摘要:

Pharmacy practice research (PPR) is a developing area of research in the United Kingdom. To date, most studies have been carried out in secondary care, although efforts have been made recently to encourage studies in primary care. The quality of PPR is variable and there have been few well‐performed studies. It is likely that this has resulted from the relative novelty of PPR and the inexperience of the researchers. Studies have usually been performed on services at a single site and have been carried out in isolation from fellow researchers or university departments with appropriate expertise. Initiatives have been taken within pharmacy to improve the quality of PPR but the resources that are available, and hence the potential for improvement, are limited. In contrast, health services research (HSR) is a relatively well‐established area of research in which related topics in the broader areas of health care are considered. Comparable methods could be employed to examine PPR and HSR topics. It is suggested that substantial improvements may be made in the quality of PPR by fostering long‐term collaborative ventures between PPR an

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00831.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Non‐prescription drug use by patients aged 65 and over in Northern Ireland was assessed. Sixteen community pharmacists collected data on 515 elderly patients who purchased non‐prescription drugs, using a short structured interview. The patients most commonly purchased oral analgesics (17.5 per cent), cough preparations (14.8 per cent) and laxatives (11.5 per cent). Almost one quarter (23.9 per cent) were already taking a prescribed medication for the same condition. Only one half of the latter patients (49.6 per cent) discussed nonprescription drug use with their general medical practitioner.Patients' main reasons for the purchase of non‐prescription medicines were: symptoms were not severe enough to visit their doctor, convenience of the pharmacy and the product had been used before. Patients who presented to their pharmacist with either gastrointestinal or pain symptoms were found to be twice as likely as patients with other symptoms to be taking a prescribed drug for the same condition(s) (P<0.001). Since elderly patients are more susceptible to adverse drug reactions, health care professionals must endeavour to obtain a complete medication history from

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00832.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Tape recordings of verbal interactions between elderly patients (women aged 60 or over; men aged 65 or over) and community pharmacists about prescription medicines were made in four study pharmacies to determine the frequency with which information was provided and to elucidate communication issues relevant to this patient group. Overall, 65 per cent of elderly patients receiving prescribed medications had no verbal interaction at all with the pharmacist, speaking only to other pharmacy staff. The pharmacists provided verbal information to 12.5 per cent of elderly patients about their prescription medicines. It was generally limited to aspects of the dosage regimen and the most common number of items of information given was three. There was no obvious pattern in advice giving related to the estimated workload. However, the frequencies with which advice was provided at all the pharmacies were too low to draw definite conclusions. The mean length of interactions where information was provided was 71 seconds (range 8 to 335).During 43 interactions studied, pharmacists asked 38 questions, nearly all of which were closed; patients asked 15 questions of which more than a third were open. As expected, the number of elderly patients visiting the pharmacies and the number of patient interactions showed marked intra‐ and inter‐pharmacy variation. This is relevant to the development of realistic advice‐giving prot

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00833.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The potential benefits of home visits by community pharmacists to housebound people with medication difficulties were examined. Sixteen community pharmacist volunteers made initial home visits to 39 patients referred by 14 general practitioners. The medication in their possession was noted, and information about the medication recorded from the medication container label, a patient medication record provided by the referring sugery and the patients' own knowledge. In 35 cases there were discrepancies between the medicines in the patient's possession, those they were currently taking and those listed on the patient medication record. Non‐adherence, medication hoarding and adverse drug reactions were found. After each visit a summary was sent to the patient's GP and dispensing pharmacist. GP intervention was requested for 25 patients and dispensing pharmacist intervention for 17. Follow‐up visits to 18 patients one month later showed that 37 per cent of suggested GP interventions and 50 per cent of suggested dispensing pharmacist interventions had been acted on. Feedback was received from the visiting pharmacists during a meeting and from the GPs and dispensing pharmacists by interview. The service was valued by the patients and endorsed by the GPs and all the community pharmacists involved, indicating that community pharmacists have a potential role to play in enhancing the care of specific housebound patients through domiciliary vis

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00834.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The effectiveness of a pharmacist‐initiated drug regimen review (DRR) in reducing the incidence of drug‐related problems (DRPs), such as drug interactions, additive adverse effects and duplicate therapy, in the elderly was investigated. The medication profiles of 85 patients aged over 65 years, in an elderly care facility in South Africa, were evaluated for potential DRPs. It was found that 77 per cent of the patients were receiving one or more drugs at a dose exceeding the recommended geriatric dose. Some 68 per cent were receiving six or more drugs. Potential drug interactions and duplicate therapy were identified in 64 per cent and 34 per cent, respectively. A total of 85 pharmacist‐initiated recommendations was presented to seven medical practitioners over a period of 16 weeks. Of these, 66 (77.7 per cent) met with the approval of the prescribers. Statistical interpretation of results showed that the incidence of all DRPs declined significantly post‐recommendation. The cost benefit of the study was clearly illustrated by a 41 per cent reduction in the incidence of polypharmacy (

