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Dissertations / Theses on the topic 'Pharmaceutical services'
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Crealey, Grainne. "Remuneration of community pharmaceutical services." Thesis, Queen's University Belfast, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301733.
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Stern, Philip. "Patterns of pharmaceutical prescribing." Thesis, London Business School (University of London), 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.309363.
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Andersson, Karolina. "Swedish pharmaceutical benefit reforms : analyses of implementation, pharmaceutical sales patterns and expenditures /." Göteborg : Department of Public Health and Community Medicine, The Sahlgrenska Academy at Göteborg University, 2006. http://hdl.handle.net/2077/724.
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Thomas, Karen Anne. "The National Health Service contract for pharmaceutical services 1995 to 1998." Thesis, University of Portsmouth, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.368471.
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Wuliji, Tana. "Factors influencing human resource development for pharmaceutical services." Thesis, University College London (University of London), 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.522828.
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Begley, Susanne. "The establishment and evaluation of a domiciliary pharmaceutical service." Thesis, University of Brighton, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.282561.
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Burnett, Kathryn M. "The value of hospital based pharmaceutical audit." Thesis, Queen's University Belfast, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.322768.
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Bronkhorst, Elmien. "An Assessment of the need of pharmaceutical services in the intensive care unit and high care unit of Steve Biko Academic hospital." Thesis, University of Limpopo (Medunsa Campus), 2012. http://hdl.handle.net/10386/1081.
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Thesis (MSc(Med)(Pharmacy)) -- University of Limpopo, 2012.The role of the pharmacist has evolved over the last two decades beyond the traditional functions of dispensing and stock control. The focus has shifted toward patient-oriented functions, in which the pharmacist assumes responsibility for the patient’s drug- and healthcare needs as well as the outcome of treatment. The aim of this research was to assess the need for pharmaceutical care to the Surgical Intensive Care Unit of Steve Biko Hospital. The surgical and trauma ICU is a 12 bed unit to which the researcher rendered pharmaceutical care over an eight week period, from 14 February to 26 March 2011. Interventions to assess drug therapy and achieve definite outcomes to improve patients’ quality of life were documented for 51 study patients according to the system developed by the American Society of Health-System Pharmacists (1992). Of the 51 patients, 35 were male and 16 were female. The age of the patients ranged from 12 years to 86 years, with most patients admitted to the unit in the age groups 21 to 30 years, and 51 to 60 years. The patients’ estimated weights ranged from 40kg to 120kg with older patients, from age 41 upwards, weighing more. The average stay in the unit was 8.7 days, with the minimum stay for one patient being only one day, and the maximum stay for one patient was 26 days. In the study, the HIV status of only 13 of the 51 patients was tested. Of the 13 patients, six were HIV positive, while seven tested negative. All the patients admitted to the unit were not tested for HIV, because they were not admitted to the unit for HIV-related causes, and test results would not have had an effect on their outcome. Diagnoses encountered most frequently in the unit were trauma (21 patients), skeletal involvement or fractures (16 patients), infections or sepsis (15 patients) and gastro-intestinal bleeds (14 patients). In most cases more than one diagnosis applied to the same patient, since patients admitted with trauma also had skeletal or gastro-intestinal involvement. An Assessment of the need of Pharmaceutical Services in the Intensive Care Unit and High Care Unit of Steve Biko Academic Hospital viii The medications prescribed most frequently were enoxaparin (49 patients), sucralfate (41 patients) and multivitamin syrup (47 patients); in accordance with the standard ward protocol for prophylactic regimens. The drug class most often used was the anti-infectiveshaving124 items prescribed during the study period. Of these, the broad spectrum antibiotics were used most frequently, e.g. piperacillin/tazobactam (22 patients), meropenem (11 patients) and imipenem (11 patients). An average of 12 medications was prescribed for each patient in the ward. A total of 181 interventions were suggested for the 51 patients during the study period, of which 127 (70%) were accepted and implemented by the medical and nursing staff. The average number of interventions per patient ranged from 0 to 13 with a median of 3.5 interventions per patient. The four most frequent problem types were untreated medical conditions (15.5%), length or course of therapy inappropriate (13.8%), investigations indicated or outstanding (12.2%) and prescribed doses and dosing frequency appropriate (11%). Interventions were also made regularly to address system errors or non-compliance and factors hindering achievement of therapeutic effect. The perceived need for pharmaceutical care by healthcare professionals in the SICU was measured by questionnaires before and after the study period. The feedback by staff regarding the pharmacist working in the ward was very positive. They appreciated the researchers input on ward rounds, as well as assistance with problems encountered with the pharmacy. Of the total time spent in the ward, the researcher spent 28% of her time on patient evaluation. Ward rounds also took up a great deal of time (21.7%), since ward rounds were done with different members of the multidisciplinary team. Most interventions were suggested during ward rounds. The costs saved during the study period were enough to justify the appointment of a pharmacist to the ward on a permanent basis, albeit for limited hours daily. The researcher designed an antibiotic protocol for the unit. The protocol was designed according to international standards, and after discussion with the microbiologists, adapted for use in the specific unit. An Assessment of the need of Pharmaceutical Services in the Intensive Care Unit and High Care Unit of Steve Biko Academic Hospital ix In conclusion, the study results have demonstrated that a pharmacist’s contribution to patient care at ward level in a surgical ICU resulted in clinical outcomes that improved the patient’s quality of life. Drug-related problems were identified and addressed. Medical staff in the S-ICU accepted the pharmacist’s interventions and even welcomed her contribution to other ward functions, for instance managing medication and providing education. Pharmaceutical care should be rendered on a permanent basis to the Surgical ICU and the pharmacist should increasingly become a key part of the multidisciplinary team, taking responsibility for patients’ medication needs.
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O'Hare, John D. G. "The development and function of pharmaceutical services in psychiatric hospital practice." Thesis, Queen's University Belfast, 1990. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335450.
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Coopoosamy, Kribban. "An integrated maintenance management system model for the pharmaceutical industry." Thesis, Nelson Mandela Metropolitan University, 2011. http://hdl.handle.net/10948/1583.
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Organisations are continuously seeking for strategies to improve operations and gain competitive advantage. Maintenance tends to be a key management issue for many industrial companies. Maintenance management, being an integral part of manufacturing, can influence competitive companys‟ priorities, such as cost, quality and flexibility, and, hence, business strategy directly. The pharmaceutical industry also faces some unique challenges such as increasingly stringent safety and quality regulations, the effect of innovations in medical science and healthcare and a complex and costly design-to-market process (from product concept and development to market delivery). The industry is also going through turbulent times as it has to cope with challenges common to many other industries, how to deal with increasing competition, hold down costs, and expand. Regulatory compliance is one of the significant industry drivers for pharmaceutical companies. Regulations are enacted by government authorities to ensure public health and safety. The focus of regulation is on quality assurance and control in all areas such as receiving, manufacturing, storing, packaging, despatching and delivering. Apart from the required quality and safety checks, the regulations also mandate extensive record keeping of procedures, processes and systems. This treatise will investigate the maintenance management system of a pharmaceutical company and compare it to best practices. The true name of the pharmaceutical company that will be researched will not be disclosed for confidentiality reasons, instead it will be called My Pharmaceuticals. The company is based in Port Elizabeth. The research consists of a preliminary study to identify the problem areas in the maintenance management system within the company. A literature review of best practices in maintenance management systems combined with an investigation into the best pharmaceutical practices in maintenance management systems and regulatory controls are investigated and a model will be proposed to improve the current situation at the company.
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Hunt, John Anthony. "The development of pharmaceutical services in the British welfare state." Thesis, University of Portsmouth, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.266923.
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Turkistani, Yasir Abdulkader. "Pharmaceutical services provision in acute independent hospitals in the UK." Thesis, University of Bath, 1997. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.338410.
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Girolineto, Beatriz Maria Pereira. "Desenvolvimento e avaliação do INSAF-HAS: um formulário de seleção de pacientes para inserção em um serviço de atenção farmacêutica." Universidade de São Paulo, 2015. http://www.teses.usp.br/teses/disponiveis/60/60137/tde-17042015-092522/.
