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At least 343 records · Page 19Linked to original sources
PubMedDate not supplied

[The effect of implementation of a unit dose drug distribution system on drug consumption].

As an important drug consumer in Dubrava University Hospital, Department of Cardiac Surgery has been chosen for testing a new model of drug distribution system known as unit dose drug distribution system. During the first 39 weeks in 1996--comparative period, drugs were delivered from the Pharmacy to the Department of Cardiac Surgery in traditional way, known as floor stock system. Next 65 weeks, until the end of 1997--pilot study period, drugs were delivered directly from the Pharmacy to the patients, using unit dose drug distribution system. Consumption of drugs was measured every week by statistical unit DDD/100 hospital days (Defined Daily Dose) according to Anatomic-Therapeutic-Chemistry (ATC) classification of drugs. For statistical measurements, beside common arithmetic means, geometric means were used which are less sensitive to extreme values of drug consumption. During comparative period drug consumption was chaotic with great oscillations around mean value, while in pilot study period that process was without great oscillations around lower mean value and did not exceed the limits of process. Drug consumption was completely under control, so it was a predictable process. In the pilot study period total drug consumption was 39% less, while consumption of drugs from group C was 30% less. During comparative period group C makes 34%, while in the pilot study period it makes 38% of the total drug consumption. This model of drug distribution in hospital leads to a rationalization of drug consumption and great savings. The pharmacist-physician interactive role began to emerge as a direct result of these changes in the drug distribution system. Hospital pharmacist has become a visible member of health care team who is responsible for Quality of all medication-related activities and thus has taken opportunity for clinical pharmacy practice.

Drug Utilization↗
PubMed2001

Economic impact of community pharmacist intervention in cholesterol risk management: an evaluation of the study of cardiovascular risk intervention by pharmacists.

The Study of Cardiovascular Risk Intervention by Pharmacists, a randomized, controlled trial in over 50 community pharmacies in Alberta and Saskatchewan, Canada, demonstrated that a pharmacist intervention program improved cholesterol risk management in patients at high risk for cardiovascular disease. In a substudy, costs and consequences were analyzed to describe the economic impact of the program. Two perspectives were taken: a government-funded health care system and a pharmacy manager. Costs were reported in 1999 Canadian dollars. Incremental costs to a government payor and community pharmacy manager were $6.40/patient and $21.76/patient, respectively, during the 4-month follow-up period. The community pharmacy manager had an initial investment of $683.50. The change in Framingham risk function for the intervention group from baseline also was reported. The 10-year risk of cardiovascular disease decreased from 17.3% to 16.4% (p<0.0001) during the 4 months. The intervention program in this study led to a significant reduction in cardiovascular risk in the intervention group during the 4-month follow-up period. The incremental cost to provide the program appeared minimal from both government and pharmacy manager perspectives. It is hoped that these results could support negotiations for reimbursement of clinical pharmacy services with payors.

Aged↗
PubMed1980

Implementation and operation of a hospital pediatric satellite pharmacy.

The planning, implementation, operation, and evaluation of a hospital pediatric satellite pharmacy are described. An initial three-month project involving establishment of a pediatric satellite pharmacy that provided unit dose drug distribution, intravenous admixtures, and a few clinical services was completed and evaluated. Positive evaluations by the medical and nursing staffs resulted in continuation of the satellite as a permanent program. Clinical services initially provided by the pediatric pharmacist were expanded to include acquisition of admission drug histories, instruction on discharge medication, participation on pediatric medical rounds and on the pediatric cardiopulmonary arrest team, operation of the poison control center, distribution of pediatric drug information, preparation of chemotherapy and monitoring of investigational protocols, and provision of pediatric nursing inservice education and community education. A five-year evaluation of the services provided by the pediatric satellite pharmacy was completed by 71 pediatric nurses and 27 Mayo Clinic physicians, all of whom had worked with the system regularly. The tabulated results are presented. Responses to overall services of the pediatric pharmacy were designated good to excellent by 100% of the physicians and by 98.6% of the nurses, indicating that the pediatric satellite pharmacy is a successful and beneficial program at this institution.

Child↗
PubMed1986

Use of a Medicaid database to analyze pharmaceutical services in long-term-care facilities.

