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"Academic drug-detailing": from project to practice in a Swedish urban area.

https://arctichealth.org/en/permalink/ahliterature210063
Source
Eur J Clin Pharmacol. 1997;52(3):167-72
Publication Type
Article
Date
1997
Author
C S Lundborg
L O Hensjö
L L Gustafsson
Author Affiliation
Department of Public Health Services, Karolinska Institutet, Stockholm, Sweden. staff@ihcar.ki.se (attn: C. Stålsby Lundborg)
Source
Eur J Clin Pharmacol. 1997;52(3):167-72
Date
1997
Language
English
Publication Type
Article
Keywords
Anti-Infective Agents - therapeutic use
Drug Information Services - organization & administration
Family Practice
Feasibility Studies
Humans
Information Services - economics
Norfloxacin - therapeutic use
Pharmacists
Questionnaires
Substance-Related Disorders
Sweden
Urinary Tract Infections - drug therapy
Abstract
To develop and test the long-term feasibility of an interdisciplinary independent drug information service providing both written and oral drug information to physicians in an urban area of Sweden (> 400,000 inhabitants).
A drug information service was developed encouraging a cooperative approach between a department of clinical pharmacology, general practitioners (GPs), pharmacists, and Drug and Therapeutic Committees. Scientifically-based drug information was condensed and interpreted by a team and presented in both written and oral form. In one part of the area, both oral and written information was provided, while in another part of the area, only written information was distributed. Questionnaires and one prescription survey were performed to elucidate the knowledge and attitudes of the GPs regarding drug treatment of one condition (urinary tract infection, UTI, and norfloxacin were used as examples), as well as their opinion of our services.
Over a period of 10 years, 75 issues of a drug bulletin (2000 copies) were distributed. Oral producer-independent drug information, provided jointly by a GP and a pharmacist, was given on 16 occasions in each of 30 health centres (150 GPs). Around 80% of the GPs participated in the meetings. Of these GPs, 75% found the service important for their daily work. A majority of the GPs had prescribed the test drug, norfloxacin, not a first-line drug according to local recommendations, 1 year after approval. A significantly lower proportion of prescribers were observed in the area where the GPs had been provided with both written and oral information regarding recommended treatment (including first-line drugs) for uncomplicated cystitis. The approximate cost for this service in 1995 was SEK 0.685 million (USD 0.1 million); the prescribing costs of the 150 GPs were estimated at SEK 255 million per year. This means that the cost of the service per GP is only around 0.3% of normal prescribing costs.
Over a period of 10 years the information/education method described here has proven sustainable and feasible in terms of providing the information, regarding participation of the target group GPs in the oral sessions, and regarding integration of the service into the existing health care system.
PubMed ID
9218921 View in PubMed
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Acceptance and importance of clinical pharmacists' LIMM-based recommendations.

https://arctichealth.org/en/permalink/ahliterature127887
Source
Int J Clin Pharm. 2012 Apr;34(2):272-6
Publication Type
Article
Date
Apr-2012
Author
Asa Bondesson
Lydia Holmdahl
Patrik Midlöv
Peter Höglund
Emmy Andersson
Tommy Eriksson
Author Affiliation
Department of Clinical Pharmacology, Lund University, Lund, Sweden. asa.c.bondesson@skane.se
Source
Int J Clin Pharm. 2012 Apr;34(2):272-6
Date
Apr-2012
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Attitude of Health Personnel
Drug-Related Side Effects and Adverse Reactions
Female
Health Knowledge, Attitudes, Practice
Humans
Interdisciplinary Communication
Male
Medication Errors - prevention & control
Medication Reconciliation - organization & administration
Medication Therapy Management - organization & administration - standards
Middle Aged
Models, organizational
Patient Care Team - organization & administration
Pharmacists - organization & administration - psychology
Pharmacy Service, Hospital - organization & administration - standards
Physicians - psychology
Quality of Health Care - organization & administration - standards
Retrospective Studies
Risk assessment
Sweden
Abstract
The objective of this study was to evaluate the quality of the clinical pharmacy service in a Swedish hospital according to the Lund Integrated Medicine Management (LIMM) model, in terms of the acceptance and clinical significance of the recommendations made by clinical pharmacists.
The clinical significance of the recommendations made by clinical pharmacists was assessed for a random sample of inpatients receiving the clinical pharmacy service in 2007. Two independent physicians retrospectively ranked the recommendations emerging from errors in the patients' current medication list and actual drug-related problems according to Hatoum, with rankings ranging between 1 (adverse significance) and 6 (extremely significant).
The random sample comprised 132 patients (out of 800 receiving the service). The clinical significance of 197 recommendations was assessed. The physicians accepted and implemented 178 (90%) of the clinical pharmacists' recommendations. Most of these recommendations, 170 (83%), were ranked 3 (somewhat significant) or higher.
This study provides further evidence of the quality of the LIMM model and confirms that the inclusion of clinical pharmacists in a multi-professional team can improve drug therapy for inpatients. The very high level of acceptance by the physicians of the pharmacists' recommendations further demonstrates the effectiveness of the process.
PubMed ID
22252773 View in PubMed
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Access to syringes for HIV prevention for injection drug users in St. Petersburg, Russia: syringe purchase test study.

