bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients' Preferences for Methods of Counselling about Glaucoma
Authors: Taylor Jeff G. , Deschamps Michelle A. , Bobyn P. Joan , Leson Darlene 
Published: June 2013

Objective: To investigate patients' preference for two counselling methods related to glaucoma therapies. Design: Nineteen volunteers with glaucoma received counselling about an eye drop medication in two sessions, one involving verbal presentation of information accompanied by a computer-generated information leaflet and the other involving verbal presentation of information supported by images. To the extent possible, the drug-related content of each session was the same. The setting was the EduLab facility of the College of Pharmacy and Nutrition at the University of Saskatchewan. Results: An equal number of subjects expressed an outright preference for each method, but results suggested that the order of presentation of the methods might be important. Most participants indicated that if a pharmacist used pictures while advising on medications, print information would still be welcomed. Conclusion: Patients were satisfied with both methods, with no clear overall preference evident within the study sample.
Assisting Consumers with Their OTC Choices
Authors: Taylor Jeffrey G. , Chorney Sherilyn , Fleck Ian , Golightly Robert , Litzenberger Valdeen , Loeppky Kristen , Tait Ashley , Tulloch Joanie 
Published: June 2013

Background: The general public recognizes the important role of pharmacists in helping select over-the-counter (OTC) medicines, yet data to quantify the level of consumer demand are scarce. Objective: The purpose of this project was to describe consumer response to offers of assistance as a measure of consumer demand. Method: Six pharmacy students spent three weeks in three community pharmacies as OTC medicine advisors. Subsequent to formal offers of assistance, acceptances and refusals were tracked to gauge consumer demand for information. Results: On average, students had contact with 19.8 consumers per hour, leading to 11,174 interventions. Of these, 27.8% involved the exchange of clinical information, 36.9% saw the person decline assistance, 30.3% were limited to product location, while 5.0% constituted non-drug queries. Conclusion: Although a modest percentage, there were 3107 (27.8%) clinical intervention transactions, which is noteworthy for the short duration of the study and indicates significant consumer demand for this aspect of practice.
Bringing the Benefits of Anticoagulation Management Services to the Community
Authors: Bungard Tammy J. , Archer Stephen L. , Hamilton Peter , Ritchie Bruce , Tymchak Wayne , Tsuyuki Ross T. 
Published: June 2013

Background: While warfarin is efficacious for the prevention of thromboembolic disorders, many patients are undertreated. To optimize therapy, anticoagulation management services (AMSs) deliver a coordinated, focused approach to this care; however, AMSs are limited in their ability to impact patients outside of tertiary care settings. Objective: To describe the methods used to develop community-based AMSs across Alberta. Methods: Through a three-staged approach, this project created community-based, pharmacist-managed AMSs for patients requiring warfarin therapy. Stage I was the initiation of a central or “core” AMS, located at a quaternary referral centre. Starting with the core enabled us to develop and test the program and create an environment to serve as a training and support centre for future aspects of the program. Next, an educational program was developed and implemented (Stage II) for a diverse group of pharmacists to establish and manage a community-based or “satellite” AMS (Stage III) at their practice site. All three stages are undergoing detailed evaluation, capturing project-specific (patient outcome) data as well as system-level (integration within the health care infrastructure) data. Conclusion: By offering a focused, coordinated, and consistent approach to warfarin management, with ongoing collaboration with other providers, the ultimate goal of this program is to optimize patient outcomes. Utilizing pharmacists as central players within a collaborative setting will enhance the use of our current infrastructure. This program may serve as a model for other health regions and other chronic diseases.
Improving Asthma Control in the Rural Setting: The BREATHE (Better Respiratory Education and Asthma Treatment in Hinton and Edson) Study
Authors: Charrois Theresa L. , Newman Stephen C. , Senthilselvan Ambikaipakan , Tsuyuki Ross T. 
Published: June 2013

