Thesis (MSc(Med)(Pharmacy)) -- University of Limpopo, 2012. / The role of the pharmacist has evolved over the last two decades beyond the traditional functions of dispensing and stock control. The focus has shifted toward patient-oriented functions, in which the pharmacist assumes responsibility for the patient’s drug- and healthcare needs as well as the outcome of treatment. The aim of this research was to assess the need for pharmaceutical care to the Surgical Intensive Care Unit of Steve Biko Hospital. The surgical and trauma ICU is a 12 bed unit to which the researcher rendered pharmaceutical care over an eight week period, from 14 February to 26 March 2011. Interventions to assess drug therapy and achieve definite outcomes to improve patients’ quality of life were documented for 51 study patients according to the system developed by the American Society of Health-System Pharmacists (1992). Of the 51 patients, 35 were male and 16 were female. The age of the patients ranged from 12 years to 86 years, with most patients admitted to the unit in the age groups 21 to 30 years, and 51 to 60 years. The patients’ estimated weights ranged from 40kg to 120kg with older patients, from age 41 upwards, weighing more. The average stay in the unit was 8.7 days, with the minimum stay for one patient being only one day, and the maximum stay for one patient was 26 days. In the study, the HIV status of only 13 of the 51 patients was tested. Of the 13 patients, six were HIV positive, while seven tested negative. All the patients admitted to the unit were not tested for HIV, because they were not admitted to the unit for HIV-related causes, and test results would not have had an effect on their outcome. Diagnoses encountered most frequently in the unit were trauma (21 patients), skeletal involvement or fractures (16 patients), infections or sepsis (15 patients) and gastro-intestinal bleeds (14 patients). In most cases more than one diagnosis applied to the same patient, since patients admitted with trauma also had skeletal or gastro-intestinal involvement. An Assessment of the need of Pharmaceutical Services in the Intensive Care Unit and High Care Unit of Steve Biko Academic Hospital viii The medications prescribed most frequently were enoxaparin (49 patients), sucralfate (41 patients) and multivitamin syrup (47 patients); in accordance with the standard ward protocol for prophylactic regimens. The drug class most often used was the anti-infectiveshaving124 items prescribed during the study period. Of these, the broad spectrum antibiotics were used most frequently, e.g. piperacillin/tazobactam (22 patients), meropenem (11 patients) and imipenem (11 patients). An average of 12 medications was prescribed for each patient in the ward. A total of 181 interventions were suggested for the 51 patients during the study period, of which 127 (70%) were accepted and implemented by the medical and nursing staff. The average number of interventions per patient ranged from 0 to 13 with a median of 3.5 interventions per patient. The four most frequent problem types were untreated medical conditions (15.5%), length or course of therapy inappropriate (13.8%), investigations indicated or outstanding (12.2%) and prescribed doses and dosing frequency appropriate (11%). Interventions were also made regularly to address system errors or non-compliance and factors hindering achievement of therapeutic effect. The perceived need for pharmaceutical care by healthcare professionals in the SICU was measured by questionnaires before and after the study period. The feedback by staff regarding the pharmacist working in the ward was very positive. They appreciated the researchers input on ward rounds, as well as assistance with problems encountered with the pharmacy. Of the total time spent in the ward, the researcher spent 28% of her time on patient evaluation. Ward rounds also took up a great deal of time (21.7%), since ward rounds were done with different members of the multidisciplinary team. Most interventions were suggested during ward rounds. The costs saved during the study period were enough to justify the appointment of a pharmacist to the ward on a permanent basis, albeit for limited hours daily. The researcher designed an antibiotic protocol for the unit. The protocol was designed according to international standards, and after discussion with the microbiologists, adapted for use in the specific unit. An Assessment of the need of Pharmaceutical Services in the Intensive Care Unit and High Care Unit of Steve Biko Academic Hospital ix In conclusion, the study results have demonstrated that a pharmacist’s contribution to patient care at ward level in a surgical ICU resulted in clinical outcomes that improved the patient’s quality of life. Drug-related problems were identified and addressed. Medical staff in the S-ICU accepted the pharmacist’s interventions and even welcomed her contribution to other ward functions, for instance managing medication and providing education. Pharmaceutical care should be rendered on a permanent basis to the Surgical ICU and the pharmacist should increasingly become a key part of the multidisciplinary team, taking responsibility for patients’ medication needs.

No description available.

Thesis (DBA(DoctorateofBusinessAdministration))--University of South Australia, 2001.

Project report (M.S.)--Virginia Polytechnic Institute and State University, 1990. / Abstract. Includes bibliographical references (leaf 113). Also available via the Internet.

No description available.

The Australian health system is undergoing substantial changes in response to consumer demands, rising health costs and consequent shifts in government policies. This thesis explored ways community pharmacists could implement new styles of practice. Results indicate that pharmacists can assist consumers to better manage their medications and reduce harm, but it requires a different practice approach to that currently offered. This research has contributed to the establishment of the nation program, Home Medications Review. / thesis (PhDPharmacy)--University of South Australia, 2005.

