bluuebunny/crossref_metadata_2025_split huggingface dataset:
Droperidol with patient-controlled analgesia
Authors: Bishop L , Madej T H , Wheatley R G , Jackson I J B , Blackburn A 
Published: February 2011

Abstract
The addition of droperidol 5mg to the first 50ml of morphine 1mg/ml was compared with morphine alone in 60 patients receiving postoperative analgesia via a patient-controlled analgesia (PCA) system. All patients underwent an abdominal hysterectomy and had a standard anaesthetic which included 2.5mg of droperidol. They were followed up daily for three days postoperatively. The PCA with additional droperidol group received half the number of supplementary antiemetic doses (P&lt;0.05). There was no difference in the incidence of emetic sequelae or reported side effects. Prophylactic droperidol with PCA morphine reduces the need for further intramuscular antiemetic treatment.
Comparison of salbutamol inhalers available in the United Kingdom
Authors: Lee M Gerard , Ireland Denis S , Dwyer Paul J , Weir Philip J 
Published: February 2011

AbstractA comparative assessment of salbutamol inhalers has shown that all licensed products currently available in the United Kingdom comply with the British Pharmacopoeia monograph for salbutamol pressurised inhalers and that there are no clinically significant differences between the various generic brands. Differences were observed between the colours of the inhalers which may cause confusion for patients. Generic manufacturers have been advised of this and say that they will be altering the design and appearance of some brands to ensure that the colour of the inhaler and the design of the mouthpiece will be consistent.
Response to dysmenorrhoea: An assessment of pharmacists' knowledge and its application in practice
Authors: Anderson Claire , Alexander Angela 
Published: February 2011

Abstract
A combination of covert participant observation and semi-structured interviews was used in 65 pharmacies to assess pharmacists' skills and knowledge in their response to the symptom of dysmenorrhoea. The pharmacists were found to ask too few questions; 12 per cent asked no questions. Over half the pharmacists did not recommend the product of choice. Few pharmacists adopted a structured approach when responding to the symptom. The disappointing results could relate to a number of factors, one of which, inadequate training, was cited in the interviews.
Hospital clinical pharmacy services provided to primary care
Authors: Cotter Siobhan M , Barber Nicholas D , McKee Martin 
Published: February 2011

Abstract
Recent changes in the United Kingdom national health service (NHS) have increased the need for pharmacy services in primary care. Government documents have advocated a role for hospital pharmacists in the provision of clinical pharmacy services to primary care. A census survey was carried out to establish the extent to which hospital pharmacists have become involved in the provision of clinical pharmacy services to primary care patients and health professionals. Questionnaires were sent to district pharmaceutical officers in England (and their equivalents in the rest of the UK). One hundred and ninety-three questionnaires were returned (92 per cent). Hospital pharmacists provided few advisory, educational or information services to patients and primary care health professionals, with the exception of primary care nurses. Pronounced variations in service provision were observed in different parts of the UK. Respondents gave reasons for their limited involvement and indicated that the provision of services is increasing.
The survey shows that government policy on the provision of hospital clinical pharmacy services to patients and health professionals in primary care has not been implemented. The provision of such service is, however, increasing, mainly as a consequence of the NHS reforms and the movement of resources to primary care.
Formulation and stability of pilocarpine oral solution
Authors: Fawcett J P , Tucker I G , Davies N M , Ferguson M M 
Published: February 2011

