bluuebunny/crossref_metadata_2025_split huggingface dataset:
Potential Support Roles for Pharmacy Technicians in Provision of Clinical Pharmacy Services
Authors: Carroll Margaret E , Galbraith Kirsten J , Dooley Michael J 
Published: March 2016

Objectives: To determine the current and possible future utilisation of pharmacy technicians in clinical pharmacy support roles in Australia. To use the information to develop a set of potential support tasks for pharmacy technicians working under the supervision of clinical pharmacists.Method: The Society of Hospital Pharmacists of Australia Committee of Specialty Practice in Clinical Pharmacy undertook a survey of Australian clinical pharmacy managers to determine current and possible future involvement of pharmacy technicians in components of clinical pharmacy activities described in The Society of Hospital Pharmacists of Australia Standards of Practice for Clinical Pharmacy. The survey was mailed to 275 hospital pharmacy departments in January 2002. A reference group of Australian pharmacists and technicians was then formed to consider the survey results and reach consensus on potential clinical pharmacy support activities suitable for technicians.Results: The survey response rate was 46%. Respondents indicated that there is currently minimal pharmacy technician involvement in clinical pharmacy support roles, but many more roles were considered possible in the future. The reference group developed a list of potential tasks for pharmacy technicians working under the supervision of a pharmacist in clinical pharmacy support roles, including detection of new patient admissions; communication with internal health professionals; assistance in managing storage and retrieval of patients' own medications; data processing of adverse drug reaction reports; accessing, recording and screening specific laboratory and therapeutic drug monitoring data; retrieval of selected drug information; gathering of consumer medicine information leaflets; and preparation of information for transfer to community healthcare providers.Conclusion: Although there is currently only limited involvement of pharmacy technicians in clinical pharmacy services, there is recognition by clinical pharmacy managers of many possible future roles. The reference group reached consensus on a selection of potential clinical pharmacy support tasks for pharmacy technicians working under the supervision of clinical pharmacists. The Committee of Specialty Practice in Clinical Pharmacy aims to incorporate these tasks into a revision of the The Society of Hospital Pharmacists of Australia Standards of Practice for Clinical Pharmacy.
Piloting an Objective Structured Clinical Examination to Evaluate the Clinical Competency of Pre‐Registration Pharmacists
Authors: Coombes Judith A , McGuire Treasure , Harrhy Karen L , Mc Robbie Duncan , Davies J Graham , Fleming Gail 
Published: March 2016

Objectives:The primary aim of the study was to pilot the Objective Structured Clinical Examination (OSCE) as a method of evaluating the clinical competency of pre‐registration pharmacists trained in Brisbane and nearby hospitals. A secondary aim was to demonstrate that this model of assessment is transferable when used to evaluate preregistration pharmacists from the UK.Method:A 15‐workstation OSCE was adapted from an examination used by the South Thames Clinical Pharmacy Network in the UK. The workstations were reviewed and updated to ensure their appropriateness to clinical pharmacy practice in Australia by a group of practising pharmacists and academics. The OSCE was first completed by pre‐registration pharmacists from Brisbane and nearby hospitals in October 1998 (QLD98) and then in November 1999 (QLD99). A sample of pre‐registration students from the UK who completed the same OSCE in 1998 (UK98) was used as the comparator group.Results:The OSCEs were completed by 10 students in 1998 (QLD98) and 13 in 1999 (QLD99). These results were compared with 52 students who completed the OSCEs in the UK in 1998 (UK98). In general, the students performed well in the ‘medication focused’ activities such as counselling, calculations and chart review. However, they were less successful in more holistic tasks such as drug history taking, information retrieval from medical notes and interpretive calculations.Conclusion:Having successfully piloted the OSCE model it was determined that the method is feasible to administer when students can be brought to an assessment centre. We recommend that the OSCE be considered a key component of assessing clinical competency as part of the registration requirements for pre‐registration pharmacists in Australia.
Patients' Willingness to Pay for Cognitive Pharmacy Services in Ambulatory Care Settings in the USA
Authors: Daftary Monika N , Lee Euni , Dutta Arjun P , Olagundoye Abiola , Xue Zhenyi (Eric) 
Published: March 2016

