Practice Forum: a new section led by the Center for Pharmacy Practice Innovation at Virginia Commonwealth University School of Pharmacy

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Challenges and opportunities of clinical pharmacy services in Ethiopia: a qualitative study from healthcare practitioners' perspective

Background: Currently, clinical pharmacists have in-depth therapeutic knowledge and scientific skills to act as drug therapy experts in healthcare settings. Objective:The aim of this study was to assess the opportunities and challenges of clinical pharmacy services from the health practitioners’ perspective in University of Gondar (UOG) hospital Ethiopia. Methods: A qualitative study was performed using face-to-face in-depth interviews with health practitioners who were directly involvedin clinical pharmacy services (clinical pharmacists, physicians, and nurses) in UOG hospital. Results: A total of 15 health professionals from various specialties were interviewed to express their views towards clinical pharmacists’ competencies and identified challenges and opportunities regarding their clinical services. Based on inter-viewees report,the opportunities for clinical pharmacists includes acceptance of their clinical services among health specialties, new government policy and high patient load in hospital. However, inadequacy of service promotions, lack of continuity of clinical pharmacy services in wards, poor drug information services, lack of commitment, lack of confidence among clinical pharmacists, conflict of interest due to unclear scope of practice, and absence of cooperation with health workers were some of the challenges identified by the interviewees. Conclusion: We identified health professionals working in UOG hospital are receptive towards clinical pharmacy services, but identified some of the potential challenges that needed to be focused to strengthen and promote clinical pharmacy services. Further, the opportunities at hand also need to be utilized astutely to boost the services (AU)

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Technology-induced errors associated with computerized provider order entry software for older patients.

Background The introduction of new technologies in the prescribing process has seen the emergence of new types of medication errors. Objective To determine the prevalence and consequences of technology-induced prescription errors associated with a computerized provider order entry (CPOE) system in hospitalized older patients. Setting Patients 65 years or older admitted to the Departments of Internal Medicine, General Surgery, and Vascular Surgery of a tertiary hospital. Method Prospective observational 6-month study. Technology-induced errors were classified according to various taxonomies. Interrater reliability was measured. Consequences were assessed by interviewing patients and healthcare providers and classified according to their severity. Main outcome measure Prevalence of technology-induced errors. Results A total of 117 patients were included and 107 technology-induced errors were recorded. The prevalence of these errors was 3.65%. Half of the errors were clinical errors (n = 54) and the majority of these were classified as wrong dose, wrong strength, or wrong formulation. Clinical errors were 9 times more likely to be more severe than procedural errors (14.8 vs 1.9%; OR 9.04, 95% CI 1.09-75.07). Most of the errors did not reach the patient. Almost all errors were related to human-machine interactions due to wrong (n = 61) or partial (n = 41) entries. Conclusion Technology-induced errors are common and intrinsic to the implementation of new technologies such as CPOE. The majority of errors appear to be related to human-machine interactions and are of low severity. Prospective trials should be conducted to analyse in detail the way these errors occur and to establish strategies to solve them and increase patient safety.

Effect of computerized prescriber order entry on pharmacy: experience of one health system.

PURPOSE: Pharmacists' satisfaction with a computerized prescriber order-entry (CPOE) system and the impact of CPOE on pharmacy workflows and order verification were investigated. SUMMARY: A mixed-method study was conducted to evaluate the implementation of a CPOE system in three hospitals of a large Michigan-based health system and early user experience with the system. Surveys of pharmacists before (n = 54) and after (n = 42) CPOE implementation indicated that they held generally positive expectations about CPOE prior to and during system implementation and continued to hold positive views about CPOE after several months of system use. In interviews and focus group discussions, pharmacists reported a number of important CPOE benefits, but they also cited challenges related to CPOE provider alerts, uncertainty about medication timing, and the need to support providers by serving as informal CPOE system trainers. Direct observation of pharmacists before and after CPOE implementation indicated decreases in both the rate of order clarification events (from 0.89 to 0.35 per hour, p < 0.001) and the average time spent per hour clarifying orders (from 4.75 to 2.11 minutes, p = 0.008). CONCLUSION: Several months after CPOE implementation, pharmacists indicated that several aspects of their workload had improved, including the process of medication order clarification, their ability to prioritize work, and their ability to move around within the hospital to respond to demand. However, pharmacists also noted that order ambiguity still existed and that the system needed to be optimized to gain efficiencies and increase clarity.

