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PubMed1988

Unresolved issues in the future of pharmacy.

The effect of the major forces shaping pharmacy's future--technology, economics, and social values--is discussed. Pharmacy can best respond to these forces by expanding the informational component of pharmacy practice and by returning to its fundamental relationship with society--that is, by accepting responsibility for drug-use control. To accomplish this, pharmacy must go through a process of occupational reconstruction and self-renewal. Technological forces shaping pharmacy practice include computers and robotics, communications, and therapeutics. Regarding economic changes, medical-care decisions are shifting away from individuals toward "third parties." This factor, combined with output-based payment systems, may lead to a consolidation of service providers. Marketing pharmaceutical services and organizing pharmacy's internal structure will become important. Some of the social forces affecting pharmacy's future include the aging population, the weakening of professional authority, and pharmacy's public image. Just as society goes through the "information revolution," pharmacy will need to undergo a "reprofessionalization." Pharmacy's societal function should involve "pharmaceutical care," a concept that includes both drug-product control and clinical pharmacy services. Pharmacy should return to its preindustrial origins in valued, complex, specific, and committed public service if it wishes a happy postindustrial future.

Pharmacy↗
PubMed2005

Counselling quality in community pharmacies: implementation of the pseudo customer methodology in Germany.

OBJECTIVES: To investigate a new method for evaluating counselling performance of staff in community pharmacies and to assess the quality of patient counselling. METHOD: Trained pseudo customers, instructed to play their role according to two different self-medication scenarios, visited voluntarily participating community pharmacies in Berlin. After documenting the counselling process, immediately after each visit, outside the pharmacy on an assessment form, the pseudo customer re-entered the pharmacy and gave detailed performance feedback to the counsellor and the pharmacist in charge in order to provide support for improving counselling skills and practice behaviour, when appropriate. This was followed with a written summary of the general performance of all participating pharmacies and additional individual feedback and suggestions for improvement. Educational needs were identified for subsequent performance-based educational strategies such as group-workshops, team-training and on-site team-coaching. RESULTS: Forty-nine community pharmacies in Berlin volunteered to participate in this pilot study. Ninety-eight per cent of the participating pharmacies offered advice. However, in 36% of the cases, advice was only given on request. The different types of scenarios--presentation of a symptom or request for a specific product--made a great difference to the spontaneity of questions and advice. At least one question to check on accuracy of self-diagnosis was asked in 95% of the cases of symptom presentation but in only 47% of the cases of specific product request. Information on appropriate self-medication was provided on at least one item in 74% of pseudo customer visits, but most of the time the information was not sufficient. Communication skills (nonverbal elements, comprehensibility etc.) were very good or good in 54% of the visits. Potential for improvement was mainly in relation to the use of open-ended questions to gain more information and on counselling about appropriate self-medication. Direct feedback was given in 96% of the pharmacies (one person refused to accept feedback and one feedback had to be postponed because of time shortage). All of the participants regarded counselling as an important subject in pharmacy practice. CONCLUSION: The pseudo customer method was successfully used in this study of German community pharmacies. It was shown that pseudo customer visits and performance feedback following the counselling process, were feasible in daily practice and well accepted by the participants. A training program, focussing on areas in most need of improvement, has been developed. The promising results have led to the Federal Chamber of Pharmacists in Germany adopting this method as part of a continuous quality improvement program in community pharmacies.

Community Pharmacy Services↗
PubMed1987

Pharmacy practice in the United States Army.

