Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PHARMACIES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 433 records · Page 24Linked to original sources
PubMedDate not supplied

Strategic planning by independent community pharmacies.

OBJECTIVES: (1) To assess the degree and level of use of the strategic planning process (none, partly, fully) by independent community pharmacy owners/managers and (2) to evaluate the relationships between independent community pharmacy owners/managers' level of strategic planning and indicators of pharmacy performance; including new and refill prescriptions filled, gross margin, rated patient care performance, rated dispensing performance, rated non-pharmacy performance, and rated financial performance. DESIGN: Cross-sectional study. SETTING: United States. PARTICIPANTS: Nationwide random sample of 1,250 owners/managers of independent community pharmacies. INTERVENTIONS: Mailed survey. MAIN OUTCOME MEASURES: Quality of strategic planning conducted; pharmacy performance measures. RESULTS: Only 141 of 527 (26.8%) usable responses indicated use of some (77 pharmacies, 54.6%) or all (64 pharmacies, 45.4%) of the seven steps typical of strategic planning. Significant associations were observed between the level of strategic planning use and all pharmacy performance variables assessed, including indicators such as greater numbers of new and refill prescriptions dispensed, gross margins, patient care performance, dispensing performance, non-pharmacy performance, and financial performance. CONCLUSION: Greater ratings of pharmacy performance were significantly associated with the level of strategic planning use. Respondents who fully used strategic planning had significantly higher indicators than partial users; respondents who partly used the process had significantly higher ratings than respondents who did not conduct strategic planning.

Community Pharmacy Services↗
PubMedDate not supplied

Workload and availability of technology in metropolitan community pharmacies.

OBJECTIVE: To assess workload characteristics and the presence of prescription processing technologies within metropolitan community pharmacies in the United States. DESIGN: Cross-sectional postal survey. SETTING: 18 metropolitan statistical areas (MSAs) in the United States. PARTICIPANTS: 3000 managers located in community pharmacies processing at least 500 third-party claims per month for four major pharmacy benefits managers. INTERVENTIONS: 34-item survey instrument designed to collect data about the pharmacy including demographics, workload issues, handling of drug-drug interactions (DDIs), and pharmacists' attitudes toward computerized DDI alerts. MAIN OUTCOME MEASURES: Workload (hours of operation, prescription volume, staffing hours, prescription processing intensity) and prescription processing technologies (telecommunication systems, automated counting/filling or verification devices, number of computer terminals, and computer software vendors). RESULTS: Overall, 736 usable surveys were returned (response rate, 25.3%). On average, respondents reported a volume of approximately 1340 prescriptions per week processed at a rate of almost 17 prescriptions per hour. Independent pharmacies processed approximately 3 prescriptions per hour more than chain pharmacies even though a statistically equal or slightly lower proportion of those pharmacies had automated technologies. The presence of technology was generally high for all pharmacies, particularly countertop tablet/capsule-counting devices and telefacsimile machines. The most common software vendors differed considerably between chain and independent pharmacies. CONCLUSION: The number of prescriptions processed per hour and number of technologies available increased with the total weekly volume of prescriptions processed in this national survey. A majority of pharmacies had at least one type of automated prescription processing technology and an automated telecommunication system for accepting new or refill prescriptions. Independent pharmacies processed more prescriptions per hour than did chains but did so with fewer categories of technologies.

Automation↗
PubMed2005

Pharmaceutical care in community pharmacy: practice and research in the Netherlands.

