Journal articles on the topic 'Prescription delivery service'
To see the other types of publications on this topic, follow the link: Prescription delivery service.
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'Prescription delivery service.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Van Gorder, Charles M., Scott H. Yost, Jenna M. Negrelli, Scott H. Anderson, and Carolyn Chew. "Effective Decentralization of a Pharmacy Technician to Facilitate Delivery of Medications Prior to Discharge in a Community Hospital." Journal of Pharmacy Technology 33, no. 4 (April 28, 2017): 123–27. http://dx.doi.org/10.1177/8755122517705398.
Full textAbstract:
Background: There are many benefits to a well-designed prescription process and delivery service at the time of discharge from the hospital. However, the discharge prescription delivery service in our hospital has historically been infrequently utilized. Objective: To assess the number of patients with prescriptions in hand prior to discharge, the number of prescriptions filled, the duration of time to get discharge prescriptions to the floor, and the motivation patients had for declining the service. Methods: This single-center, quality improvement project was initiated as a pilot program from March through December 2015, utilizing a certified pharmacy technician (CPhT) on a 56-bed cardiovascular floor from Monday through Friday, 9:00 am to 5:30 pm. All patients discharged during the pilot time period were included in the analysis. The CPhT was responsible for collecting, inputting, processing, delivering, and charging for discharge prescriptions. Results: The number of patients utilizing the service increased from an average of 68 to 132 per month, pre- and postintervention, respectively. Total prescriptions increased from 296 preintervention to 456 postintervention per month. Prescription delivery time to the patient was decreased by 28 minutes. Conclusions: The utilization of a decentralized CPhT in a 56-bed cardiology unit at a large community hospital increased both the number of patients and total number of prescriptions filled prior to discharge. Future studies are warranted to evaluate medication interventions at discharge and readmission rates in patients who have prescriptions in hand prior to discharge versus those that do not.
2
Ding, Liang, Qiuru She, Fengxian Chen, Zitong Chen, Meifang Jiang, Huasi Huang, Yujin Li, and Chaofeng Liao. "The Internet Hospital Plus Drug Delivery Platform for Health Management During the COVID-19 Pandemic: Observational Study." Journal of Medical Internet Research 22, no. 8 (August 6, 2020): e19678. http://dx.doi.org/10.2196/19678.
Full textAbstract:
Background Widespread access to the internet has boosted the emergence of online hospitals. A new outpatient service called “internet hospital plus drug delivery” (IHDD) has been developed in China, but little is known about this platform. Objective The aim of this study is to investigate the characteristics, acceptance, and initial impact of IHDD during the outbreak of COVID-19 in a tertiary hospital in South China Methods The total number of and detailed information on online prescriptions during the first 2 months after work resumption were obtained. Patients’ gender, age, residence, associated prescription department, time of prescription, payment, and drug delivery region were included in the analysis. Results A total of 1380 prescriptions were picked up or delivered between March 2 and April 20, 2020. The largest group of patients were 36-59 years old (n=680, 49.3%), followed by the 18-35 years age category (n=573, 41.5%). In total, 39.4% (n=544) of the patients chose to get their medicine by self-pickup, while 60.6% (n=836) preferred to receive their medicine via drug delivery service. The top five online prescription departments were infectious diseases (n=572, 41.4%), nephrology (n=264, 19.1%), endocrinology (n=145, 10.5%), angiocardiopathy (n=107, 7.8%), and neurology (n=42, 3%). Of the 836 delivered prescriptions, 440 (52.6%) were sent to Guangdong Province (including 363 [43.4%] to Shenzhen), and 396 (47.4%) were sent to other provinces in China. Conclusions The IHDD platform is efficient and convenient for various types of patients during the COVID-19 crisis. Although offline visits are essential for patients with severe conditions, IHDD can help to relieve pressure on hospitals by reducing an influx of patients with mild symptoms. Further efforts need to be made to improve the quality and acceptance of IHDD, as well as to regulate and standardize the management of this novel service.
3
Murray, John, Jonathan Elms, and Mike Curran. "Examining empathy and responsiveness in a high-service context." International Journal of Retail & Distribution Management 47, no. 12 (December 9, 2019): 1364–78. http://dx.doi.org/10.1108/ijrdm-01-2019-0016.
Full textAbstract:
Purpose The delivery of high-quality service is critical for the success, or otherwise, of many retailers. However, despite calls to examine the efficacy of the dimensions of quality in different service contexts, it is still largely unknown how dimensions such as empathy and responsiveness interact to determine consumers’ perceptions of service quality. Recent research also suggests that loyalty strategies may not be equally effective across all services contexts. The purpose of this paper is, therefore, to contribute to the service quality literature by providing a better understanding of how marketing strategy is effectively operationalised into improved services and consumer loyalty in physical stores. Design/methodology/approach Consumers from ten stores of one pharmacy retailer were surveyed. The retailer provides high-service levels at present and is examining ways of how to deliver a better quality service to its prescription and non-prescription account holding consumers. By examining consumer loyalties in high-services contexts in pharmacy retailing, the authors also propose how retailers in other sectors can learn to operationalise services quality into increased loyalties. Findings The findings of this research demonstrate that empathy, rather than responsiveness, is more important in a high service delivery context such as pharmacy retailing. Non-prescription account holding and non-store loyal consumers also do not perceive that high service responsiveness is compromised by offering of a highly empathetic (and possibly more time consuming) service by the retailer. Originality/value These findings present specific implications for retailers in the development of consumer loyalty in a high-service context. Moreover, the findings of this research also illustrate how retailers can more effectively target their investments in service design to enhance service quality and consumer loyalty.
4
Owen, Cathy, Christopher Tennant, Deslee Jessie, Michael Jones, and Valerie Rutherford. "A Model for Clinical and Educational Psychiatric Service Delivery in Remote Communities." Australian & New Zealand Journal of Psychiatry 33, no. 3 (June 1999): 372–78. http://dx.doi.org/10.1046/j.1440-1614.1999.00578.x.
Full textAbstract:
Objective: A model of intermittent psychiatric service provision to rural and remote New South Wales communities by metropolitan psychiatrists and mental health professionals has been evaluated. The services provided included peer support to lone mental health and generic health workers, direct psychiatric care to clients in their own environment and skills development education sessions to general health staff and other professionals affiliated with health care (e.g. police and ambulance officers). Method: There were 10 visits of teams made up of a psychiatrist and another mental health professional to six rural and remote locations. Outcomes of the services delivered were examined including clinical services and teaching skills training sessions. Indirect outcome measures included changes to Pharmaceutical Benefits Scheme prescription patterns in areas serviced and data regarding transfer of clients for psychiatric care in regional centres. Difficulties in evaluation are discussed. Results: The feasibility of intermittent service provision was demonstrated. Education packages were well received and a positive change in workers' attitudes toward mental health practice was found. Conclusion: Intermittent psychiatric services in remote settings add value to health care delivery particularly when dovetailed with skills-based education sessions.
5
Sari, Chynthia Pradiftha, Okti Ratna Mafruhah, Rizki Nurul Fajria, and Alia Meta. "Evaluasi Pelayanan Resep Berdasarkan Pelaksanaan Standar Kefarmasian di Apotek Tempat Praktik Kerja Profesi Apoteker (PKPA) Kota Yogyakarta." Jurnal Pharmascience 6, no. 1 (March 4, 2019): 18. http://dx.doi.org/10.20527/jps.v6i1.6071.
Full textAbstract:
ABSTRAK Pemerintah Indonesia menetapkan standar pelayanan kefarmasian di apotek berupa Peraturan Menteri Kesehatan (PMK) Nomor 35 tahun 2014, secara keseluruhan evaluasi terhadap pelayanan kefarmasian di apotek belum mencapai skor maksimal. Pada pelayanan resep kajian administrative dan penyampaian konseling obat jarang dilakukan. Tujuan penelitian ini adalah untuk mengevaluasi pelaksanaan standar kefarmasian dalam pelayanan resep di apotek tempat PKPA wilayah Yogyakarta. Metode penelitian yang digunakan adalah desktiptif observasional dengan rancangan potong lintang melibatkan 4 area apotek diwilayah Yogyakarta dengan total 108 resep yang diamati, 77 resep yang dijadikan sampel penelitian. Pengumpulan data dilakukan dengan mengisi lembar observasi, dan wawancara dengan apoteker pengelola apotek sejumlah 10 apoteker dan 11 TTK (tenaga teknis kefarmasian). Data hasil lembar observasi dianalisis dengan statistik deskriptif menggunakan Microsoft Excel, kemudian disimpulkan dalam bentuk persentase. Hasil penelitian menunjukkan, dalam melakukan pelayananan resep berupa pengkajian resep, peracikan dan pengemasan obat, serta penyerahan obat di tempat PKPA dilakukan oleh apoteker dan TTK, dengan rincian persentase rata-rata pengkajian resep oleh apoteker (77,84%) dan TTK (22,16%), peracikan dan pengemasan 64,99% dilakukan apoteker dan 35,01% dilakukan TTK, penyerahan obat 67,19% dilakukan apoteker dan 32,81% dilakukan TTK. Pelaksanaan standar kefarmasian dalam melakukan pelayanan resep terdapat aspek yang tidak dilakukan terkait pemeriksaan data (berat badan, tinggi badan, riwayat keluarga, riwayat penyakit, riwayat pengobatan, dan alergi) dan pemberian informasi obat (efek samping obat, cara penyimpanan, makanan dan minumamn yang harus dihindari). Kata Kunci: Standar pelayananan Kefarmasian, evaluasi pelayanan resep, apotekABSTRACT The Indonesian government has set a pharmaceutical service standard in the pharmacy in the form of Minister of Health Regulation (PMK) Number 35 of 2014, as a whole the evaluation of pharmacy services at the pharmacy has not yet reached the maximum score. In prescription services administrative studies and delivery of drug counseling are rarely done. The purpose of this study was to evaluate the implementation of pharmaceutical standards in prescription services at the PKPA place in Yogyakarta. The research method used was observational desktiptif with a cross-sectional design involving 4 pharmacy areas in the Yogyakarta region with a total of 108 prescriptions observed, 77 prescriptions being used as research samples. Data collection was carried out by filling out the observation sheet, and interviewing pharmacists managing pharmacies with 10 pharmacists and 11 TTK (pharmaceutical technical personnel). Data from the observation sheet were analyzed by descriptive statistics using Microsoft Excel, then concluded in the form of a percentage. The results showed, in conducting prescription services in the form of prescription studies, compounding and packaging of drugs, and the delivery of drugs at the PKPA site conducted by pharmacists and TTK, with a detailed percentage of prescription studies by pharmacists (77.84%) and TTK (22, 16%), compounding and packaging 64.99% were carried out by pharmacists and 35.01% were performed TTK, drug delivery 67.19% was carried out by pharmacists and 32.81% were carried out TTK. The implementation of pharmaceutical standards in prescribing services contained aspects that were not carried out related to examining data (weight, height, family history, disease history, medical history, and allergies) and providing drug information (drug side effects, methods of storing, food and drinking). must be avoided). Keyword: Pharmaceutical service standards, prescription service evaluation, pharmacy
6
Dhavalshankh, Archana G., Vikram A. Rajadnya, and Kedar L. Patil. "Prescription auditing: an important tool for sensitization of resident doctors for rationale prescription and utilization of drug." International Journal of Basic & Clinical Pharmacology 8, no. 10 (September 25, 2019): 2237. http://dx.doi.org/10.18203/2319-2003.ijbcp20194263.
Full textAbstract:
Background: The main objective of the Maharashtra Health Systems Development Project (MHSDP) is to enhance the quality of care by improving health care; in the hospitals, in the state. Improvement in the prescribing practice of resident doctors working in the hospitals is one of the initiatives taken up, to improve the rationalizing service delivery. A prescription audit may become an important tool for sensitizing resident doctors for rational prescription and utilization of drug.Methods: An observational study was carried out during the period of March 2017 to May 2017 in tertiary care teaching hospital, Kolhapur. Total 247 first prescriptions written by resident for in-door-patient department were collected, scrutinized and analysed. Prescriptions were evaluated for completeness of prescription format while legibility was graded. Prescriptions were also analysed as per World Health Organization prescribing indicators.Results: In study 247 prescriptions with 1091 drugs with average 4.42% drugs per prescription, 49.8 % prescriptions wrote the drugs by generic name. We found that 44.1 % prescriptions written with drugs included in essential medicines list while antibiotics prescribed were 27.1%. In prescription format 34% had incorrect dosage, 67% of prescriptions omitted the duration of treatment. Direction for drug use was not mentioned in 25% of prescriptions. Weight was not mentioned on any prescriptions even for paediatric group.Conclusions: Through prescription auditing, sensitizing resident doctors for rational prescription and utilization of drug can be done to achieve the goal of the MHSDP of enhancing the quality of care by improving health care; in the hospitals, in the state.
