ABSTRACT
Objective: We search valuable information in home medical care settings that impede smooth collaboration among pharmacists, home care physicians, and home care nurses. Methods: We conducted an online survey on 120 physicians and 118 nurses on “areas perceived as overloaded with tasks,” “quality of life (QOL) evaluation of patients,” and “expectations to pharmacists.” We analyzed data using the Mann-Whitney U test and conducted the customer satisfaction (CS) analysis on “stress.” Results: Physicians answered that they had a significantly higher stress on “at night-time/holidays and weekends works” than nurses (p < 0.05). Nurses experienced significantly more stress during “inter-professional collaboration” than physicians (p < 0.01). CS analysis revealed that nurses experienced more stress for items such as “having patients with dementia self-inject correctly,” etc. Both physicians and nurses evaluated QOL items at a high frequency. Majority of physicians and nurses held high “expectations to pharmacists,” particularly for the eight items related to providing information, managing drugs, and making pharmacological judgments. Nurses had significantly high expectations to pharmacists for “management of supplements taken by the patient” (p < 0.01), “explaining drug effects” (p < 0.001), and “explaining the necessity of prescription revision” (p < 0.01). Discussion: Pharmacists should utilize information on physicians and nurses’ stress as well as understand their expectations to pharmacists to facilitate stronger coordination between both professions and contribute to patient care. In particular, many items were found to cause stress, indicating that support for nurses, who have many expectations to pharmacists, needs to be enhanced.
ABSTRACT
The core curriculum of the pharmacy education model was revised in 2013 based on the “Basic competencies required of a pharmacist” that should be developed by graduation. Specific behavioral objectives to acquire include competency in “The ability to implement pharmacotherapeutic management”, which involves gaining the ability to understand patient information, prescription design and proposal, as well as pharmacotherapeutic assessment. In order to improve this ability, it is necessary for students to acquire basic knowledge about pathology, pharmacology, and pharmacotherapy and to integrate and apply this knowledge to patients in practice. We introduced an integrated program called “Integrated Clinical Pharmacy” for fifth-year students at Hokkaido Pharmaceutical University. In this program, students take an objective test on the basic knowledge of pathology, pharmacology, and pharmacotherapy and learn how to design pharmaceutical care plans using individual patient cases. A self-evaluation questionnaire survey about the ability to develop care plan was conducted on students who completed the program. Based on the objective test and self-evaluation questionnaire results, we studied whether basic knowledge was fully established and whether the ability to utilize this knowledge was acquired through this program. We found that although the ability to select an individual component of care plan did improve, this ability wasn’t correlated with the degree of basic knowledge, and performance in summarizing care plan did not improve. These results suggested that it is necessary to understand the connection between components of the care plan and strategies to focus on improving the ability to integrate basic knowledge.
ABSTRACT
The core curriculum of the pharmacy education model was revised in 2013 based on the “Basic competencies required of a pharmacist” that should be developed by graduation. Specific behavioral objectives to acquire include competency in “The ability to implement pharmacotherapeutic management”, which involves gaining the ability to understand patient information, prescription design and proposal, as well as pharmacotherapeutic assessment. In order to improve this ability, it is necessary for students to acquire basic knowledge about pathology, pharmacology, and pharmacotherapy and to integrate and apply this knowledge to patients in practice. We introduced an integrated program called “Integrated Clinical Pharmacy” for fifth-year students at Hokkaido Pharmaceutical University. In this program, students take an objective test on the basic knowledge of pathology, pharmacology, and pharmacotherapy and learn how to design pharmaceutical care plans using individual patient cases. A self-evaluation questionnaire survey about the ability to develop care plan was conducted on students who completed the program. Based on the objective test and self-evaluation questionnaire results, we studied whether basic knowledge was fully established and whether the ability to utilize this knowledge was acquired through this program. We found that although the ability to select an individual component of care plan did improve, this ability wasn’t correlated with the degree of basic knowledge, and performance in summarizing care plan did not improve. These results suggested that it is necessary to understand the connection between components of the care plan and strategies to focus on improving the ability to integrate basic knowledge.
ABSTRACT
Objective: We search valuable information in home medical care settings that impede smooth collaboration among pharmacists, home care physicians, and home care nurses. Methods: We conducted an online survey on 120 physicians and 118 nurses on “areas perceived as overloaded with tasks,” “quality of life (QOL) evaluation of patients,” and “expectations to pharmacists.” We analyzed data using the Mann-Whitney U test and conducted the customer satisfaction (CS) analysis on “stress.” Results: Physicians answered that they had a significantly higher stress on “at night-time/holidays and weekends works” than nurses (p < 0.05). Nurses experienced significantly more stress during “inter-professional collaboration” than physicians (p < 0.01). CS analysis revealed that nurses experienced more stress for items such as “having patients with dementia self-inject correctly,” etc. Both physicians and nurses evaluated QOL items at a high frequency. Majority of physicians and nurses held high “expectations to pharmacists,” particularly for the eight items related to providing information, managing drugs, and making pharmacological judgments. Nurses had significantly high expectations to pharmacists for “management of supplements taken by the patient” (p < 0.01), “explaining drug effects” (p < 0.001), and “explaining the necessity of prescription revision” (p < 0.01). Discussion: Pharmacists should utilize information on physicians and nurses’ stress as well as understand their expectations to pharmacists to facilitate stronger coordination between both professions and contribute to patient care. In particular, many items were found to cause stress, indicating that support for nurses, who have many expectations to pharmacists, needs to be enhanced.
ABSTRACT
In addition to the notion of promoting generic drugs to lower pharmaceutical costs, another approach that has gained attention as vital to policy reform is that of utilizing health insurance pharmacies to decrease over-prescription and surplus of drugs. Such a move would perforce require separating medical and dispensary practices. There is increased need for more efficient provision of pharmaceuticals, including proper inventory control, outpatient clinics that function as family pharmacies, and support of home-bound patients’ medication regimens. However, chronic ailments in particular tend to lack subjective symptoms, and decreased intake of medication and surplus medication compound to make these larger policy issues difficult to solve. This has led to the Revised Dispensing Service Fee changes in 2012 and 2014 putting stricter controls on medication regimens and checks of surplus medication. This research examines in parallel the issues of patient satisfaction and loyalty alongside adherence to medication regimens, issues that have been previously treated in isolation in the existing literature. By comparing their respective inter-relationships and influencing factors, we conducted a re-analysis of the relationship between insurance pharmacies and patients. We collected data from patients with diabetes and high blood pressure via an Internet survey. Responses on loyalty, patient satisfaction, overall perceived quality, and degree of medication adherence were obtained, as well as responses on the factors believed in a cross-sectional sense across research disciplines to contribute to the above, and the results measured on a quantitative scale. Path analysis was then used, with a model defined using overall perceived quality as a parameter and measuring the degree of satisfaction, loyalty, and medication adherence. In addition, a multiple-group analysis was simultaneously performed. Although there was variance by ailment in terms of patient satisfaction and loyalty, factors contributing to perceived quality were the strongest, followed by the rating of the prescribing doctor. However, for adherence, only self-efficacy and prescribing doctor rating contributed. Ultimately, no correlation was found between patient satisfaction, loyalty, and adherence, and the contributing causes were found to vary, so improving these various vectors would seem to require respectively differing strategies. In terms of medication adherence, the results suggested the need for strategies to increase patients’ self-efficacy, partner with prescribing doctors, and improve the perceived rating of prescribing doctors; different quality improvements are needed by medical area, whether medicine or dispensary practice.