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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
71

Developing hospital pharmacy services based on unit dose drug distribution

Hill, David Stewart January 1973 (has links)
There are many examples in the literature of conventional or traditional drug distribution systems in hospitals which possess many shortcomings with reference to medication errors, the amount of time spent by nursing personnel in medication-related duties, inventory losses, the preparation of intravenous admixtures, and the lack of adequate drug usage records. These deficiencies primarily are due to the pharmacist's minimal influence over the control of the traditional drug distribution systems. An analysis and evaluation of the present pharmacy services at St. Paul's Hospital, Vancouver, B.C., similarly identified a traditional distribution system subject to many of the aforementioned potential problems. Using information based on existing unit dose systems as reviewed in the literature and data collected from a general questionnaire, new pharmacy services based on unit dose drug distribution are projected for St. Paul's Hospital. The required facilities and personnel for a progressive unit dose drug distribution system, an intravenous (I.V.) admixture preparation service and a drug surveillance program are projected accordingly. It would appear that a "centralized" approach to implementing unit dose distribution is most appropriate for St. Paul's Hospital's present requirements. This would involve the preparation and distribution of all drugs to nursing units in single dose packages from a central pharmacy area. A similarly centralized intravenous admixture service and a decentralized drug surveillance program also are described. These services commonly feature a greater responsibility being placed with the pharmacy department for preventing therapy problems such as admixture incompatibilities, drug interactions, adverse drug reactions and inappropriate drug selection. The effect of the above services on the responsibilities and number of pharmacy and nursing personnel is estimated based on results in similar programs. These changes also reflect extended hours of coverage in each area. Finally, a potential phasing plan and time schedule for the implementation of the proposed unit dose drug distribution system, I.V. admixture preparation service and drug surveillance program at St. Paul's Hospital is suggested. / Pharmaceutical Sciences, Faculty of / Graduate
72

Hospital pharmacy simulation : a study of the inpatient dispensary

Harris, Henry David Leslie January 1972 (has links)
The objective of this research is to develop a simulation model as an aid in planning hospital operations. The hospital pharmacy is selected as an appropriate area for study. An extensive systems analysis of pharmacy functions is undertaken. A simulation model of the inpatient dispensary operations is developed using the IBM General Purpose Simulation System. This model allows experimentation with dispensary work-load, operations, and manpower schedule. Statistics are provided on service to the patient, work-load distribution, and manpower utilization. Variation in pharmacist availability and type of prescription entering the dispensary allows optimization of operations. Several experiments are conducted to illustrate the model concept and experiment possibilities. It is concluded that the model is a valuable planning tool for the hospital pharmacy administrator and can be extended to simulate operations in other areas of the pharmacy. / Business, Sauder School of / Graduate
73

Perspectives in hospital pharmacy design based on functional requirements

Overend, Robert Kenneth 01 January 1972 (has links) (PDF)
It is significant that the separation of pharmacy from medicine occurred for the first time in institutions under ecclesiastic authority which were devoted to the care of the sick. In this period of history, there was little division between the church and state; therefore, business did not play any part in the overall health care scheme. The prime consideration was the delivery of the highest quality of pharmaceutical and medical services. This was best accomplished by a division of labor between the expert in the medical treatment and the expert in the selection, preservation and prepagation of medicinals. In other words, the hospital pharmacist was the first recog- nized representative of the specialized art and science of pharmacy. Such specialists in pharmacy were employed in hospitals which formed a part of many monasteries since the fourth century A.D. In Switzerland, during the ninth century, a plan for remodeling a monastery provided for an apothecary shop and a garden for the cultivation of medicinal plants. During the plague which depopulated many European countries in the fourteenth century, hospitals sprang up everywhere. The inclusion of a pharmacy in those hospitals was the rule rather than the exception (1).
74

The applicability of a validated team-based learning student assessment instrument to assess United Kingdom pharmacy students’ attitude toward team-based learning