A profile of Wisconsin pharmacies that provide services to Medicaid recipients in long-term-care facilities (LTCFs) was developed, and the relationships among pharmacy characteristics and drug use and reimbursement for pharmaceutical services in these pharmacies were studied. Computer-generated reports of Medicaid claims of all pharmacies that had received $1000 or more for services provided to LTCFs from July through September 1984 were included in the study; these claims were submitted by 255 pharmacies on behalf of 32,410 recipients. The reports contained the following individual pharmacy data: geographic location, total dollar payments, total number of Medicaid recipients served, percentage of recipients residing in LTCFs, total number of payments from Medicaid for prescriptions, amount paid to the pharmacy for LTCF recipients as a percentage of total payments, percentage of prescriptions paid at the unit dose rate, and average number of prescriptions and cost per LTCF recipient. An average of $137.30 per recipient was reimbursed, representing an average of 12.3 prescriptions per recipient. The average number of prescriptions per recipient did not vary among pharmacies on the basis of unit dose or traditional distribution system, vendor-consultant status of the pharmacist, location of the pharmacy, or the proportion of LTCF claims to total Medicaid prescription claims. The average amount paid per recipient was related to the average number of prescriptions per recipient, the use of a unit dose system, and the proportion of nursing home claims to total claims submitted. A Medicaid database can be useful for characterizing pharmaceutical services and drug use in LTCFs.

Drug Utilization↗
PubMed1986

A survey of hospitals with computerized incorporation of the pharmacy patient profile and medication administration record.

A survey was distributed in 1985 to 48 hospitals throughout the United States known to have a single-source computer-generated pharmacy patient profile and medication administration record. The study centered on staff attitude toward this single source concept, time and staff requirements when compared to traditional methods of record keeping, and how up-to-the-minute information is disseminated between pharmacy and nursing. A major issue of consideration is the ability of such a system to maintain a method of checks and balances as far as reference to and interpretation of physicians' orders. The investigation revealed that 85% of the respondents felt that the checks and balances remains intact even though one party, nursing or pharmacy, is responsible for data entry that is used by both departments during the medication cycle. More than 88% of the returned surveys included a recommendation that such systems be adopted. Increased efficiency, maintainence of accuracy, and less time spent in dealing with discrepancies when compared with the duplicative manual process of order transcribing and profiling make transition to computerization an acceptable alternative. The information provided is subjective.

Attitude to Computers↗
PubMedDate not supplied

Consumers of oral contraceptives in a social marketing program in Honduras.

This paper presents data on the characteristics of oral contraceptive users in Honduras, obtained from a point-of-purchase survey conducted in pharmacies in 1986. The oral contraceptive Perla, provided by the Social Marketing Program, accounted for 42 percent of sales. Forty-five percent of those using Perla were considered "new" users; either they were purchasing contraceptives for the first time or had used only Perla. Almost half of those who switched to Perla previously had obtained their orals in the noncommercial sector. Brand substitution occurred among users of commercial brands at about the same rate as among Perla users (51 percent versus 55 percent). Most women switching contraceptives did so within two months of their last purchase.

Adolescent↗
PubMedDate not supplied

A consumer intercept study of oral contraceptive users in the Dominican Republic.

Purchasers of a low-cost oral contraceptive were intercepted and interviewed in a sample of Santo Domingo pharmacies that represented the highest sales of the product, yet also reflected the socioeconomic profile of the city's entire population. Users of the contraceptive were later interviewed in greater depth in their homes. The survey of users showed that the Dominican Republic's social marketing program, implemented by PROFAMILIA, was reaching an appropriate target market--that is, younger, lower-middle-class women of low parity. The program was, in addition, successful in attracting first-time adopters, and it was also expanding the overall commercial market for all contraceptives. The marketing campaign was successful in part because a mass audience was reached, through brief television spots. Program impact on contraceptive prevalence can be assessed from sales data.

Adolescent↗
PubMed1984

A respiratory therapy unit dose system in a 500-bed hospital.

