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At least 19 recordsLinked to original sources
PubMed2003

Allowing central fill pharmacies and retail pharmacies to fill prescriptions for controlled substances on behalf of retail pharmacies. Final rule.

DEA is finalizing a Notice of Proposed Rulemaking (NPRM) defining central fill pharmacy activities and permitting central fill pharmacies to prepare controlled substances prescriptions on behalf of retail pharmacies with which the central fill pharmacies have a contractual agreement to provide such services or with which the pharmacies share a common owner. When one retail pharmacy receives a prescription and a second pharmacy prepares and subsequently delivers the controlled substance medication to the first retail pharmacy for dispensing to the patient, the second pharmacy is engaging in a "central fill activity". Records must be maintained by both the central fill pharmacy and the retail pharmacy that completely and accurately reflect the disposition of all controlled substance prescriptions dispensed. With respect to security, central fill pharmacies would be required to comply with the same security requirements applicable to retail pharmacies including the general requirement to maintain effective controls and procedures to guard against theft and diversion of controlled substances. DEA is creating an allowance for retail pharmacies that also perform central fill activities to do so without separate DEA registration, separate inventories, or separate records. This rulemaking is sought by the regulated industry and will allow for more efficient delivery of controlled substance prescriptions to patients.

Contract Services↗
PubMed2000

Position paper on critical care pharmacy services. Society of Critical Care Medicine and American College of Clinical Pharmacy Task Force on Critical Care Pharmacy Services.

OBJECTIVE: The goal of the Task Force on Critical Care Pharmacy Services was to identify and describe the scope of practice that characterizes the critical care pharmacist and critical care pharmacy services. Specifically, the aims were to define the level of clinical practice and specialized skills characterizing the critical care pharmacist as clinician, educator, researcher, and manager; and to recommend fundamental, desirable, and optimal pharmacy services and personnel requirements for the provision of pharmaceutical care to critically ill patients. Hospitals having comprehensive resources as well as those with more limited resources were considered. DATA SOURCES: Consensus opinion of critical care pharmacists from institutions of various sizes providing critical care services within several types of pharmacy practice models was obtained, including community-based and academic practice settings. Existing guidelines and literature describing pharmacy practice and medication use processes were reviewed and adapted for the critical care setting. CONCLUSIONS: By combining the strengths and expertise of critical care pharmacy specialists with existing supporting literature, these recommendations define the level of clinical practice and specialized skills that characterize the critical care pharmacist as clinician, educator, researcher, and manager. This Position Paper recommends fundamental, desirable, and optimal pharmacy services as well as personnel requirements for the provision of pharmaceutical care to critically ill patients.

Critical Care↗
PubMed1985

Definition of clinical pharmacy as a specialty in clinical practice. Committee on Clinical Pharmacy as a Specialty. American Pharmacy Association.

Specialty credentialing has been discussed extensively and debated within pharmacy for more than ten years. Within the profession, there now appears to be a consensus on the need for and appropriateness of acknowledging professional practice areas as unique, defined entities. However, there remain substantive differences on how the definition of specialty practice should be constructed. One approach is to identify practice areas by functional activity (e.g., nuclear pharmacy, drug information) and/or therapeutic focus (e.g., psychopharmacy, clinical pharmacokinetics). A second approach is to define clinical pharmacy as a specialty practice that would, at least initially, coalesce clinical practitioners with the common denominator of an active role in the therapeutic decision-making process. The following document was developed by the Committee on Clinical Pharmacy as a Specialty (CCPS). The CCPS is independent of any formal organizational affiliations. It will serve as the preface to a petition that will be submitted to the Board of Pharmaceutical Specialties requesting recognition of clinical pharmacy as a specialty. The intention of the committee is to resolve the question of specialty status for clinical pharmacy through the Board of Pharmaceutical Specialties' review process. It is then hoped that pharmacy can move forward on the important issue of specialty credentialing.

Certification↗
PubMedDate not supplied

White paper on pharmacy student professionalism. American Pharmaceutical Association Academy of Students of Pharmacy--American Association of Colleges of Pharmacy Council of Deans Task Force on Professionalism.