Nation, L.M., Tweddell, Simon, Rutter, P. 2016 August 1929 (has links)
Yes / Purpose: It aimed at testing the applicability of a validated team-based learning student assessment instrument (TBL-SAI) to assess United Kingdom (UK) pharmacy students’ attitude toward team-based learning. Methods: TBL-SAI, consisting of 33 items, was administered to undergraduate pharmacy students from two schools of pharmacy each at University of Wolverhampton and University of Bradford that utilized TBL as a primary instructional method across credit bearing modules. Validity and reliability tests were conducted on the data, along with comparisons between the two schools. Results: Students’ response rate was 80.0% (138/173) in completion of the instrument. Overall, the instrument demonstrated validity and reliability when used with pharmacy students. Sub-analysis between schools of pharmacy did, however, show that four items from Wolverhampton data, had factor loadings of less than 0.40. No item in the Bradford data had factor loadings less than 0.40. Cronbach’s alpha score was reliable at 0.897 for the total instrument: Wolverhampton, 0.793 and Bradford, 0.902. Students showed preference to TBL, with Bradford’s scores being statistically higher (P < 0.005). Conclusion: This validated instrument has demonstrated reliability and validity when used with pharmacy students. Furthermore students at both schools preferred TBL compared to traditional teaching.
75

Surveillance des maladies infectieuses à partir des ventes de médicaments en pharmacies / Surveillance of infectious diseases using drug sales data in pharmacies

Pivette, Mathilde 29 September 2015 (has links)
Le suivi des ventes de médicaments en pharmacies est un outil de surveillance qui s’est développé au début des années 2000 pour la surveillance des maladies infectieuses et la détection d’épidémies. Ces données présentent en effet de nombreux avantages pour la surveillance de par le volume important, l’exhaustivité et la rapidité d’obtention des données collectées de façon automatique. L’objectif de cette thèse était de déterminer l’intérêt du suivi des ventes de médicaments pour la surveillance et la prévention des maladies infectieuses en France. Les données de ventes analysées dans cette thèse sont issues d’un échantillon de 3004 pharmacies en France Métropolitaine, développé par la société Celtipharm. Trois axes de recherche ont été développés dans cette thèse : Nous avons tout d’abord réalisé une revue systématique de la littérature sur la surveillance des maladies infectieuses à partir des ventes de médicaments. Vingt-sept articles ont été analysés et les résultats montrent que le suivi des ventes de médicaments est un outil valide pour la surveillance et la détection de la gastro-entérite et de la grippe. De plus, les médicaments achetés sans ordonnance ont le potentiel d’émettre une alerte plus précoce que les systèmes de surveillance traditionnels. Des études pourraient être développées pour la surveillance d’autres maladies infectieuses. Notre deuxième étude avait pour objectif d’évaluer l’intérêt du suivi des ventes de médicaments pour la détection des épidémies saisonnière de gastro-entérites en France. Les ventes de médicaments indiqués en cas de gastro-entérite ont été comparées au nombre de cas vus en consultation entre 2008 et 2013. La méthode de Serfling a été utilisée pour détecter les périodes épidémiques. Les cinq épidémies saisonnières ont pu être détectées à partir des ventes de médicaments, sans fausse alerte. De plus, les médicaments non-prescrits ont permis une détection précoce des épidémies, en