bluuebunny/crossref_metadata_2025_split huggingface dataset:
Counterprescribing for ophthalmic conditions: a survey of community pharmacists
Authors: Hardy N , Hodgkins P , Luff A , Moughtin S , Elkington A 
Published: February 2011

AbstractAll 123 community pharmacies in the Southampton area were telephoned and the pharmacist invited to answer questions on the management of patients with ophthalmic conditions. Of those approached, 95 per cent (n=117) agreed to participate. The mean number of patients seeking advice on eye conditions was 14 per pharmacist per week. All but one pharmacist stated that they discussed the condition with the patient, and 97 per cent (n=114) examined the eye. Fifty-one per cent (n=60) did not feel qualified to touch the eye or lids while the remainder were prepared on occasion to carry out a contact examination. Only 6 per cent (n=7) had a pen-torch to aid examination. The most commonly counterprescribed products were Brolene drops and ointment, Otrivine-Antistin drops and artificial tear preparations. Sixty per cent (n=70) of pharmacists had no information available on the diagnosis and treatment of eye conditions and 88 per cent (n=103) said they would welcome more information. Ninety-six per cent (n = 112) routinely advised the patient to consult their general practitioner if the condition failed to resolve, the remainder advising attendance at the casualty department of the eye hospital. The study shows that community pharmacists are regularly consulted by patients with ocular pathology. Locally produced guidelines and education could lead to improved patient care.
Self assessment of health status and symptoms by cancer patients
Authors: Malone Margaret , Harris Adrian L , Luscombe David K 
Published: February 2011

Abstract
A study was carried out to assess the value and feasibility of using a short questionnaire to evaluate overall health status and common symptoms in cancer patients attending an outpatient clinic.
A cancer specific questionnaire (CSQ) was developed to assess the impact of cancer on overall health, appetite, energy, mood and pain. Patient ratings were compared with the doctor rating made at the same time. A pilot study was carried out in 20 patients to identify any practical problems associated with administration of the CSQ. Thirty patients deemed to be clinically stable were asked to complete the CSQ on two separate occasions to assess its reliability. Three hundred patients were recruited to the main study.
In the pilot study, the CSQ was found to be comprehensible and practical to use. Subjects required between two and five minutes to complete the CSQ. No statistically significant difference in any of the categories of the CSQ (chi-squared test, P&gt;0.05) was found in the 30 patients who completed the CSQ on two occasions.
In the main study, the majority (72 per cent) of patients considered their overall health status as fair to good. Appetite was rated as normal in 63 per cent of patients. Only 22 per cent of patients considered their energy status as normal. Fifty-two per cent of the patients rated their mood as normal. Fifty-seven per cent of patients had some degree of pain. There was no statistically significant difference (ehi-squared, P&gt;0.05) between doctor and patient ratings made on the same occasion in any category. Assessments matched closely in cases where there was no impairment in the category assessed. However, when there was some impairment doctor and patient agreement fell to less than 50 per cent.
The data obtained were useful in the identification of problems but did not provide sophisticated qualitative information regarding the nature of the symptoms. The information obtained from the patient could provide a focus for further discussion during the medical consultation.
Does a high workload decrease ward pharmacists' clinical monitoring?
Authors: Barber N D , Blackett A , Batty R 
Published: February 2011

Abstract
In Britain prescriptions are written on proforma charts kept by the patient's bed. Pharmacists generally visit wards daily to initiate supply of drugs and monitor prescription charts. We wished to compare this service across all acute hospitals in a British regional health authority.
Pharmacists (n=210) at 31 hospitals monitored 10,337 beds in 489 wards. The median beds/pharmacist ratio was 57 (first quartile 33, third quartile 68). The median time to check 100 prescription charts was 2 hours 49 minutes (first quartile 2 hours 21 minutes, third quartile 3 hours 27 minutes) and related to the ward specialty (Spearman's rs=0.78, P=0.013). Analysis of the 19 district general hospitals showed a positive correlation between time to monitor 100 beds and prescription monitoring incidents (PMIs)/100 beds/week (P=0.002) and a negative correlation between beds/pharmacist and PMIs/100 beds/week (P=0.003). Increasing a ward pharmacist's workload may lead to a decrease in their monitoring of appropriate prescribing. It is suggested that these measures may have some value as indicators of workload, clinical effectiveness and efficiency.
Therapeutic drug monitoring in community pharmacy — a feasibility study
Authors: Maguire T A , McElnay J C 
Published: February 2011

