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PubMed1979

The performance of foreign pharmacy graduates on the National Association of Boards of Pharmacy licensure examination.

Since there is not a shortage of pharmacists, many fear that licensing foreign pharmacy graduates will create an oversupply. Boards of pharmacy are concerned with licensing qualified candidates. Until 1978, Illinois issued the national pharmacy licensure exam to foreign and U.S. graduates. The foreign graduates' scores were consistently lower. A prelicensure exam is needed to evaluate the foreign student's academic background. Foreign students could matriculate into an accredited college of pharmacy for remediation in the necessary areas.

Educational Measurement↗
PubMed2000

Private pharmacies and tuberculosis control: a survey of case detection skills and reported anti-tuberculosis drug dispensing in private pharmacies in Ho Chi Minh City, Vietnam.

SETTING: Ho Chi Minh City (HCMC), Vietnam. OBJECTIVES: To assess knowledge about tuberculosis, to describe self-reported dispensing practices and to estimate the magnitude of anti-tuberculosis drug dispensing in private pharmacies. DESIGN: Survey of a random sample of 147 private pharmacies out of a total of 1814 registered pharmacies. Interviews were carried out based on a structured questionnaire. RESULTS: Eighteen per cent of interviewees identified TB as a possible diagnosis for a fictitious case with fever and cough for 4 weeks. Fifty-eight per cent reported selling anti-tuberculosis drugs often or sometimes. Interviewees estimated that 1.3 persons on average (95%CI 0.6-1.9) had bought anti-tuberculosis drugs during the last 4-week period, and that 24% of them had bought anti-tuberculosis drugs without a prescription. CONCLUSION: We have estimated that between 1100 and 3400 persons buy anti-tuberculosis drugs each month in the 1814 registered private pharmacies in HCMC, that about a quarter of them do so without a prescription, and that at least 40% of all anti-tuberculosis drug dispensing in HCMC occurs in the private sector. Regulations need to be put in place urgently and collaboration strengthened between the strong National Tuberculosis Programme and the unorganised private sector in HCMC.

Adult↗
PubMed2002

The state of the world's pharmacy: a portrait of the pharmacy profession.

Pharmacy is the health profession that has the responsibility for ensuring the safe, effective and rational use of medicines. As such it plays a vital part in the delivery of health care world-wide. However, there remain wide variations in the practice of pharmacy, not only between countries but also within countries. Nevertheless, in recent years there has been significant convergence, driven by a number of key factors. These include World Health Organization declarations concerning the role of pharmacists, changes in the political climate of many countries, and the pursuit by pharmacists themselves of the goals of medicines management and pharmaceutical care. This paper considers the main activities undertaken by pharmacists, describes their education and regulation, and explores the current state of pharmacy around the world.

Developing Countries↗
PubMed1993

Pharmacy technicians and computer technology to support clinical pharmacy services.

Use of pharmacy technicians, computer-assisted patient-selection algorithms, and bar-code technology to increase efficiency of clinical pharmacy staff is described. Workload assessment showed that clinical pharmacists at Henry Ford Hospital (Detroit) were spending two thirds of their time with data collection, patient selection, and documentation and only one third of their time intervening to improve drug therapy. To increase pharmacist efficiency, two technicians were hired to perform the clerical functions associated with clinical pharmacy services. Also, a bar-code data-collection system was implemented to help pharmacists document their clinical activity. Computerized algorithms helped pharmacists target patients whose therapy should be most carefully reviewed. Reports generated by the system summarized workload distribution and provided information about the types of problems identified and corrected. After these changes were implemented, the fraction of time that pharmacists spent intervening to improve drug therapy increased to one half. Use of technicians to perform clerical tasks, computerized algorithms to help identify patients in need of pharmacist assistance, and bar-code technology to facilitate data collection has helped clinical pharmacists improve their time management.

Algorithms↗
PubMed1996

Pharmacy benefits management and ambulatory pharmacy services.

