Harm reduction is a concept that has gained momentum as it relates to prevention of negative consequences of drug use. Some harm reduction approaches, such as naloxone provision, have garnered significant support, whereas others, such as providing access to clean syringes, are the exception as opposed the rule. Evidence suggests there is significant variation in harm reduction behaviors among providers, including community pharmacists. Community pharmacies are one of the most accessible points for healthcare; approximately 90% of U.S. residents live within five miles of a pharmacy. Therefore, pharmacies have a great opportunity to promote and engage their communities in harm reduction approaches. This session will examine evidence-based harm reduction approaches that can be employed in community pharmacies. The presenters will use their syringe dispensing research conducted across three states to describe the current harm reduction climate in community pharmacies. During this interactive session, participants will discuss scenarios in which they are encouraged to evaluate their own attitudes and beliefs toward non-Rx syringe sales, naloxone dispensing and other harm reduction strategies while taking a look at the impact of state level policies on these approaches. The session will be targeted to practicing pharmacists, coalition leaders and harm reduction stakeholders.

In the modern society, chronic diseases have become the leading causes of death. With early recognition and proper management, however, many of the complications from chronic diseases could be prevented or delayed. Taking such a proactive approach in managing a population often requires the use of team-based approaches and delegation of certain clinical and nonclinical tasks to nonphysician team members. This three-study dissertation used a combination of methods to explore contextual factors that influence primary care teamwork and physician-pharmacist collaboration. The first study quantitatively examined baseline barriers and facilitators of physician-pharmacist collaboration in clinics participating in the Collaboration Among Pharmacists and Physicians To Improve Outcomes Now (CAPTION) Trial. Pharmacist expertise and clinic staff support were found to be the most important facilitators for physicians, while insurance reimbursement and task design factors were important for pharmacists. The second study characterized clinic personnel experience participating in the CAPTION trial and explored determinants of disease state control. Higher proportions of indigent and minority populations and higher baseline pharmacy structure scores were found to be associated with lower blood pressure control. The third study qualitatively examined organizational influences on primary care team effectiveness and the roles of pharmacists in a separate sample of primary care clinics. A lack of organizational rewards for teamwork in primary care was identified and pharmacists were integrated into clinic workflow in various degrees. These findings will be informative for practice managers and health care professionals seeking to redesign their practice to meet increasing needs of patients with chronic diseases.

The costs attributed to prescription errors negatively affect the profits of retail pharmacy businesses. The U.S. prescription error rate since 2010 was 0.1%, yet with more than 3.5 billion prescriptions filled annually in the United States, the outcome is more than 3.5 million prescription-dispensing errors and an annual cost of more than $16 billion. Using the performance prism theory, the purpose of this multiple case study was to explore strategies retail pharmacy managers used to increase profit by reducing prescription errors. Using purposeful sampling, 5 retail pharmacy managers in Miami, Florida, were selected as participants because they had implemented strategies to reduce prescription errors. Data were collected using semistructured, face-to-face interviews with 5 pharmacy managers, and company records consisting of quality improvement incident reports, income statements, and balance sheets. Data analysis occurred using methodological triangulation and following Yin's 5-step process of compiling, disassembling, reassembling, interpreting, and concluding the data. The 3 emergent themes were prescription error reducing strategy, profitability improvement strategy through reduced prescription errors, and technology strategy for reducing prescription error. The findings indicated that prescription error reducing strategies are essential for pharmacy managers to increase profits. The implications for positive social change include the potential for retail pharmacy managers to reduce the cost of health care in their communities, prevent prescription error-related hospitalizations and deaths, and improve employment conditions and economic activity in their communities.