Background: Overuse of β-agonists is a risk factor for poor control of asthma. Pharmacists can identify high-risk patients through refill information and can then initiate disease-management programs for these patients. Methods: The Better Respiratory Education and Asthma Treatment in Hinton and Edson (BREATHE) study was a randomized, controlled trial in high-risk asthma patients. The intervention included an educational program (with focus on development of a written action plan), assessment of asthma therapy, and referral to a respiratory therapist and primary care physician. The primary objective was to determine the effect of this program (initiated by community pharmacists) on asthma control, as measured by the Asthma Control Questionnaire. Secondary objectives included determining the effect of the program on numbers of emergency department visits and hospital admissions, use of inhaled corticosteroids, courses of oral steroids, and lung function. Endpoints were measured at baseline, 2 months, and 6 months. Results: A total of 70 patients were randomized (34 to usual care, 36 to the intervention). At 6 months, there was no significant difference in asthma control between the usual care and inter-vention groups (change in ACQ score 0.33 and 0.43 respectively, p = 0.66). There were no significant differences in the secondary endpoints. Generally, pharmacist compliance with the intervention was poor. Conclusions: Although no differences were found in asthma control, this model, which uses a multidisciplinary, community-based approach, offers a unique management strategy for rural asthma patients. Can Pharm J 2006;139(4):44–50.
Community Pharmacist Practices in Hypertension Management
Authors: McLean Donna L. , Bungard Tammy J. , Hui Carolyn , Tsuyuki Ross T. 
Published: June 2013

Objective: To determine the current practices of community pharmacists in the management of hypertension. Methods: This was a cross-sectional, observational study of pharmacist practice using unannounced standardized patients (SPs) with hypertension visiting a random stratified sample of 101 community pharmacies in Edmonton, Alberta. Consent was not obtained from pharmacists. Results: Knowledge of current blood pressure guidelines and target values: Of the 101 community pharmacists who were visited by the SPs, 69% offered a general blood pressure target value (<120/80 mm Hg); only 7% stated the correct target blood pressure value for the SPs' particular scenario (<140/90 mm Hg). Only 14% requested enough patient history to properly determine target blood pressure. Review of medical history: Few pharmacists questioned the SPs about their medical history (7%), medication profile (16%), family history of cardiovascular disease (19%), previous elevated blood pressure readings (20%), or previous diagnosis of hypertension (22%). Accuracy/confirmation of blood pressure reading: 53% of pharmacists inquired about the conditions under which the blood pressure reading had been taken; 39% of pharmacists offered to retake the patient's blood pressure. Patient education: Pharmacists discussed how hypertension is diagnosed (76%), what hypertension is (46%), how to take a blood pressure reading properly (46%), and the impact of lifestyle measures on blood pressure (60%); they also gave supplemental educational materials (29%). Referral: 83% of pharmacists advised the SPs to make an appointment to see a physician. Conclusions: Pharmacists took reasonable steps to determine the accuracy of the blood pressure measurement, explain the diagnosis of hypertension, and refer to a physician. Major deficiencies were observed in assessment of target blood pressure and review of medical history. Pharmacists, alone or in collaboration with other health professionals, are urgently needed to play a major role in identifying, screening, and managing individuals with hypertension. Can Pharm J 2006;139(5):38–44.
Blood Pressure Awareness and Self-Monitoring Practices among Primary Care Elderly Patients
Authors: Lau Elaine , Kaczorowski Janusz , Karwalajtys Tina , Dolovich Lisa , Levine Mitchell , Chambers Larry 
Published: June 2013