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A hipertensão arterial sistêmica é uma doença crônica em que a pressão arterial do indivíduo permanece acima de 140/90 mmHg. Ela afeta aproximadamente 70 milhões de pessoas nos EUA e 1 bilhão de pessoas em todo o mundo (ONG et al, 2007). Essa enfermidade pode levar a complicações, das quais se pode destacar o infarto agudo do miocárdio e o acidente vascular cerebral. Estudos têm demonstrado que a atenção farmacêutica pode auxiliar na obtenção de resultados clínicos importantes, como a redução da pressão arterial (ERICKSON; SLAUGHTER; HALAPY, 1997; ZILLICH et al. 2005), entretanto os recursos limitados impedem a garantia de um atendimento farmacêutico adequado a todo paciente que utiliza medicamentos. Diante do exposto, o presente estudo tem como finalidade desenvolver e avaliar um formulário para a seleção de pacientes hipertensos e inclusão destes junto a um serviço de AtenFar, bem como analisar a efetividade deste durante o período de acompanhamento e após a alta desses pacientes. Esse estudo foi dividido em quatro fases, sendo elas: fase de desenvolvimento do INSAFHAS, fase de seleção, fase de acompanhamento, e fase de alta. Em adição, os sujeitos da pesquisa foram divididos de acordo com a pontuação obtida no instrumento (G1 - maior pontuação, G2- menor pontuação) e os usuários de cada grupo foram randomizados em outros dois grupos, sendo eles, Controle (C) e Experimental (E). Com isso, obteve-se um total de quatro grupos (G1C, G1E, G2C, G2E), sendo que os sujeitos dos grupos experimentais foram incluídos em um serviço de atenção farmacêutica e acompanhados em atendimentos mensais por doze meses. Observou-se que os sujeitos do grupo 1 apresentavam idade superior, menor escolaridade, valores superiores de pressão arterial sistólica e de glicemia de jejum e menor conhecimento relativo ao tratamento medicamentoso. Verificou-se ainda, ao final da fase de acompanhamento, redução da pressão arterial no G1E e redução no IMC, aumento da adesão ao tratamento medicamentoso e do conhecimento relativo ao tratamento medicamentoso no G2E. Na fase de alta houve aumento da pressão arterial em todos os grupos, porém não foram observadas evidências científicas de que esse aumento era significativo. Sendo assim, pode-se concluir que o instrumento elaborado foi adequado para a seleção de indivíduos para um serviço de atenção farmacêutica, e que o mesmo promoveu melhoras clínicas nos hipertensos. Porém novos estudos a respeito da alta dos usuários precisam ser realizados.Hypertension is a chronic disease in which blood pressure remains above 140/90 mmHg. It affects approximately 70 million people in the United States and 1 billion people worldwide (ONG et al, 2007). This disease may lead to complications, such as, we can highlight acute myocardial infarction and stroke. Studies have shown that pharmaceutical care can help to achieve important clinical outcomes, such as reduced blood pressure (ERICKSON; SLAUGHTER; HALAPY, 1997; ZILLICH et al 2005). However limited resources hinder the assurance of an appropriate pharmaceutical service to every patient who uses drugs. Therefore this study aims to develop and evaluate a form for selection of hypertensive patients and inclusion of these patients into a pharmaceutical care service as well as analyzing the effectiveness of this service during the follow-up period and after discharge. This study was divided into four phases, namely: development of the INSAF-HAS phase, selection phase, follow-up phase, and discharge phase. Subjects were divided according to the score obtained in the form (G1 - highest score, G2 - lowest score). Patients in each group were randomized into two groups, namely, Control (C) and Experimental (E), so we obtained a total of four groups (G1C, G1E, G2C, G2E). By the way subjects in experimental groups were included in a pharmaceutical care service and followed-up at monthly visits for twelve months. We found higher age, lower education, higher systolic blood pressure and fasting glucose, slightest knowledge on the medical treatment in Group 1 than Group 2. At the end of follow-up phase it was found lowering blood pressure in G1E and reduction in BMI, increased adherence to drug therapy and knowledge relating to drug therapy at G2E. In the discharge phase there was increased BP in all groups, but evidence was not observed that this increase was significant. Thus, it could be conclude that the instrument was appropriate for screening individuals for a pharmaceutical care service, and the pharmaceutical care service promoted clinical improvement in hypertensive patients. Even so new studies about the discharge are required.
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Farina, Simone Sena. "A prática profissional em farmácias e drogarias de Jundiaí, SP: em busca da atenção farmacêutica." Universidade de São Paulo, 2005. http://www.teses.usp.br/teses/disponiveis/6/6135/tde-15042008-150932/.
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A profissão farmacêutica vive momento de busca de novas práticas baseadas na atenção farmacêutica. O objetivo deste estudo foi conhecer a prática profissional de farmacêuticos que atuavam em farmácias com ênfase em atividades relacionadas à prática da atenção farmacêutica. Material e métodos. Trata-se de um estudo descritivo tipo survey transversal; os dados foram coletados em entrevistas com farmacêuticos do município de Jundiaí/SP. Resultados. Entrevistou-se 93 farmacêuticos, sendo a maioria jovem (31,7 anos em média), do sexo feminino (62,4%), graduada em instituições privadas (90,1%) e não proprietária do estabelecimento (86,0%); desenvolviam na farmácia atividades administrativas, técnicas e de atenção ao usuário, em especial, orientações e dispensação de medicamentos; 67,7% acompanhavam o tratamento farmacoterapêutico dos usuários, mas sem registro de informações, e 77,8% já haviam detectado algum problema com a medicação. Muitos farmacêuticos (91,4%) consideravam necessário realizar um trabalho de maior proximidade com os usuários, porém apontaram como principais dificuldades a falta de: tempo, apoio dos proprietários, interesse dos usuários e conhecimento. A compreensão que 62,3% tinha sobre atenção farmacêutica estava relacionada à orientação e ao atendimento dispensados. Conclusões. A prática da atenção farmacêutica, como preconizada na literatura, não foi observada entre os entrevistados. Estudos futuros para conhecer como os farmacêuticos realizam suas atividades são importantes ao aprimoramento dos serviços farmacêuticos e melhorar a compreensão sobre atenção farmacêutica poderá ajudar na sua implementação.The pharmaceutical profession is searching for new practices based on pharmaceutical care. The purpose of this study was to get to know the professional practice of the pharmacists who worked in pharmacies, with emphasis placed on the activities related to the pharmaceutical care practice. Material and methods. This is a transversal survey descriptive study; the data were collected among pharmacists of the municipality of Jundiaí/SP. Results. In total, 93 pharmacists were interviewed, most of whom were young (31.7 years of age on average), female (62.4%), private institution graduates (90.1%), and were not pharmacy owners (86.0%); at the pharmacy, they carried out administrative, technical, and attention to patient activities, particularly providing guidance and dispensing medications; 67.7% followed-up on their patient's pharmacotherapeutic treatment, but did not record any information regarding it, while 77.8% had already detected some type of problem with medications. Many pharmacists (91.4%) considered it necessary to work more closely with their patients; however, the main difficulties they mentioned to in order to do so included the lack of time, pharmacy owner support, patient interest, and knowledge. The understanding 62.3% had about pharmaceutical care was related to providing guidance and customer service. Conclusions. The pharmaceutical care practice among the interviewees was not observed as in the literature. Future studies aimed at getting to know how the pharmacists perform their activities are important in order to improve the pharmaceutical services and to improve the understanding about pharmaceutical care can help implanting.
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Goldstein, Ruth. "Pharmaceutical care : the needs of elderly people and their carers in the community." Thesis, University of Derby, 1994. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.386533.
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Rothner, Donne. "Improving customer service through effective supply chain management in a pharmaceutical company." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1490.
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All organisations compete on the basis of service. In today‘s highly competitive world, organisations need to compete to retain their customers and to offer good customer service that will give them a competitive advantage. In the South African pharmaceutical market, the introduction of the Single Exit Price (SEP) and generic substitution have led to the price of equivalent medicines no longer being the differentiating factor in a customer deciding which manufacturer‘s product to purchase. The availability of generic medicines at the pharmacy or hospital has become the differentiating factor. Two types of customers exist in any organisation, namely, external customers and internal customers. Much has been written about the external customer, but less about the internal customer. Many managers do not perceive internal customer service as a priority. Any organisation attempting to deliver quality service to their external customers must begin by serving the needs of their internal customers. Internal service quality is characterised by the attitudes that people have towards one another and in the way that employees serve one another inside the organisation. By improving customer service, the organisation can improve its profitability, sustainability and customer retention. The aim of this study was to determine whether the levels of internal customer service between the three sections of Aspen Pharmacare are optimal. Determining the current performance levels between the staff of the sections will assist in highlighting the areas that require attention. The three sections of Aspen Pharmacare that are internal customers of one another and have been used in the study are: - production; - demand planning; and - distribution. The results of the study show that all three sections rate three service quality dimensions (communication, tangibles and reliability) as important. The results were used to develop an internal customer service model for Aspen Pharmacare.
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Foulsham, Russell Mark. "The development and delivery of pharmaceutical domiciliary services to housebound patients." Thesis, King's College London (University of London), 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.422688.
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Chua, Gin Nie. "Using a discrete choice experiment to value a community pharmacy service : how valid are the findings?" Thesis, University of Aberdeen, 2017. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=236463.
