Rola farmaceuty w wykrywaniu i rozwiązywaniu problemów lekowych wśród pacjentów ambulatoryjnych

The role of community pharmacists in identification and solving of drug-related problems among ambulatory patientsPharmacotherapy is the most often used type of therapeutic intervention. Unfortunately the huge amount of money is consumed due to lack of safety or effectiveness of medicinal products. Most of the pharmacotherapy problems are identified as a drug-related problems (DRP). The Drug-Related Problem is an event or circumstances involving drug therapy that actually or potentially interferes with desired health outcomes. The aim of our analysis was the qualitative and quantitative description of DRP among chronically ill patients. We have analyzed the Medication Drug Review of 93 patients in Cracow. Results. Almost 13% of patients used more than 10 medicinal product. The 789  DRPs was identified, the most often occur an adverse drug events and about 11% are DRP recognized as lack of effectiveness of therapy. About 1/3 of all DRPs is connected to OTC medication only or combination of OTC and prescribed medication. Conclusion. The community pharmacists should be involved in identification and solving DRPs among ambulatory patient

Are we ready to implement competence-based teaching in pharmacy education in Poland?

Pharmacists in Poland are responsible for the dispensing and quality control of pharmaceuticals. The education process in pharmacy is regulated and monitored at the national level. Pharmacy education at Jagiellonian University is organized in a traditional way based on input and content teaching. The aim of the study was to determinate whether the Jagiellonian University curriculum in the Pharmacy program meets the criteria of the European Competence Framework. The mapping of the intended curriculum was done by four academic teachers. The qualitative and quantitative analysis of the distribution of the European Competence Framework among a group of courses and study years was done. We observed that most of the personal competencies are offered to students in their senior years, while the patient care competencies are distributed equally during the cycle of the study, and only some of them are overrepresented at the senior years. We need a legislation change at the national level as well as organizational and mental change at the university level to move from learning outcome-based pharmacy education to competence-based

Assessment of knowledge and skills of patients with hypertension related to self-measurement of blood pressure (SBPM)

Background Scientific societies have provided massive guidance on the role blood pressure self-measurements play in assessing hypertension treatment effectiveness, where the necessity for the measurements to strictly follow manual and general instructions in order to obtain proper and reliable readings have been underlined and highlighted. Material and methods The present study has been aimed at assessing knowledge and skills regarding blood pressure self-measurements by hypertension patients. The patients self-monitored their blood pressure twice a day with a RossmaxAI95CA sphygmomanometer for 10 days. The videorecorded measurements were analysed and the patients’ skills were marked independently by 2 researchers with regard to 20 parameters. A 10 question test was applied to rank each patient’s knowledge. The study was performed at community pharmacies and a health centre in Malopolska region. Results The study involved 14 patients. A score of 4 points was found to be the mean test score. Less than 30% of the respondents answered properly the questions on cuff inflation value, time interval between having a coffee and taking the measurement to be respected, or which arm to select for measurements. A mean score for measurement performance skills, based on the video analysis, reached 12.2 points, which corresponds to 61% compliance. The patients tended to take blood pressure measurements while leaning forward, as they sat too far from the table, thus having their arm not supported properly. The cuff placed too low, i.e. at the bend of the elbow, or set inversely, with the air tube up, proved to be the most common mistakes. While taking measurements patients would adjust their position in the chair, re-inflate the cuff, write, or inflate the cuff with the hand on which it was placed. Conclusions The study has shown that hypertension patients due to their insufficient skills and limited knowledge shall be subjected to proper educational procedures on blood pressure self-measurements

Effect of education for hypertensive patients with correctly performed self-blood pressure monitoring (SBPM)

Introduction: The study objective was to assess the impact of pharmacist-led education on the patient’s knowledge and skills on SBPM (self-blood pressure monitoring). Methods: Patient knowledge was assessed using tests and patients’ skills were based on a checklist (20 parameters) completed by the researcher based on the SBPM video records. Patients taking pressure measurements were filmed for 20 days and after 6 months. After the first 10 days, patients were educated about the correct SBPM procedure. Knowledge tests were repeated three times (before/after/6 months after education). Results: All patients’ knowledge and skills in the field of SBPM were improved after education. After the education, patients scored an average of 9 out of 10 points in the knowledge test (increasing an average of five points after education), six months later—an average increase of 7.36 points. Patient skills after training were rated at 17.4 out of 20 points on average (increase by an average of 5.14 points after education), six months later, there was an average of 16.23 points. Conclusions: The study showed an increase in patients\u27 knowledge and skills in the field of SBPM after training

How Polish patients use hypnotics and anxiolytics : the fragmentary report from a questionnaire survey conducted in the community pharmacies

Background: Due to lack of the monitoring of benzodiazepines/zolpidem therapy duration, the problem of their improper/prolonged use in Poland is difficult to study. Aim: To evaluate how patients use the BDZ/zolpidem. The second aim was to show whether the pharmacists can identify the risk for BZD misuse during the dispensing/counseling process. Method: The pharmacists were equipped with questionnaires regarding the use of BDZ/zolpidem. The questionnaires were fulfilled during dispensing. Results: The pharmacists collected data from 71 BDZ-users. The therapy duration was exceeded in 47 responders. Almost all patients took anxiolytics/hypnotics each day. Only 11 patients have ever tried to discontinue. Only three BDZ-users were ever informed by their GP about the necessity of discontinuation. Conclusions: Pharmacists should dedicate attention to BZD-users. The results indicate the need for actions focusing on the safety of use of hypnotics and the necessity of drawing attention of GPs to the problem of long-term BDZ-users

Quality indicators for measuring the level of patients' involvement in the pharmaceutical care process

