bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the appropriateness of extemporaneous preparations prescribed in Swedish primary care
Authors: Lindblad Åsa Kettis , Isacson Dag , Eriksson Carin 
Published: February 2011

Abstract
Extemporaneous preparations are drugs that are compounded for individual patients or made in larger batches for stock-keeping. This study aimed to assess the prescribing of extemporaneous preparations in Swedish primary care, both therapeutically and pharmaceutically. An analysis of the extent to which alternative commercial drugs were available at the time of the prescription was also conducted.
Information was taken from the Swedish diagnosis and therapy survey for the time period October, 1986, to September, 1988, inclusive. This survey collects from a random sample of physicians the details of all prescriptions they write during one week, as well as the corresponding diagnoses. The present study analysed the 1,043 extemporaneous prescriptions written during that period.
The majority (62 per cent) were considered to be therapeutically appropriate in that they formed recommended treatment for the diagnosis in question according to the medical literature. Another 15 per cent were neither recommended nor questioned in the consulted sources; 20 per cent were designated as controversial because they were recommended in some sources and questioned in others. About 3.5 per cent were considered to be therapeutically inappropriate, ie, the literature suggested that their use should be abandoned. One per cent were pharmaceutically inappropriate. Many preparations probably could have been replaced by commercial alternatives, about half differing from available commercial alternatives only by strength and/or vehicle. Whether substitutions could have been made in practice would depend on the clinical picture in the individual patient case.
Threatening and violent incidents in community pharmacies: (1) An investigation of the frequency of serious and minor incidents
Authors: Smith Felicity , Weidner Derek 
Published: February 2011

Abstract
The incidence of threatening and violent behaviour in community pharmacy is of concern to pharmacists and their staff, who, if they have not experienced events themselves, will be aware of anecdotal reports and will have their own perceptions about their vulnerability and risks. The frequency of serious and more minor incidents, when and where they occur, is unknown. The concerns of pharmacists may have wide-ranging implications for pharmacy practice and the services pharmacists are prepared to offer. This study was conducted in two stages: a postal survey of all community pharmacies in six family health services authorities in and around London, followed by semi-structured interviews with pharmacists who had reported a threat and/or an assault while at work. This first paper reports an investigation of the frequency and nature of events, pharmacists' perceptions of crime and of their own safety, and the association of these findings with demographic and other variables. The second paper addresses the implications for pharmacists and community pharmacy services.
Fifty-one per cent of respondents reported that they or their staff had at some time been threatened with violence and 31 per cent had been assaulted. Incidents involving knives or firearms comprised about one-fifth of all cases. Approximately one-third of events related to robbery of drugs, supply of prescriptions or non-dispensing pharmacy services and would thus be peculiar to community pharmacy. Therefore the possession of drugs on the premises and other aspects of the professional role of pharmacists places them at increased risk over other retail businesses. Significant minorities of pharmacists did not feel safe in the pharmacy on their own, or undertaking certain everyday activities. Events and concerns were more common in areas with a high Jarman score. Only weak associations were found between whether or not pharmacists reported incidents and personal and other business characteristics.
Insights into the choice between self-medication and a doctor's prescription: a study of hay fever sufferers
Authors: SCHAFHEUTLE E I , CANTRILL J A , NICOLSON M , NOYCE P R 
Published: February 2011

AbstractSelf-medication plays an increasingly important role in the health care systems of many countries. In the United Kingdom (UK) this is reflected in the current policy of deregulating increasing numbers of prescription-only medicines (POM) to pharmacy medicines (P). The purpose of the work described in this paper was to explore factors affecting clients' choice to self-medicate or to contact their doctor for the treatment of a minor ailment, namely, hay fever. Structured qualitative interviews were conducted with 36 clients recruited through community pharmacies. The main themes investigated were clients' reasons for choosing their particular management option and their attitudes towards the increasing number of OTC medicines and towards self-medication. For clients who obtained the medicine through their doctor, the most common reason for doing so was cost. For clients who obtained their medicine over the counter, the incentive to self-medicate was convenience. Payment for or exemption from prescription charges was a major factor. Many clients mentioned potential risks involved in self-medication and the need for appropriate information. However, clients drew differing conclusions on these issues, reflecting either a negative or a positive attitude towards self-medication.
Comparison of attitudes of general medical practitioners and community pharmacists to prescribing matters
Authors: Holden John D , Wolfson David J 
Published: February 2011