The current status of pharmaceutical services in the United States Army Medical Department is described. The mission of the Army Medical Department is to ensure the health of the soldier during times of peace and war. Of the 225 commissioned pharmacy officers currently on active duty, 156 are assigned to U.S. Army medical centers and community hospitals in the United States, and 29 are stationed at hospitals in Europe, Korea, Panama, and Japan. Army pharmacy officers are supported by 879 Army-trained pharmacy technicians and 319 civilian pharmacists employed by the Army. Army Medical Department hospital pharmacies provide inpatient and ambulatory-care services as well as specialized nuclear pharmacy, oncology, investigational drug, and materials development services. Pharmacy officers assigned to the Pharmacy Branch of the U.S. Army Academy of Health Sciences conduct 17-week technician training programs six times a year and provide other pharmacy courses and continuing education programs. The U.S. Army Allergen Extract Laboratory dispenses diagnostic and immunotherapy agents by mail in response to prescriptions submitted by military allergy clinics. Pharmacy officers may be deployed with field hospitals during times of combat or for extended training exercises in places such as Egypt, Grenada, and Honduras. Pharmacy officers may also be assigned to three- or four-year tours of duty in Army hospitals located in Europe. In the future, the emphasis of Army pharmacy practice will be on the expansion of clinical pharmaceutical services and the development of advanced interactive communication systems, quality assurance programs, and peer-review programs.

Allergens↗
PubMedDate not supplied

Impact of Hurricane Ivan on pharmacies in Baldwin County, Alabama.

OBJECTIVE: To evaluate the impact of Hurricane Ivan, which made landfall east of Mobile, Alabama, on September 16, 2004, on pharmacies in the affected areas. DESIGN: Retrospective cross-sectional analysis. SETTING: Baldwin County, Alabama. INTERVENTIONS: Pharmacy community rapid-needs-assessment survey. PARTICIPANTS: 41 hospital and community (chain and independent) pharmacies. MAIN OUTCOME MEASURES: Posthurricane pharmacy hours of operations, prescription volumes, infrastructure damage, and prehurricane disaster planning. RESULTS: During the week of the hurricane, both chain and independent community pharmacies within the evacuation zone worked significantly fewer hours (46% and 49%, respectively) and dispensed significantly fewer prescriptions (37% and 52%) compared with the same week of the prior year. Overall, 40% of pharmacies depleted their supplies of certain medications (e.g., anxiolytics, antihypertensives). A total of 60% of the chain and independent pharmacies outside the evacuation zone closed because of loss of electricity, but pharmacies with a generator were significantly less likely to report having turned away patients. The proportion of pharmacies that had a disaster plan but turned away patients or rationed or ran out of medications was similar to that of pharmacies without a disaster plan. CONCLUSION: Although Hurricane Ivan primarily affected the operation of pharmacies within the evacuation zone, pharmacies in the surrounding area were also affected because of loss of power. Emergency management officials should evaluate the efficacy of specific guidelines outlined in disaster plans and identify ways to deliver essential medications to people in disaster-affected areas.

Alabama↗
PubMed1999

Pharmacy Distribution of Advice, Symptomatic Treatment and Antimicrobial Drugs to Patients with Cough.

It is an accepted fact that, in many countries, pharmacies are the predominant source of medical advice over-the-counter drugs, and supplies of "prescription-only" drugs for sale without a prescription. To assess the activities conducted by pharmacists or pharmacy counter assistants in response to a common health problem, a cross-sectional study was done at 114 pharmacies in Porto Alegre, Brazil. A fictitious case-history of cough was used by trained personnel entering the pharmacy and the subsequent activities by the pharmacist or pharmacy counter assistant were analyzed. Some kind of medication was provided in 101 (88.5%) of the pharmacies. Pharmacists gave medication in 80% of pharmacies, and pharmacy assistants in 95.5% (p<0.03). The class of medication most frequently dispensed was the expectorants (97 times, 92.4%), however, systemic antibiotics were provided in 11 pharmacies (10.5%). Of note, the pharmacists provided antibiotics more frequently than did pharmacy assistants (p=0.016). We conclude that pharmacy advice and symptomatic medical care (expectorants) are very common and that pharmacy assistants are more likely than pharmacists to provide medication. Of concern, when pharmacists were the drug dispensers of antibiotics which should be provided by prescription only, drugs were provided without proper diagnosis, and often in incorrect dosages. This reflects a potentially dangerous practice in need of careful evaluation, education and supervision.

Journal Article↗
PubMed1996

The impact of face-to-face educational outreach on diarrhoea treatment in pharmacies.