7
Hoang, Huy T., Dorsa Saghira, Mary Finch, and Jeff Fortner. "Evaluating COVID-19’s Impact on Patient Access to Care in the Community Pharmacy Setting." INNOVATIONS in pharmacy 13, no. 4 (December 29, 2022): 17. http://dx.doi.org/10.24926/iip.v13i4.4959.
Full textAbstract:
Introduction: Community pharmacies across the country have been adapting the ways their patients receive medications and prescription information during the COVID-19 pandemic. In order to reduce the risk of COVID-19 infection, the CDC encouraged patients to use pharmacy drive-throughs, curbside pickup, or home delivery services to obtain medications. This research study is one of the first studies to analyze how patients utilize and access Medication Management Services (MMS) in the community pharmacy setting during the COVID-19 pandemic. Objective: To evaluate changes to patients’ utilization of Medication Management Services in the community pharmacy setting during the COVID-19 pandemic. Methods: Eligible patients included persons 18 years old and older, and currently taking at least (1) chronic prescription medication in the last three months. Pharmacists were excluded from the study. Telephonic or video interviews were conducted with patients from community pharmacy settings. Descriptive statistics were used to summarize patient characteristics and responses to select interview questions. A qualitative thematic analysis was conducted with data collected from open-ended interview questions. Results: Thirty-five patients participated in interviews. Patients reported increased use of telehealth and technology, increases in quantity or days supply of medications, initiation of mail delivery services, and curbside pick-up. Five (14.3%) patients used telehealth or increased their technology usage due to the pandemic. Seven (20%) patients reported they were more proactive in refilling their medications. Eleven (31.4%) patients indicated they were currently using a prescription delivery service and were likely to continue the service. On the contrary, five (14.3%) patients experienced decreased healthcare professional interactions, while 3 (8.6%) patients encountered slowed pharmacy processing and 2 (5.7%) faced technology barriers. However, 58% of patients reported no changes to the way they utilized MMS during COVID-19. Conclusion: Like many other healthcare providers, the COVID-19 pandemic caused a shift in how community pharmacies care for the patients they serve. This study identified various changes in how the pandemic impacted the way patients accessed and utilized community pharmacy services. These findings can serve to inform community pharmacies on how to best serve their patients during this and future pandemic.
8
Fiorentine, Robert. "Beyond Equity in the Delivery of Alcohol and Drug Abuse Treatment Services." Journal of Drug Issues 23, no. 4 (October 1993): 559–77. http://dx.doi.org/10.1177/002204269302300401.
Full textAbstract:
Equity in service utilization has become an important policy goal of federally-, state-, and locally-funded alcohol and drug treatment programs. A number of conceptual and methodological issues surrounding equity, including its strengths and limitations as a policy goal, are addressed. Among the many issues discussed is the observation that inequity in service utilization carries evaluative connotations in that a service system is likely to be judged as unsatisfactory, inadequate, or inappropriate when the inequity is modest, and as morally reprehensible when the inequity is significant. Violation of the norm of equity is a prescription for institutional reform and political action. On the other hand, policies that would increase the equity in service utilization may be incompatible with the goal of “service on demand” and they may have no consequent effect of increasing service efficacy. Moreover, there are some arrangements in which maintaining or even increasing inequity would be cost-effective. Other methodological, conceptual and policy-related issues are addressed.
9
Guhl, Dennis, Katharina E. Blankart, and Tom Stargardt. "Service quality and perceived customer value in community pharmacies." Health Services Management Research 32, no. 1 (April 3, 2018): 36–48. http://dx.doi.org/10.1177/0951484818761730.
Full textAbstract:
A patient’s perception of the service provided by a health care provider is essential for the successful delivery of health care. This study examines the value created by community pharmacies—defined as perceived customer value—in the prescription drug market through varying elements of service quality. We develop a path model that describes the relationship between service elements and perceived customer value. We then analyze the effect of perceived customer value on customer satisfaction and loyalty. We use data obtained from 289 standardized interviews on respondents’ prescription fill in the last six months in Germany. The service elements personal interaction (path coefficient: 0.31), physical aspect (0.12), store policy (0.24), and availability (0.1) have a positive significant effect on perceived customer value. Consultation and reliability have no significant influence. We further find a strong positive interdependency between perceived customer value, customer satisfaction (0.75), and customer loyalty (0.71). Thus, pharmacies may enhance customer satisfaction and loyalty if they consider the customer perspective and focus on the relevant service elements. To enhance benefit, personal interaction appears to be most important to address appropriately.
10
Latter, Sue, Natasha Campling, Jacqueline Birtwistle, Alison Richardson, Michael I. Bennett, David Meads, Alison Blenkinsopp, et al. "Patient and carer access to medicines at end of life: the ActMed mixed-methods study." Health and Social Care Delivery Research 10, no. 20 (July 2022): 1–208. http://dx.doi.org/10.3310/fiqe5189.
Full textAbstract:
Background Patient access to medicines at home during the last 12 months of life is critical for effective symptom control, prevention of distress and unplanned admission to hospital. The limited evidence suggested problems with different components of service delivery and, to the best of our knowledge, the impact of innovations in end-of-life service delivery has remained unevaluated. Objective To provide an evaluation of patient and carer access to medicines at end of life within the context of models of service delivery. Design and data sources The study used a multiphase mixed-methods design, comprising (1) a systematic literature review; (2) an online questionnaire survey of health-care professionals delivering end-of-life care; (3) evaluative mixed-method case studies of service delivery models, including cost and cost-effectiveness analysis; (4) interviews with community pharmacists and pharmaceutical wholesalers and distributors; and (5) an expert consensus-building workshop. Setting Community and primary care end-of-life services in England. Participants Health-care professionals delivering end-of-life care and patients living at home in the last 12 months of life and their carers. Results A systematic review identified a lack of evidence on service delivery models and patient experiences of accessing medicines at end of life. A total of 1327 health-care professionals completed an online survey. The findings showed that general practitioners remain a predominant route for patients to access prescriptions, but nurses and primary care-based pharmacists are also actively contributing. However, only 42% of clinical nurse specialists and 27% of community nurses were trained as prescribers. The majority (58%) of prescribing nurses and pharmacists did not have access to an electronic prescribing system. Health-care professionals’ satisfaction with access to shared patient records to facilitate medicines access was low, with 39% of health-care professionals either not at all or only slightly satisfied. Respondents perceived that there would be a significant improvement in pain control if access to medicines was greater. Case studies (n = 4) highlighted differences in speed and ease of access to medicines between service delivery models. Health-care professionals’ co-ordination facilitated the access process. The work of co-ordination was frequently burdensome, for example because general practitioner services were hard to access or because the stock of community pharmacy medicines was unreliable. Prescription cost differentials between services were substantial when accounting for the eligible population over the medium term. The supply chain generally ensured stocks of palliative medicines, but this was underpinned by onerous work by community pharmacists navigating multiple complex systems and wholesaler interfaces. Limitations Patient records lacked sufficient detail for timelines to be constructed. Commissioners of community pharmacy services and wholesalers and distributors were difficult to recruit. Conclusions Accessing medicines required considerable co-ordination work. Delays in access were linked to service delivery models that were over-reliant on general practitioners prescribing, unreliable stocks of community pharmacy medicines and clinical nurse specialists’ lack of access to electronic prescribing. Key issues were relationships and team integration, diversifying the prescriber workforce, access to shared records and improved community pharmacy stock. Future work Further research should consider policy and practice action for nursing and pharmacy services to fulfil their potential to help patients access medicines, together with attention to improving co-ordination and shared electronic records across professional service interfaces. Study registration This study is registered as CRD42017083563 and the trial is registered as ISRCTN12762104. Funding This project was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme and will be published in full in Health and Social Care Delivery Research; Vol. 10, No. 20. See the NIHR Journals Library website for further project information.
11
Maddison, Ralph, Jonathan Charles Rawstorn, Ralph A. H. Stewart, Jocelyne Benatar, Robyn Whittaker, Anna Rolleston, Yannan Jiang, et al. "Effects and costs of real-time cardiac telerehabilitation: randomised controlled non-inferiority trial." Heart 105, no. 2 (August 27, 2018): 122–29. http://dx.doi.org/10.1136/heartjnl-2018-313189.
Full textAbstract:
ObjectiveCompare the effects and costs of remotely monitored exercise-based cardiac telerehabilitation (REMOTE-CR) with centre-based programmes (CBexCR) in adults with coronary heart disease (CHD).MethodsParticipants were randomised to receive 12 weeks of telerehabilitation or centre-based rehabilitation. REMOTE-CR provided individualised exercise prescription, real-time exercise monitoring/coaching and theory-based behavioural strategies via a bespoke telerehabilitation platform; CBexCR provided individualised exercise prescription and coaching via established rehabilitation clinics. Outcomes assessed at baseline, 12 and/or 24 weeks included maximal oxygen uptake (V̇O2max, primary) modifiable cardiovascular risk factors, exercise adherence, motivation, health-related quality of life and programme delivery, hospital service utilisation and medication costs. The primary hypothesis was a non-inferior between-group difference in V̇O2max at 12 weeks (inferiority margin=−1.25 mL/kg/min); inferiority margins were not set for secondary outcomes.Results162 participants (mean 61±12.7 years, 86% men) were randomised. V̇O2 max was comparable in both groups at 12 weeks and REMOTE-CR was non-inferior to CBexCR (REMOTE-CR-CBexCR adjusted mean difference (AMD)=0.51 (95% CI −0.97 to 1.98) mL/kg/min, p=0.48). REMOTE-CR participants were less sedentary at 24 weeks (AMD=−61.5 (95% CI −117.8 to −5.3) min/day, p=0.03), while CBexCR participants had smaller waist (AMD=1.71 (95% CI 0.09 to 3.34) cm, p=0.04) and hip circumferences (AMD=1.16 (95% CI 0.06 to 2.27) cm, p=0.04) at 12 weeks. No other between-group differences were detected. Per capita programme delivery (NZD1130/GBP573 vs NZD3466/GBP1758) and medication costs (NZD331/GBP168 vs NZD605/GBP307, p=0.02) were lower for REMOTE-CR. Hospital service utilisation costs were not statistically significantly different (NZD3459/GBP1754 vs NZD5464/GBP2771, p=0.20).ConclusionREMOTE-CR is an effective, cost-efficient alternative delivery model that could—as a complement to existing services—improve overall utilisation rates by increasing reach and satisfying unique participant preferences.
12
Baburao Ushir, Rahul, and Dr P. Dolly Diana. "Covid 19 Pandemic Impacts On Online Pharmacy And Offline Pharmacy With Reference To Mumbai Region." Asian Journal of Pharmaceutical Research and Development 10, no. 3 (June 14, 2022): 44–51. http://dx.doi.org/10.22270/ajprd.v10i3.1129.
Full textAbstract:
The Organization ( Who ) declared COVID-19 a swine flu on March 11, 2020, ushering in a global medical emergency of unprecedented scope and magnitude. The approach by countries all over the world differed slightly, but the provisions of frontline universal health care were characterized as critical to the disease outbreak reaction. COVID-19 had also entailed changes in healthcare service delivery. Respirators are one example of a modification aimed to increase public and care worker safety. Pharmacy services, particularly pharmacy moves of care options, just haven't been immune to change, bringing with them it using set of challenges to consider. Pharmacy services had played a critical role there in situation, and there was a high demand for them. That was expanding both online and offline. Methods applied to limit the effects or downturn of COVID-19, like reduced clinical training or amended user laws, had already produced obtaining the best possible prescriptions the person must've been trying to take just before to arrival at the hospital more difficult, leading to greater rely on independent sources to fulfil medication histories. To limit interaction with patients in ambulatory health centres, liking has transitioned with the use of online vs. printed version treatments, internet shopping, and use of clinic to sleep programmes and other healthcare medication delivery services for discharge prescriptions. An There has been an increased initiative to rectify prescription drug buyout troubles untreated by utilising patient assistance programmes or other inpatient programmes to pay the expenses of treatments for COVID treated cases within certain contexts. This paper examines why COVID-19 must have influenced pharmacy clips of quality healthcare website demand supply there in India.
Purpose: A study is being conducted to determine the impact of the Covid 19 outbreak on online and offline pharmacies in the Mumbai region.
13
Ku, Benny Pang Shing, Ada Wai Shan Tse, Benny Chu Hang Pang, Ngai Tseung Cheung, Joanna Yuk Wa Pang, Joyce Ka Yin Chan, Hing Loi Hui, Dave Chu, and Kevin Hoi Wa Choi. "Tele-Rehabilitation to Combat Rehabilitation Service Disruption During COVID-19 in Hong Kong: Observational Study." JMIR Rehabilitation and Assistive Technologies 8, no. 3 (August 19, 2021): e19946. http://dx.doi.org/10.2196/19946.