OBJECTIVE: To describe the pharmaceutical care activities and research in community pharmacy in the Netherlands. FINDINGS: Pharmaceutical care is well advanced in Dutch pharmacy practice. This is largely due to the fact that clinical pharmacy was already an integrated part of community pharmacy practice by the end of the 1980s. Activities of the International Pharmaceutical Federation (FIP), some wholesale companies, and influential individuals in the Netherlands stimulated universities and the Royal Society for the Advancement of Pharmacy to advance the implementation of pharmaceutical care. DISCUSSION: Not all pharmacies in the Netherlands provide pharmaceutical care at the same level, although medication surveillance (concurrent and prospective medication analysis) is part of everyday practice. Implementation of quality assurance systems in community pharmacy practice could be helpful in assuring high levels of care. Similar to those in other countries, Dutch pharmacists are torn between the wish to provide pharmaceutical care and economic considerations, although the financial status of most pharmacies is still (very) healthy. New entrants into the market, such as supermarket and pharmacy chains, seem to put little emphasis on care provision. CONCLUSIONS: Pharmaceutical care has been implemented in many Dutch community pharmacies, but not everywhere to the same extent. Due to excellent automated medication surveillance; structured, high-quality medication counseling; and the fact that patients usually visit the same pharmacy, Dutch patients are well protected against many drug-related problems.

Community Pharmacy Services↗
PubMedDate not supplied

Community pharmacists and Colleges of Pharmacy: the Ohio partnership.

OBJECTIVE: To develop pharmacist practice standards, pharmacy preceptor standards, and objectives for students completing advanced practice community pharmacy rotations. SETTING: Ohio. PRACTICE DESCRIPTION: Pharmacy schools and community pharmacies that serve as advanced practice rotation sites. PRACTICE INNOVATION: Developed standards for preceptors and objectives for student experiences. INTERVENTIONS: Focus groups that included both community pharmacists and pharmacy faculty collaborated on defining key standards for advanced community pharmacy rotations. MAIN OUTCOME MEASURE: Not applicable. RESULTS: Three main documents were produced in this initiative, and these are provided as appendices to this article. Professional and patient care guidelines for preceptors define minimum standards for these role models. Expectations of pharmacists as preceptors provide insights for managing this student-teacher relationship, which is fundamentally different from the more common employer-employee and coworker relationships found in pharmacies of all types. Objectives for student experiences during advanced practice community pharmacy rotations present core expectations in clinical, dispensing, patient education, wellness, and drug information areas. CONCLUSION: Through this collaboration, Ohio colleges of pharmacy developed a partnership with practitioners in community settings that should enhance the Ohio experiential educational program for student pharmacists. Use of the established guidelines will help educators and practitioners achieve their shared vision for advanced practice community pharmacy rotations and promote high-quality patient care.

Community Pharmacy Services↗
PubMed2002

Quality of global e-pharmacies: can we safeguard consumers?

OBJECTIVE: E-pharmacies are web sites selling prescription-only medicines and other products including non-prescription and complementary medicines to consumers via the internet. This study aims to evaluate the quality of global e-pharmacies, discuss whether e-pharmacies support the safe and appropriate use of medicines, and consider how we can protect consumers in the future. METHODS: A survey of public information published on global e-pharmacy web sites was conducted between July and September 2001. We used a meta-search engine, Copernic, and the search terms of 'online' or 'internet', and 'pharmacy', 'pharmacies' and 'medicines' to identify a sampling frame of global e-pharmacies. We surveyed all web sites in the sampling frame except those under construction or only offering electronic refills, members-only and non-English web sites. Survey data included country of origin, range of medicines sold, prescription requirements, availability of online medical consultations and pharmacists' advice, quality accreditation seals, policies and advertisements. RESULTS: E-pharmacies operated in at least 13 countries; however, the country of origin could not be identified for 22 web sites. Twenty web sites (19%) appeared to supply prescription-only medicines with no prescription required. Only 12% of e-pharmacies displayed quality accreditation seals. We observed information published on e-pharmacy web sites that potentially undermines the safe and appropriate use of medicines. CONCLUSION: Safeguarding consumers and ensuring the quality of web sites that sell medicines across state and national boundaries is both complex and difficult. Strategies to improve the quality of e-pharmacies include independent third-party regulation of providers, evaluation and enforcement of sanctions in cases of dissemination of fraudulent or harmful information and practices, self-regulation and consumer education. The development of internet regulatory technologies themselves and the resolution of jurisdictional issues offer future solutions but international co-operation is vital.

Data Collection↗
PubMed2005

Do online pharmacies fit European internal markets?

