pharmaceutical care

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Pharmacy Students Learning Styles and Preferences toward Teaching Methods in Learning Pharmaceutical Care Concept

The paradigm concerning the role of pharmacist has shifted from supplying drugs to providing pharmaceutical care services.1 Pharmacy faculties have responsibility to develop a curriculum that enables pharmacy students to provide pharmaceutical care services. Pharmaceutical care is provided by identifying, solving and preventing drug-related problems in patients.2 There is a need to use alternative teaching methods to aid the students develop abilities for providing pharmaceutical care. Some research has demonstrated an association between preference toward certain teaching methods and individual s learning style.3 Learning style is the process by which an individual obtains their knowledge or skills.4 Understanding pharmacy students learning style will support educators to facilitate learning process by applying appropriate teaching methods. The purpose of the study was to describe pharmacy students learning style and preferences toward some teaching methods in learning Pharmaceutical Care Concept. The study was a survey using questionnaire that consisted of two parts. Part one was Kolb s Learning Style Inventory to assess students learning styles and second part were statements of four teaching methods to know students preferences. The questionnaire was given to 4th year pharmacy students registered in Clinical Pharmacy II course. In Clinical Pharmacy II course students were taught to identify and solve drug-related problems as a component of pharmaceutical care services. After completed the questionnaire, students were asked to choose their preferences toward four teaching methods. The study surveyed 63 pharmacy students. There were 11 incomplete questionnaires excluded from analysis. The characteristic of students surveyed is described in Table I. The students’ learning styles and preferences are described in Table II. Of the 52 students, the largest group was Assimilators (52%). The remaining students were divided among other three learning styles (23% Divergers, 21% Convergers, and 4% Accommodators). All Accommodator preferred case study as their teaching method. Lecturing was the most preferred teaching method for Divergers and Assimilators, while most Convergers prefered case study as their teaching method. Of all teaching methods, the most preferred was lecturing

Geriatric pharmacotherapy : optimisation through integrated approach in the hospital setting

Since older patients are more vulnerable to adverse drug-related events, there is a need to ensure appropriate prescribing in these patients in order to prevent misuse, overuse and underuse of drugs. Different tools and strategies have been developed to reduce inappropriate prescribing; the available measures can be divided into medication assessment tools, and specific interventions to reduce inappropriate prescribing. Implicit criteria of inappropriate prescribing focus on appropriate dosing, search for drug-drug interactions, and increase adherence. Explicit criteria are consensus-based standards focusing on drugs and diseases and include lists of drugs to avoid in general or lists combining drugs with clinical data. These criteria take into consideration differences between patients, and stand for a medication review, by using a systematic approach. Different types of interventions exist in order to reduce inappropriate prescribing in older patients, such as: educational interventions, computerized decision support systems, pharmacist-based interventions, and geriatric assessment. The effects of these interventions have been studied, sometimes in a multifaceted approach combining different techniques, and all types seem to have positive effects on appropriateness of prescribing. Interdisciplinary teamwork within the integrative pharmaceutical care is important for improving of outcomes and safety of drug therapy. The pharmaceutical care process consists offour steps, which are cyclic for an individual patient. These steps are pharmaceutical anamnesis, medication review, design and follow-up of a pharmaceutical care plan. A standardized approach is necessary for the adequate detection and evaluation of drug-related problems. Furthermore, it is clear that drug therapy should be reviewed in-depth, by having full access to medical records, laboratory values and nursing notes. Although clinical pharmacists perform the pharmaceutical care process to manage the patient’s drug therapy in every day clinical practice, the physician takes the ultimate responsibility for the care of the patient in close collaboration with nurses

Desarrollo de una taxonomía de las intervenciones farmacéuticas en pacientes VIH+ basados en el modelo CMO

Objective: To agree on a proposal for pharmaceutical interventions and establish their classification taxonomy according to the CMO-Pharmaceutical Care Model (Capacity-Motivation- Opportunity). Method: A study conducted between March and May, 2016. Two phases of development were defined. A literature review was initially conducted. Then, the DELPHI-Rand-UCLA methodology was used in order to reach a consensus about those interventions selected, and to define the taxonomy. Fifteen (15) experts, specialists in Pharmaceutical Care for HIV+ patients, were selected. This selection was explicitly conducted, following a protocol in order to avoid any bias. An initial proposal was developed according to the interventions extracted from Phase 1. These were tentatively classified according to the CMO Model, in a category based on their design and utility. Three issues were raised from the initial question: Do you agree with the proposed classification? If not, there was an option to re-categorize. Additionally, they were asked about the importance, priority and impact to achieve pharmacotherapeutic objectives that they would assign to it. Interventions were classified according to the degree of agreement. Once a consensus was reached, the final taxonomy was established. Results: Eighteen (18) articles were finally considered. The initial proposal included 20 pharmaceutical interventions with the following classification: seven in Capacity, eight in Motivation, and five in Opportunity. Those interventions considered to have greater importance and priority were: Review and Validation, Safety, and Adherence. The interventions with the greatest impact were: Review and Validation, Coordination, Adherence, and Motivation. On the other hand, the lowest scores for importance were for: Planning and Social Coordination; and in terms of impact: Social Coordination. Conclusions: The taxonomy reached by consensus will allow to classify pharmaceutical interventions with the new model, and therefore to conduct an improved research and patient care

