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Yes / The health supply chain within the United Kingdom follows a traditional model adopted by many countries globally. This is typically the sourcing of products from manufacturer to pharmacy (hospital and community) via wholesaler or direct. New models of delivery are being piloted and evaluated to improve supply chain efficiency and effectiveness

Yes / Objective: To investigate timely access to palliative medicines/drugs (PMs) from community pharmacies to inform palliative care service delivery. Design: Mixed methods in two sequential phases: (1) prospective audit of prescriptions and concurrent survey of patients/representatives collecting PMs from pharmacy and (2) interviews with community pharmacists (CPs) and other healthcare professionals (HCPs). Setting: Five community pharmacies in Sheffield, UK and HCPs that deliver palliative care in that community. Participants: Phase 1: five CPs: two providing access to PMs within a locally commissioned service (LCS) and three not in the LCS; 55 patients/representatives who completed the survey when accessing PMs and phase 2: 16 HCPs, including five phase 1 CPs, were interviewed. Results: The prescription audit collected information on 75 prescriptions (75 patients) with 271 individual PMs; 55 patients/representatives (73%) completed the survey. Patients/representatives reported 73% of PMs were needed urgently. In 80% of cases, patients/representatives received all PMs on the first pharmacy visit. One in five had to travel to more than one pharmacy to access PMs. The range of PMs stocked by pharmacies was the key facilitating factor. CPs reported practical issues causing difficulty keeping PMs in stock and playing a reactive role with palliative prescriptions. Confidentiality concerns were cited by other HCPs who were reluctant to share key patient information proactively with pharmacy teams. Inadequate information transfer, lack of CP integration into the care of palliative patients and poor HCP knowledge of which pharmacies stock PMs meant patients and their families were not always able to access PMs promptly. Conclusions: Consistent routine information transfer and integration of pharmacy teams in the care of palliative patients are needed to achieve timely access to PMs. Commissioners of PM access schemes should review and monitor access. HCPs need to be routinely made aware and reminded about the service and its locations. / EJM received research funding from Pharmacy Research UK and Sheffield Teaching Hospitals NHS Foundation Trust as well as support from St Luke’s Hospice, Sheffield. AB and JDM report grants from Pharmacy Research UK during the conduct of the study.

Yes / The aim of this study was to examine the prevalence and importance of management skills in the pharmacy profession and pharmacists’ ability to respond to current and future challenges in healthcare provision. As service professionals, pharmacists are engaged based on their expertise and skills, and are noted for their contribution to the knowledge-based economy and control over the application of their knowledge (Abbott, 1991). The same premise would apply to other professionals e.g. healthcare (nurses, doctors and psychologists); legal (lawyers, solicitors and barristers); consultancy; accountancy; banking and architecture (von Nordenflycht, 2010). An exploratory analysis of UK and Spanish pharmacists’ roles and their adoption of management skills was thus undertaken. Both healthcare systems are very similar and likewise the clinical training and role of pharmacists, professional standards and regulations are similar but there are subtle differences. Data were collected using semi-structured online surveys; two thirds of the data were collected from a UK audience and the final third from Spanish pharmacists. The data collection was planned and iterative in the first two stages (stage one influencing stage two) (UK) and the final stage (Spain) offered an opportunistic comparator study. The results demonstrated that there was overwhelming support for management skills to be part of undergraduate studies. The outputs of this study identify the most important management skills pharmacists need to perform effectively. Consideration was also given to the impact of inability to perform in their role, and hence the possibility of occupational derailment (leaving their role or being demoted). These findings offer important learning to support workforce development in all professional services.

