Pharmacists’ ability to interfere with prescription drug abuse is hindered back a lack of confidence, training, and time.

Abstract available through Pharmacotherapy.

Prescription drug abuse (PDA) is an epidemic nationwide and has disproportionally impacted the Southern Appalachian region. Situated within a geographic area known for pervasive PDA and its consequences, The Gatton College of Pharmacy and Academic Health Sciences Center (AHSC) at East Tennessee State University are proactively engaging the Region and its health professions students to address the problem. Over the College’s six-year history of community engagement in PDA, efforts have focused on primary prevention activities, PDA treatment, awareness, education, and interprofessional collaboration as the key impact sectors. Notable programs include Generation Rx, Operation Rx Disposal, continuing education (CE) programming, and establishment of the ETSU Diversity-promoting Institutions Drug Abuse Research Program. In 2013-2014, 3 faculty and 38 Generation Rx pharmacy students engaged 4000 children and adolescents in PDA prevention education. Operation Rx Disposal employed 5 faculty members and 35 student pharmacists to assist more than 1000 households in removing unwanted medication from their homes through conduction of drug take-back events. Over 2000 health care providers from regional communities participated in PDA CE events conducted by 3 pharmacy faculty members. Additionally, 3 externally funded, PDA-specific grants totaling $2.26 million were awarded to pharmacy faculty members to engage communities, health care professionals, and students in innovative PDA prevention research. The College’s efforts have been nationally recognized by peers, professional organizations, state boards of pharmacy and within the evidentiary literature.

No description available.

The overall aim of this thesis was to evaluate clinical pharmacist interventions with the focus on methods aiming to improve the quality of drug therapy and increase patient safety. Adverse drug events caused by medication errors, suboptimal dosages and inappropriate prescribing are common causes of drug-related morbidity and mortality. Clinical pharmacists integrated in multi-professional health-care teams are increasingly addressing these issues. A randomised controlled trial (RCT) was conducted to investigate the effectiveness of clinical pharmacists’ interventions in reducing morbidity and use of hospital care for patients 80 years or older. The results showed that the intervention group had fewer visits to hospital and that the intervention was cost-effective. In a subsequent study based on the population in the RCT, the appropriateness of prescribing was assessed using three validated tools. The results indicated improved appropriateness of prescribing for the intervention group as a result of the intervention. The tools and the number of drugs at discharge were then tested for validity in terms of causal links between the scores at discharge and hospitalisation. No clear correlations between high scores for the tools or a high number of drugs and increased risk of hospitalisation could be detected. During the inclusion period of the RCT a survey based study was conducted where the perceived value of ward-based clinical pharmacists, from the perspective of hospital-based physicians and nurses as well as from general practitioners (GPs) was evaluated. The respondents were positive to the new collaboration to a high degree and stated increased patient safety and improvements in patients’ drug therapy as the main advantages. In the last study the frequency and severity of prescription and transcription errors, when patients enrolled in the multidose-dispensed medications (MDD) system are discharged from hospital, was investigated. The results showed that errors frequently occur when MDD patients are hospitalised.