Is Taking a Pill a Day Good for Health Expenditures? Evidence from a Cross Section Time Series Analysis of 19 OECD Countries from 1970 – 2000

This paper differs in two ways from previous comparative health system research. First, it focuses on the impact of pharmaceutical expenditures on total health expenditures as trends in pharmaceutical expenditures have been blamed of being a major driver of national health expenditures. In addition to pharmaceutical expenditures, other variables of interest are income, public financing, public delivery, ageing and urbanization. Second, the analysis includes a thorough sensitivity analysis on the proposed model using four samples (with and without the US, and imputed and not imputed data) to address the issue of robustness. Based on a typology of health care systems, trends of relevant explanatory variables are described using OECD Health Data 2003 data. Unlike any other of the variables, pharmaceutical expenditures show contradicting trends when measured as per capita pharmaceutical expenditures and pharmaceutical share of total health expenditures. Next, a regression analysis is performed on data from 1970 – 2000 for 19 OECD countries. Regression diagnostics indicated the absence of multicollinearity but the presence of heteroscedasticity and autocorrelation. Based on the Hausman test, a fixed effect model was chosen. As in all previous empirical research, per capita GDP turned out to be the most influential explanatory variable. While public financing of health care was always three out of four samples significantly inversely related to health expenditures, public delivery as a NHS dummy was always significantly positively related to the dependent variable. Unlike previous research, ageing is consistently and significantly related to higher total health expenditures and, so is urbanization. Finally, all samples show a highly negative relationship between share of pharmaceutical expenditures and health expenditures, suggesting support for the substitution theory.health care expenditure ; health care system ; health economics ; health policy ; comparative

Recession Proof Pills: An Examination of the Relationship Between Recession Economics and Pharmaceutical Expenditures

The first decade of the 21st century proved to be a time of turbulence and volatility in the worldwide economy. Oddly enough, even as Americans’ disposable income decreased, spending on health care steadily increased. Americans spent $249.9 billion on prescription drugs in 2009, contrasted against$120.9 billion in 2000—a 105% increase.1 We may question the overall ramifications of such increases in pharmaceutical sales and the correlation to other economic factors. That is, how was the pharmaceutical sector able to boast gains when the housing market collapsed? One answer is that people place a priority on their health, even with limited resources. A report sanctioned by the World Health Organization illustrates the problem when it states that, “It is hard to gauge the implications of the recession on people\u27s health”.2 In this paper, I examine pharmaceutical sales figures to develop a better understanding of how the Great Recession (2009) affected health care and pharmaceutical expenditures in the United States. A January 2011 Health Affairs article argues that, “In 2009, despite the economic downturn, the number of prescription drugs dispensed rebounded to prerecession rates of growth”.3 While the recession stifled the overall rate of spending on prescription drugs, Americans allocated a greater amount of GDP to pharmaceuticals—$249.9 billion in 2009 contrasted against$237.2 billion in 2008.4 The pharmaceutical industry, then, really dispenses recession-proof pills. Understanding the complexities of recession economics will ultimately illustrate the need for restructuring how pharmaceutical companies produce and government agencies regulate prescription drugs in the United States

Association of Over-The-Counter Pharmaceutical Sales with Influenza-Like-Illnesses to Patient Volume in an Urgent Care Setting

We studied the association between OTC pharmaceutical sales and volume of patients with influenza-like-illnesses (ILI) at an urgent care center over one year. OTC pharmaceutical sales explain 36% of the variance in the patient volume, and each standard deviation increase is associated with 4.7 more patient visits to the urgent care center (p<0.0001). Cross-correlation function analysis demonstrated that OTC pharmaceutical sales are significantly associated with patient volume during non-flu season (p<0.0001), but only the sales of cough and cold (p<0.0001) and thermometer (p<0.0001) categories were significant during flu season with a lag of two and one days, respectively. Our study is the first study to demonstrate and measure the relationship between OTC pharmaceutical sales and urgent care center patient volume, and presents strong evidence that OTC sales predict urgent care center patient volume year round. © 2013 Liu et al

