bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preliminary investigation of patient information leaflets as package inserts
Authors: Bandesha G , Raynor D K , Teale C 
Published: February 2011

Abstract
In the United Kingdom, patient information leaflets (PILs) are now supplied with all medicines licensed or re-licensed since January, 1994. This means that, by 1998, all medicines will come with one of these detailed leaflets inside the pack. In a preliminary investigation of the impact of these leaflets, 117 elderly inpatients were questioned on their experience of PILs prior to admission. Ninety-one (78 per cent) said they had received a PIL and 57 (49 per cent) had read one. The main reasons for not reading a leaflet were the perceived difficulty in understanding and being put off by excessive information. Of the patients who had read a leaflet, 23 (40 per cent) reported difficulty in reading the small print and 26 (46 per cent) said they had difficulty understanding the content. Thirteen patients (23 per cent) reported having to seek help with reading a leaflet. Forty-two of those who had read a leaflet rated it as helpful. Eleven patients said they had asked for advice from their doctor or pharmacist as a result of reading a leaflet. Nine patients said the leaflet had caused some anxiety, with two stopping their medicine as a result. The move to universal PILs in patient packs is a major development in the provision of information to patients about medicines. This study suggests that elderly patients have problems relating to understanding the content of PILs and reading the size of print used in these leaflets.
Influencing prescribing in primary care: a collaboration between clinical pharmacology and clinical pharmacy
Authors: Wood Kay M , Mucklow John C , Boath Elizabeth H 
Published: February 2011

Abstract
A study was carried out to determine whether the standard of prescribing in primary care can be improved by a therapeutics advisory service provided by a consultant clinical pharmacologist and a clinical pharmacist.
Audit, feedback, peer review, guidelines, target setting and small group teaching were used to influence behaviour in two fundholding practices: a four partner semi-rural practice in Staffordshire (practice A) and a five partner urban practice in Shropshire (practice B), both of whom paid for the therapeutics advisory service from their practice funds. The main outcome measures were changes in prescribing and disease management.
Practices A and B showed a 62 per cent and 28 per cent compliance, respectively, with recommendations for making financial savings. Blood pressure control improved in both practices, with the proportion of patients with blood pressure readings less than 160/90 mmHg rising from 47 per cent to 65 per cent in practice A, and from 53 per cent to 72 per cent in practice B, over the study period. After an intervention, the percentage of patients with non-valvular atrial fibrillation who were anticoagulated rose from 24 per cent to 57 per cent at practice B. Adherence to guidelines on the use of omeprazole by the two practices occurred in 41 per cent and 42 per cent of prescriptions, respectively, after one year, improving to 58 per cent and 56 per cent after a further year.
The approach of peer group audit, education and clinical pharmacy support was well accepted by the GPs, and early results show it may have led to an improvement in the standard of prescribing.
Pharmacists' quality of learning in a diploma/MSc course in pharmacy practice
Authors: Kostrzewski Andrzej , Dhillon Soraya 
Published: February 2011

Abstract
A rapid expansion of postgraduate courses in pharmacy practice has raised the issue of quality. An understanding of how pharmacists approach their learning is one factor that influences learning outcomes. It would, therefore, be of value to identify pharmacists' approaches to learning. This paper describes the approaches to learning on a postgraduate diploma/MSc course in pharmacy practice. The Approaches to Study Inventory was administered to a total of 103 pharmacists over a period of three years. Overall, the pharmacists demonstrated a high meaning orientation and low reproducing orientation, indicating a high quality of learning. This was supported by a consistently low negative attitude score. The surface approach increased significantly in 1993 and 1994 compared with 1992. This is difficult to interpret but may have been due to increased workload. The use of this instrument in combination with other methods of evaluation has allowed a good database to be built up for designing the future of the pharmacy practice course.
Diarrhoea management by pharmacy staff in retail pharmacies in Hanoi, Vietnam
Authors: Duong Dat , Le Truyen , Binns Colin William 
Published: February 2011

Abstract
A survey was conducted in a sample of 29 pharmacies in the Badinh district of Hanoi, Vietnam, to determine the knowledge and behaviour of pharmacy staff in dealing with cases of acute diarrhoea in children. The survey found that antibiotics and antidiarrhoeal drugs were suggested in the majority of cases (45 per cent and 69 per cent, respectively) while oral rehydration salts (ORS) were suggested in only one case. In about 80 per cent of the observed cases in which antibiotics were supplied, one to four tablets were given, enough for only one to two days. The advice given by pharmacy staff to purchasers was poor. Only about half the pharmacy staff asked for information about the stool, age of the child and frequency of diarrhoea, while questions about medicines that had already been taken, feeding and health status were rarely asked. In about 10 per cent of the cases, no questions at all were asked. The mean cost of the treatment was $ 0.53 (95 per cent CI = 0.37–0.68). Constraints of knowledge, time and finance could be the reasons for this inappropriate management of childhood diarrhoea.
Design of a computer program for automatic capture of adverse drug interaction and contraindication data detected during prescription labelling
Authors: Balon D , Stevens R G 
Published: February 2011