Full textAbstract:
Background A tele-rehabilitation platform was developed to improve access to ambulatory rehabilitation services in Hong Kong. The development was completed in October 2019 and rolled out for use to occupational therapists, physiotherapists, and speech therapists. During the COVID-19 pandemic, rehabilitation services were severely interrupted. Tele-rehabilitation was used extensively to meet the demand for rehabilitation service delivery. Objective The aims of this study were to (1) describe the design and development process of a tele-rehabilitation service, and (2) study how the tele-rehabilitation platform was used to overcome the disruption of rehabilitation service during the COVID-19 pandemic. Methods Tele-rehabilitation was developed utilizing 4 core determinants of Unified Theory of Acceptance and Use of Technology as guiding principles. A generic prescription platform, called the activity-based prescription system, and a mobile app, called the Rehabilitation App, were built. Five outcomes were used to examine the utilization of tele-rehabilitation both before and during the pandemic: throughput, patient demographic, patient conditions, workforce, and satisfaction from patients and staff. Results There was a tremendous increase in the use of tele-rehabilitation during pandemic. The total number of patients (up until July 2020) was 9101, and the main age range was between 51 to 70 years old. Tele-rehabilitation was used for a much wider scope of patient conditions than originally planned. More than 1112 therapists, which constituted 50.6% of the total workforce (1112/2196), prescribed tele-rehabilitation to their patients. Moreover, there was a high satisfaction rate from patients, with a mean rating of 4.2 out of 5, and a high adherence rate to prescribed rehabilitation activities (107840/131995, 81.7%). Conclusions The findings of our study suggested that tele-rehabilitation in the form of a generic prescription platform and mobile app can be an effective means to provide rehabilitation to patient. During the COVID-19 pandemic, tele-rehabilitation has been used extensively and effectively to mitigate service disruption. Our findings also provide support that there is a high level of satisfaction with tele-rehabilitation; however, a longer duration study is required to demonstrate the sustained use of tele-rehabilitation, especially after the pandemic.
14
Nam, Jin Young, Eun-Cheol Park, and Eun Cho. "Does Urinary Incontinence and Mode of Delivery Affect Postpartum Depression? A Nationwide Population-Based Cohort Study in Korea." International Journal of Environmental Research and Public Health 18, no. 2 (January 8, 2021): 437. http://dx.doi.org/10.3390/ijerph18020437.
Full textAbstract:
We investigated the association between urinary incontinence and postpartum depression. Data were extracted from the Korean National Health Insurance Service-National Sample Cohort and included women who delivered between 2004 and 2013. Postpartum depression was determined using diagnostic codes during the six-month postpartum period. Urinary incontinence was identified as having a prescription of incontinence drugs or a diagnosis. Cox proportional hazard models were used to calculate adjusted hazard ratios. Of the 83,066 women, 5393 (6.49%) had urinary incontinence and 691 (0.83%) had postpartum depression. Postpartum depression was higher among women with urinary incontinence, aged 15–19 years, ≥40 years old, the lowest income level, and who underwent cesarean section delivery. In the combined analysis, women with urinary incontinence and cesarean section had an approximately three times higher risk of postpartum depression compared with those without urinary incontinence and with spontaneous delivery. Women without urinary incontinence and cesarean section, and those with urinary incontinence and spontaneous delivery were at higher risk of postpartum depression compared with the reference group. Urinary incontinence and cesarean section delivery were significantly associated with postpartum depression during the first six months after childbirth. Therefore, further research should be conducted to evaluate whether urinary incontinence contributes to postpartum depression.
15
Nam, Jin Young, Eun-Cheol Park, and Eun Cho. "Does Urinary Incontinence and Mode of Delivery Affect Postpartum Depression? A Nationwide Population-Based Cohort Study in Korea." International Journal of Environmental Research and Public Health 18, no. 2 (January 8, 2021): 437. http://dx.doi.org/10.3390/ijerph18020437.
Full textAbstract:
We investigated the association between urinary incontinence and postpartum depression. Data were extracted from the Korean National Health Insurance Service-National Sample Cohort and included women who delivered between 2004 and 2013. Postpartum depression was determined using diagnostic codes during the six-month postpartum period. Urinary incontinence was identified as having a prescription of incontinence drugs or a diagnosis. Cox proportional hazard models were used to calculate adjusted hazard ratios. Of the 83,066 women, 5393 (6.49%) had urinary incontinence and 691 (0.83%) had postpartum depression. Postpartum depression was higher among women with urinary incontinence, aged 15–19 years, ≥40 years old, the lowest income level, and who underwent cesarean section delivery. In the combined analysis, women with urinary incontinence and cesarean section had an approximately three times higher risk of postpartum depression compared with those without urinary incontinence and with spontaneous delivery. Women without urinary incontinence and cesarean section, and those with urinary incontinence and spontaneous delivery were at higher risk of postpartum depression compared with the reference group. Urinary incontinence and cesarean section delivery were significantly associated with postpartum depression during the first six months after childbirth. Therefore, further research should be conducted to evaluate whether urinary incontinence contributes to postpartum depression.
16
Navti, Beryl, and Bugewa Apampa. "Pharmaceutical care services to people living with dementia in care homes: A qualitative study of community pharmacists' perceptions." Dementia 18, no. 6 (December 18, 2017): 2282–302. http://dx.doi.org/10.1177/1471301217743305.
Full textAbstract:
There is a paucity of information on the perceptions of community pharmacists about the nature and effectiveness of pharmaceutical care services they provide to people living with dementia in care homes. This paper explores pharmacists’ perceptions of the nature and effectiveness of pharmacy services provided, and their experiences when providing these services. Community pharmacists delivering services to care homes with dementia in Thurrock, Essex and in Medway, Kent, England were invited to participate in the study involving face-to-face interviews. Analysis of semi-structured interviews with 15 community pharmacists revealed that the main pharmaceutical service provided by the pharmacists was prescription processing, normally involving the clinical review and supply of medication into monitored dosage systems (dosette boxes) and delivery to the homes. This was coupled with advice to care homes on the appropriate storage and administration of drugs and appliances supplied, which was in line with the NHS Community Pharmacy Contractual Framework Enhanced Service for care homes. A majority of the community pharmacists interviewed acknowledged that the services they were currently commissioned to provide did not meet the pharmaceutical care needs of dementia patients in care homes, including the monitoring of the appropriateness, safety and effectiveness of drug therapy.
17
Armstrong-Kempter, Shannon, Lucinda Beech, Sarah J. Melov, Adrienne Kirby, and Roshini Nayyar. "Challenges in Antenatal Corticosteroid Prescribing: A Retrospective Study." Current Women s Health Reviews 16, no. 4 (September 9, 2020): 327–33. http://dx.doi.org/10.2174/1573404816999200430005045.
Full textAbstract:
Background: The discovery of the benefits of antenatal corticosteroids (ACS) for preterm infants was one of the most significant developments in obstetric care. However, due to the difficulty in predicting preterm delivery, optimal use of ACS, is challenging. Objective: To describe prescribing practices for antenatal corticosteroids (ACS) at a tertiary hospital over five years to determine whether ACS were received at optimal timing; to determine patient characteristics of women receiving ACS at optimal timing; to determine patient characteristics of those who did not receive ACS as indicated and to examine the trend in ACS prescribing over the study period. Methods: We performed a retrospective study of all deliveries from January 2011 to December 2015. The rates of ACS prescription for each group of women (preterm, late preterm, and term) were recorded and analysed. Results: A total of 65% of women who delivered before 34 weeks’ gestation received ACS. Of these women, 63% delivered within 7 days of receiving ACS. Women most likely to receive ACS with optimal timing were primiparous (relative risk [RR], 1.25 [CI, 1.08-1.45]), or women diagnosed with pre-eclampsia (RR, 1.34 [CI 1.10-1.63]), preterm premature rupture of membranes (RR, 1.33 [CI, 1.15-1.54]) or threatened preterm labour (RR, 1.42 [CI, 1.22-1.65]). Conclusion: A significant number of women and babies are exposed to ACS without commensurate benefit, and a significant number who deliver preterm do not receive ACS. The percentage of preterm and term infants receiving ACS should be determined to optimise service delivery.
18
Madi, Il, and Besse Arnawisuda Ningsi. "Faktor-faktor yang Mempengaruhi Kunjungan Pasien Terhadap Standar Pelayanan di Apotek Kimia Farma 278 Versailles dengan Menggunakan Analisis Faktor." Jurnal Statistika dan Aplikasinya 2, no. 2 (December 30, 2018): 17–27. http://dx.doi.org/10.21009/jsa.02203.
Full textAbstract:
To guarantee pharmaceutical service standards (Apotek), factors that need to be considered are the quality of human resources, complete facilities and infrastructure, prescription services (including drug information), counseling, monitoring drug use, health education and promotion, and evaluation of treatment. This is very important because it will have a positive impact and is very profitable, if the standard is met. Kimia Farma 278 Versailles pharmacies need to improve quality, especially in terms of service. Factor analysis methods can be used to see what factors influence patient visits to service standards. This type of research is descriptive research. Based on the results of the analysis there are 5 factors that are formed from the process of reducing delivery and Go-Mart services that can help patients. It is important to attract interest in coming to the pharmacy. Offered discounts, medicines submitted with standardized health education, offering drug packaging is more economical, the drug offered as a substitute does not have a negative impact, the ability of the knowledge officer to offer substitute drugs in accordance with the Service Standards at the pharmacy, Treatment is more maximal with the presence of checks from the officer (F1). Prices are commensurate with the drugs that are expected, quality drugs, pharmacies have a good reputation (F2). Clean, neat and comfortable, the price is commensurate with the drug you expect (F3). Having decent and adequate building facilities and interior, building exterios look good (F4), and the suitability of the product you want (F5)
19
Mohammed, Jaleel, Jayanti Rai, Hadeel Bakhsh, Julie Hobbs, and Shahrukh Hashmi. "ARTIFICIAL INTELLIGENCE FOR EARLY DETECTION AND MANAGEMENT OF MUSCULOSKELETAL COMPLICATIONS POST HEMATOPOIETIC CELL TRANSPLANT. FUTURE PERSPECTIVES." Issues of Rehabilitation, Orthopaedics, Neurophysiology and Sport Promotion – IRONS 37, no. 37 (September 2021): 17–24. http://dx.doi.org/10.19271/irons-000150-2021-37.
Full textAbstract:
Introduction To help monitor and manage complications, monitor disease progression, and help lower morbidity and mortality rates in Hematopoietic cell transplant (HCT) patients, the use of artificial intelligence technology can prove to be an efficient tool. Aim We propose a futuristic vision of an artificial intelligence model which could help in early detection of MSK related complications, improve communication between HCT healthcare professional team, improve diagnostics via machine learning (ML), help monitor symptom/ disease progression remotely, and help integrate services for a more patient-friendly service delivery, i.e., drug prescription, exercise prescription, appointment tracking, referral pathways. Materials and methods The proposed model is a three-phase integrated program where musculoskeletal physical examination is combined with wearable textiles interface platform and machine learning algorithms, thereby providing live and remote feedback of changes as they happen in at the musculoskeletal and vital signs level. Result With the help of machine learning technology, various algorithms can be created to help improve remote and live diagnostic accuracy of post-HCT musculoskeletal manifestations. Subtle changes over the course of time in various patient groups can be detected at the skin, fascia, muscle, bone level; thereby helping in better understanding of the disease and its management.
20
Griffiths, Emma, Julia V. Marley, and David Atkinson. "Preconception Care in a Remote Aboriginal Community Context: What, When and by Whom?" International Journal of Environmental Research and Public Health 17, no. 10 (May 24, 2020): 3702. http://dx.doi.org/10.3390/ijerph17103702.
Full textAbstract:
Preconception care (PCC) is acknowledged as a vital preventive health measure aiming to promote health today and for subsequent generations. We aimed to describe the content and context of PCC delivery in a very remote Australian Aboriginal Community Controlled Health Service setting. A retrospective audit was undertaken to identify what PCC was delivered between 2011 and 2018 to 127 Aboriginal women who had at least one pregnancy during this period. Of 177 confirmed pregnancies, 121 had received PCC prior to the pregnancy. Sexually transmissible infection screening (71%) was the most common care delivered, followed by folic acid prescription (57%) and smoking cessation support (43%). Younger women received PCC less often, particularly screening for modifiable pregnancy risk factors. Rates of prediabetes/diabetes, albuminuria, overweight/obesity and smoking were high amongst those screened (48–60%). PCC was usually patient-initiated and increased significantly over the audit period. Presentation for antenatal care in the first trimester of pregnancy was high at 73%. Opportunities to increase PCC delivery include integration with routine health checks, pregnancy tests and chronic disease programs. PCC programs codesigned with young people are also recommended. All primary care providers should be supported and assisted to provide opportunistic PCC and health promotion.