A comprehensive unit dose distribution system for respiratory medications is described with emphasis on generalized design principles. This system may be tailored to meet the needs of any institution. Methods for receipt and interpretation of the physician's orders, the profiling system, handling of initial orders, monitoring medications, preparation of unit dose respiratory medications, and routine distribution of orders are covered. This unit dose system allows the pharmacy to assume full responsibility for the procurement, storage, and distribution of all respiratory medication. The pharmacist can provide the respiratory therapist with standardized, sterile quality-controlled medications that are ready to administer. Controlled cost and equitable charging procedures are also provided.

Hospital Bed Capacity, 500 and over↗
PubMed1977

Pharmaceutical services in nongovernmental hospitals on the West Coast.

A survey of nongovernment, nonprofit and for-profit hospitals in Washington, Oregon and California was conducted to determine the incidence of selected hospital pharmacy services (1) directly related to drug distribution and (2) not directly related to drug distribution. Questionnaires were mailed to all qualifying hospitals in the three states; the return rate was 75.4%. Unit dose drug distribution was used in combination with other delivery systems by 58.3% of the respondents; 26.5% used unit dose exclusively. Over half of the respondents provided i.v. admixture programs, outpatient and inpatient discharge prescriptions, and inpatient medication profiles. Additionally, 77.9% provided pharmacy consultation to physicians. Nonprofit hospitals had significantly higher pharmacy staffing levels (both pharmacists and supportive personnel) than for-profit hospitals in the categories, "open seven days per week," "open nine to 16 hours per day," "open 17 to 24 hours per day, "101 to 200 beds" and "201 or more beds." Hospitals that provided the following services had significantly higher pharmacy staffing levels than those that did not provide the serices: unit dose drug distribution, i.v. admixture services, inpatient discharge prescriptions, inpatient medication profiles, drug therapy monitoring, and cardiopulmonary resuscitation team participation (difference of supportive staff only).

Hospitals, Proprietary↗
PubMed1987

Pharmaceutical services in an extracorporeal shock wave lithotripsy center.

Satellite pharmacy services in a hospital's extracorporeal shock wave lithotripsy (ESWL) center are described. At an 833-bed hospital, an ESWL center was opened in 1985. The existing surgical pharmacy satellite provided pharmaceutical services to the ESWL center with no addition of pharmacy staff. Drug boxes for the ESWL procedure were prepared, and the ESWL area was provided with a limited stock of infusion and irrigation fluids, drugs, and supplies. After each ESWL procedure, the box was checked for patient charges and restocked. Charge slips for floor-stock items were also placed in the box. The initial pharmacy cost to supply the ESWL unit was $500. The satellite pharmacist provides distributive functions, drug information, and quality assurance. Estimated annual pharmacy revenue from the ESWL is $239,240. Pharmacists' new role in the ESWL was beneficial to the pharmacy department and to the hospital.

Centralized Hospital Services↗
PubMed1987

Survey of small hospitals.

The CSHP Saskatchewan Branch created the position of Small Hospital Representative on their Executive Committee. This appointed person's major function was to improve representation on the Executive Committee for hospitals outside of Saskatoon and Regina. The representative sent a survey to these hospitals to establish the status of pharmacy practice in these hospitals and how to best serve them. There were 90 of 128 (70.3%) surveys completed. Survey results were separated into hospitals which employed pharmacists and those which did not. Elements of practice reported by hospitals with a pharmacist, which showed some degree of deficiency, included drug distribution systems, medication profiles and clinical pharmacy programs. Hospitals which did not employ a pharmacist obtained their pharmacy services from either a larger hospital or a local retail pharmacist. There were 11 hospitals which had no access to a pharmacist, depending on the Director of Nursing for medication-related activities. The Small Hospital Representative of CSHP Saskatchewan Branch, in co-operation with the professional associations used this study as a starting point in attempts to improve pharmacy practice in Saskatchewan in hospitals outside of Saskatoon and Regina.

Data Collection↗
PubMed2005

Capturing data on medicines usage: the potential of community pharmacy databases.

