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At least 1,189 records · Page 66Linked to original sources
PubMed1989

Establishment of a permanent decentralized pharmacy in the coronary and progressive care units.

Critical care units, such as Coronary Care Units (CCU) and Progressive Care Units (PCU), are patient care areas with complex and rapidly changing needs. Services that enable health care providers in these areas to function more quickly and accurately are constantly sought. A 3 week pilot project was organized in a pharmacy department to evaluate the potential impact of a decentralized pharmacy service in the CCU and PCU areas. Distributive and clinical pharmacy services were provided by two pharmacists during the study. Nursing evaluated the study period as being highly favorable, and missing doses decreased by 57%. The departments of nursing and administration responded to this pilot by funding positions from nursing toward the establishment of a permanent decentralized pharmacy in these units.

Baltimore↗
PubMed1978

Personnel requirements for improving services in a hospital pharmacy.

Pharmacy services at Boston Hospital for Women were made to meet 1976 JCAH pharmacy standards. Changes made in the pharmacy program are described, comparing the average amount of staff hours per week devoted to various pharmacy activities in 1974 and 1976. Activities are broken down into four major areas: administration, distribution of drugs, preparation of drugs and clinical programs. The clinical role of the pharmacist and updating of programs and operating procedures has been a major consideration in making changes.

Boston↗
PubMed1999

Advances in Navy pharmacy information technology: accessing Micromedex via the Composite Healthcare Computer System and local area networks.

The pharmacy profession has long used technology to more effectively bring health care to the patient. Navy pharmacy has embraced technology advances in its daily operations, from computers to dispensing robots. Evolving from the traditional role of compounding and dispensing specialists, pharmacists are establishing themselves as vital team members in direct patient care: on the ward, in ambulatory clinics, in specialty clinics, and in other specialty patient care programs (e.g., smoking cessation). An important part of the evolution is the timely access to the most up-to-date information available. Micromedex, Inc. (Denver, Colorado), has developed a number of computer CD-ROM-based full-text pharmacy, toxicology, emergency medicine, and patient education products. Micromedex is a recognized leader with regard to total pharmaceutical information availability. This article discusses the implementation of Micromedex products within the established Composite Healthcare Computer System and the subsequent use by and effect on the international Navy pharmacy community.

CD-ROM↗
PubMed2000

Managing drug costs: the perception of managed care pharmacy directors.

OBJECTIVE: To examine the perceptions of health plan pharmacy directors about drug costs and utilization drivers, interventions the plans use to control drug expenditures, and strategies considered necessary to permit continued provision of a comprehensive drug benefit. STUDY DESIGN/METHODS: A multipart survey developed and mailed to 500 pharmacy directors of managed care organizations across the country. RESULTS: The survey respondents (response rate = 18%) represented managed care health plans in the following percentages: 49% of respondents were from network/independent practice associations; mixed-model health maintenance organizations (HMOs), 20%; group HMOs, 15%; and staff-model HMOs and network/preferred provider organizations, 8% each. Drug mix and utilization were reported to be the primary drivers of drug expenditures. Half the respondents rated inflation as a somewhat strong cost driver. Interventions the health plans use to control drug expenditures include formularies, generic substitution, preauthorization, manufacturers' rebates, drug benefit design, physician profiling, target drug programs, academic detailing, and tiered copays. With the exception of formulary use, generic substitution, and manufacturers' rebates, which all the plans have instituted, the types of interventions used by the different model types vary widely. More than half the pharmacy directors reported generic substitution, drug benefit design, and differential copays as very effective interventions used to control drug costs. CONCLUSIONS: The majority of pharmacy directors predict continued double-digit increases in drug expenditures over both the short term and the long term. Of the respondents, 91% reported that additional limits and/or exclusions to the benefit design would be necessary to control these increases. To continue providing a comprehensive drug benefit, 54% indicated that they would have to achieve sufficient cost savings in other areas to offset increases in drug costs.

Attitude of Health Personnel↗
PubMed2000

[Shift to home treatment and the function of pharmacies].

