bluuebunny/crossref_metadata_2025_split huggingface dataset:
Drug and therapeutics committees — are they fulfilling their potential to improve the quality use of medicines?
Authors: Tan Ee Lyn , Day Richard O , Brien Jo-anne E 
Published: December 2005

Abstract

Objective
Drug and therapeutics committees (DTCs) promote the quality use of medicines (QUM). DTC functions have expanded beyond overseeing the hospital formulary. They are in a position to influence prescribing practice, within and beyond the hospital setting into community practice, and it is important to evaluate and augment the quality of their performance. A survey was conducted to document and investigate perceived and ideal DTC principal functions and the level to which DTCs were achieving these.

Method
A questionnaire was sent to 300 directors of pharmacy/chief pharmacists in Australian hospitals. Non-responses within two weeks of mail-out were followed-up. Returned questionnaires were anonymised, collated and analysed. The questionnaire asked about the DTC's functions, the extent to which DTC performance indicators were used, and barriers to the use of these indicators. Respondents were asked for their perceptions of the DTC's influence on prescribers' practices.

Key findings
The response rate was 73.3% (220) and 127 respondents had an in-house DTC. The final dataset comprised 125 responses (two incomplete questionnaires excluded). The most common principal function of DTCs was “ensuring patient safety” (83.3%). Only 16% of respondents used indicators developed specifically for DTC performance evaluation. Data collected by DTCs were primarily for accreditation. Lack of resources contributed to barriers to indicator data collection. Most respondents (92%) believed that DTCs have some influence on prescribers' practices.

Conclusion
DTCs are seen to be in a position to have an influence on the quality of medicines use. A means to enhance DTC performance can be explored if potential problems in quality are detected. Although there is a desire to use the available indicators, assistance in data collection is needed. Adequate resources and strong leadership may result in more effective DTCs with greater influence on medical practice, leading to better patient outcomes.
Use of over-the-counter medicines in children
Authors: McIntyre John , Conroy Sharon , Collier Jacqueline , Birchley Nicola , Rodgers Sarah , Neil Karen , Choonara Imti , Avery Anthony 
Published: December 2005

Abstract

Objective
To assess the reasons for over-the-counter (OTC) medicine use in children and the sociodemographic factors influencing this choice of self-care rather than GP consultation.

Method
Questionnaires were sent to the home address of a randomly generated list of children under 12 years of age from three GP practices in the East Midlands selected to represent bottom, middle and top tertiles of deprivation on the basis of the Jarman score. Analysis using chi-square and Mann-Whitney tests was used to identify associated factors (number of carers in the home, number of children, deprivation score, parent/carer's age, age and number of children in the house) of the responses.

Setting
Primary care setting in the East Midlands region of England.

Key findings
From 424 completed questionnaires returned (response rate 61%), 413 parents/carers had purchased OTC medicines. Fifty-one different products had been purchased, with analgesic/antipyretic and cough/cold remedies the most frequently bought. The most commonly reported reasons for parent/carer initiated medication were to avoid troubling the GP with minor childhood ailments (79% of respondents) and to have medicines available in case of future need (74%). Cost was a barrier to buying OTC medicines for the more deprived. Advice-seeking behaviour was associated with the symptom, the number of children, affluence and the age of the child.

Conclusion
Parent/carer initiated use of OTC medication is widespread, particularly for analgesic/antipyretic and cough/cold remedies. Differences in advice-seeking behaviour are associated with the presenting symptom and a variety of sociodemographic factors.
Pharmacist-led medication review clinics in general practice: the views of Greater Glasgow GPs
Authors: MacRae Fiona , Lowrie Richard , MacLaren Alister , Barbour Rosaline S , Norrie John 
Published: December 2005

Abstract

Objectives
To ascertain general practitioners' views of a pharmacist-led medication review (PLMR) service. In particular, to quantify the percentage of GPs who perceived PLMR to be a useful service to their practices; to explore key service benefits, problems and areas for future improvement; and to quantify the percentage of GPs who believed service benefits outweighed problems.

Method
Semi-structured interviews with a purposive sample of six GPs informed the development of a self-completion postal questionnaire. The questionnaire was sent to all 258 GPs in the 82 practices where PLMR clinics were held. GP views on aspects of the PLMR process were elicited using a Likert scale. Closed questions sought views on overall service value. Free-text responses were sought on benefits, problems and areas for future improvement.

Key findings
The response rate was 84% for GPs (93% of practices were represented). Ninety-five per cent of respondents considered PLMR to be a useful service. Key perceived benefits (improved prescribing practice, raised standards of patient care and satisfaction, and increased GP knowledge and confidence) outweighed problems (space and time constraints, limited GP-pharmacist contact, occasional patient dissatisfaction). Only a minority of GPs felt that the written pharmacy referrals relating to specific patients were inappropriate. Views were divided as to whether PLMR increased or decreased practice workload. Suggestions for future improvements included increased GP-pharmacist communication and extended pharmacist roles.

