Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “PHARMACISTS”

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 505 records · Page 28Linked to original sources
PubMed2004

Do pharmacists' reports of adverse drug reactions reflect patients' concerns?

AIM: The aim of the present study was to investigate whether the concerns patients express to a Drug Information Line about possible adverse drug reactions (ADRs) they have experienced, are sufficiently reflected by the ADR reports submitted by pharmacists to the Netherlands Pharmacovigilance Centre Lareb with regard to the type of ADRs and the drug groups involved. METHODS: ADR-related questions patients addressed to the Dutch Drugs Information Line were compared with the ADR reports pharmacists sent in to Lareb in the same period. The similarities and differences between the characteristics of the suspected ADRs and the kinds of drugs mentioned were investigated, as well as the severity of the reported ADRs. To compare the two data sets and to establish whether significant differences were present, a logistic regression analysis was conducted on the reported drugs and ADRs. RESULTS: Analysis of the content of the phone calls yielded 1168 (14.6%) calls concerning possible experienced ADRs. The suspected ADRs pharmacists reported to the Netherlands Pharmacovigilance Centre Lareb in the same period included 1734 reports. There were only slight differences between the queries patients put to the Drug Information Line regarding possible adverse drug reactions and the reports on suspected ADRs pharmacists submitted to the pharmacovigilance centre. With respect to possible ADRs in the psychiatric spectrum and ADRs associated with the use of antidepressants, there seems to be a deficiency in the reporting by pharmacists. CONCLUSION: The ADRs pharmacists report to the national pharmacovigilance centre reflect patients' concerns about ADRs they experience in relation to the medication they are taking.

Adult↗
PubMed1993

An investigation into sugar-containing and sugar-free over-the-counter medicines stocked and recommended by pharmacists in the north western region of England.

Sugar-containing paediatric medicines can contribute to the aetiology of dental caries, and as many are sold over-the-counter (OTC) as are prescribed. This study evaluated a dental health education initiative among pharmacists in the north-west of England in an effort to increase the sales of sugar-free preparations. It also investigated the stocks they held, their recommendations to their customers and their knowledge of, and attitudes to, sugar in medicine as a cause of dental caries. Following a baseline questionnaire, a randomly selected group of pharmacists were sent a dental health education leaflet informing them of the role of sugar-containing medicines in the aetiology of dental caries and a list of sugar-free alternatives which they were asked to stock and recommend. Twelve months later, a second questionnaire was completed by both the test and control groups of pharmacists. The most commonly stocked and recommended OTC paediatric medicines contained sugar. Of the 14 preparations stocked by over 90% of the pharmacists only two were sugar-free. During the year of the study the mean number of sugar-free medicines stocked by the pharmacists in the test group reduced from 7.70 to 7.12 (P < 0.05) and in the control group from 8.39 to 7.45 (P < 0.05). Seventy-seven per cent of the pharmacists thought that sugar in medicines could contribute to caries, but recommended sugar-containing preparations more frequently than sugar-free alternatives. The dental profession needs to actively promote medicines that are sugar-free if there is to be a change from the use of iatrogenic sugar-containing preparations.

Binomial Distribution↗
PubMed1999

Attitudinal factors associated with community pharmacists' involvement in services for drug misusers.

AIM: To assess the relationship between pharmacists' attitudes towards drug misusers and the availability and provision of services for drug misusers. DESIGN: A cross-sectional postal questionnaire survey. SETTING: All community pharmacies in Scotland (n = 1142). PARTICIPANTS: A total of 864 pharmacists managing community pharmacies on a day-to-day basis (response rate 79%). MEASUREMENTS: Descriptive data were collected on demography, drug misuse services provided and training in drug misuse. Attitude statements were used to measure attitudes to drug misusers, the role of the pharmacist in dispensing controlled drugs and providing injecting equipment, providing advice on drug misuse and financial aspects of service provision. Statements were incorporated into a scale which was correlated with behavioural data on whether and how services were provided. RESULTS: The attitude scale had good internal reliability and was unidimensional. Pharmacists that provided needle/syringe exchanges, sold needles/syringes, dispensed methadone, supervised the consumption of methadone and provided health promotion services to drug misusers had significantly more positive attitudes towards drug misusers. Attitudes were associated with health board area, sex and number of years registered as a pharmacist. After controlling for these characteristics, attitude was an independent predictor of whether needles/syringes were sold, methadone was dispensed and methadone consumption supervised. CONCLUSIONS: Addressing negative attitudes could encourage more pharmacists to provide services and enhance the process of service delivery.

