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Primary care pharmacist

Allah Bukhsh, Muhammad Sarfraz Nawaz, Hafiz Sajjad Ahmed, Tahir Mehmood Khan
BACKGROUND: Diabetes self-care activities, like, healthy diet, regular exercise, self-monitoring of blood glucose, and rational use of medicines are considered to play a vital role in establishing euglycemia. Health literacy among type 2 diabetes mellitus (T2DM) patients in Pakistan is very low, which is the most likely cause for poor clinical outcomes. This study is designed to investigate the impact of pharmacist-led educational intervention on glycemic control, self-care activities and disease knowledge among T2DM patients in Pakistan...
March 2018: Medicine (Baltimore)
Erica Dimitropoulos, Stephanie Bertucci, Kara Wong
BACKGROUND: Research has demonstrated that the combination of pharmacotherapy and psychological interventions in alcohol use disorder (AUD) treatment is superior to either alone. Despite this, medications remain highly underutilized in many outpatient treatment facilities. Pharmacists can serve as an excellent resource to aid in improving access to medications. METHODS: This study was a prospective, longitudinal evaluation of a pharmacist's role in a substance use disorder (SUD) clinic, specifically an intensive outpatient program (IOP)...
March 20, 2018: Substance Abuse
Terhi Toivo, Maarit Dimitrow, Juha Puustinen, Eeva Savela, Katariina Pelkonen, Valtteri Kiuru, Tuula Suominen, Sirkka Kinnunen, Mira Uunimäki, Sirkka-Liisa Kivelä, Saija Leikola, Marja Airaksinen
BACKGROUND: The magnitude of safety risks related to medications of the older adults has been evidenced by numerous studies, but less is known of how to manage and prevent these risks in different health care settings. The aim of this study was to coordinate resources for prospective medication risk management of home care clients ≥ 65 years in primary care and to develop a study design for demonstrating effectiveness of the procedure. METHODS: Health care units involved in the study are from primary care in Lohja, Southern Finland: home care (191 consented clients), the public healthcare center, and a private community pharmacy...
March 16, 2018: BMC Geriatrics
Helen Benson, Cherie Lucas, Walter Kmet, Shalom I Benrimoj, Kylie Williams
Background Team based care has been used internationally to improve the delivery of best practice primary health care. The WentWest General Practice Pharmacist Project, involving the integration of pharmacists within general practice teams, was commissioned to improve medication management of general practice patients. A particular focus of the project was the performance of medication review to allow the detection and resolution of drug related problems (DRPs). Objective The objectives of this 6-month study (October 2016-March 2017) were to: (1) identify and classify the DRPs detected as a result of pharmacist activities within a general practice primary care setting...
March 14, 2018: International Journal of Clinical Pharmacy
Emma L Veale, Adrian J Stewart, Alistair Mathie, Satvinder K Lall, Melanie Rees-Roberts, Vilius Savickas, Sukvinder K Bhamra, Sarah A Corlett
INTRODUCTION: Atrial fibrillation (AF) affects >6% of people aged 65 years or older. Left undetected and untreated, patients may develop significant cardiovascular complications and have a fivefold increased risk of suffering a stroke. For 40% of all sufferers, AF can be asymptomatic. Every year in the UK, £2.2 billion is spent on AF-related strokes, so there is an urgent need to improve early detection of AF. This study aims to determine the feasibility of using trained clinical pharmacists based in general practices, to screen for AF, using pulse palpation and a single-lead ECG device on participants aged 65 years or older, attending influenza vaccination clinics...
March 14, 2018: BMJ Open
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
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
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
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
Chloë Campbell, Rhiannon Braund, Caroline Morris
INTRODUCTION Recognition of the need to reduce harm and optimise patient outcomes from the use of medicines is contributing to an evolution of pharmacy practice in primary health care internationally. This evolution is changing community pharmacy and leading to new models of care that enable pharmacist contribution beyond traditional realms. There is little information about the extent of these changes in New Zealand. AIM The aim of this study was to investigate emerging roles of pharmacists in primary health care...
December 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
Caroline Christie, Susan Bidwell, Andrea Copeland, Ben Hudson
INTRODUCTION Pastoral care is recognised as an important aspect of a mature primary care network. Pegasus Health is now in its 25th year and has had a formal Pastoral Care Programme for doctors since 2009. AIM This study aimed to collect local data on the self-care of Canterbury (Christchurch, New Zealand) general practitioners (GPs), nurse practitioners (NPs), practice nurses (PNs) and community pharmacists (CPs). METHODS The survey was open to all participants in the Pegasus Small Group Education Programme in Canterbury...