The business of pharmacy is changing dramatically as new components are added to our health care system and new terms developed to describe existing functions. For example, payment for pharmacy products and services are increasingly coming under control of Pharmacy Benefits Management (PBM) companies who are also racing to develop Disease State Management Programs. Additionally, health care purchasers have welcomed the development of HEDIS (Health Employer Data Information Set) as another tool to evaluate both the cost and quality of health care provided to their enrollees. All this means pharmacy will have to change its paradigm from dispensing to managing the medication consumption/compliance process in addition to traditional dispensing activities.

Ambulatory Care↗
PubMed1996

Work activities at an ambulatory care pharmacy with an integrated model of pharmacy practice.

Activities performed by pharmacists and technicians in an ambulatory care pharmacy were evaluated by work sampling to determine circumstances in which pharmacist time was used ineffectively. Over a two-week period, pharmacists and technicians in the outpatient pharmacy at University of Utah Hospitals and Clinics recorded their activities at random intervals during the workday. The data were analyzed by using descriptive statistics and an institution-specific index of pharmacist efficiency. During the study, 1565 pharmacist observations and 1465 technician observations of work activities were collected. Pharmacists spent 50% of their shifts on clinical and professional activities, while technicians spent 50% of their shifts processing prescriptions and 30% of their shifts directly supporting pharmacists clinical and professional activities. The efficiency with which pharmacists used the available work time for patient care was 56% (100% would mean that they spent all available work time on patient care activities). During a shift, 2.3 minutes per prescription per pharmacist was available for professional and clinical activities. Self-reported work sampling enabled the ambulatory care pharmacy staff to identify staff use of time.

Hospitals, University↗
PubMed1987

Reforms in pharmacy education and opportunity to practise clinical pharmacy.

The impact on 357 newly licensed pharmacists, graduates of two colleges, of efforts to turn pharmacy into a clinical profession, was examined by way of a self-administered questionnaire. Perceptions and expectations about work, differences in consulting practices, relationship between practice and attitudes, and the presence or absence of an identifiable general value orientation (which could account for specific perceptions and attitudes), were examined. Results indicated that hospital practice was more likely to be associated with clinical pharmacy and clinical pharmacy practice was more likely to meet the expectations of recently graduated pharmacists. In addition, 52 per cent of the community-based pharmacists were found to engage in patient counseling, as compared with 39 per cent of hospital-based pharmacists. Newly licensed pharmacists are deepening the existing divisions in the profession, while moving toward a revision of their place in the health care delivery system.

Education, Pharmacy↗
PubMedDate not supplied

Acceptance of a pharmacy-based, physician-edited hospital pharmacy and therapeutics committee newsletter.

OBJECTIVE: To assess the level of physician acceptance and perceived usefulness of a pharmacy-prepared, physician-edited pharmacy and therapeutics (P&T) committee newsletter. DESIGN: Two separate surveys conducted after 7 and 24 months of publication, respectively. SETTING: 500-bed, university-affiliated, tertiary-care hospital. MAIN OUTCOME MEASURES: The initial survey was mailed to physicians after 7 months of publication and they were requested to rate various aspects of the newsletter, including timeliness of articles, usefulness of articles, quality of writing and design, and overall value of the publication on a scale of 1-4: (1 = excellent, 2 = good, 3 = fair, 4 = poor). Physicians were also asked to rank different categories of articles (articles on new drugs, drug-class reviews, topical reviews, formulary news, and articles providing P&T committee information) and were encouraged to provide comments. A separate follow-up survey conducted at 24 months asked physicians to indicate whether they (1) regularly received the newsletter, (2) regularly read the newsletter, (3) found the information in the newsletter to be useful, and (4) desired to continue receiving the newsletter. RESULTS: Initial survey results yielded mean newsletter quality scores ranging from 1.54 to 1.66. Respondents preferred, in descending order, articles on new drugs, drug-class reviews, topical reviews, formulary news, and P&T committee information. The 24-month survey revealed that 96 percent of the physicians regularly receiving and reading the newsletter found the information useful and 97 percent felt that the newsletter should continue to be published. Favorable comments were also received from several prominent physicians. CONCLUSIONS: The results indicate strong physician acceptance of a pharmacy-prepared, physician-edited newsletter and provide information about the types of articles preferred by physicians in a university hospital setting.