Conclusion
The Glasgow model of PLMR deployed across a large Primary Care Trust by a team of pharmacists was viewed by those GPs who had received input as a useful service. The majority of GPs exposed to the service believed benefits outweighed problems.
Medically-enhanced normality: an alternative perspective on the use of medicines for non-medical purposes
Authors: Møldrup Claus , Traulsen Janine Morgall , Almarsdóttir Anna Birna 
Published: December 2005

Abstract

Objective
To consider public perspectives on the use of medicines for non-medical purposes, a usage called medically-enhanced normality (MEN).

Method
Examples from the literature were combined with empirical data derived from two Danish research projects: a Delphi internet study and a Telebus (telephone interview) study with a stratified random representative sample.

Results
The results of these studies indicate an acceptance of medicine usage where “enhancement” strategies are part of the rationale for medicine use. These strategies include an overall desire to enhance the quality of life, eg, to optimise economic, working and family conditions. The term “doping” does not cover or explain the use of medicines as enhancement among healthy non-athletes.

Conclusion
We recommend wider use of the term medically-enhanced normality as a conceptual framework for understanding and analysing perceptions of what is considered rational medicine use in contemporary society.
Pharmacy services and patient choice: insights into differences between patient groups
Authors: Phul Sharon , Cooper Stacey L , Cantrill Judith A 
Published: December 2005

Abstract

Objective
To use data from the UK electronic transmission of prescriptions (ETP) pilot to examine how and why choice and use of pharmacy services differ between patients, and how introduction of new services might impact on patient choice.

Method
Patients were invited to participate in the ETP pilot in three consortia across the UK. A postal questionnaire was distributed to 276 participating patients, and 211 (76%) were returned. Questionnaires were also completed by 64 patients who had actively chosen not to take part in the ETP pilot. Semi-structured telephone interviews were conducted with 26 questionnaire respondents who had opted to use a mail order pharmacy participating in ETP.

Key findings
54% of patients participating in ETP could have their prescription collected by pharmacy staff, but only half of these (52%) had made use of the service. Patients found it convenient to collect the prescription themselves (35%) and/or preferred to collect it themselves (34%). These patients were however still happy to use the new service offered by ETP. Reasons for using the same pharmacy centred on practical aspects, such as proximity to the GP practice (65%) and short waiting times (27%). Patients also positively rated their experiences of obtaining their prescription from their GP practice (80%) and the medication from their pharmacy (82%). Patients who were offered both ETP and mail order pharmacy but chose not to participate (n = 31) were more opposed to the mail order aspect than to ETP (70% vs 14% respectively). Patients not participating who were offered ETP without mail order pharmacy (n = 33) most frequently stated that they found the current system to be convenient (23%). Interviewees using the mail order pharmacy found not having to visit either the GP practice or pharmacy to be convenient and a repeat prescription reminder service to be advantageous.

Conclusion
The introduction of ETP and mail order to pharmacy services does have some impact on patient choice. Different aspects of pharmacy services appeal to different groups of patients. Convenience was paramount to the majority of patients in this study, but its definition differed between patients. The data will support the pharmacy profession in developments that enhance patient choice and optimise service use.
Dispensing activity in a community pharmacy-based repeat dispensing pilot project
Authors: Wilson Keith A , Jesson Jill 
Published: December 2005

Abstract

Objective
To measure changes in dispensing activity in a UK repeat dispensing pilot study and to estimate any associated cost savings.

Method
Patients were provided with two successive three-monthly repeat prescriptions containing all of the items on their “repeat medicines list” and valid at a study pharmacy. Pharmacists consulted with patients at the time of supply and completed a patient-monitoring form. Prescriptions with pricing data were returned by the UK Prescription Pricing Authority. These data were used to calculate dispensing activity, the cost of dispensed items and an estimate of cost savings on non-dispensed items. A retrospective identification of items prescribed during the six months prior to the project was used to provide a comparison with those dispensed during the project and thus a more realistic estimate of changes.

Setting
350 patients from two medical practices in a large English City, with inner city and suburban locations, and served by seven pharmacies.

Key findings
There were methodological challenges in establishing a robust framework for calculating changes. Based on all of the items that patients could have obtained from their repeat list, 23.8% were not dispensed during the intervention period. A correction was then made to allow for a comparison with usage in the six months prior to the study. Based on the corrected data, there was an estimated 11.3% savings in drug costs compared with the pre-intervention period. There was a marked difference in changes between the two practices, the pharmacies and individual patients. The capitation-based remuneration method was acceptable to all but one of the community pharmacists.

