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Robin Patel, Ferric C Fang
Recent advances in microbial diagnostics are providing clinicians with information about microbes causing infections and their resistance to antimicrobial agents more rapidly than ever before. Diagnostic stewardship refers to the appropriate use of laboratory testing to guide patient management, including treatment, in order to optimize clinical outcomes and limit the spread of antimicrobial resistance. Fulfilling the promise of diagnostic stewardship requires a seamless partnership between clinical laboratories, pharmacists, and infectious diseases clinicians, so that appropriate tests are ordered and diagnostic information is translated into appropriate management in real time...
March 14, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
Sherine Ismail, Mohamed Osman, Rayf Abulezz, Hani Alhamdan, K H Mujtaba Quadri
Pharmacists possess pivotal competencies and expertise in developing clinical pathways (CPs). We present a tertiary care facility experience of pharmacists vis-a-vis interprofessional collaboration for designing and implementing CPs. We participated in the development of CPs as leading members of a collaborative team of healthcare professionals. We reviewed literature, aligning it with hospital formulary and institutional standards, and participated in weekly team meetings for six months. Several tools and services were adapted to guide prescribing and standardization of care through time-bound order sets...
March 16, 2018: Pharmacy (Basel, Switzerland)
Ali Ahmed, Maria Tanveer, Adeel Siddiqui, Gul Majid Khan
Clinical pharmacists should be increasingly important members of the healthcare team in developing countries such as Pakistan. Survey of literature was conducted to identify the determinants of clinical pharmacy in Pakistan. Lack of trained human capital, shortage of resources, patient overburden, inefficient pharmacy education curriculum, and limited job opportunities are some of the determinants of clinical pharmacy profession in developing countries. The underutilization of clinical pharmacists paves the way for an increased incidence of medication errors, adverse drug events, irrational prescribing, and suboptimal therapeutic outcomes...
March 2018: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
Boon Phiaw Kho, Mohamed Azmi Hassali, Ching Jou Lim, Fahad Saleem
OBJECTIVES: The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges. METHODS: Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations...
March 15, 2018: International Journal of Pharmacy Practice
Jacob C Easaw, Susan McCall, Adrian Azim
Stable cancer patients diagnosed with a pulmonary embolus or deep vein thrombosis are commonly referred to the emergency department for management. This practice strains an already overburdened emergency department and is associated with long wait times and poor disease/injection education for patients. This pilot study sought to determine if stable cancer patients with newly diagnosed cancer-associated thrombosis could be effectively managed by community-based pharmacists who followed an evidence-based protocol to prescribe and initiate low-molecular weight heparin therapy...
January 1, 2018: Journal of Oncology Pharmacy Practice
Johannes Wohlrab, Petra Staubach, Matthias Augustin, Lisa Eisert, Andreas Hünerbein, Alexander Nast, Holger Reimann, Klaus Strömer, Vera Mahler
The present guidelines are aimed at dermatology residents and board-certified dermatologists as well as policymakers and insurance companies. Developed by dermatologists in collaboration with pharmacists using a formal consensus process (S2k), they include general aspects with respect to pharmacokinetics and regulatory terminology. Recommendations are provided on the various indications for extemporaneous preparations and their quality assurance. The importance of pharmaceutical vehicles and problems associated with substituting one vehicle for another are discussed...
March 2018: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Geoffrey D Barnes, Erin Mouland
Peri-procedural management of oral anticoagulants can be complex and confusing for many providers. It involves a careful balance of a patient's thromboembolic risk and bleeding risk. For every patient chronically taking an oral anticoagulant who will be undergoing an elective procedure, a four step approach may be considered when creating a plan for the oral anticoagulant.(Writing Group M, 20161 ) Does the oral anticoagulant need to stop for the procedure?(Periprocedural Management of Anticoagulation Writing C, Doherty JU, Gluckman TJ, et al...
