bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preliminary findings from an economic analysis of nurse prescribing
Authors: Ferguson Brian , Luker Karen , Smith Kirsteen , Austin Lynn , Hogg Cath 
Published: February 2011

Abstract
A study was carried out to examine the economic and qualitative aspects of nurse prescribing for patients, carers, nurses and other health care professionals. The design was a case study, without controls or randomisation, and involved patients, nurses, general practitioners and other health care professionals in GP fundholding practices, one in each region of England, that were designated by the Department of Health as demonstration sites for nurse prescribing. This paper reports the data from the economic analysis. The main outcome measures were changes in the frequency and cost of prescribing compared with a range of scenarios, and the impact on health professionals' time.
There was no evidence to suggest that prescribing costs in the eight demonstration sites increased more than they would have done in the absence of nurse prescribing. It is relatively safe to conclude that the impact on prescribing costs in those sites was neutral. The range of uncertainty around the first-year costs in the demonstration sites is nevertheless high, in the order of £240,000.
Further work is required to identify the economic impact of nurse prescribing with a larger sample of practices, to assess whether prescribing costs will be contained (preferably in relation to a control sample) and whether notional time savings are cash-releasing. Research is also needed to shed light on questions of appropriateness and effectiveness of prescribing.
Shared care: a study of patients' experiences with erythropoietin
Authors: Ashcroft Darren M , Clark Christine M , Gorman Sean P 
Published: February 2011

Abstract
A study was carried out to evaluate the impact of a shared care scheme on patients receiving erythropoietin treatment. A structured, self-administered questionnaire was given to adult patients receiving recombinant human erythropoietin. Completed questionnaires were received from 86 of 119 patients (72 per cent). Thirty respondents reported problems with administration. Reports of pain were significantly higher from those patients receiving Eprex than those using Recormon (P = 0.01, χ2 test). Doses were missed occasionally by 27 patients (31 per cent) and frequently by two patients. Supply problems had resulted in missed doses for 15 respondents (17 per cent). Eleven patients claimed that their general practitioner (GP) had not been aware of dosage adjustments initiated at the hospital. Thirty respondents (35 per cent) stated that they would like to speak to a pharmacist about their treatment.
In conclusion, the shared care scheme was effective and practical for most patients. However, some difficulties were identified. Problems involved administration, concordance, supply, and communication of dosage adjustments. Furthermore, there was a general lack of information about the treatment among many patients.
Medicines counter assistants: roles and responsibilities in the sale of deregulated medicines
Authors: Ward Paul R , Bissell Paul , Noyce Peter R 
Published: February 2011

Abstract
The work reported here aimed to quantify the involvement of medicines counter assistants (MCAs) in the United Kingdom in the sale of deregulated medicines and to provide insights into their role and experiences in this process. Non-participant observation for five days in each of 10 community pharmacies was used in conjunction with interviews and focus groups with MCAs working in these pharmacies. It was found that MCAs dealt with 84 per cent of the deregulated medicines requested, without the formal involvement of a pharmacist. MCAs dealt with 96 per cent of requests for aciclovir, and 100 per cent of requests for cetirizine, Canesten Combi, famotidine, hydrocortisone cream and topical ibuprofen without the intervention of a pharmacist. MCAs viewed themselves as front-line health care workers carrying out an important role in consumer care. However, in instances where difficulties were encountered during an MCA-consumer interaction, MCAs knew and appreciated that they had the backup of a pharmacist to whom to refer. MCAs identified a number of dilemmas which impinged on their ability to ask questions and provide advice to consumers requesting deregulated medicines. Given these findings, the current role, workload and experiences of MCAs merit more attention than has hitherto been accorded in pharmacy practice and health services research.
The long-term learning effect of training in stage of change for smoking cessation: a three-year follow up of community pharmacy staff's knowledge and attitudes
Authors: Sinclair Hazel K , Bond Christine M , Lennox A Scott 
Published: February 2011

AbstractObjectiveA randomised controlled trial has already demonstrated that a training workshop on smoking cessation counselling for pharmacists and their assistants, based on the stage of change model, had a positive effect on the knowledge and attitudes of pharmacy personnel for at least a year, and was associated with increased and more useful counselling, and higher smoking cessation rates. An extension of the study aimed to monitor the duration of the training effect and so help to determine the optimum time span for refresher training. This paper reports the results of two further annual follow-ups.MethodA previously developed and validated self-completion questionnaire assessing knowledge and attitudes was re-administered to intervention and control personnel at 24 and 36 months. One hundred and thirty-four questionnaires were completed at 24 months (85 per cent response rate) and 124 (83 per cent) at 36 months.SettingCommunity pharmacies in Grampian, Scotland, United Kingdom.Key findingsThe training had a significant effect on knowledge for at least three years, since at both 24 and 36 months the intervention pharmacy teams had a significantly greater knowledge and understanding of the model than the controls (24 months, P=0.0001; 36 months, P=0.031). At 24 months, the intervention pharmacy teams were significantly more confident in their ability to counsel smokers (P=0.021) and were more positive about the outcome of smoking cessation counselling provided in community pharmacies (P=0.043). These attitudinal differences were no longer statistically significant at 36 months.ConclusionThis study has demonstrated the long-term benefit of the stage of change training over a three-year period, for both community pharmacists and their staff, on knowledge and attitudes.
National and local guidance on services for drug misusers: do they influence current practice?— results of a survey of community pharmacists in South East England
Authors: Sheridan Janie , Strang John , Lovell Selena 
Published: February 2011

