scholarly journals Evaluating the Utilisation of a Service Designed to Enhance Care with Medicines Following Acute Hospital Discharge: A Retrospective Study

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i42-i43
Author(s):  
F A Alqenae ◽  
D Steinke ◽  
R N Keers
Keyword(s):  
Community Pharmacy ◽  
Hospital Discharge ◽  
Home Delivery ◽  
World Health ◽  
Community Pharmacies ◽  
Medicines Reconciliation ◽  
Health Organization ◽  
Transfers Of Care ◽  
Care Improvement ◽  
Discharge From Hospital

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.

Prediabetes, undiagnosed diabetes and diabetes risk in Italy in 2017–2018: results from the first National screening campaign in community pharmacies

2021 ◽  
Author(s):  
P Brunetti ◽  
L Baldessin ◽  
S Pagliacci
Keyword(s):  
High Risk ◽  
Diabetes Risk ◽  
World Health ◽  
Undiagnosed Diabetes ◽  
Community Pharmacies ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Health Organization ◽  
Very High

Abstract Background Effective policies for diabetes prevention remain urgent. We conducted a mass screening campaign in Italy to identify subjects potentially having undiagnosed diabetes, prediabetes or at diabetes risk. Methods This cohort study was conducted in community pharmacies joining the unitary National federation of pharmacy holders (Federfarma) and participating in the 7-day screening campaign ‘DiaDay’ in 2017–2018. Capillary blood glucose levels and the risk of developing diabetes in 10 years (through the Finnish Diabetes Risk Score) were assessed. Results 145 651 volunteers aged ≥20 years without known diabetes were screened at 5671 community pharmacies in 2017 and 116 097 at 5112 in 2018. Overall, 3.6% had glucose values suggestive of undiagnosed diabetes; under fasting conditions (N = 94 076), 39.9% and 16.4% had values suggestive of prediabetes by the American Diabetes Association and the World Health Organization criteria, respectively. Of those without diabetes (N = 252 440), 19.2% had scores compatible with a high risk (1:3) and 2.7% with a very high risk (1:2) of developing the disease; in the prediabetes group, the risk rose with higher impaired fasting glucose values. Conclusions DiaDay, the first National screening campaign, highlights the need to screen the population and the key role of the pharmacist both in screening activities and education promotion.

scholarly journals Feeding newborns after hospital discharge from a Baby-Friendly Health Care Institution

2008 ◽  
Vol 21 (3) ◽  
pp. 439-443 ◽  
Author(s):  
Raquel Bosquim Zavanella Vivancos ◽  
Adriana Moraes Leite ◽  
Maria Cândida de Carvalho Furtado ◽  
Fernanda dos Santos Nogueira de Góes ◽  
Vanderlei José Haas ◽  
...  
Keyword(s):  
Health Care ◽  
Hospital Stay ◽  
Hospital Discharge ◽  
Health Care Institution ◽  
World Health ◽  
Sources Of Information ◽  
Secondary Sources ◽  
Care Institution ◽  
Skin Contact ◽  
Health Organization

OBJECTIVE: To characterize how babies are fed during their hospital stay and after hospital discharge from a Baby-Friendly Health Care Institution, using indicators proposed by the World Health Organization. METHODS: This investigation was performed 30 days after the binomial's discharge, through a telephone interview with the puerperal woman. Data from medical records constituted secondary sources of information. RESULTS: It was observed that, even though newborns had come from these institutions, some of them were weaned early from breastfeeding. CONCLUSION: Some factors were shown to be associated to weaning in the studied sample, such as the small percentage of binomials placed in skin-to-skin contact and early suction, mothers who smoked, the use of pacifiers and the use of dairy complements during the hospital stay.

scholarly journals Antibiotic consumption at community pharmacies: A multicenter repeated prevalence surveillance using WHO methodology