This white paper is the culmination of a 5-year commitment by the Task Force on Professionalism to study and promote pharmacy student professionalism. The Task Force is a collaborative effort involving the American Pharmaceutical Association Academy of Students of Pharmacy (APhA-ASP) and the American Association of Colleges of Pharmacy Council of Deans (AACP-COD). The two primary goals of the Task Force are to raise awareness and to lead action on the issue of pharmacy student professionalism. The intended audience for this white paper is the entire pharmacy profession, as each member plays an important role in the development of professionalism, whether he or she is a pharmacy educator, student, practitioner, association executive, or state board member. The discussion and recommendations presented herein are intended to assist these parties as they participate in the development of professional attitudes and behaviors among future pharmacists.

Professional Practice↗
PubMed2003

[Jurisprudent pharmacy as a new pharmacy--feedback from litigation to pharmacy].

Risk management in the medical field is said to be entering into the third generation. By definition, the first generation covers the period until some 10 years ago when medical errors themselves used to be regarded as inconceivable and therefore as something of a taboo. The second generation is a period in which those concerned with medical treatment grappled squarely with this issue of medical errors and compiled manuals of "near miss" cases in an effort to prevent errors. After that, such an idea has come into existence that even the deepest carefulness threatens errors that could develop into the disputes among those involved. The thought of this kind has resulted in the deepening of understanding of the importance of risk management. As a result, the point of view on this issue has been getting broader to cover not only prevention of errors but also prevention of disputes. This type is called third-generation risk management. In this sense jurisprudent pharmacy or legal pharmacy, which is a kind of pharmacy that constitutes medical pharmacy, is aimed at feeding back the lessons learned from litigations to pharmacy to improve and develop it as a practical science and contributing to the realization of "patient-centered medical science."

Adverse Drug Reaction Reporting Systems↗
PubMedDate not supplied

Predicting tobacco sales in community pharmacies using population demographics and pharmacy type.

OBJECTIVE: To determine whether the population demographics of the location of pharmacies were associated with tobacco sales in pharmacies, when controlling for pharmacy type. DESIGN: Retrospective analysis. SETTING: Iowa. PARTICIPANTS: All retailers in Iowa that obtained tobacco licenses and all pharmacies registered with the Iowa Board of Pharmacy in 2003. MAIN OUTCOME MEASURE AND INTERVENTIONS: Percentage of pharmacies selling tobacco (examined by pharmacy type using chi-square analysis); median income and distribution of race/ethnicity in the county for pharmacies that did or did not sell tobacco (t tests); predictors of whether a pharmacy sold tobacco (logistic regression using the independent variables county-level demographic variables and pharmacy characteristics). RESULTS: County gender composition, race/ethnicity make-up, and income levels were different for tobacco-selling and -nonselling pharmacies. Logistic regression showed that whether a pharmacy sold tobacco was strongly dependent on the type of pharmacy; compared with independent pharmacies (of which only 5% sold tobacco products), chain pharmacies were 34 times more likely to sell tobacco products, mass merchandiser outlets were 47 times more likely to stock these goods, and grocery stores were 378 times more likely to do so. Pharmacies selling tobacco were more likely to be located in counties with significantly higher numbers of multiracial groups. CONCLUSION: The best predictor of whether an Iowa pharmacy sells tobacco products is type of pharmacy. In multivariable analyses, population demographics of the county in which pharmacies were located were generally not predictive of whether a pharmacy sold tobacco.

Commerce↗
PubMed2003

Frequency, nature and determinants of pharmacy compounded medicines in Dutch community pharmacies.