Attitude of Health Personnel↗
PubMed2001

Attitudes and knowledge of hospital pharmacists to adverse drug reaction reporting.

AIMS: To investigate the attitudes of UK hospital pharmacists towards, and their understanding, of adverse drug reaction (ADR) reporting. METHODS: A postal questionnaire survey of 600 randomly selected hospital pharmacists was conducted. RESULTS: The response rate was 53.7% (n = 322). A total of 217 Yellow Cards had been submitted to the CSM/MCA by 78 (25.6%) of those responding. Half of those responding felt that ADR reporting should be compulsory and over three-quarters felt it was a professional obligation. However, almost half were unclear as to what should be reported, while the time available in clinical practice and time taken to complete forms were deemed to be major deterrents to reporting. Pharmacists were not dissuaded from reporting by the need to consult a medical colleague or by the absence of a fee. Education and training had a significant influence on pharmacists' participation in the Yellow Card Scheme. CONCLUSIONS: Pharmacists have a reasonable knowledge and are supportive of the Yellow Card spontaneous ADR reporting scheme. However, education and training will be important in maintaining and increasing ADR reports from pharmacists.

Adult↗
PubMed2006

Clinical medication review by a pharmacist of elderly people living in care homes--randomised controlled trial.

OBJECTIVE: to measure the impact of pharmacist-conducted clinical medication review with elderly care home residents. DESIGN: randomised controlled trial of clinical medication review by a pharmacist against usual care. SETTING: sixty-five care homes for the elderly in Leeds, UK. PARTICIPANTS: a total of 661 residents aged 65+ years on one or more medicines. INTERVENTION: clinical medication review by a pharmacist with patient and clinical records. Recommendations to general practitioner for approval and implementation. Control patients received usual general practitioner care. MAIN OUTCOME MEASURES: primary: number of changes in medication per participant. Secondary: number and cost of repeat medicines per participant; medication review rate; mortality, falls, hospital admissions, general practitioner consultations, Barthel index, Standardised Mini-Mental State Examination (SMMSE). RESULTS: the pharmacist reviewed 315/331 (95.2%) patients in 6 months. A total of 62/330 (18.8%) control patients were reviewed by their general practitioner. The mean number of drug changes per patient were 3.1 for intervention and 2.4 for control group (P < 0.0001). There were respectively 0.8 and 1.3 falls per patient (P < 0.0001). There was no significant difference for GP consultations per patient (means 2.9 and 2.8 in 6 months, P = 0.5), hospitalisations (means 0.2 and 0.3, P = 0.11), deaths (51/331 and 48/330, P = 0.81), Barthel score (9.8 and 9.3, P = 0.06), SMMSE score (13.9 and 13.8, P = 0.62), number and cost of drugs per patient (6.7 and 6.9, P = 0.5) (pounds sterling 42.24 and pounds sterling 42.94 per 28 days). A total of 75.6% (565/747) of pharmacist recommendations were accepted by the general practitioner; and 76.6% (433/565) of accepted recommendations were implemented. CONCLUSIONS: general practitioners do not review most care home patients' medication. A clinical pharmacist can review them and make recommendations that are usually accepted. This leads to substantial change in patients' medication regimens without change in drug costs. There is a reduction in the number of falls. There is no significant change in consultations, hospitalisation, mortality, SMMSE or Barthel scores.

Accidental Falls↗
PubMed1997

Involvement of HMO-based pharmacists in clinical rounds at contract hospitals.