Aim: To assess patients' willingness to pay (WTP) for cognitive pharmacy services and the current level at which patients receive these types of services.Method: A self‐administered questionnaire was given to patients who visited two local ambulatory care pharmacies in metropolitan Washington DC, USA.Results: Ninety patients responded to the questionnaire—the majority female (60%) and African American (58%). Analyses showed that WTP status was associated with annual income. However, the number of prescriptions, race, and insurance type did not show any associations with patients' WTP. Although the majority of respondents were not receiving cognitive pharmacy services many of them would be willing to pay for this type of service, and over 90% reported that insurance companies should cover cognitive pharmacy services.Conclusion: The majority of patients surveyed were not receiving cognitive pharmacy services from the two local ambulatory care pharmacies. However, many were willing to pay for this type of service and would pay more for long‐term cognitive pharmacy services. Certain patient characteristics, such as high annual income, age, and perceived health status, were associated with WTP.
Developing a Form to Enhance the Continuum of Medication Care Following Hospital Discharge
Authors: Parke John , Howat Celia 
Published: March 2016

Aim: To develop a form to enhance the continuum of medication care following hospital discharge, trial its introduction in a public hospital medical ward and estimate the human resources required for full implementation.Method: A form was developed to facilitate the collection of information for compliance with the guidelines of the Australian Pharmaceutical Advisory Council to enhance the continuum of medication care. The form was trialed for one month by a project officer and for one month by the treatment team.Results: During the first period there was a marked increase in the quantity and quality of medication histories, recording of medication pathways, medication risk assessments and counselling. None of these functions were performed by the treatment team during the second period. The time taken to gather the required information averaged 0.56 hours per patient.Conclusion: The form enhanced the continuum of medication care from admission through to, and beyond, discharge. The treatment team did not have the time to complete the form and noted that pharmacists are ideally placed to perform this task. For the successful implementation of the form, sufficient staff may need to be employed.
Stability of Insulin Aspart in Normal Saline Infusion
Authors: Lim Stephen CB , Roberts Malcolm J , Paech Michael J , Peng Li , Jones Allan 
Published: March 2016

Aim: To investigate the stability of insulin aspartin sodium chloride 0.9% (normal saline) during storage and continuous IV infusion.Method: Five bags containing insulin 0.1 unit per mL were prepared for each of the four different experimental conditions‐room temperature, 37°C, 2 to 8°C, and within an IV administration set. Insulin was assayed by high pressure liquid chromatography.Results: The insulin concentration fluctuated for 4 hours and then remained within the prescribed range over a 24‐hour period at both room temperature and 37°C. When stored at 2 to 8°C for eight days, the concentration remained stable after one day and was always within the prescribed range. Infusion through an administration set provided a stable concentration after the initial first hour of infusion.Conclusion: Insulin aspart can be produced in batches in normal saline, stored at room temperature or 37°C for 24 hours or in the refrigerator for eight days, and administered without significant change in the prepared concentration.
Renal Function, Peak Anti‐Xa Levels and Enoxaparin Dosing
Authors: Peng Yan Ghee , Eikelboom John W , Tenni Peter , McQuillan Andrew , Thorn Jim 
Published: March 2016

Background: Low molecular weight heparin is administered in a fixed, weight‐adjusted dose without laboratory monitoring in the majority of patients. However, there is still uncertainty regarding optimum dosing in patients with renal impairment.Aim: To examine the association between peak anti‐Xa levels and creatinine clearance in patients treated with enoxaparin.Method: Prospective study of hospitalised patients receiving enoxaparin 1 mg/kg twice daily. Peak anti‐Xa levels were measured after patients received at least 3 doses of SC enoxaparin and were compared in 3 patient groups according to baseline creatinine clearance (Group 1: Crcl ≤ 30 rnUmin; Group 2: Crcl < 30 and ≤ 60 mL/min; Group 3: Crcl < 60 mL/min).Results: 50 patients were studied (54% male). Peak anti‐Xa levels after a mean of 5.2 doses of enoxaparin were within or above the recommended therapeutic range (0.6‐1.0 unit per mL) in 96% of patients ( 48/50). At this time, five of the seven patients (71.4%) in Group 1 had peak anti‐Xa levels < 1.0 unit per mL, compared with 15/19 (78.9%) in Group 2 and 7/24 (29.2%) in Group 3. Mean peak anti‐Xa levels were 1.58 ± 0.54 unit per mL, 1.25 ± 0.38 unit per mL and 0.93 ± 0.28 unit per mL in Groups 1, 2 and 3 respectively, p = 0.001.Conclusion: Patients with reduced creatinine clearance who were receiving enoxaparin 1 mg/kg twice daily achieved significantly higher peak anti‐Xa levels compared with those with normal creatinine clearance. Dose reduction and/or routine laboratory monitoring of enoxaparin should be considered in patients with impaired renal function.
Attitudes of Physicians to Professional Roles of Community Pharmacists in Lebanon
Authors: Saab Yolande B , Hachem Alya H 
Published: March 2016