21
Agrawal, Sanjay, Zaheer Mangera, Rachael L. Murray, Freya Howle, and Matthew Evison. "Successes and Challenges of Implementing Tobacco Dependency Treatment in Health Care Institutions in England." Current Oncology 29, no. 5 (May 20, 2022): 3738–47. http://dx.doi.org/10.3390/curroncol29050299.
Full textAbstract:
There is a significant body of evidence that delivering tobacco dependency treatment within acute care hospitals can deliver high rates of tobacco abstinence and substantial benefits for both patients and the healthcare system. This evidence has driven a renewed investment in the UK healthcare service to ensure all patients admitted to hospital are provided with evidence-based interventions during admission and after discharge. An early-implementer of this new wave of hospital-based tobacco dependency treatment services is “the CURE project” in Greater Manchester, a region in the North West of England. The CURE project strives to change the culture of a hospital system, to medicalise tobacco dependency and empower front-line hospital staff to deliver an admission bundle of care, including identification of patients that smoke, provision of very brief advice (VBA), protocolised prescription of pharmacotherapy, and opt-out referral to the specialist CURE practitioners. This specialist team provides expert treatment and behaviour change support during the hospital admission and can agree a support package after discharge, with either hospital-led or community-led follow-up. The programme has shown exceptional clinical effectiveness, with 22% of all smokers admitted to hospital abstinent from tobacco at 12 weeks, and exceptional cost-effectiveness with a public value return on investment ratio of GBP 30.49 per GBP 1 invested and a cost per QALY of GBP 487. There have been many challenges in implementing this service, underpinned by the system-wide culture change and ensuring the good communication and engagement of all stakeholders across the complex networks of the tobacco control and healthcare system. The delivery of hospital-based tobacco dependency services across all NHS acute care hospitals represents a substantial step forward in the fight against the tobacco epidemic.
22
Sadler, Tonie, Kevin Yan, Daniel Brauner, Harold Pollack, and R. Tamara Konetzka. "Caregiving During COVID-19: A Multi-State Qualitative Study of Family Caregiver Experiences and Decision Making." Innovation in Aging 5, Supplement_1 (December 1, 2021): 438. http://dx.doi.org/10.1093/geroni/igab046.1702.
Full textAbstract:
Abstract COVID-19 poses unique challenges to family caregivers. This study explores how family caregivers for older adults with cognitive impairments experience and make decisions about caregiving during a global pandemic. Using purposive sampling, 63 family caregivers across eight states participated in open-ended qualitative interviews (2019-2020), until thematic saturation was reached. Questions broadly examined caregivers’ experiences and decisions, focusing on decisions made around type of care setting. Questions about responses to the Pandemic were added as events unfolded. States were selected to represent variation in Home and Community Based Service (HCBS) expenditures as a percentage of total Medicaid long-term services and supports expenditures. Family caregivers experienced significant concern about COVID-19 itself, and about the indirect consequences of caregiving caused by the pandemic. Caregivers also displayed flexibility and adaptability in ceasing selected services, contingently continuing services, and utilizing telemedicine and other remote healthcare interventions to protect their loved ones. Many family caregivers utilized remote health care tools such telemedicine, no-contact prescription and grocery delivery. Such measures improved service access and reduced caregiver workload. Given the persistent challenges posed by COVID-19, long-term service organizations have an opportunity to enhance their policies to meet the needs of caregivers and those they care for. There is a need to expand telemedicine and other remote healthcare tools, while adapting these technologies to the needs of families. Also, procedures are needed for safe pathways to utilize HCBS and nursing care during a pandemic including communication supports, sufficient PPE, increased staffing, and utilization of evidence-based protocols.
23
Sari, Ratih Pratiwi, Aditya Maulana Perdana Putra, and Ulfah Masran. "HUBUNGAN PENGETAHUAN DAN KEBUTUHAN PASIEN TERHADAP INFORMASI OBAT DI APOTEK AMANDIT FARMA BANJARMASIN." Jurnal Ilmiah Manuntung 4, no. 2 (December 28, 2018): 98. http://dx.doi.org/10.51352/jim.v4i2.188.
Full textAbstract:
The current pharmaceutical service has shifted its orientation from drug oriented to patient oriented with reference to pharmaceutical care. Pharmaceutical service activities are not limited to drug preparation and drug delivery to patients but pharmacy needs to interact or communication with the patient. The purpose of this study was to determine how is the relationship between knowledge and patient needs for drug information at Amandit Farma Pharmacy Banjarmasin. This type of research is descriptive analysis. Sampling was taken on March 9 - April 8, 2018 by giving questionnaires to 250 patients who redeemed the prescription at Amandit Farma Banjarmasin Pharmacy using systematic random sampling method according to exclusion and inclusion criteria. Data analysis using Chi Square 3x3. Based on the results of this study can be known the relationship between knowledge and needs of patients on drug information at Amandit Farma Pharmacy in Banjarmasin is statistically meaningful
24
Giesbrecht, Ed M., Paula W. Rushton, and Evemie Dubé. "Wheelchair service provision education in Canadian occupational therapy programs." PLOS ONE 17, no. 2 (February 17, 2022): e0262165. http://dx.doi.org/10.1371/journal.pone.0262165.
Full textAbstract:
Occupational therapists in Canada play a central role in wheelchair service provision. Inadequate entry-to-practice professional education has been identified as a major concern in the delivery of wheelchair related services. The goal of this study was to describe the current education provided in Canadian occupational therapy programs and to map this content against the recommended WHO 8-step wheelchair service provision process. The study used a descriptive cross-sectional online survey design. Educators were recruited from accredited occupational therapy programs in Canada. Participants completed a short sociodemographic questionnaire and a survey with 97 closed- and open-ended questions regarding the wheelchair service provision education provided in their curriculum. Survey data was then mapped according to the WHO 8-step wheelchair service provision process. Twenty-nine educators from all Canadian occupational therapy programs (n = 14) were enrolled. Most participants (55.2%) were full-time faculty members that had been teaching in occupational therapy programs for an average time of 10.9 years. All programs covered at least 4 of the WHO recommended steps, but only 5 programs covered all steps. Assessment and Prescription steps were covered in every program while the Referral & Appointment, Funding & Ordering, Fitting and User Training steps were covered in most programs. The pedagogic approach, the amount of time dedicated to wheelchair-related content, and the type of evaluation used varied greatly between programs. This study is the first to provide a detailed description of wheelchair service provision education across all Canadian occupational therapy programs according to the WHO 8 steps and provides a foundation for collaborative efforts to promote best practice in entry-to-practice professional education.
25
Noor Fakhruzzaman, Muhammad, Ghea Sekar Palupi, and Thinni Nurul Rochmah. "Fear of missing out during a pandemic: the driving factors of telemedicine application acceptance." Bulletin of Electrical Engineering and Informatics 11, no. 4 (August 1, 2022): 2331–38. http://dx.doi.org/10.11591/eei.v11i4.3848.
Full textAbstract:
COVID-19 pandemic changed how society behaves. Travel and social restrictions, commonly associated with the term lockdown became popular and ubiquitous. Given the rise of gig economy and mobile app delivery in the past several years, combined with lockdowns during the pandemic, and the application of telemedicine becomes essential. Halodoc is one of the popular telemedicine applications in Indonesia, having several useful features such as text-based doctor consultation and prescription drug order-delivery, and Halodoc is easily preferred by many. This article explored the motivation behind using Halodoc as the preferred method of getting health service during the pandemic, behind the perceived usefulness and perceived ease of use of the application, we found that fear of missing out (FOMO) has an indirect role in the application adoption in society, especially during lockdowns, where social interaction is limited to social media and other internet-based platforms. The reason why FOMO can be an important factor in technology adoption and how advertisers should explore FOMO is further discussed.
26
Grabenstein, John D. "Should Vaccines Require a Prescription?" Annals of Pharmacotherapy 32, no. 4 (April 1998): 495–500. http://dx.doi.org/10.1345/aph.17313.
Full textAbstract:
OBJECTIVE: To review the rationale for requiring prescriptions to control vaccine access, in contrast to other medications. DATA SOURCES: Literature on immunization delivery and health-service barriers was reviewed via MEDLINE search and relevant textbooks. Additional literature was obtained from reference lists of pertinent articles. DATA SYNTHESIS: Society controls access to medications to protect consumers. Many medications have changed from prescription-only to over-the-counter (OTC) status. No parenteral drug has been switched, although insulin has long had OTC status. Limiting access to vaccines has advantages in record-keeping, storage, injection quality, and response to anaphylactic reactions. These advantages are outweighed by 600 000 people who will die over the next decade for lack of pneumococcal and influenza immunizations. Physicians see most of those who die of these diseases, but many neglect to vaccinate them. Three options are offered to expand access to these vaccines. The most feasible one involves expanding prescribing authority for pneumococcal and influenza vaccines to all licensed healthcare professionals and paraprofessionals with physiologic and pharmacologic expertise to responsibly vaccinate. Community pharmacies offer advantages as immunization delivery sites, in terms of proximity, hours of operation, and knowledge of people at highest risk. Expanded professional training can ensure high levels of public safeguards while expanding immunization delivery. CONCLUSIONS: Society decides the controls needed to protect the health of the people. If society restricts vaccine access too severely, people die needlessly. Increasing prescribing authority for pneumococcal and influenza vaccines to more health professionals will save many lives. OBJETIVO: Discutir argumentos a favor y en contra de requerir una receta como método de control de acceso a las vacunas. FUENTES DE INFORMACIÓN: Se realizó una búsqueda bibliográfica en MEDLINE y se revisaron libros de texto para obtener literatura relacionada a la inmunización y las barreras para obtener servicios de salud. Se obtuvo literatura adicional de las listas de referencias de manuscritos relacionados al tema. SÍNTESIS: La sociedad controla el acceso a medicamentos con el propósito de proteger a los consumidores. Muchos medicamentos que anteriormente sólo se podían obtener con receta médica shora se pueden obtener sin receta. Ningún medicamento que se administra por la vía parenteral se puede obtener sin receta con excepción de la insulina. Limitar el acceso a las vacunas tiene como ventajas un mayor control sobre el mantenimiento de expedientes, el almacenaje, la calidad del producto, y la respuesta a reacciones anafilácticas. Por otro lado, 600 000 personas morirán en la próxima década por no haber recibido inmunización contra neumococos y la influenza. Los proveedores de servicios de salud ven a muchos de los pacientes que mueren como consecuencia de estas enfermedades, pero muchos se niegan a vacunarlos. Se ofrecen tres opciones para expandir el acceso a estas vacunas: (1) otorgar autoridad de prescribir las vacunas a otros profesionales de la salud, (2) autorizar la venta de vacunas sin receta pero únicamente si son dispensadas y administradas por un farmacéutico con adiestramiento, y (3) autorizar la venta de las vacunas sin receta y confiar que el mercado limite su distribución únicamente en farmacias, tal como ocurre con insulina. La opción más viable tiene que ver con otorgar autoridad de prescribir vacunas contra neumococos e influenza a todos los profesionales y para-profesionales de la salud con conocimiento fisiológico y farmacológico suficiente para responsablemente vacunar. Las farmacias de comunidad ofrecen ventajas como lugares donde se podría vacunar a las personas en términos de proximidad, horario de operación, y conocimiento de las personas en alto riesgo. Para salvaguardar la seguridad pública ante la expansión en los servicios de inmunización es necesario asegurar que los ofrecimientos de adiestramiento profesional serán ampliados. CONCLUSIONES: La sociedad decide los controles necesarios para proteger la salud de las personas. Si la sociedad limita el acceso a las vacunas, algunas personas morirán innecesariamente. El aumentar la autoridad para prescribir vacunas contra neumococos y la influenza a un mayor número de profesionales de la salud salvará muchas vidas. OBJECTIF: Examiner la nécessité d'obtenir les prescriptions afin de contrôler l'accès aux vaccins contrairement à d'autres médicaments. REVUE DE LITTÉRATURE: La documentation scientifique concernant la distribution des vaccins et les normes du réseau de la santé ont été revisées à l'aide d'une recherche informatisée MEDLINE et de livres de références sur le sujet. De la documentation additionnelle a été obtenue des bibliographies provenants de manuscrits pertinents. RÉSUMÉ: La société contrôle l'accès aux médicaments dans le but de protèger le public. Plusieurs médicaments sont passés du statut de médicaments prescrits à celui de médicaments de vente libre (MVL). Aucun produit parentérale n'a changé de statut, quoique l'insuline a depuis longtemps un statut de MVL. L'accès limité aux vaccins facilite la tenue de livres, les conditions d'entreposage, la qualité de l'injection et la réponse à des réactions anaphylactiques. Ces avantages s'opposent cependant au fait que 600 000 individus mourront dans la prochaine décennie par manque d'immunisation contre le pneumocoque ou l'influenza. Les médecins voient la majorité de ces patients qui décéderont suite à ces troubles, mais plusieurs négligent de les vacciner. Trois options sont offertes pour accroître l'accès à ces vaccins. L'option la plus praticable implique d'élargir l'autorité en matière de prescriptions pour les vaccins contre le pneumocoque et l'influenza à tous les professionnels et paraprofessionnels licenciés de la santé avec expérience physiologique et pharmacologique afin de vacciner de façon responsable. Les pharmacies communautaires offrent des avantages comme sites de distribution des vaccins en terme de proximité, heures d'ouverture et connaissance des patients à risques plus élevés. Une formation plus étendue des professionnels peut assurer une protection accrue du public tout en élargissant la distribution des vaccins. CONCLUSIONS: La société décide des contrôles nécessaires à la protection de la santé du public. Si la société restreint l'accès aux vaccins trop sévèrement, des gens décèdent inutilement. Accroître l'autorité de prescrire les vaccins contre le pneumocoque et l'influenza à plus de professionnels de la santé pourrait sauver des vies.