Purpose: The Purpose of this research was to design, implement and evaluate a patient centered asthma intervention pilot program directed by physicians and administered by community pharmacists to a group of Managed Care contracted Oregon Health Plan asthmatics. The evaluation was to determine if the proposed intervention could improve the enrolled asthma patient's related education and quality of life while simultaneously creating economic benefit for the sponsoring health plan. Methods: The study was designed to be a prospective, six month pre and posttest quasi-experimental evaluation combined with a Solomon-like two-control group comparison. All patients in the sponsoring health plan twelve years of age and older who had six months of continuous enrollment were eligible. Enrollment of the target patients was voluntary and the time period of the evaluation (November, 1997 to May, 1998) was purposely conducted to capture the notoriously difficult asthma trigger cold and allergy seasons. Information regarding the cost and frequency of pre and post emergency room visits, hospitalizations, physician's office and medications use and Health Related Quality of Life (HRQL) was collected for the intervention group and control group. Satisfaction information for the major actors was collected and analyzed at posttest. Within group comparisons were conducted using the paired T-test and the unpaired T-test was used for between group comparison. Results: Patients in the intervention group who had their physician and pharmacist fully participate in respectively directing and administering the study protocol showed associated improvements in their quality of life measures. Economic benefit to the health plan is suggested by a cost benefit ratio of 1:5.71 resulting from favorable decreases in health care related resources and improved asthma related medication utilization. Analysis of the satisfaction measures suggests that all the major participants were very satisfied with the intervention. Conclusion: Even though the sample size in this pilot study was relatively small, the resulting information should not be immediately discounted. The evidence suggests that in those cases where the study protocol was followed, favorable economic, HRQL and satisfaction is comparable to larger, previously conducted studies. / Graduation date: 2000

The Canadian health care system is primarily public funded. With constant rise in health care costs, there is debate on how to best fund Canadian health care. <p>Public, private and mixed funding options are being discussed. The funding options people support will depend on how they view the health care system. Is health care a commodity or a public right? Pharmacists interact with patients daily and are involved in the delivery of health services. Their views on whether health care should be a public right or a commodity can add meaningful input to the debate.<p>The primary objective of this study was to develop a scale to measure pharmacists perceptions of health care as a commodity or a public right. In turn, this scale was used to see if a relationship exists between pharmacists orientation to health care (commodity vs. public right) and their support for different health care funding options.<p> A mail-in survey of community pharmacists in Saskatchewan was conducted based on the Dillman approach. The questionnaire consisted primarily of six-point Likert scale questions. Data analysis was performed using non-parametric tests such as Mann-Whitney U and Kruskal Wallis tests. One-way ANOVA was used for parametric data and post-hoc analysis was performed using Bonferroni test. Correlation of the scales was tested using Spearmans and Pearsons correlation coefficients. The response rate achieved was 64.2%.<p>The study results indicate that pharmacists are not willing to provide cognitive services free of charge. However, they are willing to continue providing OTC drug counseling free of charge. They will not restrict provision of cognitive services only to patients able pay. They prefer being reimbursed through other sources. They are unwilling to make time and income adjustments to improve patient health outcomes. They do not want to link the financial rewards they receive to the amount of benefit the patient receives.<p>Pharmacists favour the current system of funding health care in Canada but would prefer more choice in the delivery and funding methods. The results do not indicate any relationship between pharmacists orientation to health care (commodity vs. public right) and their level of support for different health care funding strategies. <p>The study conclusions suggest that pharmacists value and appreciate the direct impact of their work on patients. However they consider themselves to be professionals first and expect to be compensated financially for their services. Their willingness to spend time and effort towards provision of services as a public right seems to be predicated to a certain extent by the financial rewards they receive.