Private pharmacies are an important source of health care in developing countries. A number of studies have documented deficiencies in treatment, but little has been done to improve practices. We conducted two controlled trials to determine the efficacy of face-to-face educational outreach in improving communication and product sales for cases of diarrhoea in children in 194 private pharmacies in two developing countries. A training guide was developed to enable a national diarrhoea control programme to identify problems and their causes in pharmacies, using quantitative and qualitative research methods. The guide also facilitates the design, implementation, and evaluation of an educational intervention, which includes brief one-on-one meetings between diarrhoea programme educators and pharmacists/owners, followed by one small group training session with all counter attendants working in the pharmacies. We evaluated the short-term impact of this intervention using a before-and-after comparison group design in Kenya, and a randomized controlled design in Indonesia, with the pharmacy as unit of analysis in both countries (n = 107 pharmacies in Kenya; n = 87 in Indonesia). Using trained surrogate patients posing as mothers of a child under five with diarrhoea, we measured sales of oral rehydration salts (ORS); sales of antidiarrhoeal agents; and history-taking and advice to continue fluids and food. We also measured knowledge about dehydration and drugs to treat diarrhoea among Kenyan pharmacy employees after training. Major discrepancies were found at baseline between reported and observed behaviour. For example, 66% of pharmacy attendants in Kenya, and 53% in Indonesia, reported selling ORS for the previous case of child diarrhoea, but in only 33% and 5% of surrogate patient visits was ORS actually sold for such cases. After training, there was a significant increase in knowledge about diarrhoea and its treatment among counter attendants in Kenya, where these changes were measured. Sales of ORS in intervention pharmacies increased by an average of 30% in Kenya (almost a two-fold increase) and 21% in Indonesia compared to controls (p < 0.05); antidiarrhoeal sales declined by an average of 15% in Kenya and 20% in Indonesia compared to controls (p < 0.05). There was a trend toward increased communication in both countries, and in Kenya we observed significant increases in discussion of dehydration during pharmacy visits (p < 0.05). We conclude that face-to-face training of pharmacy attendants which targets deficits in knowledge and specific problem behaviours can result in significant short-term improvements in product sales and communication with customers. The positive effects and cost-effectiveness of such programmes need to be tested over a longer period for other health problems and in other countries.

Adult↗
PubMed1995

The future of pharmacy: Armageddon or Pollyanna?

OBJECTIVE: To review important events and predictions about pharmacy that have occurred in the practice since my career began and describe changes in opportunities that have developed over the past 35 years. DATA SOURCES: I used personal recollections and information from the State of Florida Pharmacy Association journal over a 35-year period. Other supporting data were used to describe current practice opportunities. DATA SYNTHESIS: Over the past 35 years many people have predicted the demise of the pharmacy profession. The reasons stated for this demise have varied over the years and include government interference, the expansion of chain and mail-order pharmacies, managed care, loss of the compounding function, Medicaid reimbursement, national health insurance, and pharmacy technicians. Despite these gloomy predictions, community and hospital pharmacies have flourished over the past 35 years and new roles for pharmacists have emerged in managed care, consultant pharmacy, academic pharmacy, and the pharmaceutical industry. With the enactment of the Omnibus Budget Reconciliation Act of 1990 requirements, it appears that the public has even greater expectations from community pharmacists as medication advisors. The pharmacy profession is changing more rapidly than ever and pharmacists must prepare for these rapid changes. Colleges of pharmacy should inculcate in their students the importance of lifelong learning to keep abreast with change. CONCLUSIONS: Society will always need experts on drugs. Pharmacists must rise to the challenge and accept new and changing roles in drug therapy management. If that occurs the future of pharmacy will be ensured.

Forecasting↗
PubMed2005

Providing patient care in community pharmacies in Australia.

