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PubMed2003

The effect of an intervention programme to improve health education leaflet uptake and distribution in community pharmacies.

The effect of an intervention programme to improve health education leaflet uptake in community pharmacies was conducted with a small convenience sample of 12 community pharmacies in North Staffordshire, UK. The intervention consisted of four different modes of leaflet provision. Modes 1 and 2 (without and with overt offer of advice from pharmacist respectively) relied upon the pharmacy client to actively obtain a leaflet, whereas Modes 3 and 4 (without and with offer of advice from pharmacist respectively) relied upon pharmacy staff to actively provide a leaflet. All 12 community pharmacies received 50 copies of a purposefully designed leaflet. The intervention extended over one calendar month. Data was collected during the intervention via monitoring forms completed by the pharmacist on a day to day basis, and interviews were conducted with the pharmacists at the end of the study. The overall uptake or distribution rate of leaflets was 64%. In both modes which offered advice (Modes 2 and 4), approximately one of every five leaflet recipients sought advice. The community pharmacists considered the intervention to be feasible, effective and enabled the utilisation of their skills.

Attitude of Health Personnel↗
PubMed1998

Staff attitudes about the use of robots in pharmacy before implementation of a robotic dispensing system.

Hospital pharmacy staff members at a Mid-western university medical center were surveyed to determine their attitudes about the use of robots in pharmacy dispensing before a robotic system was implemented. A questionnaire seeking attitudes about the use of robots in pharmacy was distributed to 147 pharmacy staff (pharmacy managers, pharmacist practitioners, pharmacotherapists, pharmacy residents and fellows, pharmacy technicians, and salaried pharmacy students). Attitudinal items were scored on a 5-point scale ranging from very favorable to very unfavorable. The response rate was 75%. Overall, staff expressed favorable attitudes in terms of job security, professional impact, and general robotics orientation. Pharmacy managers and pharmacotherapists were the most likely to report feeling secure about their jobs; pharmacy technicians and salaried pharmacy students were slightly less positive. Favorable attitudes about the professional impact of the robotic system were demonstrated by all groups except pharmacist practitioners and pharmacy technicians. Attitudes about management issues were unfavorable; pharmacist practitioners demonstrated the least favorable attitudes. In general, responses to semantic-differential statements reflected favorable attitudes; where there were differences, pharmacy technicians showed the least positive and pharmacy managers the most positive attitudes. Respondents reported that pharmacist practitioners would be most positively affected and pharmacy technicians most negatively affected by robotic dispensing. Almost half of the respondents who provided general comments indicated that they needed more information about the use of robots. Pharmacy staff had generally favorable attitudes about the use of robots in pharmacy.

Analysis of Variance↗
PubMedDate not supplied

Changes in number and distribution of community and ambulatory pharmacies in Virginia from 1994 to 1999.

OBJECTIVE: To determine whether market changes have resulted in a decrease in the number or geographic distribution of pharmacies available to ambulatory patients in Virginia. DESIGN: Retrospective review of Virginia Board of Pharmacy records of pharmacy registrations in 1994 and 1999. SETTING: The Commonwealth of Virginia. PARTICIPANTS: All pharmacies classified as outpatient pharmacies (including community and other types of ambulatory pharmacies) and operating in Virginia in 1994 and 1999. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Changes in the total number, geographic distribution, and metropolitan/nonmetropolitan distribution of outpatient pharmacies between 1994 and 1999. RESULTS: The total number of outpatient pharmacies increased from 1,290 to 1,337 between 1994 and 1999. Chain pharmacies, mass merchandiser, and grocery pharmacies increased in number while independent pharmacies declined. There was little change in the geographic or metropolitan/nonmetropolitan distribution of pharmacies. CONCLUSION: Changes in the number and distribution of community and other ambulatory pharmacies in Virginia have not diminished their availability to consumers.

Pharmacies↗
PubMed1983

Combination medication cart and computer terminal in decentralized drug distribution.