A crisis point has been reached in the medical health system in Japan, where there has been a rapid aging of the population. The method of providing health system benefits is being reconsidered. As a result, medical treatment has been classified into inpatient, outpatient, and home care systems according to treatment functions. In concrete terms, the insurance system now classifies medical treatment and care separately, payment for medical fees has changed from payment at piece rates to a fixed amount system, and the number of days patients stay in hospital has been reduced. It is predicted that hospital treatment will increasingly rely on early discharge, and patients highly reliant on medical treatment will be shifted to home treatment. For this shift to home treatment, therefore, supplies of injectable agents such as used in total parenteral nutrition, and equipment by specialist pharmacies have become necessary. However, to dispense injectable agents, "standards of compounded sterile pharmaceuticals by licensed pharmacies" is applied, meaning there are very few pharmacies that can meet these standards. In the present survey, we found that 40 pharmacies have been recognized as meeting these standards.

Home Care Services, Hospital-Based↗
PubMed1994

[The teaching of pharmacy in Lvov until 1889].

The first Lvov pharmacists and a role of congregatio apothecariorum in the vocational training are presented. During the Austrian rule in Galicia the first chanages in the training system date as of 1835. In 1853 the first pharmacy college was set up at the Faculty of Philosophy of the Lvov University whose students were pharmacists trained within the vocational system framework, who graduating would receive their M.Sc. The first pharmacy school in Lvov began in 1879, closed in 1897. The pharmacy studies at Lvov University were reformed after a pharmacy teaching reform in Austria in 1889.

Austria↗
PubMed1994

[The teaching of pharmacy in Lvov between 1890-1940].

The paper discusses the continuation of the education of pharmacists following the 1889 reform until 1940 when the Jan Kazimierz University was converted into the National Medical Institute. The teaching programmes and the history of departments training pharmacists at the courses run by the Studium Farmaceutyczne operating in Lvov until 1924 are considered. The activities of the pharmacy milieu aimed at reopening of the university studies of pharmacy are presented. Eventually they resulted in setting up of the Pharmacy Section at the Medical Department of Lvov University which followed a four year curriculum. The teaching programmes and the teaching staff of the Pharmacy Chair are also reviewed in the paper.

Education, Pharmacy↗
PubMedDate not supplied

The Strasbourg's pharmacy school transfer to Nancy (October the 1st, 1872).

After a short history of the High school of pharmacy of Strasbourg and of the school of medicine and pharmacy of Nancy, and their situation in 1870, the author describes the modalities of the transfer concerning pharmacy. The first years in Nancy and the difficulties due to the existence of military fellows and to vacancy of two chairs are evocated here. The names of numerous teachers are given. The paper continues about the autonomy of the school in 1876, with the professors nominated at the chairs, with the extension of buildings and increase of students. Despite of early difficulties encountered during the settling in Nancy, it appears that the transfer from Strasbourg was a success and the school of pharmacy found rapidly its place inside the great University created in Nancy after the war.

France↗
PubMed1993

[History of Polish pharmacy].

Doctoral thesis (in French) by Monika Debska-Donnet, entitled "History of pharmacy and pharmaceutical art collections in Poland" which was presented to Paris XI University (Faculty of Pharmaceutical and Biological Sciences) in 1991, was translated into Japanese and summarized. In this report, histories of pharmacy education, pharmacists, community pharmacies, pharmacopoeiae, pharmaceutical industries in Poland were described, and four representative Polish museums of history of pharmacy were also explained.

Academic Dissertations as Topic↗
PubMed2002

Private pharmacies in tuberculosis control--a neglected link.

In most settings in India, private pharmacies dispense prescriptions for anti-tuberculosis drugs made out by private practitioners. In a cross-sectional study, we assessed the dispensing practices for tuberculosis and knowledge about the national tuberculosis programme of 300 pharmacies. In all, 2800 prescriptions were dispensed monthly by the pharmacies. Doctors' prescriptions were for durations of several months, but half of the patients bought drugs one dose at a time for self-administration. This practice might promote drug resistance. Although 95% of pharmacists were not aware of the existence of the tuberculosis programme, the majority (97%) were willing to learn and contribute towards tuberculosis control. The need and the potential of private pharmacies for participation in tuberculosis control are highlighted.

Antitubercular Agents↗
PubMed2003

[Evaluation of the adherence to the asthma guidelines by the administration of a questionnaire in community pharmacies].