2021 ◽  
Vol 5 ◽  
pp. 239920262110647
Author(s):  
Zikria Saleem ◽  
Erwin Martinez Faller ◽  
Brian Godman ◽  
Muhammad Sajeel Ahmed Malik ◽  
Aqsa Iftikhar ◽  
...  
Keyword(s):  
Action Plan ◽  
Antibiotic Consumption ◽  
World Health ◽  
Resistant Bacteria ◽  
Published Data ◽  
Community Pharmacies ◽  
Prevalence Survey ◽  
Defined Daily Doses ◽  
Consumption Data ◽  
Health Organization

Background: Antibiotics are losing their effectiveness because of the rapid emergence of resistant bacteria. Unnecessary antimicrobial use increases antimicrobial resistance (AMR). There are currently no published data on antibiotic consumption in Pakistan at the community level. This is a concern given high levels of self-purchasing of antibiotics in Pakistan and variable knowledge regarding antibiotics and AMR among physicians and pharmacists. Objective: The objective of this repeated prevalence survey was to assess the pattern of antibiotic consumption data among different community pharmacies to provide a baseline for developing future pertinent initiatives. Methods: A multicenter repeated prevalence survey conducted among community pharmacies in Lahore, a metropolitan city with a population of approximately 10 million people, from October to December 2017 using the World Health Organization (WHO) methodology for a global program on surveillance of antimicrobial consumption. Results: The total number of defined daily doses (DDDs) dispensed per patient ranged from 0.1 to 50.0. In most cases, two DDDs per patient were dispensed from pharmacies. Co-amoxiclav was the most commonly dispensed antibiotic with a total number of DDDs at 1018.15. Co-amoxiclav was followed by ciprofloxacin with a total number of 486.6 DDDs and azithromycin with a total number of 472.66 DDDs. The least consumed antibiotics were cefadroxil, cefotaxime, amikacin, and ofloxacin, with overall consumption highest in December. Conclusion: The study indicated high antibiotic usage among community pharmacies in Lahore, Pakistan particularly broad-spectrum antibiotics, which were mostly dispensed inappropriately. The National action plan of Pakistan on AMR should be implemented by policymakers including restrictions on the dispensing of antimicrobials.

Providing Patient Care in Community Pharmacies: Practice and Research in Finland

2007 ◽  
Vol 41 (6) ◽  
pp. 1039-1046 ◽  
Author(s):  
J Simon Bell ◽  
Minna Väänänen ◽  
Harri Ovaskainen ◽  
Ulla Närhi ◽  
Marja S Airaksinen
Keyword(s):  
Community Pharmacy ◽  
Patient Care ◽  
Pharmacy Practice ◽  
Professional Associations ◽  
World Health ◽  
Electronic Prescribing ◽  
Community Pharmacies ◽  
University Departments ◽  
Medication Counseling

OBJECTIVE: To describe the provision of patient care in community pharmacies in Finland. FINDINGS: The network of 799 community pharmacies across Finland dispensed 42.1 million prescriptions in 2005. Medication counseling has been mandated by law since 1983 and only pharmacists are permitted to provide therapeutic advice in pharmacies. Measurable improvements in the rates of pharmacists' medication counseling have been observed since 2000. Long-term national pharmacy practice initiatives commenced with the World Health Organization EuroPharm Forum's Questions to Ask About Your Medicines campaign from 1993 to 1996. This was followed by the larger Customized Information for the Benefit of Community Pharmacy Patients project. Since the late 1990s, Finnish pharmacies have actively participated in ongoing national public health programs, initially in the areas of asthma and diabetes, and more recently in the treatment and prevention of heart disease. Automated dose dispensing and electronic prescribing are in the process of wider uptake and implementation. A nationwide multidisciplinary project to improve the use of drugs in older people has recently been announced and research in this area is underway. DISCUSSION: Research has focused on improving the quality of patient care as a strategic priority in community pharmacies. The development of community pharmacy services in Finland has been characterized by strong collaboration among the professional associations, university departments of social pharmacy, continuing education centers, and practicing pharmacists. CONCLUSIONS: Implementation of new patient care services has required long-term, systematic, and well coordinated actions at the local and national levels. Future services will seek to promote the quality use of medications and to ensure that rising costs do not limit uniform access to drugs by all Finnish residents.

