Community pharmacy type 2 diabetes risk assessment: demographics and risk results

Objectives: To determine the demographics and risk results of patients accessing a community pharmacy diabetes risk assessment service. Method: Participating patients underwent an assessment using a validated questionnaire to determine their 10-year risk of developing type 2 diabetes. Patients were given appropriate lifestyle advice or referred to their general practitioner if necessary. Key findings: In total, 21 302 risk assessments were performed. Nearly one-third (29%) of 3427 risk assessments analysed yielded a result of moderate or high chance of developing the condition. Conclusions: Community pharmacies can identify a significant number of patients at risk of developing type 2 diabetes in the next 10 years. Further follow-up work needs to be done to determine the cost-effectiveness of such a service and the consequences of receiving a risk assessment

Mandatory Arbitration of Employment Disputes: Implications for Policy and Practice

In jurisdictions where mandatory-arbitration policies for employment disputes are enforceable, they can be a useful tool for employers and employees alike

Sexual-Harassment Liability in 1998: Good News or Bad News for Employers and Employees?

In June 1998 the U.S. Supreme Court issued three separate rulings regarding workplace sexual harassment. In an apparent victory for employers, the court ruled in one case that a victim must actually suffer a tangible loss (i.e., a demotion or unwelcome transfer) to establish a case for quid pro quo harassment. The court affirmed, moreover, that employers can absolve themselves of liability in hostile-environment cases by establishing a meaningful and effective policy against sexual harassment. Absent a meaningful policy, however, employers will be liable for a hostile environment created by supervisors. Thus, in another case, the court found an employer liable for workplace harassment because the employer pp. 14-21 failed to disseminate its existing policy and to follow its terms. Finally, in a same-sex harassment case, the court rejected the notion that egregious sexual harassment is per se unlawful, leaving open the possibility that a harasser who treats men and women equally, no matter how badly, could be found not guilty of unlawful behavior. Still, the court made it clear that an employer\u27s best defense against supervisors\u27 sexual-harassment behavior is an effective prevention policy. Consequently, employers should draft a policy that (1) defines sexual harassment; (2) states the company prohibits such conduct; (3) provides a clear procedure for submitting claims, including the names of individuals involved in the resolution process; (4) states that those who complain or cooperate with an investigation will not be retaliated against; and (5) is disseminated to all new employees when they join the company, reissued to all employees each year, and posted in a conspicuous location in the workplace

The pharmacy care plan service: Service evaluation and estimate of cost-effectiveness

Background: The UK Community Pharmacy Future group developed the Pharmacy Care Plan (PCP) service with a focus on patient activation, goal setting and therapy management.  Objective: To estimate the effectiveness and cost-effectiveness of the PCP service from a health services perspective.  Methods: Patients over 50 years of age prescribed one or more medicines including at least one for cardiovascular disease or diabetes were eligible. Medication review and person-centred consultation resulted in agreed health goals and actions towards achieving them. Clinical, process and cost-effectiveness data were collected at baseline and 12-months between February 2015 and June 2016. Mean differences are reported for clinical and process measures. Costs (NHS) and quality-adjusted life year scores were estimated and compared for 12 months pre- and post-baseline.  Results: Seven hundred patients attended the initial consultation and 54% had a complete set of data obtained. There was a significant improvement in patient activation score (mean difference 5.39; 95% CI 3.9 – 6.9; p<0.001), systolic (mean difference -2.90 mmHg ; 95% CI -4.7 - -1; p=0.002) and diastolic blood pressure (mean difference -1.81 mmHg; 95% CI -2.8 - -0.8; p<0.001), adherence (mean difference 0.26; 95% CI 0.1 – 0.4; p<0.001) and quality of life (mean difference 0.029; 95% CI 0.015 – 0.044; p<0.001). HDL cholesterol reduced significantly and QRisk2 scores increased significantly over the course of the 12 months. The mean incremental cost associated with the intervention was estimated to be £202.91 (95% CI 58.26 to £346.41) and the incremental QALY gain was 0.024 (95% CI 0.014 to 0.034), giving an incremental cost per QALY of £8,495.  Conclusions: Enrolment in the PCP service was generally associated with an improvement over 12 months in key clinical and process metrics. Results also suggest that the service would be cost-effective to the health system even when using worst case assumptions