OBJECTIVE: To describe Australia's community pharmacy network in the context of the health system and outline the provision of services. DATA SYNTHESIS: The 5000 community pharmacies form a key component of the healthcare system for Australians, for whom health expenditures represent 9% of the Gross Domestic Product. A typical community pharmacy dispenses 880 prescriptions per week. Pharmacists are key partners in the Government's National Medicines Policy and contribute to its objectives through the provision of cognitive pharmaceutical services (CPS). The Third Community Pharmacy Agreement included funding for CPS including medication review and the provision of written drug information. Funding is also provided for a quality assurance platform with which the majority of pharmacies are accredited. Fifteen million dollars (Australian) have been allocated to research in community pharmacy, which has focused on achieving quality use of medicines (QUM), as well as developing new CPS and facilitating change. Elements of the Agreements have taken into account QUM principles and are now significant drivers of practice change. Although accounting for 10% of remuneration for community pharmacy, the provision of CPS represents a significant shift in focus to view pharmacy as a service provider. Delivery of CPS through the community pharmacy network provides sustainability for primary health care due to improvement in quality presumably associated with a reduction in healthcare costs. CONCLUSIONS: Australian pharmacy practice is moving strongly in the direction of CPS provision; however, change does not occur easily. The development of a change management strategy is underway to improve the uptake of professional and business opportunities in community pharmacy.

Australia↗
PubMed1990

Revisiting "The strengths of pharmacy": the 1953 Remington Medal address.

Five reasons for the continued strength of the pharmacy profession, each of which was originally proposed in 1953 by Hugh Muldoon, are explored in this address by 1990 Remington Medalist Joseph A. Oddis. The strengths of pharmacy in the 1990s are based on the same factors that served the profession well in the 1950s. As outlined in Muldoon's 1953 Remington Medal address, these factors are (1) pharmacists' character and motivation, (2) the profession's public trust, (3) the profession's respect for education, (4) pharmacy's willingness to confront its problems, and (5) pharmacy's concern for the future. Today's pharmacists are strongly motivated; they continue to strive to raise the level of services provided in all practice settings and to maximize their value to patients. Pharmacists retain a high degree of public trust; they should take advantage of this position to expand their scope of services in areas such as managed care. During the 1990s pharmacy's concern for education is focused on pharmacy work force needs as a whole, including issues related to technical personnel and specialization as well as the role of the Pharm.D. degree in the overall education program. Pharmacy's willingness to resolve its problems is evident in the growth of such organizations as the Joint Commission of Pharmacy Practitioners, which has allowed the profession to achieve strength through unity. Pharmacy's concern for the future is reflected in the deliberations at recent conferences on Pharmacy in the 21st Century, where participants concurred that pharmacy's highest priority is to demonstrate and communicate to others its value in health care.(ABSTRACT TRUNCATED AT 250 WORDS)

Education, Pharmacy↗
PubMed1987

Pharmacy: a profession in transition or a transitory profession?

Areas in pharmacy that are in transition are described, and ways to prevent the perception of pharmacy as a transitory profession are detailed. Pharmacy has adapted itself over the past 75 years to changes in the health-care system and in societal demands of the profession. The evolution of pharmacy functions has included drug product preparation, establishment of standards, drug distribution, and clinical pharmacy. The profession is continuing to change in reaction to economic and social forces. Hospital pharmacy flourished when it shifted from a profit to a cost center because pharmacy practice researchers documented the contribution of clinical pharmacy to patient care and because hospital pharmacy administrators developed sound management procedures to maintain efficient inventories. Current controversies in pharmacy practice are discussed, including pharmacist prescribing, physician dispensing, and therapeutic substitution. These terms inadequately describe the concepts, especially when they are taken out of context of the total health-care process involving a physician-pharmacist team. Because of the success of this teamwork in acute-care institutions, ambulatory pharmaceutical services should involve cooperative activities of pharmacists in professional service administrative organizations (PSAOs) and physicians in independent practice associations. The cost-effectiveness of PSAOs is discussed. Marketing of drug products is changing as the physician-pharmacist interaction becomes integral to the drug therapy decision-making process. Drug distribution should not be viewed as less professional than clinical activities. Although the pharmacy profession is reorienting itself toward patient care and the rational use of drugs in society, it must maintain its authority over the drug distribution system.

Drug Prescriptions↗
PubMed2006

Consumer satisfaction with community pharmacies in Warri, Nigeria.