The aim of this article is to consider the suitability of online pharmacies into European internal market area. This required considering the models of present online pharmacies in respect to the existing legislation. Data on online pharmacy settings was collected by looking some online pharmacies, which were found by using Goggle search machine with term "online pharmacy" and by studying websites of some well-known online pharmacies. European legislation and policy were studied from European Union's official website. Online drug markets seem to be increasing in popularity for reasons related to their ready availability and cost benefits. Few online pharmacies are based in Europe, yet online markets are worldwide. Community legislation does not stipulate on the legality of online pharmacies on European internal markets. Instead Community legislation offers framework for electronic commerce that could also include online pharmacy practise. National legislation, however, may rule them out either directly or indirectly. Regardless of European internal markets online pharmacies' cross-border operations are particularly complicated. Preliminary ruling from the European Court of Justice concerning one European online pharmacy's cross-border practise is awaited 2003-2004 and will offer some aspects for future.

European Union↗
PubMed2005

"We are white coats whirling round"--moral distress in Swedish pharmacies.

OBJECTIVE: The extended role of pharmacists has made pharmacy practice more complex and increased the moral responsibility of pharmacy staff. Consequently, ethics has become an important part of their daily work. In health care, ethical dilemmas have been shown to cause distress, usually referred to as "moral distress". Moral distress among hospital personnel has been well described and discussed in numerous studies. There are very few similar studies in pharmacy settings. This article reports on the results of an investigation concerning whether and in what situations moral distress is present in pharmacy practice. METHOD: A questionnaire derived from focus group data, covering ethically troubling situations in pharmacy settings, was distributed to all staff of three pharmacies in Sweden. RESULTS: The results show that moral distress is experienced in the day-to-day pharmacy practice, and that it is in many ways connected to care providing. For example, prioritizing between customers was reported as very stressful. Younger personnel reported higher moral distress than their older colleagues did. However, there were no differences between pharmacies. A lack of support structures, such as meetings where ethical issues can be discussed, was reported by all the participating pharmacies. CONCLUSION: It is reasonable to assume that moral distress is even more present in pharmacy practice than in other health care areas as it is, in general, much more sensitive and exposed to the modern, demanding customer. The meeting with the customer is on a more neutral ground than in, for example, a hospital setting. Although there are ethical codes for pharmacists, they are not enough. Moral distress is experienced anyway; general codes and personal coping strategies must be supplemented with support from the management and work organization. There is a need to look more closely at specific factors related to the degree and extension of moral distress, going beyond individual coping strategies.

Attitude of Health Personnel↗
PubMed1984

Hospital pharmacy supportive personnel utilization: a regional survey.

The results of a regional survey of hospital pharmacy supportive personnel (technicians) are presented. The data represents the responses from 118 directors of pharmacy in hospitals within a 150-mile radius of Pittsburgh, Pennsylvania. A high percentage of the hospitals (92.4%) utilize pharmacy technicians in some capacity. In hospitals employing pharmacy technicians, on the average, there is approximately one technician for each pharmacist. The demand for technicians is relative strong with 120 job openings each year because of turnover and new positions. The requirements for employment vary, but most institutions minimally required a high school diploma or equivalent. The vast majority of hospital pharmacy technicians possess a high school diploma with only a small percentage having any additional training. Only about 15% of the hospitals have any type of formal pharmacy technician program and almost 80% of the directors are in favor of external continuing education programs. Regarding how best to train and educate hospital pharmacy technicians, 66% of hospital pharmacy directors feel that a formal college or university based program should be required. Approximately one-third of the hospitals have various levels of pharmacy technicians, and the most important criteria for determining levels are experience, technical responsibility, and seniority. Although only eight percent of the hospital pharmacy technicians have any formal training, 36% of the hospitals would start graduates of formal educational programs at higher entry level positions.

Analysis of Variance↗
PubMed1988

Adjustments of distributive and clinical pharmacy services to financial constraints.