Drug interaction alert override rates in the Meaningful Use era: no evidence of progress.

BACKGROUND: Interruptive drug interaction alerts may reduce adverse drug events and are required for Stage I Meaningful Use attestation. For the last decade override rates have been very high. Despite their widespread use in commercial EHR systems, previously described interventions to improve alert frequency and acceptance have not been well studied. OBJECTIVES: (1) To measure override rates of inpatient medication alerts within a commercial clinical decision support system, and assess the impact of local customization efforts. (2) To compare override rates between drug-drug interaction and drug-allergy interaction alerts, between attending and resident physicians, and between public and academic hospitals. (3) To measure the correlation between physicians' individual alert quantities and override rates as an indicator of potential alert fatigue. METHODS: We retrospectively analyzed physician responses to drug-drug and drug-allergy interaction alerts, as generated by a common decision support product in a large teaching hospital system. RESULTS: (1) Over four days, 461 different physicians entered 18,354 medication orders, resulting in 2,455 visible alerts; 2,280 alerts (93%) were overridden. (2) The drug-drug alert override rate was 95.1%, statistically higher than the rate for drug-allergy alerts (90.9%) (p < 0.001). There was no significant difference in override rates between attendings and residents, or between hospitals. (3) Physicians saw a mean of 1.3 alerts per day, and the number of alerts per physician was not significantly correlated with override rate (R2 = 0.03, p = 0.41). CONCLUSIONS: Despite intensive efforts to improve a commercial drug interaction alert system and to reduce alerting, override rates remain as high as reported over a decade ago. Alert fatigue does not seem to contribute. The results suggest the need to fundamentally question the premises of drug interaction alert systems.

Impact of a pharmacotherapy alerting system on medication errors.

PURPOSE: An evaluation of a rules-based pharmacotherapy alerting system configured to identify improperly verified new medication orders in an inpatient setting is described. METHODS: A retrospective pre-post cohort study was conducted to assess order-verification alerts and pharmacy interventions at a 900-bed hospital before and after implementation of a commercial pharmacotherapy alerting system. In the preintervention phase of the study, the pharmacotherapy alerting system was used on a limited basis, with clinical pharmacists responding to all alerts and the resulting data used to refine the trigger rules; for the intervention phase, the pharmacotherapy alerting system was programmed to alert only on order-verification errors involving four medications (darbepoetin, filgrastim, fondaparinux, and warfarin). In the event of alerts, a pharmacy response team provided nearly real-time feedback to the order-verification pharmacist, mainly via e-mail or paging. RESULTS: From the preintervention period to the intervention period, there was a 36% decrease in the frequency of order-verification alerts (p = 0.035), and the average number of alerts per day declined from 1.0 to 0.6, suggesting that the pharmacotherapy alerting system and associated oversight mechanisms were effective in enabling pharmacy staff to prevent future errors at the order-verification step before such errors could result in patient harm. The review team spent an average of 10.2 minutes carrying out interventions in response to alerts during the intervention phase. CONCLUSION: Incorporation of a real-time pharmacotherapy alerting system with an oversight response process reduced the number of pharmacotherapy alerts and facilitated interception and prevention of adverse drug events.

Optimización de la farmacoterapia en un hospital de Traumatología / Optimisation of pharmacotherapy in a trauma centre