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Introduction: Expanding the role of community pharmacists within primary care has become an important policy agenda in the UK. To ensure that pharmacy services are delivered to their full potential, services need to be better tailored to consumers' needs and preferences. The discrete choice experiment (DCE), a technique rooted in economic theory, has been used extensively to elicit consumers' preferences and values in healthcare. However, despite its popularity, there is limited empirical evidence on the external validity of DCEs. Aims: The aim of this thesis was to assess consumers' preferences for a community pharmacyled health check using a DCE with a methodological focus to investigate the external validity of DCE. Method: This thesis employed a four-phased mixed methods study design. In Phase I, a convenience sample of participants was recruited from within a community pharmacy, a colocated dental practice and nearby public spaces and invited to complete a DCE questionnaire to assess preferences for a community pharmacy-led health-check. The DCE comprised twelve choices examining preferences for six attributes of the health check. Additionally, the questionnaire included post-choice certainty questions and attitudinal measures developed from the Theory of Planned Behaviour (TPB). Four weeks later, these participants were offered a real choice between two actual health-checks (Phase II). Their actual choices were compared with DCE-predicted choices; if these differed, participants were invited to an in-depth, face-toface interview (Phase III). In Phase IV, leaflets promoting the service were handed out to the local population and uptake was compared with that predicted by the DCE. Results: The DCE was completed by 423 individuals; 133 (31.4%) were contactable in Phase II and 10 were interviewed in Phase III. The DCE suggested that consumers preferred a healthcheck that was: cheaper; delivered by experienced personnel; with follow-up; available by appointment; lasted 30-minutes; with weekend availability. The estimated value of the health check was £49. The DCE correctly predicted 42.1% of participants' actual choices in Phase II. Calibration of the DCE with certainty questions and incorporation of the TPB into DCE improved DCE-prediction. From the interviews in Phase III, reasons for discrepancies in stated choice and actual behaviour included differences in decision-making processes in DCE and real life, attitudinal and other contextual factors (e.g. timing, location). Discussion & Conclusion: Consumers valued the role of community pharmacists in providing public health services targeted at disease prevention. This finding supports government policies to increase community pharmacists' contribution to public health. Whilst the results raised questions about the external validity of DCE in this study context, different choice modelling approaches (i.e. incorporation of TPB and certainty calibration) improved external validity of DCE. Qualitative findings provided deeper insights into why participants did not do as they said and do not necessarily invalidate DCE findings. The findings from this study should not act as a deterrent to future use of DCEs but more to raise awareness of the need to take into account how choices are made in real life. Ideally the development of DCE and the modelling of choice responses should mimic as closely as possible the decision-making process individuals face in reality.
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Ma, Wing-yan. "Contract research organizations : performance and evaluation of services /." View the Table of Contents & Abstract, 2006. http://sunzi.lib.hku.hk/hkuto/record/B38030561.
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Kessomboon, Nusaraporn. "Patient's willingness to pay for pharmaceutical care from community pharmacies in the North East of Thailand." Thesis, Robert Gordon University, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.365426.
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Lee, Amy, and Nisha Patel. "A Consumer Assessment of Pharmaceutical Care Services in a Diabetes Ambulatory Clinic." The University of Arizona, 2009. http://hdl.handle.net/10150/623965.
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Class of 2009 AbstractOBJECTIVES: To assess patients’ satisfaction with pharmaceutical care services provided in a community health center diabetes management clinic. METHODS: Patients who received diabetes-related pharmaceutical services from the clinical pharmacist at El Rio Health Center in Tucson, Arizona from November 2008 to January 2009 were contacted during a visit to the diabetes clinic and asked to complete the consumer assessment of pharmaceutical services questionnaire. The questionnaire included 14 likert-type items with response options ranging from “Never” to “Always” or “Disagree” to “Agree.” In addition, the patient’s most recent hemoglobin A1C (HgbA1C) was obtained from the electronic medical record. The survey instrument was also translated from English to Spanish to serve the Hispanic participants who could not communicate fluently in English. A descriptive cross-sectional analysis was completed in order to assess patient satisfaction. Dependent variables extracted from the survey were analyzed by Mann-Whitney U test. Interval and ratio data were analyzed by calculating means, standard deviations, and an independent t-test. Nominal data were analyzed using the Chi-Square test. RESULTS: A total of 46 patients completed the questionnaires, including 17 men and 29 women (mean age = 56, SD = 11.3, 80% Hispanic). All patients had seen the clinical pharmacist at least 3 times. Overall, this study showed that majority of the patients were satisfied with the service provided in the clinic. There was no statistically significant difference between English and Spanish patient populations in terms of satisfaction with pharmaceutical services provided about their disease management. CONCLUSIONS: Patients in this clinic were highly satisfied with the pharmaceutical care services provided by the clinical pharmacist.
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Lu, Jyh-Cherng 1959. "The national survey of hospital pharmaceutical services in the Republic of China." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277927.
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A study of hospital pharmacy practice in the Republic of China was conducted in the Summer of 1987. The status of selected innovative pharmaceutical services and the attitudes of pharmacy directors toward developing and implementing those services were assessed. The innovative services were unit dose drug distribution, pharmacy-prepared i.v. admixtures, pharmacy computerization, drug information and clinical pharmacy services. A questionnaire was used to obtain data and information from a random sample of hospitals in Taiwan, R.O.C.. Most of selected services were performed in about 25% of the surveyed hospitals. The i.v. admixture program was performed by the lowest percent of general hospitals as compared to the other services in this study. Pharmacy directors indicated that their attitudes toward selected innovative pharmaceutical services in terms of seven possible effects or outcomes were positive, but the scores relating to the other professionals and operating expenses were neutral or negative.
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Notman, Frances. "Investigating patients' experience and self-management of early cancer symptoms prior to their cancer diagnosis in order to identify the role of community pharmacy in earlier diagnosis." Thesis, University of Aberdeen, 2016. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=231748.
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Hill, Peter William. "The South African community pharmacist and Type 2 Diabetes Mellitus a pharmaceutical care intervention." Thesis, Rhodes University, 2009. http://hdl.handle.net/10962/d1003238.
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Type 2 diabetes mellitus is a chronic disease of pandemic magnitude, increasingly contributing to the disease burden of countries in the developing world, largely because of the effects of unhealthy lifestyles fuelled by unbridled urbanisation. In certain settings, patients with diabetes are more likely to have a healthcare encounter with a pharmacist than with any other healthcare provider. The overall aim of the study was to investigate the potential of South African community pharmacists to positively influence patient adherence and metabolic control in Type 2 diabetes. The designated primary endpoint was glycated haemoglobin, with the intermediate health outcomes of blood lipids, serum creatinine, blood pressure and body mass index serving as secondary endpoints. Community pharmacists and their associated Type 2 diabetes patients were recruited from areas throughout South Africa using the communication media of various nonstatutory pharmacy organisations. Although 156 pharmacists initially indicated interest in participating in the study, only 28 pharmacists and 153 patients were enrolled prior to baseline data collection. Of these, 16 pharmacists and 57 patients participated in the study for the full twelve months. Baseline clinical and psychosocial data were collected, after which pharmacists and their patients were randomised, nine pharmacists and 34 patients to the intervention group and 8 pharmacists and 27 patients to the control group. The sample size calculation revealed that each group required the participation of a minimum of 35 patients. Control pharmacists were requested to offer standard pharmaceutical care, while the intervention pharmacists were provided with a scope of practice diabetes care plan to guide the diabetes care they were to provide. Data were again collected 12-months postbaseline. At baseline, proportionally more intervention patients (82.4%) than control patients (59.3%) were using only oral anti-diabetes agents (i.e. not in combination with insulin), while insulin usage, either alone or in combination with oral agents was conversely greater in the control group (40.7%) than in the intervention group (17.6%) (Chi-squared test, p=0.013). Approximately half of the patients (53.8% control and 47.1% intervention) reported having their HbA1c levels measured in terms of accepted guidelines. There was no significant difference in HbA1c between the groups at the end of the study (Independent t-test, p=0.514). In the control group, the mean HbA1c increased from 7.3±1.2% to 7.6±1.5%, while for the intervention patients the variable remained almost constant (8.2±2.0% at baseline and 8.2±1.8% at post-baseline). Similarly, there were no significant differences between the groups with regard to any of the designated secondary clinical endpoints. Adherence to medication and self-management recommendations was similarly good for both groups. There were no significant differences between the two groups for any of the other psychosocial variables measured. In conclusion, intervention pharmacists were not able to significantly influence glycaemic control or therapeutic adherence compared to the control pharmacists.
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Fujita, Kenji. "The development of quality indicators for home pharmaceutical care in Japan." Thesis, University of Sydney, 2020. https://hdl.handle.net/2123/22994.
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Taking into account the challenges posed by an ageing society, Japan, one of the most rapidly ageing countries in the world, has recently seen a shift in focus of its health delivery system for the elderly from hospital care to home healthcare. In Japan, home pharmaceutical care (HPC) is provided to home-bound elderly who have difficulties in accessing a community pharmacy, for regular medicine supplies and medication management. Although the number of HPC services provided has increased, little is known about the quality of care provided. Quality indicators (QIs) are a recognised mechanism for evaluating the quality of health services, if they have been robustly developed and their measurement properties scientifically tested. The overall aim of the research described in this thesis was to develop a set of QIs for HPC in Japan and assess their measurement properties. A 4-step QI development procedure was applied. First, the results of a qualitative study regarding what constitutes ‘quality’ in HPC revealed that multiple stages of the home care pathway should be covered in order to comprehensively evaluate the quality of HPC. Second, in line with the determined scope, 52 QIs were developed based on the following three sources; 1) national guidelines, 2) existing QIs, and 3) healthcare professionals’ experiences and opinions. Third, appropriateness of the preliminary set of 52 QIs was assessed using the RAND/UCLA appropriateness method. Of these, 45 QIs were judged as ‘appropriate’ by the expert panel. Fourth, a 6-month observational study followed by semi-structured interviews were carried out to evaluate measurement properties of each QI (feasibility, applicability, improvement potential, discriminatory capacity, sensitivity to change, acceptability and implementation issues). As a result, 9 QIs met all measurement properties. A set of QIs for HPC was rigorously developed and tested. This QI set may be useful in evaluating the quality of HPC services in Japan.