A decentralized unit dose distribution system using mobile pharmacy carts and computer terminals for filling inpatient and discharge medication orders is described. The system uses computer terminals mounted on mobile medication carts. Medication orders are collected from each nursing station by the pharmacist. Using the mobile combination decentralized medication cart/computer terminal (cart/CRT), the pharmacist examines and updates the patient's drug profile, checking for drug allergies and interactions, and bills the patient for drugs dispensed. Unit dose drugs requiring no additional labeling are dispensed from the decentralized cart to the patient's drawer in the unit dose medication cart. When a label is necessary, the pharmacist commands the computer to print a label in the central pharmacy. Discharge orders are entered at the cart/CRT, filled and recorded in the central pharmacy, and distributed to the patients by the pharmacist on the nursing unit. Turnaround time for routine inpatient orders and discharge orders decreased substantially using this system, and the system was perceived as beneficial by nurses, physicians, and pharmacists.

Computers↗
PubMed2000

ASHP national survey of pharmacy practice in acute care settings: dispensing and administration--1999.

Results of the 1999 ASHP national survey of pharmacy practice in acute care settings that pertain to drug dispensing and administration practices are presented. Pharmacy directors at 1050 general and children's medical-surgical hospitals in the United States were surveyed by mail. The response rate was 51%. About three-fourths of respondents described their inpatient pharmacy's distribution system as centralized. Of those with centralized distribution, 77.4% indicated that their system was not automated. Decentralized pharmacists were used in 29.4% of the hospitals surveyed; an average of 58.9% of their time was spent on clinical, as opposed to distributive, activities. About 67% of directors reported pharmacy computer access to hospital laboratory data, 38% reported access to automated medication-dispensing-unit data, and 19% reported computer access to hospital outpatient affiliates. Only 13% of hospitals had an electronic medication order-entry system; another 27% reported they were in the process of developing such a system. Decentralized medication storage and distribution devices were used in 49.2% of hospitals, while 7.3% used bedside information systems for medication management. Machine-readable coding was used for inpatient pharmacy dispensing by 8.2% of hospitals. Ninety percent reported a formal, systemwide committee responsible for data collection, review, and evaluation of medication errors. Virtually all respondents (98.7%) reported that their staff initiated manual reports. Only two thirds tracked these reports and reported trends to the staff. Fewer than 15% reported that staff were penalized for making or contributing to an error. Pharmacists are making a significant contribution to the safety of medication distribution and administration. The increased use of technology to improve efficiency and reduce costs will require that pharmacists continue to focus on the impact of changes on the safety of the medication-use system.

Ambulatory Care↗
PubMed1988

Pharmacies as alternative sources of medical care: the case of Cincinnati.

Since the distribution of pharmacies is more equal, vis-a-vis population, than the distribution of physicians in Cincinnati the feasibility of using pharmacies as supplements to the primary care system was explored. In a sample of 108 pharmacies, it was found that 13% of the customer population asked medically related questions; pharmacists estimated that on average some 35% of their customers ask such questions. Women ask questions more frequently than men. Some 61% of the pharmacists would be willing to write and fill prescriptions should such a law be enacted in Ohio. If such a law were to be enacted consumer education and architectural modification of pharmacies would enhance the use of pharmacies as sources of medical care.

Adolescent↗
PubMed1995

Work activities of pharmacy teams with drug distribution and clinical responsibilities.

The time spent by satellite pharmacists and technicians on various activities was measured by using work sampling to evaluate the pharmacists' use of time for patient care. Between December 1992 and April 1993, pharmacists and technicians on satellite pharmacy teams at a tertiary care teaching hospital reported their work activities on forms. A total of 11,485 observations of pharmacist work activities and 7,626 observations of technician work activities were made. Pharmacists on teams with fewer support staff members spent less time on patient care-related work activities, and vice versa. As measured by an institution-specific index, the efficiency with which pharmacists used the available work time for patient care ranged from 60% to 83% for the various teams (100% would mean that pharmacists spent all their work time on patient care tasks). Changes were made in technician staffing that enabled the pharmacists to devote more time to patient care. Measuring the time pharmacists and technicians spent on various work activities provided a means of identifying and correcting organizational inefficiencies in order to give the pharmacists more time for patient care.