Objetivo Evaluar los resultados de la implantación de un programa de atención farmacéutica dirigido a optimizar el tratamiento farmacoterapéutico individualizado en un hospital de Traumatología con historia clínica informatizada (HCI) y sistema integral de dispensación individualizada de medicamentos (SIDIM).Métodos Estudio retrospectivo observacional de 3 años de duración (2007-2009). Se realizó un seguimiento diario del tratamiento farmacoterapéutico de los pacientes ingresados en unidades de hospitalización con SIDIM. Mediante el registro en un documento normalizado, se clasificaron los problemas relacionados con los medicamentos (PRM) y/o errores de medicación (EM) identificados, así como las intervenciones farmacéuticas realizadas de acuerdo con la idoneidad y el grado de aceptación de las mismas. Para la identificación de pacientes con oportunidades de mejora en su farmacoterapia (PRM y/o EM) se empleó el método IASER®.Resultados Se realizaron 1.971 intervenciones farmacéuticas (IF) tras revisar 124.336 líneas de tratamiento correspondientes a 12 IF por cada 100 pacientes. La prevalencia de pacientes con PRM fue del 12% distribuidos de la siguiente manera: 50,66% categorizados en seguridad, 22,98% en indicación, 12,23% en efectividad y 14,13% en adherencia. Los grupos fármacológicos principalmente implicados fueron: antiinfecciosos (29%), fármacos para el aparato locomotor (..) (AU)

Objective To evaluate the results for implementing a pharmaceutical care programme aimed at optimising personalised pharmacotherapeutic treatment in a Trauma Centre with electronic medical records (EMR) and an integral system for personalised medication dispensing (ISPMD).Method A three-year observational, retrospective study (2007-2009). On a daily basis, we checked the pharmaceutical treatment of patients admitted to hospital units with ISPMD. The medication-related problems (MRP) and medication errors (ME) were identified and classified by recording them on a standardised document. We also recorded data on the Pharmaceutical Interventions performed in accordance with fitness and level of acceptance. We used the laser® method to identify patients with pharmacotherapy improvement opportunities (MRP and/or ME).Results One thousand nine-hundred and seventy-one pharmaceutical interventions (PI) were found after having reviewed 124 336 treatment lines, resulting in 12 PI for every 100 patients. The prevalence of patients with MRP was 12%, distributed as such: 50.66% were safety-related, 22.98% indication-related, 12.23% effectiveness-related and 14.13% adherence-related. The main drug groups involved were: anti-infectious agents (29%), drugs for the musculoskeletal system (21%), drugs for blood and haematopoietic organs (12%), and drugs for the nervous system (11%). The active ingredient that required most PI in 2007 was dexketoprofen (15.6%), followed by ketorolac (12.4%). In 2008, it was dexketoprofen (22.0%) followed by gentamicin (7.3%), and in 2009 enoxaparin (19.0%) followed by dexketoprofen (14.3%). The origin of MRP was due to ME in 91% of cases in 2007and 81% in 2008, decreasing (..) (AU)

Implantación de un programa sistemático de revisión de prescripciones electrónicas / Implementation of a systematic review program of electronic prescriptions

Objetivo: Implantar un programa de revisión sistemática de prescripciones electrónicas para potenciar el uso seguro y eficiente de los medicamentos. Material y método: Proyecto que comenzó en mayo de 2010 en un distrito sanitario de Atención Primaria que da cobertura a medio millón de habitantes aproximadamente. Consiste en la revisión y seguimiento estrecho de las prescripciones electrónicas por los médicos de familia. En esta revisión se incluyó a todos los pacientes con prescripciones electrónicas, priorizando a aquellos polimedicados. Este programa, que desde su implantación fue considerado como punto crítico para mejorar el uso de los medicamentos, fue diseñado e impulsado por la Dirección del Distrito y el Servicio de Farmacia, y contó con el seguimiento de los directores de cada centro de salud. Para dimensionar su impacto, se analizaron como indicadores de seguimiento: el importe/TAFE estimado anual y el número de recetas/TAFE estimado anual. La TAFE es la tarjeta sanitaria ponderada según la edad del usuario y su peso en farmacia asociado. Resultados: El objetivo del proyecto se ha alcanzado con éxito, lo que se ha visto reflejado en el elevado número de pacientes revisados, la disminución del número de recetas estimadas anuales y por tanto, del importe generado por ellas. Conclusión: La receta electrónica es una herramienta importante para conseguir una gestión más eficiente de las consultas médicas, pero la falta de seguimiento por parte de los médicos de los tratamientos prescritos durante períodos prolongados conduce a una utilización inadecuada de los recursos terapéuticos, que es necesario abordar con estrategias como la realizada (AU)

