bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is hospital admission a sufficiently sensitive outcome measure for evaluating medication review services? A descriptive analysis of admissions within a randomised controlled trial
Authors: Krska Janet , Hansford Denise , Seymour D Gwyn , Farquharson Judy 
Published: July 2007

Abstract

Objective
The aims of the study were: to describe and assess hospital admissions occurring during a randomised controlled trial (RCT) of a pharmacist-led medication review service; to describe the admissions in terms of emergency status and main cause; to estimate the potential contribution of pharmaceutical care issues (PCIs) to admission; and to assess the proportion of admissions that could be influenced by a pharmacist intervention.

Setting
Within the context of a RCT of pharmacists providing medication review for 332 elderly patients living at home, taking at least four repeat medicines, carried out in one region of Scotland. Method Hospital data were obtained for all admissions occurring during the 9-month period studied, summarised and evaluated by two independent medical reviewers for the contribution of PCIs to admission. Two pharmacists assessed the extent to which PCIs were preventable by pharmacist intervention.

Key findings
Approximately two-thirds of the 77 admissions were unplanned, and two-thirds were to medical wards. Only 17 (22%) of all admissions were considered to be related to PCIs and 10 (13%) possibly preventable by pharmacist intervention. Although the majority of surgical admissions were considered to be unrelated to PCIs (26/29), both unplanned and planned medical admissions were related to PCIs. One of these occurred as a direct result of the pharmacist's recommendation.

Conclusion
The overall numbers of hospital admissions, medical admissions and unplanned admissions may not be sufficiently sensitive outcome measures for evaluating the impact of pharmacist interventions. Consideration could be given to developing categories of admission that are related to medicines or are likely to be preventable as more relevant measures. Including more details of hospital admissions in future studies may be useful.
Supplementary pharmacist prescribers' views about communication skills teaching and learning, and applying these new skills in practice
Authors: Cleland Jennifer , Bailey Karen , McLachlan Seonaid , McVey Lisa , Edwards Ruth 
Published: July 2007

Abstract

Objective
To explore supplementary pharmacist prescribers' (SPPs') views of communication skills teaching and learning, and its impact on their practice.

Method
Semi-structured in-depth telephone interviews.

Key findings
A total of 66/143 (46%) pharmacists consented to take part. Of these 66, nine SPPs were purposively selected to represent three different sectors of pharmacy: primary care, hospital and community. Questions for a semi-structured interview schedule were derived from themes identified from SPP self-reflective essays submitted earlier in the course. Framework analysis was used to interpret the data. SPPs' views of communication skills teaching and learning were positive. Topics raised as particularly useful were how to structure the consultation, eliciting a patient-centred history, including the patient's perspective on their situation and/or illness, and working in partnership with the patient. However, interviewees highlighted some practical difficulties with putting these new skills into practice.

Conclusions
The results indicate that SPPs view communication skills training as changing aspects of their consultation practice. The communication skills identified for further development tended to be those not usually required in traditional pharmacy consultations. The results emphasise the importance of providing communication skills training for extended roles.
Medication errors in community pharmacy: an investigation into the types and potential causes
Authors: Lynskey D , Haigh S J , Patel N , Macadam A B 
Published: July 2007

Abstract

Objectives
To establish the nature of medication errors occurring within community pharmacy and analyse common error patterns. To identify factors which influence the occurrence of medication errors and near misses, with the intention of designing systems or strategies to reduce the occurrence of these events.

Setting
Fifteen community pharmacies situated within Brighton and Hove City Primary Care Trust, East Sussex, between January and March 2004.

Method
A self-reporting form was designed, piloted and administered to pharmacists, which gathered information on the detection of an error or near miss in the dispensing process.

Key findings
One-hundred and thirteen near misses and thirty-two medication errors were reported. The majority of near misses were detected by the pharmacist at the final check, and the majority of medication errors were detected by the patient or patient's representative. Selection errors were most common, with similar drug names and packaging cited as the main contributory factors. ‘Business’ was frequently cited as the circumstance surrounding the error.

Conclusion
This study demonstrates that pharmacists do have an important part to play and the positive impact of community pharmacists in preventing, detecting and correcting errors and thus preventing harm to patients in the primary care setting. However, medication errors do occur, and therefore a multifactorial approach by manufacturers, marketing and packaging personnel, in addition to input from pharmacists, may be an effective permanent solution in reducing the errors made.
An evaluation of a rural community pharmacy-based smoking-cessation counselling and nicotine replacement therapy initiative
Authors: Cramp Geoffrey J , Mitchell Caroline , Steer Cathy , Pfleger Sharon 
Published: July 2007

Abstract

Objective
To evaluate the efficiency and the effectiveness of a rural community pharmacy-based smoking-cessation counselling and nicotine replacement therapy (NRT) initiative.

