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PubMed1991

Drug-usage evaluation and the patient-care pharmacist: a synergistic combination.

The Joint Commission requires a continuous monitoring program to assure quality pharmaceutical care. The only way to achieve compliance with this standard is to enlist the help of the patient-care pharmacists. Equally important to the pharmacy manager is the way a DUE program can benefit the patient-care pharmacists. The key to an effective program is to assist the patient-care pharmacists in taking responsibility for the quality of drug therapy provided to their patients. Through education, encouragement, and recognition, the DUE Coordinator can elevate the practice of the patient-care pharmacists. The outcome is a synergistic program that enriches the practice of the patient-care pharmacists who, in turn, enrich the quality of pharmaceutical care received by their patients.

Concurrent Review↗
PubMed1994

Pharmacist empowerment: taking practice guidelines to the next level (Part 2).

Empowering pharmacists to have direct control and responsibility for institutional drug-use protocols can assist in reducing costs and improving the quality of patient care. This article examines pharmacist involvement in two drug use protocols in place at St. Luke's Episcopal Hospital in Houston. The first is a pharmacist conversion order protocol in which pharmacists are given the responsibility of flagging and monitoring IV to oral dosage conversions of selected medications; the second is a pharmacist screening program for parenteral ketorolac dosing.

Clinical Protocols↗
PubMed1979

Motivating pharmacists.

Although pharmacists are developing interest in many types of pharmacy practice, they are still spending the bulk of their time in the prescription dispensing process. Any effort to provide motivation must consider the prescription dispensing process. The pharmacy literature includes only a few studies that dealt with pharmacists as people. The studies usually showed that pharmacists basically were unhappy with their jobs. In developing a motivational climate for pharmacists, pharmacy supervisors have several concepts to consider: the hierarchy of needs by Maslow; the expectancy theory by Hampton; the gygiene-motivator theory by Herzberg; and the Theory Y management approach by McGregor. Because pharmacists must be induced to enter and remain in an organization, supervisors should be aware of the need to use any technique available in developing a motivational climate.

Humans↗
PubMed1980

Pharmacists as instructors of health education in community colleges.

The public is demanding quality information on the appropriate use of medicinal agents. The pharmacist is a potential source of this information; however, lack of time and appropriate environment often limit this interaction. An educational model has been developed, used, and evaluated in order to increase public knowledge on nonprescription medications, increase pharmacist professional visibility in the community, and provide a practical means of creating this interaction. Using the setting of four California community colleges, consumer education courses were developed during 1972 to 1977. Instructional syllabi, written and audiovisual materials, and evaluations were developed at these colleges by five pharmacists. The courses were presented in an aggregate of 17 semesters to 514 enrollees. Results from objective examination on presented topics showed a mean score increase from 18 to 82% among 62 enrollees. Subjectively, participant response was enthusiastic, with frequent reports of daily usefulness and increased awareness of the pharmacist as a health information resource person. The described model has proven to be an effective means of providing lay persons access to important health care information, while providing pharmacists with an effective means of meeting professional responsibilities, increasing professional visibility in the community, and gaining professional satisfaction.

California↗
PubMed1986

Evaluating the impact of education by a clinical pharmacist on antibiotic prescribing and administration in an acute care state psychiatric hospital.

An antibiotic utilization review program was implemented by a clinical pharmacist in an acute care state psychiatric facility. Antibiotic utilization was concurrently audited in 61 antibiotic orders, written for 48 patients, in order to determine antibiotic prescribing and administration practices and problems. Interventions, consisting of educational presentations, problem-solving meetings, and distribution of written educational materials, were provided by a clinical pharmacist to improve antibiotic prescribing and administration practices. A second audit of 68 antibiotic orders written for 47 patients was concurrently audited after completion of the interventions. When prescribing problems were detected, the clinical pharmacist made recommendations to the prescribing physician. Statistically significant changes in the use of culture and sensitivity tests, appropriate dosage regimens, correct antibiotic administration, and selection of cost-effective therapy were found after all educational interventions were provided. A positive trend not resulting in statistical significance was noted for documentation of infectious disease and selection of appropriate antibiotic agents. This study demonstrates a drug utilization review role for clinical pharmacist's involvement in the acute care psychiatric facility, and illustrates one method by which clinical pharmacists can provide educational programs to improve nonpsychotropic drug prescribing and administration in this setting.