Abstract
A study was carried out to examine the feasibility of providing a community pharmacy based theophylline therapeutic drug monitoring service for asthma patients. Twenty-two patients attending 12 general practitioners (GPs) participated in the study. Their serum theophylline concentrations were measured and via the use of patient medication records an estimate of compliance with the prescribed dosage regimen was made. If the latter was satisfactory and the serum theophylline concentration was not within the target range of 10–20 μg/ml agreed with GPs, a computer program using Bayesian kinetic principles was used to calculate an appropriate dosage adjustment. This dosage adjustment was made after agreement was obtained from each patient's GP. Patients found to be non-compliant were counselled. Follow-up assessments were carried out after three and nine months; compliance was also assessed at 12 months. Eighteen per cent of patients had serum concentrations within the target range at the beginning of the study; this improved significantly (P&lt;0.05, chi-squared) to 72 per cent and 68 per cent at three and nine months, respectively. Compliance data also improved significantly (P&lt;0.01) over the study period, from a baseline of 59 per cent compliant to a final figure of 86 per cent. Both outcome measures indicate the value of the community pharmacy based monitoring service.
Reasons consumers do not ask for advice on non-prescription medicines in pharmacies
Authors: Taylor J 
Published: February 2011

AbstractReports in the literature indicate that consumers may hesitate to ask for advice when considering the purchase of non-prescription products in community pharmacies. Consumers observed purchasing products in 11 pharmacies without asking for advice were surveyed to ascertain why they did not do so. Of the 151 consumers who completed questionnaires, 145 indicated they had not wanted advice, mainly because they had used the product before or had received advice elsewhere on what to purchase. Only six consumers indicated that in fact they had wanted advice, but had hesitated to ask for it. Their main reason for not asking was that the pharmacist appeared too busy.
Nursing sisters' satisfaction with the pharmacy service — a survey
Authors: Newton S A , Black M 
Published: February 2011

Abstract
A questionnaire was sent to all nursing sisters in Hammersmith and Queen Charlotte's special health authority, a provider of specialist hospital services in London. They were asked for their overall impression of the pharmacy service and staff, for their opinions of specific services and for suggestions for improving the service. Eighty-six per cent of respondents thought the service was good, very good or excellent and 92 per cent thought the service was either the same or better than that of other hospitals in which they had worked.
Just under half the suggestions received were for service improvements related to supply of drugs stocked on the ward. The other main areas commented on were drug delivery, discharge medication and the pharmacy on-call service. The survey provided useful information about the pharmacy service and has enabled the department to implement some of the changes suggested as well as look at the feasibility of other improvements. It is intended to repeat this survey annually.
A community-based pharmaceutical care model for the elderly: report on a pilot project
Authors: Grymonpre Ruby E , Williamson Dawn A , Huynh Dieu H , Desilets Lynn M 
Published: February 2011

