[Law No. 74-1026 of 4 December 1974, containing various provisions pertaining to fertility regulation].
Explore the source record for details and available documents.
Ambulatory Care Facilities↗
SEARCH · Search PubMed
Results for “Pharmacy Distribution”
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.
Management and delivery of contraceptive in China.
Explore the source record for details and available documents.
Asia↗
Extension of medical insurance, 1989.
Explore the source record for details and available documents.
Asia↗
Judgment of 6 July 1989.
Explore the source record for details and available documents.
Clinical Laboratory Techniques↗
Biotechnology products: new opportunities and responsibilities for the pharmacist.
The opportunities and responsibilities of pharmacists with respect to the new biotechnology products are described. Recent advances in the fields of molecular genetics and nucleic acid chemistry have resulted in a proliferation of biotechnology products. Those produced by recombinant DNA techniques offer particular promise for the treatment of a wide variety of medical disorders such as cancer, anemia, neutropenia, diabetes, and myocardial infarction. Since the turn of the century, the pharmacy profession has expanded its role from drug preparation and distribution to modern clinical pharmacy, in which pharmacists act as a source of drug information for physicians, nurses, and patients. In response to the new biotechnology revolution, pharmacists must once again undergo a role expansion, this time actively assuming responsibility for educating themselves about the nature and clinical use of the new biopharmaceuticals. The curriculum of students undergoing training in pharmacy should cover such areas as immunoglobulins, immunomodulators, growth hormones, targeted drug-delivery systems, and advanced diagnostic techniques that use biotechnology products. Continuing-education programs in these areas will update currently practicing pharmacists on the new biotechnology products. Although use of biologic proteins is currently targeted toward hospitalized patients, future advances may allow for dispensing these new drugs through community pharmacies as well. Therefore, change will be necessary at all levels of the pharmacy profession. As pharmacists accept the responsibility of dispensing, monitoring, and providing information about the new biotechnologic agents, they will enhance the rational use of these compounds.
Biotechnology↗
[In vitro studies of factors possibly influencing the performance of latex condoms].
Male condoms are undoubtedly the best protection against sexually transmitted diseases. The French Military Health Service buys condoms from civilian manufacturers using a public purchasing process. This process includes strict technical analysis that allows selection of the best supplier. In addition each batch of condoms delivered to French armed forces undergoes quality testing in the laboratory of the Armed Services Central Pharmacy before being distributed to troops. Despite these strict control measures, several isss remain unclear. One issue involves the shelf life of condoms stored in warm humid tropical conditions. Another issue involves the effect of lubricants on condom quality. The purpose of this report is to describe a study designed to gain insight into these two issues. This study was conducted by the Armed Services Central Pharmacy in colaboration with the Procuremnt and Central Establishment Directorate. Findings showed that stage conditions have no negative effects on the intrinsic physico-chemial properties of condoms supplied by two different manufacturers. Conversely use of inadequate lubricants (alimentary or cosmetic compounds) appeared to have extremely deleterious effects on condom quality. Laboratory tests showed that lubricants composed mainly of fatty acids dramatically decreased the effectiveness of condoms.
Condoms↗
What do mothers of young children think of community pharmacists? A descriptive survey.
AIM: To discover the attitudes of mothers of young children towards community pharmacists, and mothers' use of community pharmacies for childhood illnesses OBJECTIVES: To discover how frequently mothers visit pharmacies; for which childhood complaints they tend to consult a pharmacist first, rather than other health professionals; to identify how helpful mothers feel their pharmacists are; and to identify whether mothers prefer pharmacists with particular demographic characteristics, eg having children of their own. METHODS: A questionnaire survey based on the results of four focus groups conducted with mothers of children aged under five years. 117 questionnaires were distributed by five pharmacies in Northern England to a convenience sample between July and September 2000, with one written reminder to non-respondents one month later. A total of 85 (73%) were returned and the anonymised data were entered into SPSS for Windows for analysis. RESULTS: 61% of mothers claimed to visit the pharmacy once a month or more but only 22% of mothers claimed to have had advice from the pharmacist once a month or more. 57% of the mothers are loyal customers to one pharmacy. 87% of the mothers reported that pharmacist's advice was helpful or very helpful. Mothers sought advice from pharmacists for minor childhood ailments but not always in the first instance. Mothers did not feel that the demographic characteristics of the pharmacists affected the advice given but they expressed a personal preference for receiving advice from female pharmacists with children. LIMITATIONS AND RECOMMENDATIONS: This was an exploratory study with a small sample so the results cannot be generalised. Also, convenience sampling is prone to bias. However, this qualitative study presents some preliminary indications about mothers' use of pharmacies for advice on young children's ailments, and suggests aspects that warrant further investigation. CONCLUSION: In this study, mothers of children under five years of age rated pharmacist's advice as helpful. They did not consider that the demographics of the pharmacist would affect the advice they received, but preferred to consult a pharmacist with children.