AIMS: To examine the frequency, nature and determinants of pharmacy compounded medicines in Dutch community pharmacies. METHODS: A prospective nested case-control study comparing prescriptions for pharmacy compounded medicines (cases) with non-pharmacy compounded medicines (controls) was carried out in 79 Dutch community pharmacies. 991 Prescriptions for compounded medicines (cases), dispensed by the pharmacy on a predetermined day in a specific period (29 March until 11 April 2001), and 993 prescriptions for non-compounded medicines (controls) randomly selected on the same day, were studied. The nature and frequency of compounded medicines as well as patient, drug and prescriber related determinants were assessed. In addition, some organisational characteristics, like compounding site and use of protocols, were investigated. Also, the value of compounded medicines in terms of the availability of an industrially compounded equivalent and patient specific reasons, as perceived by the participating pharmacists, was evaluated. RESULTS: The overall frequency of prescriptions for pharmacy compounded medicines in relation to the total number of prescriptions was 3.4%. This means 12.5 compounded medicines per pharmacy per day on average, but there was a large variation between pharmacies. Excluding the products purchased from specialised compounding companies (28.4%) and the small part of medicines coming from other pharmacies (5.2%), we found an overall frequency of 2.3% of actual compounding in the pharmacy itself. On average, approximately one employee was needed for compounding activities with a large variation between pharmacies. More than 13% of the pharmacists stated that they delivered more than 25% of their compounded medicines to other pharmacies. In 2 pharmacies (2.6%) no actual compounding took place. For 58% of the products manufactured in the pharmacy itself or coming from other pharmacies a (semi-) standardised protocol was used. Compared to non-compounded medicines we found a huge share of dermatological dosage forms among compounded medicines (62.1% versus 5.3%). Oral solutions and ear-nose-throat (ENT) products were also found relatively often. While no ATC class was very pronounced in the control group, the group of dermatologicals was prominently present in the case group (57%) followed by CNS agents (8.4%). The dermatologist was a very strong determinant of compounded medicines compared to GPs (ORadj 12.2 [6.3-23.6]). Patients of 12 years or younger received a significantly higher rate of compounded medicines than persons older than 12 years of age (ORadj 3.4 [2.5-4.8]). Compounding occurred almost twice as often when a medicine was prescribed for the first time compared to a repeat prescription (ORadj 1.8 [1.5-2.2]). In about 63% of the cases the pharmacist judged that an industrially produced medicine could not substitute for the compounded medicine. In about 33% of the compounded products they indicated a patient specific reason. In about 10% this reason concerned a strictly defined pharmaceutical care issue. CONCLUSIONS: Based upon our research, all Dutch community pharmacies compound more than 13,000 medicines per day (2.3% of all prescriptions). They consist mainly of dermatological preparations. Younger children (< 12 yr) receive a significantly higher rate of compounded medicines than other people. At least 1.2 compounded prescriptions per pharmacy per day have a specific pharmaceutical care reason according to the pharmacists.

Community Pharmacy Services↗
PubMedDate not supplied

Kaiser Permanente Colorado Region Pharmacy Department: innovative leader in pharmacy practice.

OBJECTIVE: To describe innovative programs within the Kaiser Permanente Pharmacy Department in the Colorado Region. SETTING: One of eight regions of the nation's largest nonprofit health maintenance organization. PRACTICE DESCRIPTION: The pharmacy department comprises two services, Clinical Pharmacy Services and Pharmacy Operations/Support Services, which are integrated to provide comprehensive care. PRACTICE INNOVATION: Within Clinical Pharmacy Services, the Primary Care Clinical Pharmacy Services team works alongside physicians to provide integrated patient care. The Centralized Clinical Pharmacy Service teams manage large groups of patients effectively and efficiently. The Clinical Pharmacy Specialty staff and the Disease State Management clinical pharmacy specialists provide focused drug therapy expertise. MAIN OUTCOME MEASURES: Clinical and economic outcomes; recognition by national organizations. RESULTS: Technological innovations are used within Pharmacy Operations/Support Services to increase pharmacists' time for patient care activities. The use of technology by the Pharmacy Automated Refill Center and the implementation of ScriptPro in the medical office pharmacies decrease dispensing demands by processing large volumes of prescriptions. Workflow in the medical office pharmacies has also been reengineered to increase efficiency. Various programs have been developed by the Pharmacy Information Technology Service to support patient care initiatives. Benchmark clinical and economic outcomes have been demonstrated. Positive outcomes have also resulted in quality and safety awards and captured the attention of national pharmacy and medical organizations. CONCLUSION: The Colorado Region Pharmacy Department has been recognized as a leader in pharmacy practice through the development of innovative services that provide exceptional patient care.

