Establishment and evaluation of a serum cholesterol monitoring service in a community pharmacy

A clinical pharmacy service providing blood cholesterol testing and consultation was implemented in a community pharmacy. In this pilot study, 27 patients each paid $10 to have a serum cholesterol determination. All subjects completed a questionnaire to determine attitude toward such a service, intention to use it in the future, and willingness to pay for its use. A posttest patient satisfaction questionnaire was completed after blood-level results were reported and discussed with the patient. All subjects stated that they were strongly in favor of such a service, that they would use it, and that they would pay an average of $11.60 for the test. On the posttest questionnaire, patients expressed strong satisfaction with various aspects of the service, and the amount that they were willing to pay increased significantly to $14.35. It is recommended that community pharmacies implement such patient-oriented services.     

Perception of the role of medical-service representatives in hospitals

How sales directors of pharmaceutical manufacturing firms and hospital pharmacy directors perceive the role of medical-service representatives (MSRs) in hospitals was studied. Pharmacy directors at U.S. hospitals and sales directors of Pharmaceutical Manufacturers Association member firms were surveyed by questionnaire in February 1988. Respondents were presented with a list of 13 product-related services and a list of 11 professional and informational services; they were asked to use a five-point scale to indicate how important they believed each service was and how frequently they believed that most MSRs performed the service. A total of 251 (47.0%) usable questionnaires were returned from the hospital pharmacy directors, and 35 (38.5%) were returned from the pharmaceutical sales directors. Hospital pharmacy directors perceived professional and informational services as more important than product-related services. The results suggest that pharmacy directors would like MSRs to place more emphasis on (1) providing drug information to pharmacy before promoting their products to physicians, (2) supporting the role of the clinical pharmacist in promoting appropriate and rational use of a product, and (3) complying with pharmacy and therapeutics committee formulary decisions. Compared with sales directors, pharmacy directors placed less emphasis on information about new dosage forms, assistance in drug recalls, and assistance in obtaining hospital-specific pricing. Differences in perceptions of the role of MSRs exist between hospital pharmacy directors and sales directors of pharmaceutical manufacturing firms.     

Existing arrangements for monitoring community pharmacies in England: Can they have a role in the revalidation of pharmacists?

BackgroundMaintaining and regulating professional competence in health care is a growing concern. Tasked with developing a system of revalidation for pharmacy professionals, the pharmacy regulator in Great Britain commissioned a series of studies to evaluate existing sources of evidence as potential contributors to the revalidation process.ObjectivesTo explore the utility of existing regulatory inspections and service commissioners' contract monitoring processes in the community pharmacy sector as sources of evidence of the fitness to practice of pharmacists in England.MethodsThirteen semistructured telephone interviews conducted with representatives of the regulatory Inspectorate and community pharmacy commissioners.ResultsInterviewees described current processes for inspecting and monitoring community pharmacy premises and the services they provided. Their focus was primarily on the pharmacy and not on the pharmacist. Views were given as to how the roles of the Inspectorate and service commissioners might be developed to incorporate aspects of revalidation. Particular issues were raised in relation to the revalidation of self-employed locum and independent owner pharmacists.ConclusionsExisting inspection and contract monitoring processes have little utility in providing evidence of the fitness to practice of individual community pharmacists in England. However, there may be potential for the Inspectorate and service commissioners to develop a role in revalidation, particularly for locum pharmacists and/or independent pharmacy owners. Moreover, they may take a role in providing the infrastructure required to support the process of revalidation for community pharmacists. Current financial pressures and restructuring in the National Health Service, however, are obstacles to the development of revalidation processes.     

A survey of Estonian consumer expectations from the pharmacy service and a comparison with the opinions of pharmacists