The overall objective of this study was to evaluate the impact of cardiovascular safety concerns on the utilization of the thiazolidinediones (TZDs), pioglitazone and rosiglitazone, and other oral antidiabetic drugs. In May 2007, a meta-analysis was published that found a potential increased risk of myocardial infarction (MI) associated with TZDs, particularly with rosiglitazone. A two-year retrospective study of patients diagnosed with type 2 diabetes (ICD9 250.xx) using prescription and medical databases from the Scott & White Health System (SWHS) was conducted. Patients aged 18 or older who were continuously enrolled with SWHS from 2006 to 2008 and had high adherence (Medication Adherence Ratio ≥80%) for either pioglitazone or rosiglitazone during the pre-safety warning period (May 2006- April 2007) were included. Patients were followed through the post-safety warning period (May 2007 - October 2008) or occurrence of event (discontinuation of index TZD drug). Patients who discontinued their index TZD drug by April 2008 were identified if they had a prescription filled for a new oral antidiabetic drugs (OADs), and followed until October 2008 or occurrence of event (discontinuation of new OAD). Cox proportional hazards models were used to assess the rate of and time to discontinuation of index TZD and new OAD with adjustment of age, gender and Charlson Comorbidity Index (CCI). A total of 531 patients (58 percent male; mean age [SD] = 61 [9.1] years) were included in the final analysis, 255 and 276 patients in the rosiglitazone and pioglitazone groups, respectively. The rate of discontinuation for the pioglitazone and rosiglitazone groups began to separate within 90 days of the index event (meta-analysis published in May 2007). In the pioglitazone group, the rate of discontinuation was significantly lower than in the rosiglitazone group ( HR = 0.56; 95% CI = 0.47, 0.67). A total of 21 patients did not experience discontinuation of their index medication. Among patients receiving a new OAD after discontinuing their index TZD (N = 95 rosiglitazone and N = 33 pioglitazone patients), there was no statistical significant in the rate of discontinuing their new OAD between the rosiglitazone and pioglitazone groups (HR = 0.98; 95% CI = 0.61, 1.59). However, patients who received metformin/sulfonylurea combinations had a lower rate of discontinuation compared to patients who received sulfonylureas (HR = 0.38; 94% CI = 0.21, 0.66). The analysis showed the cardiovascular safety concern of TZDs had a significant impact on the utilization of oral antidiabetic drug utilization. / text

The Australian health system is undergoing substantial changes in response to consumer demands, rising health costs and consequent shifts in government policies. This thesis explored ways community pharmacists could implement new styles of practice. Results indicate that pharmacists can assist consumers to better manage their medications and reduce harm, but it requires a different practice approach to that currently offered. This research has contributed to the establishment of the nation program, Home Medications Review. / Thesis (PhDPharmacy)--University of South Australia, 2005.

The Australian health system is undergoing substantial changes in response to consumer demands, rising health costs and consequent shifts in government policies. This thesis explored ways community pharmacists could implement new styles of practice. Results indicate that pharmacists can assist consumers to better manage their medications and reduce harm, but it requires a different practice approach to that currently offered. This research has contributed to the establishment of the nation program, Home Medications Review. / thesis (PhDPharmacy)--University of South Australia, 2005.

Organisations are continuously seeking for strategies to improve operations and gain competitive advantage. Maintenance tends to be a key management issue for many industrial companies. Maintenance management, being an integral part of manufacturing, can influence competitive companys‟ priorities, such as cost, quality and flexibility, and, hence, business strategy directly. The pharmaceutical industry also faces some unique challenges such as increasingly stringent safety and quality regulations, the effect of innovations in medical science and healthcare and a complex and costly design-to-market process (from product concept and development to market delivery). The industry is also going through turbulent times as it has to cope with challenges common to many other industries, how to deal with increasing competition, hold down costs, and expand. Regulatory compliance is one of the significant industry drivers for pharmaceutical companies. Regulations are enacted by government authorities to ensure public health and safety. The focus of regulation is on quality assurance and control in all areas such as receiving, manufacturing, storing, packaging, despatching and delivering. Apart from the required quality and safety checks, the regulations also mandate extensive record keeping of procedures, processes and systems. This treatise will investigate the maintenance management system of a pharmaceutical company and compare it to best practices. The true name of the pharmaceutical company that will be researched will not be disclosed for confidentiality reasons, instead it will be called My Pharmaceuticals. The company is based in Port Elizabeth. The research consists of a preliminary study to identify the problem areas in the maintenance management system within the company. A literature review of best practices in maintenance management systems combined with an investigation into the best pharmaceutical practices in maintenance management systems and regulatory controls are investigated and a model will be proposed to improve the current situation at the company.