moyenne 2,25 semaines plus tôt que les données de référence. La troisième étude a porté sur l’estimation de la couverture vaccinale (CV) contre la grippe et le rotavirus à partir des ventes de vaccins en pharmacies. Nous avons pu estimer la couverture vaccinale grippe chez l’ensemble de la population, et avons développé une méthode pour estimer en temps-réel la CV dans la population cible des plus de 65 ans. Il n’existe actuellement pas d’estimation de la CV rotavirus en France car le vaccin n’est pas remboursé, et nos analyses ont permis d’apporter une information sur cette couverture depuis 2008. Les études développées dans cette thèse ont permis de démontrer que le suivi des ventes de médicaments était un outil valide et utile pour la surveillance des maladies infectieuses. Ses intérêts principaux résident dans la rapidité d’obtention des données qui offre la possibilité de déclencher rapidement une alerte et l’obtention de données de ventes de médicaments non-remboursés qui permettent d’avoir des informations sur des pathologies légères ou les premiers symptômes de maladies. / Drug sales data analysis is a tool that has been developed in the early 2000s for infectious diseases surveillance and outbreak detection. These data present indeed many advantages for disease surveillance: the large volume and the completeness of the data, the rapidity to obtain the data automatically collected from pharmacies. The objective of this thesis was to determine the value of drug sales analysis for infectious disease surveillance in France. Sales data analyzed in this thesis were collected from a sample of 3,004 pharmacies in Metropolitan France, set up by the company Celtipharm. Three research axes have been developed in this thesis: We first did a systematic literature review on the surveillance of infectious diseases based on drug sales data. Twenty-seven articles have been analyzed and results showed that drug sales data analysis is a valid tool for the surveillance and outbreak detection of gastroenteritis and influenza. Besides, over-the-counter (OTC) drugs have the potential to detect outbreaks earlier than traditional surveillance data. Further studies could be developed for other infectious diseases. The second study focused on the detection of seasonal gastrointestinal disease outbreak in France based on drug sales data. Drug sales data have been compared to the number of cases reported by a network of GPs between 2008 and 2013. The Serfling method was used to detect epidemic periods in the times series. The five seasonal epidemic periods have been detected based on drug sales data, without false alert. Moreover, non-prescribed drugs allowed the detection of outbreaks on average 2.25 weeks earlier than reference data. The third study focused on the estimation of vaccination coverage (VC) against influenza and rotavirus using vaccine sales in pharmacies. We estimated the influenza vaccination coverage in the whole population and developed a method to estimate the VC in real time in the target population of the ≥ 65 years old. There is no estimation of rotavirus vaccination coverage in France as the vaccine is not reimbursed and we were able to estimate vaccination coverage since 2008 based on vaccine sales. The studies developed in this thesis showed that drug sales data analysis is a valid and useful tool for infectious disease surveillance. The main interests of this method are the rapidity to obtain the data that allows early outbreak detection and the collection of non-prescribed drugs that can reflect mild diseases or the first symptoms of a disease.
76