Objective: To implement a systematic review of electronic prescriptions with a view to promoting the safe and efficient use of drugs. Materials and method: This scheme was introduced in May 2010 in a Primary Healthcare District serving a population of approximately half a million inhabitants, and involved the analysis and close monitoring of the electronic prescriptions generated by general practitioners. All patients receiving electronic prescriptions were included in the study, and priority was given to patients on multiple medication. From its very inception the project was considered crucial to improving the safe and efficient use of prescription drugs, and was designed and promoted by the Directors of the Primary Healthcare District and by the members of its Pharmacy Department, with monitoring provided by the Directors of each Primary Healthcare Centre. To measure its impact, we employed the following as monitoring indicators: estimated annual cost/TAFE and estimated annual number of prescriptions/TAFE. TAFE relates to the individual healthcare card weighted in accordance with the age of the user and his or her related pharmaceutical cost. Results: The original aim was successfully achieved, and is reflected in the large number of patients reviewed, in a decrease in the estimated annual number of prescriptions, and, consequently, in the corresponding pharmaceutical cost. Conclusion: Electronic prescribing is an important tool in developing more effective management of the general practitioner clinic, but failure by the physician to monitor prescribed treatments over prolonged periods leads to the inappropriate use of therapeutic resources and, to avoid this, it is essential to implement strategies such as the one described (AU)

Resultados preliminares de la implementación de un servicio de seguimiento farmacoterapéutico a pacientes con diabetes mellitus tipo 2 atendidos en la Farmacia Principal Municipal Santiago de Cuba / Preliminary results of the implementation of a pharmacotherapeutic follow-up service in the dispensarized patients with type 2 diabetes mellitus in the main Municipal Pharmacy of Santiago de Cuba

Objetivos: Detectar, prevenir y resolver los resultados negativos asociados a la medicación que presentaron los pacientes con diabetes mellitus tipo 2 atendidos en la Farmacia Principal Municipal Santiago de Cuba. Métodos: Estudio prospectivo y de intervención realizado a 30 pacientes, en el periodo comprendido entre enero de 2009 y enero de 2010, siguiendo la metodología Dáder actualizada y adaptada a las condiciones concretas de la investigación. Resultados: Se detectaron 98 sospechas y resultados negativos asociados a la medicación, siendo la inseguridad no cuantitativa (42,85%) y la inefectividad no cuantitativa (30,61%) los de mayor incidencia. Las interacciones (21,42%) y la probabilidad de efectos adversos (18,36%) fueron los problemas relacionados con medicamentos que más influyeron en el resultado negativo asociado a la medicación de tipo inseguridad no cuantitativa, mientras que las interacciones (24,48%) y las características personales (6,12%) resultaron los más prevalentes en la inefectividad no cuantitativa. Se realizaron 98 intervenciones farmacéuticas, que posibilitaron la solución del 100% de los resultados negativos asociados a la medicación y la prevención del 97,05% de las sospechas. Conclusión: Resultó adecuada la implementación del servicio farmacéutico, pues posibilitó la detección de las sospechas y resultados negativos asociados a la medicación, que fueron prevenidos y resueltos satisfactoriamente con la identificación de los problemas relacionados con medicamentos; en ellos actuó el profesional farmacéutico, a fin de alcanzar los objetivos terapéuticos planteados en estos pacientes, ayudándoles a conseguir mejores resultados en salud mediante el control de su enfermedad y la optimización de la terapéutica medicamentosa (AU)

Objectives: To detect, prevent and resolve the negative outcomes associated with medication that appeared in patients with Type 2 Diabetes Mellitus dispensed in the Main Municipal Pharmacy of Santiago de Cuba. Methods: Prospective and intervention study done in 30 patients in the period comprehended from January 2009 to January 2010, following the Dáder methodology, adapted to the specific conditions of the investigation. Results: 98 suspicion and negative outcomes associated with the medication were detected this being the non-quantitative safety problem (42.85%) and non-quantitative ineffectiveness (30.61%) the highest incidence. The interactions (21.42%) and the probability of adverse effects (18.36%) constituted the drug related problems that most influenced on the negative outcome associated with the medication type non-quantitative safety problem while the interactions (24.48%) and personal characteristics (6.12%) were most prevalent in the non-quantitative ineffectiveness. 98 pharmaceutical interventions were done, enabling the solution of 100% of negative outcomes associated with medication and prevention of 97.05% of suspicion. Conclusion: It was adequate pharmaceutical service implementation, since it made possible the detection of suspicion and negative outcomes associated with the medication, which were prevented and resolved satisfactorily with the identification of drug related problems by operating in such a professional pharmacist, to achieve therapeutic goals outlined in these patients, helping them achieve better health outcomes through control of their disease and optimize drug therapy (AU)

[New technologies applied to the medication-dispensing process, error analysis and contributing factors]. / Nuevas tecnologías aplicadas al proceso de dispensación de medicamentos. Análisis de errores y factores contribuyentes.

