The pharmacist as a trauma team member.

Mission Community Hospital in a 220-bed medical center. The pharmacy department is involved with services for the trauma center, neonatal ICU, oncology, nursery, critical care, pediatric, and medical/surgical patients. The role of the pharmacist in both the acute phase and the follow-up care of the trauma patient is described. The purpose of this article is to show contributions pharmacists can make in the care of trauma patients. Areas such as drug distribution, patient monitoring, and cost containment will be discussed.     

The clinical pharmacist as a member of the burn team

Pharmacists are becoming involved increasingly in a patient care. At the University of California, San Diego Medical Center, a pharmacist has become a member of the multidisciplinary burn team. Through participation in work rounds and team conferences, the pharmacist has had a considerable beneficial impact on drug therapy, drug dosing, monitoring adverse drug reactions, and total parenteral nutrition. Specific benefits to patient care that the pharmacist provides are discussed and also the benefits derived in using a burn unit as a clinical teaching rotation for pharmacy students. The pharmacist has found his association with the burn unit to be professionally rewarding and the attending surgeons and surgical house staff have found his input to be valuable. The authors encourage other burn units to enlist a pharmacist as part of their burn team.     

Evaluation of mental health care interventions made by three community pharmacists — a pilot study

Objective — To assess the clinical significance of drug‐related interventions made by three community pharmacists (CPs) in the pharmaceutical care of 30 long‐term mentally ill patients in the UK. Method — Three CPs (“study pharmacists”) participated in a nine‐month study in which they collaborated with the community mental health team (CMHT) to provide pharmaceutical care for long‐term mentally ill patients in the community. In particular, they liaised with the patients' keyworkers, accompanying them on home visits. The pharmacists had previously attended a specially organised training course. Their primary tasks were to assess patient need and identify medication‐related problems, intervene as appropriate and document patient outcome. An expert review panel (two specialist hospital mental health pharmacists and a consultant psychiatrist) evaluated the appropriateness of the interventions and the level of clinical significance of the interventions (using a validated four‐point rating scale). Key findings — Thirty‐eight patients consented to participate in the study and 35 were contactable. Ninety‐four medication‐related problems were identified involving 30 patients (mean number of recorded problems per patient=3), of which full data were available for 92. Eighty‐four problems (91 % n=92) were said to have had appropriate interventions, and eight (9 per cent) inappropriate interventions. In 35 per cent of problems the three reviewers agreed that the interventions were clinically significant. Inter‐rater agreement for paired agreements (assessed by the kappa statistic) was fair in all cases except one, where it was poor. Conclusions — The reviewers considered the study pharmacists to have made a valuable pharmaceutical contribution to mental health care through clinically significant interventions, although they identified cases in which further clinically significant interventions could have been made. The reviewers saw the work undertaken as providing a positive way forward in primary mental health care.     

Primary care pharmacist workforce mobility: why do pharmacists want to work in primary care and how do these reasons differ for community and hospital pharmacists?

Objective The purpose of this study was to describe the migratory and working patterns of primary care pharmacists, to explore the reasons pharmacists changed jobs, and in particular to ascertain from which sector pharmacists moved into primary care. Method A self‐completion postal questionnaire was used to gather quantitative data on current post and working practices and reasons for movement into the primary care sector, and semi‐structured interviews to explore in more depth reasons for movement across sectors. Setting Primary care pharmacists in England in 2001. Key findings Just over half (52%) of the sample worked exclusively in primary care, having most likely left a post in hospital pharmacy, while almost half (48%) of the sample adopted a ‘portfolio’ pattern of working, where the primary care pharmacists have more than one job. This is most likely to be a locum position in community pharmacy. Pharmacists in this study were mostly attracted into primary care because they wanted to undertake more interesting work, make better use of their knowledge and get involved with the primary healthcare team. They left their previous place of work because they needed a change. The importance primary care pharmacists gave to each of these reasons differed, depending on the sector of employment they had left or continued to work in. Conclusion As a sector of practice, primary care is drawing pharmacists from both the community and hospital sectors of the profession. However, the impact on the hospital sector is more marked as pharmacists are leaving this sector completely, while primary care pharmacists are more likely to maintain their practice commitments in the much larger community sector.     

Role of the pharmacist in primary health care.

The provision of primary health care to a rural American Indian population by a pharmacist is discussed. The training and responsibilities of the pharmacist are described. An evaluation of the care provided by the pharmacist to 393 patients is presented.     