What, who and when? Incorporating a discrete choice experiment into an economic evaluation

Acknowledgements The Medman study was funded by the Department of Health for England and Wales and managed by a collaboration of the National Pharmaceutical Association, the Royal Pharmaceutical Society of Great Britain, the Company Chemist Association and the Co-operative Pharmacy Technical Panel, led by the Pharmaceutical Services Negotiating Committee. The research in this paper was undertaken while the lead author MT was undertaking a doctoral research fellowship jointly funded by the Economic and Social Research Council (ESRC) and the Medical Research Council (MRC). The Health Economics Research Unit (HERU), University of Aberdeen is funded by the Chief Scientific Office of the Scottish Government Health and Social Care Directorate.Peer reviewedPublisher PD

Pharmacy intervention at an intensive care rehabilitation clinic

Introduction: During an intensive care stay, patients often have their chronic medications withheld for a variety of reasons and new drugs commenced [1]. As patients are often under the care of a number of different medical teams during their admission there is potential for these changes to be inadvertently continued [2]. Intensive Care Syndrome: Promoting Independence and Return to Employment (InS:PIRE) is a five week rehabilitation programme for patients and their caregivers after ICU (Intensive Care Unit) discharge at Glasgow Royal Infirmary. Within this programme a medication review by the critical care pharmacist provided an opportunity to identify and resolve any pharmaceutical care issues and also an opportunity to educate patients and their caregivers about changes to their medication. Methods: During the medication review we identified ongoing pharmaceutical care issues which were communicated to the patient’s primary care physician (GP) by letter or a telephone call. The patients were also encouraged to discuss any issues raised with their GP. The significance of the interventions was classified from those not likely to be of clinical benefit to the patient, to those which prevented serious therapeutic failure. Results: Data was collected from 47 of the 48 patients who attended the clinic (median age was 52 (IQR, 44-57) median ICU LOS was 15 (IQR 9-25), median APACHE II was 23 (IQR 18-27) and 32 of the patients were men (67%). The pharmacist made 69 recommendations; including 20 relating to drugs which had been withheld and not restarted, dose adjustments were suggested on 13 occasions and new drug recommendations were made for 10 patients. Duration of treatment for new medications started during hospital admission was clarified on 12 occasions. Lastly adverse drug effects were reported on 4 occasions and the incorrect drug was prescribed on 2 occasions. Of the interventions made 58% were considered to be of moderate to high impact. Conclusions: The pharmacist identified pharmaceutical care issues with 18.6% of the prescribed medications. Just over half of the patients reported that they were not made aware of any alterations to their prescribed medication on discharge. Therefore a pharmacy intervention is an essential part of an intensive care rehabilitation programme to address any medication related problems, provide education and to ensure patients gain optimal benefit from their medication

An Overview of Progress in the International Regulation of the Pharmaceutical Industry

[Excerpt] “The pharmaceutical industry, a significant source of healthcare throughout the world, has several features that distinguish it from the rest of the health industry. In the last half-century, new technology, better technological know-how, and overall economic growth have led to widespread and rapid growth in the pharmaceutical sector. Advancements in pharmaceutical research and development have led to the production of drugs that can routinely combat afflictions that, only years ago, were untreatable or even fatal. Since 1970, the average share of Gross Domestic Product (GDP) on pharmaceutical goods has increased in most Organization for Economic Cooperation and Development (OECD) countries by approximately 50%, meaning that pharmaceutical expenditure has increased on average 1.5% more per year than GDP growth. Given that access to health care is fundamental to developed society and that pharmaceutical goods are a significant source of healthcare, drugs should be accessible to everyone across the world. However, universal accessibility to drugs is not an easy feat. As nations work with their pharmaceutical industries to provide the best possible access to drugs, they must do so on limited budgets and while maintaining proper incentives for pharmaceutical companies to continue to innovate. These conflicting objectives are problems unique to the pharmaceutical industry and critical to its successful future. In the European Union (EU), major steps are being made to balance these objectives through the establishment of a Single Market for Pharmaceuticals. As stated in a Commission Communication on the single market in pharmaceuticals, “The purpose of the completion of the Single Market in Pharmaceuticals is not just to provide an environment which is favorable for pharmaceutical innovation and industrial development, it is also to improve consumer choices in pharmaceuticals of the required quality, safety and efficacy, at an affordable cost.” The aim of this note is to present an overview of the major factors that are currently shaping and effecting international trade in the international pharmaceutical industry, and of how these factors contribute to the EU\u27s progression towards a single market. Through outlining the present status of the industry, we hope to facilitate the making of future decisions to reach a better balance between industry innovation and healthcare accessibility.