Evaluation of patient satisfaction and experience towards pharmacist-administered vaccination services in Western Australia

Background Pharmacist-administered vaccination services have been available in various countries for several years. In 2014, Western Australian (WA) legislation was introduced to allow pharmacist immunisers to administer the influenza vaccine to consumers 18 years and older. Objective To determine consumer satisfaction with pharmacist-administered influenza vaccination services in WA and identify factors associated with opinions to extend the service to include other vaccines. Setting Thirteen WA community pharmacies. Method In 2015, 133 pharmacies in WA offered pharmacist-administered influenza vaccinations. Of the 133 pharmacies, a purposive sample of 10% (13) were invited to participate in this 2016 study. Following vaccination, consumers were given a questionnaire and asked to evaluate the service and if they would support expansion of the service to include other vaccinations. Main outcome measure Consumer satisfaction with aspects of the service using a 5-point Likert scale. Results A total of 434 (66.8%) questionnaires were completed at the 13 pharmacies and returned. The majority of consumers (99.5%) were satisfied with the service overall, and 97.2% advised they would receive a vaccination from a community pharmacist in the future. Over 60% would like vaccinations to expand to other conditions. Women and those who would again have their influenza vaccine from the pharmacist were particularly supportive of this expansion. Conclusion Consumer satisfaction with pharmacist-administered vaccinations was high. Consumers found the service convenient, comfortable and professional. The majority of respondents supported expansion of pharmacist-administered vaccination services to a wider range of vaccines.     

经尿道绿激光汽化联合电切割治疗前列腺增生的应用与创伤评价

目的:应用定量指标白细胞介素6和C-反应蛋白评估经尿道绿激光联合电切割手术对机体的创伤程度,进而评价其治疗老年前列腺增生的可行性。方法:选择2005-06/2006-04在解放军第四军医大学西京医院住院的良性前列腺增生患者98例(年龄>60岁),分别行开放性手术(28例)、经尿道绿激光汽化合并电切割术(PVP TURP组,33例)和经尿道绿激光汽化术(PVP组,37例)。绿激光汽化采用美国Laserscope公司生产的非接触式绿激光治疗系统,额定输出汽化功率为80W,电凝功率为30W。用酶联免症吸附法测定3组患者手术前2h,术后24,48h血清中白细胞介素6和C-反应蛋白水平。结果:98例患者全部进入结果分析。①血清白细胞介素6水平:术前2h3组比较差异不显著(P>0.05),术后24和48h均明显高于术前(P<0.05);术后24,48h开放性手术组高于PVP组和PVP TURP组[24h:(5.97±1.35),(1.81±1.64),(2.44±1.45)μg/L,P<0.05;48h:(1.63±0.86),(0.77±0.51),(0.80±1.46),P<0.05]。②血清C-反应蛋白水平:术前2h3组比较差异不显著(P>0.05),术后24和48h均明显高于术前(P<0.05);术后24,48h开放性手术组高于PVP组和PVP TURP组[24h:(62.38±13.65),(10.03±4.05),(28.57±9.8)mg/L,P<0.05;48h:(118.85±20.82),(38.86±8.35),(69.44±13.66),P<0.05];PVP TURP组高于PVP组(P<0.05)。结论:在这3种术式中,开放性手术对机体的创伤最大,机体急性时相反应最显著,经尿道绿激光汽化术合并电切割术对机体创伤较轻,可用于治疗老年前列腺增生症。     

Aggressive polyfibromatosis: A 10 year follow-up

Polyfibromatosis syndrome is a condition characterized by the occurrence of several cutaneous fibrotic conditions including Dupuytren's contracture and keloid formation. A 10 year follow-up of a patient with an aggressive type of polyfibromatosis associated with erosive arthropathy is presented. The underlying pathogenesis and management of this uncommon condition is discussed.     