BACKGROUND: Consumer satisfaction is likely to affect the image of the pharmacist and pharmacy profession. Efforts should not only be made to track consumer satisfaction with pharmacy services but also to improve it where needed. OBJECTIVE: To investigate consumer satisfaction with community pharmacies in a Nigerian city. METHODS: A cross-sectional survey of a consecutive sample of 700 pharmacy consumers at 35 randomly selected community pharmacies was conducted. Data were gathered on consumer demographics and their satisfaction with the community pharmacies using a 32-item rated instrument that combined pharmaceutical care and traditional pharmacy items. Descriptive statistics was computed on sample characteristics and the questionnaire items. Inferential statistics used Student's t test and one-way ANOVA. RESULTS: The response rate for the survey was 71.9% (503/700). Cronbach's alpha test of reliability was computed to be 0.980. Of the respondents, 298 (59.2%), 284 (56.5%), and 101 (20.1%) rated their satisfaction as excellent regarding availability of genuine drugs, the pharmacist, and household consumer goods, respectively. The mean total score for pharmaceutical care items was found to be 3.50+/-1.32, while the mean total score for traditional pharmacy items was computed to be 3.56+/-1.34 (midpoint=3, range=1 to 5). Consumers' income status was associated with their satisfaction, with the lower income earners experiencing higher satisfaction (F=2.668, P=.050). CONCLUSION: Consumers in this survey experienced moderate service satisfaction with their community pharmacy encounters. The consumers were most satisfied with the pharmacists' professional attitude but dissatisfied with the provision of nondrug services in the community pharmacy. These services are mainly health promotion activities that are advocated under pharmaceutical care philosophy. There is an opportunity for the community pharmacies to introduce new services and enhance their consumer loyalty.

Adolescent↗
PubMedDate not supplied

Profitability, third-party reimbursement, and access to community pharmacies.

The purpose of this study was to analyze the extent to which third-party reimbursement programs have affected the profitability and availability of community pharmacies. Data were taken from records maintained by the Virginia Board of Pharmacy and a survey of 177 community pharmacies. Between 1989 and 1994, 258 outpatient pharmacies opened and 342 closed. Chain and independent pharmacies suffered net losses, and supermarket and mass merchandiser pharmacies experienced net increases. Few significant changes occurred in the distribution of pharmacies over the study period. Fifty-nine chain and independent pharmacies and 1 supermarket pharmacy chain provided usable profit and reimbursement data. These pharmacies experienced declines in profits and increases in the percentage of prescriptions reimbursed by private third-party prescription programs over the last several years. Regression analyses indicated that higher ratios of sales of private third-party prescriptions to private-pay prescriptions were associated with lower profits. All respondents indicated that changes in private third-party reimbursement had substantially reduced profits over the past 5 years. The results indicate that the growth of private third-party payment has led to lower pharmacy profits but has not yet resulted in problems of consumer access.

Costs and Cost Analysis↗
PubMed1995

Factors influencing the delivery of pharmacy services.

This study of 590 community pharmacies examined relationships between prescription payment methods and the number of pharmacy services provided at community pharmacies. Also studied were pharmacists' perceptions regarding: (1) the importance of 24 different pharmacy services, (2) the importance of three motivating factors in providing pharmacy services, (3) satisfaction with three methods of payment for pharmacy services, and (4) agreement with factors cited in the literature as barriers to pharmaceutical care. Results revealed a significant positive relationship (p < 0.05) between the number of pharmacy services provided and the percentage of private-pay prescriptions processed. A significant (p < 0.05) inverse relationship was identified between the number of pharmacy services provided and both the percentage of prescriptions processed for third parties other than Medicaid and the percentage of all third party prescriptions processed. Financial incentives were identified as the most important motivator in providing pharmacy services. Private-pay reimbursement was significantly more satisfactory to respondents than Medicaid reimbursement, and both were more satisfactory than reimbursement by a third party other than Medicaid. The greatest perceived barriers to the provision of pharmacy services involved financial and administrative considerations. Results suggest that financial incentives play a critical role in stimulating the provision of pharmacy services.

Adult↗
PubMed2005

Australian national strategy for pharmacy preceptor education and support.