Background: Seniors are perceived as relatively passive recipients of health care, and levels and predictors of blood pressure awareness and self-monitoring in these patients are poorly understood. Objectives: To determine the extent to which seniors are aware of their blood pressure status and targets and to examine correlates of blood pressure awareness and self-monitoring. Methods: We conducted a cross-sectional analysis of a 32-item baseline questionnaire that was completed by patients aged 65 years and older who were attending pharmacy-based cardiovascular health promotion sessions. The study comprised sociodemographic data, as well as data on health-related quality of life, knowledge of current blood pressure readings and targets, and treatment and monitoring of blood pressure in the previous year. Results: Of the 983 respondents, 379 (38.5%) recalled their most recent blood pressure reading. For one-third of these respondents (323/983), their physicians relayed blood pressure targets; of these, 26.9% (87/323) reported targets consistent with current guidelines. Overall, 47.1% (463/983) reported monitoring blood pressure in the past year. Multivariate logistic regression analysis revealed that older patients (aged 80 years and older) were less likely to know their blood pressure readings, compared with those who were younger. Patients with a postsecondary education, those who were diagnosed with high blood pressure, and those who were told their target blood pressure were more apt to know their readings, relative to those less educated, undiagnosed, or unaware of their target blood pressure. Participants who were aged 80 years and older were a negative predictor of self-monitoring in multivariate analysis, whereas living with someone, previous diagnosis of high blood pressure, and being advised of their target blood pressure were positive predictors. Conclusion: Seniors had a relatively poor understanding of their blood pressure readings and targets, but a subset was considerably more knowledgeable and potentially suited to be more involved in blood pressure self-management.
Pharmacotherapy of Hypertension
Authors: Campbell Norm , Semchuk William , Lewanczuk Richard 
Published: June 2013

Background: Hypertension is a leading risk factor for death and disability in Canada. Pharmacists can help to improve the treatment and control of hypertension through collaboration with physicians and patients to improve pharmacotherapy. Objective: To review appropriate pharmacotherapy for hypertension, as outlined in the recommendations of the Canadian Hypertension Education Program. Methods: The recommendations of the Canadian Hypertension Education Program were reviewed with a view to identifying gaps in the recommendations as they apply to pharmacy practice. For some of these gaps, it was determined that pharmacists could provide further care to patients with hypertension, and opportunities for pharmacist involvement are suggested here. Results: Initial pharmacotherapy for uncomplicated hypertension includes thiazide-type diuretics, beta-blockers for patients under 60 years of age, angiotensin-converting enzyme (ACE) inhibitors, long-acting calcium channel blockers, and angiotensin receptor blockers. For additive hypotensive action in two-drug combinations, either a diuretic or a calcium channel blocker should be combined with a beta-blocker, ACE inhibitor, or angiotensin receptor blocker. Other combinations are less effective or unproven. Areas where pharmacists must become more actively involved in the management of patients with hypertension include provision of balanced information about benefits and side effects, identification of secondary druginduced causes of hypertension or drug interactions, and suggestion of adjustments to medication dosage for patients with renal dysfunction. Conclusions: There are specific and unique roles for pharmacists in the management of hypertension. Pharmacists can play a greater role in improving the pharmacological management of hypertensive patients, aided in part by regular updates to the recommendations of the Canadian Hypertension Education Program.
Pharmaceutical-Related Strategies for Health Care Reform in Canada: Federal Party Principles, Priorities, and Actions 2004–2006
Authors: Al-Sukhni Mayce , Ballantyne Peri 
Published: June 2013

Background: The guiding principle of the Canada Health Act (CHA) is to provide Canadians with “medically necessary care.” We note the historic limitations of the CHA with respect to the full integration of medicines and pharmaceutical health care and point to the priority given to drugs and pharmacy-related care in 2 recent federal reports on health care reform. In The Health of Canadians — The Federal Role (Kirby 2002) and Building on Values: The Future of Health Care in Canada and its related submissions (Romanow 2002), the role of drugs and pharmacy in Canadian health care receives unprecedented emphasis. Methods: To determine whether the emphasis on pharmacare made by Kirby, Romanow, and others is retained in federal-level health reform planning, we conducted a content analysis of major federal party platforms and policies tabled for the spring 2004 election (as well as brief reference to those tabled for the winter 2006 election). Results: Recommended pharmacy-related reforms focus on potential catastrophic costs to individual patients rather than on a consideration of essential medicines as medically necessary for a growing number of Canadians. Furthermore, little consideration is given to the role pharmacists could play in minimizing the potential risks of inappropriate drug use and associated costs. Discussion: We consider the difficulty of reconciling the principles of the CHA and the reality of a piecemeal pharmaceutical health care system. Conclusion: Health reforms are needed that take into consideration the growing importance of drugs in health care and the issue of equity and access to drugs for Canadians.
Pharmacist Intervention in Risk Reduction Study in High-Risk Cardiac Patients: The Effect of 2 Methods of Pharmacist Training
Authors: Taylor Jeffrey , Semchuk William , Deschamps M. , Sulz L. , Tsuyuki Ross T. , Duffy P. , Wilson T. 
Published: June 2013

