranges of effectiveness, it is likely to be as effective as the male condom (about 85%-98%). In a study of 106 women at the margaret Pyke Center in London, there were 7 unplanned pregnancies: 4 were due to inconsistent use of the method and 3 were method failures. Breakages were rare. 1/3 of participants dropped out in the 1st month. Users should continue with their existing contraceptive method until they are sure that they are using Femidom efficiently, recommended the authors. In October the FPA is launching a new free consumer leaflet on male and female condoms. 1/2 million leaflets will be distributed to UK pharmacies in October and November via the Pharmacy Healthcare Scheme as part of a safer sex campaign. a launch event will include the results of a survey asking pharmacists and consumers what they think of condoms.

Behavior↗
PubMed1991

[Blood donation in the Balearic Islands. Analysis of supply and demand of blood from 1982 to 1987].

BACKGROUND: The supply and consumption of blood products in the autonomous community of the Balearic Islands were evaluated for the years 1982 to 1987 to assess the degree of hemotherapy coverage. METHODS: The registries of blood banks from 1982 to 1987, the clinical records of patients with congenital coagulation deficiencies and the registries of the hospital pharmacies and pharmaceutic distributing agencies were reviewed. RESULTS: The rates of use per product (units) and per one thousand population were as follows: red blood cells 22-25, platelets 0.8-3.2, transfusional plasma 0.5-2.8, and cryoprecipitates less than 0,2. The consumptions of albumin and gammaglobulins were 80 and 7.7 kg per one million population, corresponding to 3.200 and 1.540 I of plasma, respectively. The consumption of factor VIII was 1.3-0.9 international units (IU) per inhabitant, in highly of very highly purified form, corresponding to 18.500-12.857 I of plasma. CONCLUSIONS: The results show that a supply of 25-27 blood donations per one thousand population and per year and with a fractionning of 80%, yield 5.000 I of plasma per one million population. This fulfils the needs of all blood products, except those of highly or very highly purified factor VIII.

Blood↗
PubMed1982

Adaptation of a workload measurement system.

An adaptation of a previously reported patient-care unit (PCU) system of workload measurement is described. A PCU is any distributive or clinical pharmacy activity related to patient care, and the PCU system of workload measurement relates the activity frequency and the usual time required to complete each activity. The key to the system is the weighting factor (usual time) for each PCU. The PCU system was modified by breaking each PCU into its various elements and determining the time required to complete each element. Several time units were available from references; other units specific for hospital pharmacy were measured. The modified PCU definitions, counting mechanisms, and weighting factors used at the study hospital are included in an appendix. The number of service hours, which is the product of the frequency of each activity and its weighting factor, is an indicator of personnel time devoted to each pharmacy activity. The cost per service hour can be computed and used to set fees for each pharmacy activity. Other practical applications of the PCU system include evaluation of staffing patterns, trend analysis, and documentation of clinical services. The modified PCU system provides a more precise measurement of weighting factors than previously described methods, and it can be adapted by other institutions.

Drug Compounding↗
PubMed1976

Detection of urinary tract infections in 3- to 5-year-old girls by mothers using a nitrite indicator strip.

A program to detect urinary tract infections among 3- to 5-year-old girls was conducted in Madison-Dane County, Wisconsin using local pharmacies as the distribution site for test kits. Screening was conducted at home by mothers with a nitrite dip-strip on three consecutive first morning specimens. Twenty-one percent of the target population participated during a one-month study period. Eighteen cases were found among 1,573 participants (1.1%). In addition, 243 girls other than those in the target area or age group participated and yielded eight additional cases, for a total of 26 cases among 1,816 total participants. The rate of false-positive nitrite tests was 0.3%. Newspapers were the most effective means of alerting the public to the program. The only factors which were associated with less awareness or participation were low socioeconomic and rural residence. Past history of infection, minor urinary symptoms, and pyuria were common among the bacteriuric girls. Immunoglobulin-coated bacteria suggestive of tissue invasion were present in one third of the cases. Vesico-ureteral reflux was present in five and caliectasis in two of 23 girls studied. Despite the likelihood that some bacteriuric girls, particularly those infected with gram-positive organisms were not detected, screening at home appears to be a highly efficient method of detecting urinary tract infections in large populations of preschool children.