Abstract
This article describes the design of a computer program for the automatic recording and analysis of all potentially harmful incidents identified during prescription labelling after reference to data held in patient medication records (PMRs). Information extracted from the British National Formulary (BNF) is incorporated into the program, which provides warnings of potential drug/drug interactions and drugs contraindicated for patients belonging to particular age groups or suffering from specific clinical conditions or allergies. Individual clinical patient data are stored in patient profiles within the PMRs. Access to the monitoring software is provided by a purpose-built labelling program. Unlike other systems, the program requires the pharmacist to enter information about the action taken in response to any warnings generated before it permits the labelling procedure to continue. Data relating to the warnings and the action taken by the pharmacist are captured automatically and stored for later analysis.
Detection of hazardous drug/drug interactions in a community pharmacy and subsequent intervention
Authors: Stevens Robert G , Balon Derek 
Published: February 2011

Abstract
The interaction data in the British National Formulary were used to create a program which automatically recorded all potentially harmful drug/drug interactions from patient medication records. The program was used in a project pharmacy for 29 months to detect and record major drug/drug interactions.
Analysis of the data from approximately 58,000 prescriptions showed that one in every 80 was written for a drug which interacted with a previously prescribed drug and might have caused a major harmful event. Many of the apparent interactions referred to previously prescribed drugs which were not currently part of the patient's drug regimen. Elimination of non-concurrent pairs still left one potentially hazardous prescription in every 180. Examination of these potential problems and consultation with both prescribers and patients indicated that few changes of prescriptions were required.
Changing medication: general practitioner and patient perspectives
Authors: Wood Kay M , Boath Elizabeth H , Mucklow John C , Blenkinsopp Alison 
Published: February 2011

Abstract
This study, carried out in one fundholding general practice with 9,680 patients, assessed the acceptability to patients and general practitioners of three types of prescribing changes to repeat medication: generic substitution, therapeutic substitution, and changing delivery device. Patients' opinions were sought via a postal questionnaire, face-to-face semi-structured interviews and telephone interviews. Prescribers' views were sought via face-to-face interviews with five GPs and an asthma clinic doctor. The interviews assessed the acceptability of the changes to the patients, and the attitudes of prescribers towards identifying the need for change and carrying it out. Of 78 patients who returned the postal questionnaire following a change from branded to generic medicine, 14 (18 per cent) were “happy” with the change, 48 (62 per cent) were “not bothered” and 12 (15 per cent) were “unhappy” (four did not answer the question). Of 25 patients, interviewed face-to-face, whose prescription for ranitidine had been changed to cimetidine, 21 (84 per cent) were not concerned about the change. Of 15 patients, interviewed by telephone, who were asked to change their asthma delivery device, eight had refused to be changed, one had reverted back and the remaining six were happy with their new delivery device. Interviews with the prescribers showed that they had expected a higher level of resistance and complaints from patients than had proved to be the case. Simple changes to patients' repeat medication are feasible and have a high level of acceptance provided the proposed change is appropriately communicated to the patient.
An investigation into adverse drug reaction monitoring by United Kingdom hospital pharmacy departments
Authors: Green Christopher F , Mottram David R , Rowe Philip , Brown Adrian M 
Published: February 2011

Abstract
Prior to the nationwide introduction of the Committee on Safety of Medicines “yellow card” adverse drug reaction reporting for hospital pharmacists, a study was carried out to investigate the activities undertaken by hospital pharmacists in adverse drug reaction (ADR) reporting. A survey of 200 United Kingdom hospitals was conducted and 172 (86 per cent) questionnaires were returned. Local ADR reporting schemes were in operation in 26 (15.1 per cent) surveyed hospitals. The majority used locally designed cards to report ADRs. The most common reasons for the lack of a local ADR scheme (n=141) were staffing, the fact that a scheme had never been considered, time factors and the lack of perceived need to operate a scheme. Of these 141 departments, 80.1 per cent said they would consider implementing schemes in their hospital. With the inclusion of pharmacists in the CSM “yellow card” scheme, there is an incentive for them to become officially and further involved in the management and reporting of ADRs. Local ADR reporting schemes encourage pharmacovigilance and could allow pharmacists to take a leading role in this area of clinical practice.
HEALTH SERVICES RESEARCH METHODS IN PHARMACY: Survey research: (2) Survey instruments, reliability and validity
Authors: Smith Felicity 
Published: February 2011