Setting
Community pharmacies in NHS Highland in the north of Scotland.

Key findings
Most clients (77%) smoked cigarettes for an average of 34 pack-years ranging from 1 to 174 pack-years. Almost three-quarters (73%) of the NRT prescribed was in the form of patches. Most respondents (91%) claimed pharmacists' advice was useful, and most (65%) thought that the pharmacist was their preferred healthcare professional for smoking-cessation advice because of ease of access. At the end of week four, 45% of clients reported that they had stopped smoking, this fell to 35% at the end of week 12, and at 44 weeks the point prevalent abstinence rate was 15.8%. Of those that did not stop, 19% reduced their smoking level. This initiative cost £525 for each quitter. Thirteen quality criteria were defined in the assessment framework of which six were achieved.

Conclusions
There are no established criteria for evaluating community pharmacy-based smoking-cessation initiatives currently available, neither are reductions in smoking levels reported. Enhancing the role of the community pharmacist to include health improvement improves the interface between healthcare and the consumer, and helps to meet the national recommendations. Community pharmacy-based smoking-cessation initiatives impact on smoking-cessation targets, allow for the variety of services relevant to the needs of the population and are part of the key to making a difference.

Methods
A review of the literature on community pharmacy-based smoking-cessation initiatives informed a performance assessment framework. Data for evaluation were collected through client records, questionnaires and semi-structured interviews of the stakeholders, and a cost-effectiveness analysis was undertaken.
Extemporaneous compounding in New Zealand hospitals
Authors: Kairuz Therése , Myftiu Joana , Svirskis Darren , Hasan Fhazeel , Lal Aarti , Patel Roshni , Kumar Karishma , Chhim Srey , Singh Ranjani , Garg Sanjay 
Published: July 2007

Abstract

Objective
The skill to compound non-sterile products is one of the seven competencies required of entry-level pharmacists for registration with the New Zealand Pharmacy Council. The need for extemporaneous compounding skills has been questioned in other countries, as it is argued that the skill is not often required in modern pharmacy settings. The aim of the current study was to determine the scope and frequency of extemporaneous compounding in New Zealand hospitals

Method
Retrospective data were collected from eight large hospitals where extemporaneous compounded is regularly undertaken, for the period June 1, 2004 to December 31, 2004. Data were retrieved from compounding logbooks and batch sheets in hospital dispensaries. Data were collected from the north and south islands of the country. There are 32 hospitals of various sizes in New Zealand but extemporaneous compounding is not undertaken at all of them due to staff shortages or lack of demand.

Key findings
There were 2015 products compounded over the seven-month period, with an average of 251.9 per month. Suspensions were the most frequently compounded oral dosage form. Omeprazole suspension was the most frequently compounded extemporaneous product. Nearly one-third of the compounded products were for beta-blockers. Creams, ointments and non-oral solutions were the most common topical compounded products.

Conclusion
Pharmacists perform a broad range of extemporaneous compounding, and the skill of compounding is thus an essential competency for all hospital pharmacists.
The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist's time and activities
Authors: Franklin Bryony Dean , O'Grady Kara , Donyai Parastou , Jacklin Ann , Barber Nick 
Published: July 2007

Abstract

Objective
To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out.

Setting
Surgical ward, London teaching hospital.

Method
All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made.

Key findings
Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P = 0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with ‘self’. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P &lt; 0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P &lt; 0.0001; chi-square test).

Conclusion
The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the design, introduction and use of similar systems.
The effect of training and service provision on the self-assessed competence of community pharmacists
Authors: Laaksonen Raisa , Mills Elizabeth R , Duggan Catherine , Davies J Graham , Bates Ian , Mackie Clare A 
Published: July 2007

AbstractObjectiveThe purpose of this study was to explore self-assessed competence of community pharmacists who had completed additional clinical pharmacy training at certificate level and were accredited to provide a clinical medication review service to primary care patients (the ‘trained’ group). The self-assessed competence of these pharmacists was compared with others who had not undertaken the training (the ‘untrained’ group).MethodA postal questionnaire was sent to 179 community pharmacists in both groups across four primary care trusts in the east of London. The questionnaire comprised two parts: characteristics of the respondents; and 81 behavioural statements divided into four competency clusters.Key findingsThe response rate was 50% (n = 90). While pharmacists who possessed a postgraduate qualification were more likely to assess themselves to be more competent in the ‘Delivery of patient care’ competency cluster, there was no difference in self-assessed competence between ‘trained’ and ‘untrained’ groups.ConclusionTraining and experience in providing clinical medication reviews did not seem to influence the self-assessed competence of community pharmacists: indeed, the ‘trained’ pharmacists seemed to have become more aware of their competence gaps. As the roles of community pharmacists expand, pharmacists need greater targeted support to face new challenges and to deliver the new services in chronic medicines management.
Exploring pharmacists' views about the contribution that reflective learning can make to the development of professional practice
Authors: Black Patricia E , Plowright David 
Published: July 2007