Objective To assess the preferences of pharmacy customers when choosing a pharmacy and their expectations of the service, and␣comparing these with the opinions of pharmacists. Main outcome measure Opinion and satisfaction of community pharmacy clients in Estonia. Methods A written survey was carried out among pharmacy customers (n=1979) in cities (in 3 community pharmacies), towns (in 2 community pharmacies), and in small towns (in 2 community pharmacies). The survey was also carried out among community pharmacists (n=135) in different regions of Estonia. Results When choosing a pharmacy, its location was considered most important, costs and wide choice are less important. The most important expectations of customers’ included help choosing the right medicine, as well as professional consultation. Preferences and expectations of pharmacy customers depended on their age, gender and income. Parking space, quickness and pleasantness were considered important by men. Costs and wide choice were considered to be more important by women. Pharmacists wish to give patients more information, but they overestimate the importance of quick service. Customers favoured privacy, discretion and confidentiality more. These characteristics were especially important to younger well-paid people living in big cities. Conclusion In contrast to the opinions offered by pharmacists’, a rapid customer service is so not as important as the quality of service in pharmacy according to customers. They also emphasised that pharmacies should highlight the choice of products, quality of service, a professional consultation, as well as ensure privacy.     

Nursing sisters' satisfaction with the pharmacy service — a survey

A questionnaire was sent to all nursing sisters in Hammersmith and Queen Charlotte's special health authority, a provider of specialist hospital services in London. They were asked for their overall impression of the pharmacy service and staff, for their opinions of specific services and for suggestions for improving the service. Eighty-six per cent of respondents thought the service was good, very good or excellent and 92 per cent thought the service was either the same or better than that of other hospitals in which they had worked. Just under half the suggestions received were for service improvements related to supply of drugs stocked on the ward. The other main areas commented on were drug delivery, discharge medication and the pharmacy on-call service. The survey provided useful information about the pharmacy service and has enabled the department to implement some of the changes suggested as well as look at the feasibility of other improvements. It is intended to repeat this survey annually.     

Physician perceptions of clinical pharmacy encounters in a family practice clinic

The purpose of this study was to classify pharmacist-physician encounters in a family medicine center into three progressive levels of service in order to determine the physician's perception of the relative value of each level. The three levels of service were drug information, pharmacy consultation individualized to the patient, and pharmaceutical care-consultation with follow-up to monitor patient outcome. Physicians received a questionnaire with each encounter and were asked to rank questions regarding the quality of the information provided, the impact they perceived that the information had on patient care, and to assign a monetary value for each encounter. A total of 106 of 141 (75 percent) questionnaires suitable for analysis were stratified into drug information (25.5 percent), pharmacy consultation (49 percent), and pharmaceutical care (25.5 percent). Physicians' perceptions toward the quality, impact, and value of pharmacy services were favorable overall, but they perceived a significantly higher quality, impact, and value to pharmaceutical care encounters than for drug information and pharmacy consultation (p < 0.05).     

The management and development of hospital pharmacy in the new National Health Service in the UK

The introduction of an internal market in health care in the United Kingdom has created a structured relationship, defined by contracts, between health care providers, such as NHS hospitals, and purchasers, such as general practitioner fundholders. Similar relationships are developing within hospitals between clinical directorates and support service departments, such as pharmacy. A 1993/4 interview survey, conducted at eight hospitals, obtained the views of 129 pharmacy, nursing, medical and managerial staff on pharmacy service development and management in this new environment. Contracts between pharmacy and clinical directorates were in place in only two of the hospitals. Where contracts existed, pharmacy managers viewed them positively but they acknowledged the resultant managerial challenges. Most pharmacy managers at sites without contracts were threatened by the prospect of them. In contrast, non-pharmacy staff welcomed contracts as an opportunity to define their service requirements. For most managers of support services such as pharmacy, the implementation of the internal market will present challenges. Managers will need to become familiar with their customers' needs using information from several sources, including pharmacists working within directorates. Then efforts will have to be made to negotiate contracts that meet those needs while permitting the further development of staff and services.     

Shared pharmacy services: a cost-effective programme for small hospitals.

A pilot project for shared pharmacy service was undertaken to investigate costs and benefits under an agreement established between University Hospital, London and South Huron Hospital, Exeter, Ontario. The programme involved the use of facsimile telecopiers to transmit direct copies of the physicians' orders to the Pharmacy Department at University Hospital where they were entered into the computerized pharmacy system. At South Huron Hospital therapy was initiated from floor stock while the drug, dispensed in unit-of-use packaging, was delivered to the Exeter Hospital by courier service. The shared service pharmacist visited South Huron Hospital once weekly for nursing orientations, inservice lectures, patient consultations, medical staff meetings and direct contact with physicians. With the approval of the Bureau of Dangerous Drugs the pharmacist delivered Narcotic and Schedule G medications once weekly. After three months the patient census and average number of medication orders per patient per day had increased. The hours of pharmacy operation were extended, while the medication costs per patient day were reduced from $2.16 to $1.64. A shared pharmacy service can result in an improved element of drug use control for smaller hospitals in a cost-effective manner.     