The effects of hospital budget constraints on a pharmacy department's ability to provide distributive and clinical services are described, and the development and use of workload-monitoring systems to match resources with demand is discussed. In 1980, the pharmacy department at Grace Hospital, a 402-bed community hospital in Detroit, Michigan, began quantifying workload by using five drug distribution indicators. After the pharmacy began providing clinical services in 1981, workload elements were measured in a pilot program for ASHP's Hospital Pharmacy Management Information System. Hospitalwide staff reductions occurred in 1985, eliminating most clinical pharmacy services. From 1985 to 1986, drug costs increased more than expected; also, turnaround time for medication orders increased. In 1986, 1.4 full-time-equivalent positions were added, and the pharmacy instituted use of decentralized carts and a pharmacist on the patient-care units to provide first doses. The hospital's management engineering department had selected patient days as the single indicator for pharmacy workload, but pharmacy used the ASHP Pharma Trend monitoring system to present data that convinced management engineering that patient days was an inadequate indicator of pharmacy workload. Also, drug costs decreased after the drug distribution changes and the reinstitution of patient drug therapy monitoring. Pharmacy managers need workload monitoring systems that are responsive to changes and include departmental expense information; these systems should be able to interrelate to hospital cost-accounting systems.

Cost Control↗
PubMed2006

Agreement and validity of pharmacy data versus self-report for use of osteoporosis medications among chronic glucocorticoid users.

PURPOSE: Pharmacy and linked claims databases are commonly used to determine medication receipt as a measure of quality of care. However, these data sources have not been previously compared with self-reported data for receipt of medications used for glucocorticoid-induced osteoporosis (GIOP). METHODS: Using databases from a national managed care organization (MCO), we identified 6282 chronic glucocorticoid users (60+ days in 18 months). We compared self-reported current use of alendronate, risedronate, calcitonin, and raloxifene (reference standard) to different intervals of preceding pharmacy data to determine agreement, sensitivity, specificity, and positive and negative predictive values of the pharmacy data. RESULTS: Survey respondents (n = 2363) were mean +/- SD age 53 +/- 14 years old, 70% women, and 78% Caucasian. Agreement between self-reported and pharmacy data ranged from Kappa = 0.64 (95%CI 0.53-0.75) (calcitonin) to 0.80 (0.76-0.84) (alendronate). The positive predictive value of a filled prescription in the pharmacy database in the prior 6 months exceeded 90% compared to the reference standard of self-reported current bisphosphonate use. However, the 6-month interval of pharmacy data failed to capture >25% of self-reported current bisphosphonate users. The optimal interval of pharmacy data to distinguish between current and past bisphosphonate users was 120-180 days. CONCLUSIONS: Among chronic glucocorticoid users enrolled in managed care, underreporting of current osteoporosis medication use was uncommon, and agreement between self-report and pharmacy data was high. Use of pharmacy data alone is unlikely to underestimate quality of osteoporosis care, but different intervals of pharmacy data have important implications on the ability to identify current users of osteoporosis medications.

Alendronate↗
PubMed1986

Utilization of pharmacies and pharmaceutical drugs in Addis Ababa, Ethiopia.

This paper examines recent developments in the pharmaceutical retail trade in socialist Ethiopia and presents the results of two surveys on pharmacy utilization in Addis Ababa. Surveys were carried out in 6 private and 5 government pharmacies. Objectives are: (1) to examine drug retailer utilization in relation to locational, transportation and retailer-related factors; (2) evaluate the role of socioeconomic factors in pharmacy and drug utilization; and (3) determine distance decay associated with clients' trip origins and the location of their residences as indicators of service areas. Although most clients originated in Addis Ababa, large numbers came from rural areas, especially in the pharmacies near large markets and other shopping areas in the inner city. Centrally located retailers also served more Addis Ababa residents and larger sections of the city than peripherally located retailers, largely due to a combination of urban structure, distribution of health care facilities, prevailing drug shopping behavior and population distribution. Government pharmacies had larger service areas and served larger numbers of clients than private pharmacies, primarily due to lower prices and greater availability of pharmaceuticals. Mean distance from pharmacies to places of origin of trips was smaller than mean distance from pharmacies to residences of the same clients. Similarly, distance decay gradients were steeper for the former than the latter in the 4 pharmacies studied in the second part of the survey, indicating the greater suitability of origin of trip as a parameter of service area. Type and price of drugs purchased were associated with socioeconomic factors, particularly level of education and housing/environmental health conditions in two districts, but there was little variation in the small number of drugs purchased per client. Several forms of drug-purchasing behavior of pharmacy clients and selling practices of private retailers are described as adaptive responses to prevailing economic and sociopolitical conditions. The study concludes that population-based studies of disease occurrence and health behavior are needed to better evaluate the health needs of the population for the planning of additional drug retailers in Addis Ababa's suburban districts.