Assessing community pharmacists’ involvement and clients’ opinion on HIV/AIDS services in community pharmacies in Nigeria: a cross-sectional survey

2021 ◽  
Vol 32 (6) ◽  
pp. 538-550
Author(s):  
Yejide O Oseni ◽  
Wilson O Erhun
Keyword(s):  
Community Pharmacy ◽  
Community Pharmacists ◽  
World Health ◽  
Community Pharmacies ◽  
Willingness To Participate ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Medication Therapy ◽  
Southwest Nigeria ◽  
Hiv Aids

The World Health Organization is promoting community-based services to end HIV/AIDS by 2030. In Nigeria, studies on community pharmacists’ involvement in HIV testing services (HTS) and antiretroviral (ARV) medication therapy management (MTM) are scarce, and no study had evaluated the clients’ opinion on community pharmacy HTS. We assessed the community pharmacists’ involvement in HIV/AIDS services and clients’ opinions of community pharmacy HTS. Semi-structured questionnaires on a five-point Likert scale were administered to 701 selected community pharmacists and 5840 clients in southwest Nigeria in 2019. Data were analyzed with descriptive and inferential statistics. Response rates were 68.6% and 69.8% for community pharmacists and clients, respectively. Only 18.5% of community pharmacists offered rapid HTS and 30% refills of ARV. The total score of their involvement on the HTS was 20.94 ± 17.521 (range 8–40; midpoint 24) and on ARV/MTM was 22.98 ± 19.61 (range 9–45; midpoint 27), while 91% were willing to participate in training. Barriers to integrating services into practice were lack of clinical tools (46.8%), lack of collaboration with other healthcare professionals (39.1%), and lack of training on HIV/AIDS services (36.2%) among others. Also, 77% of the clients were willing to participate in community pharmacy HTS, and about 83% of them responded that knowing their HIV status will help them to take necessary precautionary actions. Community pharmacists’ involvement in HIV/AIDS services was low. However, they showed willingness to participate in training to improve services. Also, clients were willing to receive community pharmacies HTS to know their status.

scholarly journals Continuity of care between hospital pharmacies and community pharmacies, and costs avoided: a pilot experience in times of COVID-19 in Spain

2021 ◽  
Vol 8 ◽  
pp. 8-13
Author(s):  
Néboa Zozaya ◽  
Almudena González-Domínguez ◽  
Natividad Calvente ◽  
Rita De la Plaza ◽  
Ana Herranz ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Continuity Of Care ◽  
Home Delivery ◽  
Community Pharmacies ◽  
Social Perspective ◽  
Time Saving ◽  
Good Opportunity ◽  
Productivity Losses ◽  
Hospital Pharmacies ◽  
Pilot Experience

Introduction: In March 2020, due to the pandemic caused by COVID-19, a pilot experience of pharmaceutical continuity of care received by hospital outpatients was launched in Cantabria, a Spanish autonomous community. Thanks to this experience, the medication was dispensed by the hospital pharmacy through the community pharmacy of the patient’s choice. Our objective was to estimate the costs avoided by this practice during the months of April and May 2020. Methods: The analysis of the economic impact was carried out in terms of saved costs, from the hospital and from the social perspective. Savings associated with the avoided home delivery of medication and avoided labor productivity losses were calculated, as well as the time associated with avoided trips in monetary terms. Results: A total of 2,249 hospital-dispensed drugs were delivered through the community pharmacy in the analyzed period, with an average of 57.7 daily deliveries. The experience, which involved one hospital and 262 pharmacies of Cantabria, saved patients 93,305 km in trips to the hospital, associated with an average time saving of 1,374 hours. In terms of costs, the hospital saved on shipments by courier, estimated at €30,205, since it was the community pharmacy and the distribution warehouses that delivered the drugs. From a social perspective, this initiative saved €23,309 due to the trips (€8,907) and productivity losses (€14,402) that were avoided. Conclusions: This exceptional situation may be a good opportunity to improve the coordination between hospital pharmacies and community pharmacies in Spain, not only during the pandemic but also in the post-COVID-19 era.