Abstract

Objective
To investigate levels of awareness of national and local guidance about services for drug misusers and their effect on pharmacy practice.

Method
A postal survey in 1997 to collect data on current involvement in services for drug misusers, awareness of and receipt of key documents pertaining to drug misuse, effects of guidelines and protocols on practice, and influences on decisions to provide services.

Setting
A random one in two sample (n=1,582) of community pharmacies in the South East of England (North and South Thames regions).

Key findings
A 65.1 per cent response rate was achieved. Just over half (54.7 per cent) were dispensing Controlled Drugs for the management of dependence, 47.2 per cent were selling clean injecting equipment and 15.5 per cent were offering a needle exchange service. Most respondents were unaware of key government documents, with the exception of “Health of the nation,” and only a small minority had received copies. The most influential factors on current position on service provision were “personal experience,” “local need” and “Royal Pharmaceutical Society of Great Britain (RPSGB) policy.” New local guidelines and initiatives mainly related to supervised consumption of methadone in pharmacies and pharmacy needle exchange.

Conclusion
Community pharmacies are substantially and increasingly involved in providing*** primary care services for drug misusers. However, there is a disturbing lack of awareness of key government initiatives, possibly due to the lack of dissemination of such documents. RPSGB policy as a key influencing factor points to an opportunity for the profession to take a more influential position.
The cost-effectiveness of intensive pharmaceutical intervention in assisting people to stop smoking
Authors: Sinclair Hazel K , Silcock Jonathan , Bond Christine M , Lennox A Scott , Winfield Arthur J 
Published: February 2011

Abstract

Objective
To assess the cost-effectiveness of intensive pharmaceutical intervention in assisting people to stop smoking.

Method
A randomised control trial was used to evaluate training of pharmacy personnel based on the “stage of change” model. All 76 non-city community pharmacies registered in Grampian were invited to participate. All intervention personnel were invited to attend the training. Control and intervention groups then recruited clients over a 12-month period. Detailed records were kept of the costs borne by the health service, pharmacies and clients. The effectiveness of the training was assessed by comparing the smoking cessation rates of the two groups at one, four and nine months.

Setting
Community pharmacies in the Grampian region of Scotland.

Key findings
Sixty-two pharmacies (82 per cent) were recruited. The training was undertaken by 94 participants (40 pharmacists, 54 assistants). A total of 492 clients (224 intervention, 268 controls) was recruited. Assuming that non-responders had lapsed, intervention subjects tended to be more likely than control subjects to report not smoking at each follow up. As reported previously, one-month point prevalence was 29.9 per cent intervention and 23.6 per cent control (P=0.12); four months' continuous abstinence was achieved by 16.1 per cent in the intervention group and 10.9 per cent of controls (P&lt;0.094) and nine months' continuous abstinence by 12.0 per cent in the intervention group and 7.4 per cent of controls (P&lt;0.089). The cost of producing one additional successful attempt to quit smoking by using intensive rather than standard pharmaceutical support was £300.

Conclusion
The intervention was associated with higher smoking cessation rates, confirming that community pharmacy personnel have the potential to make a significant, cost-effective contribution to smoking cessation.
Health Services Research Methods In Pharmacy
Authors: Smith Felicity 
Published: February 2011

Abstract
The aim of this paper is to review the methodologies employed by health service and pharmacy practice researchers in the evaluation of pharmacy services. The review is in two parts. Part 1 discusses the application of different study designs and frameworks in the evaluation of existing and innovative services and interventions; part 2, to be published in a later issue, will address the methods and measures employed in the evaluation process. The studies included in this review were selected to give examples of different study objectives, designs and frameworks and their application in pharmacy settings. Although many of the issues regarding study design and evaluation frameworks may be relevant to clinical trials comparing the efficacy of alternative drug therapies, the focus of this paper is on pharmacy services.
Patient awareness of the adverse effects of aspirin and non-aspirin non-steroidal anti-inflammatory drugs
Authors: Wynne H A , Dorward M 
Published: February 2011