Developing Countries↗
PubMed2006

Birth control within reach: a national survey on women's attitudes toward and interest in pharmacy access to hormonal contraception.

OBJECTIVE: This survey was conducted to better understand women's experiences with hormonal contraception and their interest in and attitudes toward gaining direct access to oral contraception (OC), patch, ring or emergency contraception (EC) in pharmacies. METHOD: A nationally representative telephone survey of 811 women aged 18-44 years who were at risk for unintended pregnancy was conducted in the United States. RESULTS: It was found that 68% of women in the United States said they would use pharmacy access to OC, patch, ring and/or EC. Likely users include women not using contraception who would begin using hormonal contraceptives (41%) if they were available directly in pharmacies, and OC, patch or ring users who were interested in obtaining their method this way (66%). Over half of the women (55%) said they would be more likely to use EC if they were available directly in pharmacies. Interest in pharmacy access is higher among uninsured and low-income women. Support for pharmacy access hinges on pharmacist screening, with 63% of women agreeing that OC, patch and ring should be available without prescription if pharmacists screen women for medically safe use. CONCLUSION: Most women in the United States believe that hormonal contraception should be available without prescription and would personally use pharmacy access. Seventeen to 22 million women constitute the potential market for pharmacy access to hormonal contraceptives in the United States. Women's enthusiasm for pharmacy access suggests that the pharmacy is an important site for the provision of sexual health education, screening and supplies.

Administration, Cutaneous↗
PubMed2005

Differences in prescription opioid analgesic availability: comparing minority and white pharmacies across Michigan.

UNLABELLED: Little is known about physical barriers to adequate pain treatment for minorities. This investigation explored sociodemographic determinants of pain medication availability in Michigan pharmacies. A cross-sectional survey-based study with census data and data provided by Michigan community retail pharmacists was designed. Sufficient opioid analgesic supplies was defined as stocking at least one long-acting, short-acting, and combination opioid analgesic. Pharmacies located in minority ( or=70% white residents) zip code areas were randomly selected by using a 2-stage sampling selection process (response rate, 80%). For the 190 pharmacies surveyed, most were located in white areas (51.6%) and had sufficient supplies (84.1%). After accounting for zip code median age and stratifying by income, pharmacies in white areas (odds ratio, 13.36 high income vs 54.42 low income) and noncorporate pharmacies (odds ratio, 24.92 high income vs 3.61 low income) were more likely to have sufficient opioid analgesic supplies (P < .005). Racial differences in the odds of having a sufficient supply were significantly higher in low income areas when compared with high income areas. Having a pharmacy located near a hospital did not change the availability for opioid analgesics. Persons living in predominantly minority areas experienced significant barriers to accessing pain medication, with greater disparities in low income areas regardless of ethnic composition. Differences were also found on the basis of pharmacy type, suggesting variability in pharmacist's decision making. PERSPECTIVE: Michigan pharmacies in minority zip codes were 52 times less likely to carry sufficient opioid analgesics than pharmacies in white zip codes regardless of income. Lower income areas and corporate pharmacies were less likely to carry sufficient opioid analgesics. This study illustrates barriers to pain care and has public health implications.

Adult↗
PubMedDate not supplied

Pharmacy staff interventions in a medical center hematology-oncology service.