OBJECTIVE: Calculate error prevalence occurred in different medication-dispensing systems, the stages of occurrence, and contributing factors. METHODOLOGY: Prospective observational study. The staging of the dispensing process were reviewed in five dispensing systems: Stock, Unitary-Dose dispensing systems (UDDS) without Computerized Prescription Order Entry (CPOE), CPOE-UDDS, Automated Dispensing Systems (ADS) without CPOE and CPOE-ADS. Dispensing errors were identified, together with the stages of occurrence of such errors and their contributing factors. RESULTS: 2,181 errors were detected among 54,169 opportunities of error. Error-rate: Stock, 10.7%; no-CPOE-UDDS, 3.7%, CPOE-UDDS, 2.2%, no-CPOE-ADS, 20.7%; CPOE-ADS, 2.9%. Most frequent stage when error occurs: Stock, preparation of order; no-CPOE-UDDS and CPOE-UDDS, filling of the unit dose cart; no-CPOE-ADS and CPOE-ADS, filling of the ADS. Most frequent error: Stock, no-CPOE-ADS and CPOE-ADS, omission; CPOE-UDDS, different amount of drug and no-CPOE-UDDS, extra medication. Contributing factor: Stock, CPOE-ADS and no-CPOE-ADS, stock out/supply problems; CPOE-UDDS, inexperienced personnel and deficient communication system between professionals; no-CPOE-UDDS, deficient communication system between professionals. CONCLUSIONS: Applying new technologies to the dispensing process has increased its safety, particularly, implementation of CPOE has enabled to reduce dispensing errors.

Adherence: a review of education, research, practice, and policy in the United States / Cumplimiento: revisión de la educación, investigación, práctica y política en Estados Unidos

Objective: To describe the education, research, practice, and policy related to pharmacist interventions to improve medication adherence in community settings in the United States. Methods: Authors used MEDLINE and International Pharmaceutical Abstracts (since 1990) to identify community and ambulatory pharmacy intervention studies which aimed to improve medication adherence. The authors also searched the primary literature using Ovid to identify studies related to the pharmacy teaching of medication adherence. The bibliographies of relevant studies were reviewed in order to identify additional literature. We searched the tables of content of three US pharmacy education journals and reviewed the American Association of Colleges of Pharmacy website for materials on teaching adherence principles. Policies related to medication adherence were identified based on what was commonly known to the authors from professional experience, attendance at professional meetings, and pharmacy journals. Results: Research and Practice: 29 studies were identified: 18 randomized controlled trials; 3 prospective cohort studies; 2 retrospective cohort studies; 5 case-controlled studies; and one other study. There was considerable variability in types of interventions and use of adherence measures. Many of the interventions were completed by pharmacists with advanced clinical backgrounds and not typical of pharmacists in community settings. The positive intervention effects had either decreased or not been sustained after interventions were removed. Although not formally assessed, in general, the average community pharmacy did not routinely assess and/or intervene on medication adherence. Education: National pharmacy education groups support the need for pharmacists to learn and use adherence-related skills. Educational efforts involving adherence have focused on students' awareness of adherence barriers and communication skills needed to engage patients in behavioral change. Policy: Several changes in pharmacy practice and national legislation have provided pharmacists opportunities to intervene and monitor medication adherence. Some of these changes have involved the use of technologies and provision of specialized services to improve adherence. Conclusions: Researchers and practitioners need to evaluate feasible and sustainable models for pharmacists in community settings to consistently and efficiently help patients better use their medications and improve their health outcomes (AU)