OBJECTIVES: (i) To develop a national strategy for pharmacy preceptor education and support, with special consideration for rural and remote practitioners. (ii) To deliver an innovative national core pharmacist preceptor education and support model that could be customised for specific undergraduate programs. DESIGN: A steering committee, with representatives from four Pharmacy Schools in three Australian states, was established to develop an educational curriculum and implementation strategy. SETTING: The project was designed to provide an online educational program for preceptors of Australian pharmacy students, particularly those in rural areas. SUBJECTS: The recipients of this program will primarily be rural pharmacy preceptors but could also be urban practitioners. INTERVENTIONS: After consultation with an advisory group, the steering committee considered the educational content, delivery strategy and adaptability of the package to maintain its currency and links to universities, pharmacy boards and professional organisations: an extensive literature search was conducted; writers and an educational designer were employed. The steering committee reviewed and modified the content before transfer of the program to the worldwide web. MAIN OUTCOME MEASURE: The development of a Pharmacy Preceptor Education Program suitable for national application and able to fulfil the needs of rural preceptors. RESULTS: A Preceptor Education Program has been developed suitable for use in all Australian states and capable of meeting the needs of rural pharmacy preceptors. CONCLUSIONS: Collaboration between four schools of pharmacy and pharmacy professional bodies has resulted in development of a flexible program for preceptors of undergraduate pharmacy students. This program can be developed for use by preceptors of pharmacy graduates, and in other disciplines.

Australia↗
PubMed2004

Merchandising of cigarettes in San Francisco pharmacies: 27 years later.

OBJECTIVE: To estimate changes since 1976 in the proportion of San Francisco pharmacies that sell cigarettes and to characterise the advertising of cigarettes and the merchandising of non-prescription nicotine replacement therapy (NRT) products in these retail establishments. METHODS AND SETTING: 100 randomly selected San Francisco pharmacies were visited in 2003. Pharmacies were characterised based on the sale of cigarettes, advertising for cigarettes, and the merchandising of non-prescription NRT products. RESULTS: In 2003, 61% of pharmacies sold cigarettes, a significant decrease compared to 89% of pharmacies selling cigarettes in 1976 (p < 0.001); 84% of pharmacies selling cigarettes also displayed cigarette advertising. Non-prescription NRT products were stocked by 78% of pharmacies, and in 55% of pharmacies selling cigarettes, the NRT products were stocked immediately adjacent to the cigarettes. CONCLUSIONS: Since 1976, there has been a decline in the overall proportion of pharmacies in San Francisco that sell cigarettes yet most pharmacies, particularly traditional chain pharmacies, continue to merchandise the primary known risk factor for death in the USA.

Advertising↗
PubMed2003

Faculty turnover within academic pharmacy departments.

BACKGROUND: Pharmacy faculty manpower has been debated within the academic pharmacy community over the last several decades. Previous investigations studied job satisfaction among faculty members, but have not evaluated faculty retention and turnover among academic pharmacy departments. OBJECTIVE: To evaluate retention and turnover rates in the departments of Pharmacy Practice and Basic Science (Pharmacology/Toxicology, Pharmaceutics, Medicinal Chemistry) over the last 5 years. METHODS: Individual instructors and assistant, associate, and full professors across 80 colleges of pharmacy in the US were tracked between the years 1996 and 2001 using the American Association of Colleges of Pharmacy published rosters. Differences between departments were analyzed by year-stratified cross-tabulation table analysis. RESULTS: A greater percentage of Pharmacy Practice faculty resigned (10.6%) compared with Basic Science faculty (6.0%; percent ratio 1.76; 95% CI 1.58 to 1.95; p < 0.001), which remained constant across each academic year. Approximately 2.7 faculty members left their academic institutions per year in Pharmacy Practice compared with 1.1 faculty members in the aggregate of Basic Science departments. A higher percentage of women resigned in Pharmacy Practice (13.2%) than did men (8.7%; percent ratio 1.5; 95% CI 1.34 to 1.68; p < 0.001), despite a 1.3-fold male to female ratio. Likewise, regardless of a 4.1-fold male to female ratio in the Basic Science group, a higher percentage of women resigned (8.0%) than men (5.5%; percent ratio 1.45; 95% CI 1.18 to 1.78; p < 0.001). CONCLUSIONS: Over a 5-year period, Pharmacy Practice exhibited a higher turnover compared with Basic Science. Women displayed significantly higher turnover than men across all pharmacy academic departments. New retention approaches, especially for female faculty members, should be explored.

