COVID-19 pandemic challenges and lessons learned by pharmacy educators around the globe

The coronavirus identified in 2019 (COVID-19) has affected peoples’ lives worldwide. This pandemic forced both pharmacy faculty members and students to adapt to a new teaching and learning environment not only in the United States but around the globe. Pharmacy educators faced challenges and opportunities to convert classroom learning and experiences, as well as student assessments, to a remote or online format. The unique approaches taken to overcome difficulties in various countries showed pharmacy faculty members’ resilience in the face of adversity and their determination to continue providing education to students. The pandemic also shed light on areas needing improvement for pharmacy educators to work on in the future

Areal geology of the Illinois fluorspar district : Part III, Herod and Shetlerville Quadrangles

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Patient feedback questionnaires to enhance consultation skills of healthcare professionals: a systematic review

Objective: To identify patient feedback questionnaires that assess the development of consultation skills (CSs) of practitioners. Methods: We conducted a systematic search using seven databases from inception to January 2017 to identify self-completed patient feedback questionnaires assessing and enhancing the development of CSs of individual practitioners. Results were checked for eligibility by three authors, and disagreements were resolved by discussion. Reference lists of relevant studies and open grey were searched for additional studies. Results: Of 16,312 studies retrieved, sixteen were included, describing twelve patient feedback questionnaires that were mostly designed for physicians in primary care settings. Most questionnaires had limited data regarding their psychometric properties, except for the Doctor Interpersonal Skills Questionnaire (DISQ). Most studies conducted follow-up, capturing positive views of practitioners regarding the process (n = 14). Feedback was repeated by only three studies, demonstrating different levels of improvement in practitioners’ performance. Conclusion: Identified questionnaires were mainly focused on physicians, however, to support using patient feedback, questionnaires need to be validated with other practitioners. Practice implications: Several patient feedback questionnaires are available, showing potential for supporting practitioners’ development. Valid questionnaires should be used with appropriate practitioners in developing more evidence for the impact they may have on actual consultations

Pharmacist provided medicines reconciliation within 24 hours of admission and on discharge: A randomised controlled pilot study

Background: The UK government currently recommends that all patients receive medicines reconciliation (MR) from a member of the pharmacy team within 24 hours of admission and subsequent discharge. The cost-effectiveness of this intervention is unknown. A pilot study to inform the design of a future randomised controlled trial to determine effectiveness and cost-effectiveness of a pharmacist delivered service was undertaken. Method: Patients were recruited seven days a week from five adult medical wards in one hospital over a 9 month period and randomised using an automated system to intervention (MR within 24 hours of admission and at discharge) or usual care which may include MR (control). Recruitment and retention rates were determined. Length of stay(LOS), quality of life (EQ-5D-3L), unintentional discrepancies(UDs) and emergency re-admission(ER) within 3 months were tested as outcome measures. The feasibility of identifying and measuring intervention associated resources was determined. Result: 200 patients were randomised to either intervention or control. Groups were comparable at baseline.95(99%) of patients in the intervention received MR within 24 hours, whilst 62(60.8%) of control patients received MRat some point during admission. The intervention resolved 250 of the 255 UDs identifed at admission. Only 2 UDs were identifed in the intervention group at discharge compared with 268 in the control. The median LOS was 94 hours in the intervention arm and 118 hours in the control, with ER rates of 17.9% and 26.7%,respectively. Assuming 5% loss to follow up 1120 patients (560 in each arm) are required to detect a 6% reduction in 3 month ER rates. Conclusions: The results suggest that changes in outcome measures resulting from MR within 24 hours were in the appropriate direction and readmission within 3 months is the most appropriate primary outcome measure. A future study to determine cost-effectiveness of the intervention is feasible and warranted

The UK Pharmacy Care Plan service: Description, recruitment and initial views on a new community pharmacy intervention

Introduction: The UK government advocates person-centred healthcare which is ideal for supporting patients to make appropriate lifestyle choices and to address non-adherence. The Community Pharmacy Future group, a collaboration between community pharmacy companies and independents in the UK, introduced a person-centred service for patients with multiple long-term conditions in 50 pharmacies in Northern England. Objective: Describe the initial findings from the set up and delivery of a novel community pharmacy-based person-centred service. Method: Patients over fifty years of age prescribed more than one medicine including at least one for cardiovascular disease or diabetes were enrolled. Medication review and person-centred consultation resulted in agreed health goals and steps towards achieving them. Data were collated and analysed to determine appropriateness of patient recruitment process and quality of outcome data collection. A focus group of seven pharmacists was used to ascertain initial views on the service. Results: Within 3 months of service initiation, 683 patients had baseline clinical data recorded, of which 86.9% were overweight or obese, 53.7% had hypertension and 80.8% had high cardiovascular risk. 544 (77.2%) patients set at least one goal during the first consultation with 120 (22.1%) setting multiple goals. A majority of patients identified their goals as improvement in condition, activity or quality of life. Pharmacists could see the potential patient benefit and the extended role opportunities the service provided. Allowing patients to set their own goals occasionally identified gaps to be addressed in pharmacist knowledge. Conclusion: Pharmacists successfully recruited a large number of patients who were appropriate for such a service. Patients were willing to identify goals with the pharmacist, the majority of which, if met, may result in improvements in quality of life. While challenges in delivery were acknowledged, allowing patients to identify their own personalised goals was seen as a positive approach to providing patient services

