Class of 2017 Abstract / Objectives: To explore the available literature for information on the types of medication errors committed in community pharmacies, the rate of occurrence, and potential causation of those errors. Methods: A literature search was conducted in PubMed for articles dating from 1995-present concerning medication errors committed in community pharmacies. A total of eight studies were used in the evaluation. Results: Error types identified in the literature include content errors, labeling errors, near errors, clinically significant errors, and any other deviation from the prescriber's original order. Each study had its own individual error rate. Combining all studies reviewed, the overall average error rate was 2.2% (516 errors out of 23,455 prescriptions total). Proposed causation of medication dispensing errors include low lighting levels, high sound levels, the use of manual prescription inspection alone, pharmacy design, problems with efficiency, the use of drive through pick up windows, errors in communication, high prescription volume, high pharmacist workload, inadequate pharmacy staffing, and the use of dispensing software programs that provide alerts and clinical information. Conclusions: The available literature proposes that medication-dispensing errors in community pharmacies continue to be a frequent issue. Error types include content, labeling, clinically significant, near errors, and any other deviation from the prescriber's original order. Of the observed errors, labeling was most frequent. The data indicated low lighting, amplified noise, and sociotechnical factors could contribute to error frequency. Future studies are required to focus on other potential causes of dispensing errors and how to minimize rate of occurrence.

Class of 2009 Abstract / OBJECTIVES: To evaluate patients’ perceptions of receiving a pharmacist-administered influenza vaccine in the community pharmacy setting. METHODS: All patients receiving a pharmacist-administered influenza vaccine at a Safeway Pharmacy in Tucson, Arizona were invited to participate in the survey. Participants completed the survey in a waiting area outside the pharmacy. At the completion of the study time frame, surveys were collected, and each response was entered into an Excel spreadsheet for data analysis. RESULTS: Seventy-five patients completed the Flu Shot Survey. One hundred percent of patients reported that getting the influenza vaccine at a grocery store pharmacy is convenient. Respondents reported being either very confident (97.3%) or somewhat confident (2.7%) in pharmacists as immunizers. Only 18.7% reported having never received an influenza vaccine from a pharmacist, and 13.3% reported having no prior knowledge that Arizona pharmacists could administer the influenza vaccine. CONCLUSIONS: All patients responded that receiving the influenza vaccine from a community pharmacist was convenient. Patients wanted to receive the vaccine next year from a pharmacist, and the majority of respondents were confident in the pharmacist as an immunizer. Few patients reported never receiving the influenza vaccine from a community pharmacist, and even fewer patients were unaware that pharmacists in Arizona can immunize.

ABSTRACT This study intended to assess the nature and extent of patient counseling practice in a section of Gauteng’s community pharmacies and determine what factors have negative impact on the practice. Designed as a random cross-sectional survey, questionnaire-based engaging 60 pharmacists and 179 customers, it provided a “snapshot” of counseling services in the Johannesburg and Pretoria regions between January 2006 and September 2006. The outcomes measures assessed included the percentage of the actual practicing, the form of communication, number of items covered, and number of counseling steps accomplished. The findings showed about 74% of patients received at least one drug informational item as verbal advice, and an average of 62% of patients received six drug informational items of advice. Supplementary written information was given to 56% of patients some of the time when necessary or by request. The items of advice achieved at high rate were all about drug-instructions for use (>70%). Information about drug action, side effects and non-pharmacological advice occurred at low rate (<50). Significant difference (p<0.05) was observed between the two regions regarding the accomplishment of some items but no difference was noted referring to global counseling performance. Younger pharmacists overtook older pharmacists in performing some items (like telling when the medication begins to work: 53% versus 37%). Differences were also noted between pharmacists and other categories of dispensers with pharmacists proffering a higher level of quality and quantity of advice (e.g. counseling points summarized: 59% versus 30%). Workload, pharmacy type and gender were unrelated to current counseling practice. In conclusion, participating pharmacists showed good knowledge of the SA Gold Standard on counseling and satisfactory performed the counseling points. However, some expressed concern about the difficulty to accomplish some special GPP provisions. Future studies are advice to investigate the implementation of patient counseling from a nationwide sample of community pharmacies if the Professional Body regulating Pharmacy intends mandating counseling.

Disputats, Göteborg 2006. / Härtill 5 uppsatser. Med sammanfattning på svenska.

Diss. (sammanfattning) Göteborg : Göteborgs universitet, 2006. / Härtill 5 uppsatser.