https://arctichealth.org/en/permalink/ahliterature115926
Source
BMC Public Health. 2013;13:183
Publication Type
Article
Date
2013
Author
Ekaterina V Fedorova
Roman V Skochilov
Robert Heimer
Patricia Case
Leo Beletsky
Lauretta E Grau
Andrey P Kozlov
Alla V Shaboltas
Author Affiliation
The Biomedical Center, 8, Viborgskaya Street, St. Petersburg 194044, Russia. ekaterina_fedorova@yahoo.com
Source
BMC Public Health. 2013;13:183
Date
2013
Language
English
Publication Type
Article
Keywords
Adult
Cohort Studies
Commerce - methods
Female
HIV Infections - etiology - prevention & control
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Humans
Male
Pharmacies - classification - legislation & jurisprudence - statistics & numerical data
Pharmacists - psychology - statistics & numerical data
Professional Practice Location - statistics & numerical data
Qualitative Research
Questionnaires
Russia
Substance Abuse, Intravenous - complications - epidemiology
Syringes - economics - supply & distribution
Abstract
The HIV epidemic in Russia is concentrated among injection drug users (IDUs). This is especially true for St. Petersburg where high HIV incidence persists among the city's estimated 80,000 IDUs. Although sterile syringes are legally available, access for IDUs may be hampered. To explore the feasibility of using pharmacies to expand syringe access and provide other prevention services to IDUs, we investigated the current access to sterile syringes at the pharmacies and the correlation between pharmacy density and HIV prevalence in St. Petersburg.
965 pharmacies citywide were mapped, classified by ownership type, and the association between pharmacy density and HIV prevalence at the district level was tested. We selected two districts among the 18 districts--one central and one peripheral--that represented two major types of city districts and contacted all operating pharmacies by phone to inquire if they stocked syringes and obtained details about their stock. Qualitative interviews with 26 IDUs provided data regarding syringe access in pharmacies and were used to formulate hypotheses for the pharmacy syringe purchase test wherein research staff attempted to purchase syringes in all pharmacies in the two districts.
No correlation was found between the density of pharmacies and HIV prevalence at the district level. Of 108 operating pharmacies, 38 (35%) did not sell syringes of the types used by IDUs; of these, half stocked but refused to sell syringes to research staff, and the other half did not stock syringes at all. Overall 70 (65%) of the pharmacies did sell syringes; of these, 49 pharmacies sold single syringes without any restrictions and 21 offered packages of ten.
Trainings for pharmacists need to be conducted to reduce negative attitudes towards IDUs and increase pharmacists' willingness to sell syringes. At a structural level, access to safe injection supplies for IDUs could be increased by including syringes in the federal list of mandatory medical products sold by pharmacies.
Notes
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PubMed ID
23452390 View in PubMed
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Access to the morning-after pill in BC.

https://arctichealth.org/en/permalink/ahliterature198163
Source
CMAJ. 2000 May 30;162(11):1554
Publication Type
Article
Date
May-30-2000
Author
W D Gutowski
Source
CMAJ. 2000 May 30;162(11):1554
Date
May-30-2000
Language
English
Publication Type
Article
Keywords
British Columbia
Contraceptives, Postcoital
Drug Prescriptions
Ethics
Humans
Pharmacists
Notes
Cites: Am J Nephrol. 1991;11(2):131-71951474
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Comment In: CMAJ. 2000 Aug 8;163(3):26110951720
Comment On: CMAJ. 2000 Mar 21;162(6):876-710750481
PubMed ID
10862225 View in PubMed
Less detail