Recombinant human stem cell factor enhances myeloid colony growth from human peripheral blood progenitors

Peripheral blood hematopoietic progenitors (PBHP) are capable of colony growth in vitro. The effect of stem cell factor (SCF), interleukin-6 (IL-6), and basic fibroblast growth factor (bFGF) on myeloid colony proliferation of PBHP was determined. PBHP purified by positive selection with CD34-specific antibody were plated in semisolid agarose with reported plateau doses of interleukin-3 (IL-3), granulocyte- macrophage colony-stimulating factor (GM-CSF), and granulocyte colony- stimulating factor (G-CSF) to enhance myeloid colony growth. Experiments then were done to examine colony growth in response to SCF or with SCF and bFGF and/or IL6. SCF alone in the absence of any other growth factors did not support colony growth. SCF at a determined optimum concentration of 100 ng/mL added to the combination of IL-3, GM- CSF, and G-CSF enhanced colony growth and size relative to proliferation in response to the latter three factors alone (from 78 to 188 total colonies/10(4) PBHP plated and from 10 to 93 large [> 200 cells] colonies/10(4) PBHP plated). Furthermore, addition of bFGF and/or IL-6 to the combination of optimum concentrations of SCF, IL-3, GM-CSF, and G-CSF further enhanced colony number and size in a dose- dependent fashion. Using the optimum combination of all growth factors, we determined that the number of myeloid colony-forming PBHP in whole blood was similar between individuals at about three colonies per milliliter whole blood. We conclude that progenitors capable of responding to the early-acting growth factor, SCF, are represented in PBHP and that the number of circulating myeloid colony-forming PBHP is likely a regulated parameter that may have an important biologic function.     

Exploring the time required by pharmacists to prepare discharge medicine lists: a time-and-motion study

International Journal of Clinical Pharmacy - Discharge medicine lists provide patients, carers and primary care providers a summary of new, changed or ceased medicines when patients discharge from...     

Medication supply and management in rural Queensland: Views of key informants in health service provision

BackgroundRural settings challenge health care providers to provide optimal medication services in a manner that is timely and of high quality. Extending the roles of rural health care providers is often necessary to improve access to medication services; however, there appears to be a lack of pharmacy-based involvement and support within the medication system.ObjectivesThis article explores medication supply and management issues in rural settings, based on the governance perspectives of key informants on regulatory aspects, policy, and professional practice. The specific objectives were to (1) identify the key issues and existing facilitators and (2) explore the potential roles of pharmacy to improve medication supply and management services.MethodsSemi-structured interviews were conducted with representatives within regulatory or professional organizations. The participants were key informants who held leadership and/or managerial roles within their respective organizations and were recruited to provide insights from a governance perspective before data collection in the community. An interview guide, informed by the literature, assisted the flow of interviews, exploring topics, such as key issues, existing initiatives, and potential pharmacy-based facilitators, in relation to medication supply and management in rural settings.ResultsIssues identified that hindered the provision of optimal medication supply and management services in the rural areas centered on workforce, interprofessional communication, role structures, and funding opportunities. Legislative and electronic developments and support mechanisms aim to facilitate medication processes in rural areas. Potential initiatives to further enhance medication services and processes could explore extended roles for pharmacists and pharmacy support staff, as well as alternative service delivery models to enhance pharmacy workforce capacity.ConclusionsThe study provided an overview of key issues with medication supply and management and highlighted the potential for increased pharmacy involvement to improve and support medication services in rural areas. The governance views of these key informants could be used to inform policy and practice related to rural medication services.     

Doctor–patient concordance during HIV treatment switching decision‐making

Objectives

The aim of the study was to explore levels of doctor–patient concordance during the making of decisions regarding HIV treatment switching and stopping in relation to patient health‐related outcomes.

Methods

Adult patients attending five HIV clinics in the United Kingdom were requested to complete the study questionnaire, which included a Concordance Scale, and measures of symptoms [Memorial Symptom Assessment Short Form (MSAS) index], quality of life (EuroQol), satisfaction, adherence and sexual risk behaviour. Clinical health measures (HIV viral load and CD4 cell count) were also obtained. A total of 779 patients completed the questionnaire, giving a response rate of 86%; of these 779 patients, 430 had switched or stopped their HIV treatment and were thus eligible for inclusion. Of these patients, 217 (50.5%) fully completed the Concordance Scale.

Results

Concordance levels were high (88% scored between 30 and 40 on the scale; score range 10–40). Higher concordance was related to several patient outcomes, including: better quality of life (P=0.003), less severe and burdensome symptom experience (lower MSAS‐physical score, P=0.001; lower MSAS‐psychological score, P=0.008; lower MSAS‐global distress index score, P=0.011; fewer symptoms reported, P=0.007), higher CD4 cell count (at baseline, P=0.019, and 6–12 months later, P=0.043) and greater adherence (P=0.029).

Conclusions

High levels of doctor–patient concordance in HIV treatment decision‐making are associated with greater adherence and better physical and psychological functioning. More research is needed to establish a causal relationship between concordance and these outcomes.