Legal status and functions of hospital-based pharmacy technicians and their relationship to clinical pharmacy services.

The relationships among (1) laws and regulations governing hospital-based pharmacy technicians, (2) functions pharmacy technicians perform, and (3) pharmacists' provision of clinical pharmacy services were studied. A state-level technician-restriction score was developed, based on state rules and regulations in effect in 1989. Scoring included (1) type of supervision required for hospital-based pharmacy technicians, (2) ratio of technicians to pharmacists, (3) pharmacist-only reconstitution of injectable products, and (4) pharmacist-only counting and pouring. Actual use of hospital pharmacy technicians was measured with the technician-use index, and overall provision of clinical pharmacy services was measured with the pharmaceutical-care index. Based on the technician-restriction scores, 25 states and the District of Columbia were categorized as having less restrictive laws and 25 states as having more restrictive laws. Technician use varied with hospital size, teaching affiliation, owner-ship, type of drug delivery system, and education level of the director of pharmacy. Use of pharmacy technicians increased with the severity of hospital-patient illness treated. A fair correlation was found between the pharmaceutical-care index and the technician-use index. A positive association was found between pharmacy technician use and pharmacists' provision of clinical pharmacy services.     

Pharmacists' smoking cessation practices: relationship to their knowledge and skills, attitudes, and perceptions of roles.

OBJECTIVE: To assess factors associated with pharmacists' practices regarding patients' smoking and smoking cessation. DESIGN: Cross-sectional analysis. SETTING: Four Canadian provinces (Ontario, Québec, Saskatchewan, Prince Edward Island). PARTICIPANTS: Practicing community pharmacists (n = 906; weighted n = 897). INTERVENTION: Population-based mailed questionnaire survey with 72% response rate. MAIN OUTCOME MEASURES: Bivariate and multivariate relationships between 12 clinical interventions regarding smoking and smoking cessation and 7 domains: basic pharmacologic knowledge; applied health science knowledge and skills; positive, negative and economic-related attitudes toward smoking cessation; perceptions of pharmacists' roles with patients who smoke: assessing and motivating patients; assisting, referring and following up. RESULTS: Basic pharmacologic knowledge and applied health science knowledge and skills were independently related to 12 and 10 interventions, respectively. Positive attitudes toward smoking cessation were independently related to 8 interventions. Negative attitudes and economic-related attitudes toward smoking cessation were each independently related to only 1 intervention. Perceptions of pharmacists' roles with respect to "assessing and motivating patients," and "assisting, referring, and following up" were independently related to 8 and 3 interventions, respectively. CONCLUSION: Initiatives to increase tobacco-related knowledge and skills and enhance positive attitudes and role perceptions with respect to smoking and smoking cessation may promote interventions by community pharmacists with patients who smoke.     

Transplant pharmacists' opinions on generic product selection of critical-dose drugs.

Factors considered important by transplant pharmacists in decisions about generic product selection and in defining critical-dose drugs, as well as transplant pharmacists' attitudes about bioequivalence testing, were studied. Surveys, completed by telephone and fax in 1997, were used to assess pharmacists' role at solid-organ transplant centers, factors the pharmacists considered important for generic product selection, and pharmacists' attitudes about the FDA guidelines on bioequivalence testing. Surveys were completed by 59 pharmacists. The factors considered important by pharmacists for inclusion of generic products on the formulary were safety (97% of respondents), clinical consequences (97%), efficacy (92%), and bioequivalence (92%). Nearly all the pharmacists (95%) expressed a belief that generic products of some critical-dose drugs should not be dispensed. Only 12% of the respondents said they thought that the FDA guidelines on bioequivalence testing were appropriate for critical-dose drugs, and 92% thought that bioequivalence testing for this category of drugs should be conducted in actual patients. Efficacy, safety, the presence of a narrow therapeutic index, bioequivalence, and clinical consequences were identified by transplant pharmacists as important factors in decisions about generic product selection; current FDA guidelines for establishing bioequivalence were viewed as possibly not appropriate for critical-dose drugs.     

Availability of and attitudes toward resources on alternative medicine products in the community pharmacy setting.