Attitude of Health Personnel↗
PubMed2001

Prepharmacy predictors of success in pharmacy school: grade point averages, pharmacy college admissions test, communication abilities, and critical thinking skills.

Good admissions decisions are essential for identifying successful students and good practitioners. Various parameters have been shown to have predictive power for academic success. Previous academic performance, the Pharmacy College Admissions Test (PCAT), and specific prepharmacy courses have been suggested as academic performance indicators. However, critical thinking abilities have not been evaluated. We evaluated the connection between academic success and each of the following predictive parameters: the California Critical Thinking Skills Test (CCTST) score, PCAT score, interview score, overall academic performance prior to admission at a pharmacy school, and performance in specific prepharmacy courses. We confirmed previous reports but demonstrated intriguing results in predicting practice-based skills. Critical thinking skills predict practice-based course success. Also, the CCTST and PCAT scores (Pearson correlation [pc] = 0.448, p < 0.001) were closely related in our students. The strongest predictors of practice-related courses and clerkship success were PCAT (pc=0.237, p<0.001) and CCTST (pc = 0.201, p < 0.001). These findings and other analyses suggest that PCAT may predict critical thinking skills in pharmacy practice courses and clerkships. Further study is needed to confirm this finding and determine which PCAT components predict critical thinking abilities.

Communication↗
PubMed2000

[How the history of pharmacy should be taught to pharmacy students].

This is a question which by and of every lecturer of the history of pharmacy, especially when there is plenty of information about the subject, and very little "lecture time" available. A lecturer should also remember, that pharmaceutical faculties aim to produce a good expert on medicine, not "an historian of pharmacy". But it is also desirable for pharmacists - experts on medicines - to obtain an elementary body of information about who contributed to shaping the practice of medicine, its variety and ...its kindness. If such aims were achieved - it would be a great score. And if this basic knowledge leads and encourages on independent exploration of the history of pharmacy - we can put it down as due to the success of this first lecturer.

Education, Pharmacy↗
PubMed2003

[Historical study of clinical pharmacy education in Japan (part 2) retrospective evaluation of the roles of the one-year graduate course of clinical pharmacy practice (Yakugaku Senkouka) at Meijo University].

Clinical pharmacy practice education started 30 years ago in Japan. Since 1975, a one-year graduate course, clinical pharmacy practice (Yakugaku Senkouka), has been offered at Meijo University, making it a leading school to raise pharmacists with sufficient experience in hospital settings. This article describes the scope of the course, the development of educational systems to meet public demand for new pharmaceutical skills, and the influences on reforming the Japanese health-care system. The content consists of the following: (1) The process of building up the first curricula of clerkship, (2) requirements for admission, namely including an essay, an interview, school records and an aptitude test, (3) establishing the teaching discipline, (4) achievement goals, (5) learning process modeled on methods used in the United States, (6) establishing the concept of medical ethics, (7) professional status of course graduates, and (8) nationwide influence on the social health-care of the country. The one-year graduate course of clinical pharmacy practice was terminated in 2002 and is to be reintroduced as a two-year graduate school course to cope with the present and future trends in health-care systems.

Education, Pharmacy, Graduate↗
PubMed1978

Pharmacy services in a Federal extended care facility, as provided by a pharmacy student.