27
Alqenae, F. A., D. Steinke, and R. N. Keers. "Evaluating the Utilisation of a Service Designed to Enhance Care with Medicines Following Acute Hospital Discharge: A Retrospective Study." International Journal of Pharmacy Practice 29, Supplement_1 (March 26, 2021): i42—i43. http://dx.doi.org/10.1093/ijpp/riab015.052.
Full textAbstract:
Abstract Introduction Medication safety challenges are common after hospital discharge and an important global health care improvement target [1,2]. ‘Transfers of Care Around Medicines’ (TCAM) services have been suggested as an intervention that may help address this problem, and are designed to enable the referral of patients on discharge from the hospital to a named community pharmacy in the surrounding Clinical Commissioning Group (CCG). A TCAM service was launched by a large NHS Trust in England in February 2019 to enhance medicines communication and optimisation between primary and secondary care following hospital discharge. The TCAM service is delivered through the PharmOutcomes™ platform, and the initial focus of the service was to support patients with new or existing Monitored Dosage Systems (MDS). Aim To evaluate the utilisation of the TCAM service in the host NHS Trust and surrounding CCG through the examination of the nature and outcome of referrals made to community pharmacy. Method Anonymised service delivery data of patients referred from the TCAM service via the PharmOutcomes™ platform between March 2019 – February 2020 were retrospectively examined. The data comprised important variables, including patient demographics, status and time of referrals, and referral outcomes including problems/errors identified with medications and services provided by the community pharmacy such as medicines reconciliation. Study approvals were obtained from the host NHS Trust and the Health Research Authority (HRA); the study was exempt from the University Research Ethics Committee (UREC) approval [2019-7048-10983]. Results A total of 3,033 TCAM referrals to 67 community pharmacies were analysed. Most referrals were for patients aged 70 and above (72%, n=2,195) and 56% (n=1,713/3,033) of the referrals were for female patients. The number of referrals varied between 215 and 310 per month (median 246, Inter quartile range [IQR] 234 - 268). Most referrals (67%, 2,038/3,033) were marked as ‘completed’ by the community pharmacies, with 32.8% (n=995) left uncompleted. The rate of referral completion varied between 59 and 80% per month (median 66.4, IQR 64.5 - 70). Five (0.2%) patients were identified by community pharmacies that had adverse drug reactions (ADRs) from the cohort of 2,038 patients with completed referrals, with 45 (2%, n=45/2,038) identified as having issues that necessitated referral to the general practitioner (GP). The most common reason for referral to GP was medication changes identified from hospital, incorrect repeat prescriptions following discharge, to request a new prescription or weekly MDS, and to inform the GP that the patient has stopped taking their medication. The most common services carried out in community pharmacies following referral were reported as medicines reconciliation (47%, n=954/2,038), followed by review of information (46.7%, n=952/2,038), home delivery of medication (39%, n=798/2,038), review MDS arrangements (23.6%, n=482/2,038), commence MDS (18.6%, n=380/2,038), and pharmacy managed repeat service (12%, n=254/2,038). The main strength of this study is the inclusion of referral data that occurred over a one-year period, while the data were limited in generalisability due to inclusion of one geographical region and only patients using MDS. Conclusion The findings of this study may inform the ongoing development of electronic pharmacy referral systems for use at hospital discharge. References 1. Alqenae FA, Steinke D, Keers RN. Prevalence and Nature of Medication Errors and Medication-Related Harm Following Discharge from Hospital to Community Settings: A Systematic Review. Drug safety. 2020 Mar 3:1–21. 2. World Health Organization. Global patient safety challenge: medication without harm. 2017; p. 1–16. http://apps.who.int/iris/bitstream/10665/255263/1/WHO-HIS-SDS-2017.6-eng.pdf?ua=1&ua=1 . Accessed 20 September 2020.
28
Meiqari, Lana, Thi-Phuong-Lan Nguyen, Dirk Essink, Pamela Wright, and Fedde Scheele. "Strengthening human and physical infrastructure of primary healthcare settings to deliver hypertension care in Vietnam: a mixed-methods comparison of two provinces." Health Policy and Planning 35, no. 8 (July 1, 2020): 918–30. http://dx.doi.org/10.1093/heapol/czaa047.
Full textAbstract:
Abstract In Vietnam, the overall prevalence of hypertension (HTN) was 21%, with lower estimates for the prevalence of HTN awareness and treatment. The health systems, like other low- and middle-income countries, were designed to provide acute care for episodic conditions, rather than a chronic condition where patients need long-term care across time and disciplines. This article describes the delivery and organization of HTN care at primary healthcare (PHC) settings in both urban and rural areas at Hue Province of Central Vietnam in comparison with Thai Nguyen province in Northern Vietnam based on the infrastructure capacity and patients’ and providers’ perspectives and experiences We used mixed-methods design that included in-depth semi-structured interviews with patients and healthcare providers at purposively selected PHC facilities in two districts of each province and a modified version of the service availability and readiness assessment inventory at all PHC facilities. We found that HTN patients in both provinces can access healthcare services to diagnose, treat and control their HTN condition at the PHC level with a focus on district facilities. Health services in Hue have allowed commune health stations (CHSs) to provide routine monitoring and prescription refills for HTN patients while maintaining periodical visits to a higher level of care to monitor the stability of the disease. Such provision of care at CHSs remained restricted in Thai Nguyen. Further improvements are necessary for referral procedures, information system to allow for longitudinal follow-up across levels of care and defining a basic health insurance or benefits package, which meets patients’ preferences with a monthly timespan for prescription refills.
29
Cairney, T., S. Robertson, L. Henderson, S. A. Jacob, and P. Forsyth. "Pharmacy technician-led general practice support hub: a feasibility study." International Journal of Pharmacy Practice 30, Supplement_2 (November 30, 2022): ii9. http://dx.doi.org/10.1093/ijpp/riac089.009.
Full textAbstract:
Abstract Introduction Workforce pressures in general practice have led to Scottish Government initiatives to integrate pharmacy teams into general practice. The focus is completion of prescribing management-related activities releasing general practitioner time for patient-focused workload.1 Activities include medicines reconciliation from immediate discharge letters (IDL), processing outpatient prescription requests (OPL) and special request prescriptions (SR). Pharmacists effectively mobilise GP capacity completing these tasks.2 However, pharmacists may aspire to advanced practice roles including medication review case-load management. Therefore, alternative workload delivery models including centralised pharmacy technician-led general practice support hubs to complete IDL, OPL and SR tasks must be considered. National guidance outlines that pharmacy technicians may complete these tasks autonomously with minimal supervision.3 Unknowns include whether pharmacy technicians can lead this service delivery and the definition of the supervisory support required. Aim To evaluate the feasibility of a pharmacy technician-led hub for completion of SR, IDL and OPL. Methods Feasibility was studied over 4 weeks (12 April – 7 May 2021) during routine service delivery across three medical practices (approx. 23 800 patients) in NHS Greater Glasgow and Clyde. Quantitative real-time self-reported data on the volume of tasks (SR/IDL/OPL), task completion time and volume of pharmacist referrals was collected by pharmacy technicians and pharmacists and analysed in Microsoft Excel®. Qualitative data describing why pharmacy technicians referred tasks to pharmacists was collected and categorized using thematic analysis and Microsoft Excel® by the lead author. Ethical approval was not required for this service evaluation. Results 4485 total tasks were completed: SR 87% (n=3917); IDL 7% (n=323); OPL 6% (n=245). Pharmacy technicians completed most (71%; n=3181) prescribing management-related tasks. A service delivery gap (21%; n=921 of tasks) where workload exceeded technician resource, necessitated pharmacist support. Referral rate for tasks beyond technician competence was 11% (n=383). The locally agreed 48-hour benchmark turnaround to process tasks was achieved for the majority of tasks. Breaches of the target were noted: 53 (1%) SR; 10 (3%) IDL and 5 (2%) OPL. Technicians and pharmacists completed tasks in numerically similar times. 383 tasks were referred to a pharmacist. 134 (35%) tasks could only be completed by a pharmacists due to the need for a prescribing decision or pharmacist-specific knowledge. 226 (59%) could be completed by a technician with additional knowledge or training. Examples include queries requiring interpretation of clinical parameters or blood monitoring or answering medicines information enquiries. 6% (n=23) of referrals were uncategorised due to incomplete data collection. Discussion/Conclusion This study provides new information describing the workload volume achieved by pharmacy technicians and characterising the supervisory role of the pharmacist. Pharmacy technicians convincingly completed most activities. Service delivery gaps need addressed including maintenance of service delivery during periods of authorised absence and professional development time. Pharmacist referral rate can be improved by upskilling pharmacy technicians. The volume of SR tasks drives the workload and could be managed more effectively by converting suitable SR tasks to controlled repeats. A Health Improvement Scotland initiative is developing this work stream. Additional projects must identify training gaps to understand technician development needs and analyse achievement of advanced pharmacist activities where technician-led hub exists. References 1. Scottish Government. Achieving Excellence in Pharmaceutical Care: A Strategy for Scotland. Edinburgh. The Scottish Government, 2017 2. Maskrey M, Johnson CF, Cormack J et al. Releasing GP capacity with pharmacy prescribing support and New Ways of Working: a prospective observational cohort study. Brit J Gen Pract. 2018;68(675):e735-e42 3. Scottish Pharmacy Practice and Prescribing Advisers Association. National Pharmacotherapy Service Specification V4, 2021
30
Gobel, Nurchamidin, Teti S. Tuloli, and Madania Madania. "Studi Penjaminan Mutu (Quality Assurance) Dalam Pelayanan Kefarmasian di Apotek." Journal Syifa Sciences and Clinical Research 4, no. 2 (April 15, 2022): 237–66. http://dx.doi.org/10.37311/jsscr.v4i2.13956.
Full textAbstract:
Low Quality Assurance in Pharmacy Award Ipilo Gorontalo include pharmaceutical, security, procurement, storage, and distribution or drug delivery, drug management, on a prescription drug services, drug information services, as well as drug development, medicinal materials and traditional medicine. The impact of the implementation of activities in the pharmacy pharmacy services Anugerah Ipilo errors may occur treatment (medication errors) in the service process. Quality Assurance (QA) is one dimension that is used in the measurement of quality of service, where the application of QA in pharmacies Ipilo Award aims to provide quality assurance of pharmaceutical products and the quality of services provided to patients. This research is descriptive, the source of primary data obtained from the questionnaires with QA standard indicator framework on pharmaceutical services in pharmacies Anugerah Ipilo. The assessment results then classified based on criteria appropriate, relatively appropriate and not appropriate. The results showed that the Quality Assurance (Quality Assurance) on the quality of the equipment and the safety assurance of Pharmaceutical Services in Pharmacy Award Ipilo there are seven questions (70%) had a very good criteria, three questions (30%) had a good criterion. Quality Assurance (Quality Assurance) on the Process of Pharmaceutical Services in Pharmacy Award Ipilo there are 4 questions (40%) had a very good criteria, one question (10%) had a pretty good and 5 questions (50%) had less good. Pharmacies merely focused on the administration and management of medication alone is not the overall pharmacy services, in addition because the pharmacy Anugerah Ipilo prefer the function of the economy (business) rather than its social function, which pharmacies are required to gain / profit in business.
31
Umak, Rushikesh. "Sharing Healthcare Records in the Cloud Using Attribute-Based Encryption and De-Duplication." International Journal for Research in Applied Science and Engineering Technology 9, no. VII (July 31, 2021): 3345–50. http://dx.doi.org/10.22214/ijraset.2021.37109.