Background: Pharmacists involved in patient‐centred clinical services can potentially reduce overall healthcare costs, morbidity and mortality. However, physicians might be ambivalent about pharmacists' capabilities.Aim: To determine the opinions of medical and dental practitioners (physicians) to professional activities which could be provided by community pharmacists in Lebanon.Method: 300 questionnaires were distributed by pharmacy students to registered physicians covering a range of specialties and experience. The questionnaire consisted of 20 closed questions and an open‐ended question to determine the physician's expectations of the pharmacist's role in patient care.Results: 198 questionnaires were analysed and overall the results indicated that physicians have a need for information of the type that pharmacists can supply. However, the healthcare system is fragmented because of unclear and infrequent communication. Physicians believe that increased consensual cooperation and communication between the professions could improve therapeutic outcomes and the quality of advice given to patients.Conclusion: There is a need for collaboration between physicians and pharmacists in Lebanon to improve the quality of pharmaceutical care for patients.
Comparison of Dextropropoxyphene and Paracetamol with Paracetamol After Third Molar Dental Extractions
Authors: Sorich Michael J , Osborne George A , Jarvis David A , Macintyre Pamela E , Sprigg Jillian , Doecke Christopher J 
Published: March 2016

Background: Single‐dose studies comparing the analgesic efficacy of dextropropoxyphene and paracetamol with paracetamol have usually found equi‐analgesic effect. Whether this phenomenon is also so after multiple doses is uncertain.Aim: To determine whether the dextropropoxyphene and paracetamol combination has any advantages over paracetamol when used in multiple doses to relieve acute pain.Method: A randomised, double‐blinded, parallel, controlled trial with two study arms: dextropropoxyphene hydrochloride 65 mg and paracetamol 650 mg combination with paracetamol 1000 mg. For the first 5 days following third molar dental extraction, patients in both study arms recorded scores for analgesia, satisfaction, wellbeing, and selected adverse effects.Results: 119 patients provided data. There were no significant differences in analgesic efficacy, satisfaction or wellbeing between the two groups. Other than increased incidence of vomiting on the first day following surgery in the combination group, adverse effects were similar between the groups.Conclusion: These results suggest that when patients with acute pain are blinded to the analgesic treatment, the combination of dextropropoxyphene and paracetamol has little or no advantage over paracetamol, even when multiple doses are used.
Impact of Medication Review by General Practitioners andPatient Peer Education
Authors: Bolton Patrick GM , Parker Sharon M 
Published: March 2016

Aim: To assess the combined and independent impact, of two Quality Use of Medicines initiatives‐medication review by general practitioners (GPs) and patient peer education.Method: 27 GPs recruited 185 patients aged < 65 years and taking five or more medications. Patients were randomised to receive a medication review, peer education, both or neither. Peer educators were recruited and trained to educate and empower patients to obtain the information they need from their GPs. GPs attended an educational workshop on medication review for older patients.Results: No significant difference was found for medication review by GPs or patient peer education, or for the interaction between the two, according to the two outcome measures: SF‐36 and medication count.Conclusion: Despite the limitations of the study, particularly limited statistical power, the results raise questions about the value of medication review by GPs for the elderly. Greater engagement between peer educators and patients may be required if peer educators are to have a positive effect on health outcomes.
Diabetes Ward Management—Room for Improvement
Authors: Rando Leo , Keith Claire , Sardjono Donald A , Robertson Marion B , Colman Peter G 
Published: March 2016