Τα τελευταία χρόνια έχει παρατηρηθεί μία αλλαγή ως προς τις ανάγκες που πρέπει να καλύπτει το επάγγελμα του φαρμακοποιού. Με την εισαγωγή της έννοιας της Φαρμακευτικής Φροντίδας, ο φαρμακοποιός καλείται να αναλάβει την ευθύνη για την παροχή κατάλληλης φαρμακοθεραπείας προς τον ασθενή - πελάτη, με στόχο τη βελτίωση της ποιότητας ζωής του. Ταυτόχρονα, το μεταβαλλόμενο εξωτερικό περιβάλλον τον αναγκάζει να παίρνει στρατηγικές αποφάσεις για την επιβίωση της επιχείρησής του. Το γεγονός ότι ο διττός ρόλος του φαρμακοποιού απαιτεί τη συλλογή, επεξεργασία και ανάλυση μεγάλου όγκου δεδομένων και ο περιορισμένος του χρόνος, συμβάλλουν στην ανάγκη για διεύρυνση της χρήσης των Συστημάτων Μηχανογράφησης στα φαρμακεία. Αυτή η εργασία είχε ως στόχο να αξιολογηθούν τα διάφορα Συστήματα Μηχανογράφησης Φαρμακείων. Επίσης, να ερευνηθεί κατά πόσο η Φαρμακευτική Φροντίδα και η Διαχείριση Γνώσης με τη χρήση των συστημάτων αυτών μπορούν να οδηγήσουν στην καλύτερη ικανοποίηση των αναγκών των πελατών – ασθενών και των ιδιαίτερων προτιμήσεών τους και επομένως στην ενδυνάμωση του φαρμακοποιού. Για τη διεξαγωγή της έρευνας μοιράστηκε ερωτηματολόγιο σε 172 φαρμακοποιούς διαφόρων περιοχών της Ελλάδας. Οι ερωτήσεις εστίαζαν στις αντιλήψεις των φαρμακοποιών ως προς την έννοια της Φαρμακευτικής Φροντίδας, στις σχέσεις τους με τους πελάτες, τις φαρμακευτικές εταιρίες και τις φαρμακαποθήκες και στην αξιολόγηση των δυνατοτήτων που προσφέρονται από τα Συστήματα Μηχανογράφησης που χρησιμοποιούσε ο καθένας στο φαρμακείο του. Η έρευνα απέδειξε ότι οι φαρμακοποιοί δεν εκμεταλλεύονται τις δυνατότητες των Συστημάτων για την εφαρμογή της Φαρμακευτικής Φροντίδας. Επιπλέον, αποδείχτηκε ότι η Διαχείριση Γνώσης και η Φαρμακευτική Φροντίδα συμβάλλουν στην ικανοποίηση των αναγκών των πελατών – ασθενών, η οποία τελικά οδηγεί στην ενδυνάμωση του φαρμακοποιού μέσω της επίδρασής του στη διαδικασία λήψης αγοραστικής απόφασης των πελατών - ασθενών. / In recent years there has been a change in the needs that must be covered by the pharmacist profession. By introducing the concept of pharmaceutical care, the pharmacist is called upon to undertake the responsibility to provide the appropriate medication to the patient – client in order to improve the quality of its life. At the same time, the changing external environment forces him to take strategic decisions for the survival of his business. The fact that this dual role of the pharmacist requires, on the one hand, collecting, processing and analyzing large volumes of data and on the other hand its time is limited, contribute to the need for expanded use of computer systems in pharmacies. This Master Thesis aimed to assess the various Pharmacy Management Information Systems. Also, to investigate whether the Pharmaceutical Care and Knowledge Management with the use of these systems can lead to better satisfaction of customers’ - patients’ needs and their particular preferences and thus to strengthen the pharmacist. For the purposes of the survey, a questionnaire was distributed to 172 pharmacists in different areas of Greece. Questions focused on the perceptions of pharmacists regarding the meaning of Pharmaceutical Care in their relations and interactions with customers, pharmaceutical companies and wholesalers. Also, they focused on the evaluation of the possibilities offered by the Pharmacy Management Information Systems that pharmacists use in their pharmacies. The survey proved that pharmacists do not exploit the capabilities of Systems for the implementation of Pharmaceutical Care. Likewise, it was proved that Knowledge Management and Pharmaceutical Care contribute to the satisfaction of patients’ needs, which ultimately leads to the empowerment of the pharmacists through their effect in the purchasing decisions of patients - customers.