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00835.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Community pharmacists have been shown to advise approximately 15 per cent of clients who present to them with minor ailments to consult another health professional, usually their general medical practitioner. The clients that pharmacists refer may or may not be those that GPs most wish to see. There may be other clients or symptoms that GPs believe should be referred to them. This study investigated GPs' views on community pharmacists' referral practices, looking at which symptoms they believed should be referred, the level of agreement between them and how their recommendations compared with the referral practices of community pharmacists established by the author in an earlier study.Questionnaires were posted to a random sample of GPs in Greater London, asking them to indicate the referral advice they felt appropriate for each of 62 symptom groups, recommending either direct referral, no referral or referral only in some cases. The symptom groups were derived from the symptoms presented to the pharmacists in the earlier study.Respondents were generally positive about the pharmacist's role, indicating that for many symptom groups they felt it appropriate for the pharmacist to be a first port of call. Although the variation between responses suggested that there should be local liaison regarding practice, on the whole the GPs' recommendations were in line with the pharmacists' existing practices.

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00836.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The aim of this study was to analyse how two groups of pharmacy staff, one Finnish and one Swedish, perceived video‐taped customers who were receiving prescribed antibiotics. The study was based on a model derived from cognitive and interactional psychology.Customers who were presumed to want more extensive drug and health information tended to be regarded as more compliant than other customers. “Independent” customers tended to be regarded as less compliant than other customers. Few differences were found between the results for the Finnish and the Swedish groups, indicating that the professional culture in the two countries is similar. The study found that the pharmacist's judgment of the level of drug compliance is influenced by the pharmacist's metacognitive assumptions regarding the customer's personality and the situation within which the customer

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00837.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The growing number of women in pharmacy practice has led to a wealth of research looking at their role and impact on the profession. While anecdotal evidence supports the view that pharmacy is also an increasingly popular profession for a large number of ethnic minority groups, there is no empirical pharmacy practice research to support the claim. A small scale postal survey was conducted to determine and compare the practice environments and reasons for embarking on a pharmacy career of white and ethnic minority pharmacists (classified using the 1991 United Kingdom census classification scheme). The sample comprised graduates of one UK school of pharmacy over a 10 year period. While the data are not generalisable, and despite small numbers in the ethnic minority group, the results indicate that ethnic minority status may contribute to different practice patterns. Ethnic minority pharmacists might be more likely to practise in community pharmacy, and to be under‐represented in management positions although over‐represented as owners/partners of community pharmacies. There is also some evidence to suggest that ethnic minority pharmacy graduates might have more difficulty than white pharmacy graduates in obtaining preregistration po

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00838.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

Patient derived information to support the long term use of non‐steroidal anti‐inflammatory drugs (NSAIDs) is lacking. In contrast, data detailing the adverse effects of individual NSAIDs is accumulating. We determined the importance of NSAIDs as therapy to 153 patients with osteoarthritis (age range 36 to 92), comparing results in elderly and younger patients. Around half of the patients reported moderate relief of symptoms, with a further quarter reporting good, or even excellent, relief. One half of patients aged 75 years or less, but only one fifth of patients aged over 75 years, recalled having been informed of the adverse effects of NSAIDs. A total of 59 per cent of patients reported having used simple analgesics, such as paracetamol, as first line therapy. As some patients are helped by them, we suggest that efforts should be directed towards increasing the first line use of simple analgesics in patients with osteoarthritis and towards increasing patient awareness of potential NSAID‐related adverse ef

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00839.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY

摘要:

The magnitude of possible savings to be made by changing drug dose frequency was investigated. First, the time, labour cost and material cost involved in administering three different dosage forms on the oncology ward of a university hospital was measured. On average, administering a single oral dose took 0.6 minutes, an injection 4.8 minutes and an infusion 10.9 minutes. The dose frequencies on three wards (oncology, surgical and internal medical) were then noted. For oral medications the frequencies were similar, 39 to 53 per cent of the doses being administered three times daily, but for parenteral drugs there was a large variation in dose frequency. The total time spent on drug dosing activities in one month was 82.7 hours on the oncology ward, 74.8 hours on the surgical ward and 65.8 hours on the medical ward. The time spent giving doses of the most frequently ordered thrice daily oral drug varied from 4.0 to 5.2 hours per month on each ward. The annual costs of drug dosing, related to drug acquisition costs, varied from 5.8 per cent to 30.1 per cent. The magnitude of theoretical savings at the hospital level, made by changing the most popular intravenous antibiotic (currently administered three times a day) to a once a day alternative could mean savings of about 60,000 ECU per year. However, in practice, this kind of calculation is applicable only to the most frequently used medications.

ISSN:0961-7671    

DOI:10.1111/j.2042-7174.1996.tb00840.x

出版商:Blackwell Publishing Ltd    

年代:1996

数据来源: WILEY