Surveillance des maladies infectieuses à partir des ventes de médicaments en pharmacies / Surveillance of infectious diseases using drug sales data in pharmacies

Pivette, Mathilde 29 September 2015 (has links)
Le suivi des ventes de médicaments en pharmacies est un outil de surveillance qui s’est développé au début des années 2000 pour la surveillance des maladies infectieuses et la détection d’épidémies. Ces données présentent en effet de nombreux avantages pour la surveillance de par le volume important, l’exhaustivité et la rapidité d’obtention des données collectées de façon automatique. L’objectif de cette thèse était de déterminer l’intérêt du suivi des ventes de médicaments pour la surveillance et la prévention des maladies infectieuses en France. Les données de ventes analysées dans cette thèse sont issues d’un échantillon de 3004 pharmacies en France Métropolitaine, développé par la société Celtipharm. Trois axes de recherche ont été développés dans cette thèse : Nous avons tout d’abord réalisé une revue systématique de la littérature sur la surveillance des maladies infectieuses à partir des ventes de médicaments. Vingt-sept articles ont été analysés et les résultats montrent que le suivi des ventes de médicaments est un outil valide pour la surveillance et la détection de la gastro-entérite et de la grippe. De plus, les médicaments achetés sans ordonnance ont le potentiel d’émettre une alerte plus précoce que les systèmes de surveillance traditionnels. Des études pourraient être développées pour la surveillance d’autres maladies infectieuses. Notre deuxième étude avait pour objectif d’évaluer l’intérêt du suivi des ventes de médicaments pour la détection des épidémies saisonnière de gastro-entérites en France. Les ventes de médicaments indiqués en cas de gastro-entérite ont été comparées au nombre de cas vus en consultation entre 2008 et 2013. La méthode de Serfling a été utilisée pour détecter les périodes épidémiques. Les cinq épidémies saisonnières ont pu être détectées à partir des ventes de médicaments, sans fausse alerte. De plus, les médicaments non-prescrits ont permis une détection précoce des épidémies, en moyenne 2,25 semaines plus tôt que les données de référence. La troisième étude a porté sur l’estimation de la couverture vaccinale (CV) contre la grippe et le rotavirus à partir des ventes de vaccins en pharmacies. Nous avons pu estimer la couverture vaccinale grippe chez l’ensemble de la population, et avons développé une méthode pour estimer en temps-réel la CV dans la population cible des plus de 65 ans. Il n’existe actuellement pas d’estimation de la CV rotavirus en France car le vaccin n’est pas remboursé, et nos analyses ont permis d’apporter une information sur cette couverture depuis 2008. Les études développées dans cette thèse ont permis de démontrer que le suivi des ventes de médicaments était un outil valide et utile pour la surveillance des maladies infectieuses. Ses intérêts principaux résident dans la rapidité d’obtention des données qui offre la possibilité de déclencher rapidement une alerte et l’obtention de données de ventes de médicaments non-remboursés qui permettent d’avoir des informations sur des pathologies légères ou les premiers symptômes de maladies. / Drug sales data analysis is a tool that has been developed in the early 2000s for infectious diseases surveillance and outbreak detection. These data present indeed many advantages for disease surveillance: the large volume and the completeness of the data, the rapidity to obtain the data automatically collected from pharmacies. The objective of this thesis was to determine the value of drug sales analysis for infectious disease surveillance in France. Sales data analyzed in this thesis were collected from a sample of 3,004 pharmacies in Metropolitan France, set up by the company Celtipharm. Three research axes have been developed in this thesis: We first did a systematic literature review on the surveillance of infectious diseases based on drug sales data. Twenty-seven articles have been analyzed and results showed that drug sales data analysis is a valid tool for the surveillance and outbreak detection of gastroenteritis and influenza. Besides, over-the-counter (OTC) drugs have the potential to detect outbreaks earlier than traditional surveillance data. Further studies could be developed for other infectious diseases. The second study focused on the detection of seasonal gastrointestinal disease outbreak in France based on drug sales data. Drug sales data have been compared to the number of cases reported by a network of GPs between 2008 and 2013. The Serfling method was used to detect epidemic periods in the times series. The five seasonal epidemic periods have been detected based on drug sales data, without false alert. Moreover, non-prescribed drugs allowed the detection of outbreaks on average 2.25 weeks earlier than reference data. The third study focused on the estimation of vaccination coverage (VC) against influenza and rotavirus using vaccine sales in pharmacies. We estimated the influenza vaccination coverage in the whole population and developed a method to estimate the VC in real time in the target population of the ≥ 65 years old. There is no estimation of rotavirus vaccination coverage in France as the vaccine is not reimbursed and we were able to estimate vaccination coverage since 2008 based on vaccine sales. The studies developed in this thesis showed that drug sales data analysis is a valid and useful tool for infectious disease surveillance. The main interests of this method are the rapidity to obtain the data that allows early outbreak detection and the collection of non-prescribed drugs that can reflect mild diseases or the first symptoms of a disease.
77

Aspects of the demographic profile and standard of pharmaceutical services in South Africa / J. Adsetts