Abstract
This paper describes the development and pilot evaluation of a pharmacy consultation service for the elderly. The service is a comprehensive, community-based pharmaceutical care model which identifies drug-related problems in the elderly population. Eligible clients were 55+ years of age, taking two or more items of medication and non-institutionalised. The pharmaceutical care model involved home medication histories, drug therapy review, and consultation with physicians and individual clients. The service was evaluated through therapeutic outcomes monitoring, follow-up interviews with clients and questionnaires mailed to physicians. The 20 pilot clients had a mean age of 77 ± 7 years. They took a mean of 8.6 ±3.7 prescription drugs and 9.2 ± 7.9 non-prescription drugs. Potential and actual problems identified which could have adversely affected desired therapeutic outcomes included adverse drug reactions, untreated indications, suboptimal regimens, and improper drug selection. Sixteen of the 20 pilot clients participated in follow-up interviews. A reduction in the number of non-current labels was the only statistically significant difference noted between baseline and follow-up interviews. However, changes consistent with pharmacy recommendations were noted for almost all other drug-related problems identified. Questionnaires relating to 16 clients were completed by 15 physicians. Although the physicians agreed with 79 per cent of the recommendations, only 31 per cent of recommendations resulted in a change to the drug regimen. The majority of physicians surveyed rated the service as somewhat useful to very useful. The need for pharmaceutical review in this population is demonstrated by the number of drug-related problems identified. Although the model led to numerous positive outcomes, further research is required to evaluate the effectiveness of this proposed strategy.
General medical practitioners' perceived use of drug information sources with special reference to drug information centres
Authors: Clark J C , Gerrett D 
Published: February 2011

Abstract
This study reports the current perceived use of available sources of drug information for general medical practitioners. The sample frame, of 463 GPs practising in Derbyshire, England, on January 1, 1990, provided a 74 per cent response rate to a pre-piloted questionnaire. Two printed sources, the Monthly Index of Medical Specialities and the British National Formulary (BNF) plus one personal service, fellow colleagues, were by far the most frequently used. The estimated average minimum number of days per year on which personal information services were consulted was 28.51 days compared with 63.83 days for non-personal, printed sources. Thus, if GPs are to be guided by independent sources then the BNF must be considered a prime vehicle. Drug information centres (DICs) were ranked last with 56 per cent of GPs having consulted such a source within the previous year. Use of DICs could not be predicted from GPs' characteristics or demographic data. Interviews with 101 of 106 randomly selected GPs generally confirmed questionnaire findings. However, only 41 per cent perceived themselves as users of DICs. Collation of queries from two local centres showed 25 per cent were known to be users. From interviews, discrepancies were seen to arise from accessing DICs outside the sample frame boundary plus confusion of DICs with poisons centres and hospital pharmacy departments. Thus, for use of DICs, questionnaire techniques may be unreliable unless source definition is considered. If using DICs, GPs very significantly had lower concurrent use of community pharmacists, GP colleagues and hospital consultants for general drug information
Dimensions of pharmacists' preferences for cough and cold products
Authors: Emmerton Lynne , Gow David J , Benrimoj Shalom I 
Published: February 2011

Abstract
In Australia, purchases of cough and cold products have been found to involve pharmacists' recommendation more frequently than other minor health problems, but little information exists to explain pharmacists' preferences for cough and cold products. This report undertakes the preliminary step of identifying the underlying dimensions of preferences of this product group, using principal factor analysis of a range of potential influences on preference. Qualitative methods and review of the literature were used to develop a list of 42 influences on pharmacists' preferences for these products. A mail survey of 1,200 community pharmacists followed (response 66 per cent). Factor analysis reduced the 42 influences to seven factors, namely, advertising (variance explained, 13.65 per cent), non-scientific [product] (6.96 per cent), non-scientific [social] (4.70 per cent), financial (3.31 per cent), experience/economics (2.86 per cent), clinical (2.15 per cent) and restriction/ingredients (1.61 per cent) influences. These factors indicate the dimensions of preference and may be further analysed using multiple regression to determine their relative influence in explaining preference for specific products, enabling assessment of the appropriateness of product selection and the development of marketing strategies.
Costing inpatient drug treatment
Authors: Jenkins D , Cairns C , Dobson L , Barber N 
Published: February 2011