OBJECTIVE: To examine the availability of resources on dietary supplements in the community pharmacy setting and to assess the attitudes of community pharmacists toward these resources. DESIGN: Cross-sectional study. SETTING: Community pharmacies in New York and New Jersey that serve as experiential sites for senior student pharmacists at the Arnold & Marie Schwartz College of Pharmacy and Health Sciences, Long Island University. PARTICIPANTS: Preceptors or full-time pharmacists. INTERVENTION: Mailed survey. MAIN OUTCOME MEASURES: Frequency of use, availability of, and pharmacists' satisfaction with resources on alternative medicines, defined in the survey as any product including herbal remedies, vitamins, minerals, and natural products that may be purchased at a health food store, pharmacy, supermarket, alternative medicine store/magazine for the purpose of self-treatment. RESULTS: A total of 64 pharmacists characterized their frequency of use of resources on alternative medicines while formulating responses to questions as: never (n = 5; 7.8%), seldom (n = 31; 48.4%), often (n = 24; 37.5%), or always (n = 4; 6.3%). A total of 30 different resources were available to 40 respondents. The most commonly available resources were the PDR for Herbal Medicines (42.5%), The Review of Natural Products (20.0%), and the Web site of the National Center for Complementary and Alternative Medicine (12.5%). Of 54 respondents, 4 (7.1%) reported being completely dissatisfied with the available resources; 17 (31.5%) were somewhat dissatisfied; 25 (46.3%) were somewhat satisfied; and 8 (14.8%) were completely satisfied with the resources available to them. Topics the pharmacists most commonly wanted to see improved included safety (72.7%), interactions (70.9%), and uses (69.1%). CONCLUSION: Community pharmacists do not use information resources on alternative medicine products frequently, and many are not satisfied with the resources available to them.     

The impact of increasing workloads and role expansion on female community pharmacists in the United Kingdom

BACKGROUND: Evidence from United Kingdom and the United States indicates that community pharmacists' workloads have increased in recent years for 2 reasons. First, because of social and demographic changes there has been a greater demand for pharmaceutical services. Second, the community pharmacists' role has expanded. This article explores the effect of increased workloads on female community pharmacists. METHODS: Face-to-face interviews (n=30) were conducted with women over the age of 30 years in the North West of England who worked as community pharmacists. The interview schedule was designed to explore factors underpinning female working patterns in community pharmacy. Specifically, interviewees were asked about perceptions of working conditions, positive and negative aspects of community pharmacy working, views of recent changes in pharmacy, and future career plans. RESULTS: Findings suggest that although community pharmacists enjoy aspects of their new roles, their work environment has become increasingly pressurized, resulting in decreased job satisfaction. Additionally, this study found some evidence that increasing workloads resulted in decreased health and well-being. CONCLUSIONS: The role of the community pharmacist has significantly altered in recent years, and this has occurred following a decade of increasing workloads. Consideration of the factors shaping community pharmacy points to high-pressure working environments becoming common place. This is likely to have a negative impact on pharmacists and conceivably the services they provide.     

Pharmacists' role in smoking cessation: an examination of current practice and barriers to service provision

Objective This study addressed the potential role of pharmacists in helping their patients to quit smoking by providing a summary of their self‐reported levels of current activities, confidence, and readiness to change around the provision of brief advice and support for patients who smoke. In addition to investigating which barriers are perceived to be most important, this study also examined the relative importance of confidence, barriers and practice factors in relation to pharmacists' smoking cessation practices. Method A 58‐item questionnaire was mailed to 720 pharmacists. The questionnaire measured demographic and background variables, level of smoking cessation activity (asking, advising, assessing, assisting and arranging including follow‐up), confidence in undertaking smoking‐cessation activities, readiness to change, perceived importance of barriers to providing smoking‐cessation services, and further education or training in relation to smoking cessation. Setting Community pharmacists in South Australia. Key findings Respondents indicated high rates of activity in relation to assessing and assisting patients to quit smoking, with lower rates of advising and arranging including following up. Recording of smoking status was very low. Confidence emerged as the most important predictor of smoking‐cessation activities, with pharmacist barriers including fear of alienating patients approaching significance. Reported levels of smoking‐specific education and training were low. Conclusions South Australian pharmacists are contributing to the prevention of tobacco‐related harms. With additional support there is a greater scope for involvement. Results indicate a need for a team‐based, systematic and multifaceted approach to address barriers and enhance pharmacists' confidence. Further implementation research is required to assess the effectiveness of multifaceted pharmacy support programmes on the uptake and sustainability of smoking‐cessation services.     

