Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 5 Articles
Inhaled medications are critical in the pharmaceutical management of respiratory conditions,\nhowever, the majority of patients demonstrate at least one critical error when using an inhaler. Since\ncommunity pharmacists can be instrumental in addressing this care gap, weaimed to determine the rate\nand type of critical inhaler errors in community pharmacy settings, elucidate the factors contributing\nto inhaler technique errors, and identify instances when community pharmacists check proper inhaler\nuse. Fourth year pharmacy students on community practice placement (n = 53) identified 200 patients\nwhere at least one error was observed in 78% of participants when demonstrating inhaler technique.\nPrevalent errors of the users were associated with metered dose inhaler (MDI) (55.6%), Ellipta®\n(88.3%), and Discus® (86.7%) devices. Overall, the mean number of errors was 1.09. Possession of\nmore than one inhaler, use of rescue inhaler, and poor control of asthma were found to be significant\npredictors of having at least one critical error. In all participating pharmacies, inhaler technique is\nmainly checked on patient request (93.0%) and for all new inhalers (79.0%)....
Pharmacists in primary care settings have unique opportunities to address the causes\nof ineffective care transitions. The objective of this study is to describe the implementation of a\nmultifaceted pharmacist transitions of care (TOC) intervention integrated into a primary care practice\nand evaluate the effectiveness of the program. This was a two-phase pilot study describing the\ndevelopment, testing, and evaluation of the TOC program. In Phase 1, the TOC intervention was\nimplemented in a general patient population, while Phase 2 focused the intervention on high-risk\npatients. The two pilot phases were compared to each other (Phase 1 vs. Phase 2) and to a historical\ncontrol group of patients who received usual care prior to the intervention (Phase 1 and Phase 2\nvs. control). The study included 138 patients in the intervention group (Phase 1: 101 and Phase 2:\n37) and 118 controls. At baseline, controls had a significantly lower LACE index, shorter length of\nstay, and a lower number of medications at discharge, indicating less medical complexity. A total of\n344 recommendations were provided over both phases, approximately 80% of which were accepted.\nIn adjusted models, there were no significant differences in 30-day all-cause readmissions between\nPhase 2 and controls (aOR 0.78; 95% CI 0.21â??2.89; p = 0.71) or Phase 1 (aOR 0.99; 95% CI 0.30â??3.37; p\n= 0.99). This study successfully implemented a pharmacist-led TOC intervention within a primary\ncare setting using a two-phase pilot design. More robust studies are needed in order to identify TOC\ninterventions that reduce healthcare utilization in a cost-effective manner....
Objective: To develop and test a simple medication-focused patient counseling intervention\nat hospital discharge, with the aim of improving patient satisfaction. Methods: The intervention\nwas developed during a workshop and carried out by pharmaconomists. The final intervention\ncomprised preparing information for the discharge counseling, medication reconciliation, discussion\nwith physician, patient counseling at discharge, medication report to primary care physician, and\nphone follow-up three days after discharge. The intervention was tested against usual care in a\ngastrointestinal surgical unit in a feasibility study, using the setup of a randomized controlled trial,\nwith patient satisfaction as the primary outcome. Results: A total of 85 patients were invited to\nparticipate in the study. Following refusals (n = 11) and exclusions (n = 10), 32 patients were included\nin each trial arm (median age of 66.5 years; 52% males; median admission length of seven days).\nPatient satisfaction was high in both groups, with 75% (intervention) and 91% (control) reporting\nbeing overall satisfied with the discharge process (p = 0.10). No other differences between the groups\nwere identified. Conclusions: The intervention did not result in improved patient satisfaction. This is\nlikely attributed to the low number of patients included, the high satisfaction at baseline, and the lack\nof a validated tool to measure patient satisfaction. The developed intervention and study findings\ncan inform future studies....
Background: The World Anti -Doping Agency (WADA) specifies substances that \ncompetitive sportspersons are not allowed to take. Some of these substances are contained in \ncommon medicines used in everyday medical practice and could be used by athletes by accident. \nObjectives: This study aimed to explore pharmacistsâ?? knowledge and confidence in guiding athletes \nabout the use of medicines in professional sport. Methods: Registered pharmacists in Australia were \ninvited to participate in an online survey. The survey had five domains and aimed to identify \npharmacistsâ?? demographic information, interest in sport, familiarity with WADA guidelines, \nknowledge on prohibited drug classes, and their opinion about the role of pharmacists in educating \nathletes on medication use. Descriptive statistics were provided and where appropriate, Chi -square, \nMannâ??Whitney and independent t -test were used to identify potential associations and difference \nbetween means. Results: One hundred and thirty -five pharmacists (response rate of 10.6%) \ncompleted the survey, with the majority indicating that they were not confident in advising athletes \non medication use. Although most respondents believed that pharmacists have a role in the \neducation of athletes to help avoid unintentional doping, only about a quarter indicated that they \nhad sufficient knowledge to advise athletes. About one -half of the respondents could provide fully \ncorrect answers when asked to identify the WADA status of some commonly used drugs. \nConclusions: The results of the survey indicate that upskilling is required to enable pharmacists in \nAustralia to provide accurate medication advice to professional athletes...
The 2019 measles outbreak was the worst since the US eliminated measles in 2000. This \npaper presents the vaccination trends for a large chain -pharmacy, Walgreens, and examines the \nestimated vaccination capacity and impact of pharmacist privilege policies across states. \nSpecifically, we estimated the number of people who could have been vaccinated in eight states \nwith reduced or no measles, mumps, and rubella (MMR) vaccination privilege during the study \nperiod Januaryâ??June, 2019. During the study period, Walgreens pharmacists administered MMR \nvaccines to 62,526 patients, a 231.9% increase. If pharmacists had been permitted to vaccinate against \nmeasles in the eight states investigated, Walgreens pharmacies would have administered between \n12,404 and 36,551 additional vaccinations during that time. We also estimated all chain pharmaciesâ?? \ncapacity to vaccinate in one state that was severely impacted by the measles outbreak, New York, \nusing a range from normal pharmacy operating conditions to maximum capacity. Assuming \nsufficient demand, it was estimated that chain pharmacies in New York State would have the \ncapacity to vaccinate between 47,688 and 174,856 patients daily, achieving MMR vaccination (first \ndose) of the measles -susceptible population within 8â??28 days. Overall, this study demonstrates the \npublic health value of pharmacist vaccination privilege during a nation -wide outbreak of measles....
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