浅谈我院药房管理存在的问题和对策

药房在医院药品管理中发挥着重大作用,但目前医院药房普通存在着制度不规范、管理不科学、药学服务人员整体素质不高等问题,这严重影响了医院的对外形象,同时对医院安全用药也产生了不良影响。制定相关制度,加强管理是改善药房现状的主要措施,这对提高药品管理、医院管理水平具有重大意义。     

做好柜台式门诊药房药物咨询服务的体会

目的:提高门诊药房药物咨询服务的水平。方法:总结我院2年来开展药物咨询服务工作的经验。结果与结论:通过开展药物咨询服务,提高了合理用药水平,取得了良好的社会效益。但有必要在此基础上,继续建立健全药物咨询服务体系。     

医院药学城构建探讨

目的:建立医院药学城,促进硬件与学科和谐发展。方法:结合医院药学发展方向,设计本院药学城,并以理论分析其构建思路。结果:形成了以患者为中心的模式,有利于发挥药师团队作用及宣传医院药学,实现医院药学的高工效、低成本运行。结论:医院药学城为开展医院药学工作创造了良好的环境。     

Exploring relationships among pharmacy service use,patronage motives,and patient satisfaction

ObjectivesTo describe and identify significant relationships among pharmacy service use, general and service-specific patient satisfaction, pharmacy patronage motives, and marketing awareness in a service-oriented, independent community pharmacy.DesignCross-sectional study.SettingMidwest United States during May through July 2011.ParticipantsStratified random sample of 500 participants.InterventionSelf-reported questionnaire mailed to participants.Main outcome measuresPatient satisfaction, pharmacy service use, patronage motives, marketing awareness, and demographics.ResultsStudy participants were mostly satisfied with the pharmacy services on global and service-specific measures. Patronage motives of relationships, pharmacy atmosphere, and quality previous experience were associated with increased pharmacy service use at the study pharmacy, while a unique service patronage motivation was associated with decreased pharmacy service use at the study pharmacy. Participants citing pharmacy atmosphere and personnel competency as patronage motives did not use pharmacies other than the study pharmacy more often, whereas participants citing unique services as a patronage motive used pharmacies other than the study pharmacy more often. Direct marketing awareness increased pharmacy service awareness but not use.ConclusionOffering unique services may not be enough to bring in patients loyal to all services provided in a pharmacy. Pharmacists should focus on developing strong relationships with patients and conveying competence when delivering appropriate, quality pharmacy services in a professional pharmacy atmosphere.     

社区卫生服务机构药学服务模式研究

目的对社区卫生服务机构药学服务模式进行研究,为我国社区药学服务的发展提出参考建议,使药学服务更好地发挥在城市医疗卫生体系中的作用。方法对社区卫生服务中心实行随机抽样问卷调查,具体对象为社区卫生服务中心的药学人员和社区居民,将收集到的相关信息录入Excel2003软件,经核对无误后转入SPSS13．0进行统计分析。结果在社区居民的意识里,还没有形成正式的药学服务概念,医师对药学服务的理解不够深入,药学服务在社区卫生机构中没有形成科学的模式。结论应通过加强政策支持和相应的培训,转变服务模式,建立适宜的考核评价体系等措施,积极发展社区药学服务工作。     

社区居民药学服务需求调查与分析

目的：调查社区居民的药学知识情况和药学服务需求,探索社区药学服务的开展方法。方法：选择在万寿路社区卫生服务中心就诊的居民及在万寿路辖区内居住的居民,共计对806名居民进行了问卷调查。结果：本辖区66.2%的居民参与基本医疗保险和工伤保险; 86.43%居民家中的常用药物来源于医院,64.33%居民就医首选三级医院;有56.10%的居民对药品不良反应“大概了解”;有52.13%的居民认为社区药学服务非常重要;窗口咨询是最受居民欢迎的药学服务形式。结论：社区居民迫切需要药学服务,社区药师应转变服务观念,提高药学服务能力,开展多种形式的药学服务模式,提高社区居民的合理使用药品水平。