scholarly journals Opinions and preferences of British Columbia pharmacists and physicians on medication management services

2016 ◽  
Vol 150 (1) ◽  
pp. 42-51 ◽  
Author(s):  
Nicole W. Tsao ◽  
Amir Khakban ◽  
Louise Gastonguay ◽  
Zafar Zafari ◽  
Larry D. Lynd ◽  
...  

Background: Medication management (MM) services are being provided by pharmacists across Canada in various forms, but pharmacist-physician collaboration is still not a routine practice in most jurisdictions. This survey aimed to gather pharmacists’ and physicians’ opinions and preferences for MM provision. Methods: Two parallel, cross-sectional online surveys, including best-worst scaling tasks, were designed for pharmacists and physicians in British Columbia to capture and compare their preferences for a number of attributes of MM. Results: Surveys were completed by 119 pharmacists and 146 physicians. Results indicate that pharmacists and physicians had similar opinions on many aspects of MM. Ninety-five percent of pharmacists and 69% of physicians believed that additional health services are needed to help patients optimize the use of their medications. However, the majority of each group felt that they were the most important health care professional in providing this service. Most pharmacists (79%) and some physicians (25%) thought that optimizing use of medications would result in both decreased costs and utilization to the health care system. Both pharmacists and physicians felt that the best attribute of an MM service would be if the services resulted in improved health and medication use for patients. Both groups were motivated by increased remuneration for MM; however, the relative strength of preference for this was higher among physicians. Interestingly, physicians valued improved medication adherence as a result of MM more highly than pharmacists did. Discussion and Conclusion: Most pharmacists and physicians agreed that improving patients’ health and medication use would be the best attribute of MM and that there is a need for such services. However, physicians also had strong preferences for being remunerated for participating in MM provision.


2021 ◽  
Vol 16 (2) ◽  
Author(s):  
Gina Gaspard ◽  
Carrie Gadsby ◽  
Cindy Preston

Polypharmacy is the administration of more medications than clinically required or appropriate, and it can negatively impact wellness. Prescribers, pharmacists, nurses, and those receiving care services all have an important role to play in promoting healthy medication use and minimizing the risk related to polypharmacy. Medication management involves health care professionals regularly reviewing drug therapies with patients for any needed changes. This strategy is a key way to reduce the harms of polypharmacy. A review of the First Nations Health Authority Health Benefits Claims data in 2015 confirmed that polypharmacy is an issue for First Nations in British Columbia, Canada. This was further validated in a series of meetings held in four First Nations communities. The learnings from these meetings were that many people do not know the names of their medications, the reasons for taking them, or how to advocate for themselves during health care interactions. A unique strategy was needed to both encourage and empower First Nations and Indigenous people to discuss managing their medications, and to support health care professionals to better understand how to engage First Nations patients about their medications.



Author(s):  
Paulo Celso Prado Telles Filho ◽  
Tatiana Longo Borges ◽  
Assis do Carmo Pereira ◽  
Kelly Graziani Giacchero Vedana ◽  
Rebecca O. Shasanmi ◽  
...  


2015 ◽  
Vol 14 (3) ◽  
pp. 280-285
Author(s):  
Ashok Kumar Srivastava ◽  
Surekha Kishore ◽  
Preeti Padda

Background: Health inequity is becoming an emerging issue all over the world. Improving maternal health is one of the UN Millennium Development goals. Pregnant women inhabiting urban slums are a “high risk” group with limited access to health facility. Objective: To study the socio economic profile of the mothers and to study the differentials in utilization of maternal health care by the beneficiaries. Study Design: Descriptive, observational cross-sectional field based study in two purposively selected urban slums of district Dehradun. Results: About 70.9% of mothers belonged to social class II and III and 66% of them belonged to nuclear families. Teenage pregnancy was seen in 8.5%. 93.8% of women received complete antenatal care, majority preferring government hospitals. 93.2% of the women received 100 IFA tablets or more but only 63.7% consumed them for 100 days. Majority of the deliveries were institutional and 79.9% were conducted by trained personnel. About 68.5 % received postnatal care. Conclusion: Although usage of ANC service was high, opportunity to deliver important health services was not fully utilized. Policy and programme to improve the quality and care of antenatal mothers, especially for the poor and under privileged are essential to improve maternal health care. Special interventions should be undertaken on priority basis so as to achieve millennium developmental goals in all population groups.Bangladesh Journal of Medical Science Vol.14(3) 2015 p.280-285