Objective: To assess the effect of intensive vs conventional training on pharmacist-suggested implementation of cardiac risk reduction efforts in community practice. Methods: Sixty-one volunteer pharmacists from 40 pharmacies were randomized to 1 of 2 educational groups: intensive or conventional training in cardiac risk reduction. With training complete, pharmacists identified and approached patients at high risk for coronary artery disease (CAD) at their practice sites to participate in the program. After a patient interview, pharmacists documented the relevant CAD risk factors and medication history, and then faxed this information, along with risk reduction recommendations, to the primary care physician. Patients were then encouraged to book a medical appointment for further assessment and treatment, if warranted. Follow-up occurred at 4, 16, and 24 weeks to determine if any pharmacist-suggested risk reduction measures had been implemented. Pharmacists were reimbursed $30 per patient accrued. Results: A total of 217 patients were enrolled in the study, and of those, 216 had follow-up data available for analysis. No significant differences were observed between the groups with respect to mean number of patients enrolled per pharmacist (4.3 vs 2.7) and the proportion of pharmacists completing at least 1 patient (17/27 vs 14/34). Feedback from pharmacists on program delivery indicated no significant difference in satisfaction with the training provided. The recommendations forwarded by pharmacists of the intensive group (35.8%) received greater acceptance by physicians than those in the conventional group (23.8%). Conclusion: Although results are preliminary, intensive training for pharmacists was more likely to result in improvements in cardiovascular risk reduction therapy than when conventional training was used.
New Tools and Insights: Hyperhidrosis in a Community Setting
Authors: Koo Veronique , Kalaria Dipen , Wassenaar Willem 
Published: June 2013

Background: While excessive sweating is considered by many to be a benign condition, the physical and psychosocial impact it can have on hyperhidrosis sufferers is not always fully appreciated. Methods: A retrospective review of our pharmacy's patient records with the presenting complaint of sweating was conducted. The review covered a 2-year span and consisted of 2517 records. Using a structured questionnaire, patient information was collected via e-mail, as well as telephone and face-to-face interviews by pharmacists. Patients described their difficulties and the different coping methods they would employ to alleviate or hide their excessive sweating on different areas such as the underarms, face/scalp, hands, feet, and torso/groin. Results: Underarm sweating is the most frequent area for which both male and female patients seek help, followed by hands, feet, and face/neck. For males over 40, face and neck sweating is the most frequent area of concern, whereas for females over 40, underarms remain a top priority. Patients report numerous instances of feeling isolated, depressed, and a lack of self-confidence in all areas of professional and social life. Conclusion: It is important to recognize that for some patients, excessive sweating can be a severely debilitating condition. Appropriate action must be taken in order to improve the patient's quality of life.
The geographic accessibility of pharmacies in Nova Scotia
Authors: Law Michael R. , Heard Deborah , Fisher Judith , Douillard Jay , Muzika Greg , Sketris Ingrid S. 
Published: June 2013

