<p>Cardiovascular disease is a leading cause of death and hospitalizations in Canada. Most risk factors for cardiovascular disease are known, and many are modifiable. One such risk factor that often goes unrecognized is non-adherence. Pharmacists are ideally positioned to have an influence on cardiovascular risk reduction, including supporting medication adherence; however it is still unknown whether typical (non-specialist) pharmacists can provide strategies that are effective and sustainable in todays health care system. Thus, the overall objective of this research project was to determine what interventions typical pharmacists can adopt to effectively facilitate cardiovascular risk reduction within the constraints of the current practice environment. This objective was accomplished through 4 related studies: 1) a randomized controlled trial involving a pharmacist-directed cardiovascular risk reduction collaboration within a family physician practice; 2) a systematic review identifying and evaluating published interventions by community pharmacists for cardiovascular disease or diabetes; 3) the design of a pilot study evaluating a novel community pharmacy intervention aimed at cardiovascular risk reduction and; 4) the examination of adherence patterns among antihypertensive medication users to identify associated factors and high-risk periods for non-adherence.</p> <p>Although the randomized controlled trial did not show a statistically significant benefit of the pharmacist intervention on cardiovascular risk, it did demonstrate the feasibility of incorporating a pharmacist into a collaborative role, without the need for an advanced or specialized degree. Results from the systematic review yielded several studies involving community pharmacists and cardiovascular disease or diabetes. However, the majority of these studies were of poor quality, evaluated complex and intensive interventions, and provided questionable clinical benefits. The design of the pilot study demonstrated the feasibility of developing high quality, robust research involving community pharmacists. Finally, the observational study examining adherence patterns to antihypertensive agents revealed two important findings that can guide the development of future strategies to support adherence: the first year of therapy, and particularly the first dispensation, is a critical time for the development of non-adherence and, contrary to previously published studies, adherence is similar between all classes of antihypertensive medications.</p> <p>This program of research did not identify one particular pharmacist intervention as being superior for cardiovascular risk reduction in todays practice environment. However, it did highlight the need for improved study quality and the development of interventions that are practical and can be realistically implemented by pharmacists in todays practice environment.</p>

<p>Cardiovascular disease is a leading cause of death and hospitalizations in Canada. Most risk factors for cardiovascular disease are known, and many are modifiable. One such risk factor that often goes unrecognized is non-adherence. Pharmacists are ideally positioned to have an influence on cardiovascular risk reduction, including supporting medication adherence; however it is still unknown whether typical (non-specialist) pharmacists can provide strategies that are effective and sustainable in todays health care system. Thus, the overall objective of this research project was to determine what interventions typical pharmacists can adopt to effectively facilitate cardiovascular risk reduction within the constraints of the current practice environment. This objective was accomplished through 4 related studies: 1) a randomized controlled trial involving a pharmacist-directed cardiovascular risk reduction collaboration within a family physician practice; 2) a systematic review identifying and evaluating published interventions by community pharmacists for cardiovascular disease or diabetes; 3) the design of a pilot study evaluating a novel community pharmacy intervention aimed at cardiovascular risk reduction and; 4) the examination of adherence patterns among antihypertensive medication users to identify associated factors and high-risk periods for non-adherence.</p> <p>Although the randomized controlled trial did not show a statistically significant benefit of the pharmacist intervention on cardiovascular risk, it did demonstrate the feasibility of incorporating a pharmacist into a collaborative role, without the need for an advanced or specialized degree. Results from the systematic review yielded several studies involving community pharmacists and cardiovascular disease or diabetes. However, the majority of these studies were of poor quality, evaluated complex and intensive interventions, and provided questionable clinical benefits. The design of the pilot study demonstrated the feasibility of developing high quality, robust research involving community pharmacists. Finally, the observational study examining adherence patterns to antihypertensive agents revealed two important findings that can guide the development of future strategies to support adherence: the first year of therapy, and particularly the first dispensation, is a critical time for the development of non-adherence and, contrary to previously published studies, adherence is similar between all classes of antihypertensive medications.</p> <p>This program of research did not identify one particular pharmacist intervention as being superior for cardiovascular risk reduction in todays practice environment. However, it did highlight the need for improved study quality and the development of interventions that are practical and can be realistically implemented by pharmacists in todays practice environment.</p>

No description available.

No description available.

Mental illnesses are very common. Those who are affected experience significant disadvantages that are evident in terms of poorer health outcomes, higher rates of premature death and enduring disability, socioeconomic disadvantage and poor quality of life. People with mental illness are significant users of health services, having frequent and lengthy hospitalisations and requiring extensive medication therapy. Polypharmacy is common amongst those with psychiatric illnesses, and the drugs that are used are often of low therapeutic index and with considerable potential to cause significant medication-related problems. This thesis explores the prevalence, nature and impact of medication-related problems that affect people with serious psychiatric illnesses, and examines the ways in which specialist pharmacy practitioners can assist with strategies to address these.