Adsetts, Jacqueline January 2006 (has links)
The objects of the South African Pharmacy Council in terms of the Pharmacy Act, 1974 (5311974) as amended are, inter alia, "to uphold and safeguard the rights of the general public to universally acceptable standards of pharmacy practice in both the private and the public sector" as well as "to establish, develop, maintain and control universally acceptable standards of practice of the various categories of persons required to be registered.. ." One of the major difficulties health care providers worldwide are faced with is how to maintain a proper balance between the trio goals of health care, namely adequate access, high quality and acceptable costs (Li, 2003:192-193). Relatively little is known about such problems as do exist for patients regarding access to pharmaceutical services (Doucette et al., 1999:1268). Two main objectives were identified for this study, namely to investigate the demographic profile of community and institutional pharmacies registered with the South African Pharmacy Council; and to determine the standard of pharmaceutical services provided by these pharmacies. Inspection results of community and institutional pharmacies were obtained from the South African Pharmacy Council and extracted for the time period 1 January 2004 to 31 May 2005. To determine the demographic and geographic profile of these pharmacies, data of the Register of Pharmacies of the South African Pharmacy Council for August 2003, 2004 and 2005 were merged with the Census data of South Africa of 2001. It was found that the total number of pharmacies in both the public and private sectors increased with 2.1% (n=68) from August 2003 to August 2005. Public and private pharmacies that provided services directly to patients increased with 6.3% (n=33) and 1.3% (n=35) from August 2003 to 2005. It was found that the Gauteng province was the best provided with registered pharmacies in South Africa, as only 0.06% (n=5 783) of the population did not have any registered pharmacy available on municipality level. It was also revealed that the majority of inspections were carried out in Gauteng, whilst this province accounts for only 19.7% of the total population of South Africa. During the study period a total of 1178 community pharmacy inspections were carried out in 1103 community pharmacies (one or more inspections per pharmacy) representing 43% (n=2 550) of the total number of community pharmacies registered with the South African Pharmacy Council during May 2005. Nationally community pharmacies achieved a score of 92.27 (+ 6.65 per cent) for compliance with Good Pharmacy Practice guidelines. The lowest compliance score (73.34 + 27.49 per cent) was obtained for the availability of written standard operating procedures and the highest was for the promotion of public health (99.02 + 6.30 per cent). No practical significant differences (dc0.8) were found between the overall compliance scores obtained by community pharmacies of the different provinces. The highest compliance score was obtained by community pharmacies in the Free State (93.09 + 4.90 per cent), followed by Western Cape, Eastern Cape, Kwazulu Natal, Limpopo, Northern Cape, Gauteng, Mpumalanga and the North West. A total of 343 institutional pharmacy inspections (one or more inspections per pharmacy) were carried out in public and state subsidised institutions (n=245), private institutions (n=90) and mine hospitals (n=5). These pharmacies represented 46% of the total number of institutional pharmacies registered with the South African Pharmacy Council during May 2005. Nationally all institutional pharmacies (both private and public) achieved a score of 92.49 + 8.33 per cent for compliance with Good Pharmacy Practice guidelines for all above-mentioned aspects. Nationally public and state subsidised institutional pharmacies obtained a lower compliance score (91.02 + 9.08 per cent) than private institutional pharmacies (96.39 + 3.91 per cent). Lastly, a grading system was developed that was based on the results obtained through this study, in order to quantify the standard of pharmaceutical services provided by pharmacies in South Africa. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2007.
78

Aspects of the demographic profile and standard of pharmaceutical services in South Africa / J. Adsetts