Patient-centred counseling is an integral part of the pharmaceutical care process. Quality in- dicators can be valuable tools to measure the level of patients’ involvement in their personal healthcare. The aim of the study was to validate two quality indicators for community pharmacy care focusing on patient involvement. As part of the EDQM Pharmaceutical Care Quality Indicators Project (Council of Europe), at least 10 patients per indicator were recruited in each community pharmacy in Serbia and Po- land. Pharmacists targeted patients aged 18-65 years starting chronic treatment (Indicator 1) and elderly patients with polymorbidity receiving at least five chronic treatment medicines (Indicator 2). Based on patients’ answers to a questionnaire, patient-pharmacist consultations took place. For Indicator 2, patients were also offered a medication review. In total, 66% of Serbian patients and 29% Polish patients, for In- dicator 1, were engaged in pharmacist-patient consultations; 96% of Serbian and 84% of Polish elderly patients subsequently participated in medication reviews. Community pharmacists can increase patients’ involvement in their own pharmaceutical care, and there is a need for such services. This study defines a pragmatic approach to encourage/support the implementation of the pharmaceutical care philosophy and working methods in European community pharmacies

Safety of the patients using OTC drugs : is there a need for the change? : a study of the pharmacists and pharmacy students' views

Introduction: The rich assortment of over the counter drugs (OTC) in Poland and their advertising contributes to the increasing the purchase of OTC preparations. Aim: To investigate the opinions of pharmacists and pharmacy students on the safety of use of OTC drugs by patients. Method: The survey study among the pharmacists and pharmacy students. Respondents assessed safety of OTC drugs, the possibility of the introduction of the new drug category "dispensed only by pharmacist" for some OTC drugs as well as the necessity for development of algorithms supporting dispensing OTC drug. Results: 146 questionnaires were analyzed. 89% of the respondents find it necessary to create procedures increasing patient’s safety. 61% respondents supported the idea of new regulation: "issued only by pharmacist". The respondents pointed to the need to implement algorithms that facilitate pharmacy counseling. Conclusions: Pharmacists are aware of threat to health by OTC drugs and want the situation to change

An assessment of counseling quality provided by community pharmacies to patients during expedition of pseudoephedrine.

Badanie zaprojektowano w celu oceny jakości konsultacji farmaceutycznej towarzyszącej ekspedycji pseudoefedryny Metodyka: Badanie terenowe z zastosowaniem metodologii "tajemniczego pacjenta" przeprowadzone w 142 aptekach w Polsce. Badanie przeprowadzono z wykorzystaniem dwóch scenariuszy (scenariusz I: lek dla dziecka, II: dla pacjenta 75-letniego) oraz listy kontrolnej. W obydwu sytuacjach farmaceuta powinien odradzić lek. Listy kontrolne uzupełniano po opuszczeniu apteki. Dane analizowano zbiorczo. Oceniano, czy dokonano identyfikacji użytkownika i wykluczono przeciwwskazania do zastosowania leku. Wyniki: Analizowano 142 konsultacje (I n=72, II n= 70). Spontanicznej identyfikacji pacjenta dokonało jedynie 24 ze 142 farmaceutów. Scenariusz I: 21 farmaceutów nie zadało żadnego pytania. Scenariusz II: tylko 22% ekspediujących lek dla "starszej osoby" ustaliło jej wiek. 50% konsultujących nie zapytało o choroby/inne leki stosowane przez niego. Wnioski: Konieczna jest edukacja farmaceutów w zakresie przeprowadzania wywiadu i wprowadzenie algorytmów ekspedycji niektórych leków.The study was designed to investigate the quality of pharmaceutical counseling accompanying the expedition of pseudoephedrine. Method: the "mystery patient" study carried out in 142 community pharmacies in Poland. The study was conducted using two scenarios and a check-list. The scenario I: drug for child, II: 75-year-old man. In both situations, the pharmacy staff should discourage the use of the drug. The checklists were completed after leaving the pharmacy. The data were analyzed collectively. It was assessed whether the pharmacists/ technicians identify the drug user and/or exclude contraindications. Results: 142 consultations were analyzed (I n=72, II n=70). Only 24 out of 142 pharmacists/technicians identified the patient. Scenario I: 21 pharmacists did not ask any questions. Scenario II: only 22% pharmacists/technicians informed that the drug is for the "elderly person" determined his age, 50% of consultants did not ask about diseases/other medicines used by him. Conclusions: It is necessary to educate pharmacists about conducting interviews and introducing algorithms for the expedition of OTC drugs

The Camberwell Assessment of Need for the Elderly questionnaire as a tool for the assessment of needs in elderly individuals living in long-term care institutions

AbstractObjectivesThe aim of the study was to evaluate the Camberwell Assessment of Need for the Elderly questionnaire (CANE) in assessing the needs of elderly individuals living in long-term care institutions (LTCI) in Poland.Setting and ParticipantsThe needs of 173 residents were assessed. The inclusion criteria were age (at least 75 years of age) and the lack of severe cognitive impairment (Mini Mental Scale Examination score of at least 15 points).MeasurementsIn all participants, met and unmet needs were assessed by themselves and by the nursing staff involved in care activities.ResultsThe number of met needs assessed by the staff was higher than in the users’ opinions (p<0.0001), whereas the number of unmet needs was lower (p<0.001). However, the average percentage of the agreement between the user and the staff was as high as 86.2%. The areas characterized by the lowest agreement were Company (65.3%), Memory (75.7%), Eyesight/hearing/communication (70.5%) and Psychological distress (70.5%).ConclusionsDespite a high percentage of agreement reached between the staff and user assessments of needs in our study, we were able to identify the areas of discrepancies between these two perceptions of needs. These can be treated as signals pointing to those aspects of care that should be addressed