Abstract
The stability of four formulations of pilocarpine oral solution containing glycerol, hydroxybenzoate preservatives and lemon spirit was studied on storage for 90 days at 4, 25 and 38C using a stability-indicating high performance liquid chromatography assay. The solutions were prepared from pilocarpine hydrochloride powder (0.2 and 3mg/ml) in citrate buffer pH 5.5, or from eyedrops (3mg/ml) in citrate buffer pH 5.5 or phosphate buffer pH 7.5. Significant decomposition of pilocarpine occurred in the pH 7.5 formulation at all three temperatures. The data were adequately described by a first order model. Degradation in the pH 5.5 formulations was not significant over 90 days at 4C or 60 days at 25C. Decomposition at 38C was significant and adequately described by a zero order model. The lower 95 per cent confidence limits for 10 per cent decomposition were 36 days for the eye-drop formulation and 27 and 32 days for the 0.2 and 3mg/ml powder formulations respectively. Pilocarpine oral solution prepared from powder or eye-drops in pH 5.5 buffer is chemically stable for 60 or 90 days at 25C or 4C, respectively, and provides a stable dosage form.
Pharmacists: A resource for general practice?
Authors: Bond Christine M , Sinclair Hazel K , Taylor Ross J , Duffus Peter , Reid John , Williams Arthur 
Published: February 2011

Abstract
A postal questionnaire seeking the views of all Grampian general practitioners (n=314) to a proposed wider role for pharmacists obtained an 85 per cent response rate. The questionnaire consisted of prescribing related and general tasks compiled from the recommendations of the joint working party's report “Pharmaceutical care: the future for community pharmacy” and those identified by a local GP and pharmacist while working on a joint study.
The overall opinion of GPs was in favour of increasing the role of pharmacists. They were most likely to support a routine service for the disposal of unwanted medicines, provision of compliance aids under the NHS and a formal system for pharmacists to report adverse drug reactions. GPs were least likely to support the selection of medicine and dosage by a pharmacist following agreed protocols, an NHS funded pharmaceutical adviser within surgeries to counsel patients on the use of medicines, or the provision of diagnostic and screening services by pharmacists. It is concluded that there is a potential for the integration of the community pharmacist within the traditional primary health care team. Roles have been identified that are acceptable to GPs and which could bring job satisfaction to pharmacists, whose specialist knowledge of drugs is currently under-utilised.
Comparison of conventional metered dose inhaler and breath actuated inhaler in elderly patients
Authors: Hendry A , Coote J , Black H , Duncan G , MacDonald J B 
Published: February 2011

Abstract
Elderly patients frequently fail to achieve or to retain a competent inhaler technique using a conventional metered dose inhaler. In a prospective, randomised, crossover study of 44 subjects aged 64–94 (mean 78) years, we compared a metered dose inhaler (MDI) with a breath actuated inhaler (BAI) in terms of inhaler technique, ease of teaching and patient acceptability. Patients were stratified according to physical, functional or cognitive impairment before randomisation. Structured tuition was provided at the start of treatments, and technique was graded weekly and retaught if deficient. At the start of the treatment periods satisfactory technique was observed in 14 of 35 patients (six impaired, eight unimpaired) using the MDI and in 14 of 35 patients (three impaired, 11 unimpaired) using the BAI (P = 1.0). At the end of the four-week treatment periods satisfactory technique was observed in 19 of 30 patients (seven impaired, 12 unimpaired) using the MDI and in 27 patients (11 impaired, 16 unimpaired) using the BAI (P = 0.01). Mean weekly teaching times (minutes) were similar (MDI 7.0, BAI 6.5, P = 0.41) and there was no difference in terms of patient acceptability (P = 0.38). A breath actuated inhaler may be the preferred device for elderly patients as a greater proportion were able to retain satisfactory inhaler technique.
Risk reduction methods for self treatment
Authors: Charupatanapong Nawarut 
Published: February 2011