Adolescent↗
PubMed1989

The evaluation of pharmacist-technician teams applied to a satellite pharmacy.

The team work group design has been suggested as a mechanism to integrate clinical and distributive pharmacy services, expand clinical roles, enhance staff satisfaction, and promote resource efficiency. A pharmacist-technician team was created at Henry Ford Hospital, Detroit, and the effects of the team were assessed via pre and post data collection of attitudinal, behavioral and pharmacy service aspects. Each of three satellite teams were responsible for all pharmacy services to a target group of patients. The results of the team design include a significant decrease in pharmacist and technician perceptions of role stress, especially in the categories of role overload, role isolation, and role ambiguity, and less total hours of work lost by pharmacists (54% improved) and technicians (29% improved). The nurses perceived slightly better pharmacy services upon survey, although not statistically significant, and IV solution wastage decreased 5.6%. Clinical pharmacist compliance to standards of practice was unchanged in spite of increased supervisional responsibilities. We were able to show that the pharmacist-technician team design decreased stress and created more efficient pharmacy services.

Attitude of Health Personnel↗
PubMed1989

The expanded role of pharmacists in the Public Health Service: an overview of a pharmacy practice model.

Pharmacists in the US Public Health Service (PHS) provide direct patient-care support activities at the National Institutes of Health, Food and Drug Administration, and the Indian Health Service (IHS). This is the first of a series of articles describing pharmacists' work in the IHS, where most of the pharmacists in the PHS serve. The IHS operates medical centers, hospitals, and ambulatory health centers. Many innovative pharmacy services have been developed within the IHS since its founding in 1955. IHS pharmacists have long performed clinical and educational duties that many of their private sector colleagues are just now assuming. This paper introduces pharmaceutical services within the IHS and describes several of the important professional innovations that have been developed by IHS pharmacists.

Indians, North American↗
PubMed1975

Pharmacist's role in management of hypertensive patients in an ambulatory care clinic.

A program involving a pharmacist in the management of ambulatory hypertensive patients is discussed. A hypertension monitoring protocol was developed by a physician and a pharmacist. The protocol provided for initial patient assessment and treatment by the physician, counseling and education of the patient by the pharmacist, patient follow-up by the pharmacist every one to two months and follow-up by the physician every four to six months. In the first four months of the program, 28 of 75 newly diagnosed hypertensive patients were referred by the physician to the pharmacist for follow-up.

Ambulatory Care↗
PubMed1975

Pharmacist and physician evaluation of drug information sources.

A survey was conducted to compare how pharmacists and physicians in Tennessee rated six sources of drug information (journals, textbooks, physicians, pharmacists, the Physicians' Desk Reference and detail men) in nine different categories. A one-page questionnaire was mailed to a 10% random sample of pharmacists and physicians. The physicians rated professional journals and the PDR consistently good and rated the pharmacist poor as a source of drug information. Pharmacists rated textbooks good and rated physicians poor for some categories of information. Both groups found the available information in certain categories to be inadequate.

Drug-Related Side Effects and Adverse Reactions↗
PubMed2001

Optimal drug therapy: the role of the pharmacist in bridging the gap between knowledge and action.

Drug expenditures are rising more rapidly than other health care spending. There are a number of reasons for this difference, including the volume of medications available. Optimal drug therapy is the goal for every patient. Physicians and nurses are experiencing difficulty coping with increased health care needs and have not been able to control drug expenditures. Pharmacists, who are trained to deliver pharmaceutical care, should be an integral part of the system. Improved partnerships among patients, physicians and pharmacists have shown conclusively that the pharmacist has an important role in the delivery of health care cost effectiveness. Together, using their respective knowledge base, pharmacists and physicians could provide optimal drug therapy, which would be of benefit to patients and the health care system. This might involve a change in the reimbursement system for pharmacists.