The Canadian health care system is primarily public funded. With constant rise in health care costs, there is debate on how to best fund Canadian health care. <p>Public, private and mixed funding options are being discussed. The funding options people support will depend on how they view the health care system. Is health care a commodity or a public right? Pharmacists interact with patients daily and are involved in the delivery of health services. Their views on whether health care should be a public right or a commodity can add meaningful input to the debate.<p>The primary objective of this study was to develop a scale to measure pharmacists perceptions of health care as a commodity or a public right. In turn, this scale was used to see if a relationship exists between pharmacists orientation to health care (commodity vs. public right) and their support for different health care funding options.<p> A mail-in survey of community pharmacists in Saskatchewan was conducted based on the Dillman approach. The questionnaire consisted primarily of six-point Likert scale questions. Data analysis was performed using non-parametric tests such as Mann-Whitney U and Kruskal Wallis tests. One-way ANOVA was used for parametric data and post-hoc analysis was performed using Bonferroni test. Correlation of the scales was tested using Spearmans and Pearsons correlation coefficients. The response rate achieved was 64.2%.<p>The study results indicate that pharmacists are not willing to provide cognitive services free of charge. However, they are willing to continue providing OTC drug counseling free of charge. They will not restrict provision of cognitive services only to patients able pay. They prefer being reimbursed through other sources. They are unwilling to make time and income adjustments to improve patient health outcomes. They do not want to link the financial rewards they receive to the amount of benefit the patient receives.<p>Pharmacists favour the current system of funding health care in Canada but would prefer more choice in the delivery and funding methods. The results do not indicate any relationship between pharmacists orientation to health care (commodity vs. public right) and their level of support for different health care funding strategies. <p>The study conclusions suggest that pharmacists value and appreciate the direct impact of their work on patients. However they consider themselves to be professionals first and expect to be compensated financially for their services. Their willingness to spend time and effort towards provision of services as a public right seems to be predicated to a certain extent by the financial rewards they receive.

Thesis (Ed.D.)--East Carolina University, 2009. / Presented to the faculty of the Department of Educational Leadership. Advisor: Lynn Bradshaw. Title from PDF t.p. (viewed May 20, 2010). Includes bibliographical references.

published_or_final_version / Medical Sciences / Master / Master of Medical Sciences

No description available.

