Class of 2011 Abstract / OBJECTIVES: To examine the effects of pharmacist-provided direct patient care with consideration to the patients’ socioeconomic status as determined by the patients’ health insurance. METHODS: A meta-analysis was conducted to evaluate the effects of pharmacist-provided direct patient care on different socioeconomic populations as determined by the patients’ health insurance by including results from several independent randomized control trials. A standardized and tested data extraction form was used to collect primary data on outcome category (therapeutic, safety, and humanistic), disease category (diabetes, hypertension, cardiovascular, dyslipidemia, asthma, and other), insurance status (Medicaid, Medicare, Veterans Affairs/ Department of Defense, private and uninsured), and outcome measures. The potential for bias data were analyzed by calculating a total potential for bias score and by construction a forest plot ordered by bias score. RESULTS: Twenty-two studies were included in the meta-analysis. The insurances most often reported were Medicaid (13.6%), Medicare (18.2%), the Veterans Affairs/ Department of Defense (VA/DoD) (41%), and private insurance (27.2%). All insurance groups benefited from pharmacist intervention (p<0.01). The Medicare patients benefited the least from the pharmacist interventions [standard mean difference (SMD) = 0.21], and the benefit of intervention was significantly less than the benefit for subjects having Medicaid, Private Insurance or VA/DoD coverage (p<0.02). CONCLUSION: While patients in all insurance type benefited from pharmacist intervention, Medicare patients seemed to benefit the least; further studies are needed to verify the findings and to explore why the benefit is less than for other groups.

Pharmacists as members of health care teams, have a central role to play with respect to medication. The pharmaceutical care and cognitive services which pharmacists are able to provide can help prevent, ameliorate or correct medication-related problems. There are however many barriers to the provision of these services and one of the barriers commonly cited by pharmacists is the lack of remuneration for their expert services. The aim of this study is to ascertain if patients in South Africa are willing to pay for pharmacist-provided services which may reduce medication related problems, and thereby determine the perceived value of the pharmacist-provided services, by patients. The study will also seek to determine factors that influence willingness to pay (WTP), including financial status, gender, race, age and level of education. In addition the perceived value of the pharmacist‘s role in patient care, by third party payers (SA Medical Aid providers) and their WTP for pharmacist-provided services (such as DSM) on behalf of patients through their monthly premiums will also be investigated. The study was conducted as a two-phase process: the first phase focused on the opinions of patients and the second phase on the medical aid companies. In phase-1 a convenience sample of 500 patients was recruited by fifty community pharmacies distributed throughout the nine South African provinces. Data collection, consisting of telephonic administration of the questionnaires, was conducted and the survey responses were captured on a Microsoft Excel® spreadsheet. All the captured information was analyzed using descriptive statistics, box and whisker plots, analysis of variance (ANOVA) and regression analysis. In phase-2, medical aid schemes that are registered with the Council of Medical Schemes (CMSs) of South Africa were included in this research. A fifteen point questionnaire was completed electronically via e-mail by willing medical aid participants. Data was analyzed using descriptive statistics only. Only 233 or 88.6 percent, of the 263 participating respondents, were willing to pay at least one rand towards pharmacist-provided services. On average respondents were willing to pay R126.76 as out-of-pocket expenses. Respondents‘ WTP increased as the risk associated with medication-related problems was reduced due to pharmaceutical care intervention. Of the 263 respondents who took part in this research, fifty percent were willing to pay at least R100 for a risk reduction of 30 percent, R120 for a 60 percent reduction and approximately R150 for a greater than 90 percent risk reduction. It was also found that the respondents‘ willingness to pay was influenced by their age, earnings, racial grouping, employment status, medical aid status and their level of satisfaction with pharmacist-provided care services. Of the thirty-one open medical aid schemes only eight (25.8 percent) participated in the study. Findings indicate that all the participating medical aid respondents were unwilling to pay for pharmacist-provided care services, although they perceived pharmacists as very influential healthcare providers and as having a significant role to play in reducing medication-related problems. In conclusion it was found that majority of participants were willing to pay for pharmacist-provided services directed towards reducing risks associated with medication-related problems. Until pharmacists are able to prove pharmaceutical care‘s utility and cost-effectiveness to third-party payers, pharmacists must look to the patient for reimbursement.