Industrial contests for Oregon boys and girls : 1912

Published 1912. Facts and recommendations in this publication may no longer be valid. Please look for up-to-date information in the OSU Extension Catalog: http://extension.oregonstate.edu/catalo

Development of a Core Outcome Set for effectiveness trials aimed at optimising prescribing in older adults in care homes

Background: Prescribing medicines for older adults in care homes is known to be sub-optimal. Whilst trials testing interventions to optimise prescribing in this setting have been published, heterogeneity in outcome reporting has hindered comparison of interventions, thus limiting evidence synthesis. The aim of this study was to develop a core outcome set (COS), a list of outcomes which should be measured and reported, as a minimum, for all effectiveness trials involving optimising prescribing in care homes. The COS was developed as part of the Care Homes Independent Pharmacist Prescribing Study (CHIPPS). Methods: A long-list of outcomes was identified through a review of published literature and stakeholder input. Outcomes were reviewed and refined prior to entering a two-round online Delphi exercise and then distributed via a web link to the CHIPPS Management Team, a multidisciplinary team including pharmacists, doctors and Patient Public Involvement representatives (amongst others), who comprised the Delphi panel. The Delphi panellists (n = 19) rated the importance of outcomes on a 9-point Likert scale from 1 (not important) to 9 (critically important). Consensus for an outcome being included in the COS was defined as ≥70% participants scoring 7–9 and <15% scoring 1–3. Exclusion was defined as ≥70% scoring 1–3 and <15% 7–9. Individual and group scores were fed back to participants alongside the second questionnaire round, which included outcomes for which no consensus had been achieved. Results: A long-list of 63 potential outcomes was identified. Refinement of this long-list of outcomes resulted in 29 outcomes, which were included in the Delphi questionnaire (round 1). Following both rounds of the Delphi exercise, 13 outcomes (organised into seven overarching domains: medication appropriateness, adverse drug events, prescribing errors, falls, quality of life, all-cause mortality and admissions to hospital (and associated costs)) met the criteria for inclusion in the final COS. Conclusions: We have developed a COS for effectiveness trials aimed at optimising prescribing in older adults in care homes using robust methodology. Widespread adoption of this COS will facilitate evidence synthesis between trials. Future work should focus on evaluating appropriate tools for these key outcomes to further reduce heterogeneity in outcome measurement in this context

Industrial contests for Oregon boys and girls : 1913

Published 1913. Facts and recommendations in this publication may no longer be valid. Please look for up-to-date information in the OSU Extension Catalog: http://extension.oregonstate.edu/catalo

Areal geology of the Illinois fluorspar district : Part 2, Karbers Ridge and Rosiclare Quadrangles.

Cover title.Includes bibliographical references (p. 39-40)

A comparison of two sources of primary and social care resource use data in a care home setting

Economic evaluations are only as reliable as the data and methods upon which they are based. For both costs and outcomes there are multiple methods available and choice of approach has been demonstrated to impact on the conclusions reached for some evaluations (Drummond et al., 2015). In undertaking a cost analysis there are three broad steps: identification, measurement and valuation. At the identification stage the important resources (large cost drivers) that are likely to differ between the treatment groups are identified, though methods for this are not always evident in published economic evaluations (Thorn et al., 2013, p.159). There are also various methods for collecting resource use information, dependent on the context of the research and health sector being studied. In the UK context, the most likely sources available could include medical records, care institution records, or direct reporting (e.g. questionnaires). It is often assumed that information derived from medical notes will be more accurate than self-report which can suffer from recall bias and missing data, however, evidence suggests this is not universally true for all types of health care resources (Noble et al., 2012; Byford et al., 2007).Comparatively little research has been undertaken looking at methods of resource use measurement (Thorn et al., 2013) and as such, there remains a lack of consensus about which data source(s) should be used in economic analyses and in what circumstances a particular data source might be most appropriate. If source of data leads to different estimates of resource use and costs, then it is important to begin to understand the potential implications of choice of data source on the results and conclusions reached particularly where this may change resource allocation decisions.The objective of this study was to assess which resource items might be important to collect and to see if there are any differences in primary care and social care resource use reporting comparing two sources (General Practice (GP) records versus care home records) of this data in the care home setting