Abstract
In order to compare the attitudes of general medical practitioners (GPs) and community pharmacists to a broad range of issues concerning prescribing, a questionnaire was mailed in April, 1994, to all GPs and community pharmacists in contract with a local family health services authority (St Helens and Knowsley), an area covering 350,000 people. Replies were received from 60 per cent of the GPs and 84 per cent of the pharmacists. There was general agreement between the doctors and the pharmacists in their attitudes towards prescribing, and agreement that the quality of prescribing was a legitimate subject of concern for local health authorities. The role of community pharmacists was the main area of disagreement, with the GPs generally being more conservative while the pharmacists favoured a wider role. The professions shared a concern to improve the quality of prescribing, and about one third believed that a substantial amount of prescribing was of poor quality. A substantial minority of each profession had little contact with the opposite numbers from the other profession: 43 per cent of doctors had met a pharmacist fewer than four times in 1993.
We present evidence of general agreement between the professions on a wide range of issues concerning the quality of prescribing in the community. However, if UK pharmacists are to achieve the wider role they and the government desire, the concerns of GPs need to be addressed.
Researching change — methods for community practice research
Authors: Savage I T 
Published: February 2011

Abstract
Most of us wonder what pharmacy practice will look like as the millenium comes round. But how can we study what is happening in our profession? “Researching change” was the theme of the 9th Social Pharmacy Workshop, held at the University of Wisconsin-Madison in America, from August 10 to 14. This report summarises some of the research methods discussed at the conference.
Implementation of a patient-orientated pharmacy service
Authors: Eadon H J , Batty R , Beech E F 
Published: February 2011

Abstract
In 1994, the clinical pharmacy service at Harefield hospital was reorganised: the inpatient population was divided into five groups based on the directorate system and each group allocated to a pharmacist. Each pharmacist became responsible for the provision of a clinical pharmacy service to their group of patients, irrespective of the ward on which the patients were resident. This was a major change from the previous system where pharmacists visited a number of wards and saw all the patients on those wards. The effect of the reorganisation on pharmacists' activities, customers' satisfaction, pharmacists' job satisfaction and the supply of inpatient medication was measured. The change had minimal impact on the majority of parameters measured but significantly increased the time taken by pharmacists to carry out their rounds. The extra time commitment may be justified by the opportunities this method of organisation offers for the development of total pharmaceutical care.
A study of the appropriateness of prescribing in nursing homes
Authors: Lunn Jennifer , Chan Kelvin , Donoghue John , Riley Brian , Walley Tom 
Published: February 2011

Abstract
A study carried out in five nursing homes and 13 general practitioner practices in the North West National Health Service region investigated medicine use in the homes and assessed the extent of inappropriate prescribing using consensus derived criteria. A review of the medical and nursing records of 101 residents showed that they were using a total of 714 items (mean 7.1; range 0 to 15), of which 659 were medicines, including 51 dressings, and 55 were other items such as stoma products. When criteria for inappropriate prescribing were developed and applied, 54 (53 per cent) residents were judged to have one or more inappropriate prescriptions. Medicines most frequently associated with inappropriate prescribing were those for the cardiovascular system (57 per cent of inappropriate prescriptions) and the central nervous system (17 per cent); diuretics accounted for 41 per cent of all inappropriate prescriptions. However, these results may not be representative of the true level of inappropriate prescribing. Of the eight GPs who filled in a questionnaire, five had a system for regularly reviewing drug treatment for nursing home residents; all considered that nursing home residents could benefit if pharmacists were to support GPs by offering advice about individual residents' drug treatment.
Elderly residents in nursing homes are at high risk of inappropriate prescribing. A role for pharmacists in the monitoring of individual residents' prescriptions, in academic detailing or in guideline development could help in improving the quality of prescribing for nursing home residents.
Role of pharmacies and general practitioners in the management of dermatological conditions
Authors: Kilkenny Monique , Yeatman Josephine , Stewart Kay , Marks Robin 
Published: February 2011