Referral of clients by community pharmacists in primary care consultations

In responding to symptoms presented by clients, community pharmacists have a number of options open to them, including giving advice to seek the assistance of another health professional (ie, a referral). The objective of this study was to investigate the referral patterns of community pharmacists in primary care consultations. The analysis was performed on 716 tape-recorded consultations between pharmacists and clients collected in a random sample of community pharmacies in London. Fifteen per cent of clients were referred to another practitioner, usually their general medical practitioner. Information on the cases that pharmacists referred is provided. There was a wide variation in referral rates depending on the nature of the presenting symptoms. Pharmacists' referral patterns tended to be determined by the characteristics of the symptoms presented. A situation in which some pharmacists routinely refer a high proportion of clients irrespective of the nature of the symptoms was not apparent. The symptoms referred by pharmacists may or may not be those which other primary health carers feel they should see. A co-ordinated, safe and appropriate role as a filter to other practitioners could contribute to improvements in the effectiveness and efficiency of primary care.     

Pharmacists in primary care Determinants of the care-providing function of Dutch community pharmacists in primary care

OBJECTIVE: To identify determinants of the care-providing function of the community pharmacists (CPs) to explain variations in professional practice. SETTING: The Netherlands 2001. PARTICIPANTS: 328 CPs. METHOD: A cross-sectional questionnaire survey was performed. Questionnaires were used to collect data about the care provided in pharmacies. As dependent variables three partial constructs: 'individual patient care', 'registration of the care', and 'cooperation with GPs', and one total construct: 'care function' were formed. Independent variables were: gender, work experience, attitude to the care-providing function, tenure, relationship with GPs, pharmacist trainer, frequency of postgraduate training, workload, part-time working, frequency of contact with pharmaceutical representatives, presence of technicians with a specialised caring duty, size of the pharmacy, urbanisation, competition, franchise pharmacy, presence of sufficient personnel. A multiple-regression analysis was performed. RESULTS: Respondents 71%; of the respondents 29% never enquired about the patient's experience when supplying a medication for the second time. The supply of self-care remedies was never registered by 11% of respondents. Ninety percent of pharmacists participate more than four times per year in Pharmacotherapy Audit Meetings. The attitude of the pharmacist, relationship with the GP, presence of specialised technicians, frequency of postgraduate training and the type of tenure are significantly positively correlated with a care-providing function. Being a pharmacist trainer is significantly positively related with 'individual patient care', the frequency of postgraduate training is significantly positively correlated with 'registration of the care' and the number of years in service is significantly negatively correlated with 'cooperation with GPs'. There is a negative correlation between the cooperation with GPs and the number of years a pharmacist has been in service. CONCLUSION: Based on this survey, the development of programmes focused on optimal attitude, and cooperation between pharmacists and GPs is recommended.     

Public perceptions of community pharmacists in Benin City,Nigeria

Objective — To determine public perceptions of community pharmacists and pharmacies in Benin City, Nigeria. Method — A self‐completion questionnaire was distributed to a stratified random sample of 1,500 households. Data were collected using a 22‐item, Likert‐type scale which was shown to have 0.77 reliability. The neutral point was assumed to be 66 on the scale of 22 to 110. Scores above 66 were interpreted as positive perception. Results — The response rate was 68.3 per cent (1,025/1500). Almost two‐thirds (64 per cent) of respondents perceived the community pharmacist as a health care provider, and 70 per cent agreed that community pharmacists are needed, especially in the area of medicinal product selection (76 per cent). However, 52 per cent believed pharmacists are profit motivated and only 43 per cent said they would be willing to pay for pharmacist consultation. Respondents reported difficulty in differentiating between pharmacists and pharmacy attendants, with only 58 per cent reporting that they could tell the difference. The pharmacists scored 76.37 ± 27.63, with 60 per cent of respondents scoring them above 66. Conclusion — This study found that community pharmacists received a moderately positive rating from the public. There is a need for community pharmacists to carve out a more distinct professional identity for themselves.     

Knowledge,perceptions, and readiness of telepharmacy among community pharmacists

Telepharmacy is a practical part of telemedicine that refers to providing pharmaceutical services within the scope of the pharmacist's obligations while maintaining a temporal and spatial distance between patients, users of health services, and healthcare professionals. The present study was a cross-sectional study conducted among community pharmacists in Saudi Arabia between March and May 2022 to assess their knowledge, perceptions, and readiness for telepharmacy. The survey was filled out by 404 respondents. The majority of respondents were male (59.90%) and the age of more than half of them was between 30 and 39 years old (54.46%). Most participants worked in urban areas (83.66%), and 42.57% had less than five years of experience in a pharmacy. Most participants agreed that telepharmacy is available in Saudi Arabia (82.67%). Approximately 70% of pharmacists felt that telepharmacy promotes patient medication adherence, and 77.72% agreed that telepharmacy increases patient access to pharmaceuticals in rural areas. More than 72% of pharmacists said they would work on telepharmacy initiatives in rural areas for free, and 74.26% said they would work outside of usual working hours if necessary. In the future, this research could aid in adopting full-fledged telepharmacy pharmaceutical care services in Saudi Arabia. It could also help academic initiatives by allowing telepharmacy practice models to be included as a topic course in the curriculum to prepare future pharmacists to deliver telepharmacy services.