The contributions of managed care pharmacists who participate in clinical rounds at contract hospitals are described. A program in which pharmacists employed by Kaiser Permanente go on rounds at two contract hospitals as part of a multidisciplinary Kaiser team was implemented in January 1995. The rounding pharmacist reviews patients' charts, assesses optimal drug therapy, intervenes proactively, identifies candidates for home i.v. therapy, facilitates patient discharge, and provides on-the-spot drug information. Other services include therapeutic drug monitoring, dosage-adjustment recommendations, counseling, consultations, detecting adverse drug reactions, and education. The pharmacist documents all services and interventions, and their impact. At one hospital, a 500-bed institution, there were 1097 recommendations for intervention between April 1995 and May 1996. More than 99% of these recommendations were accepted. Over the 14-month period, the Kaiser team saved an estimated $523,907 and cost an estimated $57,643 (not counting benefits) in pharmacist participation. Managed care pharmacists on rounds at contract hospitals influenced enrolled patients' pharmacotherapy and reduced the plan's costs.

Clinical Medicine↗
PubMed1999

Charting the demand for pharmacists in the managed care era.

The demand for pharmacists in the changing health care market is discussed. The Pharmacy Manpower Project (PMP) evolved out of concerns raised in the late 1980s, when the demand for pharmacists exceeded the supply. PMP collects, analyzes, and disseminates data on pharmacy work force variables. PMP's Subcommittee to Study Demand Issues was formed after the publication in 1995 of the Pew Health Professions Commission report projecting dramatic surpluses of pharmacists. In 1996-97, the PMP subcommittee held a series of sessions to discuss the future demand for pharmacists and their services. The panel identified a wide range of work force projections, but it concluded that medication management problems in the context of increasing prescription numbers and the emergence of data-driven health care support a scenario of a steadily increasing demand for pharmacists and pharmaceutical services. The data did not show that higher penetration by managed care is associated with smaller pharmacy staffs or job loss in institutions. There is little reason to expect the dramatic downsizing of the pharmacy work force predicted by the third report of the Pew Commission. However, retaining pharmacy roles that are useful to the system and satisfying to pharmacists will require a continuation of current proactive measures by the profession.

Drug Prescriptions↗
PubMed2002

2001 anthrax crisis in Washington, D.C.: pharmacists' role in screening patients and selecting prophylaxis.

Pharmacists' development and use of a worksheet facilitating their rapid selection of patient-appropriate prophylactic antimicrobials in an anthrax clinic is described. A clinic housed at D.C. General Hospital, in Washington, D.C., treated most of the people--many of them postal workers--who may have been exposed to anthrax in that city during the 2001 anthrax crisis. A form was needed to assist pharmacists in the rapid selection of prophylactic antimicrobials and in patient education and counseling. A team of pharmacists collaborated on the development of a form tailored to the clinical and logistical needs of the operation. The questions on the form were based largely on the two antianthrax agents most likely to be used, ciprofloxacin and doxycycline, and were designed to identify the circumstances that would most frequently require a medication change or a modification of patient education. Yes-or-no check boxes allowed pertinent data to be captured most efficiently. A positive response to any question triggered a personal interview and assessment by a pharmacist. A treatment algorithm was also developed to ensure consistent pharmacist selection of agents in the face of potentially changing policies and staff. The worksheet questions sought to establish treatment objectives, document allergies and concomitant therapies, and identify patients who were pregnant or lactating. Pharmacists developed a patient-screening worksheet that helped determine their choice of treatment for people who may have been exposed to anthrax in Washington, D.C., during the 2001 anthrax crisis.

Adult↗
PubMed2002

Evaluation of pharmacists' services for hospital inpatients.

Patient satisfaction with pharmacist-conducted weekly medication-education classes and the underlying factor structure of the evaluation items are described. The pharmacist service consisted of weekly, one-hour classes for headache sufferers in a tertiary headache clinic's hospital unit. One pharmacist taught all of the classes and conducted them in the same manner each week, using the Indian Health Service patient-counseling technique. The classes included both lecture and one-on-one interactions. Any patient admitted to the hospital's headache unit was eligible to participate in the study. Patients were asked to complete a survey at the end of the class, evaluating the service in terms of performance, disconfirmation of expectations, affect, equity, and self-efficacy by rating three statements about each of these on a 7-point scale, where 1 = very strongly disagree and 7 = very strongly agree. Exploratory factor analysis was used to investigate the degree to which these five evaluation areas were distinct constructs. A total of 157 patients attended a medication-education class during the study period. Of these, 153 (97%) provided usable data. Respondents favorably evaluated the pharmacist service, as the means were significantly greater than the scales' midpoint scores (p < 0.001). Factor analysis results suggested that covariation in the data was best described by four factors rather than five: (1) performance, (2) disconfirmation of expectations, (3) equity, and (4) self-efficacy. Inpatients attending pharmacist-conducted weekly medication-education classes favorably evaluated the pharmacist service. Four different conceptualizations of patients' evaluations were identified.