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Gonçalves, Maria Gabriela Borracha. "Serviços farmacêuticos em Unidades de Saúde no Município de São Paulo: diagnóstico situacional e proposta de sistemática para o acompanhamento farmacoterapêutico." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/9/9139/tde-28112017-155501/.
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Os serviços farmacêuticos envolvem ações integradas do farmacêutico com a equipe de saúde, focadas no usuário, por meio dos serviços de clínica farmacêutica, atividades de gestão e técnico-pedagógicas. A implantação destes serviços na Atenção Básica deve buscar a adaptação e a reorganização do processo de trabalho dos farmacêuticos. Um dos serviços farmacêuticos mais complexos e completos é o acompanhamento farmacoterapêutico de pacientes. O objetivo do trabalho foi desenvolver uma proposta de sistemática para o acompanhamento farmacoterapêutico de pacientes atendidos nas Redes de Atenção Básica e de Especialidades no Município de São Paulo. Para isso foi realizado um estudo observacional descritivo por meio de um diagnóstico situacional dos serviços farmacêuticos realizados em unidades de saúde de SP e propondo-se critérios de seleção de pacientes e uma sistemática de acompanhamento farmacoterapêutico. O diagnóstico situacional foi realizado utilizando publicações da SMS-SP e as respostas auto-referidas de 45 farmacêuticos que atuam em unidades de saúde de SP a um questionário aplicado on line. A proposição dos critérios de seleção de pacientes baseou-se em dados disponíveis na literatura e na avaliação do diagnóstico situacional. A proposta da sistemática para o acompanhamento farmacoterapêutico foi elaborada tendo como base a revisão da literatura, o modelo adotado pelo MS e o modelo empregado na FARMUSP. No diagnóstico situacional observou-se que 64% dos farmacêuticos realizam atividades clínicas mas que somente 38% utilizavam algum tipo de formulário específico; 75% participam de grupos terapêuticos/ educacionais e 88% desenvolvem alguma atividade de educação em saúde. Os farmacêuticos que trabalham em unidades AMA/UBS e UBS tiveram cerca da metade do tempo de trabalho destinado a atividades técnicopedagógicas, seguidas das atividades de gestão (40%) e clínicas (10%). O principal critério de seleção relatado foi o encaminhamento por outros profissionais de saúde, seguido pelos pacientes que participam de algum grupo terapêutico da unidade. Foi proposta uma sistemática de acompanhamento farmacoterapêutico em 4 etapas com o apoio de formulários para o registro e análise de dados. Concluiu-se que as atividades clinicas são realizadas, mas não são de forma sistmática e documentada e que o número inadequado de recursos humanos e a estrutura inadequadadas unidades de saúde são barreiras para a implantação das atividades clínicas. A proposta elaborada é o início do processo de implantação do serviço de acompanhamento farmacoterapêutico, sendo a capacitação dos farmacêuticos fundamental para o desenvolvimento das habilidades necessárias para a realização deste serviço.The pharmaceutical services involve integrated actions of the pharmacist with the health team, focused on the user, through the services of pharmaceutical clinic, management, and technical-pedagogical activities. The implementation of these services in Primary Care should seek the adaptation and reorganization of the work process of pharmacists. One of the most complex and complete services of the pharmaceutical care is the pharmacotherapeutic follow-up. The objective of the project was developing a systematic method for the pharmacotherapeutic follow-up to patients of the Primary Helth Care of the city of São Paulo. For this, a situational diagnosis of the pharmaceutical services performed in health centers was developed and a selection criteria of patients and a systematic pharmacotherapeutic follow-up was proposed. The situational diagnosis was carried out using the SMS-SP publications and information obtained through the responses of 45 pharmacists who work in health care centers to the questionnaire applied on line. The selection criteria of patients was based on data available in the literature, on the situational diagnosis, in the criteria used in a project developed by MS and in the practice adopted in some health centers in the city of São Paulo. The systematic method proposed for the pharmacotherapeutic follow-up was elaborated based on the literature review and the models adopted by the MS and FARMUSP. The situational diagnosis observed that 64% of pharmacists performed clinical activities, but only 38% use standard form; 75% participate in educational groups and 88% participated in health educational activities. Pharmacists working in AMA / UBS and UBS units had about half the time spent working on technical-pedagogical activities, followed by management activities (40%) and clinical activities (10%). The main selection criterion reported was referral by other health professionals, followed by patients participating in some therapeutic groups. A systematic pharmacotherapeutic follow-up method was proposed in 4 stages with the support of forms for data recording and analysis. It was concluded that clinical activities are performed, but are not in a systematic and documented way. The inadequate number of human resources and inadequate structure of health units are barriers to the implementation of clinical activities. The proposal elaborated is the beginning of the process of implementation of the pharmacotherapeutic follow-up, and the qualification of pharmacists is fundamental for the development of the necessary skills to carry out this service.
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Sanders, Stephanie. "Exploring the Impact of Pharmaceutical Care Services on Smoking Cessation and Patient Health in a Community Setting." The University of Arizona, 2008. http://hdl.handle.net/10150/624278.
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Class of 2008 AbstractObjectives: The purpose of this study is to determine the usefulness of expanded pharmaceutical care services and pharmacist involvement in smoking cessation for patients in a community setting, to identify demographical parameters for the population which might benefit the most from pharmacist intervention, and to examine the cost benefit of such intervention. Methods: This descriptive retrospective study was conducted through a MEDLINE search for all available literature regarding the efficacy of pharmacists in a community setting and smoking cessation outcomes. The results from these studies were then analyzed in order to identify demographic factors which may be associated with higher rates of positive outcome, and the potential cost benefit of such intervention. Information examined from the various articles included: type of study, method of data anaylsis, study/intervention location, patient age, sex, race, other comorbid conditions, and success rates including p values/odds ratios when stated. Results: After the original search, 63 publications were found using MEDLINE, including 12 systematic reviews and 3 clinical trials. After filtering, a total of 28 articles were analzyed. No correlations between demographic factors and successful smoking abstinence were found. All publications, save one, found a positive correlation between higher levels of intervention and increased smoking abstinence rates. Cost effectiveness varied depending on which method of NRT was utilized, ranging from $720 to $2360 per QALY saved. Several national health organizations have published guidelines stating the role of the pharmacist as essential in smoking cessation. Conclusions: Pharmacists have begun to play an essential role in smoking cessation, as evidenced by many successful ventures that have taken place to date. Still, there is vast potential for expansion of pharmaceutical care services in this area.
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Cruickshank, Gillian M. "Building the frameworks to implement the continuous quality improvement philosophy related to pharmaceutical care." Thesis, Robert Gordon University, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.325402.
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Piccoli, Nilo Jorge. "Avaliação da assistência farmacêutica em HIV/AIDS em unidades de saúde do município de Niterói." Niterói, 2017. https://app.uff.br/riuff/handle/1/3083.