BACKGROUND: Several studies demonstrate that the adherence to asthma guidelines (GL) is poor, but only a few of them were performed in community pharmacies. Thus, we decided to study this phenomenon by administering a questionnaire (Q) in two pharmacies. METHODS: A Q was developed and administered to 138 patients-customers of two community pharmacies in Rome. RESULTS: The severity of the disease was established based on the frequency of daytime and nocturnal symptoms before therapy, following the stepwise approach recommended by the current GL. We observed up to 90 different treatments, while those listed by the GL, long-term preventive or quick-relief for the four categories of asthma, are only 19. In particular, many of them included antihistaminic drugs and mucoactive agents, pharmacological classes not recommended by the GL, while certain long-term preventive therapeutic schemes did not include glucocorticoids. CONCLUSIONS: The analysis of the effects on daytime and nocturnal symptoms and the interferences of the disease with school and work, showed that the control of asthma was inadequate, probably due to the low adherence to the GL. In conclusion, this small pilot study, which does have several methodological limitations (small population and geographic area, small number of pharmacies involved, the use of a Q to obtain information not easily reported by the patient) confirms the important role played by pharmacists in the analysis of the adherence of pharmacological treatments to official GL.

Adolescent↗
PubMed1992

Pharmacy practice in 2040.

Pharmacy practice 50 years in the future is discussed. The practice of pharmacy in 2040 will be influenced by many trends and issues, such as increasing cultural diversity, the aging population, evolving drug and information technology, rising drug costs, and increasing third-party coverage. Pharmacy may take one of two paths. In the first scenario, institutional and community practice would drift further apart, with community pharmacy becoming more involved with retailing than with health care. In the second scenario, all pharmacists would become a vital component of an integrated, patient-centered system of health care; pharmacists, like physicians, would be salaried professionals, paid for by health-care programs financed through health insurance. The difference between the two scenarios is the degree to which pharmacists actively participate in their creation: The first will happen if pharmacists do not take action; the second will require a considerable amount of work. If pharmacists wish to see an active system of patient-centered pharmaceutical care in 2040, they must begin to create it now, regardless of their practice setting. Pharmacists must work to create a future in which they are an integral part of the health-care system.

Age Factors↗
PubMed2002

Implementing competition in the pharmacy sector: lessons from Iceland and Norway.

The pharmacy market in many European countries is characterised by individual, privately-owned pharmacies that operate under tight government control regarding barriers to entry, scope of activities and profit margins. In Iceland, many of these restrictions were relaxed in 1996 in the hope of stimulating competition. Similar changes were introduced in Norway in 2001. In both countries, the new structural conditions led to horizontal mergers and coalitions between pharmacies; and in Norway, the emerging pharmacy groups integrated vertically with wholesalers. The number of independent decision units decreased and the markets rapidly transformed into oligopolies with remaining institutional barriers to entry. The rapid change took both governments by surprise, and intervention was needed to prevent monopolies from emerging. Additional intervention to strengthen competition may be needed in the future to prevent unfavourable developments, and the tradition of maintaining equal access of services may prove more difficult to uphold. Experiences in both Iceland and Norway highlight the complexity of reforms that fundamentally influence competitive behaviour.

Delivery of Health Care, Integrated↗
PubMed2003

Referring TB suspects from private pharmacies to the National Tuberculosis Programme: experiences from two districts in Ho Chi Minh City, Vietnam.

SETTING: Ho Chi Minh City, Vietnam. OBJECTIVE: To describe pharmacists' attitudes towards referring TB suspects to the National Tuberculosis Programme (NTP) and to evaluate the feasibility of a new referral system. METHODS: 1) Questionnaire survey of 150 private pharmacies; 2) qualitative interviews with 16 pharmacists; 3) monitoring the use of new referral forms for 21 months. RESULTS: Use of a simple referral form was thought to be manageable by 72% of the pharmacists. Pharmacists identified a number of different types of risks associated with referral of TB suspects to the NTP; clients could turn to another pharmacy (61% of respondents); criticise the pharmacist if it appears that they do not have TB (42%); or remain untreated because they are not able to visit the NTP (41%). Fifty-eight (39%) of eligible pharmacies referred at least one client. At least 373 suspects were referred, 149 were tested and 10 had TB. CONCLUSIONS: It is feasible to let pharmacies refer TB suspects. For there to be a significant impact on case detection, it is important to acknowledge a number of concerns expressed by pharmacists and attempt to change both clients' and providers' expectations with regard to the pharmacists' role.