OBJECTIVES: Many pharmaceutical care efforts remain undocumented, resulting in underestimation of the importance of the pharmacy staff interventions and missed opportunities to find new directions for quality improvement. The purpose of this project was to document and analyze the pharmaceutical care interventions of the staff of a hematology-oncology pharmacy. DESIGN: Interventions were self-reported by pharmacy staff members. The data collection period was October 1, 1995, to May 31, 1996. Intervention analysis consisted to types of interventions performed, categories of personnel performing interventions, intervention acceptance rate by staff physicians, and medication cost avoidance. PARTICIPANTS: This project was performed by the Hematology-Oncology Pharmacy Service, Department of Pharmacy, Walter Reed Army Medical Center, Washington, D.C. SETTING: Walter Reed Army Medical Center, Washington, DC, a 1,000-bed teaching and research institution of the U.S. Army Medical Department. RESULTS: Pharmacy staff reported 503 interventions. The leading categories of interventions were clinical consultations (167), correction of prescribing errors (85), and patient treatment procedures (65). The interventions were primarily initiated by oncology pharmacists and residents (68.8%) and oncology pharmacy technicians (30.6%). The intervention acceptance rate was 97%. Medication cost avoidance was $23,091. CONCLUSION: A significant amount of pharmaceutical care was documented by the hematology-oncology pharmacy staff, with both oncology pharmacists and oncology pharmacy technicians making key contributions. The pharmacy staff's interventions had a high rate of acceptance by the medical and nursing staffs, and resulted in significant medication cost avoidance.

District of Columbia↗
PubMedDate not supplied

Evaluating the use and quality of pharmacy drive-up services.

OBJECTIVE: To evaluate the use and quality of pharmacy drive-up services; specifically, to assess patients' and pharmacists' views of the drive-up and determine the implications for assuring or improving the quality of the services provided. DESIGN: Questionnaires developed for patients and pharmacists addressed aspects of pharmacy drive-up services. The patient questionnaire asked about prescription information and drive-up use, satisfaction with pharmacy services, importance of patronage factors, comfort in using the drive-up, and comparison of drive-up and in-store visits. The pharmacist questionnaire was similar in content, but also contained open-ended questions pertaining to the provision of pharmaceutical care at the drive-up pharmacy. SETTING: Six pharmacies in Central Iowa. PARTICIPANTS: A sample of patients who had received at least one prescription from a participating pharmacy in the previous 30 days; pharmacists from participating pharmacies. MAIN OUTCOME MEASURES: Responses from users and nonusers of the pharmacy drive-up. RESULTS: Both users and nonusers of the drive-up indicated that pharmacist-linked services--those that entail direct pharmacist-patient contact and are closely associated with the ideals of pharmaceutical care--may be provided better in-store. The pharmacists also indicated that these services were provided better in-store and mentioned other ways in which drive-up services may detract from patient care. CONCLUSION: As pharmacist-linked services become more important in health care, and as drive-up pharmacy services increase in popularity, the compatibility of drive-up service with a greater emphasis by pharmacists on patient care will increasingly become an issue. To allay potential concerns and improve the quality of service, pharmacists need to take additional steps to assess drive-up patients' level of familiarity with their medications, require patients to come into the pharmacy periodically, and, where necessary, provide alternative services at the drive-up.

Adult↗
PubMed2002

A survey of pharmacists' opinions and practices related to the sale of cigarettes in pharmacies-revisited.