Adult↗
A comprehensive measure of pharmaceutical services: the pharmaceutical-care index.
The construction, validation, and use of a numerical index for measuring the provision of pharmaceutical care are described. The 681 respondents to the 1987 Great Lakes Pharmacy Services Survey were randomly divided into two equal groups of hospitals. Data for the first group (n = 341) were used to construct and validate the pharmaceutical-care index (PCI); data for the second group were used for index analysis. Bivariate analysis of 14 major inpatient pharmaceutical services resulted in one service, admission medication histories, being dropped from the index. Multivariate analysis showed that the remaining services contributed equally to the PCI; they were therefore retained. The possible range of PCI scores was -11.166 to 26.518, with a high score indicating greater provision of service. Analysis of data for the second randomly selected group of hospitals (n = 340) showed that PCI scores differed significantly on the basis of hospital size, hospital teaching affiliation, and pharmacy director's education. The correlation between average daily census and PCI score was fair. Higher scores were associated with the presence of a clinical coordinator or a clinical pharmacist. There were weak associations between PCI score and numbers of pharmacists, pharmacy managers, drug distribution pharmacists, and clinical pharmacists. However, the number of decentralized pharmacists and the number of technicians both showed a fair association with PCI score. Hospitals that had pharmacist participation in ambulatory-care clinics or a staff development program had higher PCI scores than hospitals that did not. The provision of inpatient pharmaceutical services, as assessed by the PCI, may be influenced by hospital size, teaching affiliation, the education of the pharmacy director, and other factors. Further research is needed to extend these findings to other hospitals, expose interactions among the factors that affect pharmaceutical care, and refine the PCI.
Abstracting and Indexing↗
[Pharmacies' information pamphlets--do physicians know about them?].
Information pamphlets for certain drugs on prescription have been distributed to patients by pharmacies since 1985. A questionnaire was sent to 50 general practitioners. Only 45.2% knew about the pamphlets. However, they were satisfied with this practice of spreading information. Most physicians did not object to others giving information about the drugs, but some emphasized that the informer must have adequate knowledge of drugs. The physicians had not received many questions from their patients in connection with the pamphlets. Most of the questions received were about side-effects. Many physicians thought that the pamphlets motivated patients to better compliance with instructions on how to use the drugs. Very few physicians gave written information to their patients. Most physicians wanted to cooperate with the pharmacies on information to patients.
Drug Information Services↗
Analysis of the change in work patterns following installation of an inpatient pharmacy computer system.
An experiment was designed to determine if the installation of a pharmacy computer produced a significant change in the distribution of routine inpatient dispensing activities for pharmacy personnel. Data were obtained using time lapse motion picture photography and work sampling procedures. Cameras were placed in three different locations for 6 days over a 2-week period before and after installation of the computer. A sample of approximately 2000 observations was reduced to machine readable format and analyzed using nonparametric statistical procedures. Results indicated a shift in work patterns of pharmacy personnel. It was concluded that the installation of a pharmacy computer had a significant effect on the distribution of routine inpatient dispensing activities. Pharmacy management should consider this information in anticipating efficient use of personnel and proper placement of computer hardware.
Computers↗
Factors affecting practice-area choices by pharmacy students in the Midwest.
The results of a survey to determine the first-choice practice intentions of midwestern pharmacy students and to describe and quantify the factors affecting their decisions are reported. Questionnaires were sent to 12 pharmacy schools in American Association of Colleges of Pharmacy District IV and distributed during November 1988 to January 1989. The questionnaires were given to entry-level pharmacy students who were in their final year of study. The students were asked to indicate their preferred practice setting upon graduation and to rate the importance of 21 factors that a pharmacist might consider when selecting a first position. A total of 715 usable responses were received (response rate, 6.75%). OF the respondents, 83.2% were enrolled in B.S. degree programs and 16.8% in entry-level Pharm.D. degree programs. The distribution of first choices of a practice area was as follows: chain community pharmacy, 33.1%; hospital pharmacy, 27.6%; independent community pharmacy, 12.4%; industry, 8.4%; "other," 5.5%; ambulatory-care clinic, 5.2%; graduate school, 3.8%; department store, discount store, or grocery store, 1.7%; home health care, 1.5%; and nursing home, 0.8%. The three factors ranked as most important in affecting the choice of a practice area were personal fulfillment, salary, and the opportunity to use one's abilities and education. The ranking of the factors varied depending on the practice area chosen. Midwestern pharmacy students were most interested in chain community and hospital pharmacy practice settings. Retail-oriented students placed salary concerns first, whereas clinically oriented students emphasized personal fulfillment. These findings have implications for recruitment strategies.