AIMS: The initial aim of the research projects was to examine the geographic distribution, patronage patterns, and loyalty of prescription clients around individual community pharmacies. A second aim was to explore the geographical and socioeconomic variation in the use of prescription medicines and prescribing trends both between and within therapeutic classes. METHODS: Geographic Information Systems (GIS) technology (including the tabulating, geocoding, and mapping functions) was used to analyse the information that is held in community pharmacy databases. RESULTS: These studies demonstrated the use of this technology to show variation in local use of prescription medicines, at both an individual level and a population level, through the analysis of data already held in community pharmacy databases. CONCLUSION: The use of GIS technology and pre-existing community pharmacy databases enables improved data capture on the prescription--and medication-related behaviour of health-service consumers.

Community Pharmacy Services↗
PubMed1991

Cost considerations of analgesic therapy: an analysis of the effects of dosing frequency and route of administration.

Using work sampling methodologies, we compared both acquisition and administration costs of equivalent daily doses of controlled-release morphine tablets and morphine sulphate solution. A total cost for each drug therapy was derived by summing: (i) the acquisition cost of the medication, (ii) the cost of drug administration supplies, (iii) the cost of pharmacy time required for packaging and distribution of doses to nursing units, (iv) the cost of nursing time required to administer the medication, (v) the cost of nursing time required to complete the requisite narcotic records. Acquisition costs for controlled-release morphine tablets, morphine sulphate solution and ancillary materials required for dosing were those actually paid by the hospital pharmacy at the time of the study. Costs for nursing and pharmacy time for administration of doses were based on our analysis of the time required to perform each step of the procedure and the median hourly wage for the corresponding position from the British Columbia collective agreement. Assuming a mean total daily morphine dose of 120 mg, administered as one 60 mg controlled-release morphine tablet 12 hourly or 20 mg (4 ml of 5 mg/ml) morphine sulphate solution 4 hourly, morphine solution had a lower acquisition cost than controlled-release tablets ($0.48 vs. $2.32 per day; respectively). However, the saving in acquisition costs was offset by a higher administration cost ($10.20 vs. $2.86 per day). These figures indicate that administration of 120 mg morphine per day to hospitalized patients for 30 days would have a total cost of $155.40 using a regimen to 60 mg controlled-release morphine 12 hourly. In contrast, total cost for a 30 day regimen of 20 mg morphine solution 4 hourly would be $320.40. Thus, an analysis which considers both acquisition and administration costs reveals that the frequency of administration is an important factor in the overall cost of drug therapy and that controlled-release formulations may ultimately be less costly to administer than their immediate release counterparts. A separate analysis of costs associated with the administration of morphine by continuous subcutaneous infusion demonstrated that providing analgesia by this route was significantly more costly than via the oral route.

Administration, Oral↗
PubMed1986

Cost and price of comparable branded and generic pharmaceuticals.

Substituting generic for brand drugs has been increasing for two decades with the expectation that it leads to important savings. We studied 891 862 prescriptions, written for 21 pairs of branded and generic drugs, dispensed between April 1, 1984, and June 30, 1984, by 1363 selected pharmacies in 39 states. The cost per pill paid by the pharmacy was always less for the generic than the branded drug. The price per pill paid by the consumer was usually less for the generic than the brand. The wide and skewed distribution of consumer prices within and among pharmacies means that consumers cannot be guaranteed the lowest cost simply by buying generic drugs. The probability that generic would be less expensive than brand varied widely across drug pairs from .33 to .99. Continued search is no guarantee that the full distribution of prices or the lowest or nearly-lowest price will be found.

Cost Control↗
PubMed1989

Overestimating clinical functions of distributive staff pharmacists.

An unexpected outcome was obtained when an evaluation of the clinical functions performed by distributive staff pharmacists was completed. A random survey of clinical functions was completed by using a pharmacist activity log sheet. Direct observations made by pharmacy administration and information received through discussions with the staff pharmacists, over-estimated the actual amount of time being spent on clinical functions. Use of an integrated approach to pharmacy services requires that enough time for both distributive activities and clinical activities be appropriately balanced to assure effective intervention. PRN clinical pharmacy functions will produce sub-optimal results and negative long-term effects for the profession. Pharmacy administrators must prospectively monitor the clinical activities performed by members of their integrated staff and assure that adequate time is available for effective intervention in the drug use process. Subjective observations and information may not reflect the actual situation and should be considered extremely inaccurate.

Clinical Competence↗