Conclusion
The repeat dispensing system reduced dispensing volume in comparison with the control period. A repeat dispensing system with a focus on patients' needs and their use of medicines might be cost neutral.
Pharmacists' role in improving awareness about folic acid: a pilot study on the process of introducing an intervention in pharmacy practice
Authors: Meijer Willemijn M , de Smit Denhard J , Jurgens Renate A , de Jong-van den Berg Lolkje T W 
Published: December 2005

Abstract

Objective
To determine whether a multiple intervention programme to improve women's awareness of folic acid was feasible in community pharmacy practice; to identify adjustments in organisation and materials that could improve feasibility; and to assess how the target group would experience the intervention.

Method
An action research study was undertaken in which four community pharmacies in the Netherlands participated. In each, a core team (one pharmacist and one to two technicians) was responsible for the organisation and implementation of the intervention. The intervention had several possible levels. As a minimum, pharmacy staff added a label about folic acid to the box of dispensed oral contraceptives (OCs) and handed out a leaflet about folic acid. The intervention was discussed during core team meetings every six weeks. Modifications were made based on the experience of the pharmacy team, on responses from pharmacy customers and on the results of a questionnaire sent to women one week after they visited the pharmacy with an OC prescription. This cycle of planning, action, observation and reflection was repeated twice.

Key findings
The minimum intervention was carried out by all four pharmacies. Other activities differed: two pharmacies introduced a maximum client age limit for handing out the leaflet; two installed an electronic information display; three worked with posters and window displays; and in two pharmacies the pharmacy technicians wore project badges and an information portfolio was placed in the public area of the pharmacy. Of the target group, 44% were positive about the label, 49% were neutral and 4% were negative. Over half (56%) of the target group stated that they appreciated the public health information given through the pharmacy.

Conclusion
Working with core teams seemed to be a successful strategy to implement practice change. By discussing and modifying the intervention during each research cycle in the core team meetings, an optimal intervention was reached that fitted in with the existing organisation within the pharmacy and possible barriers were overcome. Feedback from the target group was mainly positive and motivated the core teams to continue.
Impact of pharmacist consultation versus a decision aid on decision making regarding hormone replacement therapy
Authors: Deschamps Michelle A , Taylor Jeff G , Neubauer Shannan L , Whiting Susan , Green Kathryn 
Published: December 2005

Abstract

Objective
To compare the effects of pharmacist consultation versus a decision aid on women's decisional conflict regarding use of hormone replacement therapy (HRT) and subsequent satisfaction with the decision-making process.

Setting
A family medicine clinic in Canada.

Method
The study was a prospective, randomised comparative trial. Peri- and post-menopausal female patients aged 48 to 52 years were invited to participate. Volunteers (n=128) received either a private consultation with a pharmacist or a take-home decision aid. Data collection was undertaken prior to the intervention and again following an appointment with a physician to discuss HRT. Outcome measures included: perception of being informed about HRT, decisional conflict, satisfaction with the education and the decision made regarding HRT, and adherence to HRT if prescribed. Telephone follow-up occurred three and 12 months after the physician appointment.

Key findings
After discussing HRT with their physicians, 35 of 91 women (38.5%) chose HRT, 15 (16.5%) declined it and 41 (45.1%) opted to delay their decision. Both interventions significantly increased women's perception of being informed about this form of therapy and decreased decisional conflict. Satisfaction with the education and with the HRT decision was high. More postmenopausal women in the pharmacist group reached a yes/no decision than in the decision aid group. Of those initiating HRT during the study (n =18), 16.7% had discontinued it at 12 months.

Conclusion
Consultation with a pharmacist and use of a decision aid are both effective methods for decreasing decisional conflict in peri- and post-menopausal women considering HRT.
Advice provision for women: community pharmacists' attitudes and skills
Authors: McAree Deirdre P , Scott Eileen M 
Published: December 2005

Abstract

Objective
To assess the frequency of community pharmacists' advice-giving to women and to determine pharmacists' attitudes and perceived knowledge, confidence and embarrassment in providing such advice.

Method
A postal questionnaire was sent to a random sample of 600 Northern Ireland community pharmacists for self-completion. One reminder was sent. The questionnaire asked pharmacists to rate their knowledge on a list of women's health topics and to rate their confidence in dealing with women's health issues. Pharmacists were asked what actions they took to increase women's comfort in discussing potentially sensitive topics. They were also asked about the availability of women's health services locally. Closed response data were entered into SPSS for analysis while open question responses were collated and analysed separately.

Key findings
Pharmacy customers were predominantly female and the majority of pharmacists reported providing advice on women's health on a daily basis. Most pharmacists reported being confident and knowledgeable on women's health issues. Pharmacists had strategies to ensure that women felt comfortable discussing personal problems and they were not embarrassed dealing with such problems. Respondents felt more comfortable responding to, rather than initiating, such discussions. Personal views made it difficult for some respondents to provide advice on emergency contraception. Male pharmacists considered themselves to be less confident, less knowledgeable, more embarrassed and to have greater difficulty initiating a conversation on sensitive issues compared with female pharmacists.