March 10, 2018: Progress in Cardiovascular Diseases
Ann E Vandenberg, Katharina V Echt, Lawanda Kemp, Gerald McGwin, Molly M Perkins, Anna K Mirk
Suboptimal prescribing persists as a driver of poor quality care of older veterans and is associated with risk of hospitalization and emergency department visits. We adapted a successful medication management model, Integrated Management and Polypharmacy Review of Vulnerable Elders (IMPROVE), from an urban geriatric specialty clinic to rural community-based clinics that deliver primary care. The goals were to promote prescribing quality and safety for older adults, including reduced prescribing of potentially inappropriate medications (PIMs)...
March 2018: Journal of the American Geriatrics Society
Laurence Guillaumie, Alice Ndayizigiye, Clément Beaucage, Jocelyne Moisan, Jean-Pierre Grégoire, Denis Villeneuve, Sophie Lauzier
Objectives: Patients prescribed antidepressant drug treatment (ADT) for major depression report several needs in relation to their treatment, and a large proportion of these patients will end ADT prematurely. Community pharmacists may play an important role in monitoring ADT and supporting these patients. However, little is known about patient experiences of the services provided in community pharmacies. The objectives of this study were to 1) explore patients' experiences with the services community pharmacists provide for ADT and 2) identify potential avenues for improvement of pharmacists' services within the context of ADT...
March 2018: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
Philippe Martin, Cara Tannenbaum
Context: Interprofessional communication is an effective mechanism for reducing inappropriate prescriptions among older adults. Physicians' views about which elements are essential for pharmacists to include in an evidence-based pharmaceutical opinion for deprescribing remain unknown. Objective: To develop a prototype for an evidence-based pharmaceutical opinion that promotes physician-pharmacist communication around deprescribing. Methods: A standardized template for an evidence-based pharmaceutical opinion was developed with input from a convenience sample of 32 primary care physicians and 61 primary care pharmacists, recruited from conferences and community settings in Montreal, Canada...
March 2018: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
Lee Verweel, Zahava R S Rosenberg-Yunger, Taranom Movahedi, Allan H Malek
Background: Canada legalized assisted dying with the passing of Bill C-14, Medical Assistance in Dying (MAiD), in June 2016. This legislation has implications for health care professionals participating in MAiD. This research aims to understand the effect that MAiD has on pharmacists and pharmacy technicians in Canada. Methods: We conducted a thematic document analysis of pharmacy guidelines, position statements and standards of practice from pharmacy regulatory authorities across Canada...
March 2018: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
Sarah King, Céline Miani, Josephine Exley, Jody Larkin, Anne Kirtley, Rupert A Payne
BACKGROUND: Long-term conditions place a substantial burden on primary care services, with drug therapy being a core aspect of clinical management. However, the ideal frequency for issuing repeat prescriptions for these medications is unknown. AIM: To examine the impact of longer-duration (2-4 months) versus shorter-duration (28-day) prescriptions. DESIGN AND SETTING: Systematic review of primary care studies. METHOD: Scientific and grey literature databases were searched from inception until 21 October 2015...
March 12, 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Azmeta Chowdhary, Victoria Zlotnikova, Cherie Lucas, John M Lonie
In any given year approximately 34% of the 130 million adults in the United States suffer from a mental health condition or disorder. Anxiety and depressive disorders are the most common followed by substance use disorder. Many people who suffer from a mental illness do not seek help. Studies have shown that the stigma of being perceived as having a mental illness prevents many adults from seeking help. Mental Health First Aid ™ (MHFA) is an educational program geared towards educating MHFA responders to assist those who may be experiencing a mental health condition or disorder...
February 27, 2018: Research in Social & Administrative Pharmacy: RSAP
Katharine Wallis, Rebecca Tuckey
INTRODUCTION High-risk prescribing in general practice is common and places patients at increased risk of adverse events. AIM The Safer Prescribing and Care for the Elderly (SPACE) intervention, comprising audit and feedback plus practice mail-out to patients with high-risk prescribing, was designed to promote medicines review and support safer prescribing. This study aims to test the SPACE intervention feasibility in general practice. METHODS This feasibility study involved an Auckland Primary Health Organisation (PHO), a clinical advisory pharmacist, two purposively sampled urban general practices, and seven GPs...