Mental illnesses are very common. Those who are affected experience significant disadvantages that are evident in terms of poorer health outcomes, higher rates of premature death and enduring disability, socioeconomic disadvantage and poor quality of life. People with mental illness are significant users of health services, having frequent and lengthy hospitalisations and requiring extensive medication therapy. Polypharmacy is common amongst those with psychiatric illnesses, and the drugs that are used are often of low therapeutic index and with considerable potential to cause significant medication-related problems. This thesis explores the prevalence, nature and impact of medication-related problems that affect people with serious psychiatric illnesses, and examines the ways in which specialist pharmacy practitioners can assist with strategies to address these.

Thesis (M.Sc.)--Memorial University of Newfoundland, 2004. / Bibliography: leaves 99-106.

M.Tech. / Homoeopathic mother tinctures have an extensive therapeutic history and as the emphasis of health is becoming a worldwide trend, homoeopathic preparations are becoming increasingly popular. However, the quality control and quality assurance still remains a challenge because of the high variability of chemical components involved (Pande and Pathak, 2006). Homoeopathic mother tinctures, singularly and in combinations, contain a copious number of compounds in complex matrices in which no single active constituent is responsible for the overall efficacy. This creates a challenge in establishing quality control standards for raw materials and standardization of finished herbal drugs, resulting in varying standards for these preparations globally (Chitlange, 2008). Various homoeopathic mother tinctures were selected for comparative analysis and consisted of: Artemisia absinthium, Rosmarinus officinalis e foliis recentibus, Sambucus nigra and Salvia officinalis are all manufactured according to the German Homoeopathic Pharmacopoeia method 3a, indicating the use of fresh plant material to produce the mother tincture (German Homoeopathic Pharmacopoeia, 2003). Many factors influence the quality of homoeopathic mother tinctures and many parameters must be met when assessing the quality of these products (Bandaranayake, 2006). Through thin layer chromatography analysis of the selected homoeopathic mother tinctures one is able to determine whether the active components of the samples are present and deduce whether the sample complies with the minimum standard quality stipulated in the German Homoeopathic Pharmacopoeia as well as the Good Manufacturing Practice (Waksmundzka-Hojnos et al., 2008). Samples of each homoeopathic mother tincture, purchased from both local and international manufacturers, were decanted into amber glass bottles, randomized and relabeled. The colour of each sample was assessed and compared to the standard colour stated in the German Homoeopathic Pharmacopoeia. For the thin layer chromatographic analysis, each sample together with reference sample were prepared and developed on both aluminum backed TLC plates and glass backed HPTLC plates. Photographs of the resultant chromatograms were taken, the presence of the active components were identified and the quality of each homoeopathic mother tincture was deduced.

Conclusion: The majority of independent community pharmacists are interested in incorporating personalized medicine services into their practices, but they require further education before this is possible. Future initiatives should focus on the development of comprehensive education programs to further train pharmacists for provision of these services.Objectives: To evaluate the perceptions of independent community pharmacists within a regional independent community pharmacy cooperative on implementing personalized medicine services at their pharmacies and to gauge the pharmacists' self-reported knowledge of pharmacogenomic principles.Design: Descriptive, exploratory, nonexperimental study.Setting: American Pharmacy Services Corporation (APSC), 2011-12.Participants: Pharmacists (n = 101) affiliated with the independent pharmacies of APSC.Intervention: Single-mode surveyMain outcome measures: Independent community pharmacists' interest in implementing personalized medicine services, perceived readiness to provide such services, and perceived barriers to implementation.Results: 101 completed surveys were returned for data analysis. The majority of pharmacists surveyed (75%) expressed interest in offering personalized medicine services. When asked to describe their knowledge of pharmacogenomics and readiness to implement such services, more than 50% said they were not knowledgeable on the subject and would not currently be comfortable making drug therapy recommendations to physicians or confident counseling patients based on results of genetic screenings without further training and education. Respondents identified cost of providing the service, reimbursement issues, current knowledge of pharmacogenomics, and time to devote to the program as the greatest barriers to implementing personalized medicine services.

Objective. To evaluate the talents of fellows from cohorts 1-10 of the Academic Leadership Fellows Program (ALFP). Methods. This was a descriptive analysis of previously collected ALFP cohort data reflecting the talents using the Clifton StrengthsFinder assessment tool. Data consisted of 295 fellows from the first 10 years of the ALFP program. The Clifton StrengthsFinder talents were aggregated and analyzed to determine talents (strengths) distribution and domain. The aggregate of the four domains were compared among ALFP fellows using a chi-square analysis with an a priori alpha of.05. Results. Lowest frequency of talents was found in the influencing domain (11.2%), while the domains with the largest frequency of talents were strategic thinking (34.4%) and executing (31.1%). When looking at the specific talents within the domains among the ALFP fellows, achiever (in the executing domain) and learner (in the strategic thinking domain) were the most frequent talents, while command (in the influencing domain) and adaptability (in the relationship building domain) were the least frequent talents. Conclusions. Since the profession is deficient in the influencing and relationship building domains (command and adaptability talents, respectively), this could help explain our slow progress in moving the profession from a product-focused role to a provider-based role. Perhaps the profession should be using a strategy better aligned with our signature leadership domains of executing and strategic thinking and focus on being a member of the health care team by aligning with team-based care rather than obtaining provider status.