Η παρούσα εργασία αποσκοπεί στο να διερευνήσει τις αντιλήψεις των φαρμακοποιών ως επιστημόνων υγείας απέναντι στα συμπληρώματα διατροφής, αλλά και τις πρακτικές επιλογής και προώθησης των σκευασμάτων αυτών στο φαρμακείο. Τα δεδομένα συλλέχθηκαν με τη βοήθεια ειδικά διαμορφωμένου ερωτηματολογίου που απευθυνόταν σε επαγγελματίες φαρμακοποιούς. Συγκεντρώθηκαν 100 ερωτηματολόγια από διάφορους νομούς της βόρειας Ελλάδας κυρίως, με προσωπική συνέντευξη, τηλεφωνική επικοινωνία καθώς και αποστολή στο χώρο εργασίας για τα πιο απομακρυσμένα φαρμακεία. Οι φαρμακοποιοί του δείγματος εμφανίστηκαν συγκρατημένοι όσον αφορά την ικανοποίηση απ’ τις πωλήσεις των συμπληρωμάτων διατροφής στα φαρμακεία τους. Εξίσου επιφυλακτικοί παρουσιάστηκαν και ως προς την τάση να συστήνουν κάποιο σκεύασμα με δική τους πρωτοβουλία σε περιπτώσεις που πιθανώς να αφορούν κάποιο πρόβλημα υγείας. Στοιχεία Μάρκετινγκ των συμπληρωμάτων διατροφής όπως η ισχύς της εμπορικής ονομασίας και η φήμη της παραγωγού εταιρίας φάνηκαν να επηρεάζουν καθοριστικά τόσο τις επιλογές των πελατών, κατά τη γνώμη των φαρμακοποιών, όσο και τις δικές τους επιλογές ως προς τα σκευάσματα που θα επιλέξουν να διαθέτουν στο φαρμακείο τους. Ως βασικότερος παράγοντας σύστασης κάποιου συγκεκριμένου σκευάσματος από τους φαρμακοποιούς αναδείχθηκε η πίστη στην αποτελεσματικότητά του. Γενικά το δείγμα εμφανίστηκε θετικό ως προς την αναγκαιότητα των συμπληρωμάτων διατροφής εξαιτίας των συνθηκών που επιβάλλει ο σύγχρονος τρόπος ζωής και συγκρατημένο ως προς την ανεπιφύλακτη σύσταση και προώθησή τους στο φαρμακείο. Επιπρόσθετα, σημείωσε ότι η συντριπτική πλειοψηφία των πελατών που έρχονται στο φαρμακείο αναζητώντας κάποιο συμπλήρωμα ζητούν τη συμβουλή του φαρμακοποιού ως προς την επιλογή τους, ενισχύοντας το συμβουλευτικό ρόλο του φαρμακοποιού στη διάθεσή τους. Τέλος, οι ερωτηθέντες δήλωσαν λιγότερο ενημερωμένοι σχετικά με τα συμπληρώματα διατροφής, απ’ ότι σίγουροι για τις σχετικές συμβουλές/ συστάσεις τους προς το κοινό. Αν και στη θεωρία τάχθηκαν υπέρ της αναγκαιότητας των συμπληρωμάτων διατροφής σε μια πληθώρα ανθρώπων λόγω του σύγχρονου τρόπου ζωής, εντούτοις οι φαρμακοποιοί του δείγματος εμφανίστηκαν πιο συντηρητικοί στην πράξη όσον αφορά την σύσταση και προώθηση τους. Όσο αντιλαμβάνονται να επηρεάζουν τα προϊόντικα στοιχεία των διαφόρων συμπληρωμάτων διατροφής τις επιλογές του αγοραστικού κοινού, άλλο τόσο φάνηκε να καθορίζουν τις επιλογές των φαρμακοποιών σχετικά με τα σκευάσματα που επιλέγουν να διαθέτουν στο φαρμακείο τους. Σημαντικό ρόλο στις επιλογές τους διαδραματίζει και η σχέση του φαρμακοποιού με την παραγωγό εταιρία (εμπιστοσύνη στο κύρος της εταιρίας και την αποτελεσματικότητα των σκευασμάτων της, ευελιξία της εταιρίας στη συνεργασία με τον φαρμακοποιό). Γενικά όσο πιο ικανοποιημένοι δήλωσαν οι φαρμακοποιοί απ’ τις πωλήσεις των συμπληρωμάτων διατροφής στο φαρμακείο, τόσο πιο ενημερωμένοι σχετικά εμφανίστηκαν. Η αυτοπεποίθηση των φαρμακοποιών για τις συμβουλές/ συστάσεις τους επηρεάζεται τόσο από την σχετική ενημέρωση τους όσο και από την επαγγελματική τους εμπειρία. / To explore the beliefs of pharmacists as health care professionals towards food supplements and their practices of choosing, recommending and promoting such products. Data was collected by administering a specially designed questionnaire to be completed by community pharmacists. 100 questionnaires were gathered coming from various areas, mostly in the north of Greece using personal interviews, phone interviews as well as by mailing the questionnaires to professionals based at distant areas. The pharmacists of the sample appeared merely satisfied from the sales of food supplements in their pharmacies. They also appeared reserved towards taking sole responsibility of suggesting a supplement, in cases that could involve some health problem. Certain Marketing elements such as the brand name and the prestige of the company seemed to play a key role in the buying decision of the customers from the pharmacists’ view, as well as in their own decisions over which supplements they will include for sale in the pharmacy. The belief in the effectiveness of the product was regarded as the most important reason for suggesting a certain supplement. Generally, the sample appeared more likely to believe in the necessity of food supplements as a result of the current way of living, though reserved as far as uninhibitedly suggesting and promoting their use. It was also noted that the majority of customers seeking to purchase a food supplement, ask for the pharmacist’s opinion and suggestion instead of picking one on their own, which reinforces the counseling role of the pharmacist in the buy. Finally, the pharmacists stated to be more confident over their advice/ suggestions, rather than well-informed as far as food supplements are concerned. The pharmacists included in the research seemed skeptical about the wide use and promotion of food supplements, though in theory they appeared to agree with the fact that they are necessary to various people due to the current way of living. The more they believe that certain marketing elements of these products affect the customers’ buying decisions, the more likely they are to be affected by these elements in deciding which supplements to include for sale in their pharmacies. As far as these decisions are concerned, the relationship with the producing company plays an important role (trust in the company’s credibility and its products’ effectiveness, flexibility of the company in terms of pharmacist’s needs). Generally, the more satisfied the pharmacist was from the sales of food supplements in the pharmacy, the more informed about them he/she stated to be. The confidence of the pharmacists as far as their suggestions are concerned is affected by how well-informed they are and by their experience behind the counter.