Adsetts, Jacqueline January 2006 (has links)
The objects of the South African Pharmacy Council in terms of the Pharmacy Act, 1974 (5311974) as amended are, inter alia, "to uphold and safeguard the rights of the general public to universally acceptable standards of pharmacy practice in both the private and the public sector" as well as "to establish, develop, maintain and control universally acceptable standards of practice of the various categories of persons required to be registered.. ." One of the major difficulties health care providers worldwide are faced with is how to maintain a proper balance between the trio goals of health care, namely adequate access, high quality and acceptable costs (Li, 2003:192-193). Relatively little is known about such problems as do exist for patients regarding access to pharmaceutical services (Doucette et al., 1999:1268). Two main objectives were identified for this study, namely to investigate the demographic profile of community and institutional pharmacies registered with the South African Pharmacy Council; and to determine the standard of pharmaceutical services provided by these pharmacies. Inspection results of community and institutional pharmacies were obtained from the South African Pharmacy Council and extracted for the time period 1 January 2004 to 31 May 2005. To determine the demographic and geographic profile of these pharmacies, data of the Register of Pharmacies of the South African Pharmacy Council for August 2003, 2004 and 2005 were merged with the Census data of South Africa of 2001. It was found that the total number of pharmacies in both the public and private sectors increased with 2.1% (n=68) from August 2003 to August 2005. Public and private pharmacies that provided services directly to patients increased with 6.3% (n=33) and 1.3% (n=35) from August 2003 to 2005. It was found that the Gauteng province was the best provided with registered pharmacies in South Africa, as only 0.06% (n=5 783) of the population did not have any registered pharmacy available on municipality level. It was also revealed that the majority of inspections were carried out in Gauteng, whilst this province accounts for only 19.7% of the total population of South Africa. During the study period a total of 1178 community pharmacy inspections were carried out in 1103 community pharmacies (one or more inspections per pharmacy) representing 43% (n=2 550) of the total number of community pharmacies registered with the South African Pharmacy Council during May 2005. Nationally community pharmacies achieved a score of 92.27 (+ 6.65 per cent) for compliance with Good Pharmacy Practice guidelines. The lowest compliance score (73.34 + 27.49 per cent) was obtained for the availability of written standard operating procedures and the highest was for the promotion of public health (99.02 + 6.30 per cent). No practical significant differences (dc0.8) were found between the overall compliance scores obtained by community pharmacies of the different provinces. The highest compliance score was obtained by community pharmacies in the Free State (93.09 + 4.90 per cent), followed by Western Cape, Eastern Cape, Kwazulu Natal, Limpopo, Northern Cape, Gauteng, Mpumalanga and the North West. A total of 343 institutional pharmacy inspections (one or more inspections per pharmacy) were carried out in public and state subsidised institutions (n=245), private institutions (n=90) and mine hospitals (n=5). These pharmacies represented 46% of the total number of institutional pharmacies registered with the South African Pharmacy Council during May 2005. Nationally all institutional pharmacies (both private and public) achieved a score of 92.49 + 8.33 per cent for compliance with Good Pharmacy Practice guidelines for all above-mentioned aspects. Nationally public and state subsidised institutional pharmacies obtained a lower compliance score (91.02 + 9.08 per cent) than private institutional pharmacies (96.39 + 3.91 per cent). Lastly, a grading system was developed that was based on the results obtained through this study, in order to quantify the standard of pharmaceutical services provided by pharmacies in South Africa. / Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2007.
79

Surveillance des maladies infectieuses à partir des ventes de médicaments en pharmacies / Surveillance of infectious diseases using drug sales data in pharmacies