Thesis (M. A. (PHARM.) -- University of Limpopo, 2019 / Introduction Multidisciplinary team (MDT) approach has emerged as one solution to improving chronic kidney disease (CKD) care. The MDT may include a nephrologist, physicians, nurses, dietitians, pharmacists, and social workers, all working together to deliver effective care to patients with CKD. Participation of pharmacists within the renal MDT at Polokwane hospital seems to be limited. The perceived barriers to pharmacists providing renal care services to CKD patients at Polokwane hospital could inform future strategy development, to enhance their participation. The aim of this study was to explore the role of pharmacists in renal care and develop strategies to maximise their participation in the renal multidisciplinary health care team, based on their participation at Polokwane hospital, Limpopo province. Method A qualitative study using semi-structured interviews was conducted with a purposeful sample of 8 members of the renal MDT and 9 pharmacists. The audiotaped interviews were transcribed exactly as said and analysed using thematic content analysis. Results Four themes emerged from the analysis: ‘pharmacist’s current scope of practice within the renal MDT’, ‘potential future roles of pharmacists’, ‘perceived barriers to participation of pharmacists within the renal MDT’ and ‘recommendation/Strategies to incorporate pharmacists into the MDT’. Results have shown that pharmacists have an absent role within the renal MDT. Their role is limited to just dispensing and managing stock, with no role in direct patient care. Both pharmacists and MDT members showed preference to working together during renal care. Pharmacy services suggested include medication reviews, provision of patient education and counselling, patient adherence improvement, dosage workouts, patient monitoring and education on contraindicated drugs and drug interactions. Shortage of staff, pharmacists lack of clinical skills, lack of communication and attitude of pharmacists were perceived as the major barriers to participation of pharmacists within the renal xii MDT. To overcome these barriers, it was recommended that the department of health (DoH) provide more pharmacy staff and educational opportunities in the form of workshops, to equip pharmacists clinically and broaden competency and knowledge on effective communication and coordination. In addition, it was recommended that the clinical curriculum at Universities be revised, to build solid foundation on MDT care and pharmacology and that the MDT programme be standardized through standard treatment guidelines (SOP’s), policies and drawing of job descriptions. Conclusion The role of pharmacists at Polokwane hospital is confined to just stock management and dispensing. There are promising avenues for future development of their role during patient care, which can be achieved by addressing the barriers highlighted Recommendations The expansion of the role of pharmacists within the renal MDT will require improved partnership between health care professionals, resources, legislations and guidance from formal SOPs. Having a national framework for pharmacy practice from Ministry of Health, supported by educational opportunities and a pro-active professional association would be key to incorporating pharmacists within the renal MDT.

This session will feature the best financial literacy solutions in higher education, straight from the mouths of the college administrators who have implemented the programs! By the end of this presentation, you will be an expert in the various solutions that are available, as well as having a good idea of what will work best for your institution. In this session, you will find out: (1) How the college decided on its financial literacy program, (2) How each school is integrating the resources, (3) What practices have been the most successful.

The Patient Protection and Affordable Care Act (PPACA) represents one of the most significant pieces of legislation in the history of United States healthcare. The PPACA has two main goals: to increase the insured patient population in the US and to reduce the overall cost while improving the quality of healthcare in the US. To accomplish the latter goal, healthcare providers are experiencing a movement toward integrated, team-oriented models that place increasing accountability on the providers and institutions. At the same time, these integrative models emphasize effective preventive care, which is critical in reducing the country’s overall healthcare costs. As more health care institutions and providers across the country adopt the healthcare reform models of the Patient-Centered Medical Homes (PCMH) and Accountable Care Organizations (ACOs) directly under the PPACA, the demand for pharmacists is increasing. In addition, the role of the pharmacist through Medication Therapy Management (MTM) is growing as more public and private sectors adopt MTM and its standards are being used as the medication-related cornerstone for the ACOs. There is a call for lower costs and higher quality outcomes in healthcare, and the pharmacists are increasingly integrated into direct patient care and medication management. The newly integrated responsibilities of the pharmacist are numerous and almost limitless. The roleof pharmacists is expanding, and as many studies suggest, their contributions produce auspicious results.