Abstract

Objective
To determine the extent to which patients reported having been informed about the adverse effects of aspirin and non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs)

Method
Questionnaire survey of 26 patients who had suffered an acute gastrointestinal bleed while taking aspirin, and 100 patients who had suffered an acute gastrointestinal bleed while taking a non-aspirin NSAID

Setting
Admissions to three United Kingdom hospitals. Patients were identified from endoscopy clinic records

Key findings
Five (19 per cent) of the aspirin-treated patients and 45 (45 per cent) of the non-aspirin NSAID-treated patients remembered having been informed of potential adverse effects, an odds ratio of 3.4 (95 per cent confidence interval 1.2–9.8, P&lt;0.05). Five (19 per cent) of the aspirin-treated patients recalled having been advised what to do should adverse symptoms develop, whereas 44 (44 per cent) of the non-aspirin NSAID-treated patients did so, an odds ratio of 3.3 (95 per cent CI 1.2–9.5, P&lt;0.05). Three (12 per cent) of aspirin-treated patients reported having been given an information leaflet, whereas 29 (29 per cent) of non-aspirin NSAID-treated patients did so, an odds ratio of 3.1 (95 per cent CI 0.9–11.2, P=0.08)

Conclusion
Our results suggest that aspirin-treated patients are less informed about their drug than are patients taking non-aspirin NSAIDs, in spite of the risk of gastrointestinal bleeding with which aspirin is associated
Developing and evaluating a model for pharmaceutical care in Australian community pharmacies
Authors: March Geoff , Gilbert Andrew , Roughead Elizabeth E , Quentrell Neil 
Published: February 2011

Abstract

Objective
To develop and evaluate a medication management service. The service was based on the principles of pharmaceutical care and targeted patients at risk of medication misadventure, primarily elderly patients, in five community pharmacies.

Methods
In phase one, pharmacists defined the service in consultation with consumers, medical practitioners and professional pharmacy organisations. Agreed characteristics of the service were: patient selection criteria, a structured patient care process, systematic documentation, a quality assurance process and a complementary relationship with services of other health professionals. Implementation and evaluation of the service occurred in the second phase. The service was provided over an 11-month period to 205 patients.

Key findings
Of the patients who received the service, 179 (87 per cent) had one or more medication or health-related problems. Pharmacists identified a total of 526 problems. Follow-up was available for 432 problems and 75 per cent of these problems were well managed by the end of the study. Of the 115 consumers surveyed, 74 responded. Eighty-five per cent of respondents believed the service had made a “significant” or “great” contribution to their health and 64 per cent thought that their knowledge of their medication had improved. Health economic evaluation indicated that net cost benefits were delivered to the health system. The net annual cost savings per patient ranged from $A40 to $A311.

Conclusion
Pharmacists were able to apply the principles of pharmaceutical care to meet the needs of at-risk consumers in the community. Further development of this service delivery model is under way and would appear to offer substantial advantages to consumers and the health system.
Adverse drug reaction monitoring by United Kingdom hospital pharmacy departments: impact of the introduction of “yellow card” reporting for pharmacists
Authors: Green Christopher F , Mottram David R , Rowe Philip H , Brown Adrian M 
Published: February 2011

Abstract

Objective
To assess the impact of the introduction of hospital pharmacist “yellow card” adverse drug reaction (ADR) reporting on the operation of local schemes.

Method
Prepiloted postal questionnaire sent to hospitals in 1998 following up a previous survey two years earlier.

Setting
Clinical services managers for 200 hospital pharmacies that had been randomly selected for the previous survey.

Key findings
One hundred and fifty usable questionnaires (75 per cent) were returned. Twenty-eight departments (18.9 per cent), compared with 26 departments (15.1 per cent) in 1996, operated ADR reporting schemes. Of a total of 440 local ADR reports made to participating departments, 70.0 per cent (312) were forwarded to the Committee on Safety of Medicines, a significantly higher percentage than the 14.9 per cent in the previous study (P=0.001). Only eight hospitals (5.4 per cent) had schemes for monitoring newly marketed or “black triangle” drugs. Ninety-four departments (62.3 per cent) had supported education and training activities. Of the hospitals without a scheme, 15 (12.5 per cent) said they had definite plans to introduce one in their hospital, 40 (33.3 per cent) had probable plans to introduce one and 65 (54.2 per cent) had no such plans.

Conclusion
Pharmacists' involvement in the CSM yellow card scheme appears to have had little impact on local initiatives. In areas where these local schemes have been implemented and educational activities provided, drug information pharmacists appear to have a significant role. From the results of this study, even in hospitals with local or in-house schemes, gross under-reporting of ADRs remains a major problem.
Motivations for and barriers to community pharmacy services for drug misusers
Authors: Matheson Catriona , Bond Christine M 
Published: February 2011

Abstract

Objective
To investigate what motivated pharmacists to provide drug misuse services and, conversely, what barriers prevented service provision.