Conclusion
Pharmacists on the whole were confident when dealing with requests for advice. Counselling confidence was related to counselling frequency. Initiation of conversations on women's health issues was difficult for some pharmacists. More active collaboration with the providers of other professional services available to women may enhance pharmacists' overall service provision for women customers.
(8) The work of Michel Foucault: relevance to pharmacy practice
Authors: Ryan Kath , Bissell Paul , Traulsen Janine Morgall 
Published: December 2005

AbstractMichel Foucault remains a controversial figure in social theory, his ideas giving rise to both loathing and adoration in equal measure. Writing from the 1960s to the 1980s, his work spans the disciplines of history, sociology and philosophy, and defies easy categorisation and elucidation. In this paper we attempt to situate Foucault's approach within the broad sweep of sociological thought in the late 20th century. We describe some of his central ideas, before moving on to critique his work and the contribution he and his adherents have made to medical sociology. Finally, we suggest how scholars might draw on his ideas to guide their research in pharmacy practice and social pharmacy.
The evidence-based supply of non-prescription medicines: barriers and beliefs
Authors: Watson Margaret C , Bond Christine M 
Published: December 2005

Abstract

Context
The reclassification of prescription only medicines (POMs) to pharmacy only (P) and general sale list (GSL) status is ongoing in the UK. Pharmacy staff need support to ensure the appropriate supply of these non-prescription medicines (NPMs).

Objective
To investigate the type of evidence used in the decision to supply NPMs and the barriers associated with their supply.

Methods
A participant observation study was conducted in nine pharmacies in one area of Scotland (Grampian). In-depth interviews were conducted with one pharmacist and one medicine counter assistant (MCA) from each pharmacy to explore and compare their attitudes and beliefs towards evidence-based practice (EBP) and the supply of NPMs.

Key findings
Most consultations were product requests. Pharmacy staff had little awareness or understanding of the term EBP and no specific evidence was used in the majority of consultations. Pharmacists' attitudes towards EBP varied. Personal experience or feedback from customers were cited as evidence upon which treatment recommendations were based. Many barriers and problems were associated with the supply of NPMs. These included: lack of evidence; MCAs' self-perception of their role; questioning and communication skills; safety; and training needs. There was a gap between pharmacists' and MCAs' perceptions of who should be referred to the pharmacist. Many staff used the WWHAM mnemonic for questioning customers, but this was often used as a matter of rote rather than as a framework to engage the customer in a relevant and constructive consultation. The development of adequate communication skills to allow core information to be obtained to support decision making needs to be addressed.

Conclusion
An increased awareness of EBP and its role in quality care needs to be promoted to community pharmacists and MCAs. There is currently no formal continuing education provision or requirement for MCAs in the UK. Pharmacy staff, particularly MCAs, require continuing education on the supply of NPMs.
Antibiotic prescribing control by pharmacists within UK NHS hospitals
Authors: Woodford Eleanor Marcella , Wilson Keith Alan , Marriott John Francis 
Published: December 2005

Abstract

Objective
To identify the role of clinical pharmacists in antibiotic prescribing control.

Method
A self-completion postal questionnaire was sent to the chief pharmacist at 465 UK National Health Service hospitals in 2001/2002. It contained questions covering hospital demographics and the role of pharmacists in ensuring adherence with the recommendations on antibiotic prescribing contained in hospital prescribing documents.

Key findings
Fifty-four per cent of questionnaires (n=253) were completed. Of these, 93% (n=235) of the responding hospitals had at least one of the following prescribing control documents: antibiotic formulary, antibiotic policy and antibiotic guidelines. Pharmacists routinely performed clinical review of adherence with prescribing recommendations (antibiotic prescribing control) in 83% of the responding hospitals but only in approximately two-thirds of hospitals (64%) was this review performed on every ward. The antibiotic prescribing control process appeared to be thorough, with five review activities performed by pharmacists in the majority of hospitals (74%), and proactive, with pharmacists undertaking routine daily visits to all wards (or selected units) in 85% of responding hospitals. Nearly three-quarters (71%) of hospitals had performed an audit of antibiotic prescribing; the majority had done so within the past two years. Pharmacists had been involved in these audits in 92% of responding hospitals.

Conclusions
Where performed, antibiotic prescribing control appeared to be a thorough process. Key areas for service improvement are extension of antibiotic prescribing control to all wards and the standardisation of intervention documentation. Barriers preventing the provision of a comprehensive clinical pharmacy service are discussed and future strategies identified.