Bacteriuria↗
PubMed1990

[Pharmacies' information pamphlets--what use are they to the patients?].

Information pamphlets about certain drugs on prescription have been distributed to patients by Norwegian pharmacies since 1985. A questionnaire distributed to 500 patients, answered by 48.2%, showed that most patients liked to receive the pamphlets and 85.5% found them useful. However, it was difficult to evaluate the influence of the pamphlets on the patients compliance with instructions on how to use the drug. Many patients found the pamphlets difficult to understand. Most problems were connected with interactions with other drugs etc. Only 8.3% of the patients thought that other drugs might interact with the drug prescribed. The pamphlets were only one of several sources of information to the patients. The study showed that physicians informed the patients more about the effects (67.2%) than about the side-effects (49.4%) of drugs. Only 47.7% of the patients had received the pamphlets earlier. However, this percentage varied for the three participating pharmacies, being 20.2, 62.2 and 78.0% respectively.

Drug Information Services↗
PubMed2007

Frequency, nature and determinants of pharmaceutical consultations provided in private by Dutch community pharmacists.

OBJECTIVE: According to a report published by the federation of Dutch patients' associations, patients would like to see a pharmacist, who acts more as a personal adviser. This raised the question, how often Dutch community pharmacists have personal consultations with their patients in daily practice, on which factors this depends, and what kind of topics are discussed during these meetings. SETTING: Community pharmacies in the Netherlands. METHOD: A questionnaire was distributed among 800 randomly selected pharmacies. Questions were restricted to consultations characterized by one-to-one contact, drug therapy related content, and adequate privacy. These consultations were labelled as pharmaceutical consultations in private to distinguish them from other contacts between pharmacists and patients. MAIN OUTCOME MEASURE: Number, content, and character of consultations. RESULTS: 198 (24.8%) community pharmacies responded. The pharmacists provide an average of roughly 1.2 consultations in private per working day. The vast majority of respondents provided face-to-face and telephone consultations (94.4 and 91.9%, respectively), only a minority gave consultations by e-mail (30.8%). These consultations primarily dealt with topics related to medication safety. The mean overall time spent was 290 min per month. A relatively high frequency of personal consultations was significantly associated with the absolute number of full-time equivalent pharmacists in the pharmacy. CONCLUSION: The frequency of pharmaceutical consultations in private is low, but may be improved by reorganisation of the pharmacist's activities. The possibility of personal consultations by e-mail is not yet well-developed. Further research is needed to assess the patient's view of pharmaceutical consultations in private.

Adult↗
PubMed1993

Padlocked societies.

Explore the source record for details and available documents.

Ambulatory Care Facilities↗
PubMed1977

Conceptual framework for drug usage review, medical audit and other patient care review procedures.

The following concepts are discussed: (1) quality assurance programs, (2) drug usage review, (3) utilization review, (4) peer review, (5) medical audit, (6) patient care audit and (7) medical care evaluation studies. A framework within which all types of hospital quality assurance mechanisms can be constructed is proposed and their interrelationships are described. The pharmacist's particpiation in the hospital's overall quality assurance program is stressed in two main areas-drug usage review, performed jointly with the medical staff, and quality assurance of pharmaceutical services, a peer review function of the pharmacy profession. These services are primarily drug distribution and control, drug information, clinical pharmacy, continuing education, and other pharmacy and pharmacist functions. Both functions may be viewed as parts of the pharmacy audit, one of several patient care audits within the facility. Pharmacists in skilled nursing facilities have quality assurance responsibilities similar to those of hospital-based pharmacists.

Drug Utilization↗
PubMed1999

Evaluating dispensing error detection rates in a hospital pharmacy.