Method
Telephone interviews were conducted with a purposive sample of 45 volunteering respondents to a national questionnaire survey to gain in-depth information.

Setting
Forty-five community pharmacists in Scotland.

Key findings
Pharmacists were found to be motivated to provide services by an awareness of the needs of the community, a desire to reduce the spread of blood-borne diseases and a desire to expand their professional services. Barriers to service provision were concerns for the effect on other customers, safety, workload and poor remuneration.

Conclusion
The active encouragement of local health boards, professional endorsement, further education and remuneration might encourage pharmacists' participation in drug misuse services. This would enable the principles of harm reduction to be widely practised.
Qualitative insights into general practitioners' views on the appropriateness of their long-term prescribing
Authors: Cantrill Judith A , Dowell Janey , Roland Martin 
Published: February 2011

Abstract

Objective
To explore factors which may contribute to inappropriate long-term prescribing in United Kingdom general practice.

Methods
Nine previously validated indicators of the appropriateness of long-term prescribing were applied to a sample of patients, each under the care of one of 22 general practitioners from 10 practices. The GPs were then interviewed, using as the basis for the discussion specific examples of their prescribing that had been identified as potentially inappropriate. The interview transcripts were studied repeatedly to identify key themes in the reasons or explanations for apparently inappropriate prescribing.

Setting
General practices in three health authorities in England and one health board in Scotland.

Key findings
In total, 227 instances of potentially inappropriate prescribing, relating to 101 patients, were discussed with the 22 GPs. Four key themes emerged from the interview data. One common theme was that of perceived patient preference to continue with long-term therapy. A second theme was cases where the prescribing was “historical,” ie, the drug had been started a long time before, or by another doctor. Within this context, many doctors expressed great reluctance to change a drug when there was no obvious clinical need to do so, even though they would not initiate the drug regimen within their current practice. A third theme was that “hospital-led” prescribing was perceived to pose frequent and sometimes potentially difficult problems. Fourth, many GPs expressed their unease with the process of repeat prescribing which is operated in many UK practices.

Conclusions
This study has reinforced the fact that there are a number of internal and external factors which can impact on a GP's decision to continue apparently inappropriate long-term prescribing.
Drug-related problems in the elders of the British Virgin Islands
Authors: Titley-Lake Carla , Barber Nick 
Published: February 2011

Abstract

Objective
To explore the extent of drug-related problems in elderly patients in the Caribbean.

Methods
Comprehensive medication reviews were carried out on a 1 in 20 sample of the elderly population of the British Virgin Islands, a UK dependent territory located in the Caribbean. Fifty non-institutionalised patients, 65 years or older and taking at least one prescribed medicine, were interviewed for the study.

Key findings
On average, 4.5 prescribed medications, 4.7 over-the-counter preparations and 3.3 herbal remedies/natural products were used by the sample. A mean of 5.9 potential drug-related problems per patient were identified and a mean of 3.7 complications relating to the sub-optimal use of medicines per patient were observed.

Conclusion
This study has highlighted the need for a multidisciplinary review of the prescribing, dispensing and monitoring of elderly patients receiving prescribed medications. The pharmacist has a role to play in helping prescribers achieve this review, and in educating patients in ways in which they can get the best out of their medicines.
Student assessment of postgraduate clinical pharmacy programmes in the United Kingdom (2): results of the course experience questionnaire
Authors: Quinn John , Bates Ian , Cox Roy 
Published: February 2011

Abstract

Objective
The principal objective of this paper was to use the course experience questionnaire (CEQ30) instrument to compare and evaluate aspects of provision of postgraduate clinical pharmacy programmes available through institutions of higher education in the United Kingdom.

Method
A postal survey, using the CEQ, of graduates from clinical pharmacy postgraduate programmes. Cases were subject to factor analysis, comparative statistics and regression analysis to describe differences between aspects of programme provision.

Setting
Graduates from 10 different postgraduate clinical pharmacy programmes in the UK since 1990 were surveyed. A total of 511 questionnaires were distributed and 364 were returned (72 per cent).

Key findings
Significant differences between institutions were identified in key factors of student-evaluated aspects of higher education. Factors were generally rated low by respondents. Some programmes appear more likely to encourage surface approaches to learning rather than deep learning. Analysis of factor scores enabled a ranking table to be drawn up for the postgraduate programmes included.

Conclusions
Evaluation of individual programmes shows differences in rating of aspects of provision. There is scope for postgraduate clinical pharmacy programmes to improve. The study findings raise the question of whether these differences in the learning experience may affect the quality of clinical pharmacy graduate.