Adolescent↗
PubMed2002

Role of the pharmacist in diabetes management.

The role of pharmacists in diabetes management, including patient identification, assessment, education, referral, and monitoring, is described. Pharmacists can help identify patients with diabetes through screening and should target patients at high risk, people with a family history of the disease, and women with a history of gestational diabetes or who delivered a baby weighing more than nine pounds. Patient education should be provided immediately after diagnosis, at a second stage at which time a patient assessment can be performed, and at a third stage during which patients can receive continuing education to reinforce concepts and a motivational boost. One of the pharmacist's most important roles is the referral of patients to other members of the diabetes care team. Although the role of the pharmacist in monitoring diabetes is not well defined, it might include such things as ascertaining whether physician visits and testing to assess long-term glycemic control. Obtaining certification as a diabetes educator is recommended. This process requires at least 1000 hours of experience in providing disease-state management for patients with diabetes and successful completion of an examination. Implementing diabetes management services requires a commitment of time, effort, and resources and may necessitate training of staff and changes in work patterns. The pharmacist can play an important role in diabetes care by screening patients at high risk for diabetes, assessing patient health status and adherence to standards of care, educating patients to empower them to care for themselves, referring patients to other health care professionals as appropriate, and monitoring outcomes. Providing diabetes management services requires market savvy, communication skills, and a commitment of time, effort, and resources. Pharmacists who obtain training in diabetes management reap rewards in professional satisfaction and financial reimbursement.

Diabetes Mellitus↗
PubMed2005

Pharmacists in the Omaha Metropolitan Medical Response System.

PURPOSE: The role of pharmacists in the Metropolitan Medical Response System (MMRS) for Omaha, Nebraska, is described. SUMMARY: Pharmacists have been involved in the Omaha MMRS since its inception in 2000. The Omaha MMRS has a pharmacy committee composed of pharmacists from local hospitals, community pharmacies, and two pharmacy schools. The pharmacy committee oversees the stock of pharmaceuticals available to Omaha in an emergency by continuously monitoring hospital inventories and working with state and federal planners. Pharmacists are responsible for planning for the receiving, staging, storing, distributing, and dispensing of the large quantities of pharmaceuticals that might be required in a disaster. Pharmacists also educate other health care professionals and the public about threats. CONCLUSION: Pharmacists play a major role in emergency preparedness in the Omaha metropolitan area and would be active participants in the community's response to a disaster.

Cities↗
PubMed2005

Update on the pharmacist shortage: national and state data through 2003.

PURPOSE: Aggregate Demand Index (ADI) survey results were used to describe the severity of the pharmacist shortage at the national and state levels and by practice site and impact on the U.S. population. METHODS: Time-series analysis was used to characterize national and state trends in the ADI from September 1999 through September 2003. The time trends for the distribution of ratings and the demand index by practice site were also examined. Historical data about retail prescriptions filled and related growth rates were compiled and compared. ADI survey results were also compared with data from other surveys. RESULTS: Over time, ADI data demonstrated a continuing national pharmacist shortage, as the ability to fill pharmacist vacancies was rated at least moderately difficult. A very slight downward trend in severity (slope = -0.008) was observed. Other survey series had similar findings. States with the most severe shortage levels tended to have large populations, while those with the lowest levels tended to have smaller populations. More states improved than worsened the severity of their shortage, with 30 states maintaining the same ADI rating. Although there was a high correlation between the retail prescription growth rate and the ADI (r = 0.84), there was a much greater decrease in prescription growth (73%) than ADI levels (6.5%). CONCLUSION: There was a sustained unmet demand for pharmacists throughout the United States from September 1999 through September 2003. More states moved toward having an adequate supply of pharmacists than toward having a more severe shortage of pharmacists, but the national ADI suggests that the system remains stressed.