Abstract
The aim of this study was to examine costs of charted drugs by using three data capture techniques. Data were manually extracted retrospectively from drug charts for a stratified sample of 200 inpatient stays at each of two London hospitals — a teaching hospital (St George's) and a district general hospital (Kingston). Specialties where costing was not feasible were excluded. These were: intensive care, oncology, dermatology and paediatrics. Three costs were calculated: nonstock drugs administered (the capability of traditional pharmacy computer systems), drugs prescribed (the data captured by a basic computerised prescribing system) and drugs administered (the data captured by a drug administration recording system). Pharmaceuticals not prescribed on the drug chart, such as anaesthetics, contrast media and disinfectants, were not included.
At St George's 2,739 and at Kingston 2,843 prescription entries were recorded, amounting to costs of £2,940 and £2,327, respectively, for drugs administered. A range of £0.01 to £171 per patient (median £4.67) at St George's and £0.00 to £122.66 (median £2.88) at Kingston demonstrates a skewed distribution, with most patients incurring low costs. Non-stock drugs accounted for 21 per cent of the cost of drugs administered at St George's and 15 per cent at Kingston. Twenty-four patients incurred costs above £50, their non-stock drugs being a mean of 21 per cent of their total costs. The cost of drugs administered at both hospitals was found to be 95 per cent of the cost of drugs prescribed.
Computerised prescribing and drug administration recording systems would significantly improve cost allocation. However, it is unlikely that the expense could be justified on the basis of the low value of drugs received by most patients.
Therapeutic drug and biochemical monitoring in a community pharmacy: Part 1
Authors: Hawksworth Gillian M , Chrystyn Henry 
Published: February 2011

Abstract
A therapeutic drug and biochemical monitoring service within the primary health care sector could provide positive patient outcomes. We have evaluated the possibility of measurements being made by a community pharmacist. Simultaneous blood samples were taken from a finger prick and vein of 55 patients attending a hospital outpatient clinic. The plasma drug concentrations (digoxin, carbamazepine, phenytoin and theophylline) and biochemical parameters (creatinine, potassium and urea) of these finger prick and venous samples were measured in a community pharmacy using the Ames Seralyzer and Clinimate systems. Similar measurements of the venous samples were made by the biochemistry department of a local hospital. There was no significant difference between the concentrations of the two samples (finger prick and venous) measured in the community pharmacy or between the community pharmacy measurements and those carried out by the hospital biochemistry department. External and internal quality control by the community pharmacist was satisfactory. Interpretation of the measured drug concentrations showed that optimal dosing was achieved in only 58.3, 33.3, 50.0 and 28.3 per cent of patients prescribed carbamazepine, digoxin, phenytoin and theophylline, respectively. Interpretation of biochemical concentrations showed that 38.9 per cent of the patients monitored were either hypo- or hyper-kalaemic; 80 per cent of the monitored patients taking renally excreted drugs required a change in their drug management. Although the patients in this study were attending a hospital outpatient clinic, the results highlight the potential benefit of a therapeutic drug and biochemical monitoring service within the primary health care sector.
Therapeutic drug and biochemical monitoring in a community pharmacy: Part 2
Authors: Hawksworth Gillian M , Chrystyn Henry 
Published: February 2011