Pivette, Mathilde 29 September 2015 (has links)
Le suivi des ventes de médicaments en pharmacies est un outil de surveillance qui s’est développé au début des années 2000 pour la surveillance des maladies infectieuses et la détection d’épidémies. Ces données présentent en effet de nombreux avantages pour la surveillance de par le volume important, l’exhaustivité et la rapidité d’obtention des données collectées de façon automatique. L’objectif de cette thèse était de déterminer l’intérêt du suivi des ventes de médicaments pour la surveillance et la prévention des maladies infectieuses en France. Les données de ventes analysées dans cette thèse sont issues d’un échantillon de 3004 pharmacies en France Métropolitaine, développé par la société Celtipharm. Trois axes de recherche ont été développés dans cette thèse : Nous avons tout d’abord réalisé une revue systématique de la littérature sur la surveillance des maladies infectieuses à partir des ventes de médicaments. Vingt-sept articles ont été analysés et les résultats montrent que le suivi des ventes de médicaments est un outil valide pour la surveillance et la détection de la gastro-entérite et de la grippe. De plus, les médicaments achetés sans ordonnance ont le potentiel d’émettre une alerte plus précoce que les systèmes de surveillance traditionnels. Des études pourraient être développées pour la surveillance d’autres maladies infectieuses. Notre deuxième étude avait pour objectif d’évaluer l’intérêt du suivi des ventes de médicaments pour la détection des épidémies saisonnière de gastro-entérites en France. Les ventes de médicaments indiqués en cas de gastro-entérite ont été comparées au nombre de cas vus en consultation entre 2008 et 2013. La méthode de Serfling a été utilisée pour détecter les périodes épidémiques. Les cinq épidémies saisonnières ont pu être détectées à partir des ventes de médicaments, sans fausse alerte. De plus, les médicaments non-prescrits ont permis une détection précoce des épidémies, en moyenne 2,25 semaines plus tôt que les données de référence. La troisième étude a porté sur l’estimation de la couverture vaccinale (CV) contre la grippe et le rotavirus à partir des ventes de vaccins en pharmacies. Nous avons pu estimer la couverture vaccinale grippe chez l’ensemble de la population, et avons développé une méthode pour estimer en temps-réel la CV dans la population cible des plus de 65 ans. Il n’existe actuellement pas d’estimation de la CV rotavirus en France car le vaccin n’est pas remboursé, et nos analyses ont permis d’apporter une information sur cette couverture depuis 2008. Les études développées dans cette thèse ont permis de démontrer que le suivi des ventes de médicaments était un outil valide et utile pour la surveillance des maladies infectieuses. Ses intérêts principaux résident dans la rapidité d’obtention des données qui offre la possibilité de déclencher rapidement une alerte et l’obtention de données de ventes de médicaments non-remboursés qui permettent d’avoir des informations sur des pathologies légères ou les premiers symptômes de maladies. / Drug sales data analysis is a tool that has been developed in the early 2000s for infectious diseases surveillance and outbreak detection. These data present indeed many advantages for disease surveillance: the large volume and the completeness of the data, the rapidity to obtain the data automatically collected from pharmacies. The objective of this thesis was to determine the value of drug sales analysis for infectious disease surveillance in France. Sales data analyzed in this thesis were collected from a sample of 3,004 pharmacies in Metropolitan France, set up by the company Celtipharm. Three research axes have been developed in this thesis: We first did a systematic literature review on the surveillance of infectious diseases based on drug sales data. Twenty-seven articles have been analyzed and results showed that drug sales data analysis is a valid tool for the surveillance and outbreak detection of gastroenteritis and influenza. Besides, over-the-counter (OTC) drugs have the potential to detect outbreaks earlier than traditional surveillance data. Further studies could be developed for other infectious diseases. The second study focused on the detection of seasonal gastrointestinal disease outbreak in France based on drug sales data. Drug sales data have been compared to the number of cases reported by a network of GPs between 2008 and 2013. The Serfling method was used to detect epidemic periods in the times series. The five seasonal epidemic periods have been detected based on drug sales data, without false alert. Moreover, non-prescribed drugs allowed the detection of outbreaks on average 2.25 weeks earlier than reference data. The third study focused on the estimation of vaccination coverage (VC) against influenza and rotavirus using vaccine sales in pharmacies. We estimated the influenza vaccination coverage in the whole population and developed a method to estimate the VC in real time in the target population of the ≥ 65 years old. There is no estimation of rotavirus vaccination coverage in France as the vaccine is not reimbursed and we were able to estimate vaccination coverage since 2008 based on vaccine sales. The studies developed in this thesis showed that drug sales data analysis is a valid and useful tool for infectious disease surveillance. The main interests of this method are the rapidity to obtain the data that allows early outbreak detection and the collection of non-prescribed drugs that can reflect mild diseases or the first symptoms of a disease.
80

Desenvolvimento e validação de conteúdo de um instrumento para avaliação da assistência farmacêutica em hospitais de Sergipe / Development and validation of contents of a instrument for assessment of pharmaceutical assistance in hospitals of Sergipe