Abstract
Face to face interviews with consumers at shopping mails in Houston, Texas, sought to evaluate the helpfulness of nine risk reduction methods for self-treatment of three selected health problems (minor eye problems, overweight, and indigestion). Professional advice provided by pharmacists and loyalty to a brand used previously were rated as the two most helpful methods for self-treatment of all three health problems. There were no significant differences found in the evaluation of the nine risk reduction methods across any demographic factors for either overweight or indigestion. For minor eye problems, respondents who were separated, divorced or widowed rated the “shopping-around” and comparing brands more helpful than did those who were engaged. Those who had self-treating experience with overweight and indigestion rated brand loyalty more helpful than those who did not have any self-treating experience.
Overall, professional advice provided by pharmacists was rated as the most favourable risk reduction method for self-treatment for all three selected health problems. Consumers' self-treating experience may have an impact on their evaluation of the risk reduction methods.
Ward pharmacy services — is a once daily visit less efficient than a twice daily visit?
Authors: Beech E F , Barber N D 
Published: February 2011

Abstract
Ward pharmacy services are widely provided in hospitals throughout the United Kingdom. The objective of this study was to compare the efficiency of once daily with twice daily ward visits. Over a two week period, eight matched wards — four providing a twice daily service and four a once daily service — were assessed in three areas: time taken to provide the service, clinical pharmacy activity, and supply of non-stock items. A total of 120 ward pharmacy visits occurred during the 10 day study period. The mean total daily ward visit time was 55 minutes in the twice daily group compared with 40 minutes in the once daily group, a difference of 15 ± 7.6 minutes/ward/day. Pharmacists in the once daily group spent 52 per cent of time on clinical pharmacy activities and recorded 169 prescription monitoring incidents (PMIs). In comparison, pharmacists in the twice daily group spent proportionally less time on clinical pharmacy activities (42 per cent) and recorded significantly fewer PMIs (107). The proportion of non-stock items originating from the ward pharmacy service was similar in both groups. This study found a once daily ward pharmacy service more efficient than a twice daily service, saving an average of 15 minutes/ward/day.
Ethnic minority consumers of community pharmaceutical services
Authors: Jesson J , Sadler S , Pocock R , Jepson M 
Published: February 2011

Abstract
A survey carried out by the authors in the West Midlands area of England found that use of, and access to, community pharmaceutical services appeared to be lower among ethnic minority customers than in the majority population, although their needs were probably higher. The survey has been published in full elsewhere. In this article, the authors summarise the main results of their survey, and compare these with the results from a similar study involving respondents predominantly from the white population. They also discuss some of the methodological difficulties in carrying out research into ethnic minority health issues.
General medical practitioners' attitudes towards the use of patient medication records
Authors: Rogers Philip J , Rees John E 
Published: February 2011

Abstract
A survey was conducted to ascertain general medical practitioners' (GPs') attitudes to community pharmacists' use of patient medication records (PMRs) and to assess whether GPs envisage a role for family health service authorities (FHSAs) in maintaining records of patients' data.
The survey questionnaire was sent by post to all 1,257 GPs in contract with Avon and Devon FHSAs. A total of 811 questionnaires was returned, an overall response rate of 64.5 per cent. A majority (59 per cent) of GPs considered that community pharmacists should keep patient medication records and there was strong support for pharmacists holding PMRs for the elderly and confused, and also for patients with diabetes, asthma, epilepsy, and those patients who had experienced major adverse drug reactions or allergies. Some GPs, however, remained unconvinced of the usefulness of a pharmacy PMR. Seventy four per cent of respondents considered that patients should keep their own medication records. In contrast, only 4 per cent were in agreement with patient medication data being stored by FHSAs. The community pharmacist's role in maintaining PMRs received less support from doctors in dispensing practices than from their non-dispensing counterparts. Some 80 per cent of respondents were in favour of pharmacists providing PMR system-generated patient information leaflets with dispensed medicines. Most GPs considered that such leaflets had a positive effect on patient compliance. Recently registered GPs were found to be more supportive than their older colleagues of community pharmacists recording patients' clinical conditions and providing information leaflets.
Stability of ipratropium bromide and salbutamol nebuliser admixtures
Authors: Jacobson Glenn A , Peterson Gregory M 
Published: February 2011