Abstract
Social surveys are an important tool in health services research. They have been used in a high proportion of pharmacy practice research studies and in a wide range of settings. Extensive hand searches of published studies has enabled a review of the issues and problems that survey methods present when applied in pharmacy practice and an exploration of how they have been addressed by researchers. It is hoped that the review will enable pharmacy practice researchers to benefit from the experience of their colleagues when conducting their own research. This is the second part of a two-part review of surveys in pharmacy practice research. The first part (IJPP, 1997;5:152) focused on research questions, study design, sampling frames and procedures, response and non-response. This second part discusses the development of survey instruments and the issues of validity, reliability and generalisability.
Pharmacy research: the place of work measurement
Authors: Rutter Paul M , Brown David , Jones Ian F 
Published: February 2011

AbstractIn this review, work measurement techniques involved in establishing what pharmacists do and how they perform their various duties are described. Initially, a comprehensive literature search was undertaken using Medline, Pharmline and Bath Information and Data Services (BIDS). Seven methods of work measurement were found to have been used in pharmacy research. Each method is explained and its applicability to pharmacy research evaluated. Work measurement studies have proved to be of value in analysing individual jobs and quantifying institutional staffing levels. By understanding both the advantages and disadvantages of each method, the pharmacist researcher should be able to choose the most appropriate method for his or her own investigation.
Patient Education in 20 Dutch Community Pharmacies: Analysis of Audiotaped Patient Contacts
Authors: Blom Lyda , Jonkers Ruud , Kok Gerjo , Bakker Albert 
Published: February 2011

Abstract
The level of patient education activity in Dutch community pharmacies was examined. A total of 200 hours' audiotapes of pharmacy patient contacts were collected in a selective sample of 20 community pharmacies. All pharmacists involved were selected on the basis of their interest in developing patient education in their pharmacies. The outcome measure was the percentage of patient contacts which included the provision of oral drug information. Both pharmacists and technicians participated in the audiotapes and their behaviour at the counter was compared. The results demonstrated that the provision of oral drug information was concentrated on contacts where patients collected drugs, and the contents of the information mainly concerned drug instructions. The pharmacists provided significantly more frequent oral drug information than the technicians. No differences were found in the frequency of provision of oral drug information to female and to male patients, or to patients and to relatives collecting the drug. Mostly the oral drug information was given without patients' questioning. The effects of these kind of activities on patients' drugs use are questioned because it is known that efforts to increase patient compliance should meet the educational principles of individualisation. Therefore, the development of patient instruction into patient education remains a challenge to pharmacists in the future.
HEALTH SERVICES RESEARCH METHODS IN PHARMACY: Qualitative interviews
Authors: Smith Felicity 
Published: February 2011

Abstract
Qualitative approaches have gained an increased prominence in health services and pharmacy practice research in recent years. Although the numbers of qualitative studies are small compared with those using survey methodology, a substantial body of work has been undertaken in pharmacy practice and related settings. The aim of this paper is to review research employing qualitative interviews in terms of the methodological issues and problems that this approach presents and to explore how these have been addressed. Study objectives, sampling procedures, data collection, processing and analysis and issues of validity, reliability and generalisability will be discussed.
Factors used by pharmacists in the recommendation of the active ingredient(s) and brand of non-prescription analgesics for a simple, tension and migraine headache
Authors: Roins Sylvia , Benrimoj Shalom I , Carroll Peter R , Johnson Lester W 
Published: February 2011

Abstract
The objective of this study was to determine the factors (dimensions) that are considered by community pharmacists in their recommendation of the active ingredients and brands in non-prescription analgesics for an adult with a simple, tension or migraine headache. The research was conducted in four stages: a qualitative stage, a pre-pilot study, a pilot survey and the main quantitative study. The main study was conducted across 1,500 randomly selected Australian community pharmacies (68.3 per cent usable response rate). Principal components analysis with varimax rotation was employed on a list of statements concerning pharmacists' recommendation of the active ingredient(s) and the brand. For each type of headache, a four factor solution was interpreted for reasons for recommendation of the active ingredient(s) and reasons for recommendation of the brand. All the factors extracted were meaningful and easily interpreted. The highest percentage of the total variance was explained by the clinical influences factor for simple (20.4 per cent) and tension headache (18.8 per cent) and the two clinical influences factors for migraine headache (20.3 per cent and 10.1 per cent, respectively), indicating that the clinical influences construct accounted for the highest potential influence on pharmacists' recommendation of the active ingredient(s). The highest percentage of the total variance was explained by the economic influences factor for simple (29.9 per cent), tension (28.8 per cent) and migraine headache (30.8 per cent), indicating that the economic influences construct accounted for the highest potential influence on pharmacists' brand recommendation. This research could be useful for educators, professional associations and pharmaceutical companies in pharmacy-oriented marketing strategies.
Targeted medication review: patients in the community with chronic pain
Authors: Read Rhona W , Krska Janet 
Published: February 2011

