摘要:

Pharmacists can no longer be the middle men

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00724.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00725.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

There is renewed interest in saliva as a “non‐invasive” specimen for therapeutic drug monitoring, diagnosis and doping c

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00726.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Elderly people are often dependent on carers, both informal and formal. This article reviews the role of carers and discusses their involvement in the administration of medicines.

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00727.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Accurate prediction of those elderly people who are at a high risk of unplanned hospitalisation may assist pharmacists and other health care providers to target health care initiatives more specifically. A prospective study of 84 elderly persons, suffering from either ischaemic heart disease or obstructive airways disease, or both, was conducted to identify health‐related factors that may be used to predict unplanned hospitalisation. Non‐invasive factors, including the sickness impact profile (SIP) health status measure scores, drug consumption, demographic data, smoking history and disease/symptoms experience were determined. For hospitalised patients the overall SIP score was significantly higher (18.93) than for those non‐hospitalised (10.54). The physical dimension score (20.76) and the psychosocial dimension score (16.74) were also both significantly higher in the hospitalised than the non‐hospitalised group (10.85 and 9.44, respectively). The number of medicines used was higher (8.2) in the hospitalised group than in the non‐hospitalised group (6.3). Logistic regression determined that the overall SIP score was highly predictive (P<0.01) of unplanned hospitalisation. Classification and regression tree (CART) analysis was used to determine the mix of health‐related factors that could best classify subjects as being at either a high or low risk for unplanned hospitalisation within the six month prospective study period. A selected CART‐generated decision protocol determined that the health‐related parameters that enabled a useful prediction for unplanned hospitalisation were overall SIP score, the person's age, whether the person lived alone and smoking history. Seventy‐nine per cent of those hospitalised and 91 per cent of those non‐hospitalised had been correctly predicted. The results of this study show that it is possible to predict unplanned hospitalisation of elderly people in a retirement village setting by using previously measured non‐invasive health related parameters in a decision protocol to determine t

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00728.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Patient management of solid oral dosage steroid reducing courses was studied over a 20‐week period at North Tees General hospital. Seventy‐five eligible patients were identified, of whom 57 were recruited and subsequently interviewed at home towards the end of their reducing dosage programme.Tablet count was used to assess compliance in 50 patients. Thirty‐seven patients (74 per cent) were found to be compliant. Patients whose present courses of steroid treatment were of more than six months' duration and those who had undertaken eight or more reducing dosage courses during the previous two years were less compliant than others. Thirty‐six (65 per cent) of 55 patients on once‐daily regimens regularly took their medication within two hours of 8am. Five patients (9 per cent) inappropriately divided their daily dosages.Although compliance was assessed as being good, possibilities exist for effecting im

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00729.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

A survey was performed on the survival of 446 peripheral intravenous infusion sites in 82 babies in a neonatal intensive care unit. Median survival was 31 hours. Factors identified by multivariate survival analysis as significantly decreasing site survival were faster infusion rates, total parenteral nutrition rather than dextrose, decreased gestational age, and co‐infusion of phosphate, ceftazidime and metronidazole. Pancuronium, aminophylline and, possibly, saline and ampicillin increased survival. These data indicate that, while neonatal infusions fail more rapidly than infusions in adults, there appear to be relatively few factors that have marked effects of the rate of failur

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00730.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

In responding to symptoms presented by clients, community pharmacists have a number of options open to them, including giving advice to seek the assistance of another health professional (ie, a referral). The objective of this study was to investigate the referral patterns of community pharmacists in primary care consultations. The analysis was performed on 716 tape‐recorded consultations between pharmacists and clients collected in a random sample of community pharmacies in London. Fifteen per cent of clients were referred to another practitioner, usually their general medical practitioner. Information on the cases that pharmacists referred is provided. There was a wide variation in referral rates depending on the nature of the presenting symptoms. Pharmacists' referral patterns tended to be determined by the characteristics of the symptoms presented. A situation in which some pharmacists routinely refer a high proportion of clients irrespective of the nature of the symptoms was not apparent. The symptoms referred by pharmacists may or may not be those which other primary health carers feel they should see. A co‐ordinated, safe and appropriate role as a filter to other practitioners could contribute to improvements in the effectiveness and efficiency of primary c

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00731.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

This article reports the results of an analysis of recorded community pharmacist‐client interactions. The results showed that 98 per cent of all pharmacist questions asked were closed, over two thirds of which were of the Yes/No variety. Twenty four per cent were leading in nature and almost all of these were subtle leads. Pharmacists asked, on average, four questions per consultation as compared with a mean of 2.5 for clients. Only 2 per cent of all pharmacist questions addressed the psychosocial dimensions of practice, the vast majority being concerned with purely clinical matters. The findings are discussed within the context of a communication audit approach to community pharmacy practice, directed to effecting improvements in the quality of interviewing performance in pharmacist‐client consultati

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00732.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY

摘要:

Data from a survey of 906 members of the public (570 females, 336 males; age range 13–90 years) with regard to opinions on, and use of present and proposed community pharmacy services are presented. It was shown that the majority of people (67.7 per cent) visit pharmacies at least once a month. Females visit pharmacies more frequently than males (P<0.05). Respondents who were less than 25 years old were more likely than older age groups to purchase non‐prescription medicines from pharmacies although they were less likely to use the same pharmacy (P<0.05). Proximity to a person's home was the major deciding factor for patronising a particular pharmacy (43.7 per cent). The major factor determining choice of non‐prescription medicines was previous use (34.7 per cent), with pharmacist's advice (29.3 per cent) the second most frequent response. For a range of common minor ailments, respondents were more likely to seek their doctor's advice or self‐treat the condition than seek advice from the pharmacist. With respect to extended role activities, 93.4 per cent felt that the pharmacist had a role to play in health education, the provision of individualised advice being the most frequently noted method for this (34.6 per cent). Health screening services were highly supported (90.6 per cent), as was the maintenance of patient medication records (93.6 per cent). A greater proportion of the younger age group (<25 years old) than the older age groups supported the provision of health screening services (P<0.05). In response to a question on services that the public would like to see provided by community pharmacists, the most popular responses were: giving more advice on the treatment of minor ailments and the provision of a private consultation area within the pharmacy. Overall, the results show a positive response to the current and future use of community based pharmaceutical s

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1993.tb00733.x

出版商:Blackwell Publishing Ltd    

年代:1993

数据来源: WILEY