The objective of this study was to identify the role of the pharmacy student in providing health care to a Federal Nursing Home Care Unit. Under the supervision of a graduate pharmacy resident, the student was responsible for monitoring compliance in drug therapy, providing consultation services, and developing several research projects. A detailed study of allergy documentation in 78 patients showed that 25.6 percent of their records indicated drug allergies, but upon further investigation only 5.1 percent could be confirmed. Fourteen (41 percent) of the 34 reported allergy-producing substances had been administered again after the initial allergic incident, without ensuing difficulties. Evaluation of the self-medication program indicated that 71.4 percent of 14 study patients could not easily open their child-proof medicine container. A change to "tight" containers enhanced the patients' ability to open them. However, no significant conclusions could be drawn regarding improvement in the patients' compliance with prescription directions. Pharmacy students can be a valuable resource in improving documentation, testing drug prescription compliance, and participating in the general care of patients in long-term facilities.

Aged↗
PubMed1989

Application of a hospital pharmacy computer system to nuclear pharmacy.

A hospitalwide decentralized computer system using the software module for outpatient pharmacy is applied to the nuclear pharmacy. Computer benefits of label production, medication profiling, permanent record keeping, inventory control, and screening for drug interactions are applicable in the nuclear pharmacy setting.

Colorado↗
PubMedDate not supplied

Economic evaluations of clinical pharmacy services--1988-1995. The Publications Committee of the American College of Clinical Pharmacy.

The objectives of this effort were to summarize and critique original economic assessments of clinical pharmacy services published from 1988-1995, and to make recommendations for future work in this area. A literature search was conducted to identify articles that were than blinded and randomly assigned to reviewers to confirm inclusion, abstract information, and assess the quality of study design. The 104 articles fell into four main categories based on type of service described: disease state management (4%), general pharmacotherapeutic monitoring (36%), pharmacokinetic monitoring services (13%), and targeted drug programs (47%). Articles were categorized by type of evaluation; 35% were considered outcome analyses, 32% outcome descriptions, and 18% full economic analyses. A majority (89%) of the studies reviewed described positive financial benefits from the clinical services evaluated; however, many (68%) did not include the input costs of providing the clinical service as part of the evaluation. Studies that were well conducted were most likely to demonstrate positive results. Commonly, results were expressed as net savings or costs avoided for a given time period or per patient. Seven studies expressed results as a benefit:cost ratio (these ranged from 1.08:1 to 75.84:1, mean 16.70:1). Overall this body of literature contains a wealth of information pertinent to the value of the clinical practice of pharmacy. Future economic evaluations of clinical pharmacy services should incorporate sound study design and evaluate practice in alternative settings.

Cost-Benefit Analysis↗
PubMed1997

[Pharmacies during the transformation of health care. IV. Sociologic study of pharmacy service].

In Slovakia, similarly as in the Czech Republic, marked changes in the pharmaceutical services have gradually been taking place since 1990. Principal legal and organizational changes have been connected also with the extent and standard of provided pharmaceutical services. The present paper reports the results of a questionnaire research regarding the evaluation of the standard of pharmaceutical services in the year 1995 where there existed both state-owned and private public pharmacies. The questionnaire research was carried out in 20 pharmacies of the Region of West Slovakia, 407 questionnaires were evaluated. The questionnaires were evaluated from the viewpoint of sociological classification of respondents (economically active persons, old-age pensioners) as well as the sex of pharmacy customers. The results confirmed relatively little significant differences between the satisfaction with pharmaceutical services either according to the sex or the social position of the respondents. A relatively significant proportion of the respondents have expressed critical views about the participation of the patient in covering the costs of drugs and slow execution of order of drugs.

Consumer Behavior↗
PubMedDate not supplied

The Academy of Managed Care Pharmacy Format for Formulary Submissions: an evolving standard--a Foundation for Managed Care Pharmacy Task Force report.