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O fortalecimento das políticas de Assistência Farmacêutica aos usuários com HIV/AIDS é de grande importância para garantir a sustentabilidade do programa, principalmente pelos altos custos envolvidos para sua implantação e execução. Neste trabalho foi realizada uma avaliação da Assistência Farmacêutica em HIV/AIDS no município de Niterói, com ênfase no seu gerenciamento. O trabalho teve como objetivo responder duas perguntas avaliativas: As condições de estrutura e os processos de trabalho existentes são adequados para que se exerça uma assistência farmacêutica de qualidade às pessoas vivendo com HIV/AIDS (PHVA) atendidas no município de Niterói? As condições de estrutura e os processos de trabalho existentes são adequados para que se garanta o acesso aos medicamentos ARV e para infecções oportunistas às PHVA atendidas no município de Niterói? O desenho da avaliação foi o de um estudo de caso, e a abordagem utilizada foi uma avaliação normativa com foco na qualidade, envolvendo análise da estrutura, do processo e dos resultados, através da construção de um modelo lógico teórico. Das oito UDM existentes no município, seis foram avaliadas neste trabalho. Foram construídas matrizes de relevância e de análise e julgamento, em que os indicadores foram divididos em quatro grupos, de acordo com os componentes da assistência farmacêutica sob a responsabilidade do município descritos no modelo lógico. Os indicadores foram inicialmente analisados individualmente, destacando-se como pontos positivos a disponibilidade dos ARV, a ausência de medicamentos vencidos e de prescrições em desacordo com o consenso de tratamento para pacientes com HIV/AIDS, bem como a boa orientação dos pacientes no uso dos medicamentos ARV. Como problemas destacaram-se os baixos índices de conformidade em relação a boas práticas de dispensação e armazenamento e um prazo elevado para a distribuição dos medicamentos. Foram também efetuadas análises por componente da assistência farmacêutica, em que apenas o componente distribuição obteve um grau de qualidade aceitável. Considerando-se as dimensões de avaliação disponibilidade de recursos, organização da assistência e qualidade técnica, os resultados mostraram deficiências na dimensão organização da assistência. O resultado individual de cada UDM mostrou que apenas duas possuem grau de qualidade bom, e o resultado geral para a FMS de Niterói foi de 50,3% de atendimento aos critérios de qualidade, considerado apenas regular. Foram sugeridas propostas de ações e intervenções, entre elas, a melhoria nas condições estruturais das farmácias das unidades de saúde do município, e aumento na capacitação dos profissionais envolvidos com a assistência para melhoria dos processos de trabalho
The strengthening of the pharmaceutical services to patients having HIV/AIDS is of major importance to maintain the sustainability mainly for its high implementation and execution costs. On this paper it was performed an evaluation of the pharmaceutical HIV services in the city of Niterói, emphasizing its management. The study aimed to answer two evaluative questions: The structure and existing work processes are suitable for guarantee pharmaceutical services’ quality to people living with HIV (PHVA) in Niterói? The structure and existing work processes are adequate to ensure access to medicines for opportunistic infections and ARV patients to PHVA in Niterói? The evaluation design was a case study, and a normative approach focusing on quality was also used, involving analysis of the structure, process and results, by building a logical theoretical model. Out of the eight existing UDM in the city, six were evaluated in this study. Matrices of relevance and analysis and judgment were created, in which the indicators were divided into four groups according to the components of the pharmaceutical services under the responsibility of the city described in the logical model. The indicators were initially analyzed individually, where as positive points, the availability of ARVs, the absence of expired drugs and prescriptions in disagreement with the consensus of treatment for patients with HIV / AIDS as well as good guide of patients in the use of antiretroviral medications were highlighted. The main problems identified were the low levels of conformity against good practice criteria of dispensing and storage and a high period for the medicine distribution. Pharmaceutical services components were also analyzed and distribution was the only component that obtained an acceptable level of quality. The dimensions availability of resources, organization of services and technical quality were investigated and the organization of services aspect obtained the lowest grade. The individual result of each UDM showed that only two achieved good quality degrees, and the overall result to Niterói’s FMS was 50.3 %, which was considered only regular. Actions and interventions have been suggested, amongst them, the improvement of the structural conditions of pharmacies’ health facilities in the city, and an increase in the training of professionals involved with assistance to improve work processes
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Ma, Wing-yan, and 馬詠恩. "Contract research organizations: performance and evaluation of services." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2006. http://hub.hku.hk/bib/B39724888.
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Reilly, Paul Matthew 1955. "Assessing decision-making by hospital pharmacy directors in implementing clinical pharmacy services." Thesis, The University of Arizona, 1987. http://hdl.handle.net/10150/276575.
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Decision-making by hospital pharmacy directors when deciding which clinical pharmacy services to implement and/or continue to provide was assessed. Also examined was how these decision-making activities, hospital characteristics, pharmacy characteristics, and pharmacy director demographics might be associated with the number and quality of clinical pharmacy services provided, as well as the number of clinical services implemented under the current pharmacy director. Hospital pharmacy directors reported considering a relatively large number of perceived goals for a clinical service and also indicated they use a rather broad range of decision-making methodologies in evaluating those goals when determining clinical services. Numerous variables were found to be significantly associated with the number of clinical services provided by the pharmacy department and the number of clinical services implemented under the current pharmacy director. However, relatively few variables were found to be significantly related to the quality of clinical pharmacy services being provided.
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Botha, Risca. "The effective management of customer orders received by a pharmaceutical manufacturer." Thesis, Nelson Mandela Metropolitan University, 2016. http://hdl.handle.net/10948/9087.
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There is a great need for a pharmaceutical manufacturer to provide its customers with the right product at the right time, place and price and also to deliver the product in the right quantity and quality. Should pharmaceutical customers not receive their orders on time from the pharmaceutical manufacturer, the customers might face out-of-stock situations. As a result, the patients or customers might turn to an alternative product from a different pharmaceutical manufacturer, which has the required stock readily available. This could lead to loss in sales and even death amongst its customers. The main objective of this study was to determine the key factors that form part of the demand and operations planning strategies to ensure that these factors are in place to effectively manage and execute the supply chain and logistics processes to reduce possible out-of-stock situations amongst its customers. As a starting point to the study, an analysis was performed based on the review of relevant research and literature from various text books, journals, publications, as well as internet sources. The literature study covered various aspects such as demand planning, production planning, the use of different demand and operations planning strategies, as well as the importance of continuous internal and external customer service levels to ensure that customer orders are delivered on time. The analysis of the literature review was used to establish a theoretical basis for the design and structure of the questionnaire that was used as a research instrument in this study. A survey was conducted amongst the employees that are responsible for executing the supply chain and logistics processes within Aspen Pharmacare. These employees resided within the three main departments of the pharmaceutical manufacturer, namely, the Demand and Operations Planning, Production and Packing, as well as the Warehouse and Distribution departments. Each question posed in the questionnaire related to the role of each employee within these departments that are responsible for the logistics processes within Aspen Pharmacare. The empirical results from the study indicated that the respondents were in support that specific key factors are important for a pharmaceutical manufacturer to manage incoming customer orders efficiently and effectively to reduce possible out-of-stock situations amongst its end customers. However, the respondents also highlighted that there were a number of obstacles preventing them from implementing the key factors that are required to manage incoming customer orders more efficiently within the pharmaceutical manufacturer. Some of these obstacles include: the lack of pro- activeness; lack of accountability; and the lack of constant communication between the employees from the three main departments. Furthermore, incomplete hand-over information during shift changes amongst the employees of the Production and Packing department created unnecessary down-time. Also, the employees from the Warehouse and Distribution department were not informed timeously when changes to the production schedule were made. These obstacles will have a negative impact on the ultimate customer delivery dates and need to be addressed. The empirical results highlighted some recommendations to assist pharmaceutical manufacturing companies to more effectively and efficiently manage their incoming customer orders to reduce or eliminate any possible out-of-stock situations amongst its end customers. Some recommendations include: improved communication between the three main departments; to react immediately to out-of-stock products; and to ensure that internal and external customer service levels are adhered to at all times. The implementation of the recommendations based on the empirical findings of the study will assist the pharmaceutical manufacturing company to achieve excellence and to become a world-class supplier of generic pharmaceutical products. In this way, all incoming customer orders can be fulfilled on time.
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EINARSON, THOMAS RAY. "EVALUATION OF A BLOOD LEVEL SERVICE IN A COMMUNITY PHARMACY PRACTICE." Diss., The University of Arizona, 1987. http://hdl.handle.net/10150/184019.
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A clinical pharmacy service that determined blood potassium levels was implemented and evaluated in a community pharmacy practice. The pharmacy service utilization model was developed to guide the research. Data were gathered by two questionnaires. The study spanned four weeks at two locations. During one week at each location, blood testing was offered for a fee of $5, and on the other week it was free. A total of 320 subjects filled out a questionnaire. Patient attitude was positive toward the provision of blood level testing service in a community pharmacy. Subjects perceived a pharmacy to be a convenient place for the service, and they stated that they would use such a service if it were available. Subjects stated that they would pay a mean of $12.46 to use the service. Tests they were most interested in having were cholesterol, potassium, and glucose. Of the 320 subjects, 159 had a blood test; 63 paid a fee and 96 received it free. All subjects expressed satisfaction with the service and all said that they would use it again. The mean amount that those tested were willing to pay was $14.49. The proposed model was partially successful in describing the relationships involved in utilization of a clinical pharmacy service. Demographics did not correlate with other variables nor did the two measures of willingness to pay. All other relationships were significant. The service was shown to be financially feasible based on projections from the data collected. It was recommended that such services be implemented.
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Chandratre, Chaitanya. "Medicare drug plan formulary response to the patent expiration of atypical antipsychotics in the State of Washington for fiscal year 2010." Pullman, Wash. : Washington State University, 2010. http://www.dissertations.wsu.edu/Thesis/Spring2010/C_Chandratre_042310.pdf.
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Thesis (M.H.P.A.)--Washington State University, May 2010.Title from PDF title page (viewed on July 20, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 30-35).
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Tien, Yu-Yu. "Factors associated with the prescription of antipsychotics : Medicare utilization and costs in 2004." Pullman, Wash. : Washington State University, 2009. http://www.dissertations.wsu.edu/Thesis/Spring2009/Y_Tien_042109.pdf.
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Thesis (M.H.P.A.)--Washington State University, May 2009.Title from PDF title page (viewed on Apr. 13, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 37-46).
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Monsanto, Homero A. "A Study of factors influencing the utilization of non-dispensing professional pharmaceutical services by consumers /." Ann Arbor : Univ. Microfilms, 1989. http://www.gbv.de/dms/bs/toc/016181085.pdf.
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Adsetts, Jacqueline. "Aspects of the demographic profile and standard of pharmaceutical services in South Africa / J. Adsetts." Thesis, North-West University, 2006. http://hdl.handle.net/10394/82.
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The objects of the South African Pharmacy Council in terms of the Pharmacy Act, 1974
(5311974) as amended are, inter alia, "to uphold and safeguard the rights of the general public
to universally acceptable standards of pharmacy practice in both the private and the public
sector" as well as "to establish, develop, maintain and control universally acceptable standards
of practice of the various categories of persons required to be registered.. ." One of the major
difficulties health care providers worldwide are faced with is how to maintain a proper balance
between the trio goals of health care, namely adequate access, high quality and acceptable
costs (Li, 2003:192-193). Relatively little is known about such problems as do exist for patients
regarding access to pharmaceutical services (Doucette et al., 1999:1268).