Adult↗
PubMed2004

Management of acute respiratory infections in drug shops and private pharmacies in Uganda: a study of counter attendants' knowledge and reported behaviour.

BACKGROUND: In Uganda, private pharmacies and drug shops are important sources of drugs for the majority of the population. In addition to selling drugs, these outlets often serve as primary sources of information about illness and drug therapy. However, the appropriateness of dispensing by staff in these drug outlets has been found to be suboptimal. Yet there has been no study documenting the determinants that underlie the dispensing pattern at these outlets. This study evaluated counter attendants' training background, their knowledge of acute respiratory infections (ARI), and their reported behaviour in the management of ARI in order to identify factors associated with dispensing behaviours. STUDY DESIGN AND SETTING: This descriptive study was conducted in Kampala District, Uganda and used a cross-sectional survey research design to analyse the practice of 197 drug outlets including 28 pharmacies and 169 drug stores. MAIN OUTCOME MEASURES: Counter attendants' training background; their knowledge of the causes, signs and symptoms of ARI; their perception of the dangers of ARI; and the drugs and advice offered for the management of mild and severe ARI. RESULTS: Majority of the counter attendants had medical or pharmacy training. Most of them were nurses. The attendants' workload was generally low. High levels of self-medication among clients were reported at the outlets. Staff at a management level had low knowledge of the aetiology, signs and symptoms, and dangers of ARI. Prescribing an antibiotic was found to be the usual practice for managing ARI cases. Counter attendants at those outlets seldom gave advice or referrals for ARI cases. In particular, patient demand was a main barrier to appropriate dispensing. Strategies suggested by attendants for improving rational dispensing were to educate the public, provide training for the attendants, and re-enforce government supervision of drug outlets. CONCLUSIONS: This study identified several self-reported inappropriate behaviours in the outlets. The formal training background and workload of counter attendants at drug shops and pharmacies were not found to be important contributors to irrational prescribing. The results of this study suggest that a combination of regulatory and educational interventions may yield to improvement in counter attendants' practices in private drug outlets.

Acute Disease↗
PubMed1992

Implementation and financial analysis of an operating room satellite pharmacy.

The rationale and implementation of an operating room (OR) pharmacy satellite is described, and the first-year savings are evaluated. The OR in an 874-bed university teaching hospital, consisting of 17 rooms for inpatients, 6 rooms for ambulatory patients, and a postanesthesia care unit, lacked comprehensive pharmacy services; this resulted in poor drug-use control and accountability, varied controlled-substance audit trails, and suboptimal patient services. A task force examined other institutions' OR pharmacy satellites and chose to implement a satellite that provides all pharmaceuticals and i.v. admixtures by using case trays for each surgical patient. One year after implementation of the satellite, inventory in the operating-room areas was reduced by 56.5%, annual pharmaceutical costs by 2.6% (adjusted for inflation), and average cost per patient by 8.0% (adjusted for inflation). First-year cost reductions and revenue identification exceeded operating costs for materials, supplies, and labor by $271,755. Implementation of an OR pharmacy satellite reduced the net cost of providing pharmaceutical services to the OR.

Ambulatory Care↗
PubMed1992

Perceptions and use of performance measures by hospital pharmacy directors.

The extent to which hospital pharmacy directors use and value specific pharmacy department performance measures was studied. Questionnaires were mailed to pharmacy directors at 834 randomly selected hospitals. The questionnaires contained a list of seven data collection methods and 32 financial, 25 productivity, and 9 quality assurance measures obtained from a review of the literature. Respondents were asked to indicate familiarity, perception of usefulness, and current use of each method or measure. Perception of usefulness was measured on a five-point scale (1 = not useful, 5 = very useful). Respondents were also asked if the measures were requested by hospital administration or an external consultant. The overall response rate was 24.1%. Less than 30% of the respondents indicated that they used any of the data collection methods; however, the mean value for perceived usefulness was higher than 3 for almost all of the methods. Only five of the financial measures, two of the productivity measures, and two of the quality assurance measures were being used by more than 50% of the respondents. The value for mean perceived usefulness was higher than 3 for all but two of the measures. Most of the measures showed significantly higher frequency of use when they were requested by hospital administrators than when they were not. Requests by external consultants showed less effect on the use of the measures. The use of performance measures was low, but hospital pharmacy directors were familiar with many of these measures and perceived them to be useful.

Efficiency↗