OBJECTIVE: The objective of this report is to provide, in detail, the evidentiary requirements contained in Version 2.0 of the Academy of Managed Care Pharmacy's (AMCP's) Format for Formulary Submissions and to elaborate on several key issues regarding the use of the Format that users, potential users, and pharmaceutical manufacturers have raised since AMCP published the first version of the guidelines in October 2000. BACKGROUND: The AMCP published its Format for Formulary Submissions in October 2000. The AMCP leadership and its members were motivated to develop these guidelines by a growing need to ensure that any increased utilization of medications, biopharmaceuticals, and vaccine products was appropriate and that newer products would bring added clinical and economic value to covered populations. Since publication of the Format, it has garnered nationwide publicity and attracted considerable positive and negative attention. As adoption of the AMCP Format has spread, manufacturers have begun to standardize the framework within which they present population-specific data. Since publication of the AMCP Format, the AMCP and the Foundation for Managed Care Pharmacy (FMCP) have continuously sought input from pharmaceutical manufacturers and health-system pharmacists through various venues to improve and clarify the process. Version 2.0 is the first attempt to address user's comments and concerns. METHODS: The majority of the article text is taken directly from Version 2.0 of the AMCP Format for Formulary Submissions published by the AMCP in October 2002. CONCLUSION: The AMCP and the FMCP believe that the AMCP Format is a tool that will help health systems establish a record of commitment to rational decision making, thus gaining the confidence of patients, clinicians, and members. While providing manufacturers a vehicle for communicating the scientifically based value of their product to a health system, the required evidence to substantiate that value argument allows a pharmacy and therapeutics committee to determine the clinical benefits of a drug, verify any cost savings the drug may generate, and determine the overall cost consequences to their health system. The AMCP Format for Formulary Submissions is an essential tool to evaluate medications, but requires thoughtful consideration as it is used.

Academies and Institutes↗
PubMedDate not supplied

Pharmacy benefit forecast for a new interferon Beta-1a for the treatment of multiple sclerosis: development of a first-line decision tool for pharmacy-budget planning using administrative claims data.

OBJECTIVE: To estimate the incremental change in pharmacy per-member-permonth (PMPM) costs, according to various formulary designs, for a new interferon beta-1a product (IB1a2) using administrative claims data. METHODS: Cross-sectional sex- and age-specific disease prevalence and treatment rates for relapsing, remitting multiple sclerosis (RRMS) patients were measured using integrated medical and pharmacy claims data from a 500,000- member employer group in the southern United States. Migration to IB1a2 from other drugs in the class was based on market-share data for new and existing RRMS patients. Duration of therapy was estimated by analyzing claims for current RRMS therapies. Daily therapy cost was provided by the manufacturer of IB1a2, adjusted for migration from other therapies, and multiplied by estimated volume to predict incremental and total PMPM cost impact. Market-share estimates were used to develop a PMPM cost forecast for the next 2 years. PMPM cost estimates were calculated for preferred (copayment tier 2) and nonpreferred (copayment tier 3) formulary designs with and without prior authorization (PA). One-way sensitivity analysis was performed to assess the influence of product pricing, duration of therapy, and other market factors. RESULTS: Annual incremental PMPM change was $0.047 for the scenario of third copayment tier with PA. The incremental change was greatest for those aged 55 to 65 years ($0.056 PMPM) and did not vary greatly by benefit design. Duration of therapy had the greatest impact on the PMPM estimate across benefit designs. CONCLUSION: IB1a2 will not cause a significant change in managed care pharmacy budgets under a variety of formulary conditions, according to this crosssectional analysis of current care-seeking behavior by RRMS patients. Economic impact may differ if IB1a2 expands RRMS patients. treatment-seeking behavior.

Adjuvants, Immunologic↗
PubMed1990

Long-term care pharmacy services: a new dimension of pharmacy practice.

Pharmacists providing care to patients must have a commitment to quality patient care, have well-developed operations systems, possess refined clinical skills, and be able to effect excellent communication with the clinical and administrative staff. These attributes of pharmacy practice should exist in both the acute care and long-term care settings. Pharmacy practice in the long-term care setting, a unique position due to the everchanging definition of long-term care, may best be referred to as an alternative site for the application of contemporary pharmacy distribution and clinical systems for patient care over an extended period.

Drug Therapy↗