Access to the morning-after pill in BC.

https://arctichealth.org/en/permalink/ahliterature198164
Source
CMAJ. 2000 May 30;162(11):1554
Publication Type
Article
Date
May-30-2000
Author
B. Osmond
Source
CMAJ. 2000 May 30;162(11):1554
Date
May-30-2000
Language
English
Publication Type
Article
Keywords
British Columbia
Contraceptives, Postcoital
Drug Prescriptions
Humans
Legislation, Pharmacy
Pharmacists
Notes
Cites: Soc Sci Med. 1985;21(10):1063-93936186
Cites: CMAJ. 2000 Jan 25;162(2):195-810674051
Cites: CMAJ. 2000 Mar 21;162(6):876-710750481
Cites: Public Health Rep. 1977 Jan-Feb;92(1):72-8189344
Cites: Ann Intern Med. 1984 Feb;100(2):258-686362512
Cites: CMAJ. 1999 Jan 12;160(1):41-69934342
Cites: J Health Econ. 1989 Mar;8(1):109-3210293367
Cites: J Clin Pharmacol. 1992 Mar;32(3):277-831564133
Cites: N Engl J Med. 1993 Nov 11;329(20):1456-628413456
Cites: J Clin Pharmacol. 1996 Aug;36(8):674-828877670
Cites: CMAJ. 1999 Jan 12;160(1):31-79934341
Comment On: CMAJ. 2000 Mar 21;162(6):876-710750481
PubMed ID
10862224 View in PubMed
Less detail

Adapting the US Institute for Safe Medication Practices' Medication Safety Self Assessment tool for community pharmacies in Finland.

https://arctichealth.org/en/permalink/ahliterature128089
Source
Int J Pharm Pract. 2012 Feb;20(1):15-24
Publication Type
Article
Date
Feb-2012
Author
Tuula Teinilä
Suvi Halmepuro-Jaatinen
Kirsi Yritys
Katri Manni
Marja Airaksinen
Author Affiliation
Division of Social Pharmacy, Faculty of Pharmacy, University of Helsinki, Finland.
Source
Int J Pharm Pract. 2012 Feb;20(1):15-24
Date
Feb-2012
Language
English
Publication Type
Article
Keywords
Community Pharmacy Services - standards
Delphi Technique
Drug-Related Side Effects and Adverse Reactions
Feasibility Studies
Finland
Health Care Surveys
Humans
Medication Errors - prevention & control
Pharmacists - standards
Pilot Projects
Quality of Health Care
Self-Assessment
Abstract
To adapt a US Institute for Safe Medication Practices' Medication Safety Self Assessment (MSSA) tool to, and test its usefulness in, Finnish community pharmacies.
A three-round Delphi survey was used to adapt self-assessment characteristics of the US MSSA tool to Finnish requirements, and to obtain a consensus on the feasibility and significance of these characteristics in assessing the safety of medication practices in community pharmacies. The Delphi modified self-assessment tool was piloted in 18 community pharmacies in order to refine the tool, using a questionnaire containing structured and open-ended questions.
A total of 211 self-assessment characteristics were accepted to the self-assessment tool for pilot use by expert panellists in the Delphi rounds. Most pilot users considered the tool as useful in: identifying medication safety targets for development; medication safety assessment; and identifying the strengths of medication safety. The substance of the self-assessment tool was considered as comprehensive and essential for medication safety. Most criticism was regarding: the multiplicity of self-assessment characteristics; interpretation of some characteristics; and that all the characteristics were not yet available. After the modification, according to the pilot users' comments, the final Finnish tool consisted of 230 medication safety characteristics.
The study indicated the feasibility of adapting a US medication safety self-assessment tool for use in community pharmacy practice in Finland. More efforts should be made to familiarise Finnish community pharmacists with the self-assessment tool and its benefits, and get them to use the tool as part of their long-term quality improvement.
PubMed ID
22236176 View in PubMed
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The adherence support gap: the 'ideal' versus 'reality' of antiretroviral adherence support provided by HIV health providers in clinical practice.