AbstractThe physicochemical stability of an admixture of ipratropium bromide and salbutamol nebuliser solutions, 1:1 v/v, was determined by storing solutions for five days in a refrigerator at 4C, at 22C protected from light and at 22C under 24 hour fluorescent lighting. Concentrations of ipratropium and salbutamol were periodically determined using a high performance liquid chromatography assay. The nebuliser solution admixtures retained greater than 90 per cent of their original concentrations of ipratropium and salbutamol for the duration of the study. Differences in losses between storage conditions were not statistically significant.Admixtures of proprietary ipratropium bromide and salbutamol nebuliser solutions (1:1 v/v) retain greater than 90 per cent of their initial concentrations if stored between 4C and 22C for periods of up to five days. An expiry period of five days for these admixtures would seem reasonable in practice.
Stability of epidural opiate solutions in 0.9 per cent sodium chloride infusion bags
Authors: Grassby Paul F , Roberts David E 
Published: February 2011

Abstract
The stability of pethidine 2.5mg/ml, and of a mixture of bupivacaine hydrochloride 1.25mg/ml and diamorphine hydrochloride 125μg/ml, in 500ml 0.9 per cent sodium chloride infusion bags was determined. Samples of the solutions were stored uncovered at room temperature, exposed to natural and artificial light, for 24 and 28 days, respectively. No colour change, crystallisation or precipitation was observed, and although the mean pH of the bupivacaine and diamorphine mixtures increased slightly, the mean pH of the pethidine samples remained essentially unchanged. The only significant (P &lt; 0.05) change in potency was a reduction in diamorphine concentration by a mean of 8.22 per cent after 28 days, which is in accordance with other reports on diamorphine degradation.
Thus pethidine 2.5mg/ml in 500ml 0.9 per cent sodium chloride infusion bags is stable for at least 24 days at room temperature, and a mixture of bupivacaine hydrochloride 1.25mg/ml and diamorphine hydrochloride 125μg/ml in 500ml 0.9 per cent sodium chloride infusion bags is stable (less than 10 per cent loss of potency) for 28 days at room temperature. Both these solutions could, therefore, be prepared in pharmacy central intravenous additive units and supplied to hospital wards as 500ml infusion bags for use in epidural analgesia following surgery. As each bag would provide nearly three days' worth of analgesic, the risk of infection and the nursing workload should both be reduced.
Cumulative costs of inadvertent excess prescribing on multiple item prescription forms
Authors: Rees J A , Collett J H , Asher D M 
Published: February 2011

Abstract
Prescription forms listing more than one item, ie, multiple item prescriptions, may be termed non equivalent if the number of days' treatment prescribed for each of the drugs is different. Patients presenting such prescriptions at 15 community pharmacies were identified and records maintained of all prescriptions presented by these patients over a nine month period. The total amounts of drugs and number of days' treatment prescribed were identified and costed. A total of 53.5 per cent of the non-equivalent items were for amounts representing between one and five days' excess treatment. Excess treatment represented 13.9 per cent of the total cost of these prescriptions. The estimated national cost of inadvertent excess prescribing for 1991/92, based on a projected calculation, was £60m (2.4 per cent of the total expenditure).
Long term stability of heparin in dextrose-saline intravenous fluids
Authors: Wright Alex , Hecker John 
Published: February 2011

AbstractIn vitro studies showed that heparin added at liu per ml to 5 per cent dextrose solution lost most of its activity during 12 months' storage at both 20 to 25C and 2 to 5C but retained its activity when added to normal saline and to a 3.75 per cent dextrose-saline mixture at these temperatures. Activity of 10iu per ml of heparin in 5 per cent dextrose solution was retained at 20 to 25C for 12 months. These findings suggest that low-dose heparin is stable for long periods in dextrose-saline but not in dextrose solutions
Pharmacy practice research in the United Kingdom: which issues should shape future developments?
Authors: Cotter Siobhan M , Mays Nicholas 
Published: February 2011