Generic medicines are very important in driving down the health care cost. In a country like South Africa, where more than 80% of the population depend on the state health care, it is important to find ways to reduce cost. The main aim of the study was to evaluate the attitude towards generic medicines by pharmacists in Gauteng province of South Africa. Gauteng as the economic hub of the country, with the highest population and the highest number of pharmacies and pharmacists, obtaining a picture around the attitude towards generic medicines would help the all the stakeholders in the health care sector to identify areas of concern and address them to drive a positive attitude. In order to evaluate the attitude, Fishbein models, which noted the intention to perform the behaviour in question as the immediate antecedent of any behaviour, were used. The models identified two conceptually independent determinants of intention, which are attitude towards the behaviour (personal) and subjective norm (social). Depending of which model one is using, one more determinant of the intention “perceived behavioural control” can be added on the theory of reasoned action to form model of planned behaviour. By evaluating the attitude one can therefore determine the level of intention to perform the behaviour of interest which is generic substitution in this study. An empirical study was conducted among 116 pharmacists and assistants in Gauteng province. The methodology included research design, instrument development, sampling methods, data collection, capturing and statistical analysis. The results were analysed using Cronbach Alpha coefficients to measure reliability of the research instrument, t-test and ANOVA to test the hypothesis and the variance between groups; the effect sizes and Spearman's rho to determine the correlation and relationship between two variables of interest. The results of the study showed that, 94% of the respondents believe that generics are viable alternatives to innovator medicines. On the question of pharmacists’ attitude towards generic medicines results showed that there was no significant difference in almost all the demographic characteristics gender, age, qualifications, employment level, years of experience and type of pharmacy one practices. The only significant driver of the difference in attitude is the location of the pharmacy where pharmacists practicing in the townships and the city centre were found to be more receptive to generics than those in the suburbs. Due to reliability failure on the control belief construct, the theory of planned behaviour was downgraded to theory of reasoned action, to exclude the control belief construct for further statistical analysis. Correlation between the two attitudes constructs, behavioural belief and evaluation of behavioural outcome was one of the highest, where behavioural belief was identified as the direct measure of attitude and also the main driver. The study concluded that attitude is one of the most important personal factors influencing both the organisation and individual consumer buying behaviour. Evaluating individuals’ attitude to the behaviour (use of a product or service) would help marketers to communicate the right message to the right customers. / MBA, North-West University, Potchefstroom Campus, 2015

Generic medicines are very important in driving down the health care cost. In a country like South Africa, where more than 80% of the population depend on the state health care, it is important to find ways to reduce cost. The main aim of the study was to evaluate the attitude towards generic medicines by pharmacists in Gauteng province of South Africa. Gauteng as the economic hub of the country, with the highest population and the highest number of pharmacies and pharmacists, obtaining a picture around the attitude towards generic medicines would help the all the stakeholders in the health care sector to identify areas of concern and address them to drive a positive attitude. In order to evaluate the attitude, Fishbein models, which noted the intention to perform the behaviour in question as the immediate antecedent of any behaviour, were used. The models identified two conceptually independent determinants of intention, which are attitude towards the behaviour (personal) and subjective norm (social). Depending of which model one is using, one more determinant of the intention “perceived behavioural control” can be added on the theory of reasoned action to form model of planned behaviour. By evaluating the attitude one can therefore determine the level of intention to perform the behaviour of interest which is generic substitution in this study. An empirical study was conducted among 116 pharmacists and assistants in Gauteng province. The methodology included research design, instrument development, sampling methods, data collection, capturing and statistical analysis. The results were analysed using Cronbach Alpha coefficients to measure reliability of the research instrument, t-test and ANOVA to test the hypothesis and the variance between groups; the effect sizes and Spearman's rho to determine the correlation and relationship between two variables of interest. The results of the study showed that, 94% of the respondents believe that generics are viable alternatives to innovator medicines. On the question of pharmacists’ attitude towards generic medicines results showed that there was no significant difference in almost all the demographic characteristics gender, age, qualifications, employment level, years of experience and type of pharmacy one practices. The only significant driver of the difference in attitude is the location of the pharmacy where pharmacists practicing in the townships and the city centre were found to be more receptive to generics than those in the suburbs. Due to reliability failure on the control belief construct, the theory of planned behaviour was downgraded to theory of reasoned action, to exclude the control belief construct for further statistical analysis. Correlation between the two attitudes constructs, behavioural belief and evaluation of behavioural outcome was one of the highest, where behavioural belief was identified as the direct measure of attitude and also the main driver. The study concluded that attitude is one of the most important personal factors influencing both the organisation and individual consumer buying behaviour. Evaluating individuals’ attitude to the behaviour (use of a product or service) would help marketers to communicate the right message to the right customers. / MBA, North-West University, Potchefstroom Campus, 2015

Thesis (M.Tech.: Homoeopathy)-Dept. of Homeopathy, Durban Institute of Technology, 2006 xvii, 168 leaves / It was my perception, after having worked in the Complementary and Alternative Medicines Industry, that the knowledge and understanding of homeopathy by retail providers, was poor. Considering that pharmacies also sold over-the- counter homeopathic medicine, I felt it would be of value to do an empirical study in order to obtain more accurate data on this topic.