https://arctichealth.org/en/permalink/ahliterature150598
Source
Ann Pharmacother. 2009 Jun;43(6):1036-44
Publication Type
Article
Date
Jun-2009
Author
Laura Y Park-Wyllie
Derek Kam
Ahmed M Bayoumi
Author Affiliation
Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON, Canada. parkwylliel@smh.toronto.on.ca
Source
Ann Pharmacother. 2009 Jun;43(6):1036-44
Date
Jun-2009
Language
English
Publication Type
Article
Keywords
Anti-HIV Agents - administration & dosage
Attitude of Health Personnel
Data Collection
HIV Infections - drug therapy
Humans
Medication Adherence - statistics & numerical data
Nurses - organization & administration - psychology
Ontario - epidemiology
Pharmacists - organization & administration - psychology
Physicians - organization & administration - psychology
Quality of Health Care
Urban Health Services - statistics & numerical data
Abstract
Guidelines suggest that clinicians should provide their patients with antiretroviral adherence support, but there is uncertainty about the types of adherence support clinicians think are important, the methods they use to provide adherence support, and the barriers they face in providing such support in clinical practice.
To study clinician perspectives on the importance of different antiretroviral adherence support activities and compare these with clinicians' self-reported actual adherence support practices.
From March to August 2005, surveys were mailed to physicians, pharmacists, and nurses who provide care to HIV patients in Ontario, Canada. The 84-item survey asked providers to rate how necessary it was to provide 30 types of adherence support activities and how frequently they actually provided each of the types of adherence support. From this, we assessed healthcare provider perceptions of best or ideal practices in supporting medication adherence and actual or usual care in adherence support provision. We also examined whether an adherence support gap existed between the provision of best practice adherence support and actual adherence support in clinical practice.
One hundred sixty-nine of 300 mailed surveys were returned, for a response rate of 56%. Respondents were highly specialized in HIV care and nearly all practiced in urban settings. Respondents indicated that most of the surveyed adherence support activities should be provided to all patients. However, most clinicians did not actually provide these adherence supports to their patients to the extent that they desired. We calculated an adherence support gap that ranged from 31% to 75% across the different types of adherence support activities.
We observed important adherence support gaps between ideal best practices in the provision of adherence support and actual provision of adherence support in clinical practice.
PubMed ID
19491319 View in PubMed
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Advent of mail-order pharmacy causes concern among some pharmacists.

https://arctichealth.org/en/permalink/ahliterature215208
Source
CMAJ. 1995 May 1;152(9):1485-6
Publication Type
Article
Date
May-1-1995
Author
D. Spurgeon
Source
CMAJ. 1995 May 1;152(9):1485-6
Date
May-1-1995
Language
English
Publication Type
Article
Keywords
Humans
Pharmaceutical Services - utilization
Pharmacies - utilization
Pharmacists
Postal Service
Professional-Patient Relations
Quebec
Societies, Pharmaceutical
Abstract
MEDITrust, a major mail-order pharmacy, promises low drug prices and dispensing fees for people who order drugs via mail. Its arrival has created some strong opposition in Quebec. The Canadian Pharmaceutical Association says the arrival of mail-order companies may give community pharmacists an opportunity to promote the benefits of face-to-face contact with pharmacists. The CMA's Dr. Anne Carter says there will always be a need for community pharmacists, who can provide drugs on short notice and provide personal counselling for patients.
PubMed ID
7728698 View in PubMed
Less detail
Source
CMAJ. 2004 Sep 14;171(6):549-50; author reply 550, 552
Publication Type
Article
Date
Sep-14-2004
Author
Neil Johnson
Myrella T Roy
Source
CMAJ. 2004 Sep 14;171(6):549-50; author reply 550, 552
Date
Sep-14-2004
Language
English
Publication Type
Article
Keywords
Canada
Clinical Pharmacy Information Systems
Drug-Related Side Effects and Adverse Reactions
Humans
Interprofessional Relations
Medical Staff, Hospital
Medication Errors - prevention & control
Patient Discharge
Pharmacists
Notes
Cites: CMAJ. 2004 Apr 13;170(8):1235-4015078845
Cites: JAMA. 2001 Apr 25;285(16):2114-2011311101
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Cites: JAMA. 1999 Jul 21;282(3):267-7010422996
Comment On: CMAJ. 2004 Apr 13;170(8):1235-4015078845
PubMed ID
15367444 View in PubMed
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AIDS awareness and education: does pharmacy have a role?

https://arctichealth.org/en/permalink/ahliterature235193
Source
CPJ. 1987 Jun;120(6):374-6
Publication Type
Article
Date
Jun-1987

385 records – page 1 of 39.