June 2017: Journal of Primary Health Care
Susan Bidwell, Andrea Copeland
INTRODUCTION Pegasus Health Charitable Ltd, a Christchurch Primary Health Organisation, is contracted by the Canterbury District Health Board to provide continuing professional development for primary care practitioners in the region. Rurally located health practitioners have largely been unable to participate because of the travel time and distances involved. AIM The initiative reported in this paper aimed to fill this gap by developing an accessible and high-quality multidisciplinary model of professional development for general practitioners, nurse practitioners, practice nurses and community pharmacists in rural areas of North Canterbury, New Zealand...
December 2017: Journal of Primary Health Care
Carmen Martín Fernández, Carlos Maroto Martín, Luis Fernández Salazar
BACKGROUND AND AIMS: patients need information for shared decision making. The aims of the study were to ascertain how patients with inflammatory bowel disease (IBD) felt about the information available and the way that their doctors informed them. In addition, how patients used the internet and factors that predicted a positive information evaluation were also assessed. METHOD: a 39-item survey was designed that was distributed via the internet, principally using a Spanish Facebook site...
March 12, 2018: Revista Española de Enfermedades Digestivas
Ryan Tewell, Lisa Edgerton, Elizabeth Kyle
PURPOSE: A program at a family medicine clinic to provide naloxone prescriptions in conjunction with education on naloxone use and opioid hazards to patients at risk for opioid overdose is described. SUMMARY: Consistent with a 2016 Centers for Disease Control and Prevention (CDC) guideline on opioid prescribing for chronic pain, a family medicine clinic implemented updated controlled substance agreements and medical record templates for documentation of pain management visits and established a pharmacist-led naloxone clinic...
March 15, 2018: American Journal of Health-system Pharmacy: AJHP
Anne L Donovan, J Matthew Aldrich, A Kendall Gross, Denise M Barchas, Kevin C Thornton, Hildy M Schell-Chaple, Michael A Gropper, Angela K M Lipshutz
OBJECTIVES: We describe the importance of interprofessional care in modern critical care medicine. This review highlights the essential roles played by specific members of the interprofessional care team, including patients and family members, and discusses quality improvement initiatives that require interprofessional collaboration for success. DATA SOURCES: Studies were identified through MEDLINE search using a variety of search phrases related to interprofessional care, critical care provider types, and quality improvement initiatives...
March 7, 2018: Critical Care Medicine
M A J M Buijsen
Physicians are regularly confronted with pharmacists who refuse to provide euthanasia drugs. They do not always understand that the provision of euthanasia drugs is not a normal professional activity for pharmacists. It is a lot less clear that pharmacists are also allowed to have fundamental objections. In addition, professional standards lack clarity for pharmacists who do not have such objections to the provision of euthanasia drugs. The relationship between physicians and pharmacists in the context of euthanasia presents problems overlooked by researchers of the third evaluation of the Termination of Life on Request and Assisted Suicide (review procedures) Act (WTL)...
2018: Nederlands Tijdschrift Voor Geneeskunde
Brooke L Griffin, Rebecca H Stone, Shareen Y El-Ibiary, Sarah Westberg, Kayce Shealy, Alicia Forinash, Abigail Yancey, Kathleen Vest, Lamis R Karaoui, Sally Rafie, Cheryl Horlen, Nicole Lodise, Nicole Cieri-Hutcherson, Sarah McBane, Anahit Simonyan
OBJECTIVE: To provide guidance for clinicians on risk assessment of medication use during pregnancy and lactation. DATA SOURCES: Authors completed PubMed searches to identify articles focused on the use of medications in pregnancy, including fetal development, drug transfer across the placenta, trimester exposure, chronic conditions in pregnancy, medications in lactation, and lactation and chronic disease. STUDY SELECTION AND DATA EXTRACTION: Articles were reviewed to provide overall guidance to medication selection during pregnancy...
March 1, 2018: Annals of Pharmacotherapy
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