Pharmacists experience high levels of stress at work, especially from factors intrinsic to their jobs and management roles. In South Africa, the public sector is confronted with situational difficulties such as a shortage of staff and poor working conditions Accordingly, a comparative survey was conducted using a self–constructed questionnaire to obtain individual responses from the pharmacists in the public, as well as the private sector. The focus population was the pharmacists in the public, as well as the private hospitals in the North–West Province. The public sector consists of 30 hospitals and the private sector of 20. By using the convenient sampling method, 100 samples were taken. The questionnaire measured six factors of job satisfaction, namely: job design, salary/remuneration satisfaction, performance management, working arrangements, organisational climate, and professional development. The questionnaire was distributed to 100 pharmacists in total, and a response rate of 66% was obtained. The only medium practical significance shown in the results was between the averages of the private sector (2.89) in contrast with the public sector (3.38). This indicates that the public sector demonstrates less satisfaction with their performance management than the private sector. The data also indicated that the public sector pharmacists are less satisfied with job design, performance of management, professional development, and their working arrangements. The private sector showed only a small difference in the means, when compared to the public sector. It is clear that both sectors illustrate a moderate level of job satisfaction. Recommendations, therefore, included the revisiting of the job design by increasing job rotation and task identity. The need for self–actualization has to be acknowledged and the opportunity for promotion needs to be provided. The link between the actual activity and the bonus, with regards to performance management, has to be re–established, and there has to be transparency throughout. Decision–making control is extremely important and seeing that 82% of the pharmacists were female, the employer can consider accommodating family responsibilities, compressed working weeks, flexible working hours, job sharing, and part–time work. Professional development is also very important within any company and it is vital that the employer deposits time, money and skill into the staff. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2011.

Pharmacists experience high levels of stress at work, especially from factors intrinsic to their jobs and management roles. In South Africa, the public sector is confronted with situational difficulties such as a shortage of staff and poor working conditions Accordingly, a comparative survey was conducted using a self–constructed questionnaire to obtain individual responses from the pharmacists in the public, as well as the private sector. The focus population was the pharmacists in the public, as well as the private hospitals in the North–West Province. The public sector consists of 30 hospitals and the private sector of 20. By using the convenient sampling method, 100 samples were taken. The questionnaire measured six factors of job satisfaction, namely: job design, salary/remuneration satisfaction, performance management, working arrangements, organisational climate, and professional development. The questionnaire was distributed to 100 pharmacists in total, and a response rate of 66% was obtained. The only medium practical significance shown in the results was between the averages of the private sector (2.89) in contrast with the public sector (3.38). This indicates that the public sector demonstrates less satisfaction with their performance management than the private sector. The data also indicated that the public sector pharmacists are less satisfied with job design, performance of management, professional development, and their working arrangements. The private sector showed only a small difference in the means, when compared to the public sector. It is clear that both sectors illustrate a moderate level of job satisfaction. Recommendations, therefore, included the revisiting of the job design by increasing job rotation and task identity. The need for self–actualization has to be acknowledged and the opportunity for promotion needs to be provided. The link between the actual activity and the bonus, with regards to performance management, has to be re–established, and there has to be transparency throughout. Decision–making control is extremely important and seeing that 82% of the pharmacists were female, the employer can consider accommodating family responsibilities, compressed working weeks, flexible working hours, job sharing, and part–time work. Professional development is also very important within any company and it is vital that the employer deposits time, money and skill into the staff. / Thesis (M.B.A.)--North-West University, Potchefstroom Campus, 2011.

Despite extensive research on the history of medicine, little has been written on the role played by pharmacists. The diminished demand for compounding services that accompanied the explosion of manufactured pharmaceuticals after World War II left pharmacists over educated and underutilized. This study demonstrates how British Columbia pharmacists reconstructed their professional authority in the 1960s through the formation of a Pharmacy Planning Commission, a process that pre-dated and influenced other jurisdictions. Examination of the archives of the College of Pharmacists of British Columbia reveals that pharmacists overcame ethical restrictions, adopted clinically focussed education and increased accessibility to facilitate a role as consultant to the public on non-prescription medications. The addition of prescription drug counselling and an increased role as drug consultants to physicians allowed British Columbia pharmacists the authority to claim a core competency as drug information experts.