Data Collection↗
PubMed2002

Impact of a pediatric clinical pharmacist in the pediatric intensive care unit.

OBJECTIVE: To study the impact of a clinical pharmacist in a pediatric intensive care unit. The goals of the study were to determine the type and quantity of patient care interventions recommended by a clinical pharmacist and to specifically examine cost savings (or loss) that resulted from clinical pharmacist recommendations. DESIGN: A prospective case series. SETTING: Ten-bed pediatric intensive care unit in a university-affiliated children's hospital. PATIENTS: All patients admitted to the pediatric intensive care unit during the study period. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: During the 24-wk study period, the pediatric clinical pharmacist documented all interventions that occurred during her shift. She rounded with the pediatric intensive care unit team approximately two times a week and reviewed medication lists daily. Drug acquisition costs were used to calculate drug cost savings. Demographic information was collected on all the patients in the pediatric intensive care unit during the study period. There were 35 recommendations per 100 patient days. The most common interventions were dosage changes (28%), drug information (26%), and miscellaneous information (22%). The average time spent per day by the clinical pharmacist in the pediatric intensive care unit was 0.73 hrs or 0.02 full-time equivalent. The total cost direct savings for the study period was $1,977. Extrapolated to direct cost savings per year, the total amount saved was $9,135/year or 0.15 full-time equivalent. Indirect savings from educational activities, avoidance of medication errors, and optimization of medical therapies represent an additional nonquantifiable amount. CONCLUSION: We conclude that a clinical pharmacist is an important and cost-effective member of the pediatric intensive care unit team.

Cost Savings↗
PubMed1983

A comparison of pharmacists and physicians on the quality of prescribing for ambulatory hypertensive patients.

This article discusses a quasi-experimental study of the quality of pharmacists' and physicians' drug prescribing for ambulatory hypertensive patients in a health maintenance organization. The null hypothesis was that there is no difference between pharmacists and physicians as to the quality of drug prescribing for hypertensive patients. Analysis revealed no difference in prescribing between the physician group and the pharmacist group on the scoring for the presence of drug interactions, appropriateness of quantities, dose, and patient directions. The pharmacist prescriber group did significantly better than the physician group, however, on choosing the appropriate drug, prescribing for a "positive effect on the patient's health," and overall appropriateness from combining all the above scales (p less than 0.05). The diastolic pressures of the patients assigned to the pharmacists' group were not significantly different from the physicians' group on pretest, but on posttest the diastolic pressures were slightly lower in the pharmacists' group (p less than 0.10).

California↗
PubMed2006

Refusals by pharmacists to dispense emergency contraception: a critique.

Over the past several months, numerous instances have been reported in the United States media of pharmacists refusing to fill prescriptions written for emergency postcoital contraceptives. These pharmacists have asserted a "professional right of conscience" not to participate in what they interpret as an immoral act. In this commentary, we examine this assertion and conclude that it is not justifiable, for the following reasons: 1) postcoital contraception does not interfere with an implanted pregnancy and, therefore, does not cause an abortion; 2) because pharmacists do not control the therapeutic decision to prescribe medication but only exercise supervisory control over its dispensation, they do not possess the "professional right" to refuse to fill a legitimate prescription; 3) even if one were to grant pharmacists the "professional right" not to dispense prescriptions based on their own personal values and opinions, pharmacists "at the counter" lack the fundamental prerequisites necessary for making clinically sound ethical decisions, that is, they do not have access to the patient's complete medical background or the patient's own ethical preferences, have not discussed relevant quality-of-life issues with the patient, and do not understand the context in which the patient's clinical problem is occurring. We conclude that a policy that allows pharmacists to dispense or not dispense medications to patients on the basis of their personal values and opinions is inimical to the public welfare and should not be permitted.