Abstract

Objective
Postgraduate courses for pharmacists are increasingly incorporating reflection on learning and on professional practice as the theory of learning in use. This paper provides an insight into the views of pharmacists, who participated in a prescribing course, about using reflection to contribute to the development of their learning and professional practice.

Method
The research was exploratory in nature and employed an inductive, grounded theory strategy. Qualitative data were collected from focus groups and individual interviewees. Twenty-six individuals, who had been registered on Keele University's Supplementary Prescribing (SP) course, participated in total.

Key findings and conclusions
Two key themes are discussed in this paper that appear to the authors to provide an insight into how reflective learning contributes to the development of professional practice. The structured reflective activities included in participants' reflective portfolios were a catalyst to making them aware of the reflective learning process that they instinctively or intuitively used in their professional practice to some degree. Participants also appeared to be aware of different levels or depths of reflection. They articulated these in a more pragmatic way than the theoretical presentations of levels that appear in published literature. Overall, they saw reflection as being of benefit to their professional development, patient care and their interactions with other health professionals. They perceived it as a way of building the healthcare team through helping them integrate with other health professionals by developing a community of practice.
Electronically transferred prescriptions: picked up faster than paper prescriptions
Authors: Nilsson J Lars G , Bäckström Sara , Sundström Johanna 
Published: July 2007

Abstract
The pick-up rate of 2149 e-prescriptions and 414 paper prescriptions for short-term treatments was determined at a middle-sized Swedish pharmacy. We found a high pick-up rate of 90% within 5 days from the date of issue. The number of patients with a pick-up delay of more than 5 days was significantly higher among those with paper prescriptions (15%) compared to those with e-prescriptions (10%).
Changes in macrophage metabolism in mice heavily infected with Hexamita muris
Authors: Keast D. , Chesterman F. C. 
Published: July 2007

The rate of 3H-RNA synthesis is increased in macrophages cultured from mice with severe, and often fatal, infestation with the intestinal flagellate Hexamita muris. The response of the cultured macrophages to foreign antigen is also impaired at such times. The macrophages behave normally when the flagellate is present as a commensal. The pathology of the heavily infested mice is described and the results are discussed with reference to present concepts of the role of the macrophage in immunity.
Cuffed tube tracheostomy in the dog
Authors: Leverment J. N. , Rae S. 
Published: July 2007

A surgical technique of performing tracheostomy in dogs requiring prolonged intubation with either cuffed or uncuffed tubes is described. Cannulae used in humans are anatomically unsuitable for the dog. The cannula and cuff described in this paper did not predispose to severe mechanical trauma to the trachea and we attempted to minimize factors that may predispose to tracheal damage during the period of intubation and the subsequent development of late tracheal injuring after extubation. A simple method of humidification in these healthy dogs proved adequate; neither tenacious tracheobronchial secretion nor the retention of secretions were seen.
Prevention of catheter-related infections by a new, catheter-restricted antibiotic filling technique
Authors: Palm Ülo , Boemke Willehad , Bayerl Daniela , Schnoy Norbert , Juhr Norbert-C. , Reinhardt H. Wolfgang 
Published: July 2007

Catheter-related infections pose a hazard to both humans and laboratory animals. The aim of this study was to develop a technique preventing bacterial colonization of intravascular catheters. In 27 dogs a total of 70 catheters were implanted. On an average catheters were used for 207 days. Three protocols were compared: (1) flushing the catheters with a heparinized solution; (2) filling only the catheter lumen with α-ctchymotrypsin solution (225 units/ml); (3) filling only the catheter lumen with a solution containing a mixture of the aminoglycoside antibiotic gentamicin (20 mg/ml) and chymotrypsin (225 units/ml). Catheter fillings were always withdrawn before catheter use. Catheter exit sites were all treated with povidone iodine ointment once a day. Body temperatures and weights were recorded, bacteriological and electron microscopical examinations of catheters performed. Without gentamicin filling all catheters were colonized after a few weeks. The dogs showed clinical signs of chronic bacteraemia. Gentamicin filling eradicated colonization. No further bacteraemia was observed. We conclude that filling only the catheter lumen with a concentrated solution of chymotrypsin and gentamicin, combined with measures to prevent infections via the subcutaneous catheter tunnel, is an effective and safe technique to prevent catheter-related infections.
An outbreak of Streptococcus pyogenes infection associated with calcium oxalate urolithiasis in guineapigs (Cavia porcellus)
Authors: Okewole P. A. , Odeyemi P. S. , Oladunmade M. A. , Ajagbonna B. O. , Onah J. , Spencer T. 
Published: July 2007