Canada↗
PubMed2001

[The community pharmacist and the problem of excessive drinkers].

On a daily basis, the community pharmacist is just as concerned with alcohol (when detecting the interactions between alcohol and medication, or the use of alcohol as an excipient or active ingredient), as with alcoholism (when filling prescriptions, providing advice and guidance to patients, or undertaking other health education actions). In order to define the pharmacist's perception of the problem of alcoholism, an opinion poll was conducted by direct interrogation using a standardised questionnaire. The poll surveyed the owners of 101 randomly selected pharmacies in Puy de Dome. All of the pharmacists questioned are sensitive to and aware of the problem of interactions resulting from mixing alcohol and medication at the time of filling prescriptions. On the other hand, their perception of alcoholism and their behavior towards alcoholic patients vary. They frequently stressed the difficulty of establishing a dialogue. In spite of receiving information and training on alcoholism, perceived as insufficient, pharmacists claim to be really concerned by this problem. As field workers, community pharmacists think that they have a major role to play in carrying out health education campaigns and alcoholism prevention. In fact, the pharmacy is a privileged setting for facilitating encounters and discussions, where alcoholism, like all public health problems, can be addressed.

Adult↗
PubMed2003

Comparison of physician- and pharmacist-managed warfarin sodium treatment in open heart surgery patients.

OBJECTIVES: To compare the effectiveness of pharmacists and physicians in obtaining therapeutic anticoagulation on initiation of warfarin sodium therapy immediately following prosthetic cardiac valve insertion. Secondary objectives were the percentage of days with an international normalized ratio (INR) greater than four, the percentage of days with an INR less than two, the time to stabilize the INR within the therapeutic range, and the percentage of patients experiencing at least one major bleed. METHODS: This study was a before and after comparison using a retrospective chart review of patients who received warfarin sodium following cardiac valve surgery. Physicians dosed independently and pharmacists used a warfarin sodium nomogram to manage patients. RESULTS: A total of 227 patients (physician group, n=130; pharmacist group, n=97) satisfied the inclusion criteria. No differences were found between the two groups in the percentage of days in the therapeutic range (P=0.27), the percentage of days with INR less than two (P=0.06), the percentage of patients discharged before their INR stabilized (P=0.91) or the percentage of patients with a major bleed (P=0.72). The pharmacist group had 5.9% fewer days (P<0.001) with an INR greater than four than the physician group. CONCLUSIONS: Appropriately trained pharmacists appear equally safe and effective as physicians when managing warfarin sodium therapy in patients who have undergone cardiac valve replacement.

Anticoagulants↗
PubMed1992

The pharmacist's role in the recognition and management of insomnia.

Pharmacists, in collaboration with physicians, are in a unique position to assist the many patients who complain of disturbed sleep and/or impaired daytime functioning. The aim of this article are to familiarize physicians with the role that is and can be played by the pharmacist and to reinforce for practicing pharmacists their multifaceted approach to the insomniac patient. Suggestions are made for pharmacist involvement in patient evaluation, education, and monitoring, and for other possible roles of the pharmacist in dealing with the insomniac patient and the appropriate use of hypnotics.

Databases, Bibliographic↗
PubMed2004

[Clinical pharmacist improves the use of drugs in hospital].

BACKGROUND: We investigated how a clinical pharmacist can contribute to quality assurance of the use of drugs for inpatients in a respiratory ward. MATERIAL AND METHODS: Up to twice a week over two periods (43 meetings, 31 in the first and 12 in the second period), a clinical pharmacist sat in on the morning meetings regarding patients. Various drug-related problems were identified and discussed. RESULTS: The clinical pharmacist took part in discussions of 232 (70%) of a total of 332 patients. On average, 0.71 drug-related problems per patient resulting in a prescription change were identified. This included 239 drug-related problems: lack of use of drugs (25), unnecessary use (18) or wrong use (1); too low dose (16), too high dose (30); adverse effects (29); compliance (10) and miscellaneous problems (110). The average number of prescription changes suggested by the clinical pharmacist went down from 0.81 per patient in the first period to 0.57 in the second (p < 0.001). INTERPRETATION: We conclude that many drug-related problems were identified and the quality of drug use was improved by including a clinical pharmacist in the medical team.