Efficiency, Organizational↗
PubMed1998

An economic analysis of needle exchange and pharmacy-based programs to increase sterile syringe availability for injection drug users.

Our objectives were to estimate the cost per syringe distributed for five syringe distribution strategies (a needle exchange program [NEP], a pharmacy-based NEP, free pharmacy distribution of pharmacy kits, sale of such pharmacy kits to injection drug users [IDUs], and sale of syringes in pharmacies); to assess the total costs of these strategies; and to conduct an economic analysis of these strategies in preventing HIV infection in IDUs. We estimated the costs for NEPs by using data from previous research; costs for the four pharmacy-based strategies were resource-based. Using estimates of the number of syringes required to provide a sterile syringe for each IDU injection, we estimated the total costs of the strategies in three representative U.S. cities. The lifetime cost of treating a person for HIV infection, discounted into current value, was used to estimate the number of syringes that could be distributed for that amount by the five strategies and thus the number of IDUs who could be ensured a sterile syringe for each injection. We then conducted a threshold analysis for calculating the annual HIV seroincidence for the program to be cost-neutral. The cost per syringe distributed in U.S. dollars was $0.97 for the NEP, $0.37 for the pharmacy-based NEP, $0.64 for pharmacy kit distribution, $0.43 for pharmacy kit sale, and $0.15 for syringe sale. The total annual cost in U.S. dollars of providing 50% of the syringes needed for a single syringe for every injection ranged from $6 to $40 million for New York City, from $1 to $6 million for San Francisco, and from $30,000 to $200,000 for Dayton, Ohio. The annual HIV seroincidence for the program to be cost-neutral compared with the cost of medical treatment for HIV injections was 2.1% for the NEP, 0.8% for the pharmacy NEP, 1.4% for pharmacy kit distribution, 0.9% for pharmacy kit sale, and 0.3% for syringe sale. All five strategies could distribute syringes at relatively low unit costs; NEPs would be the most expensive and syringe sales would be the cheapest. At annual seroincidences exceeding 2.1%, all strategies are likely to be cost-saving to society.

Costs and Cost Analysis↗
PubMedDate not supplied

Time savings associated with dispensing unit-of-use packages.

OBJECTIVES: To determine how much time can be saved with the use of unit-of-use packaging in a community pharmacy, the distribution of work between the pharmacist and the pharmacy technician when unit-of-use packaging is used, and the number of errors that occur when either unit-of-use or bulk packaging is used in dispensing prescriptions. DESIGN: A simulation comparing count-and-pour dispensing with unit-of-use package dispensing. SETTING: An independent community pharmacy. PARTICIPANTS: Two teams, each composed of one pharmacist and one pharmacy technician. INTERVENTION: Each team prepared 50 typical prescription orders, once using unit-of-use packaging and once by transferring medication from a bulk container. MAIN OUTCOME MEASURES: Time needed to dispense 50 prescriptions, dispensing activities performed by technicians and pharmacists, and number of dispensing errors. RESULTS: The time saved with unit-of-use packaging compared with count-and-pour dispensing was 46.5 minutes per 100 prescriptions, which represents an average time savings of more than 27 seconds per prescrition. In the bulk package dispensing simulation, the pharmacists assisted in retrieving and counting medication for 26% of the prescriptions. This percentage dropped to 4% when unit-of-use packaging was used because the technicians dispensed prescriptions at a rate that occupied the pharmacist with verifying the prescription orders and dispensed products. Each team committed two counting errors when executing the bulk package trial and no errors when using unit-of-use packaging. CONCLUSION: Unit-of-use packaging can reduce the time needed for and increase the efficiency of pharmacists' dispensing activities. Unit-of-use packaging may also reduce the number of counting errors.

Drug Packaging↗