An outbreak of Streptococcus pyogenes infection occurred in a colony of 800 Dunkin-Hartley guineapigs resulting in 364 (46%) deaths involving breeders, sucklings, weaners, but mainly adults used as a source of blood meals for haematophagus flies ( Glossina palpalis). Clinical signs included bleeding from the nose, mouth and vagina before death. Necropsy revealed pneumonia with consolidation of one or both lungs, haemopericardium and haemothorax. There were yellowish-grey deposits in the urinary bladder of more than 50% of both affected breeders and adults used for feeding haematophagus flies. Beta-haemolytic Streptococcus pyogenes was isolated in pure culture from many tissues including the urinary bladder. The survivors were treated with oxytetracycline (Terramycin-LA; Pfizer) using the intra-muscular route and the response was good.
Incomplete protection mechanism against vesico-ureteral reflux and hydronephrosis in the inbred mouse strain DDD
Authors: Mannen H. , Tsuji S. , Goto N. 
Published: July 2007

We have previously reported the occurrence and inheritance mode of hydronephrosis in the inbred mouse strain DDD. The present investigation examined the possibility that hydronephrosis may be caused by a vesico-ureteral reflux (VUR). Bladder pressure was measured under anaesthesia in 3 strains of mice (DDD, ddY and C57BL/6). VUR was demonstrated by lower bladder pressure only in the DDD strain. Loading pressure into the renal pelvis (LPP) was significantly higher in DDD than in C57BL/6 ( P<0·001). Correlations between LPP and severity of hydronephrosis were significantly positive in DDD and ddY, indicating that mice showing higher LPPs had the severest disease. Scanning electron micrography revealed that the ureteral orifice of DDD (100-300 μm) was much larger than in C57BL/6 (30 μm), and thus offered scant protection against VUR in DDD. These results suggest that DDD hydronephrosis caused by VUR is related primarily to the absence of an adequate protection mechanism in the ureteral orifice.
Commercial rodent diets and nephrocalcinosis in weanling female rats
Authors: Ritskes-Hoitinga J. , Mathot J. N. J. J. , Danse L. H. J. C. , Beynen A. C. 
Published: July 2007

This study addresses the questions to what extent commercial rodent diets would induce nephrocalcinosis, and which dietary components would be responsible for inducing this condition. For this purpose, 10 commercial diets were analysed for selected components and fed to weanling female rats. On the basis of histological inspection of kidney sections, two diets were found to produce significant nephrocalcinosis. The condition could be considered relatively mild because concentrations of Ca in kidney tissue were not increased. There was considerable variation between the commercial diets in the (analysed) concentrations of Ca, P, Mg and protein as well as in the diet-induced urinary pH, urinary volume and caecal weight. Of these parameters, only the dietary Ca: P ratio and group mean urinary pH correlated significantly with the observed variation in group mean calcification scores, the relationships being negative. It is suggested that the Ca : P ratio of commercial rodent diets is an important determinant of nephrocalcinosis.
Change in locomotor activity pattern in mice: a model for recognition of distress?
Authors: van't Land C. Jansent , Hendriksen C. F. M. 
Published: July 2007

Recognition and assessment of pain and distress is made by observing common clinical and behavioural signs. Observation usually occurs during a limited period of time and results can be biased by interpretation of an individual observer. To improve objective assessment of distress we studied the locomotor activity pattern of mice during a 24-h interval. As a reference compound, Freund's complete adjuvant (FCA) was used. Mice were injected intraperitoneally with different doses FCA (0, 0.1, 0.2 and 0.5 ml) and observed for 5 to 7 days. Animals did not appear to be in pain and seemed to have a normal activity and behaviour pattern at first sight, however FCA induced a dose-dependent decrease of body weight. Open field activity (total distance run) measured during a limited period of time was not altered as a result of FCA. However, nocturnal activity was dose dependently decreased during the first 3 to 4 nights after treatment with FCA. The data presented indicate that using locomotor activity patterns over 24 h might be a useful adjunct and an objective approach to assess distress.