bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic use in elderly hospital inpatients before and after the introduction of treatment guidelines
Authors: McCaig D J , Hind C A , Downie G , Wilkinson S 
Published: February 2011

AbstractObjective(1) To establish the pattern of antibiotic use in elderly hospital inpatients, using data to draw up antibiotic treatment guidelines; (2) To assess the short-term and longer-term impact of the guidelines on antibiotic use and their acceptability to medical staff.MethodAntibiotic use was assessed in relation to suitability for site and severity of infection, appropriateness of drug choice, outcome of therapy and cost, before, immediately after and 10 months after guideline introduction. Acceptability to medical staff was gauged through a questionnaire.SettingGeriatric hospital inpatients in long-stay, assessment and GP-supervised wards in the Grampian region of Scotland (phase 1: 324 patients; phase 2: 302 patients; phase 3: 263 patients).Key findingsThe antibiotic prescribed was appropriate for site and severity of infection in 92 per cent of patients in phase 1, but was a policy drug in only 56 per cent. After guideline introduction, adherence to policy did not improve, but use of non-policy drugs without identified reason fell from 24 per cent in phase 1 to 13 per cent in phase 3. Adjustment of antibiotic dose for renal function increased from 73 per cent in phase 1 to 86 per cent in phase 3. Duration of treatment for a single infection was significantly reduced in phase 3, but outcome and cost were unchanged after guideline introduction. Medical staff were supportive of the guidelines and felt they had changed their prescribing practices.ConclusionAntibiotic treatment guidelines did not have a major impact on antibiotic use, although some positive trends were observed. New ways of promoting adherence to guidelines need to be explored.
Effect of incentives on recruitment and response rate in a community-based pharmacy practice study
Authors: Kennedy Emily , Krska Janet , John Dai , Hansford Denise 
Published: February 2011

Abstract

Objectives
To study the feasibility of carrying out a community pharmacy-based drug utilisation study of H2 antagonists and alginate-containing preparations, and to study the effect of two methodological variations — payment of pharmacists and the free issue of medicines — on recruitment rates and response rates.

Method
Pharmacists were asked to recruit customers into the study after deciding that one of these products was appropriate for purchase. Customers were asked to provide their signed consent, their name, address and information about their general practitioner and to complete an initial questionnaire provided by the pharmacist and a second questionnaire which was sent out by the researchers two weeks later. In 20 of the pharmacies the medicines were offered free once customers had agreed to participate; in the remaining pharmacies, customers paid the normal retail price for the product. All pharmacies received incentive payments for each of the three months in the second half of the study period in which they recruited five or more customers.

Setting
Thirty-nine community pharmacies in Scotland and Wales.

Key findings
Similar numbers of customers were recruited to the study irrespective of whether free medicines were offered. Significantly more (P&lt;0.001) customers recruited by pharmacies providing free medicines returned both the first (339/383) and second questionnaires (264) than those recruited by pharmacies not providing free medicines (269 and 208/384, respectively). Of the 608 customers who returned the first questionnaire and were subsequently issued with a second questionnaire, 77.6 per cent returned it; there was no difference in return rates between customers who received free medicines and those who did not. Incentive payments to pharmacies resulted in a small increase (14 per cent) in recruitment rate in the second half of the study and no difference in response rates from the customers recruited.

Conclusion
The study established the feasibility of undertaking drug utilisation studies with high response rates in community pharmacies. The provision of free medicines increased customer response rates, but incentive payments for pharmacists showed no clear effect on recruitment rates.
Assessing pharmaceutical services at primary care clinics in KwaZulu-Natal: an indicator-based approach
Authors: Kishuna Aarti , Smit Jennifer 
Published: February 2011

Abstract

Objective
To obtain baseline data on the provision of pharmaceutical services at primary care clinics

Method
Internationally used standard and objective indicators were adapted for this study and used to assess the availability and quality of key drugs, and the quality of dispensing practice in a sample of primary care clinics in 1994

Setting
The study was undertaken in three regions of the province of KwaZulu-Natal, South Africa

Key findings
It was found that the delivery of pharmaceutical services at primary care facilities was good, considering South Africa is a developing country in transition. However, some deficiencies were apparent. Recommendations for addressing these shortcomings are described. The challenge now is to maintain and improve the delivery of pharmaceutical services at primary care facilities in KwaZulu-Natal