Career Choice↗
Use of prescription and nonprescription hypnotics in a Canadian elderly population.
BACKGROUND: Hypnotics are commonly used by older adults, yet little is known about the patterns of their use and effectiveness in this population. METHODS: Three thousand eight hundred sixty anonymous, self-report surveys were distributed to community pharmacies (n=356) across Canada to obtain information on the patterns of use of hypnotics from elderly volunteers. RESULTS: The mean age of respondents was 72+/-7 years (range 60 to 95 years) and 66% were women. In the past year, 53% of respondents used hypnotics. Prescription products accounted for 83% of the past year's use (66% benzodiazepines, 11% zopiclone, 4% antidepressants, 2% opioids), and 17% of the products used were over-the-counter (5% herbal, 5% antihistamines, 3% analgesics). Use was regular (50% daily) and chronic (mean duration six years: range two weeks to 30 years). Hypnotics significantly (P<0.001) improved subjective sleep latency (mean 32 min compared with 93 min), number of nocturnal awakenings (mean two compared with four) and total hours of sleep (mean 7 h compared with 4 h). Effectiveness was highly rated: at the most recent use of the product, mean 7.6 (SD+/-2.2) of 10; initially, 7.9 (SD+/-2.3) with a significance of P=0.02. Most respondents (59%) reported side effects, mainly dry mouth (30%), memory problems (22%) and daytime sleepiness (22%), although 60% rated the side effects as mild. The mean number of other medications used was five (range zero to 17). Of the 54 subjects who used nonprescription sleep products, only half (52%) indicated that their physician was aware of this use. CONCLUSIONS: Prescription drugs were primarily used for sleep and were perceived to be effective even with long term use, despite mild side effects.
Aged↗
How many hospital pharmacy medication dispensing errors go undetected?
BACKGROUND: Hospital pharmacies dispense large numbers of medication doses for hospitalized patients. A study was conducted at an academic tertiary care hospital to characterize the incidence and severity of medication dispensing errors in a hospital pharmacy. METHODS: Direct observation of dispensing processes was undertaken to determine presence of errors with review by a physician panel to determine severity. RESULTS: A total of 140,755 medication doses filled by pharmacy technicians were observed during a seven-month period, and 3.6% (5075) contalned errors. The hospital pharmacist detected only 79% of these errors during routine verification; thus, 0.75% of doses filled would have left the phannacy with undetected errors. Overall, 23.5% of undetected errors were potential adverse drug events (ADEs), of which 28% were serious and 0.8% were life threatening. The most common potential ADEs were incorrect medications (36%), incorrect strength (35%), and incorrect dosage form (21%). DISCUSSION: Given the volume of medications dispensed, even a low rate of drug distribution process translates into a large number of errors with potential to harm patients. Pharmacy distribution systems require further process redesign to achieve the highest possible level of safety and reliability.
Academic Medical Centers↗
New guideline for tramadol usage following adverse drug reactions reported to the Iranian Pharmacovigilance Center.
BACKGROUND: Tramadol was introduced as injection and oral form to Iranian Pharmaceutical Market in 2002. Shortly after, the injection form of the drug was observed at the top of suspected drug list of Adverse Drug Reactions (ADRs) received monthly by Iranian Pharmacovigilance Center (IPC). OBJECTIVES: To detect, assess and report total number of Tramadol-induced ADRs received by IPC. To assess the frequency of reported Tramadol-induced ADRs before and after interventions. To design a guideline for prevention of probable ADRs due to Tramadol injection. METHODS: A descriptive study was conducted on spontaneous reporting received by IPC from April 2002 to February 2005. All ADRs suspected to be induced by Tramadol registered in the database during mentioned period were analysed. To assess the effect of different interventions based on Spontaneous Reporting System, the trend of reporting frequency of Tramadol-induced ADRs was evaluated before and after interventions. RESULTS: There were 337 cases of Tramadol-induced ADRs describing 939 reactions, reported to IPC during the study period. Although causal relationship had not been established, three cases of deaths appeared among the reports. The severity of reactions led to implementation of limitations on injectable Tramadol distribution to community pharmacies and the restriction of its use to hospitals only. Since most adverse reactions were dose-dependent, the drug potency of injectable Tramadol available in the country changed from 100 mg to 50 mg. The assessment of ADR reports received by IPC showed that the frequency of adverse reactions registered in the centre was reduced considerably following these interventions. CONCLUSION: Designing a detailed programme by Pharmacovigilance Centres and closely monitoring of newly marketed pharmaceutical products is highly recommended.
Adult↗
Medication errors in an internal medicine department. Evaluation of a computerized prescription system.