Full textAbstract:
Cloud based healthcare computing have changed the face of healthcare in many ways. The main advantages of cloud computing in healthcare are scalability of the required service and the provision to upscale or downsize the data storge, collaborating Artificial Intelligence (AI) and machine learning. The current paper examined various research studies to explore the utilization of intelligent techniques in health systems and mainly focused into the security and privacy issues in the current technologies. E-Healthcare is an emerging field of medical informatics, referring to the delivery of health services and information using the Internet and related technologies. Rendering efficient storage and security for all data is very important for cloud computing. Securing and privacy preserving of data is of high priority when it comes to cloud storage. E-Healthcare is the most important source in the healthcare society. E-healthcare system is now being popularized globally. Implementing the E-healthcare system will have more advantages such as online services for teleconsultation (second medical opinion), e-prescription, e-referral, telemonitoring, telecare etc. E-healthcare system provides high level of security and cost-effective use of patients records, information and communication in support of healthcare and health related issues.
32
Smith, Matthew Lee, Justin B. Dickerson, Monica L. Wendel, SangNam Ahn, Jairus C. Pulczinski, Kelly N. Drake, and Marcia G. Ory. "The Utility of Rural and Underserved Designations in Geospatial Assessments of Distance Traveled to Healthcare Services: Implications for Public Health Research and Practice." Journal of Environmental and Public Health 2013 (2013): 1–11. http://dx.doi.org/10.1155/2013/960157.
Full textAbstract:
Health disparities research in rural populations is based on several common taxonomies identified by geography and population density. However, little is known about the implications of different rurality definitions on public health outcomes. To help illuminate the meaning of different rural designations often used in research, service delivery, or policy reports, this study will (1) review the different definitions of rurality and their purposes; (2) identify the overlap of various rural designations in an eight-county Brazos Valley region in Central Texas; (3) describe participant characteristic profiles based on distances traveled to obtain healthcare services; and (4) examine common profile characteristics associated with each designation. Data were analyzed from a random sample from 1,958 Texas adults participating in a community assessment. K-means cluster analysis was used to identify natural groupings of individuals based on distance traveled to obtain three healthcare services: medical care, dental care, and prescription medication pick-up. Significant variation in cluster representation and resident characteristics was observed by rural designation. Given widely used taxonomies for designating areas as rural (or provider shortage) in health-related research, this study highlights differences that could influence research results and subsequent program and policy development based on rural designation.
33
Mangan, Maggie, and Sara Shoreman. "Working in partnership to implement change in wound dressings use." British Journal of Nursing 31, no. 15 (August 11, 2022): S14—S20. http://dx.doi.org/10.12968/bjon.2022.31.15.s14.
Full textAbstract:
Background: Wound care provision relies on safety, effectiveness, patient acceptance and accessibility of selected wound management products, supported by a sound education programme. Challenges with changing patient needs and service provision before and during the COVID-19 pandemic have resulted in new training and service delivery programmes to manage increased prevalence of wounds with dwindling resources. Method: South Warwickshire University NHS Foundation Trust incorporated a wound care audit identifying local challenges, available resources and areas for improvement, which led to changes in practice around training and the supply of dressings. This article sets out the rationale for change and steps taken to implement new practice, keeping the patient at the heart of care while following clinical governance. Results: The new practice resulted in a rigorous training programme to cover total wound management from assessment to standardised treatment that could encourage self-care where possible and improve patient outcomes. Wise use of all resources to manage stock levels released more qualified staff to focus on complex cases. Non-prescription ordering of dressings reduced stock wastage and the Trust recorded cost savings of more than 25% on the previous year. Conclusion: Sound wound care practice aligned to the National Wound Care Strategy, training in partnership with industry and the use of an efficient dressings delivery system achieved positive patient outcomes and significant financial savings for the Trust.
34
Chew, Lan-Sim, Yee-Ling Yeo, Chee-Tao Chang, Chii-Chii Chew, Doris George, and Philip Rajan. "Satisfaction among patients and caregivers receiving value-added services during the COVID-19 pandemic outbreak in a tertiary hospital in the Perak state of Malaysia." Journal of Pharmaceutical Health Services Research 12, no. 4 (October 23, 2021): 477–84. http://dx.doi.org/10.1093/jphsr/rmab057.
Full textAbstract:
Abstract Objectives Patient satisfaction was used as an indicator of service quality in the public hospitals. The pharmacy value-added services (VAS) were intensified after the COVID-19 outbreak, and evaluation of user’s satisfaction was important for service improvement. Methods This was a single-centre, cross-sectional, web-based study in the outpatient pharmacy in a tertiary hospital in the Perak state of Malaysia. Patients and caregivers aged 18 years and above, received at least one prescription refill using the pharmacy VAS from April to September 2020, were included. The questionnaire was adapted from a validated tool, underwent face and content validation before dissemination. The link was disseminated to the targeted population through short messages service (SMS). Key findings Out of 1200 invited people, 303 agreed to participate. Majority of the respondents were male (160, 52.8%), Chinese (156, 51.5%), with tertiary education (201, 66.3%) and retiree (112, 37.0%). Out of a maximum score of 5, the overall mean satisfaction score was 4.42 (SD: 0.55). The respondents were most agreeable to time-saving benefits of the pharmacy VAS (4.56 ± 0.63). Majority of the respondents felt that pharmacy VAS had made their life easier (290, 95.7%) and planned to recommend the pharmacy VAS to others (292, 96.4%) Respondents aged more than 60 (versus age 18–35, β = 2.375, P < 0.001) and those who used drive-through service (versus SPUB, β = 2.272, P = 0.001) reported higher satisfaction scores. Several suggestions were made for service improvement, including longer operating hours (18, 6.0%), upgraded communication system (9, 3.0%), smoother registration process (9, 3.0%), more polite staff (9, 3.0%), selection of preferred postage delivery time (6, 2.0%) and promotion of VAS (4, 1.3%) Conclusions Majority of the respondents were highly satisfied towards the pharmacy VAS. Future studies should compare the satisfaction of VAS with traditional counter service to compare the level and factors that contributed to the users’ satisfaction.
35
Ironbar, Archibong E., Uno Ijim Agbor, and Mary Eru Iji. "Awareness of National Health Insurance Scheme Activities and Service utilization Among Enrolled Employees in Government Institutions in Nigeria." JINAV: Journal of Information and Visualization 2, no. 1 (January 19, 2021): 33–41. http://dx.doi.org/10.35877/454ri.jinav294.
Full textAbstract:
The study examined awareness of National Health Insurance Scheme activities and service utilization among enrolled employees in government institutions in Nigeria. Adopting the survey research method, data was collected from 1200 samples employed in three federal Government Institutions in Calabar, Cross River State, Nigeria using a structured self-developed questionnaire. The samples were selected using the purposive and proportional sampling technique. Descriptive analysis was used to present result and linear regression was used to check the variable under study at 0.05 confidence level. The result from the descriptive analysis revealed that there was moderate knowledge (48 per cent) that there are drugs not on the NHIS drug list. Result also revealed minimal knowledge (30 per cent) that there is some treatment not on the NHIS treatment List. Regression analysis revealed a moderate correlation (30 per cent) between awareness of NHIS activities and service utilisation (F (1, 1112) = 16.472; p < .000). The study concludes that there is moderate knowledge about the activities of the NHIS and this affects service utilization and satisfaction. The study recommends among others that the operators of the National Health Insurance Scheme should include more drugs on the prescription list to address the health needs of participants. The scheme should be expanded to cover all medical cases of enrollees. The government and the agencies in charge of the health insurance scheme should carry out periodic assessments of clients’ satisfaction with the scheme so as to make future policy decisions for better service delivery
36
Ayre, K., A. Bittar, R. Dutta, and L. Howard. "Suicide and self-harm in women with mental disorders during pregnancy and the year after birth." European Psychiatry 64, S1 (April 2021): S173. http://dx.doi.org/10.1192/j.eurpsy.2021.459.
Full textAbstract:
IntroductionThere is little prospective data on the risk factors for later suicide in women who experience perinatal mental disorders, particularly beyond one-year postnatal.ObjectivesAmong a cohort of women who were in contact with a mental healthcare provider during the perinatal period, to: (1) Describe sociodemographic and clinical characteristics of the women who died by suicide (2) Understand when, in relation to childbirth, most suicides tended to occur.MethodsData-linkage of de-identified service-user electronic healthcare records, national hospital episode statistics and mortality data generated a cohort of women in contact with a mental healthcare service provider in London, UK, perinatally. Using Natural Language Processing and structured field extraction, we identified clinical, socio-demographic characteristics, self-harm exposure, and suicide.ResultsAmong 5204 women, clinical and demographic characteristics of women who did and did not die by suicide were similar apart from indicators of illness severity including perinatal sedative medication prescription, clinician-rated functional impairment and smoking, which were more common in women who died by suicide. Suicide deaths occurred most frequently in the second year post-delivery. The most common method of suicide ocurring wihtin two years was by violent means, whereas after two years postnatal, the most common method was non-violent.ConclusionsOur findings support the extension of perinatal mental healthcare service provision to two years post-delivery.DisclosureNo significant relationships.
37
Gohil, S. "AB0908-HPR SIGNED, SEALED, DELIVERED: PHARMACISTS ACHIEVING BETTER CARE CLOSER TO HOME IN RHEUMATOLOGY HIGH COST DRUG MANAGEMENT DURING THE COVID-19 PANDEMIC." Annals of the Rheumatic Diseases 80, Suppl 1 (May 19, 2021): 1476.1–1476. http://dx.doi.org/10.1136/annrheumdis-2021-eular.3944.
Full textAbstract:
Background:The Pharmacy High Cost Drug (HCD) and Homecare (HC) team, based at a large acute teaching hospital consists of a range of skilled pharmacists, technicians and administrative staff. The team act as a HCD liaison between the hospital and commissioners, working closely with an expanding variety of specialist clinical teams to manage prescription processing for the following patient groups; HC: 2238; Hospital FP10: 1060; Outsourced Subsidiary Pharmacy Model: 41. HCD management, particularly immunosuppressive biologic therapies for complex rheumatology conditions such as rheumatoid arthritis, has been challenging during the Covid-19 pandemic. The inelasticity in demand for better care closer to home and a functional Integrated Care Records system has intensified, as many patients are now shielding/self-isolating at home.1 Frugal innovations have been key during this time – achieving value and simplicity in service re-design to deliver better patient care.Objectives:This review explores the support provided by the Pharmacy HCD and HC team to the rheumatology service since March 2020 to aid in service improvements during the pandemic.Methods:The Pharmacy HCD and HC team reviewed existing practice to better respond to the service changes required during the pandemic in regard to the following areas; identifying patients for Covid-19 shielding; responding to changes in HC service provision; communication with commissioners; remote staff working; reviewing HCD formulations and administration routes; changes in commissioning arrangements.Results:i) Rapid development of patient datasets following identification of 1,623 immunosuppressive drug entries in line with BSR Covid-19 guidance (first published in March 2020), thus enabling social distancing/shielding guidance to be issued to patients via letters/virtual platforms.2 ii) Swift re-routing of urgent new biologic HC registrants to a new hospital pharmacy home delivery provision when certain HC providers temporarily imposed restrictions on intake of new registrants. This hospital initiative was further enhanced to a hub and spoke model enabling patients to have easy access to their medications from their nominated local community pharmacy branch. iii) Providing assurance to commissioners that clinical follow up reviews could continue virtually, blood samples could be taken at an external hub and blueteq documentation would be completed covering NICE technology appraisal (TA) criteria. iv) A successful pilot utilising the lean PDSA (Plan, Do, Study, Act) quality improvement methodology, to enable remote working pharmacists and technicians to process HC prescriptions remotely in the absence of an electronic prescribing and medicines administration system. v) Reviewing potential plans to switch certain hospital day-case intravenous biosimilar infusions such as infliximab to subcutaneous administration via HC. vi) Business contingency development plans to protect fragile medication supply chains. vii) Clarifying implications for changes in contracting and payment arrangements announced by NHS England and NHS Improvement due to the pandemic.3Conclusion:In summary, the role of the HCD Pharmacists during the pandemic in supporting rheumatology patients and the multidisciplinary team has been fundamental; ensuring signed prescriptions are securely processed to safely deliver medication to those in need.References:[1]NHS. The NHS long term plan. 2019. [Online].[2]British Society for Rheumatology (2020) Covid-19 - Identifying patients for shielding in England. [Online].[3]NHS. Revised arrangements for NHS contracting and payment during the COVID-19 pandemic. 2020. [Online].Acknowledgements:Mark Easter, UHCW and Interim Integrated Care System Chief Pharmacist, Hardeep Bagga, Deputy Chief Pharmacist, UHCW Pharmacy Homecare Team and UHCW Specialist Rheumatology Clinical Team.Disclosure of Interests:None declared
38
Lee, Jinhee, Thomas F. Kresina, Melinda Campopiano, Robert Lubran, and H. Westley Clark. "Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care." BioMed Research International 2015 (2015): 1–11. http://dx.doi.org/10.1155/2015/137020.
Full textAbstract:
Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.
