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MONITORING DRUG-THERAPY IN SKILLED NURSING FACILITY PATIENTS

DRUG INTELLIGENCE & CLINICAL PHARMACY 1978年第12期12卷 704-709页

作者： STEWART, JE MARTTILA, JK KABAT, HF WERTHEIMER, AI UNIV MINNESOTA COLL PHARMMINNEAPOLISMN 55455

A discussion of one system designed for monitoring drug therapy in skilled nursing facility (SNF) patients is presented. This system will enable the pharmacist to fulfill the federal requirement for monitoring drug therapy and will provide the opportunity for gathering and analyzing drug usage data in fulfillment of the facility's utilization review requirement. The system described was developed and tested at five SNF's. Follow-up studies at each of the five facilities were then performed for comparison purposes. The data presented describe and analyze the results from both studies for two of the ten drugs studied: Digoxin and hydrochlorothiazide. The high rates of nonconformance to the established criteria are discussed and specific insights as to why drug therapy in these patients often seems inappropriate are provided.

关键词：地高辛/治疗应用药物疗法/利用药物利用氢氯噻嗪/治疗应用药学服务/标准药剂师技术性护理设施/标准利用情况审核/方法人类

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TRENDS IN CLINICAL PHARMACY IN SPAIN

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DRUG INTELLIGENCE & CLINICAL PHARMACY 1980年第4期14卷 259-265页

作者： BONAL, J CASTRO, I DURAN, J

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INADEQUACIES IN PHARMACOLOGIC MANAGEMENT OF AMBULATORY CHILDREN

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JOURNAL OF PEDIATRICS 1975年第1期87卷 137-141页

作者： MATTAR, ME MARKELLO, J YAFFE, SJ SUNY SCH MED DEPT PEDIAT BUFFALO NY USA CHILDRENS HOSP DIV PHARMACOL 219 BRYANT ST BUFFALO NY 14222 USA

The compliance with treatment of acute otitis media in 300 pediatric outpatients was evaluated. Complete compliance in taking prescribed antibiotics was noted in 7.3% of the patients. Pharmacists dispensed less than prescribed amounts of antibiotics to 15% of patients. Bottles were incorrectly labeled 3% of the time. Volumes of 130 “teaspoons” examined varied from 2 to 9 ml. Parental understanding of the illness and of the effects of medication was inadequate and erroneous in many instances. Parents gave fewer than the prescribed number of doses in 36% of cases, and therapy was discontinued early in 37%. Recommendations for improving the quality of therapy for ambulatory pediatric patients are outlined.

关键词：剂型用药计划表药物相互作用药物标签/标准中耳炎/药物疗法中耳炎/遗传学中耳炎/护理双亲药学服务/标准维生素类/投药和剂量儿童儿童学龄前人类婴儿

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Twenty qualities of a desirable pharmacy environment

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 1999年第9期56卷 909-910页

作者： Summerfield, MR Med Univ S Carolina Dept Pharm Serv Charleston SC 29425 USA

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Benefits of residency training programs in home care pharmacy practice

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2000年第23期57卷 2214-2216页

作者： Monk-Tutor, MR Conrad, WF Samford Univ McWhorter Sch Pharm Dept Pharm Practice Birmingham AL 35229 USA Univ Cincinnati Med Ctr Coll Pharm Div Pharm Practice Cincinnati OH 45267 USA

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The impact of face-to-face educational outreach on diarrhoea treatment in pharmacies

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HEALTH POLICY AND PLANNING 1996年第3期11卷 308-318页

作者： RossDegnan, D Soumerai, SB Goel, PK Bates, J Makhulo, J Dondi, N Sutoto Adi, D FerrazTabor, L Hogan, R HARVARD PILGRIM HLTH CARE BOSTONMA MANAGEMENT SCI HLTH DRUG MANAGEMENT PROGRAMBOSTONMA MINIST HLTH CONTROL DIARRHOEAL DIS PROGRAMNAIROBIKENYA MINIST HLTH CONTROL DIARRHOEAL DIS PROGRAMJAKARTAINDONESIA WHO PROGRAMME CONTROL DIARRHOEAL & RESP DISCH-1211 GENEVASWITZERLAND

Private pharmacies are an important source of health care in developing countries. A number of studies have documented deficiencies in treatment, but little has been done to improve practices. We conducted two controlled trials to determine the efficacy of face-to-face educational outreach in improving communication and product sales for cases of diarrhoea in children in 194 private pharmacies in two developing countries. A training guide was developed to enable a national diarrhoea control programme to identify problems and their causes in pharmacies, using quantitative and qualitative research methods. The guide also facilitates the design, implementation, and evaluation of an educational intervention, which includes brief one-on-one meetings between diarrhoea programme educators and pharmacists/owners, followed by one small group training session with all counter attendants working in the pharmacies. We evaluated the short-term impact of this intervention using a before-and-after comparison group design in Kenya, and a randomized controlled design in Indonesia, with the pharmacy as unit of analysis in both countries (n = 107 pharmacies in Kenya;n = 87 in Indonesia). Using trained surrogate patients posing as mothers of a child under five with diarrhoea, we measured sales of oral rehydration salts (ORS);sales of antidiarrhoeal agents;and history-taking and advice to continue fluids and food. We also measured knowledge about dehydration and drugs to treat diarrhoea among Kenyan pharmacy employees after training. Major discrepancies were found at baseline between reported and observed behaviour. For example, 66% of pharmacy attendants in Kenya, and 53% in Indonesia, reported selling ORS for the previous case of child diarrhoea, but in only 33% and 5% of surrogate patient visits was ORS actually sold for such cases. After training, there was a significant increase in knowledge about diarrhoea and its treatment among counter attendants in Kenya, where these changes we