Conclusion
The study provided baseline data against which progress in the implementation of the South African National Drug Policy (NDP) can be measured
A survey of adverse drug reaction reporting by hospital pharmacists to the Committee on Safety of Medicines — the role of pharmacy departments
Authors: Ferguson Martin , Dhillon Soraya 
Published: February 2011

Abstract

Objectives
To identify: (1) how adverse drug reaction (ADR) reporting by hospital pharmacists is managed, (2) the education of pharmacy personnel on ADR reporting, (3) pharmacy personnel with a specific role in ADR reporting, (4) the numbers of ADR reports sent to the Committee on Safety of Medicines (CSM) and (5) barriers to reporting

Method
Postal questionnaire survey of 250 hospital-based drug information (DI) departments

Setting
All hospital-based DI departments listed in the United Kingdom Drug Information Pharmacists' Group directory

Key findings
A total of 185 questionnaires was returned (74 per cent response). Thirty-five per cent of respondents had a procedure for the reporting of ADRs by pharmacists; 62 per cent of departments actively promoted reporting; 44 per cent of departments reviewed reports before they were sent to the CSM. DI pharmacists were frequently involved in the review of the reports and were usually the designated ADR person. Education on ADR reporting was provided by 69 per cent of departments. Few specialist pharmacists (n=9) were identified as having established a direct link with the CSM. The majority of departments had submitted five or fewer ADR reports to the CSM. The presence of a procedure, promotion of reporting, education and the presence of a designated ADR person were found to be associated with above average rates of ADR reporting (chi-square test)

Conclusion
The survey showed that the role played by pharmacy departments in the area of hospital pharmacist ADR reporting varied considerably but in most cases was insufficiently developed
The impact of professional socialisation on pharmacy students' role perceptions
Authors: Collins David M , Benson Heather A E , Occhipinti Stefano , Wright Anthony , Mcelnay James C 
Published: February 2011

AbstractObjectiveTo evaluate pharmacy students' perceptions of the relative status of seven health professional groups: dentists, general medical practitioners (GPs), medical specialists, nurses, pharmacists, physiotherapists and social workersMethodA 56-item questionnaire was sent to 389 pharmacy undergraduate students, from the University of Queensland, Australia, and the Queen's University of Belfast, Northern IrelandKey findingsIn comparison with their Australian counterparts, students from Northern Ireland rated pharmacists significantly higher, and GPs, medical specialists, physiotherapists, and social workers significantly lower, on a measure of overall professional status. Respondents also rated pharmacists significantly higher, and GPs, physiotherapists and social workers significantly lower, on a professional potency dimension to the status measure. However, both student groups ranked pharmacists first on a receptivity dimension to the status measure, indicating their perception of pharmacy as an empathetic profession. Medical specialists were uniformly rated highest of the professions on the potency dimension and lowest on receptivityConclusionIt is posited that differences between the students' perceptions of the health professionals reflect both cultural and educational differences
Hospital doctors' perceived barriers to pharmacist prescribing
Authors: Child Damian , Cantrill Judith A 
Published: February 2011

Abstract

Objective
To examine the reasons behind hospital doctors' perceived barriers to pharmacist prescribing in the United Kingdom.

Method
Postal questionnaires using a combination of open and closed questions were sent to hospital doctors seeking responses to scenarios describing pharmacists writing prescriptions for drug treatment. Content analysis of the qualitative responses was undertaken to identify the major themes which represented potential barriers.

Setting
Five National Health Service teaching hospitals in Birmingham, UK.

Key findings
Completed questionnaires were received from 94/193 doctors (49 per cent). Fifty-two respondents (55 per cent) expanded on their opinions in responding to the scenarios presented. Thirty-eight respondents described potential problems or gave reasons why they believed pharmacists should not be permitted to transcribe or prescribe drug treatment. Eleven respondents spontaneously added supportive comments and the remainder were neutral. Five major themes clearly emerged: pharmacists' awareness of clinical and patient details, potential communication problems, belief that a doctor should write the initial inpatient prescription, the division of overall clinical responsibility and loss of the opportunity to review the drug treatment.