Objetivo: Describir la educación, investigación, practica y política relacionadas con las intervenciones farmacéuticas para mejorar el cumplimiento de la medicación en establecimientos comunitarios en Estados Unidos. Métodos: Los autores utilizaron Medline e International Pharmaceutical Abstracts (desde 1990) para identificar los estudios de intervención de farmacia comunitaria y ambulatoria que trataban de mejorar el cumplimiento de la medicación. Los autores también buscaron en literatura primaria usando Ovid para identificar estudios relativos a la enseñanza de farmacia sobre cumplimiento de la medicación. Se revisaron las bibliografías de los estudios relevantes para identificar literatura adicional. Buscamos en los sumarios de tres revistas de educación de farmacia de Estados Unidos y se revisó la web de la Asociación Americana de Facultades de Farmacia a la busca de materiales sobre principios de educación sobre cumplimiento. Las políticas relacionadas con cumplimiento de medicación se identificaron mediante lo que era conocido por los autores desde su experiencia profesional, asistencia a congresos y revistas farmacéuticas. Resultados: Investigación y práctica: se identificaron 29 estudios: 18 ensayos controlados aleatorizados; 3 estudios de cohorte prospectivos; 2 estudios de cohorte retrospectivos; 5 estudios de caso control; y otro estudio. Hubo una considerable variabilidad en los tipos de intervenciones y en el uso de medidas del cumplimiento. Muchas de las intervenciones eran realizadas por farmacéuticos con formación clínica avanzada y no por típicos farmacéuticos comunitarios. Los efectos positivos de las intervenciones disminuyeron o no se mantuvieron después de que las intervenciones desaparecieron. Aunque no se evaluó formalmente, en general, las farmacias comunitarias normales no evaluaban rutinariamente y/o intervenían en el cumplimiento de la medicación. Educación: Los grupos nacionales de educación de farmacia apoyan la necesidad de que los farmacéuticos aprendan y usen habilidades relacionadas con el cumplimiento. Los esfuerzos educativos relacionados con el cumplimiento se han centrado en el conocimiento de los estudiantes de las barreras al cumplimiento y en las habilidades de comunicación necesarias para envolver a los pacientes en un cambio actitudinal. Política: Varios cambios en el ejercicio de la farmacia y en la legislación nacional han proporcionado a los farmacéuticos la oportunidad de intervenir y monitorizar el cumplimiento de la medicación. Algunos de estos cambios incluyeron el uso de tecnologías y la provisión de servicios especializados para mejorar el cumplimiento. Conclusiones: Los investigadores y facultativos necesitan evaluar modelos factibles y sostenibles para los farmacéuticos en la comunidad para ayudar consistente y eficientemente a pacientes en su mejor uso de las medicaciones y mejorar sus resultados en salud (AU)

Health information, an area for competition in Swedish pharmacies / Información sanitaria, un área de competencia en las farmacias suecas

Objective: To investigate the views and expectations of a selected group of customers regarding health information in Swedish pharmacies. Methods: A repeated cross sectional, questionnaire study carried out in 2004 and 2005. Customers buying calcium products answered questions on osteoporosis and general questions on health promotion and information. Results: Respondents had a positive attitude towards receiving health information from the pharmacies and towards the pharmacies’ future role in health promotion. However, only 30% of the respondents expected to get information on general health issues from the pharmacy. In spite of this, 76% (2004) and 72% (2005) of the respondents believed that the pharmacies could influence people’s willingness to improve their health. Conclusion: There is a gap between the respondents’ positive attitudes towards the Swedish pharmacies and their low expectations as regards the pharmacies’ ability to provide health information. In the light of the upcoming change to the state monopoly on medicine sales, this gap could be an important area for competition between the actors in the new situation for medicine sales in Sweden (AU)