39
Assefa, Yibeltal, Abiyou Kiflie, Betru Tekle, Damen Haile Mariam, Marie Laga, and Wim Van Damme. "Effectiveness and Acceptability of Delivery of Antiretroviral Treatment in Health Centres by Health Officers and Nurses in Ethiopia." Journal of Health Services Research & Policy 17, no. 1 (January 2012): 24–29. http://dx.doi.org/10.1258/jhsrp.2011.010135.
Full textAbstract:
Objective The World Health Organization (WHO) recommends shifting tasks from physicians to lower cadres for the delivery of antiretroviral treatment (ART) for countries short of physicians. Our objective was to evaluate the effectiveness and acceptability of ART delivery by health officers and nurses in Ethiopia. Methods A retrospective cohort study to evaluate outcomes of ART services in 25 health centresstaffed with health officers and/or nurses and 30 hospitals staffed with physicians in 2009. Median CD4-cell counts, mortality, loss to follow-up and retention were the primary outcomes. Interviews and focus group discussions were conducted with people living with HIV/AIDS, AIDS programme managers and health care providers to identify the types and acceptability of the tasks conducted by the health officers, nurses and community health workers. Results Health officers and nurses were providing ART, including ART prescription, for non-severe cases. The management of severe cases was exclusively the task of physicians. Community health workers were involved in adherence counselling and defaulter tracing. The baseline median CD4-cell counts per micro-liter of blood were 117 (interquartiles [IQ] 64,188) and 119 (IQ 67,190) at health centres and hospitals respectively. After 24 months on ART, the median CD4-cell counts per micro-literof blood increased to 321 (IQ 242, 414) and 301 (IQ 217, 411) at health centres and hospitals respectively. Retention in care was higher in health centres (76%, 95% confidence interval [CI] [73%-79%]) than hospitals (67%, 95% CI [66%-68%]). This difference is mainly due to the higher loss to follow-up rate in hospitals (25% versus 13%). Mortality was higher in health centres than hospitals (11% versus 8%), but the difference is not statistically significant. Service delivery by non-physicians was accepted by patients, health care providers and programme managers. However, the absence of a regulatory framework for task shifting, the lack of extra remuneration for the additional roles assumed by nurses and health officers, and the high cost for training and mentorship were identified as weaknesses. Conclusion ART delivery in health centres, based on health officers and nurses is feasible, effective and acceptable in Ethiopia. However, issues related to regulation, remuneration and cost need to be addressed for the sustainable implementation of these delivery models.
40
Kolko, David J., Jonathan A. Hart, John Campo, Dara Sakolsky, Jeffrey Rounds, Mark L. Wolraich, and Stephen R. Wisniewski. "Effects of Collaborative Care for Comorbid Attention Deficit Hyperactivity Disorder Among Children With Behavior Problems in Pediatric Primary Care." Clinical Pediatrics 59, no. 8 (June 5, 2020): 787–800. http://dx.doi.org/10.1177/0009922820920013.
Full textAbstract:
This study evaluates the impact of a 6-month care management intervention for 206 children diagnosed with comorbid attention deficit hyperactivity disorder (ADHD) from a sample of 321 five- to 12-year-old children recruited for treatment of behavior problems in 8 pediatric primary care offices. Practices were cluster-randomized to Doctor Office Collaboration Care (DOCC) or Enhanced Usual Care (EUC). Chart reviews documented higher rates of service delivery, prescription of medication for ADHD, and titration in DOCC (vs EUC). Based on complex conditional models, DOCC showed greater acute improvement in individualized ADHD treatment goals and follow-up improvements in quality of life and ADHD and oppositional defiant disorder goals. Medication use had a significant effect on acute and follow-up ADHD symptom reduction and quality of life. Medication continuity was associated with some long-term gains. A collaborative care intervention for behavior problems that incorporated treatment guidelines for ADHD in primary care was more effective than psychoeducation and facilitated referral to community treatment.
41
Akyıldız, Fulya. "Citizen Participation in Local Government Services: İzmir Metropolitan Municipality Example." European Journal of Multidisciplinary Studies 6, no. 2 (June 10, 2017): 323. http://dx.doi.org/10.26417/ejms.v6i2.p323-323.
Full textAbstract:
The aim of this study is to demonstrate citizen participation in local government services in Turkey, for example in İzmir Metropolitan Municipality. In accordance with the amendments made in the Municipal Law and the Special Provincial Administration Law in 2005, the Regulations published by the Ministry of Interior in 2006 opened the way for citizen participation in the execution of public services in local governments. Despite the past decade, citizen participation in local services is still in its infancy, with few exceptions today. Programs that include citizen participation in İzmir Metropolitan Municipality which is one of these exceptions are analyzed with this study and it is presented as an example to other local administrations. A reason for the selection of a metropolitan municipality within the scope of the study is that the metropolitan municipalities of 30 provinces, which are metropolitan with an amendment made in Law No. 6360 in 2012, are responsible for providing services on the provincial property boundary. In spite of the increased service obligation and responsibility of the metropolitan municipalities, the cost of services has also increased, and at the extreme, it seems difficult to take local services effectively and efficiently. The study suggests that the metropolitan municipalities should make widespread use of this method in the welfare services that affect people's daily life and quality of life. Citizen participation in services has a critical prescription for the success of local programs and for institutional performance. In the study, voluntary participation in local services is linked to the New Public Service (NPS) approach within the framework of democracy, citizen participation and democratic governance concepts. Among public service delivery and distribution methods is very important, and although the New Public Management approach is an alternative model to privatization practices, the citizen participation in public services has been underestimated in Turkey. This study aiming to fill this gap aims to attract the attention of the academic field to this topic and to give new ideas to the local politicians and practitioners. In this context, first of all, the issue of NPS approach and citizen participation in the services is discussed. Later, information on citizen participation in local government services in Turkey is given and the existing applications of the Izmir Metropolitan Municipality are examined. Following the presentation of the findings and suggestions, a general evaluation is made and the study is terminated.
42
Hung, Chien-Ching, Sumita Banerjee, Ishwar Gilada, Kimberly Green, Yoji Inoue, Adeeba Kamarulzaman, Kate Leyritana, et al. "Impact of COVID-19 on the HIV care continuum in Asia: Insights from people living with HIV, key populations, and HIV healthcare providers." PLOS ONE 17, no. 7 (July 20, 2022): e0270831. http://dx.doi.org/10.1371/journal.pone.0270831.
Full textAbstract:
Background The COVID-19 pandemic has threatened continued access to public health services worldwide, including HIV prevention and care. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV service access and delivery in the Asia region. Methods A descriptive, cross-sectional, online study, conducted between October-November 2020, assessed the impact of COVID-19 on HIV prevention and care among people living with HIV (PLHIV), key populations (KPs), and healthcare providers (HCPs). The study populations were recruited across ten Asian countries/territories, covering Hong Kong, India, Japan, Malaysia, Philippines, Singapore, Korea, Taiwan, Thailand, and Vietnam. Results Across the region, 702 PLHIV, 551 KPs, and 145 HCPs were recruited. Both PLHIV and KPs reported decreased or had yet to visit hospitals/clinics (PLHIV: 35.9%; KPs: 57.5%), reduced HIV RNA viral load testing (21.9%; 47.3%), and interruptions in antiretroviral therapy (ART) (22.3%) or decreased/complete stop of HIV prevention medication consumption (40.9%). Travel constraints (40.6%), financial issues (28.9%), and not receiving prescription refills (26.9%) were common reasons for interrupted ART access, whereas reduced engagements in behaviours that could increase the risks of HIV acquisition and transmission (57.7%), travel constraints (41.8%), and less hospital/clinic visits (36.7%) underlie the disruptions in HIV preventive medications. Decreased visits from PLHIV/KPs and rescheduled appointments due to clinic closure were respectively reported by 50.7%-52.1% and 15.6%-17.0% of HCPs; 43.6%-61.9% observed decreased ART/preventive medication refills. Although 85.0% of HCPs adopted telemedicine to deliver HIV care services, 56.4%-64.1% of PLHIV/KPs were not using telehealth services. Conclusions The COVID-19 pandemic substantially disrupted HIV prevention to care continuum in Asia at the time of the study. The findings highlighted differences in HIV prevention to care continuum via telehealth services utilisation by PLHIV, KPs, and HCPs. Efforts are needed to optimise infrastructure and adapt systems for continued HIV care with minimal disruptions during health emergency crises.
43
Astley, Carolyn M., Isuru Ranasinghe, David Brieger, Chris J. Ellis, Julie Redfern, Tom Briffa, Bernadette Aliprandi-Costa, et al. "Expertise and infrastructure capacity impacts acute coronary syndrome outcomes." Australian Health Review 42, no. 3 (2018): 277. http://dx.doi.org/10.1071/ah16244.
Full textAbstract:
Objective Effective translation of evidence to practice may depend on systems of care characteristics within the health service. The present study evaluated associations between hospital expertise and infrastructure capacity and acute coronary syndrome (ACS) care as part of the SNAPSHOT ACS registry. Methods A survey collected hospital systems and process data and our analysis developed a score to assess hospital infrastructure and expertise capacity. Patient-level data from a registry of 4387 suspected ACS patients enrolled over a 2-week period were used and associations with guideline care and in-hospital and 6-, 12- and 18-month outcomes were measured. Results Of 375 participating hospitals, 348 (92.8%) were included in the analysis. Higher expertise was associated with increased coronary angiograms (440/1329; 33.1%), 580/1656 (35.0%) and 609/1402 (43.4%) for low, intermediate and high expertise capacity respectively; P < 0.001) and the prescription of guideline therapies observed a tendency for an association with (531/1329 (40.0%), 733/1656 (44.3%) and 603/1402 (43.0%) for low, intermediate and high expertise capacity respectively; P = 0.056), but not rehabilitation (474/1329 (35.7%), 603/1656 (36.4%) and 535/1402 (38.2%) for low, intermediate and high expertise capacity respectively; P = 0.377). Higher expertise capacity was associated with a lower incidence of major adverse events (152/1329 (11.4%), 142/1656 (8.6%) and 149/149 (10.6%) for low, intermediate and high expertise capacity respectively; P = 0.026), as well as adjusted mortality within 18 months (low vs intermediate expertise capacity: odds ratio (OR) 0.79, 95% confidence interval (CI) 0.58–1.08, P = 0.153; intermediate vs high expertise capacity: OR 0.64, 95% CI 0.48–0.86, P = 0.003). Conclusions Both higher-level expertise in decision making and infrastructure capacity are associated with improved evidence translation and survival over 18 months of an ACS event and have clear healthcare design and policy implications. What is known about the topic? There are comprehensive guidelines for treating ACS patients, but Australia and New Zealand registry data reveal substantial gaps in delivery of best practice care across metropolitan, regional, rural and remote health services, raising questions of equity of access and outcome. Greater mortality and morbidity gains can be achieved by increasing the application of current evidence-based therapies than by developing new therapy innovations. Health service system characteristics may be barriers or enablers to the delivery of best practice care and need to be identified and evaluated for correlations with performance indicators and outcomes in order to improve health service design. What does this paper add? This study measures two system characteristics, namely expertise and infrastructure, evaluating the relationship with ACS guideline application and clinical outcomes in a large and diverse cohort of Australian and New Zealand hospitals. The study identifies decision-making expertise and infrastructure capacity, to a lesser degree, as enabling characteristics to help improve patient outcomes. What are the implications for practitioners? In the design of health services to improve access and equity, expertise must be preserved. However, it is difficult to have experienced personnel at the bedside no matter where the health service, and engineering innovative systems and processes of care to facilitate delivery of expertise should be considered.
44
Henson, Katherine E., Rachael Brock, Brian Shand, Victoria H. Coupland, Lucy Elliss-Brookes, Georgios Lyratzopoulos, Philip Godfrey, et al. "Cohort profile: prescriptions dispensed in the community linked to the national cancer registry in England." BMJ Open 8, no. 7 (July 2018): e020980. http://dx.doi.org/10.1136/bmjopen-2017-020980.
Full textAbstract:
PurposeThe linked prescriptions cancer registry data resource was set up to extend our understanding of the pathway for patients with cancer past secondary care into the community, to ultimately improve patient outcomes.ParticipantsThe linked prescriptions cancer registry data resource is currently available for April to July 2015, for all patients diagnosed with cancer in England with a dispensed prescription in that time frame.The dispensed prescriptions data are collected by National Health Service (NHS) Prescription Services, and the cancer registry data are processed by Public Health England. All data are routine healthcare data, used for secondary purposes, linked using a pseudonymised version of the patient’s NHS number and date of birth.Detailed demographic and clinical information on the type of cancer diagnosed and treatment is collected by the cancer registry. The dispensed prescriptions data contain basic demographic information, geography measures of the dispensed prescription, drug information (quantity, strength and presentation), cost of the drug and the date that the dispensed prescription was submitted to NHS Business Services Authority.Findings to dateFindings include a study of end of life prescribing in the community among patients with cancer, an investigation of repeat prescriptions to derive measures of prior morbidity status in patients with cancer and studies of prescription activity surrounding the date of cancer diagnosis.Future plansThis English linked resource could be used for cancer epidemiological studies of diagnostic pathways, health outcomes and inequalities; to establish primary care comorbidity indices and for guideline concordance studies of treatment, particularly hormonal therapy, as a major treatment modality for breast and prostate cancer which has been largely delivered in the community setting for a number of years.