Nutritional support: pharmacists' influence on the prescribing process

A commitment was made at a 1,025-bed county teaching facility to increase staff pharmacists' involvement in nutritional support and physician prescribing. The plan was to utilize the Nutritional Support Clinical Pharmacy Specialist (NSCPS) to train the staff pharmacists to provide direct patient care for patients receiving parenteral nutrition. The implementation included specialized training for staff pharmacists, staff pharmacists monitoring all parenteral nutrition patients, pharmacists' attendance at nutritional support rounds, documentation of all pharmacist interventions, and pharmacists' involvement in the drug-usage evaluation (DUE) process. The results of the increased influence of pharmacists on the prescribing process included more appropriate parenteral nutrition therapy, earlier transitioning from parenteral to enteral nutrition, recognition of staff pharmacists as resources by the physicians, and increased job satisfaction for pharmacists.     

新入职药师核心能力的现状调查及对医院药师规范化培训的启示

目的：了解河南省新入职药师核心能力的现状,为制定医院药师规范化培训方案提供依据。方法：采用新入职药师核心能力问卷,对河南省21家三级综合医院2017年、2018年入职的182名药师进行调查。结果：新入职药师核心能力平均得分为（3.63±0.73）分,其中协调沟通能力维度得分最高,为（3.93±0.67）分,药学服务咨询能力维度得分最低,为（3.51±0.80）分。结论：新入职药师的核心能力处于中等水平,规范化培训除了各方面继续加强外,应更加注重培养药师的药学服务咨询能力、管理能力、批判性思维和专业实践能力。     

Characterizing pharmacy part-time practice

OBJECTIVES: (1) To characterize pharmacists who work part-time and compare them with pharmacists who work a secondary part-time job (moonlighters) with respect to their motivations for working in a part-time job, and (2) to identify the set of characteristics that best describes pharmacists engaged in each of the part-time work arrangements under study. DESIGN: A five-page questionnaire was mailed to 3,002 licensed pharmacists nationwide. Two follow-up surveys were sent to nonrespondents at the fifth and ninth weeks from the original mailout to ensure an adequate response rate. RESULTS: The net response rate was 57% (n = 1,637). Assessment of the sample did not detect any potential nonresponse bias. Sixty-eight percent of the respondents reported working full time, 13% were moonlighters, 14% were part-timers, and 5% were part-timers in more than one job. Reasons for working part-time were analyzed for the moonlighter and part-timer subsamples. A principal components analysis revealed that both groups have distinct motivations for selecting their chosen work arrangement. CONCLUSION: This study provides some insight into those factors affecting pharmacists' decisions to engage in two different types of part-time work. Since pharmacists' alternative work schedules can have repercussions on the quality of pharmacy being practiced, further research on pharmacists' work arrangement choices should provide useful information for work force-related endeavors.     

Continuing education and community pharmacists in Galicia: a study of opinions

AIM OF THE STUDY: To determine the opinions of a volunteer group of community pharmacists concerning general and specific issues related to continuing education. METHODS: Participants were required to complete questionnaires before and after attendance at a refresher course, and score the relevant options provided on a scale from 0 to 10. The responses of the survey were analyzed to identify preferences and to detect any possible changes in opinion. MAIN OUTCOME MEASURE: Arithmetic means of pharmacists' opinions. RESULTS: The teaching methods preferred by the community pharmacists were workshops for resolution of practical cases (9 +/- 0.25 and 8.88 +/- 0.13) and the distance-learning computer programmes (6.74 +/- 0.25 and 8.18 +/- 0.20). In selecting which topics that should be taught, the participants gave the highest ratings to healthcare needs (8.75 +/- 0.14 and 8.57 +/- 0.15) and the demands of the pharmacists (8.15 +/- 0.16 and 8.40 +/- 0.16), with pharmaceutical care being the most requested topic (29 points). Participants preferred courses lasting 20 to 50 hours (6.94 +/- 0.26 and 7.89 +/- 0.16), without preference for schedule. CONCLUSION: Community pharmacists in Galicia show a great interest in the provision and organization of continuing education activities that meet their needs and expectations.     

呼吸病区药师参与临床药物治疗方案二例报告

目的：临床药师尝试在呼吸内科病区参与临床药物治疗。方法：临床药师对出现病情异常变化的患者查询病史，分析其病情变化与用药的关系，发现用药禁忌。结果：临床药师提出解决的方法，并且被医生接受。结论：这种参与临床用药的方式不仅切实可行，而且十分有效。