Background: Diabetes control frequently deteriorates during hospitalisation and changes to management are often required.Aim: To evaluate the prevalence, diabetes type, admitting unit and glycaemic control of hospital inpatients with diabetes mellitus and the use of insulin‐to‐test orders (sliding scales).Method: Information on demographics, glycaemic control and insulin‐to‐test orders were collected for inpatients with diabetes mellitus by surveying medical records, 48 hours of blood glucose levels (BGLs) and drug charts.Results: Of the 698 inpatients, 108 (15%) had diabetes comprising 24 (22%) with type 2 controlled with diet, 39 (36%) with type 2 treated with oral hypoglycaemic agents, 40 (37%) with type 2 treated with insulin with or without oral hypoglycaemic agents and 5 (5%) with type 1. Diabetes was present in 82/351 (23%) medical, 7/61 (11%) psychiatric and 19/286 (7%) surgical patients. Control was ideal (BGL 3.5‐8.0 mmol/L) in 12% and modest (BGL 3.5‐8.0 mmol/L, plus at least one BGL 8.1‐12 mmol/L) in 29%, leaving 59% suboptimal (BGL not 3.5‐12 mmol/L). Severe hyperglycaemia (at least one BGL≥20 mmol/L) occurred in 12% and moderate hyperglycaemia (at least one BGL≥15 but none≥20 mmol/L) in 30%. Hypoglycaemia (at least one BGL < 3.5 mmol/L) was documented in 11%. Mean BGL was < 6 mmol/L in 5%, 6.1–8.0 mmol/L in 33%, 8.1‐10 mmol/L in 23%, and > 10 mmol/L in 39%. Suboptimal control was identified in 100% of type 1, 87% of type 2 treated with insulin with or without oral hypoglycaemic agents, 58% of type 2 treated with oral hypoglycaemic agents, and 9% of type 2 controlled with diet (p < 0.0001). There was no difference in glycaemic control between patients from medical, psychiatric or surgical units. Insulin‐to‐test orders, used in 34 (31%) patients, were judged as ‘safe’ in only 9 (26%) patients.Conclusion: Management of inpatients with diabetes requires improvement, supporting the need for guideline development and continuing education.
Role of Therapeutic Drug Monitoring in HIV Therapy
Authors: Samios Peter A , Maxwell David J 
Published: March 2016

Background: Therapeutic drug monitoring (TDM) is increasingly becoming part of the management of antiretroviral therapy for the treatment of HIV.Aim: To review the role of TDM in HIV therapy focusing on the indications for its use and resultant changes to drug therapy.Method: A 6‐month retrospective review of protease inhibitor TDM requests made by HIV clinicians was conducted. Patient medical records, STOCCA (dispensing program), pathology and the HIV outpatient unit database were reviewed to classify each TDM episode according to indication and outcome.Results: 50 protease inhibitor TDM requests were identified for 38 patients. Indications for use ofTDM included 47 cases of suspected inadequate dosing, two suspected toxicities and one suspected drug interaction. Therapy was altered in approximately 16% of all protease inhibitor TDM requests. Drug dose alterations were recorded for 7 of 4 7 levels measured for adequate dosing and 1 of the 2 levels measured for suspected toxicities.Conclusion: TDM is a valuable tool in managing antiretroviral therapy. It may play an important role in detecting both suboptimal or potentially toxic levels of protease inhibitors, which is an important factor in the success of antiretroviral therapy and the management of HIV.
Consumer Perceptions of Generic Drug Substitution Practices in the USA
Authors: Sansgiry Sujit S , Bhosle Monali J 
Published: March 2016