Anticoagulants↗
PubMed2006

A comparative evaluation of pharmacy services in single and no pharmacy towns.

BACKGROUND: Recent attention has focused on access of communities to pharmacy services in rural areas. To increase access to pharmacy services in rural Western Australia some doctors have been granted a licence to dispense medication on the rationale that a pharmacy would not be economically viable in that community. However, there have been no studies conducted on whether a doctor dispensing service adequately provides a pharmacy service with respect to access and quality. METHOD: Residents of seven single pharmacy towns and seven non-pharmacy rural towns were surveyed to evaluate pharmacy services delivered by a pharmacist and doctor. The towns were chosen to match closely on key demographic features, with an average population of 1,246 and 1,263 respectively. A random sample of 150 households from each town was sent the questionnaire on pharmacy services (1050 in each group). Data was also collected from the Health Insurance Commission (HIC) on dispensing locations for the residents of the two groups of towns. RESULTS: There was a significant difference in access to pharmacy services with 82.4% of participants from pharmacy towns accessing medications within their town compared to 51.3% of non-pharmacy town participants. The HIC data supported these trends with pharmacy town residents having relatively higher prescription rates within their town compared to non-pharmacy town residents where they were more likely to access prescriptions out of their town. CONCLUSION: Pharmacy town participants were more satisfied with access to health and pharmacy services within their town. Continuation of the doctor dispensing policy requires a greater consideration of the pharmacy needs of rural residents.

Journal Article↗
PubMed2004

The feasibility of implementing an evidence-based core set of clinical pharmacy services in 2020: manpower, marketplace factors, and pharmacy leadership.

Development of a national plan to implement a core set of clinical pharmacy services in United States hospitals by 2020 requires assertive leadership from pharmacy organizations and state boards of pharmacy, and a commitment from the profession. Factors that may affect the development are grouped into three areas: manpower, marketplace variables, and pharmacy leadership. Although the number of pharmacy school graduates (7000) was about the same in 1990 and 2000, a greater number of pharmacy schools and high student enrollment, coupled with the Accreditation Council for Pharmacy Education's acceptance of foreign-trained pharmacists, suggest that the number of pharmacists will increase substantially in the near future. We estimate that the net increase in pharmacists (new pharmacy graduates less pharmacists who retire or die) in the United States will be 139,929 from 2000-2020, for a total of 335,040 pharmacists (71% increase). The number of pharmacy technicians increased substantially (66%), from 150,000 in 1996 to 250,000 in 2002. The number of residents in programs accredited by the American Society of Health-System Pharmacists increased 148%, from 435 in 1990 to 1080 in 2002. We conservatively project an increase of 33,000 pharmacists who complete residencies from 2000-2020. The pharmacy marketplace has changed dramatically over the last 12 years, with 10,754 independent community pharmacies closing (2.46 pharmacies/day) and 8459 chain outlets opening (1.93 chains/day). In recent years, mail-order pharmacies have expanded faster than other retail outlets and now process over 18% of U.S. prescriptions. Increased use of robotic systems (some can process 5000 prescriptions/hr) and technicians will diminish the demand for dispensing pharmacists. In addition, up to 10% of U.S. retail prescriptions may be filled outside the country's borders. These data indicate that there will be a sufficient supply of pharmacists and technicians in the future. Thus, it is feasible, based on manpower, marketplace factors, and pharmacy leadership, to implement a core set of clinical pharmacy services for patients in U.S. hospitals by 2020.

Education, Pharmacy↗
PubMed2002

Pharmacy representatives: a non-pharmacy outlet of prescribed medicines in Sweden.