Drug Information Services↗
PubMedDate not supplied

[Human resources in Iaşi Pharmacists Association].

The authors present the results of the 2000 and 2001 census of the human resources of the Iaşi County, realised by the Pharmacists Association. The results underline that most of the pharmacists are working in public pharmacies (69%). In the 188 community pharmacies are working 490 pharmacists, meaning a pharmacist/1707 inhabitants of the Iaşi County. Most of the actual pharmacies (75%) are small, with 1-2 pharmacists. Comparing the results of the two consecutive census it was observed an increase of the number of the pharmacies and pharmacists.

Community Pharmacy Services↗
PubMed2004

[Preparing pharmacists for participating in health promotion programs as exemplified by the smoking prevention program].

Health promotion is an interdisciplinary subject which glue together such sciences as medicine, psychology, sociology, social politics and many others. It appears to be the most interesting theme for the pharmacists. One of the most important problem carried in the drug-stores is the fight against the nicotine dependency, which gives the pharmacists a large field to show his knowledge and competence in helping people with the smoking problem. To make the pharmacist-patient cooperation happen, we need to instruct chemists at pre-, and postgradual courses about treating the nicotine addiction. We cannot underestimate the pharmacists' role in the whole fighting nicotine dependency process. Modern pharmacist is fully qualified to give tips or guide patient who get to finish his addiction.

Education, Pharmacy↗
PubMedDate not supplied

Assessment of a fax document for transfer of medication information to family physicians and community pharmacists caring for hemodialysis outpatients.

BACKGROUND: Studies have clearly identified the outpatient dialysis population as one that is at high risk for drug-related problems. The objective of this study was to evaluate whether a fax document was useful for community pharmacies and family physicians to notify these health care providers that their patient was receiving hemodialysis, to update medication and allergy records, provide dosing information on antibiotics and drugs to avoid, facilitate communication from the hemodialysis unit, and to decide if this was a worthwhile project to continue on an on-going basis. METHODS: Fax documents were sent to community pharmacists and family physicians of 70 hemodialysis patients from two different hemodialysis satellite units. The fax document consisted of a brief cover letter with contact numbers, a copy of the patient's medication and allergy list, a table of appropriate antibiotic doses and medications to avoid in dialysis, and a survey to evaluate this project's usefulness. Fisher's exact test was used to determine whether there were any significant differences between the family physician and community pharmacist responses. RESULTS: The survey response rate was 37%. Ninety-five per cent (20/21) of family physicians and 81% (22/27) of community pharmacists who responded to the survey would use the medication profile to update their records. Ninety-five per cent of family physicians and 93% of community pharmacies thought the fax document was an improvement in communication from the dialysis unit. Ninety per cent of family physicians and 85% of community pharmacies thought that the fax document was a worthwhile project for the dialysis unit to continue. No significant differences were found between family physician and community pharmacist responses. CONCLUSIONS: Implementation of a fax document for the transfer of medication information to family physicians and community pharmacists caring for hemodialysis patients aids in updating medication and allergy profiles, improves communication fom the dialysis unit and is considered a worthwhile project to continue on an ongoing basis.

Ambulatory Care↗
PubMedDate not supplied

[Pharmacist drug dispensing in clinical trials].

Dispensing experimental drugs in part of a pharmacist's task in the hospital since the 20.12.1988 law. A 13 month critical evaluation dispensing drugs for clinical trials is presented. Drug management, distribution and control in 61 new studies included 1,165 patients need a full time pharmacist. This new organization is well accepted by sponsors and investigators. The hospital pharmacist's contributions to clinical trials are: protocol application in hospital practice, nurses information, efficient and safe storage and distribution to patients. The pharmacist facilitates good clinical practices and quality assurance. The problem is that in many french hospitals the pharmaceutical department is chiefly a wholesale dealer for pharmaceutical products. Our opinion is that the pharmacists should deliver drugs to improve patient compliance.

Clinical Trials as Topic↗