Objetivo: Investigar las visiones y expectativas de un grupo seleccionado de clientes en relación a la información en las farmacias suecas. Métodos: Un cuestionario repetido transversal realizado en 2004 y 2005. Los clientes que compraban productos con calcio respondieron a preguntas sobre osteoporosis y preguntas generales sobre promoción de la salud e información. Resultados: Los respondentes tenían una actitud positiva hacia recibir información de las farmacias y hacia el futuro papel del farmacéutico en la promoción de la salud. Sin embargo, solo el 30% de los respondentes esperaba obtener información sobre aspectos generales de salud en la farmacia. A pesar de esto, el 76% (2004) y 72% (2005) de los respondentes creían que las farmacias podrían influir en la voluntad de las personas para mejorar su salud. Conclusión: Hay una brecha entre las actitudes positivas de los respondentes hacia las farmnacias suecas y sus bajas expectativas sobre la capacidad de las farmacias de proporcionar información sobre la salud. A la vista del inminente cambio en el monopolio estatal de la venta de medicamentos, esta brecha podría ser un área importante de competencia entre los actores de esta nueva situación de venta de medicamentos en Suecia (AU)

La farmacia hospitalaria en Venezuela / No disponible

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Pharmacists’ views on involvement in pharmacy practice research: strategies for facilitating participation

In order for community pharmacy practice to continue to evolve, pharmacy practice research on potential new services is essential. This requires the active participation of community pharmacists. At present, the level of involvement of community pharmacists in pharmacy practice research is minimal. Objectives: To ascertain the attitudes of a group of research-experienced community pharmacists towards participating in research; to investigate the barriers and facilitators to participation; to identify potential strategies to increase the involvement of community pharmacists in research. Methods: A focus group was conducted with a purposive sample of 11 research-experienced community pharmacists. A pharmacist academic moderated the focus group using a semi-structured interview guide. The participants were asked a bout their attitudes towards research, previous involvement in research, barriers to their involvement and strategies to overcome these barriers. The session was audio-taped and notes were taken by an observer. Thematic analysis of the notes and audio-tape transcripts was conducted. Results: Three themes emerged around pharmacists' attitudes towards research: pharmacists’ perception of the purpose of research, pharmacists' motivation for involvement in research, and pharmacists’ desired role in research. Barriers to research participation were grouped into four themes: pharmacists’ mindset, communication, infrastructure (time, money and staff), and skills/knowledge. Strategies to address each of these barriers were suggested. Conclusions: Participants recognised the importance of research towards advancing their profession and this was a motivating factor forinvolvement in research. They perceived their role in research primarily as data collection. A series of practical strategies to overcome the barriers participation were offered that researchers may wish to consider when promoting research outcomes and designing research projects (AU)

Para que la práctica farmacéutica continúe evolucionando, es esencial la investigación de farmacia práctica sobre nuevos servicios. Esto requiere la participación activa de farmacéuticos comunitarios. Actualmente, el nivel de participación de los farmacéuticos comunitarios en la investigación en farmacia práctica es mínimo. Objetivos: Evaluar las actitudes de un grupo de farmacéuticos comunitarios con experiencia en investigación; investigar las barreras y facilitadores para la participación; identificar las posibles estrategias para aumentar la participación de los farmacéuticos comunitarios en investigación. Métodos: Se realizó un grupo focal con una muestra conveniente de 11 farmacéuticos comunitarios con experiencia en investigación. Un profesor de farmacia moderó el grupo focal utilizando una guía de entrevista semi-estructurada. Se preguntó a los participantes sobre sus actitudes hacia la investigación, participación previa en investigaciones, barreras para su participación y estrategias para superar esas barreras. La sesión fue grabada y un observador tomó notas. Se realizó un análisis temático de las notas y de las transcripciones del as cintas. Resultados: Emergieron tres temas sobre las actitudes de los farmacéuticos hacia la investigación: la percepción de los farmacéuticos del propósito del a investigación, la motivación para la participación de los farmacéuticos en investigación y el papel que desean los farmacéuticos en la investigación. Las barreras para la investigación se agruparon en cuatro temas: mentalidad de los farmacéuticos, comunicación, infraestructura (tiempo, dinero y personal) y habilidades/conocimientos. Se sugirieron estrategias para afrontar cada una de esas barreras. Conclusiones: Los participantes reconocieron la importancia de la investigación para el avance de su profesión y este era el factor motivador para su participación en la investigación. Percibían su papel en la investigación fundamentalmente como de recogida de datos. Se ofrecieron varias estrategias para superar las barreras a la participación que los investigadores deberían considerar cuando promocionen los resultados de investigaciones y cuando diseñen proyectos de investigación (AU)