Introduction: Geographic proximity is an important component of access to primary care and the pharmaceutical services of community pharmacies. Variations in access to primary care have been found between rural and urban areas in Canadian and international jurisdictions. We studied access to community pharmacies in the province of Nova Scotia. Methods: We used information on the locations of 297 community pharmacies operating in Nova Scotia in June 2011. Population estimates at the census block level and network analysis were used to study the number of Nova Scotia residents living within 800 m (walking) and 2 km and 5 km (driving) distances of a pharmacy. We then simulated the impact of pharmacy closures on geographic access in urban and rural areas. Results: We found that 40.3% of Nova Scotia residents lived within walking distance of a pharmacy; 62.6% and 78.8% lived within 2 km and 5 km, respectively. Differences between urban and rural areas were pronounced: 99.2% of urban residents lived within 5 km of a pharmacy compared with 53.3% of rural residents. Simulated pharmacy closures had a greater impact on geographic access to community pharmacies in rural areas than urban areas. Conclusion: The majority of Nova Scotia residents lived within walking or short driving distance of at least 1 community pharmacy. While overall geographic access appears to be lower than in the province of Ontario, the difference appears to be largely driven by the higher proportion of rural dwellers in Nova Scotia. Further studies should examine how geographic proximity to pharmacies influences patients’ access to traditional and specialized pharmacy services, as well as health outcomes and adherence to therapy. Can Pharm J 2013;146:39-46.
The willingness of community pharmacists to participate in a practice-based research network
Authors: Hébert Joanie , Laliberté Marie-Claude , Berbiche Djamal , Martin Elisabeth , Lalonde Lyne 
Published: June 2013

Background: Practice-based research networks (PBRNs) are groups of practitioners and researchers with an interest in designing, evaluating and disseminating solutions to the real-world problems of clinical practices. Objective: To evaluate the level of interest of community pharmacists in participating in a PBRN and to document the services such a network should offer. Method: In a survey of community pharmacists in Montreal, Quebec, and surrounding areas, a questionnaire was mailed to a random sample of 1250 pharmacists. Two of the 28 questions were related to PBRNs: one assessed the pharmacists’ interest in participating in a PBRN; the other sought their views on which services and activities this network should offer. Results: In total, 571 (45.7%) pharmacists completed the questionnaire, but 6 did not answer the questions about the PBRN. Of the respondents, 58.9% indicated they were “very interested” or “interested” in joining a PBRN, while 41.1% reported little or no interest. The most popular potential services identified were access to clinical tools developed in research projects (77.0%), access to continuing education training programs developed in research projects (75.9%), information about conferences on pharmacy practice research (64.1%) and participation in the development of new pharmaceutical practices (56.1%). Conclusion: This study suggests that the level of interest that community pharmacists have in PBRNs is sufficient to further evaluate how such networks may optimize and facilitate pharmacy practice research. Can Pharm J 2013;146:47-54.
The 2009 pandemic (H1N1) viruses isolated from pigs show enhanced pathogenicity in mice
Authors: Li Yongtao , Zou Wei , Jia Guangmin , Ke Jianjiang , Zhu Jiping , Lin Xian , Zhou Hongbo , Jin Meilin 
Published: June 2013

Abstract
Since the emergence of the 2009 pandemic (H1N1) virus (2009/H1N1) in April 2009, cases of transmission from humans to pigs have been reported frequently. In our previous studies, four 2009/H1N1 variants were isolated from pigs. To better understand the phenotypic differences of the pig isolates compared with the human isolate, in this study mice were inoculated intranasally with different 2009/H1N1 viruses, and monitored for morbidity, mortality, and viral replication, cytokine production and pathological changes in the lungs. The results show that all isolates show effective replication in lungs, but varying in their ability to cause morbidity. In particular, the strains of A/swine/Nanchang/3/2010 (H1N1) and A/swine/Nanchang/F9/2010 (H1N1) show the greatest virulence with a persisting replication in lungs and high lethality for mice, compared with the human isolate A/Liaoning /14/2009 (H1N1), which shows low virulence in mice. Furthermore, the lethal strains could induce more severe lung pathological changes and higher production of cytokines than that of other strains at an early stage. Amino acid sequence analysis illustrates prominent differences in viral surface glycoproteins and polymerase subunits between pig isolates and human strains that might correlate with their phenotypic differences. These studies demonstrate that the 2009/H1N1 pig isolates exhibit heterogeneous infectivity and pathogencity in mice, and some strains possess an enhanced pathogenicity compared with the human isolate.