Jesus, Elisdete Maria Santos de 21 January 2013 (has links)
As part of the health services, pharmaceutical services consist in the supply of drugs, maintenance, quality control, safety, therapeutic efficacy, as well as monitoring and evaluation of its use by subsidizing the guarantee rational use. However, since 1992, Brazilian authorities point to the need for tools that allow evaluating pharmacy services in hospitals inserted, making it necessary to perform diagnostic pharmaceutical services at all levels of health care. Given the above this thesis was aimed to develop and validate the content of an instrument for evaluation of pharmaceutical care in hospitals of Sergipe. Therefore a study of type Evaluative Research in Health Initially, we conducted a survey on the theoretical evaluation of the quality of health services, with emphasis on pharmaceutical care services, and the conceptual aspects involved in the validation of a measuring instrument. The practical section was developed with a systematic review of the pharmaceutical services that utilized the psychometric characteristics of reliability and validity and content validation procedure for an instrument using the Delphi technique. In validation strategy content, which was found after analysis and opinion of the evaluators (judges) of the 60 indicators proposed assessment, four experienced changes between standard and compliance elements of measurement. After the modifications, the instrument was administered, applicability of the results showed that 94% of hospital pharmacists understand the questions posed in the instrument, however 33.3% of pharmacists chose not to answer the item related to service pharmacotechnics hospital for not being inserted or structured in some of the hospitals assessed. In parameter suggestion only 11.1% suggested change in the structure of the instrument, the doubts about the instrument in general, 100% of pharmacists said they have no doubts about the proposed questions. This study contributed to improving the quality of hospital pharmacy through content validation process, underscores the importance of further studies to determine the reliability of this instrument, which is to determine the degree of consistency with which the instrument measures the attribute under study. / Como parte integrante dos serviços de saúde, os serviços farmacêuticos, consistem no fornecimento de medicamentos, manutenção, controle de qualidade, segurança, eficácia terapêutica, bem como o acompanhamento e avaliação do seu uso subsidiando a garantia do uso racional. No entanto desde 1992, entidades brasileiras apontam a necessidade de instrumentos que possibilitem avaliar os serviços de farmácia inseridos em hospitais, tornando-se necessário realizar diagnósticos dos serviços farmacêuticos em todos os níveis de atenção à saúde. Diante do exposto a presente dissertação teve como meta o desenvolvimento e validação de conteúdo de um instrumento para avaliação da assistência farmacêutica em hospitais de Sergipe. Para tanto foi realizado um estudo do tipo Pesquisa Avaliativa em Saúde. Inicialmente, foi realizado uma fundamentação teórica sobre à avaliação da qualidade de serviços de saúde, com ênfase nos serviços da Assistência Farmacêutica, e os aspectos conceituais envolvidos na validação de um instrumento de medida. O capítulo prático foi desenvolvido com uma revisão sistemática sobre os serviços farmacêuticos que utilizaram as características psicométricas de validação e confiabilidade e o procedimento de validação de conteúdo de um instrumento utilizando a técnica Delphi. As análises das variáveis dos estudos obtidos com a revisão sistemática evidenciaram que o campo dos serviços farmacêuticos ainda precisa ser explorado, com pesquisas que elaborem e validem instrumentos direcionados aos serviços farmacêuticos, sobretudo no âmbito hospitalar. O painel de avaliadores utilizado para validação do conteúdo do instrumento apresentou-se como um painel misto com um alto grau de qualificação. À estratégia de validação de conteúdo, foi verificada que após análise e parecer dos avaliadores (juízes) dos sessenta indicadores de avaliação propostos, quatro sofreram modificações entre padrão de conformidade e elementos de mensuração, após o resultado das modificações o instrumento foi aplicado com seus resultados aplicabilidade do instrumento sobre o nível de compreensão dos farmacêuticos hospitalares quanto às diretrizes foi de 94%, 100%para não apresentação de dúvidas e 12% para sugestão de mudança na estrutura do instrumento. Este estudo contribuiu para a melhoria da qualidade dos serviços de Farmácia Hospitalar, através processo de validação de conteúdo, ressalta-se a importância de estudos posteriores para determinação da confiabilidade deste instrumento, que vem determinar o grau de coerência com que o instrumento mede o atributo em estudo.

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