Abstract
Patients with chronic pain may be in need of improved pharmaceutical care because of lack of pain relief and lack of understanding of pain management, the potential for drug interaction and adverse effects. This study assessed the need for a pharmacist to review the medication of a population of patients with chronic pain in a domiciliary setting, using specific validated outcome measures to determine any benefits of pharmacist intervention.
Ninety-six patients who had rheumatoid arthritis or were taking regular nonsteroidal anti-inflammatory drugs (NSAIDs) or combination analgesics were interviewed after reviewing their medical records. Expectations of pain relief and severity of pain were assessed using McGill pain questionnaire (MPQ), visual analogue scales (VAS) and verbal descriptor scales. Twenty-eight patients required referral to their GP as a result of meeting preset criteria for poor outcome from current therapy; these patients had higher expectations of pain relief than the remaining patients and also higher pain scores. Pain scores using the MPQ and VAS were generally well correlated with each other and both showed changes in the 14 patients who were re-interviewed after pharmacist intervention. A further 59 patients required advice to optimise current therapy and 12 required referral concerning inappropriate therapy. Many patients' medicine use deviated from that prescribed, and a high proportion used alternative medicines in addition. The prescription of drugs for prophylaxis against ulceration was inappropriate in 17 patients and evidence of monitoring in patients on NSAIDs and disease-modifying antirheumatic drugs (DMARDs) was poor.
HEALTH SERVICES RESEARCH METHODS IN PHARMACY: Focus groups and observation studies
Authors: Smith Felicity 
Published: February 2011

AbstractThis paper reviews research undertaken in pharmacy practice and related settings employing focus groups and observation methods. The aim of the review is to identify the main methodological considerations of these approaches to enable pharmacy practice researchers to benefit from the experiences of their colleagues when conducting their own research. The paper is in two parts. Focus groups have become increasingly prominent in pharmacy practice and health services research. They are an attractive and effective alternative to individual qualitative interviews for particular problems in pharmacy research. In this paper, the use of focus groups by researchers in pharmacy practice and related settings is reviewed. Observation studies have been applied widely to address many research questions. They are a valuable method of obtaining data, documenting actual events and activities rather than relying on self-reports of behaviours and events. Observation methods have been used both as a sole method for a research study and in combination with other methods. In the pharmacy practice literature there are examples of participant and non-participant observation studies and both quantitative and qualitative approaches. Through the experiences of pharmacy practice researchers, the methodological and ethical issues that these studies present are identified and ways in which they have been addressed are explored.
Asthma advice giving by community pharmacists
Authors: Osman L M , Bond C M , MacKenzie J , Williams S 
Published: February 2011

Abstract

Objective
To investigate the frequency and type of asthma-related advice provided by community pharmacists to customers, and pharmacist attitudes to advice giving and training needs.

Method
Postal questionnaire surveying the provision of advice to asthma patients in the previous month. Responses were discussed in a focus group of 13 pharmacists representing different types of community pharmacy and stratified by age and sex.

Setting
All community pharmacists in the Grampian health board area, in North East Scotland.

Key findings
Of an estimated 180 community pharmacists, 125 responded. Respondents had dispensed a median of 70 asthma medications per week to approximately 40 customers. Most had given advice no more than twice a week. In the previous month, half had checked inhaler technique and most (75 per cent) had “loaned” relief inhalers on an emergency basis. The most common areas where patients sought advice were problems with inhalers, concerns about side effects of asthma medications and using peak flow meters. In the focus group, pharmacists expressed concerns about their training in advice giving for inhaler skills and peak flow meter use and self-management plans. The 69 pharmacists who had undertaken additional training were significantly more likely to feel confident in giving asthma-related advice and to give advice more often. Sixty-one per cent of pharmacists wanted more training in advice giving.

Conclusion
At present, asthma-related advice is given infrequently. Reasons for missed opportunities for giving such advice are limited facilities in premises, lack of pharmacist knowledge of some aspects of asthma management and patient attitudes (ie, lack of awareness that pharmacists can fulfil this role).