Background: To improve the uptake of generic drugs, understanding consumer perceptions is important. Increased use of generic drugs may help contain escalating healthcare costs.Aim: To evaluate consumer perceptions of generic drug substitution practices by pharmacists in the USA and predict the effect of health and social factors on the use of generic drugs.Method: Surveys were administered to consumers filling prescriptions at 10 community pharmacies in metropolitan Houston, Texas. A 12‐item, 5‐point scale was used to evaluate consumer perceptions. Information on current drugs, purchase behaviour and sociodemographic factors was also requested.Results: 505 surveys were completed (61% response rate). Participants had a slightly positive attitude toward generic drug substitution practices (mean 3.59, SD 1.13). Although participants perceived generic drugs to be safe (68%) and effective (62%), 50% did not consider them to be identical to brand equivalents. Attitude towards generic drugs was the most important predictor of consumer perceptions towards generic drug substitution practices by pharmacists.Conclusion: To improve consumer perceptions of generic drug substitution practices, it is imperative to develop strategies to increase positive attitudes towards generic drugs. Pharmacists can improve consumer perceptions of generic drugs, enhance consumer awareness of potential savings, and help reduce the overall healthcare costs.J Pharm Pract Res 2004; 34: 262–6.
Patients' Attitudes to Discharge Medications Supplied under the Pharmaceutical Benefits Scheme
Authors: Bortoletto Diana A , Swan Bryson J , Weeks Greg R 
Published: March 2016

Aim: To assess patients' attitudes to discharge medications supplied under the Pharmaceutical Benefits Scheme (PBS).Method: Patients who received discharge medications from The Geelong Hospital, Victoria between February and June 2003, and also in 2001 prior to the introduction of the PBS were surveyed. Demographic data and information on discharge medications and admitting specialities was collected from computer records of dispensing and patient information. Suitable patients were sent a reply‐paid questionnaire that assessed their attitudes towards the PBS and previous discharge systems.Results: 180 patients returned the questionnaire. 79% either strongly agreed or agreed that the quantity of medications supplied under the PBS system was convenient compared to 63% for the ‘5‐day supply’ system. In a direct comparison between the two systems, 68% preferred the PBS. Only 24% had been informed of the possible cost of discharge medications prior to admission. Nonetheless, 69% either strongly agreed or agreed that paying for discharge medications was appropriate.Conclusion: Discharge medications supplied under the PBS system was positively accepted by patients.J Pharm Pract Res 2004; 34: 288–9.
Pharmacist Prescribing: Review of the Literature
Authors: Kay Olivia C , Brien Jo‐anne E 
Published: March 2016

Aim: To evaluate the literature describing pharmacist prescribing activities and identify areas in need of further research.Method: Relevant literature was identified by searching Medline (1974 to February 2004), Embase (1980 to February 2004) and Pharmline (1980 to February 2004). Relevant studies were selected based on titles and abstracts.Results: 18 studies (17 USA, 1 UK) measured outcomes of drug therapy management by a dependent pharmacist prescriber compared to standard care. 19 studies described pharmacist interventions or recommendations on drug therapy that could be implemented with the approval of an independent prescriber. 52 papers described pharmacist‐prescribing activities in practice but lacked an experimental design. Prescribing protocols used were presented in 14 papers. Evidence from these studies supports the role of dependent prescribing pharmacists through positive patient outcomes.Conclusion: Few studies employed adequate research designs to control threats to internal and external validity. Additional research is needed to assess clinical, humanistic and economic outcomes to establish the viability of pharmacist prescribers.J Pharm Pract Res 2004; 34: 300–4.
Ginger for Nausea and Vomiting in Pregnancy
Authors: Dib Jean G , El‐Saddik Rita A 
Published: March 2016

Background: Ginger has a long tradition of use for the treatment of nausea and vomiting in pregnancy but there are doubts about its efficacy and safety.Aim: To evaluate the efficacy and safety of ginger in the treatment of nausea and vomiting in pregnancy.Method: Relevant clinical studies were identified by searching Medline, Embase and ScienceDirect in December 2003.Clinical studies: Six clinical trials were considered and summarised. Although the studies were limited in scale and duration the results suggested that ginger is well tolerated and available evidence does not indicate an increased risk of congenital malformations. Ginger appears to have a modest potential for efficacy.Conclusion: The limited studies suggest that low‐dose, short‐term use of ginger may be considered as an alternative for nausea and vomiting in pregnancy.J Pharm Pract Res 2004; 34: 305–7.