关键词：止泻药/标准止泻药/治疗应用信息交流社区卫生服务/标准腹泻/药物疗法腹泻/流行病学腹泻/预防和控制教育药学/标准补液疗法/标准健康知识态度实践印度尼西亚/流行病学干预性研究肯尼亚/流行病学动机药学服务/标准药剂师助手/教育成年人儿童女(雌)性人类

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Advice provided in British community pharmacies: What people want and what they get

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Journal of Health Services Research and Policy 1998年第4期3卷 219-225页

作者： Hassell, K. Noyce, P. Rogers, A. Harris, J. Wilkinson, J. Natl Primary Care Res Develop Ctr Williamson Building Manchester M13 9PL Oxford Road United Kingdom

Objectives: This study explored advice-giving behaviour in community pharmacies in order to understand the nature and process of pharmaceutical consultations and consumers' views of the advice-giving role. Method: An ethnographic research strategy was used, combining patient interviews with non-participant observation of interactions between consumers and pharmacy staff. One week was spent in each of 10 pharmacies. Results: The study demonstrated that the advice given in a community pharmacy is almost wholly focused on product recommendation and use. Advice-giving varies according to whether consultations concern prescription or non-prescription medicines. When the latter are involved, advice-giving is mostly consumer-led. Consumers' major 'need' for pharmacy services appears to be for information about the effectiveness of products they buy, whilst pharmacists and pharmacy assistants concentrate on providing advice on the safety of medicines. Conclusion: The notion of pharmacists as general health advisors does not appear to be shared by the public and may be at odds with how the public view and use pharmacies. Protocols to guide staff may be improved by including the consumer perspective. Most consumers have previous experience of their ailments and use pharmacies as one of several resources available to them to treat their minor illness, having made their own diagnosis and assessment before entering the pharmacy. The scope for giving new advice is therefore limited. The broader role of community pharmacies merits further attention.

关键词：咨询英格兰卫生服务研究病人满意度药学服务/标准药房/分类药剂师处方药物专业场所职业病人关系公费医疗人类

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Development of pharmaceutical care in The Netherlands: pharmacy's contemporary focus on the patient.

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Journal of the American Pharmaceutical Association (Washington,D.C. : 1996) 1999年第3期39.0卷 395-401页

作者： van Mil, J.W. Tromp, D.F. McElnay, J.C. de Jong-van den Berg, L.T. Vos, R. Department of Social Pharmacy and Pharmacoepidemiology School of Pharmacy University of Groningen Netherlands

OBJECTIVE: To describe how developments in the pharmacy profession in The Netherlands converged into the current movement toward pharmaceutical care. SETTING: Dutch community pharmacy. DESCRIPTION: Literature was reviewed for key elements of pharmacists' professional development over the last 40 years--the pharmacist-physician relationship, the pharmacist-patient relationship, the education of the pharmacist, provision of information to patients, medication surveillance, clinical pharmacy, and social pharmacy. Consideration was given to how, when and if these elements interacted and contributed to the movement toward pharmaceutical care. RESULTS: During the early years of the 20th century the professional role of the pharmacist, based on preparing medications, declined because of the increased industrial production of drugs. In The Netherlands, a number of developments, starting around 1995, led to a "reprofessionalization" movement in pharmacy, characterized by pharmacists' increased awareness of social and ethical responsibilities with respect to drugs and patients. These developments included an improved relationship between pharmacists and physicians, the implementation of clinical pharmacy and medical surveillance in daily community pharmacy practice in the 1970s and 1980s, and the increased awareness of the rights of patients to quality drug information and counseling in the 1980s and 1990s. By the end of 1980 these trends had coalesced into a professional movement supporting the need for a pharmaceutical care model of practice. CONCLUSION: Dutch pharmacy is gradually implementing pharmaceutical care in daily community practice. However, a proactive attitude, not only from the "front runners," but from all pharmacists, is desirable if pharmaceutical care is to be incorporated into routine community practice.

关键词：荷兰病人医疗护理以病人为中心医护/方法药学服务/历史药学服务/标准职业病人关系历史 20世纪人类

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Predictors of Patient Satisfaction with Pharmacy Services in a Health Maintenance Organization

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Journal of Pharmaceutical Marketing & Management 1987年第2期2卷 73-88页

作者： Fincham, Jack E. Wertheimer, Albert I. Health Care Administration School of Pharmacy University of Mississippi Mississippi MS 38677 United States Department of Social and Administrative Pharmacy College of Pharmacy University of Minnesota Minneapolis MN 55455 United States

In a study of Health Maintenance Organization (HMO) patients, five variables were shown to be predictive of patient satisfaction with pharmacy services through multiple regression analysis. The variables of satisfaction with the HMO in general, convenience of prescription filling, self-assessed positive health status, communication between provider and patient, and the view of prescription drugs as being inexpensive accounted for 26.4% of the variance in patient satisfaction with HMO pharmacy services. The results suggest areas in which attention should be directed toward maintenance of patient satisfaction with pharmacy services, especially when considering that patients may have the option of utilizing in-house or out-of-plan pharmacies for services. The authors suggest administrators of HMOs, pharmacy directors, and out-of- plan vendor pharmacists should periodically assess HMO pharmacy patient satisfaction. © 1987, Informa UK Ltd. All rights reserved.

关键词：用户满意健康维护组织/组织和管理药学服务/标准问卷调查回归分析美国

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Developing a strategic plan for quality in pharmacy practice

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 2000年第5期57卷 470-474页

作者： Shane, R Gouveia, WA Cedars Sinai Med Ctr Serv Pharm Los Angeles CA 90048 USA Tufts Univ New England Med Ctr Serv Pharm Boston MA 02111 USA

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