The objective of the study was to follow-up on important findings from a 1996 statewide survey of Indiana pharmacists regarding their opinions and practices related to the sale of cigarettes in pharmacies. More specifically, this study was designed to (1) collect 2001 state-wide data concerning the percentage of Indiana pharmacies selling cigarettes and to learn what pharmacists think about the sale of cigarettes in their stores; (2) compare these findings with results from a 1996 study; and collect new information on (3) whether a cigarette selling policy in pharmacies in which pharmacists are employed differs from their professional and personal values; (4) pharmacists' opinions related to state-wide initiatives on tobacco control in Indiana; and (5) the level of involvement with smoking cessation activities by community pharmacists. A 1996 survey instrument of Indiana pharmacists opinions and practices related to the sale of cigarettes in pharmacies served as the basis for questionnaire design. In addition, 11 new items were added to assess the three new objectives of the study. This questionnaire was administered to half of the 1,280 pharmacies in Indiana. Collected data were analyzed by using descriptive and inferential statistical methods. Findings reveal that independent pharmacies had significantly reduced their sale of cigarettes from 1996 while there was no significant change among retail chain pharmacies. Additionally, significantly more pharmacists in 2001 believed that pharmacies should not sell cigarettes compared to five years ago. Also, more than three-fourths of pharmacists who worked in pharmacies that sold cigarettes felt it differed from their professional values. When it came to pharmacists involvement in tobacco control activities, results were mixed. This study found that the majority of pharmacists do not ask their patients about their smoking habits. In addition, an overwhelming majority of Indiana pharmacists were unfamiliar with a number of state public health programs/resources on smoking preven- tion and cessation. Nevertheless, it was very encouraging that nearly three-fourths of the pharmacies offer counseling programs for smokers who want to quit and more than one-half believed that increasing the state excise tax on cigarettes would be effective on tobacco control in Indiana.

Adult↗
PubMed1995

The ethics of leadership in pharmacy.

The pharmacy profession's responsibility to provide ethical leadership to its members is explained, and areas where pharmacy should take a leadership role are described. Changes taking place in health care offer many opportunities for pharmacy in its transformation into a fully clinical discipline. The profession needs to address the ethical issues that will affect it as part of this revolution. The role pharmacy is taking to eliminate medication misadventuring will be a test case for the profession's ability to exert the leadership it must, as part of its new definition of itself. Pharmacy needs to define the structure, process, and outcomes necessary to improve its own practice to avoid drug misadventuring, with a clear set of practice and ethical standards, and engage medicine and nursing to adopt similar standards. Pharmacy should also take a leadership role in health care reform, working with other clinicians to ensure that the changes provide better outcomes for patients. Health care professionals are bound together by a common moral purpose: to act in the patient's best interest. Thus, each health profession is a moral community, which must determine and promote ethical behavior among its members. Pharmacy must practice ethical leadership: it must define and prove its contribution to patient outcomes, further develop legal and ethical standards, and examine its responsibilities for vulnerable patient groups such as children. It must work to overcome the traditional dominance of medicine; pharmacy, nursing, and medicine must come together in service of the patient and develop a cross-professional conception of ethics. Pharmacy also must participate in the broader debate about health care. Pharmacy has begun to take a leadership role among the health professions through its efforts to eliminate medication misadventuring. Additional leadership challenges for the profession are suggested.

Delivery of Health Care↗
PubMed1998

Advice provided in British community pharmacies: what people want and what they get.

OBJECTIVES: This study explored advice-giving behaviour in community pharmacies in order to understand the nature and process of pharmaceutical consultations and consumers' views of the advice-giving role. METHOD: An ethnographic research strategy was used, combining patient interviews with non-participant observation of interactions between consumers and pharmacy staff. One week was spent in each of 10 pharmacies. RESULTS: The study demonstrated that the advice given in a community pharmacy is almost wholly focused on product recommendation and use. Advice-giving varies according to whether consultations concern prescription or non-prescription medicines. When the latter are involved, advice-giving is mostly consumer-led. Consumers' major 'need' for pharmacy services appears to be for information about the effectiveness of products they buy, whilst pharmacists and pharmacy assistants concentrate on providing advice on the safety of medicines. CONCLUSION: The notion of pharmacists as general health advisors does not appear to be shared by the public and may be at odds with how the public view and use pharmacies. Protocols to guide staff may be improved by including the consumer perspective. Most consumers have previous experience of their ailments and use pharmacies as one of several resources available to them to treat their minor illness, having made their own diagnosis and assessment before entering the pharmacy. The scope for giving new advice is therefore limited. The broader role of community pharmacies merits further attention.

Counseling↗