Philosophiae Doctor - PhD / This thesis presents research on the emergence of sub-structure and sub-district pharmacists in Cape Town by considering their roles and related competencies, and the support required to establish them in these new positions. The research was carried out in partnership with Metro District Health Services (MDHS) and City Health. Both organisations provide services across the whole of the Cape Metro. The research took place as MDHS was dividing the Cape Town Metro District into four sub-structures, and the research is embedded in these unfolding developments. The four sub-structures were created to be closer in size to WHO health districts than the unmanageably large Metro District. Consequently, sub-structures and sub-structure pharmacists in this study should be considered equivalent to districts and district pharmacists in other settings. I used a participatory action research (PAR) approach to partner with pharmacists and managers in both organisations between 2008 and 2011. The partnership benefitted from the contextual and practice experiences of the health services stakeholders and my evolving research expertise. Including a broad stakeholder group was considered important for developing the shared learning and understanding that would translate into action and changen in the organisations. The flexible and emergent approach of PAR was considered suited to a complex health system in the midst of change. After an initiation stage, the research evolved into a series of five iterative cycles of action and reflection, each providing increasing understanding of the roles and related competencies of sub-structure and sub-district pharmacists, and their experiences as they transitioned into these new management positions in the two organisations. The research centered around two series of three interactive workshops I facilitated, attended by both pharmacists and managers, in which I contributed information from published literature and documentary reviews to the collaborative processes. Semi-structured interviews and focus groups were conducted at various stages during the research, to inform conceptualization and supplement workshops, and later on, during years three and four, to reflect on the experiences of substructure and sub-district pharmacists. The research identified five main roles each for sub-structure and sub-district pharmacists. Four of these roles are the same for each: Sub-structure (sub-district) management Planning, co-ordination and monitoring of pharmaceuticals, human resources, budget, infrastructure Information and advice Quality assurance and clinical governance But their fifth roles are different: Research, for sub-structure pharmacists. Dispensing at clinics for sub-district pharmacists. But although they look similar, there were substantial differences between sub-structure and sub-district pharmacist roles in the two organisations. Their roles were shaped by the differences in leadership and governance, as well as by the services provided by the two organisations. Sub-structure pharmacists were generally involved in strategic level management functions whilst sub-district pharmacists combined sub-district management activities with dispensing in clinics. Essentially the two cadres were working at different management and leadership levels, with sub-structure pharmacists working at middle management level and sub-district pharmacists straddling first level and middle management levels. Five competency clusters were identified for both cadres, each with several competencies. Professional pharmacy practice Health system/public health Management Leadership Personal, interpersonal and cognitive Whilst professional pharmacy practice competencies were particularly valued by substructure and sub-district managers, overall, sub-structure and sub-district pharmacists required generic management and leadership competencies. Along with the more technical management and leadership competencies, both organisations recognised the importance of viii „softer‟ competencies for pharmacists moving into these management positions. Again, although the competencies appear similar, there were differences between the roles, so that the different cadres required different competencies within these competency clusters. Transitioning into these new management positions was an emergent process, which entailed pharmacists changing form performing technical and clinical functions associated with professional pharmacy practice to co-ordinating pharmaceutical services across the substructure or sub-district. They moved from working in a pharmacy to being a member of a multi-professional team in a sub-structure or sub-district. Adjusting to these new management positions took time and was facilitated by several personal and organisational factors which varied in the two organisations. Managers and pharmacists mentioned the positive contribution of the PAR in assisting with this transition through the development of shared understanding of the DHS and the roles and functions of pharmacists working in these management positions. The research assisted with practical aspects including the development of new job descriptions. Several implications for developing competencies in sub-structure and sub-district pharmacists emerged during the research. Firstly, although competency frameworks for substructure and sub-district pharmacists are useful for selecting new staff, conducting performance appraisals and identifying learning needs, they need to be tailored for each setting. Secondly, a mixture of traditional training options, including academic qualifications and short courses, as well as innovative on-the-job support such as mentoring and coaching are required to support sub-structure and sub-district pharmacists, and other similar cadres in these positions.