45
Baker, Jannah, Helena Britt, and Christopher Harrison. "GP services in Australia: presentation profiles during usual practice hours and after-hours periods." Australian Journal of Primary Health 26, no. 2 (2020): 117. http://dx.doi.org/10.1071/py19169.
Full textAbstract:
After-hours general practitioner (GP) services can reduce emergency department demand, which is currently increasing in Australia. Understanding GP after-hours care may assist in service planning. From April 2014 to March 2015, 986 GPs recorded 38275 consultations with start and finish times in the Bettering the Evaluation and Care of Health (BEACH) study, a national, cross-sectional, representative study of GP activity. GP and patient characteristics and the content of encounters in usual-hours and after-hours were compared. Significantly more after-hours than usual-hours encounters were with: GPs aged 60+ years; in metropolitan practices; and practices with 10+ GPs. Patients seen after-hours were more often: male; aged 15–64 years; new to practice; and less likely to hold a Commonwealth Concession Card. They were more likely to be prescribed antibiotics and less likely to: have chronic problems managed; be referred; receive psycholeptic or psychoanaleptic prescription; and undergo a procedure. Throat symptoms, fever and injury were more common reasons for encounter, while infections and injury were more frequently managed problems after-hours. The patient mix, GP characteristics, problems managed and management actions in after-hours care differ from those in usual-hours care in Australia. This greater understanding of after-hours care is the first step to informed resource allocation to improve the delivery of after-hours primary care.
46
Paanakker, Hester L. "Values of Public Craftsmanship: The Mismatch Between Street-Level Ideals and Institutional Facilitation in the Prison Sector." American Review of Public Administration 49, no. 8 (July 4, 2019): 884–96. http://dx.doi.org/10.1177/0275074019859944.
Full textAbstract:
Public craftsmanship, as the normative prescription of a myriad of public values, is receiving renewed attention. This study aims at empirical insight into how such abstract principles acquire practical meaning in specific professional settings, and how they are practically facilitated on the shop floor. We use an explorative case study among Dutch prison professionals ( N = 32) to contrast perceptions of ideal values and practices with perceptions of institutional facilitation at street level. In the case of prison officers, the institutional context of the prison was found to substantially restrain rather than support the ideals that professionals attach to good street-level craftsmanship. The study’s theoretical contribution is to show craftsmanship as uniquely localizing the normative underpinnings of good work. Empirically, the findings show how an unyielding neoliberalist administrative practice can hamper the potential of public craftsmanship and is likely to have negative impact on staff commitment and successful public service delivery. We end with implications for the further examination and development of public craftsmanship in public administration theory and practice.
47
Rawlinson, C., E. Hardaker, and A. Philpot. "Evaluating the impact of clinical screening by a hospital pharmacy team on the homecare prescription service." International Journal of Pharmacy Practice 30, Supplement_2 (November 30, 2022): ii42—ii43. http://dx.doi.org/10.1093/ijpp/riac089.050.
Full textAbstract:
Abstract Introduction The homecare prescription service delivers medicines initiated by hospital prescribers directly to patients. The Trust utilises homecare services for approximately 4,000 patients spanning a range of specialities. Historically, homecare prescriptions were directly sent to the homecare company by clinicians and hospital pharmacy received payment invoices. In response to published professional standards for homecare1, the hospital pharmacy clinical screening process was introduced to ensure the safe use of medicines and to reduce wastage. Aim To evaluate the impact on pharmacy clinical screening on the homecare prescription service by: Identifying query types and measuring the error rate; and, measuring query resolution times and the delay in prescription processing. Methods The data collection was conducted over a 6-month period commencing November 2021 at a teaching NHS Trust. The sample included 100% of homecare prescriptions received by the hospital pharmacy department. Pharmacy technicians involved in the processing of payment invoices recorded the number of received prescriptions. During the clinical screening process, pharmacists involved in the identification of queries or errors relating to homecare prescription documented the presenting issue, any action taken, and the outcome on a purposefully created data collection form. The data was entered into Excel and analysed descriptively. This service evaluation did not require ethical approval. Results In total, 4,580 homecare prescriptions were clinically screened by the pharmacy team. Most prescriptions had no issues; 2.5% (n=114) had a query raised. Of these queries, 47% (n=54) necessitated clarification from prescribers without subsequent prescription amendments; 14% (n=16) required new blood tests; 13% (n=15) required prescription amendments; 8% (n=9) resulted in prescriptions being returned and not reissued; and 18% (n=20) had no documented outcome. A lack of recent in-range blood test results accounted for 39% (n=45) of queries. Data were collected during the Covid-19 pandemic, potentially impacting on patients’ ability to obtain blood tests every 3-6 months, depending on indication, to comply with Trust policy.2 Dosage enquiries accounted for 26% (n=30) of queries; most arose from discrepancies between the prescription and the most recent clinic letter. The prescribing error rate was low: 1% (n=40) of prescriptions had an error identified during the evaluation. Time from clinical screening to resolution of the raised issue was documented on 82% of (n=93) forms. Of these queries, 50% (n=46) were resolved within 3 working days, 45% (n=42) took up to 14 days, and 5% (n=5) over 14 days. Discussion/Conclusion The introduction of hospital pharmacy clinical screening of homecare prescriptions reduced prescription errors and increased safety of the service by ensuring patients had required monitoring and appropriate medicine doses. However, the project identified that clinical screening added additional processing time for those prescriptions with discrepancies, therefore potentially leading to delays in patients receiving their medications. Further work is planned to improve clarity of clinical letters and create a more robust process in achieving timely query resolutions. The main strength of the project was the relatively large sample size and prolonged data collection period. Limitations included accuracy of the recorded data on the enquiry forms for data analysis. References 1. Royal Pharmaceutical Society (RPS). Professional Standards for Homecare Services in England. [internet] Royal Pharmaceutical Society; 2013 [cited 2022 May 20]. Available from: https://www.rpharms.com/Portals/0/RPS%20document%20library/Open%20access/Professional%20standards/Professional%20standards%20for%20Homecare%20services/homecare-standards-final-sept-13.pdf 2. Hull University Teaching Hospitals NHS Trust. SOP 16.2-Management of low and medium tech homecare paper prescriptions. Hull; Hull University Teaching Hospitals NHS Trust; 2022 [cited 2022 May 20].
48
Ansell, Jack E., Marissa L. Buttaro, Orsula Voltis Thomas, and Calvin H. Knowlton. "Consensus Guidelines for Coordinated Outpatient Oral Anticoagulation Therapy Management." Annals of Pharmacotherapy 31, no. 5 (May 1997): 604–15. http://dx.doi.org/10.1177/106002809703100516.
Full textAbstract:
OBJECTIVE: TO provide primary and referring healthcare practitioners with guidelines for the provision of safe and effective anticoagulation management in any venue to standardize and improve quality of care and to permit negotiation for reimbursement from third-party payers. DATA EXTRACTION AND SYNTHESIS: Data on the current practice of anticoagulation providers and outcomes related to anticoagulation clinic care were obtained through the literature, interviews with anticoagulation providers, and a focus group meeting of anticoagulation clinic stakeholders. This information collation process revealed that an anticoagulation service consists of three separate areas for which guidelines should be developed. Based on the consensus opinions of the committee members, the literature review, and the current practice of anticoagulation services providers, a draft guideline was developed and reviewed by an independent multidisciplinary panel of anticoagulation services providers whose comments were incorporated into the final guideline. CONCLUSIONS: Systematic outpatient anticoagulation services are systems of care designed to coordinate and optimize the delivery of anticoagulation therapy by (1) evaluating patient-specific risks and benefits to determine the appropriateness of therapy; (2) facilitating the management of anticoagulation dosages and prescription pick up or delivery; (3) providing ongoing education of the patient and other caregivers about warfarin and the importance of self-care behavior leading to optimal outcomes; (4) providing continuous systematic monitoring of patients, international normalized ratio results, diet, concomitant drug therapy, and disease states; and (5) communicating with other healthcare practitioners involved in the care of the patient. To create a reproducible framework for the provision of these services, guidelines for structure, process, and outcomes of coordinated outpatient anticoagulation management services were developed. Guidelines for organization and management include (1) qualifications for personnel, (2) supervision, (3) care management and coordination, (4) communication and documentation, and (5) laboratory monitoring. Guidelines for the process of patient care include (6) patient selection and assessment, (7) initiation of therapy, (8) maintenance and management of therapy, (9) patient education, and (10) management and triage of therapy-related and unrelated problems. Guidelines for the evaluation of patient outcomes include (11) organizational components and (12) patient outcomes. The impact of these 12 guidelines on patient care and reimbursement procurement will depend on their implementation and the perceived value of their use.
49
Lazarou, Mattea, Lisa Fitzgerald, Melissa Warner, Sandra Downing, Owain D. Williams, Charles F. Gilks, Darren Russell, and Judith A. Dean. "Australian interdisciplinary healthcare providers' perspectives on the effects of broader pre-exposure prophylaxis (PrEP) access on uptake and service delivery: a qualitative study." Sexual Health 17, no. 6 (2020): 485. http://dx.doi.org/10.1071/sh20156.
Full textAbstract:
Background The addition of pre-exposure prophylaxis (PrEP) for HIV prevention to the Australian Government-subsidised Pharmaceutical Benefits Scheme (PBS) enables any doctor or nurse practitioner to prescribe it and has increased accessibility options. However, understanding of Australian healthcare providers’ (HCP) knowledge and preparedness to prescribe PrEP remains limited. Methods: Semistructured interviews, conducted before PBS listing (October 2016–April 2017), explored PrEP knowledge and prescription experiences of 51 multidisciplinary HCPs involved with the Queensland Pre-Exposure Prophylaxis Demonstration study. Results: Thematic analysis revealed that participants viewed PrEP as a necessary HIV prevention option, but there was concern about confusing prevention messages and potential risk compensation. Clinical capacity, stigma, cultural norms, rural access and PrEP-associated costs were identified as barriers to access and uptake. Some of these barriers may be addressed by the PBS listing; nonetheless, there was strong specialist concern about the preparedness of general practitioners without sexual health experience to prescribe PrEP. Participants identified a need to educate all HCPs, implement multidisciplinary supply models and provide timely access to PrEP for vulnerable populations and those ineligible for Medicare (Australia’s universal healthcare insurance system). Conclusions: Although PrEP listing on the PBS addressed structural barriers to access, this study highlights the role of nurses and other interdisciplinary healthcare workers in the provision of PrEP in addressing the sociocultural barriers that still affect the access of certain populations to HIV prevention measures. These findings will inform further professional training as PrEP is more widely accessed and requested outside specialist sexual health services. Future work is needed to ensure that the primary healthcare workforce is prepared to provide competent and safe access to PrEP across diverse locations and population groups.
50
Ryabokin, N. O., and Y. M. Shatkovsky. "The concept of instruction, its communicative tasks." Bulletin of Luhansk Taras Shevchenko National University, no. 4 (335) (2020): 27–37. http://dx.doi.org/10.12958/2227-2844-2020-4(335)-27-37.
Full textAbstract:
This article deals with the concept of instructions, its types and communication tasks. It was found that the instruction can be characterized as an official business document of technical content and its design at all levels has a high degree of standardization, which ensures the economy in writing and perception of this text. The instructional discourse is investigated and its features are determined: the presence of different speech genres, in particular, the operation manual, the memo, the user manual, the prescription, the service directive; certain speech tactics, namely, informing, shifting responsibility, prompted to action; minimal change in communicative roles. Analyzed four standard types of instructions: 1) instructions for goods (household appliances, food, vehicles, etc.); 2) annotation to medicines; 3) departmental instructions (rules for filling out documents, customer behavior: customs declaration, fire instructions, etc.) 4) job description (rules of behavior for employees in a certain position) and six new types were added: audio / video instructions, interactive instructions, pop-up hints, hypertext knowledge base, hypertext online resource, electronic document. It was also found that the communicative tasks of the instructions are the message of information and the prescription of actions and for the design of the texts of the instructions of the product the optimal system of language means. It was determined that the compositional structure of the text of a typical instruction contains, as a rule, the following sections: introduction, general information, technical data, delivery set, safety requirements, the procedure for installing and preparing the product for work, the procedure for operating the product, product care, maintenance, rules storage and transportation, possible malfunctions and methods of their elimination, warranty obligations.