Two main objectives were identified for this study, namely to investigate the demographic profile
of community and institutional pharmacies registered with the South African Pharmacy Council;
and to determine the standard of pharmaceutical services provided by these pharmacies.
Inspection results of community and institutional pharmacies were obtained from the South
African Pharmacy Council and extracted for the time period 1 January 2004 to 31 May 2005.
To determine the demographic and geographic profile of these pharmacies, data of the Register
of Pharmacies of the South African Pharmacy Council for August 2003, 2004 and 2005 were
merged with the Census data of South Africa of 2001.
It was found that the total number of pharmacies in both the public and private sectors
increased with 2.1% (n=68) from August 2003 to August 2005. Public and private pharmacies that provided services directly to patients increased with 6.3% (n=33) and 1.3% (n=35) from
August 2003 to 2005. It was found that the Gauteng province was the best provided with
registered pharmacies in South Africa, as only 0.06% (n=5 783) of the population did not have
any registered pharmacy available on municipality level. It was also revealed that the majority
of inspections were carried out in Gauteng, whilst this province accounts for only 19.7% of the
total population of South Africa.
During the study period a total of 1178 community pharmacy inspections were carried out in
1103 community pharmacies (one or more inspections per pharmacy) representing 43% (n=2
550) of the total number of community pharmacies registered with the South African Pharmacy
Council during May 2005. Nationally community pharmacies achieved a score of 92.27 (+ 6.65
per cent) for compliance with Good Pharmacy Practice guidelines. The lowest compliance
score (73.34 + 27.49 per cent) was obtained for the availability of written standard operating
procedures and the highest was for the promotion of public health (99.02 + 6.30 per cent). No
practical significant differences (dc0.8) were found between the overall compliance scores
obtained by community pharmacies of the different provinces. The highest compliance score
was obtained by community pharmacies in the Free State (93.09 + 4.90 per cent), followed by
Western Cape, Eastern Cape, Kwazulu Natal, Limpopo, Northern Cape, Gauteng, Mpumalanga
and the North West.
A total of 343 institutional pharmacy inspections (one or more inspections per pharmacy) were
carried out in public and state subsidised institutions (n=245), private institutions (n=90) and
mine hospitals (n=5). These pharmacies represented 46% of the total number of institutional
pharmacies registered with the South African Pharmacy Council during May 2005. Nationally all
institutional pharmacies (both private and public) achieved a score of 92.49 + 8.33 per cent for
compliance with Good Pharmacy Practice guidelines for all above-mentioned aspects.
Nationally public and state subsidised institutional pharmacies obtained a lower compliance
score (91.02 + 9.08 per cent) than private institutional pharmacies (96.39 + 3.91 per cent).
Lastly, a grading system was developed that was based on the results obtained through this
study, in order to quantify the standard of pharmaceutical services provided by pharmacies in
South Africa.Thesis (M.Pharm. (Pharmacy Practice))--North-West University, Potchefstroom Campus, 2007.
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Montgomery, Anna. "Counselling in Swedish Community Pharmacies : Understanding the Process of a Pharmaceutical Care Service." Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-108973.
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Community pharmacy practice is moving towards patient care and away from the mere dispensing of medicines. In this movement, which is guided by the philosophy of Pharmaceutical care (PC), new counselling services emerge. The purpose of the thesis was to add knowledge about the real-world provision of PC services by studying a defined PC service in Swedish pharmacies. Specific aims of this thesis were to investigate the experiences of professionals working with or close to the service and to describe the content of consultations, counselling behaviour and patterns of follow-up. Further aims were to characterise patients receiving the service and describe their perceived outcomes, in relation to standard service. Data were collected via focus groups, telephone interviews, observations, a patient medication record database and a cross-sectional survey. The practitioners reported greater use of their pharmaceutical knowledge and provision of more thorough patient support. Perceived barriers in delivering the service included difficulties in documenting and getting commitment from colleagues, managers and prescribers. Doctors working close to PC pharmacies held varying opinions about the service. Consultations dealt with issues potentially improving the outcomes of medical treatment, but the level of patient centredness varied and was limited by the practitioners’ focus on the computer screen. The rate of follow-up evaluations was modest, but was higher at pharmacies with a high volume of patients receiving the service. PC patients were mostly elderly and female, using about 10 prescription drugs. In comparison to patients receiving standard service, they were more worried, vulnerable and information-seeking. At the same time, their feelings of safety following the pharmacy visit were more pronounced than those of patients receiving standard service. They also felt better prepared for doctor visits. In order for community pharmacy to better meet patients’ needs and optimise PC services, increased attention should be given to implementation strategies, interprofessional collaboration and educational efforts focusing on patient centredness.
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Renberg, Tobias. "Patient Perspectives on Community Pharmacy Services." Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-108392.
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Community pharmacy practice is changing, putting a greater emphasis on patient involvement and empowerment than on physical drug products. Developing practice philosophies, such as pharmaceutical care, are operationalised through an ever-evolving service proliferation. There is, however, a paucity of studies addressing the patients’ subjective perceptions of pharmacy services. The few studies that measure the impact of pharmacy services on humanistic outcomes show little or no effect. This might be due to the services, or the assessment instruments used. The aim of this thesis was to enhance the understanding of how patients perceive community pharmacy services, their preferences for community pharmacy services, and how these services could be evaluated from the patient perspective. This was done by: 1.exploring patients’ perceptions of an existing pharmaceutical care service using in-depth interviews; 2. exploring patient preferences for the ideal pharmacy visit using Q methodology, and characterising those patient groups that have different preferences and; 3. testing the validity of the Swedish version of the Pharmaceutical Therapy-Related Quality of Life (PTRQoL)-instrument, using think aloud methodology. Patients had vague, and sometimes erroneous, understandings about a pharmaceutical care service that they were currently receiving. They reported that the service had increased their feeling of safety, enhanced their knowledge, provided drug treatment control, and empowered them. Seven different viewpoints of the ideal pharmacy service were identified, which could be broadly divided into two groups, those emphasising the physical drug products as central to the encounter and those seeking a relationship with the pharmacist. Some differences between the group characteristics were identified, but not specific enough to guide individualised care practice. Several problems with the validity of the PTRQoL-instrument were detected. Overall, the thesis has highlighted various aspects of patient perspectives on community pharmacy services that could be used for the development andassessment of such services.
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Sangoi, Salete Maria Girardi. "SERVIÇOS FARMACÊUTICOS: AÇÕES DE GESTÃO NA LINHA DE CUIDADO MATERNO INFANTIL DE UM HOSPITAL UNIVERSITÁRIO." Centro Universitário Franciscano, 2017. http://www.tede.universidadefranciscana.edu.br:8080/handle/UFN-BDTD/631.
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The Unified Health System was created to carry out health promotion, prevention and recovery actions, obeying the principles of equality, universality and integral access to actions and services. The pharmaceutical professional is inserted in all levels of attention, that is, from primary care, specialized services and tertiary care. However, there is a gap in what refers to the performance of the pharmacist in the management of the health system. So that, this dissertation had as objective to enhance the integration and participation of the pharmaceutical professionals of the clinical analysis and hospital pharmacy services in the management of the Maternal Child Care Line of an University Hospital. Its specific objectives were: to present the main demands of the Maternal and Child Care Line for the pharmaceutical services linked to the laboratory of clinical analysis and hospital pharmacy of the institution; to discuss the result of prioritizing problems with managers of the clinical laboratory and hospital pharmacy and to elaborate informative material with the data collected, aiming to support the decision-making process by the management team of the Maternal Child Care Line. This work is justified by the need to promote greater integration of pharmacy professionals, as well as their recognition, of the importance of the performance of the pharmaceutical services in the management actions established for the Maternal and Child Care of the hospital. For that, a research-action methodology was developed, from November 2016 to May 2017. Ten of the health professionals who are part of the Line of Maternal Child Care participated in the research. Based on the data collected, the group's priorities were the resolvability of laboratory tests and the need for constant and permanent dialogue between the team. As a result, two articles were produced. The first one consists in a narrative review about the role of the pharmacist in tertiary services, whose objective was to get to know the recent literature on the subject and, based on it, to build a solid data base capable of subsidizing the discussion presented in this paper. The second, in turn, presents the demands of the pharmaceutical services of a university hospital, which were listed based on the empirical research developed. The product generated was informative material in a banner format, which was exposed in the meeting room of the Child Care Line of the team in order to give visibility to the priorities listed by the team.