2020 ◽  
Vol 73 (2) ◽  
Author(s):  
Amélie Chabrier ◽  
Pauline Rault ◽  
Suzanne Atkinson ◽  
Jean-François Bussières

RÉSUMÉContexte : En établissement de santé, le circuit du médicament est complexe, puisqu’il compte plus de 50 étapes. Pour évaluer la conformité du circuit du médicament de notre établissement, nous avons mis en place un processus annuel d’audit.Objectifs : L’objectif principal vise à décrire la conformité de certaines étapes du circuit du medicament (principalement la gestion des médicaments) aux unités de soins et dans les cliniques externes d’un centre hospitalier universitaire mère-enfant. L’objectif secondaire consiste à comparer les résultats à ceux des audits précédents.Méthodes : Il s’agit d’une étude descriptive observationnelle transversal réalisée à l’été 2018 dans les unités de soins (n = 34) et les cliniques externes (n = 28) de l’établissement. Les données ont été recueillies à partir d’une grille d’audit.Résultats : En 2018, le taux de conformité de l’ensemble des unités de soins aux critères mentionnés dans la grille d’audit variait de 32 % à 100 %. Par rapport à l’année précédente, le taux de conformité à 30 critères est demeuré inchangé et celui à quatre critères s’est détérioré. La conformité à 35 % des critères (12/34) était totale à plus de 85 %. En 2018, le taux de conformité de l’ensemble des cliniques externes aux critères mentionnés dans la grille d’audit variait de 0 % à 100 %. Le taux de conformité à un critère s’est amélioré, celui à 21 critères est demeuré inchangé et celui à deux critères s’est détérioré. La conformité à 32 % des critères (9/28) était totale à plus de 85 %. Trente-cinq recommandations ont été formulées au comité pharmacie-soins infirmiers et un rapport personnalisé a été transmis aux gestionnaires.Conclusions : Cette étude descriptive observationnelle transversale décrit le degré de conformité du circuit du médicament relatif à la gestion des médicaments, principalement dans les unités de soins et les cliniques externes. Cette démarche originale à l’initiative du Département de pharmacie a abouti à la formulation de 35 recommandations au comité pharmacie-soins infirmiers, ce qui a permis d’améliorer la sécurité du circuit du médicament dans les unités de soins et les cliniques externes. ABSTRACTBackground: In the hospital setting, the medication-use system is complex, having more than 50 steps. To assess the compliance of the study organization’s medication-use system with established criteria, an annual audit process was developed.Objectives: The primary objective was to describe the compliance of certain steps in the medication-use system (mainly medication management) in care units and outpatient clinics of a mother and child university hospital centre. The secondary objective was to compare the current results with those of previous audits.Methods:This cross-sectional descriptive observational study was carried out in summer 2018 in patient care units (n = 34) and outpatient clinics (n = 28) of the study hospital. Data were collected according to an audit matrix.Results: In 2018, the rate of compliance with audit criteria varied between 32% and 100% for the patient care units. Relative to the previous year, the compliance rate remained unchanged for 30 criteria and worsened for 4 criteria. For 35% of the criteria (12/34), compliance was greater than 85%. In 2018, the rate of compliance with audit criteria varied between 0% and 100% for the outpatient clinics. The compliance rate increased for one criterion, remained unchanged for 21 criteria, and worsened for 2 criteria. For 32% of the criteria (9/28), compliance was more than 85%. Thirty-five recommendations were made to the pharmacy and nursing care committee, and a personalized report was sent to managers.Conclusions:This cross-sectional descriptive observational study reports the degree to which the medication-use system complies with medication management criteria, mainly in patient care units and outpatients’ clinics. This original approach from the Pharmacy Department led to the formulation of 35 recommendations to the pharmacy and nursing care committee, which helped to improve the safety of the medication-use system in patient care units and outpatient clinics.



2017 ◽  
Author(s):  
Karla Lancaster ◽  
Aseel Abuzour ◽  
Manmeet Khaira ◽  
Annalise Mathers ◽  
April Chan ◽  
...  