OBJECTIVE: Evaluation of a computerized physician order entry in an Internal Medicine Department, with a unit-dose distribution system. SETTING: Pharmacy Department, Internal Medicine Department. S. Francisco Xavier Hospital, Lisbon, Portugal. METHOD: This study was carried out in December 2001 and January 2002. After two years experience of the CPOE system, medication errors were evaluated prospectively, in an internal medical department of a 360-bed academic hospital. Data were collected once a week. Pharmacists reviewed all medical prescriptions as part of their routine work. Medication errors detected were recorded on a data collection form with a design based on the types of errors as defined by the American Society of Hospital Pharmacists (ASHP). Completed forms were reviewed and medication errors were classed according to ASHP guidelines. RESULTS: A total of 2268 orders were monitored (162 patients). In these orders, 73 medication errors (22.4% of the patients) were detected and documented (59 prescribing errors and 14 monitoring errors). The most common prescribing errors were deficiencies related to the right class but wrong drug (28.3%): omeprazole vs. ranitidine/sucralfate in stress ulcer prophylaxis; incorrect dose (30%) and unclear orders (13.3%). Errors related to incorrect frequency of administration (5%); maintenance of IV route (5%); duplicated drug therapy (11.7%); drug interactions (1.7%) and length of therapy (3.3%) were also detected. The 14 monitoring errors detected were failures to review a prescribed regimen for appropriateness and detection of problems. CONCLUSIONS: Computerized prescription order entry has demonstrated effectiveness in eliminating medication errors related to transcribing and patient identification. Nevertheless, medication errors related to prescription and monitoring still occur. The use of clinical decision support systems and pharmacist involvement is vital to achieve maximum medication safety and reduce medication error rates.
Drug Prescriptions↗
Drawing on international experience to reform the Belgian market for ostomy appliances.
This article aims to review the regulatory framework governing the Belgian ostomy appliance market in the light of the experience of Denmark, France, the Netherlands and Ontario (Canada) with regulation of ostomy appliances. Information about the regulatory framework was derived from the international literature, analysis of legal texts and a survey completed by national experts. The comparative analysis revealed that these countries have adopted varying approaches towards regulating their domestic ostomy appliance market. Strategies to keep down prices include public procurement in Denmark, maximum prices in France and exclusion of expensive appliances from reimbursement in the Netherlands. To contain public expenditure on ostomy appliances, consumption patterns are monitored in the Netherlands, the quantity of reimbursed appliances is limited in Belgium and public reimbursement is restricted in Ontario. Ostomy appliances are generally distributed by community pharmacies and medical equipment shops. In countries that emphasise home care delivery such as Denmark, domiciliary distributors dominate the market to the detriment of community pharmacies which do not seem to be able to offer this service at a competitive price. An avenue for reforming the Belgian ostomy appliance market is proposed which valorizes the role of ostomy care nurses in guiding the choice of ostomy appliances. Furthermore, it is recommended that a competitive tendering process determines the price of ostomy appliances, that reimbursement for service provision by distributors is separated from reimbursement of appliances, and that patients receive a fixed grant from the third-party payer to buy ostomy appliances.
Belgium↗
A computerized patient information system in a psychiatric hospital.
The authors describe a computerized patient information system at a psychiatric hospital in Israel. The system is a fully implemented work instrument that promotes clinical safety and cost containment. It allows interactive online consultations, clinical cross-checking, the production of computerized reports and schedules, fast response to laboratory results, and safer drug administration, all of which help improve the quality of care. Cost savings have been achieved in areas such as pharmacy and food distribution. The initial investment in the system was $400,000, which is expected to be recouped after 11.4 years.
Computers↗
Report of the Council on Scientific Affairs: methadone maintenance and needle-exchange programs to reduce the medical and public health consequences of drug abuse.
Extensive evaluation studies show that methadone maintenance therapy (MMT) reduces heroin use and associated problems in a cost-effective manner, without negative public health impact. MMT is limited by inadequate funding and understanding of relevant research, extensive regulation, and limits on the freedom of physicians to provide methadone in a variety of medical settings. Broad-based medical, public health, and scientific support exists for expansion of MMT with greater emphasis on consistency and quality, and provision of ancillary services. Programs for the exchange, free distribution, and legal pharmacy sale of needles and syringes reduce injection drug use and prevent the spread of bloodborne pathogens; drug abuse treatment and other services are important components. Neither strategy increases existing drug use nor leads to drug use initiation. The scientific literature supports assertions that drug abuse issues should be treated primarily as medical and public health rather than criminal justice issues. The effectiveness of both strategies warrants increased support for services, easing of federal and state restrictions governing their availability, and advocacy in their support.
Community Mental Health Services↗