O Sistema Único de Saúde foi criado para executar ações de promoção, prevenção e recuperação da saúde, obedecendo aos princípios da igualdade, universalidade e integralidade do acesso às ações e aos serviços. O profissional farmacêutico encontra-se inserido em todos os níveis de atenção, ou seja, desde a atenção primária, serviços especializados e na atenção terciária. No entanto, há uma lacuna no que se refere à atuação do farmacêutico na gestão do sistema de saúde. Assim, essa dissertação teve como objetivo geral potencializar a integração e a participação dos profissionais farmacêuticos dos serviços de análises clínicas e farmácia hospitalar na gestão da Linha de Cuidado Materno Infantil do Hospital Universitário de Santa Maria. E como objetivos específicos: apresentar as principais demandas da Linha de Cuidado Materno Infantil para os serviços farmacêuticos vinculados ao laboratório de análises clínicas e farmácia hospitalar do Hospital Universitário de Santa Maria; discutir o resultado da priorização de problemas com os gestores do laboratório de análises clínicas e farmácia hospitalar; elaborar material informativo com os dados coletados, visando apoiar o processo de tomadas de decisão pela equipe gestora da Linha de Cuidado Materno Infantil. Esse trabalho se justifica pela necessidade de promover maior integração dos profissionais farmacêuticos, bem como o reconhecimento por parte destes, da importância da atuação dos serviços farmacêuticos nas ações de gestão estabelecidas para a Linha de Cuidado Materno Infantil do Hospital Universitário de Santa Maria. Para tanto, desenvolveu-se metodologia de pesquisa-ação, no período de novembro de 2016 a maio de 2017. Participaram da pesquisa dez profissionais de saúde que fazem parte da equipe da Linha de Cuidado Materno Infantil. A partir dos dados coletados, observou-se como prioridades do grupo a resolutividade nos exames laboratoriais e a necessidade de um diálogo constante e permanente da equipe. Como resultado, foram produzidos dois artigos. O primeiro deles consiste em uma revisão narrativa acerca do papel do farmacêutico em serviços terciários, a qual teve como objetivo conhecer a literatura recente acerca do tema e, a partir dela, construir uma base sólida de dados capaz de subsidiar a discussão apresentada neste trabalho. O segundo, por sua vez, apresenta as demandas dos serviços farmacêuticos de um hospital universitário, as quais foram elencadas a partir da pesquisa empírica desenvolvida. O produto gerado foi material informativo em formato banner, o qual ficou exposto na sala de reuniões da equipe da Linha de Cuidado Materno Infantil com a finalidade de dar visibilidade às prioridades elencadas pela equipe.
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Dipzinski, Aaron. "Comparison of Washington state 2010 Medicare prescription drug plan coverage of pharmacotherapies for opioid and alcohol dependence." Pullman, Wash. : Washington State University, 2010. http://www.dissertations.wsu.edu/Thesis/Spring2010/A_Dipzinski_042310.pdf.
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Thesis (M.H.P.A.)--Washington State University, May 2010.Title from PDF title page (viewed on July 22, 2010). "Department of Health Policy and Administration." Includes bibliographical references (p. 42-51).
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Abughosh, Susan M. "Drug benefit plans for elderly under managed care and utilization of lipid lowering agents /." View online ; access limited to URI, 2003. http://0-wwwlib.umi.com.helin.uri.edu/dissertations/dlnow/3112111.
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Adams, Edries. "Independent community pharmacy : quo vadis?" Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/14640.
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Thesis (MBA)--University of Stellenbosch, 2011.On 16 January 2004, the Parliament of the Republic of South Africa published the Draft Regulations to the Medicines and Related Substances Act No. 101 of 1965 (Republic of South Africa, 2010a) for comments due by 16 April 2004. These regulations would change the retail pharmacy landscape that generations of pharmacists had become dependent on in supporting themselves and the communities that they served. These regulations proposed a single exit price (SEP) that manufacturers might charge pharmaceutical wholesalers, which included the distribution cost. The wholesaler in turn would sell the pharmaceutical to the pharmaceutical retailer at the listed SEP, thus prohibiting discounts and in the process creating transparency in the pharmaceutical industry. This transparency would ensure that all people would pay the same price for their medication with the aim of making it affordable and available to those in need. Preceding these draft regulations was the amendment to the Pharmacy Act No. 53 of 1974 (Republic of South Africa, 2010c) concerning pharmacy ownership, which allowed non-pharmacist and legal entities to own pharmacies as of 2003. This amendment posed the first external threat to the autonomy of pharmacists regarding independent pharmacy ownership. Pharmacists now had to compete not only amongst themselves but also with large corporate food and health shops with in-house pharmacies. The resources and capabilities inherent to independent community pharmacies given the events of the past few years proved inadequate in competing with the corporate retailers. These two amendments to acts that influenced the existing pharmacy landscape posed a real threat to the sustainability of independent pharmacy business models. This paper investigates the issues that independent community pharmacies in South Africa are facing and their strategic options in the pharmaceutical and services value chain.
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Lelubre, Melanie. "Implementation Study of Professional Pharmacy Services in Community Pharmacies." Doctoral thesis, Universite Libre de Bruxelles, 2018. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/268974.
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Introduction: In recent year, the role of the pharmacist has evolved from product-focused to patient-focused activities. Following this evolution, new professional pharmacy services were simultaneously developed by researchers and started to be legally implemented and remunerated for community pharmacists around the world. Implementation, essential to ensure a good programme delivery and therefore its effectiveness, was seen as a passive process for which diffusion and dissemination were sufficient to translate research into practice. However, the transition from theory to practice is often difficult as different factors hinder or facilitate the implementation of such services. In consequence of that, implementation research started to be developed in the community pharmacy field to understand and fil the gap between theory and practice.Objectives of the thesis: Three projects were conducted in Belgium and Switzerland; (1) to understand the implementation of an existing programme in Belgium; the isotretinoin pregnancy prevention programme (PPP) (Chapter IV, point 4.1), and (2) to study the implementation of two new developed pharmaceutical services, which include an interview between the pharmacist and the patient and require interprofessional collaboration; the medication adherence program in Switzerland and the medication review in Belgium (Chapter IV, point 4.2). Methods: To understand the implementation of the isotretinoin PPP, two studies were conducted. The first study was a survey sent to health care professionals (pharmacists, general practitioners and dermatologists) and patients. The outcomes of the survey were the PPP awareness and compliance to safety recommendations related to the teratogenic risk of isotretinoin. The second study was cross-sectional and analysed the reimbursed prescription data of the Belgian population taking isotretinoin between January 2012 and August 2015. The outcomes were medication adherence to isotretinoin and to contraception, and the concomitant use of contraception and isotretinoin. Medication adherence was measured using the medication possession ratio (MPR), dividing the total days of medication supplied within the refill interval by the number of days in the refill interval. The concomitant use of isotretinoin and contraception was realised in combining prescription database of both isotretinoin and contraception of women between 12 and 21 years old, who received at least one prescription of isotretinoin during the study period.To study the implementation of the medication adherence program in Switzerland and the medication review service in Belgium, two prospective and observational studies were conducted with a mixed method approach (quantitative and qualitative outcomes). The defined outcomes, based on the RE-AIM model, were; reach of the target patients, adoption of the service by health care professionals providing the service, implementation (facilitators, barriers and fidelity or the extent to which the intervention is delivered as intended), and maintenance (the extent to which the intervention become institutionalized or part of the routine activity). Outcomes were collected through web platforms for quantitative data, and interviews and focus groups for qualitative data.Results and discussion: The study of the isotretinoin PPP implementation showed that two safety recommendations related to the teratogenic risk were particularly poorly applied by interviewed health care professionals. These two recommendations were the use of a second contraceptive method (like condoms) and the monthly pregnancy test. They considered these two recommendations as unnecessary for women taking an effective contraceptive method. Through the prescription refill data analysis, we observed that 46.1% of patients were adherent to isotretinoin (MPR ≥ 0.8) and 74.0% of women taking isotretinoin to their prescribed contraception (oral contraceptive, rings and patches). Lastly, 83.4% of women between 12 and 21 years taking isotretinoin did not receive an effective contraceptive method one month before, during and one month after isotretinoin treatment. However, the proportion of women receiving at least one prescription of contraception during (74.1%) and after (72.1%) isotretinoin treatment was higher than one month before isotretinoin treatment (35.7%). Regarding these results, less adopted recommendations should be reviewed by an expert committee and interventions focused on the improvement of the use of contraception during isotretinoin treatment could be developed.The two studies related to two new developed pharmaceutical services showed that their implementation was feasible in community pharmacy practice. Most of pharmacists participating in both projects had positive attitude regarding the implementation of these services in their daily practice. They considered it as professionally satisfying and important for patients and perceived the benefits of the programs. However, similar barriers were observed; difficulties to include patients and lack of interprofessional collaboration, and lack of time (related to lack of staff, administrative burden and lack of team adoption). According to participating health care professionals, the development of new strategies to overcome these barriers is necessary to anticipate the future implementation and the maintenance of these services at the national level. Following these results, the proposed strategies are for example the development of broad based media campaigns (for health care professionals and patients), or the development of specific trainings focusing on interprofessional collaboration, service-process, practice change management and leadership. Conclusion: The legal evolution of the pharmacists’ role is a positive progress but insufficient to ensure a full implementation in practice. Implementation strategies should be considered at different implementation stages (exploration, preparation, testing, operation and maintenance) and levels (individual, pharmacy, local setting, and system). The use of implementation science would allow a quicker and more effective implementation of these new professional pharmacy services. The anticipation of change and the selection of appropriate strategies would allow a higher fidelity level to the different components of the service by health care professionals and therefore a higher effectiveness, e.g. clinical and economic outcomes. Health care professionals, professional associations, academics and policy makers should be aware of implementation science and integrate it in the development of the new pharmacists’ role. As shown in our results, it should also be considered for existing programmes such as the isotretinoin PPP.Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie)
info:eu-repo/semantics/nonPublished
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Gamage, Piyadasa Gallala. "Improving the quality management systems for pharmaceutical services in developing countries : a case study in Sri Lanka." Thesis, King's College London (University of London), 2004. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.409696.