Education, Pharmacy↗
PubMedDate not supplied

Implementation of a patient medication assistance program in a community pharmacy setting.

OBJECTIVE: To describe the establishment of a community pharmacy-based patient medication assistance program to improve access to medications by indigent patients, lessen the burden placed on physicians in obtaining such medications, reduce the amount of money spent on such medications by area charitable organizations, and improve therapeutic outcomes by improving patient adherence with therapy. SETTING: Supermarket-based pharmacy in Ashland, Ohio. PRACTICE DESCRIPTION: Community pharmacy. PRACTICE INNOVATION: A partnership was developed among Buehler's Pharmacy #3, United Way of Ashland County, and United Way Affiliates to establish a community pharmacy-based medication assistance program to help indigent patients obtain needed medications through manufacturer assistance programs and discount card programs. INTERVENTIONS: Following initial screening by a United Way affiliate agency, patients are seen by appointment by a Certified Pharmacy Technician at the pharmacy. An electronic application is completed, printed, and sent to the patient's physician for signatures and medication orders. The paperwork is returned to the pharmacy, where it is completed, signed by the patient, and filed. The patient pays the United Way agency $10 and the pharmacy $15 for these services. MAIN OUTCOME MEASURES: Number of prescriptions dispensed cumulatively from April 1, 2003, to July 31, 2003, within the program, patients' cumulative savings, and community response. RESULTS: Between April 1, 2003, and July 31, 2003, a total of 123 patients and 47 physicians were served, and 512 medications valued at $112,139.00 were applied for and/or procured. The time lapse between filing of paperwork and receipt of medications varies from 1 to 6 weeks. While some manufacturers ship product to physicians or directly to patients, the process works better when the product is sent to the pharmacy, where it can be added to the patient's profile, screened for drug interactions and allergies, and dispensed with proper labels and counseling. CONCLUSION: Establishing a community pharmacy-based medication assistance program is an innovative spin on the traditional physician office, advocacy, or health-system setting and was found to be beneficial to the patients, physicians and other health care providers, and the community it served.

Charities↗
PubMedDate not supplied

Pharmacy executive leadership issues and associated skills, knowledge, and abilities.

OBJECTIVES: To identify challenges that current and future pharmacy executives are facing or will face in the future and to define what skills, knowledge, and abilities (SKAs) are required to successfully negotiate these challenges. DESIGN: Delphi method for executive decision making. SETTING: Civilian pharmacy profession. PARTICIPANTS: 110 pharmacists who graduated from the GlaxoSmithKline Executive Management Program for Pharmacy Leaders. INTERVENTIONS: Two iterations of the Delphi method for executive decision making separated by an expert panel content analysis. MAIN OUTCOME MEASURES: Round 1--participants were asked to identify five major issues they believed to be of greatest importance to pharmacy leaders in the next 5-10 years and name specific SKAs that might be needed by future leaders to successfully deal with those issues. An expert panel reviewed the issues, classified issues into specific domains, and titled each domain. Round 2-participants rated the SKAs on a 7-point scale according to their individual assessment of importance in each domain. RESULTS: For Delphi rounds 1 and 2, response rates were 21.8% and 18.2%, respectively. More than 100 total issue statements were identified. The expert panel sorted the issues into five domains: management and development of the pharmacy workforce, pharmacy finance, total quality management of work-flow systems, influences on the practice of pharmacy, and professional pharmacy leadership. Five of the top 15 SKAs-and all four highest ranked items--came from the professional pharmacy leadership domain, including ability to see the big picture, ability to demonstrate the value of pharmacy services, ability to lead and manage in an ethical manner, and skills for influencing an organization's senior leadership. CONCLUSION: Through successful integration of communication skills, critical thinking, and problem solving techniques, future public-sector pharmacy executives will be better equipped to effectively position their organizations and the profession for the challenges that lie ahead.

Decision Making↗