Abstract
Pharmacy practice research (PPR) is a developing area of research in the United Kingdom. To date, most studies have been carried out in secondary care, although efforts have been made recently to encourage studies in primary care. The quality of PPR is variable and there have been few well-performed studies. It is likely that this has resulted from the relative novelty of PPR and the inexperience of the researchers. Studies have usually been performed on services at a single site and have been carried out in isolation from fellow researchers or university departments with appropriate expertise. Initiatives have been taken within pharmacy to improve the quality of PPR but the resources that are available, and hence the potential for improvement, are limited. In contrast, health services research (HSR) is a relatively well-established area of research in which related topics in the broader areas of health care are considered. Comparable methods could be employed to examine PPR and HSR topics. It is suggested that substantial improvements may be made in the quality of PPR by fostering long-term collaborative ventures between PPR and HSR.
Pharmacist intervention in an elderly care facility
Authors: Bellingan M , Wiseman I C 
Published: February 2011

Abstract
The effectiveness of a pharmacist-initiated drug regimen review (DRR) in reducing the incidence of drug-related problems (DRPs), such as drug interactions, additive adverse effects and duplicate therapy, in the elderly was investigated. The medication profiles of 85 patients aged over 65 years, in an elderly care facility in South Africa, were evaluated for potential DRPs. It was found that 77 per cent of the patients were receiving one or more drugs at a dose exceeding the recommended geriatric dose. Some 68 per cent were receiving six or more drugs. Potential drug interactions and duplicate therapy were identified in 64 per cent and 34 per cent, respectively. A total of 85 pharmacist-initiated recommendations was presented to seven medical practitioners over a period of 16 weeks. Of these, 66 (77.7 per cent) met with the approval of the prescribers. Statistical interpretation of results showed that the incidence of all DRPs declined significantly post-recommendation. The cost benefit of the study was clearly illustrated by a 41 per cent reduction in the incidence of polypharmacy (P&lt;0.01).
The Delphi and nominal group techniques in health services research
Authors: Cantrill J A , Sibbald B , Buetow S 
Published: February 2011

Abstract
This review examines two methodologies that are being increasingly used in health services research (HSR): the Delphi and nominal group techniques. The Delphi is a survey technique for decision making among isolated respondents while the nominal group technique (NGT) is a highly controlled small group process for the generation of ideas. Typical applications of the techniques are for the development of consensus guidelines or standards in areas where research based evidence is absent or inconclusive. We discuss methodological issues associated with these techniques, namely, sample size and composition, response rates, anonymity, feedback and consensus, and reliability and validity. We also illustrate the range of applications of the techniques in HSR, including pharmacy practice. Although not widely used to date, both methodologies are potentially valuable additions to the practice researcher's toolbox.
Dyspepsia treatment guidelines in general practice — an observational study
Authors: McKenzie J , Timoney A , Kirby-Jones S 
Published: February 2011

Abstract
An observational study of prescribing for dyspepsia, in Glasgow, used Scottish Prescribing Analysis (SPA) and Prescribing Information for Scotland Computer Programme (PRISMS) data to monitor the implementation of a set of locally produced guidelines on dyspepsia. The main outcomes measured were the proportion of cimetidine prescribed generically, the ratio of prescriptions for cimetidine and ranitidine, the number of prescriptions for omeprazole per 1,000 patients per month and the total number of prescriptions for tripotassium dicitratobismuthate (De-Nol) per month. The results suggest that the dyspepsia guidelines have been successfully implemented as there has been an increase in the proportion of cimetidine prescribed generically, an increase in the use of cimetidine as the H2 antagonist of choice and an increase in the use of the recommended triple therapy regimen to eradicate Helicobacter pylori infection from patients with peptic ulcer disease. This study shows that consensus guidelines on a common clinical condition can be widely accepted in primary care if appropriately designed, developed and implemented. Their implementation can be followed from routine prescription information.