Abstract
Opportunistic blood samples, at appropriate times post-dose, were taken from patients presenting prescriptions at a community pharmacy. Measurement and interpretation of carbamazepine (19 patients), digoxin (23), phenytoin (13) and theophylline (51) plasma concentrations indicated that 63.1 per cent (12 patients), 47.8 (11), 84.6 (11) and 58.6 (30), respectively, of the patients could benefit from a change to their therapeutic management to provide plasma concentrations with the highest probability of efficacy and the smallest possibility of side effects. Changes in the therapeutic management of 22 out of 46 patients (47.8 per cent) were necessary because of their plasma potassium concentrations. Of these, 13 (28.3 per cent of the total) were hypokalaemic and their medication included diuretics with no potassium assistance. Nine patients (19.6 per cent) were hyperkalaemic and were taking either a potassium sparing diuretic or potassium supplements with their diuretics. Thirty three (70.2 per cent) of the 47 patients whose creatinine clearance was determined required a change to their therapy. These patients had some degree of renal impairment and, according to the British National Formulary, a dosage adjustment was justified. We have previously shown (in part 1) that accurate measurements of these therapeutic drugs and biochemical parameters can be made in a community pharmacy from plasma samples. The study reported here shows that community pharmacists can use clinical pharmacokinetic and therapeutic knowledge to recommend optimal therapeutic regimens. Liaison between community pharmacists and general practitioners could provide a therapeutic drug and biochemical monitoring service with patient and economic benefits.
Prescription errors detected by Swedish pharmacists
Authors: Claesson Cecilia B , Burman Kerstin , Nilsson J Lars G , Vinge Ellen 
Published: February 2011

Abstract
Prescription errors identified and dealt with by personnel at 36 Swedish community and hospital pharmacies during March, 1992, were analysed. During the study period, the participating pharmacies handled 76,956 prescriptions for 41,908 patients. All prescription errors, even minor ones, were registered. In total 32,132 errors were detected and reported, corresponding to an overall rate of 42 per cent. The most common error was omission of the purpose of the therapy. This type of error was found in 20,517 prescriptions (64 per cent of all noted errors). Most detected errors did not require any special intervention by the dispensing pharmacist. Errors of commission, which are potentially harmful to the patient, totalled 338 or 1 per cent of the errors. The most common of these was that the dosage form stated was incorrect. The pharmacists were able to resolve almost three-quarters of the errors that required intervention and dispense the elucidated or amended prescription.
Customer feedback as a tool for improving pharmacy services
Authors: Airaksinen Marja , Ahonen Riitta , Enlund Hannes 
Published: February 2011

Abstract
The quality of pharmacy services can be assessed by using both profession-based measures and customer feedback. The aim of this population-based survey (n=848) in Finland was to evaluate how well the existing service level matched customer expectations and to examine whether pharmacy-specific quality dimensions derived from recent service quality models were found in population-based data. The survey indicated that the Finns seemed to be very satisfied with the professional competence and trustworthiness of pharmacy personnel. The highest dissatisfaction was experienced with queuing times, privacy and time for customer-pharmacist interaction (40 per cent). Pharmacies also seem to have various opportunities to extend their services beyond traditional dispensing, especially in the field of patient counselling and diagnostic screening. The importance of customer-based feedback through surveys will grow in the future when trying to develop pharmacy services. This study shows that theoretical models of service quality dimensions are suitable for processing the data although the methodology needs further development.
The pharmacist's contribution to clinicians' ward rounds: analysis by the stages in the drug use process
Authors: Fletcher P J , Barber N D 
Published: February 2011

Abstract
Hospital pharmacists are increasingly becoming an integral part of the clinical team, with many pharmacists now attending clinicians' ward rounds. This exploratory study observed five pharmacists attending ward rounds in hospitals in South East England, each on two or three occasions. The pharmacists volunteered to take part in the study and consent was obtained from the clinicians in charge. Each round was observed, tape recorded and transcribed. The verbal contributions of each member of the team to the discussions of drugs were analysed and categorised using the stages of the drug use process.
The rounds involved 109 patients and there were 269 separate conversations involving medication. Of these, 135 were patient-specific drug discussions where therapy was reviewed; the pharmacists made proposals to start, stop or alter therapy in nearly half of these discussions. There was no review of therapy in 38 per cent of patients in the study, ranging from 0 per cent on a medical round, to 75 per cent on a surgical round. The pharmacists were particularly involved in selecting the most appropriate dose, stopping drug therapy, and monitoring drugs. The clinicians were more involved in initiating drug therapy. All doctors questioned expressed their satisfaction with the pharmacists and their contribution to the ward rounds.