Increasing collaborative working between GPs and community pharmacists has recently become a high priority for the NHS. Previous research suggests that interaction is limited and problematic between the two professions, forming a barrier to service provision. This PhD aimed to explore the level, nature and process of interaction between GPs and community pharmacists, using a social network analysis approach.The study focused on four geographically different case study areas and 90 GPs and community pharmacists participated in total. A two-stage design was adopted. Firstly data were collected through a network questionnaire and analysed using social network analysis. Secondly, qualitative interviews were conducted to provide narrative to the network findings and analysed using the framework approach.The nature of contact was characterised as mostly indirect through brokers, de-personalised and non-reciprocal and seemingly at odds with collaborative behaviour. A misalignment in responses pointed to asymmetry in the relationship, representing little commonality, knowing and understanding of each other. Through social network analysis, individuals and dyads in possession of strong ties were identified. Strong ties were not the norm and were characterised by more personalised forms of reciprocal contact. Qualitative interviews provided insight into the processes of interaction between the two professional groups. An approach to the interaction, which involved pharmacists tactically managing the potential conflict in the interaction through use of deferential and sometimes subservient behaviour, was conceptualised as the ‘pharmacist-GP game’. Those pharmacists with strong ties to GPs also, at times, adopted aspects of this approach but also attempted to set themselves apart from other pharmacists in order to develop and maintain their strong ties with GPs. However, possession of strong ties did not always lead to capitalisation, and the benefits of possessing these were often viewed as efficiency and convenience gains rather than anything more wide-reaching. Often, more isolated GPs and pharmacists did not view strong ties as a necessity, with the benefits of these not considered rewarding enough for the time and effort required to achieve them. This effort-reward conflict was identified as an important constraint faced by GPs and pharmacists in relation to transforming these loose connections into more integrated networks. Other micro and macro level constraints were also identified and a series of accompanying recommendations made for future practice and research.

1 Abstract Analysis of education of pharmacists in the Czech Republic after graduation Author: Eliška Röslerová Tutor: PharmDr. Josef Malý, Ph.D. Consultant: Mgr. Aleš Krebs, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aim of study: A Pharmacist, as a worker in a health service has to continue to further the education of themselves throughout their career in pharmacy. The main goal of this diploma thesis was to analyse continuing education after graduation used by selected members of the District Association of Pharmacists. Methods: Data for a practical part of this diploma thesis were collected by a questionnaire survey. A 39-item survey was administered to selected pharmacists (members in the Czech Chamber of Pharmacists) from randomly chosen the District Associations of Pharmacists. The address to access the survey was added in a recruitment letter. In this letter, the study was also described and was sent to 858 pharmacists through their e-mail addresses. The first mailing was sent after 7 days, the second mailing after 14 days. The respondents who filled in compulsory questions were included in the analysis. Descriptive statistics were used for analysing the results of the survey. Results: The survey of the 299 respondents...

Pulse check in pharmacies I Author: Michaela Frnková Supervisor: PharmDr. Kateřina Malá, Ph.D. Consultant: PharmDr. Anna Rejmanová, Ph.D. De artment o ocial an linical Pharmac , Fac lt o Pharmac in ra ec Králov , harle University Introduction: Atrial fibrillation is one of the most common supraventricular disorders of the heart rhythm. Unless properly treated, it leads to higher mortality and morbidity rates. Early detection of such fibrillation, which is often asymptomatic, may prevent further associated complications, especially ischemic stroke, and a sudden cardiac death. Aim: The thesis focused on the feasibility of involving pharmacists in the screening of the patients with heart rhythm disorders. Further increase awareness of the possibilities and meaning of monitoring heart rhythm disorders in pharmacies and ensure that patients can verify their own heart rate at home. Methods: The heart rhythm measurements were carried within four weeks (11/2017; 11/2018; 6/2019; 12/2019), during the global health initiative "Know o r l e". Mea ring took place at the pharmacy in Pardubice; the pharmacy offers individual consultations to patients. Participation in the screening for the atrial fibrillation was offered to all incoming pharmacy persons who were older than 40 years and without chronic...