Community pharmacy practice is moving towards patient care and away from the mere dispensing of medicines. In this movement, which is guided by the philosophy of Pharmaceutical care (PC), new counselling services emerge. The purpose of the thesis was to add knowledge about the real-world provision of PC services by studying a defined PC service in Swedish pharmacies. Specific aims of this thesis were to investigate the experiences of professionals working with or close to the service and to describe the content of consultations, counselling behaviour and patterns of follow-up. Further aims were to characterise patients receiving the service and describe their perceived outcomes, in relation to standard service. Data were collected via focus groups, telephone interviews, observations, a patient medication record database and a cross-sectional survey. The practitioners reported greater use of their pharmaceutical knowledge and provision of more thorough patient support. Perceived barriers in delivering the service included difficulties in documenting and getting commitment from colleagues, managers and prescribers. Doctors working close to PC pharmacies held varying opinions about the service. Consultations dealt with issues potentially improving the outcomes of medical treatment, but the level of patient centredness varied and was limited by the practitioners’ focus on the computer screen. The rate of follow-up evaluations was modest, but was higher at pharmacies with a high volume of patients receiving the service. PC patients were mostly elderly and female, using about 10 prescription drugs. In comparison to patients receiving standard service, they were more worried, vulnerable and information-seeking. At the same time, their feelings of safety following the pharmacy visit were more pronounced than those of patients receiving standard service. They also felt better prepared for doctor visits. In order for community pharmacy to better meet patients’ needs and optimise PC services, increased attention should be given to implementation strategies, interprofessional collaboration and educational efforts focusing on patient centredness.

Class of 2009 Abstract / OBJECTIVES: To assess patients’ satisfaction with pharmaceutical care services provided in a community health center diabetes management clinic. METHODS: Patients who received diabetes-related pharmaceutical services from the clinical pharmacist at El Rio Health Center in Tucson, Arizona from November 2008 to January 2009 were contacted during a visit to the diabetes clinic and asked to complete the consumer assessment of pharmaceutical services questionnaire. The questionnaire included 14 likert-type items with response options ranging from “Never” to “Always” or “Disagree” to “Agree.” In addition, the patient’s most recent hemoglobin A1C (HgbA1C) was obtained from the electronic medical record. The survey instrument was also translated from English to Spanish to serve the Hispanic participants who could not communicate fluently in English. A descriptive cross-sectional analysis was completed in order to assess patient satisfaction. Dependent variables extracted from the survey were analyzed by Mann-Whitney U test. Interval and ratio data were analyzed by calculating means, standard deviations, and an independent t-test. Nominal data were analyzed using the Chi-Square test. RESULTS: A total of 46 patients completed the questionnaires, including 17 men and 29 women (mean age = 56, SD = 11.3, 80% Hispanic). All patients had seen the clinical pharmacist at least 3 times. Overall, this study showed that majority of the patients were satisfied with the service provided in the clinic. There was no statistically significant difference between English and Spanish patient populations in terms of satisfaction with pharmaceutical services provided about their disease management. CONCLUSIONS: Patients in this clinic were highly satisfied with the pharmaceutical care services provided by the clinical pharmacist.

No description available.

Class of 2005 Abstract / Objectives: 1) Determine the compliance rate with 12 dispensing workflow criteria; 2) note if any dispensing errors occurred; and 3) summarize characteristics of the pharmacies studied (pharmacy staffing, dispensing workload, presence of a drive-through window, etc.). Methods: At least fifty out-window (i.e., pharmacy prescription pick up window) transactions per store were observed within 18 community retail pharmacies. Based on the historic pharmacy error incidence reports, pharmacies were categorized as being either high- or low-risk pharmacies. The compliance rates for the dispensing workflow criteria were observed between high- and low-risk pharmacies and also between different employee categories. Employee categories included pharmacists, pharmacy interns, and pharmacy technicians who were involved in the dispensing process. Results: Between August 2004 and January 2005, a total of 950 out-window transactions were observed. There were statistically significant differences seen between high- and low-risk pharmacies and between the various categories of employees. The lack of the verification of patients’ name and number of prescriptions being picked up were procedures that were more commonly associated with pharmacies reported to have high dispensing error rates. Implications: This study identified several areas where the dispensing workflow criteria were not being performed. Based on this study, the lack of the verification of patients’ name and number of prescriptions being picked up were procedures that were more commonly associated with pharmacies reported to have high dispensing error rates.

Background: Improving adherence to medication is a persistent challenge within the health system. Adherence is influenced by many factors at the patient, provider, treatment and health system levels. Adherence may also be affected by continuity of care; defined as the consistent professional relationship between a health provider or source of care and a patient. Objective: To estimate the strength of association between continuity of community pharmacy care and adherence to statin medication among persons initiating statin therapy in Nova Scotia between 1998 and 2008.  Methods: This was a retrospective cohort study using administrative data from the Nova Scotia Seniors’ Pharmacare program. Subjects were included if they were dispensed at least one prescription for a statin medication between 1998 and 2008. Continuity of care was calculated via two methods: the Usual Provider of Care (UPC) index and the Continuity of Care Index (COCI), which measure the density and dispersion of relational continuity of care, respectively. Adherence was calculated using the medication possession ratio. The strength of association between continuity of care and adherence was analyzed using hierarchical regression. Results: During the study period, 31 592 individual subjects received a first statin dispensation. Adjusted hierarchical regression showed that for each 0.10 increase in continuity of care, the odds of adherence increase by 3% (95% CI: 1.01-1.05). Continuity of care measured by the UPC is highly correlated with continuity of care measured by the COCI (r=0.98). Conclusions: Continuity of community pharmacy care is positively associated with adherence to statins among Nova Scotian seniors who initiated statin therapy between 1998 and 2008.