Adolescent↗
PubMed2002

Exploring generic drug use behavior: the role of prescribers and pharmacists in the opportunity for generic drug use and generic substitution.

OBJECTIVES: The first objective of this study was to examine the prevalence of prescriptions that offer the opportunity for generic drug use (a prescription for a multisource drug product). The second objective was to examine the prevalence of generic drug use by examining the rate of generic drug prescribing for multisource drug products and the rate of generic substitution by pharmacists. The last objective was to examine the association of prescriber, pharmacist, insurance, patient, and drug variables with the prescribing of drugs allowing the opportunity for generic drug use and generic substitution. RESEARCH DESIGN: A database containing information for 6380 prescription orders was used for analysis. MEASURES: Random-effects logistic regression panel data estimation was used to examine the association of independent variables with whether a prescription allowed the opportunity for generic drug use and whether a prescription allowing generic drug use and written using the brand name was generically substituted. RESULTS: The opportunity for generic drug use existed for 63% of prescription orders. Prescriptions covered by private third party and indemnity insurance were 33% (97.5% CI, 0.56-0.80), and 21% (97.5% CI, 0.62-0.98), less likely, respectively, to allow the opportunity for generic drug use relative to uninsured prescriptions. Unobserved prescriber characteristics accounted for 23% (95% CI, 0.14-0.34) of the variance in the opportunity for generic drug use. Pharmacists generically substituted 83.8% of prescriptions that could be generically substituted. Prescriptions covered by Medicaid were 4.57 (97.5% CI, 2.83-7.39), 5.15 (97.5% CI, 3.25-8.13), and 4.85 (97.5% CI, 2.83-8.17) times more likely, respectively, to be generically substituted relative to uninsured, private third party and indemnity prescriptions. Unobserved characteristics of pharmacists accounted for 44% (95% CI, 0.33-0.55) of the variance in the occurrence of generic substitution. CONCLUSIONS: Pharmacists play a large and important role in generic drug use and efforts to increase generic drug use directed at pharmacists should be maintained. Additional efforts to increase generic drug use likely should be targeted at prescribers.

Adult↗
PubMed1997

Comparative evaluation of patient information leaflets by pharmacists, doctors and the general public.

This study was undertaken to compare and contrast the views of pharmacists, general practitioners (GPs) and the general public on the value or otherwise of pharmacy-generated patient information leaflets. All three groups perceived these leaflets to be useful and an aid to improving compliance. Concerning the information included in leaflets, GPs rated the inclusion of a section on side-effects as being the least important, whilst pharmacists and the general public rated information on the storage of medicines as being least important. Pharmacists' estimates on what percentage of patients actually read leaflets were significantly lower than estimates by the general public. General practitioners and pharmacists generally concurred on the types of patients for whom leaflets are considered unsuitable, although a significantly higher percentage of pharmacists than GPs identified unsuitable patients. There were reservations by the pharmacists concerning the cost-effectiveness of leaflet facilities and on the value of leaflets compared with verbal counselling. The general public expressed the view that a leaflet facility would affect their choice of pharmacy and that they would be prepared to wait an additional short time to receive such a leaflet. Almost all GPs thought that it was in the patient's best interest to receive an information leaflet.

Adolescent↗
PubMed1996

The involvement of pharmacists in professional and clinical audit in the UK: a review and assessment of their potential role.

This review addresses the uptake and implementation of the principles of audit by community, hospital and health authority pharmacists. The pressures to audit professional services are discussed, as are the barriers to cooperation among pharmacists and between pharmacists and prescribers in primary care. The development of standards of professional practice is then described taking into account the particular difficulty in developing standards for health care workers who are geographically separated from other members of the primary care team and are in commercial competition with each other. The review identifies audit of professional services in both community and hospital pharmacy and of clinical services in the latter. The role of pharmacists employed by health authorities to advise them and general practitioners on the optimum use of the drug budget is described and their potential role for involvement in audit is discussed. The particular advantages that pharmacists in hospital and health authorities have in developing the specific aspect of clinical audit related to medicines usage (drug utilization review) is then described. The potential for pharmacists to contribute to clinical and management audit is discussed.

Community Pharmacy Services↗