OBJECTIVE: To characterise patients who collect their prescribed medicines from pharmacy representatives and compare them with those using regular pharmacies. METHOD: Data were collected from the prescriptions delivered via pharmacy representatives and by questionnaires to the patients. Data for pharmacies were obtained from the Swedish drug statistics. The data were used to determine gender and age of the patients and the types of drugs delivered from the pharmacies and from the pharmacy representatives. SETTING: Pharmacy representatives connected to 20 randomly selected pharmacies in Sweden. KEY FINDINGS: Prescriptions were analysed with respect to the patients' gender, age and prescribed medicine(s). The proportion of elderly patients (> or = 75 years) as greater among users of pharmacy representatives than among pharmacy users (40% compared to 24%), but in most other respects the two patient groups were similar. Patients used pharmacy representatives because it was more convenient, and only 5% of patients using pharmacy representatives had called the pharmacy to ask how their medicine should be used. CONCLUSIONS: Patients using the pharmacy representatives may serve as reference groups in studies of the effect of pharmaceutical care interventions. Only a small number of these patients receive any advice from the pharmacists and this may have a negative effect on adherence and therapy outcome.

Adolescent↗
PubMed2004

Pharmacy customers' views and experiences of using pharmacies which provide drug misuse services.

This study aimed to determine whether pharmacy customers are deterred from using a pharmacy that offers services to drug misusers. If patients are deterred, what are their specific concerns? The study was qualitative and three different groups were interviewed about their views on pharmacies providing services to drug misusers (i) pharmacy customers, (ii) local community councils and (iii) local drug forums. This paper focuses on pharmacy customer interview results. Interviews were conducted in 10 pharmacies, five in Aberdeen and five in Glasgow, both areas of high drug misuse. The pharmacy customers were attending pharmacies with high, medium and low involvement with drug misusers and were located in city centre, suburban and rural locations. Pharmacy customers were generally supportive of pharmacies offering services to drug misusers. However, their support was often qualified by a wish to see a private area provided for methadone consumption. Pharmacy customers were more knowledgeable of the rationale for and supportive of needle exchange services compared to methadone maintenance and supervised consumption. The results of the study demonstrate that the majority of pharmacy customers are supportive of drug misuse services, provided there is adequate privacy in the pharmacy. These results should be used to encourage more pharmacists to provide drug misuse services.

Adult↗
PubMed2006

Pharmacy Service Orientation: a measure of organizational culture in pharmacy practice sites.

BACKGROUND: The importance of organizational culture in shaping everyday organizational life is well accepted, but little work has focused on organizational culture in pharmacy. Examining new pharmacists' experiences at various practice sites may help us to understand how these shape their professional ethos and practice habits. OBJECTIVES: (1) Present development and assessment of the Pharmacy Service Orientation (PSO) measure, a tool for assessing pharmacists' impressions of pharmacy practice sites. (2) Use data gathered from a sample of new pharmacists to explore potential predictors of PSO, including type of practice site, type of pharmacy work experience, and type of pharmacy degree. METHODS: Mail survey of randomly selected class of 1999 pharmacy graduates within 3 months of graduation (response rate: 259 of 1,850; 14%), each of whom reported on up to 6 different pharmacy practice sites for a total of 1,192 pharmacy observations. Pharmacy Service Orientation is scored on a 1-10 semantic differential scale and reliability was assessed using Cronbach's alpha. Predictors of PSO were explored using t test and ordinary least squares regression procedures. RESULTS: Reliability of the PSO across all observations was 0.86. When divided according to recency of experience and type of experience, reliabilities ranged from 0.78 to 0.87. Analysis of potential predictors of PSO showed that non-corporate-community sites had significantly greater pharmaceutical care-oriented cultures (mean PSOs of 7.42 and 5.13, respectively; P<.001). The same pattern was seen for academic and nonacademic worksites (mean PSOs of 7.46 and 6.01, respectively; P<.001). The pharmacist's pharmacy degree type was not predictive of PSO. Multivariate regression results showed that type of practice site and type of pharmacy work experience explained more than 25% of the observed variance in PSO. CONCLUSIONS: Pharmacy Service Orientation is a reliable measure. Statistically significant differences in PSO comparisons by degree and by experience type are explained by significant differences between the PSOs of corporate-community and non-corporate-community sites.

Adult↗