No description available.

Introduction The study aimed at determining health workers’ prescription patterns using selected WHO/INRUD core drug-use indicators and investigated determinants of appropriate antibiotic prescribing in public Zambian primary health care facilities. Methods The study was a secondary data analysis of a cross sectional survey of health facility data collected in four districts of Zambia. This study extracted patients’ diagnoses and treatments and linked them to the health worker demographics and health facility characteristics in order to determine prescription patterns and factors influencing appropriate antibiotic prescribing. Results A total of 2206 prescriptions were analysed. An average of 2.5 drugs per encounter was prescribed. Injections were prescribed in 4% of the encounters. While over 95% of drugs were from the essential drug list fewer drugs were prescribed by their generic names. Only 1.5% of encounters did not result in a prescription. Antimalarial drugs and antipyretics were prescribed in at least 70% of encounters while antibiotics were prescribed in close to 40% of encounters. Of all encounters in which a systemic antibiotic was prescribed, just above a quarter were of appropriate indication and dosage. Determinants of appropriate antibiotic prescribing included patient’s age, presence of clinical wall charts and treatment guidelines; and the health worker cadre. Under-5s were more likely to receive antibiotics when indicated, though at wrong dosages. Health workers with access to guidelines were more likely to prescribe antibiotics only when indicated. Health worker cadre iv without pre-service clinical training were more likely to prescribe antibiotics when not indicated and at wrong dosages. Discussion This study showed that health workers’ performance for most of the WHO drug-use core indicators was similar to findings in other developing countries. The study also revealed overuse of antibiotics for diseases that do not require antibiotics as treatment. Increasing access to guidelines and other clinical job aids, continuous medical education for all health workers and targeted training of health worker cadres without prior medical training will contribute to better prescribing of antibiotics.

Class of 2011 Abstract / OBJECTIVES: To quantify and explore the trends of medications which are left unclaimed in community pharmacies. METHODS: Walgreens’ pharmacies have a process that prints off a list of all prescriptions that are left unclaimed for a period of 10 days. The paperwork accounting for the medications unclaimed between the dates of September 1, 2010 through September 30, 2010 were analyzed from two Tucson Walgreens’ pharmacies. Medications were grouped into one of fifteen categories (i.e. anti-lipids, anti-hypertensives, etc) and once data collection was completed total number of prescriptions for each category was determined. Data was then compared between the two pharmacies. RESULTS: A total of 907 prescriptions were accounted for during the 30-day period with anti-psychotics and anti-hypertensive medications being the most common prescriptions left unclaimed in both pharmacies. CONCLUSION: Pharmacists need to make a large effort to stress patient compliance on all medications, with even greater emphasis on those medications that tend to be left unclaimed more often than others.

Illegible written prescriptions and “Doctor’s handwriting” may have been synonymous, but this stereotype has begun to change with the gradual uptake of e-prescriptions. These eprescriptions are electronically captured and delivered prescriptions, and are touted as the solution to the many medical risks caused by written prescriptions. Whilst there is published support for the benefits of e-prescriptions, the uptake of e-prescribing has been too gradual for all patients to enjoy these benefits. The inadequate research into physicians’ adoption of e-prescribing systems presents a need for further study in this area, in an effort to improve the general use of these systems. Based on a review of literature, this study proposes six factors which may explain physicians’ intentions to use e-prescribing systems. These factors are based upon the Unified Theory of Acceptance and Use of Technology (UTAUT). This model is extended in this study by Social Dominance Theory, Commitment-Trust Theory and the Product Evaluation Model. Quantitative data was collected to test the proposed hypotheses. This data was gathered from physicians who have had some exposure to an e-prescription system. 72 usable responses were obtained for this study. The results of the study suggest that Performance Expectancy and Price Value have the highest influence on Behavioural Intention. Effort Expectancy and Social Influence had no direct influence on Behavioural Intention when in the presence of other variables, but they, along with Trust, had an indirect effect on Behavioural Intention through Performance Expectancy. Surprisingly, Social Dominance Orientation was not found to have an influence on Behavioural Intention. Implications, contributions and further research are discussed.

Class of 2010 Abstract / OBJECTIVES: To investigate whether the use of electronic-prescriptions reduces the amount of interventions being performed by pharmacists in a retail community setting. METHODS: Investigators directly observed local community pharmacist for a period of 3 weeks, during the working hours of 9am to 6pm. Information recorded with each intervention was the type of prescription, drug in question, reasons for intervention, final outcome, and time spent performing intervention. RESULTS: After 3 weeks of direct observation a total of 21 interventions were performed on electronic-prescriptions versus 154 interventions on other types of prescriptions (handwritten, faxed, verbal). The percentage of prescriptions that needed interventions was 11.7% of electronic-prescriptions versus 10.3% of all other types (p = 0.565). CONCLUSIONS: In this limited study, the rate of interventions appears to be similar between electronic-prescriptions and other types of prescriptions as a whole.