OBJECTIVES: The filling of unit dose orders and checking for filling errors are two essential distributive responsibilities of a hospital pharmacy. Previous studies have shown that nonpharmacists, usually technicians, are capable of assuming these distributive tasks traditionally performed by hospital pharmacists. The study tested whether nonpharmacists, in this case licensed practical nurses/medication nurses, were as competent as pharmacists in checking for errors in unit dose cassettes prepared for hospital patients. METHODS: A university teaching hospital was used for the study. Artificial errors (n = 812) were introduced into the drug distribution system during a 4-month period in 1995. Included in the study were seven staff pharmacists and nine medication nurses (licensed practical nurses) involved in the decentralized drug distribution system. The primary measure was the ratio of errors detected to the number of artificial errors introduced into the system. This primary measure is different from those used in prior studies that do not separate dispensing errors and checking errors. RESULTS: Overall, pharmacists were significantly more accurate in detecting errors (87.7% vs. 82.1%). In one category of serious errors, that of wrong strength, the difference between pharmacists and licensed practical nurses was even greater (93.3% vs. 83.3%). CONCLUSIONS: This study's results do not support conclusions of prior studies that nonpharmacists can match the error detection accuracy of pharmacists. It demonstrates the importance of considering the types of errors under examination and of using appropriate measures of error checkers when drawing conclusions on relative competence.

Clinical Competence↗
PubMed1984

Pharmacists' role in smoking cessation.

"Time to quit", a program piloted in Winnipeg in 1983, is an example of the importance of the pharmacist in the smoking cessation issue. Through the Manitoba Pharmaceutical Association, pharmacies were utilized as distribution centres for a self-help smoking cessation booklet. In the city of Winnipeg, 82% of city pharmacies received a total of 40,500 books; 93.5% of these booklets were picked up by the public. Pharmacists also had the option to become more involved in the anti-smoking campaign if they so desired. Pharmacists not only have the knowledge to discuss the area of smoking cessation, they arein a strategic position for dissemination of that knowledge.

Canada↗
PubMed1993

Association of antineoplastic drug handling with acute adverse effects in pharmacy personnel.

The relationship between occupational exposure to antineoplastic drugs and the presence of acute symptoms of exposure was investigated by questionnaire. Data were derived from a questionnaire distributed to 8566 pharmacists, pharmacy technicians, nurses, and nurse aids at 57 member institutions of the National Surgical Adjuvant Breast and Bowel Project nationwide. Of the 4659 respondents (54%), 1057 were pharmacists or pharmacy technicians; after exclusions, the sample size was 738. Data were collected on four handling activities: mixing of antineoplastic drugs, administering these drugs, cleaning up spills, and handling patient excreta. Information on mixing was divided into dose, duration, use of protection, and reported skin contact. Respondents indicated which of 27 acute symptoms they had experienced during the past three months. Handling of antineoplastics was associated with a small but significant increase in the number of symptoms compared with controls; reported skin contact was the most important predictor of symptoms. The number of doses handled and the extent of protection were significantly associated with the number of symptoms, but their effect was not independent of that of skin contact. Body mass was significantly associated with the number of symptoms in women but not men. Pharmacists and technicians who handle antineoplastic drugs reported more symptoms associated with exposure than did those who do not handle such agents. All available protective measures should be used.

Adult↗
PubMed1982

Hospital pharmacy practice in the People's Republic of China.

The practice of hospital pharmacy in the People's Republic of China is described. Since 1949, health care in China has improved. The number of hospitals has increased. While medicines previously were scarce, China now produces approximately 95% of the drugs it needs. China has a long history of traditional medicine; although there are attempts to integrate the concepts of traditional and Western medicine, the practices are still segregated. All hospital pharmacies in China have the responsibilities to guarantee the safe and effective use of drugs within the hospital and to do research. Even though Chinese factories manufacture many pharmaceutical products, the hospital pharmacy must manufacture many more. Hospitals have established Agreed Prescription programs, whereby drugs are manufactured in large batches, repackaged, and distributed to other hospital pharmacies in the area if needed. Quality is assessed chemically and by modern techniques when equipment is available. Most large hospitals now have automated facilities to manufacture sterile solutions. Each hospital has a medical supply committee that supervises the procurement of medical supplies and the reasonable use of drugs. A government resolution mandates that every hospital pharmacy do research. A primary focus of their research is the integration of traditional and Western medicine. Concepts of traditional and Western medicine are taught in separate pharmacy schools. Most pharmacy undergraduate programs are four years, but some schools recently changed to five years. Future challenges for hospital pharmacists in China are to develop the theoretical and technological knowledge of pharmacy, and to expand the scientific and technical information system that is necessary to do research.

China↗