Magister Pharmaceuticae - MPharm / Antibiotic resistance (ABR) is a global healthcare burden complicating the treatment of various infections. The infectious diseases burden is heavy in primary care. Urinary tract infections (UTIs) are common outpatient infections. Miscommunication in healthcare may lead to non-adherence, adverse events and fuel ABR. Labelling antibiotics should be explicit and understood by patients. Treatment of UTIs in primary care in the Western Cape is not well defined. This study’s aim is to describe the treatment of UTIs in primary care in the Cape Metropole of the Western Cape province.

No description available.

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Background: Lay press investigations have been published that describe pharmacist errors and the workplace environment in the community pharmacy setting. However, recent studies that explore pharmacists' perceptions of patient safety in the workplace are limited. Objectives: 1) To describe pharmacists' perceptions of workplace patient safety; 2) To compare pharmacists' perceptions of workplace patient safety across practice setting type, pharmacist roles, average hours worked per shift, and average hours worked per week. Methods: Actively licensed Tennessee pharmacists were recruited from January 1 and June 30, 2019 to complete a 13-item survey of workplace patient safety perceptions ( =1391). Descriptive statistics were calculated, and nonparametric statistical tests employed to compare differences in perceptions across practice setting type, pharmacist roles, and hours worked per shift and per week. Results: Statistically significant differences in workplace patient safety perceptions were noted across practice setting type (p values <.001) and pharmacist roles (p values <.001). The extent to which pharmacists agreed/strongly agreed that their employer provides a work environment that allows for safe patient care ranged from 29.7% of chain community pharmacists to 85% of compounding pharmacists. Fifty-two percent of staff pharmacists, 56.5% of relief pharmacists, and 58.5% of managers/pharmacists in charge agreed or strongly agreed that their employer provides a work environment that allows for safe patient care, whereas 89.3% of regional managers/directors/vice-presidents and 72.5% of clinical/specialty pharmacists indicated the same. Average hours per shift was inversely correlated with perceptions of workplace patient safety (p values <.001). Conclusion: Tennessee pharmacists' perceptions of workplace patient safety varied widely across practice setting type and pharmacist roles. Perceptions of safety were notably lower in the chain community pharmacy setting. Additional research is warranted to better understand the relationship between pharmacist perceptions and quantifiable patient safety metrics, particularly in the chain community pharmacy setting.

Yes / Background In the United Kingdom, nurses and pharmacists who have undertaken additional post-registration training can prescribe medicines for any medical condition within their competence (non-medical prescribers, NMPs), but little is known about patients' experiences and perceptions of this service. Objective to obtain feedback from primary care patients on the impact of prescribing by nurse independent prescribers (NIPs) and pharmacist independent prescribers (PIPs) on experiences of the consultation, the patient–professional relationship, access to medicines, quality of care, choice, knowledge, patient-reported adherence and control of their condition. Design Two cross-sectional postal surveys. Setting and participants Patients prescribed for by either NIPs or PIPs in six general practices from different regions in England. Results 30% of patients responded (294/975; 149/525 NIPs; 145/450 PIPs). Most said they were very satisfied with their last visit (94%; 87%), they were told as much as they wanted to know about their medicines (88%; 80%), and felt the independent prescriber really understood their point of view (87%; 75%). They had a good relationship with (89%; 79%) and confidence in (84%; 77%) their NMP. When comparing NMP and doctor prescribing services, most patients reported no difference in their experience of care provided, including access to it, control of condition, support for adherence, quality and safety of care. Discussion and conclusions Patients had positive perceptions and experience from their NMP visit. NMPs were well received, and patients' responses indicated the establishment of rapport. They did not express a strong preference for care provided by either their non-medical or medical prescriber. / Policy Research Programme in the Department of Health