The adoption of the Lions Gate Hospital Drug Formulary by the British Columbia Hospital Association for distribution and use in all provincial hospitals endorses the growing trend toward regionalization of drug information. Several aspects of this Formulary were investigated in the present study with the objective of designing a text even more applicable to the varied needs of the province. The format of the Formulary and a mechanism for regularly evaluating and updating the information therein were the major areas receiving consideration. One major change in format proposed is the increase in the number of drug monographs to approximately 600 from the present 300 entries. This increase is based on the requests for additional drugs from the representative hospitals sampled in the province. Changes in the format of individual monographs include an expansion of information under the heading "Mode of Action", that an additional section on "Instructions to the Patient" be added to facilitate effective instructions for self-administration in ambulatory services, that each monograph receive a Canadian Drug Identification Code reference and that the information in each monograph be referenced where possible to the primary literature source. Changes in the format of the overall Formulary include a cross-index of monographs to manufacturers' brand names, a bibliography of the referenced information and a "Mini" Formulary format for use on individual hospital wards. The latter recommendation is made in recognition of the potential bulk of the overall Master Formulary which would make it awkward for efficient and frequent use. In this respect, it is anticipated that one Master Formulary containing all 600 eventual monographs, the bibliography for each and the various indices be made available in each hospital for resource reference. On each ward a complete Formulary of all drug monographs but not the accompanying bibliographies would be available. Studies showed that something less than 100 of these drugs (less than 20 percent) were used with any frequency on any specialty ward studied. Therefore, a "Mini" Formulary containing only the monographs of drugs frequently used in a specialty area would make the information more readily available in that service. Changes in printing format also are recommended with the objective of reducing the bulk of the proposed Formulary. A regular updating mechanism must be activated to keep the information in the Formulary current. Such a mechanism related to an annual literature evaluation assignment by the senior students of the Faculty of Pharmaceutical Sciences, University of British Columbia, is proposed. Based on this academic exercise, two types of updating are identified. First, a complete evaluation and referencing of the existing monograph information is required. Second, annual updating of this information from current literature should be maintained. To evaluate, revise and condense the students' evaluations to monograph format, a "service" component of faculty instructor time and of stenographer time have been projected. It is anticipated that the provision of approximately one-half time instructor per year and one-tenth time stenographer will be required on a "service" basis to enable the regular updating of the current Formulary as defined above. The arrangement for a Medical Review Board to review the evaluated monographs from a clinical validity standpoint also should be made. The above projections are based on studies related to the evaluation and updating of 100 drug monographs during 1972-73. A final recommendation is that the basis for generating, updating and additional referencing of the Drug Formulary should be a provincial Drug Information Centre. / Pharmaceutical Sciences, Faculty of / Graduate

No description available.

Thesis (MSc.(Med.)(Pharmacy))--University of Limpopo, 2010. / According to the World Health Organisation, there should be an essential medicines list in every functioning health care system in the world. The Department of Health of South Africa published its first Essential Drugs List for Primary Health Care in 1996 and for paediatric and hospital use in 1998. The South African Defence Force published its Military Medicine Code List (MMCL) in 2002. Since the implementation of the code list in the military service, no research study has been undertaken to determine adherence to the code list by prescribers or to determine indicators for possible non-adherence to the MMCL. The main aim of the study was to evaluate prescribing adherence to the MMCL list by doctors and nurses in the Primary Health Care military clinics in Gauteng. Further objectives were to establish indicators for non-adherence and provide suggestions to improve adherence, to determine to which drugs non-adherence was directed and to determine the average number of items prescribed per prescription. A cross-sectional, mainly quantitative, descriptive study was conducted at 14 military PHC dispensing points in Gauteng. Data were collected retrospectively from 838 prescriptions, of which 348 were written by doctors and 490 by nurses. A questionnaire was used to collect data prospectively from seven doctors and 34 nurses on their perceptions of the use of the MMCL. The prescriptions were analysed for adherence to the stipulations of the MMCL. Proportions of adherent prescriptions and items were compared between prescriber type (doctors and nurses), facility type (pharmacies and dispensaries) and facility location (Northern Region, close to 1 Military Hospital and Southern Region), using the Chi-square test. Non-adherent items were tabulated and grouped. Data from the questionnaires were analysed descriptively. Indicators for possible non-adherence and suggestions for improvement of adherence were listed and grouped. The average number of items per prescription was 3.4. Overall, 89.9% of prescriptions (n=838) and 96.4% of items (n=2832) were adherent to the MMCL. xii More prescriptions written by doctors (96,8%) were adherent, compared to nurses (84,9%; P<0.001). Only a few items were responsible for non-adherence. Nonadherent items specifically for nurses included corticoid nasal sprays, azithromycin, meloxicam and ispagula husks. Adherence of prescriptions dispensed in dispensaries (no pharmacist) (93.0%) was higher compared to pharmacies (87.0%; P<0.004). Prescriptions from facilities in the South of Gauteng (96.5%) were more adherent than those near 1 Military Hospital (North) (87.7%; P<0.001). Reasons for non-adherence included staff shortages, implementation and availability of the MMCL, absence of standard treatment guidelines (STGs) in the MMCL and delayed referrals to specialist departments. Suggestions for improvement of adherence to the MMCL included better implementation and distribution of the code list, addressing staff shortages, including Standard Treatment Guidelines (STGs) in the code list and improving the referral system from clinics to hospitals.

Thesis (M.S.)--University of Wisconsin--Madison, 1963. / Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references.

Thesis (Ph.D.) -- Virginia Commonwealth University, 2006. / Prepared for: School of Pharmacy. Bibliography: leaves 107-112. Also available online.