Conclusion
Potential barriers to pharmacist prescribing were identified both by doctors who agreed and by doctors who disagreed with the general concept. Some doctors had misconceptions about the division of responsibility relating to drug treatment. This study has identified important issues that the pharmacy profession will need to address if we are to be accepted as prescribers and provides a valuable starting point for further work.
The impact of social change on professions — gender and pharmacy in the UK: an agenda for action
Authors: Hassell Karen 
Published: February 2011

AbstractIn several countries a growing number of women are entering the pharmacy profession. This paper examines the nature of increasing female entry into the pharmacy profession in the United Kingdom, possible reasons for this, and the implications for workforce management and planning. The review forms part of a research agenda setting exercise about the pharmacy workforce commissioned by the Royal Pharmaceutical Society of Great Britain. The paper aims to provide an overview of gender-related workforce issues for researchers and commissioning bodies alike, describes what is currently known about the gender profile of the UK workforce and identifies some of the key areas that remain under-researched. Participation and activity rates, career influences, explanations around the increased entry of women into pharmacy, and the consequences of women's involvement for the profession, are all considered. Gaps are identified and priority topics for research are also suggested.
Workcoping and homecoping: achieving a balance in part-time community pharmacy
Authors: Symonds B Sue 
Published: February 2011

AbstractObjectives(1) To explore different concepts of part-time work by means of a study of part-time work in community pharmacy; (2) to ascertain the complexity and diversity of part-time work patterns; (3) to consider the strategies employed by part-time pharmacists to make their part-time working possible.MethodsRecords of part-time work in community pharmacy were examined. A quantitative survey was conducted by sending a postal self-completion questionnaire to 975 pharmacists. There were 727 valid responses. Qualitative semi-structured interviews were conducted with 33 community pharmacists, identified from the survey as working part time. The emphasis was on data representing the part-timers' own perceptions of their work and careers.SettingThe total membership of two Midlands branches of the Royal Pharmaceutical Society of Great Britain.Key findingsOf the 230 pharmacists (31 per cent of all respondents) who worked part time, 200 (140 women; 60 men) worked in community pharmacy. There was a considerable range and variability of working patterns, the clearest division being between employed (70) and self-employed (122) part-timers. The strategies used to cope with work and family responsibilities by both men and women of different ages and under different circumstances were sometimes very complex. The terms “workcoping” and “homecoping” were devised to describe these strategies.ConclusionsExisting concepts of part-time work do not fully explain the complexities revealed in this study. Many part-time pharmacists believed they had achieved a balance which was both professionally satisfying and socially responsible. They employed strategies which enabled them to maintain this balance and keep control over their lives.
Development and evaluation of a survey tool to explore patients' perceptions of their prescribed drugs and their need for drug information
Authors: Duggan Catherine , Bates Ian 
Published: February 2011

Abstract

Objective
To explore the effect of providing information about their prescribed drugs on patients' perceptions and use of the drugs.

Method
A survey tool was administered to 501 general medical patients in their own homes during a trial to reduce discrepancies between supplies of hospital prescribed drugs and those received in the community following hospital discharge. The patient sample was randomly recruited into two cohorts: 264 in the intervention group (given information regarding drugs prescribed on discharge from hospital to take to their community pharmacy) and 237 in the comparison group. Responses to the survey were explored to assess any effects on patients of providing such information.

Setting
Domiciliary visits to general medical patients in East London.

Key findings
The survey tool was subjected to factor analysis and reliability testing. Principal components analysis (PCA) was used to extract five factors that described an intrinsic desire for information, perceived impact of the illness, perceived utility of medicines, anxiety about illness and worry about changes to medicines. Internal consistency was good, ranging from 0.8 to 0.91 (Cronbach's coefficient alpha). Interconstruct relationships between the scales, patient demographics and the two cohorts were explored. The findings indicated that the degree of patient empowerment is related to two constructs: “intrinsic desire for information” and “worry about changes to medicines.” Patients who expressed a low degree of worry about changes and a high desire for information about their drugs seemed less worried and more empowered when given additional information. Conversely, those who expressed worries about changes in their medicines and did not want information about their medicines (were happy knowing little) seemed more worried and less empowered when given additional information about those changes.

Conclusion
Further exploration of relationships between patient perceptions and information provision is needed to influence appropriately the development of pharmaceutical care between hospital and community.
Ethical awareness of community pharmacists
Authors: Hibbert Derek , Rees Judith A , Smith Ian 
Published: February 2011

Abstract

Objective
To explore the extent to which community pharmacists in the United Kingdom encounter and resolve ethical dilemmas in their daily work.

