scholarly journals Can a long-term continuing education course in patient counselling promote a change in the practice of Finnish community pharmacists?

2003 ◽  
Vol 11 (3) ◽  
pp. 153-160 ◽  
Author(s):  
Heli Kansanaho ◽  
Kirsi Pietilä ◽  
Marja Airaksinen
2011 ◽  
Vol 106 (2) ◽  
pp. 175-182 ◽  
Author(s):  
Anita MacDonald ◽  
Kirsten Ahring ◽  
Katharina Dokoupil ◽  
Hulya Gokmen-Ozel ◽  
Anna Maria Lammardo ◽  
...  

The usual treatment for phenylketonuria (PKU) is a phenylalanine-restricted diet. Following this diet is challenging, and long-term adherence (and hence metabolic control) is commonly poor. Patients with PKU (usually, but not exclusively, with a relatively mild form of the disorder) who are responsive to treatment with pharmacological doses of tetrahydrobiopterin (BH4) have either lower concentrations of blood phenylalanine or improved dietary phenylalanine tolerance. The availability of a registered formulation of BH4 (sapropterin dihydrochloride, Kuvan®) has raised many practical issues and new questions in the dietary management of these patients. Initially, patients and carers must understand clearly the likely benefits (and limitations) of sapropterin therapy. A minority of patients who respond to sapropterin are able to discontinue the phenylalanine-restricted diet completely, while others are able to relax the diet to some extent. Care is required when altering the phenylalanine-restricted diet, as this may have unintended nutritional consequences and must be undertaken with caution. New clinical protocols are required for managing any dietary change while maintaining control of blood phenylalanine, ensuring adequate nutrition and preventing nutritional deficiencies, overweight or obesity. An accurate initial evaluation of pre-sapropterin phenylalanine tolerance is essential, and the desired outcome from treatment with sapropterin (e.g. reduction in blood phenylalanine or relaxation in diet) must also be understood by the patient and carers from the outset. Continuing education and support will be required thereafter, with further adjustment of diet and sapropterin dosage as a young patient grows.


1996 ◽  
Vol 16 (2) ◽  
pp. 21-30
Author(s):  
Mary Anne Hilker ◽  
Raymond T. Coward ◽  
Tiffany L. Hogan ◽  
Loree C. Francis-Felsen ◽  
R. Paul Duncan ◽  
...  

Author(s):  
Joan M. Brewster ◽  
Mary Jane Ashley ◽  
Claudine Laurier ◽  
Rachel Dioso ◽  
J. Charles Victor ◽  
...  

Background: Pharmacists can be effective in helping patients to quit smoking, and opportunities for such interaction have been facilitated by legislative change making nicotine replacement therapy (NRT) available without prescription in Canada. However, there are no previous studies of Canadian pharmacists' preparation for, perception of, or practices regarding their roles in smoking cessation. Methods: Practising community pharmacists in four Canadian provinces were surveyed about their tobacco-related education and knowledge, practice environment, perceptions of their roles and practices related to helping people quit smoking, and factors perceived to facilitate tobacco-related practice. Results: A corrected response rate of 72% was obtained, giving a weighted n of 960 responses. Most pharmacists reported good or excellent knowledge of the health effects of smoking and the use of NRT in smoking cessation. Fewer reported being knowledgeable about behavioural approaches to quitting smoking. Advising patients about NRT was seen as a more important role for pharmacists than giving patients pamphlets or behavioural counselling. Pharmacists' reported practices corresponded to their knowledge and judged importance of roles; pharmacists were not proactive in approaching patients about smoking, but when smokers were identified, pharmacists gave brief advice about the use of NRT. Respondents reported that their smoking cessation practice was facilitated by their own knowledge and skills, patients' interest in quitting, opportunities for patient interaction, and the support of pharmacy management for patient counselling. Conclusions: Improving pharmacist education in patient counselling and behavioural approaches to smoking cessation would help to develop skills in initiating discussions about smoking and would give pharmacists a wider range of options to help patients quit smoking.


2003 ◽  
Vol 43 (2) ◽  
pp. 259-271 ◽  
Author(s):  
S. Aylward ◽  
P. Stolee ◽  
N. Keat ◽  
V. Johncox

2016 ◽  
Vol 101 (9) ◽  
pp. e2.54-e2
Author(s):  
Jeff Aston ◽  
Keith Wilson ◽  
David Terry

AimTo identify the experiences of patients, parents or carers when a child/young person is prescribed a new long-term medicine.MethodPatients' prescribed a new long-term (>6 weeks) medicine were recruited from a single UK paediatric hospital out-patient pharmacy.A semi-structured questionnaire was administered to participants, via telephone, 6 weeks after the dispensing of their medicine. The questionnaire included the following themes: information requirements, resources used to seek further information, medicine administration issues, new concerns or questions that have arisen, adverse effects, arranging repeat supplies and an assessment of adherence.The results were analysed using Microsoft Excel 2013 and NVivo Version 10.ResultsFifty patients consented and were included in the study. Eighteen (36%) participants had undertaken further research prior to taking/administering their new medicine. 13 (72%) of these used the internet for further information. Participants had further concerns/questions in 18 (36%) cases with 7 (38.9%) contacting the hospital team for further advice. Thirteen (26%) participants experienced difficulty administering/taking the medicine. Sixteen (36%) believed that they had experienced an adverse effect. Eight (16%) participants experienced difficulties when obtaining further supplies. With regard to adherence, 17 (34%) participants had forgotten a dose on at least one occasion and 4 (8%) found it difficult to keep to the medication regimen.ConclusionThis research has demonstrated that paediatric patients, parents and carers experience a wide range of issues during the first few weeks after starting a new medicine. This is in accordance with a recent review of non-adherence in paediatric long-term medical conditions.1 The New Medicines Service (NMS) offered through community pharmacists is designed to support patients' who have recently been prescribed a medicine to manage a long-term condition.2 However, this is not readily available to children/young people or their carers. The main barriers being the targeted conditions included in the service, consent and exclusion of undertaking an NMS consultation with a carer. Further research is required to establish and evaluate a paediatric specific medication review service for children/young people and their parents/carers when a new long-term medicine has been prescribed. This research will support the recent research recommendation of the National Institute of Health and Care Excellence.3


2009 ◽  
Vol 31 (6) ◽  
pp. 630-637 ◽  
Author(s):  
J. G. Hugtenburg ◽  
S. D. Borgsteede ◽  
J. J. Beckeringh

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