Abstract
Interviewers in the three community pharmacies in Maryborough, Central Victoria, Australia, collected data over four weeks from 830 people obtaining 1,011 skin related products. At the same time, the general practitioners in the area recorded all patients seen with skin related conditions, the management they required and the diseases for which they were treated. Over 70 per cent of the products obtained were non-prescription items, the sources of recommendation for these being pharmacy staff (39 per cent), family (27 per cent), medical practitioner (19 per cent) and other sources (15 per cent). Purchasers of one-third of the OTC products had already sought advice at some stage from their medical practitioner; 57 per cent of these products were subsequently bought on advice from sources other than their medical practitioner. For 34 per cent of the OTC purchases the consumers had described their symptoms to pharmacy staff, and in one third of these the consumer had at some stage seen a medical practitioner about the condition. Of those who described symptoms within the pharmacy, 55 per cent were seen only by a pharmacy assistant, the remainder being seen at some stage by the pharmacist. More consumers with inflammatory skin diseases purchased an OTC product from a pharmacy than visited their GP. All people with suspected neoplasms consulted a GP rather than a pharmacist. Education programmes are required to ensure that pharmacists have adequate knowledge of the conditions for which OTC skin products are available. Public education is required to ensure that consumers who seek advice for skin disease in the pharmacy do so from the person in that environment who is appropriately qualified to give it.
Pharmacists' perceptions and experiences of pharmacy protocols: a step in the right direction?
Authors: Cantrill J A , Weiss M C , Kishida M , Nicolson M 
Published: February 2011

Abstract
A postal questionnaire to 300 pharmacists in Lancashire, investigating community pharmacists' perceptions of the usefulness of medicine sales protocols, was completed by 138 (46 per cent). Almost all of the respondents (96 per cent) stated that they used protocols in their place of work. Of the 95 respondents who indicated the frequency with which customers were unwilling to answer questions, 94 per cent stated this frequency was at least one in every 10 customers. Examples of customers who were sometimes unwilling to answer questions included some who had used the medicine previously, some with a condition of a sensitive nature and some purchasing on behalf of a third party. Although the majority of respondents were positive towards the impact and future development of protocols, 37 felt protocols required modification and greater flexibility. Comments suggested that protocols could both enhance the professional image of pharmacy and be professionally restrictive. Protocols should be developed which reflect both the patient, as well as the professional, perspective.
Identification and costs of prescriber-defined repeat prescribing
Authors: Davidson William , Collett John H , Jackson Clive , Rees Judith A 
Published: February 2011

Abstract
The use of different definitions of repeat prescribing has, understandably, resulted in different published values of both numbers of prescriptions and their costs. One possible way of determining the number of repeat prescriptions would be to allow prescribers to self-identify prescriptions at source. However, the cost of repeat prescription items only becomes a tangible cost if, and when, the patient has the prescription dispensed. The aim of this work was to allow prescribers from six general practices in one family health services authority to self-identify repeat prescriptions. Only those prescriptions presented for dispensing were analysed and costed. Out of a total of nearly 54,000 prescription items, 29.4 per cent were identified as repeats; they accounted for 32.2 per cent of the total cost of the prescriptions. Overall, the average cost of repeat prescription items was higher than that for new prescription items.
The approach used in this work is a novel method of identifying, quantifying and determining the extent and costs of repeat prescribing in a study population. The limitations of the method are discussed.
In vitro evaluation of the complexation of non-steroidal anti-inflammatory drugs with caffeine
Authors: Gerber Jan J , Villiers Melgardt M , Toongsuwan Siriporn , Liebenberg Wilna 
Published: February 2011

Abstract
The complexation of five non-steroidal anti-inflammatory drugs (NSAIDs) with caffeine was evaluated. Mixtures were prepared by powder mixing, trituration in a mortar with a pestle and recrystallisation from a common solvent. The properties of the mixtures and the recrystallised materials, evaluated by differential scanning calorimetry (DSC) and dissolution rate measurements, differed significantly (P&lt;0.05). Disappearance of peaks in DSC thermograms, or lowering of melting points of the NSAIDs in NSAID-caffeine co-precipitates were ascribed to the complexation of caffeine with the NSAIDs. The dissolution rate of ketoprofen was not affected by the addition of caffeine but the dissolution rates of ibuprofen, mefenamic acid, naproxen and indomethacin were significantly enhanced (P0.05) after being co-precipitated, or mixed in a mortar or V-blender, with caffeine. Higher dissolution rates, because of the complexation of caffeine and the drugs in solution, could translate into changed bioavailability and different pharmacokinetic parameters.
Less gastrointestinal irritation and quicker onset of required blood levels might improve the efficacy of NSAIDs, a factor that, if confirmed, should be considered when prescribing these drugs to patients.
Opinions and practices with regard to confidentiality in French hospital pharmacies
Authors: Auguste V , Guerin C , Hazebroucq G 
Published: February 2011