Method
Semi-structured interviews were carried out with a sample of community pharmacists representing a range of ages and pharmacy backgrounds. Two were from independent pharmacies and five from multiples.

Key findings
Analysis of the transcripts of the interviews showed that ethical dilemmas were a feature of community pharmacy although most of the pharmacists were not conversant with the details of the Royal Pharmaceutical Society's Code of Ethics. The examples of ethical dilemmas quoted could be classified and interpreted to demonstrate a knowledge of the basic ethical concepts and the wider legal, occupational, organisational and personal value sets which encompass ethics in the work place. Ethical dilemmas arose as a result of the pharmacist's role as supplier of prescription medicines, guardian of over-the-counter medicines and intermediary between patient and carer/doctor. Other dilemmas were related to the legal framework surrounding medicines as well as the organisational, occupational and personal values of the pharmacist.

Conclusion
The pharmacists in this study demonstrated awareness of ethical issues and their accounts indicate possession of practical skills to deal with moral uncertainty.
Group interviews with people taking long-term medication: comparing the perspectives of people with arthritis, respiratory disease and mental health problems
Authors: Smith Felicity , Francis Sally-Anne , Rowley Emma 
Published: February 2011

Abstract

Objective
To examine experiences of medicine use, advice and support from the perspectives of people taking medicines long term for arthritis, respiratory disease and mental health problems.

Method
Twelve group interviews were conducted, four with each of the three chronic illness groups.

Setting
Interviews were arranged through national and local voluntary organisations and conducted as part of their regular meetings.

Key findings
The most prominent issue for all the Arthritis Care groups was information about side effects. People discussed the benefits of having this information and the reasons they believed that it was not generally provided. People with respiratory disease described difficulties of obtaining information as a problem in the operation of the health service in Britain, where participants may or may not find out about different products by chance. In all these discussions there were examples of how people used their regular group meetings to inform each other. For people with mental health problems, participation in decisions concerning medicines and the attitudes of health professionals were the most prominent issues. Members of all groups, across all chronic illnesses, claimed that adequate information was not shared with them during consultations with professionals. However, different perspectives of involvement in decision-making regarding therapy were distinguishable. Pharmacy services did not feature prominently in any of the group discussions.

Conclusion
The study revealed differences between the illness groups in the emphasis participants placed on different issues. However, there were also common concerns, in particular relating to obtaining information and the attitudes of professionals. While pharmacy services were not prominent in discussions, a range of unmet needs concerning medicines were identified. This indicates that opportunities exist for pharmacists to provide more responsive services that would be valued by people taking long-term medication.
Evaluation of a new health centre pharmacy: a case study
Authors: Wilson Keith A , Jesson Jill K , Staunton Noel 
Published: February 2011

Abstract

Background
This case study describes the evaluation of a primary care intervention in the Isle of Wight, United Kingdom, arising from the decision to move a medical practice from its town location into a new health centre in a nearby village. The new centre incorporated a new community pharmacy within the practice.

Aim
To determine stakeholders' views on whether there was any perceived benefit resulting from the location of a pharmacy within the new health centre, over and above that of supply.

Method
The evaluation explored both process and outcome features by means of self-completion questionnaires with patients and semi-structured interviews with health centre staff. The first phase of the study was undertaken prior to the medical practice move into the new health centre in July, 1996, and the second phase 12 months after the move. An interim report was used to influence change by making recommendations to the health authority to provide support and resources for the new pharmacist.

Key findings
Prior to the move: three-quarters of medical practice patients surveyed expected to use the new pharmacy, and 55 per cent expected to receive a better service. The health centre staff and pharmacist were enthusiastic about the potential for service development in the pharmacy. The general practitioners (GPs) had the clearest ideas about possible additional services but there was no implementation strategy. Based on these findings, the evaluators made specific recommendations on action to be taken by the health authority.
After the move: 88 per cent of patients surveyed had used the pharmacy and considered that the service was better. The perception was based on matters of convenience. Health centre staff and GPs considered that the pharmacy was providing services beyond supply and had raised awareness of prescribing issues.

Conclusion
A pharmacy located within a health centre can, given appropriate support, enhance the pharmacist's contribution to primary health care over and above supply, and provide a mechanism for developing pharmaceutical support for the prescribing function. Evaluation can help to provide insight into ways of ensuring a more satisfactory outcome following organisational change.