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Chiarello, Sabrina Pereira. "Competências para a prática dos serviços farmacêuticos prestados na atenção primária nos municípios de Itaperuna e Campos dos Goytacazes do estado do Rio de Janeiro." Niterói, 2017. https://app.uff.br/riuff/handle/1/3084.
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O Sistema Único de Saúde desde a sua criação tem avançado de forma significativa. Dentro desse processo ressalta-se a importância da Atenção Primária à Saúde, que é considerada a principal porta de entrada do sistema de saúde no Brasil. Independente do nível de atenção, a maioria das ações em saúde resulta em intervenção medicamentosa. O medicamento é considerado um insumo importante na prestação dos serviços de saúde. Diante da necessidade de disponibilizar medicamentos e da utilização destes de forma racional, é fundamental a organização dos serviços farmacêuticos, bem como a capacitação dos recursos humanos. O trabalho aborda as competências para a prática dos serviços farmacêuticos na Atenção Primária. Objetivos: Analisar as competências para o desempenho dos serviços farmacêuticos ao nível de Atenção Primária, identificando o perfil dos profissionais e realizando uma avaliação dos seus conhecimentos. Metodologia: Estudo descritivo e transversal, baseado em entrevistas com profissionais que realizam dispensação de medicamentos na Atenção Primária. O estudo foi realizado nos municípios de Campos dos Goytacazes e Itaperuna do estado do Rio de Janeiro. Foi empregado um questionário do tipo estruturado com perguntas fechadas. No questionário aplicado foram solicitadas informações sobre os dados pessoais do entrevistado, como formação profissional, vínculo empregatício, carga horária, informações sobre as unidades de trabalho, faixa salarial, gênero e grau de satisfação em relação aos funcionários da farmácia e da unidade de saúde. Na segunda parte foram solicitadas para cada atividade citada o grau de importância na opinião do entrevistado, a frequência de realização das atividades e o grau de conhecimento. Resultados: Foram entrevistados 19 profissionais que fazem a dispensação de medicamentos na atenção primária. Dentre os entrevistados 12 eram farmacêuticos. Treze entrevistados possuíam mais de um vínculo empregatício. Sobre a renda mensal, 4 tinham faixa salarial de até 3 salários. Onze fizeram estágio em atenção primária. Dez entrevistados fizeram curso de atualização. Sobre as farmácias das unidades de saúde, Campos tem 8 farmácias com sistema informatizado. A média de funcionários nas farmácias foi de 2. Seis entrevistados trabalham 40 horas por semana. Doze relataram que a infra-estrutura da unidade de saúde é o seu maior desafio no trabalho. Sobre a análise das competências dos serviços farmacêuticos, o escore para a opinião do grau de importância para as atividades citadas foi alto. O escore de frequência de realização das atividades foi baixo, o farmacêutico foi o profissional que mais praticou as atividades citadas no questionário. O grau de conhecimento foi elevado entre os farmacêuticos. Conclusão: O resultado sugere a discrepância entre a opinião do grau de importância e a frequência da realização das atividades (indicadores de competência) referentes aos serviços farmacêuticos. A maioria dos participantes do estudo relatou que consideram as atividades referentes aos serviços farmacêuticos citadas no questionário importantes, porém na prática algumas atividades não são praticadas. O farmacêutico foi o profissional que obteve maiores escores para a frequência de realizações de atividades e do grau de conhecimento em relação aos demais profissionais, demonstrando assim a importância da sua participação no contexto da atenção primária
The Health System since its inception has advanced significantly. Within this process highlights the importance of primary health care, which is considered the main health system gateway in Brazil. Regardless of the level of attention, most health actions results in drug intervention. The drug is considered an important input in the provision of health services. According to the need to provide medicines and the use of these rationally, the services organization is important, as well as the training of human resources. It considers the competence for the practice of pharmaceutical services in primary care. Objectives: To analyze the competences for the performance of pharmaceutical services at the level of primary care, identifying the profile of professionals and conducting a self-assessment of their knowledge. Methodology: Descriptive, cross-sectional study, based on interviews with professionals involved in dispensing drugs in primary care. The study was conducted in Campos dos Goytacazes and Itaperuna cities of the state of Rio de Janeiro. It was used a semi-structured questionnaire type with open and closed questions. In the questionnaire were asked about the respondent's personal data, such as vocational training, employment, working hours, information on units of work, salary range, gender and degree of satisfaction with pharmacy staff and health unit. In the second part were required for each activity mentioned how important the opinion of the respondent is, the frequency of the activities and the degree of knowledge. Results: We interviewed 19 professionals who are drugs dispensers in primary care. Among the respondents were 12 pharmacists. Thirteen respondents had more than one job. About the monthly income, 4 had salary range of up to 3. Eleven had training in primary care. Ten respondents did refresher course. About pharmacies of health facilities, Campos has 8 pharmacies with computerized system. The average number of employees in pharmacies was 2. Six respondents work 40 hours a week. Twelve reported that the health facility infrastructure is your biggest challenge at work. On the analysis of the competences of pharmaceutical services, the score for the opinion of the degree of importance for the mentioned activities was high. The frequency score of carrying out activities was low, the pharmacist was the professional who carried out most of the activities mentioned in the questionnaire. The degree of knowledge was high among pharmacists. Conclusion: The results suggest the discrepancy between the opinion of the degree of importance and frequency of performing activities (competence indicators) relating to pharmaceutical services. Most of the study participants reported that think the importance of the activities related to pharmaceutical services mentioned in the questionnaire, but in practice some activities are not practiced. The pharmacist was the professional who obtained higher scores for the frequency of activities and achievements of the degree of knowledge in relation to other professionals, thus demonstrating the importance of their participation in the context of primary care
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Ibrahim, Osama Mohamed. "Evaluating cholesterol screening in a community pharmacy." Scholarly Commons, 1988. https://scholarlycommons.pacific.edu/uop_etds/2162.
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The purpose of this research project was to evaluate the role of the community pharmacist in screening, identifying, and referring ambulatory patients with high total blood cholesterol (TBC) in a community pharmacy. Fifty seven patients, out of 241 initially screened individuals, met the study inclusion criteria and were accepted into this study. Of these 57 patients, 51 patients completed the six month study period. The normal population group consisted of 164 participants with TBC < 200 mgjdL at the initial cholesterol testing (visit 1). The drop out group represented six patients who failed to continue attending the two follow up tests (visit 2 and 3). For screening purposes, a non-fasting whole blood sample was used to measure TBC using the Boehringer Mannheim Reflotron analyzer.
The project was evaluated based on mean TBC levels obtained during the initial screening and the two follow up tests, pre-test and post-test scores, behavior and lifestyle changes, and the number of patients who received a physician's order for lipid analysis as a result of initial screening results. In addition, influence of age and educational background on lowering TBC in visits 2 and 3, patient acceptance of blood screening in a community pharmacy and willingness to pay for this service in the future were also determined.
To assess the level of significance among the means of the tested parameters, both parametric (one-way analysis of variance, Scheffe's post hoc test and two sample t-test) and non-parametric statistics (Mann-Whitney and chi-square test) were used at a probability level of less than 0.05. There was a significant difference in mean TBC levels between visit 1 and 2, and between visit 1 and 3 (P< 0.01). However, no statistically significant difference was found between visit 2 and 3 (P= 0.48). In addition, there was no significant difference in the incidence of high blood cholesterol in terms of gender or age difference at the initial screening. Further, mean TBC levels between males and females remained statistically insignificant during the two follow up tests. However, younger patients were able to lower their mean TBC level in visit 2 and 3 compared with older patients (P=< 0.031). The one-way analysis of variance results showed that there was no statistically significant difference in TBC changes during the three visits by subjects categorized by educational background levels. Patient's attitude toward the idea of blood test measurement in community pharmacies was positive. Ninety eight percent of the study group stated that they strongly liked such an idea, 92.16% expressed a willingness to pay an average of $4.55 (range $3 or less to $10), and all agreed that it was a convenient service for them.
It was concluded that cholesterol screening in this community pharmacy was effective and acceptable, and may prove to be financially feasible when effectively planned and marketed. This service provides the community pharmacist with an opportunity to offer a unique patient-oriented public service.
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Byrt, Sarah. "Social, medical and geographical aspects of the provision of community pharmacy services in rural West Wales." Thesis, University of Wales Trinity Saint David, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683168.
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Buttarazzi, Michael James. "A systems approach to automated pharmacy dispensing." Master's thesis, This resource online, 1990. http://scholar.lib.vt.edu/theses/available/etd-12162009-020010/.
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Smith, David Harold. "Medication compliance and cost and utilization outcomes associated with pharmacist's cognitive service interventions /." Thesis, Connect to this title online; UW restricted, 1998. http://hdl.handle.net/1773/7941.
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