scholarly journals Evaluation of Prescription Pattern and Rational Prescribing in Eastern Nepal

2016 ◽  
Vol 5 (1) ◽  
pp. 32-36
Author(s):  
Kumud Chapagain ◽  
Rais Pokharel ◽  
Bhaskar Diwakar Paranjape
Keyword(s):  
Drug Use ◽  
Essential Medicine ◽  
World Health ◽  
Community Pharmacies ◽  
Prescribing Practices ◽  
Prescription Pattern ◽  
Essential Drug List ◽  
Rational Prescribing ◽  
Generic Prescribing ◽  
Health Organization

Background To promote rational prescribing and appropriate use of drugs, it is important to evaluate the prescription pattern using the World Health Organization (WHO) drug use indicators. The aim of this study was to evaluate the prescription patterns and rational prescribing at the private community pharmacies of Biratnagar, Eastern Nepal, using some of the WHO core drug use indicators.Material and Methods Five private community pharmacies were selected using systemic random sampling. Nine hundred patient encounters from these pharmacies were assessed prospectively for four months from September 2015–December 2015. Data was collected from each patient encounter and were recorded directly into a prescription indicator form.Results Average number of drugs prescribed per encounter was 2.14 (n=1930). Percentage of drugs prescribed by generic name and from essential drug list was 45.18% (n=872) and 76.11% (n=1469) respectively. Percentage of encounters in which antibiotic and injection was prescribed were 40.44% (n=364) and 3.44% (n=31) respectively.Conclusion Prescribing practices in Eastern Nepal are not up to the standards recommended by WHO. Drug use evaluation can help to ensure whether the antibiotics are appropriately prescribed or not. Poly-pharmacy, excessive use of antibiotics was quite common and concept of generic prescribing and National Essential Medicine List (NEML) was not appreciable. Standard guidelines should be recommended and strictly followed by the prescribers and National Formulary and NEML should be made available in every health institution. Physicians should be emphasized to prescribe medicines from NEML.Journal of Nobel Medical CollegeVolume 5, Number 1, Issue 8, January-July 2016, 32-36

scholarly journals Ibuprofen in the current practice of the pharmacist in the community pharmacy

2020 ◽  
Vol 13 (3) ◽  
pp. 115-120
Author(s):  
Paula Antonoaea ◽  
◽  
Nicoleta Todoran ◽  
Emőke Rédai ◽  
Robert Alexandru Vlad ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Current Practice ◽  
Legal Aspects ◽  
World Health ◽  
Medical Prescription ◽  
National Agency ◽  
Health Specialist ◽  
Gastrointestinal Side Effects ◽  
Inflammatory Drugs ◽  
Health Organization

The pharmacist from the community pharmacy plays a key role in the case of patients who seek directly for pathologies related to pain. Being a health specialist, he has the ability to offer pharmaceutical healthcare for drugs that need a medical prescription and also for the ones that are registered as OTC’s. Ibuprofen (IBU) is a part of the drug group called nonsteroidal anti-inflammatory drugs (NSAIDs) being registered in Romania under 17 pharmaceutical formulation by the National Agency of Drugs and Medical Devices. Due to its pharmacological profile which consists of a low risk of gastrointestinal side effects, IBU is an OTC recommended and frequently prescribed for decreasing the low and moderate pain. World Health Organization (WHO) indicates IBU as a drug that can be used to babies aged over three months. Through this paper, we try to analyze the pharmacist’s vision from the community pharmacy in IBU recommendation. In this paper were mentioned some legal aspects that are linked to the pharmacist competences, and also its approach regarding IBU recommendation during pregnancy and breastfeeding and also to children and to a category of patients who have various associated pathologies.

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