Abstract
During the past 10 years, the profession of hospital pharmacy has undergone radical changes in France. These include changes in laws and regulations, the development of activities related to clinical pharmacy and direct contact with patients. Situations now arise where the pharmaceutical team has access to personal data and is confronted with problems concerning confidentiality.
An inquiry designed to highlight the problems and study pharmaceutical practice was conducted by interviewing 15 hospital pharmacists. The interviewees represented a variety of grades and came from hospitals of different sizes, with different specialisations. Although the small number of interviewees did not allow us to draw quantitative conclusions, their replies were of great interest. The work shows the need to revise present practice in order to preserve confidentiality. Such revision calls for collective discussion and decisions, based on the pre-eminence of ethics respecting the individual. This investigation forms a preliminary phase for a more ambitious larger scale investigation.
HEALTH SERVICES RESEARCH METHODS IN PHARMACY: Survey research: (1) Design, samples and response
Authors: Smith Felicity 
Published: February 2011

Abstract
Social survey methodology is the most widely used approach by pharmacy practice researchers, accounting for a higher proportion of published papers than any other. Survey techniques have been used to address a range of research objectives in a variety of populations and settings.
Extensive hand searches of published survey research have enabled a review of the issues and problems that social survey research presents when applied in pharmacy settings, and an exploration of how they have been addressed. This review is in two parts. This first part focuses on the research questions that have been addressed by survey methods, design of the studies, sampling frames and procedures, response rates and management of non-response. A second paper will discuss the development of survey instruments, and the issues of validity, reliability and generalisability.
Drug pushers or health care professionals: the public's perceptions of pharmacy as a profession
Authors: Varnish John 
Published: February 2011

Abstract
This study explores the extent to which consumers view pharmacy as a fully fledged profession that commands and fulfils a legitimate role in the primary health care team, or alternatively as just another retailer in the high street who happens to sell drugs instead of newspapers.
The data were generated through the use of five focus groups involving a total of 23 participants. These group discussions were tape-recorded and transcribed. The resulting data were analysed using the definitions of “professions” and “professionalisation” as found in the sociological literature. The results may be seen by the profession as very encouraging. While there are a few grey areas in the lay public's understanding of pharmacy, the overall feelings expressed were ones of recognition of the profession, understanding of its area of expertise, and support for the role it is playing.
Reviewing Repeat Prescribing — General Practitioners and Community Pharmacists Working Together
Authors: Goldstein Ruth , Hulme Helen , Willits Judy 
Published: February 2011

Abstract
In the United Kingdom, patients receiving medication to treat chronic conditions frequently obtain treatment via repeat prescriptions. This reduces the workload of general practitioners (GPs) but increases the potential for patients to receive inappropriate and unnecessary medication over long periods of time. The aim of this project was to determine the potential role that community pharmacists could fulfil in reviewing and rationalising medication received on repeat prescriptions. Volunteer pharmacists and general practitioners in two health authorities in England formed 47 GP-pharmacist partnerships. Each GP identified up to 50 patients receiving six or more “repeat” medicines. Pharmacists reviewed GP notes and record systems to identify potential problems. Discussions addressing the identified problems and possible solutions were held between the GP-pharmacist partners. Three months later the pharmacists revisited the surgeries to review GP notes to determine whether changes had occurred. On completion of the project, focus groups were held with participating GPs and pharmacists to ascertain their views on the project. In total, repeat prescriptions for 1,564 patients were investigated which resulted in 13,194 medicines being reviewed. The pharmacists identified 9,762 potential “problems” of which the most common were: drugs no longer required, inappropriate quantity ordered, and unsatisfactory directions. The GPs agreed with 58 per cent of identified problems and acted upon 56 per cent of these (32 per cent of the original total). In general, the involvement of pharmacists was beneficial in terms of rationalising prescribing and reducing possible drug interactions and adverse drug reactions resulting from multiple supplies of potentially inappropriate and unnecessary medication. Furthermore, pharmacists were able to rationalise patients' supplies to help improve the actual management of medication in terms of ordering and collecting supplies and coping with complex daily regimens.
Personal learning outcomes of structured work-based learning in a summer vacation work placement in community pharmacy
Authors: Rees J A , Collett J H , Crowther I , Mylrea S 
Published: February 2011

Abstract
If work-based learning is to become an acceptable and accredited part of an undergraduate course, it is essential to incorporate assessment methods in order to measure the students' learning outcomes. Learning outcomes can be subject based or personal. The development of intra- and interpersonal skills by students as a result of work-based learning would lend credit to such learning. This paper describes the methods used to assess the development of students' personal learning outcomes as a result of participation in structured work-based learning activities in a vacation training programme in community pharmacy. Overall, quantitative and qualitative results show that, during work-based learning, the students were able to develop personal skills such as communication, teamworking, motivation, confidence, professional attitudes and decision making. The development of some of these skills would be difficult to achieve in the academic environment.