BACKGROUND Electronic health (eHealth) tools are becoming increasingly popular for helping patients’ self-manage chronic conditions. Little research, however, has examined the effect of patients using eHealth tools to self-report their medication management and use. Similarly, there is little evidence showing how eHealth tools might prompt patients and health care providers to make appropriate changes to medication use. OBJECTIVE The objective of this systematic review was to determine the impact of patients’ use of eHealth tools on self-reporting adverse effects and symptoms that promote changes to medication use. Related secondary outcomes were also evaluated. METHODS MEDLINE, EMBASE, and CINAHL were searched from January 1, 2000, to April 25, 2018. Reference lists of relevant systematic reviews and included articles from the literature search were also screened to identify relevant studies. Title, abstract, and full-text review as well as data extraction and risk of bias assessment were performed independently by 2 reviewers. Due to high heterogeneity, results were not meta-analyzed and instead presented as a narrative synthesis. RESULTS A total of 14 studies, including 13 randomized controlled trials (RCTs) and 1 open-label intervention, were included, from which 11 unique eHealth tools were identified. In addition, 14 RCTs found statistically significant increases in positive medication changes as a result of using eHealth tools, as did the single open-label study. Moreover, 8 RCTs found improvement in patient symptoms following eHealth tool use, especially in adolescent asthma patients. Furthermore, 3 RCTs showed that eHealth tools might improve patient self-efficacy and self-management of chronic disease. Little or no evidence was found to support the effectiveness of eHealth tools at improving medication recommendations and reconciliation by clinicians, medication-use behavior, health service utilization, adverse effects, quality of life, or patient satisfaction. eHealth tools with multifaceted functionalities and those allowing direct patient-provider communication may be more effective at improving patient self-management and self-efficacy. CONCLUSIONS Evidence suggests that the use of eHealth tools may improve patient symptoms and lead to medication changes. Patients generally found eHealth tools useful in improving communication with health care providers. Moreover, health-related outcomes among frequent eHealth tool users improved in comparison with individuals who did not use eHealth tools frequently. Implementation issues such as poor patient engagement and poor clinician workflow integration were identified. More high-quality research is needed to explore how eHealth tools can be used to effectively manage use of medications to improve medication management and patient outcomes.



2013 ◽  
Vol 21 (3) ◽  
pp. 309-318 ◽  
Author(s):  
Cormac G. Ryan ◽  
Patricia Schofield ◽  
Denis J. Martin

Negative views of older adults can lead to suboptimal care. For older adults with persistent low back pain (LBP), promotion of physical activity by health care professionals is important. Health care professionals’ views of older adults are influenced by their training. This study aimed to compare recommendations for physical activity for managing persistent LBP offered by students in physiotherapy and occupational therapy to an older person vs. a younger person. In a cross-sectional online survey, participants (N = 77) randomly received a vignette of either a 40-yr-old or 70-yr-old patient with persistent LBP. Other than age, the vignettes were identical. There was no difference between the younger and older vignettes in the likelihood of participants making overall appropriate physical activity recommendations—63% vs. 59%, OR (95%CI) = 1.19 (0.48–2.99), p = .71—although there was a trend toward age bias on recommendations specific to daily activity. Postqualification education may be where ageist views need to be addressed.



Author(s):  
Caspar C. Berghout ◽  
Jolien Zevalkink ◽  
Abraham N. J. Pieters ◽  
Gregory J. Meyer

In this study we used a quasiexperimental, cross-sectional design with six cohorts differing in phase of treatment (pretreatment, posttreatment, 2-year posttreatment) and treatment type (psychoanalysis and psychoanalytic psychotherapy) and investigated scores on 39 Rorschach-CS variables. The total sample consisted of 176 participants from four mental health care organizations in The Netherlands. We first examined pretreatment differences between patients entering psychoanalysis and patients entering psychoanalytic psychotherapy. The two treatment groups did not seem to differ substantially before treatment, with the exception of the level of ideational problems. Next, we studied the outcome of psychoanalysis and psychoanalytic psychotherapy by comparing the Rorschach-CS scores of the six groups of patients. In general, we found significant differences between pretreatment and posttreatment on a relatively small number of Rorschach-CS variables. More pre/post differences were found between the psychoanalytic psychotherapy groups than between the psychoanalysis groups. More research is needed to examine whether analyzing clusters of variables might reveal other results.



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