December 2017: Journal of Primary Health Care
Ronald G Victor, Kathleen Lynch, Ning Li, Ciantel Blyler, Eric Muhammad, Joel Handler, Jeffrey Brettler, Mohamad Rashid, Brent Hsu, Davontae Foxx-Drew, Norma Moy, Anthony E Reid, Robert M Elashoff
Background Uncontrolled hypertension is a major problem among non-Hispanic black men, who are underrepresented in pharmacist intervention trials in traditional health care settings. Methods We enrolled a cohort of 319 black male patrons with systolic blood pressure of 140 mm Hg or more from 52 black-owned barbershops (nontraditional health care setting) in a cluster-randomized trial in which barbershops were assigned to a pharmacist-led intervention (in which barbers encouraged meetings in barbershops with specialty-trained pharmacists who prescribed drug therapy under a collaborative practice agreement with the participants' doctors) or to an active control approach (in which barbers encouraged lifestyle modification and doctor appointments)...
March 12, 2018: New England Journal of Medicine
Zahira Latif, Abhishek Abhishek
To discuss alternate models of long-term gout management RECENT FINDINGS: Nurse-led care of gout appears to improve the uptake of and adherence to urate-lowering treatment in a research setting. Less impressive improvements were achieved with pharmacist-led remote management of gout; however, both strategies were more effective than usual primary care provider management of gout. Individualised education about gout, patient involvement in decision-making, and access to trained support in managing side-effects and gout flares can improve the uptake of fine and adherence to urate-lowering treatment...
March 8, 2018: Current Rheumatology Reports
Nienke Elske Dijkstra, Carolina Geertruida Maria Sino, Eibert Rob Heerdink, Marieke Joanna Schuurmans
BACKGROUND: Home care patients often use many medications and are prone to drug-related problems (DRPs). For the management of problems related to drug use, home care could add to the multidisciplinary expertise of general practitioners (GPs) and pharmacists. The home care observation of medication-related problems by home care employees (HOME)-instrument is paper-based and assists home care workers in reporting potential DRPs. To facilitate the multiprofessional consultation, a digital report of DRPs from the HOME-instrument and digital monitoring and consulting of DRPs between home care and general practices and pharmacies is desired...
March 7, 2018: JMIR Human Factors
Deepti Shanbhag, Ian D Graham, Karen Harlos, R Brian Haynes, Itzhak Gabizon, Stuart J Connolly, Harriette Gillian Christine Van Spall
BACKGROUND: The uptake of guideline recommendations that improve heart failure (HF) outcomes remains suboptimal. We reviewed implementation interventions that improve physician adherence to these recommendations, and identified contextual factors associated with implementation success. METHODS: We searched databases from January 1990 to November 2017 for studies testing interventions to improve uptake of class I HF guidelines. We used the Cochrane Effective Practice and Organisation of Care and Process Redesign frameworks for data extraction...
March 6, 2018: BMJ Open
E Matifat, K Perreault, M Gagné, M Léveillé, F Desmeules
BACKGROUND: To improve the efficiency of the health care system, new interprofessional models of care are emerging. In 2015, two provincial professional colleges, regulating the practice of physiotherapists and that of pharmacists in the province of Québec, Canada, developed a new interprofessional model of care. This model is designed to guide non-prescription medication recommendations by physiotherapists treating patients in primary care with neuromusculoskeletal disorders (NMSKD) with the collaboration of pharmacists...
March 6, 2018: Journal of Evaluation in Clinical Practice
James N Fleming, Frank Treiber, John McGillicuddy, Mulugeta Gebregziabher, David J Taber
BACKGROUND: Medication errors, adverse drug events, and nonadherence are the predominant causes of graft loss in kidney transplant recipients and lead to increased healthcare utilization. Research has demonstrated that clinical pharmacists have the unique education and training to identify these events early and develop strategies to mitigate or prevent downstream sequelae. In addition, studies utilizing mHealth interventions have demonstrated success in improving the control of chronic conditions that lead to kidney transplant deterioration...
March 2, 2018: JMIR Research Protocols
Jo Brett, Mary Boulton, Debbie Fenlon, Nick J Hulbert-Williams, Fiona M Walter, Peter Donnelly, Bernadette A Lavery, Adrienne Morgan, Carolyn Morris, Eila K Watson
Introduction: Despite evidence of the efficacy of adjuvant endocrine therapy (AET) in reducing the risk of recurrence and mortality after treatment for primary breast cancer, adherence to AET is suboptimal. This study aimed to explore factors that influence adherence and nonadherence to AET following breast cancer to inform the development of supportive interventions. Methods: Interviews were conducted with 32 women who had been prescribed AET, 2-4 years following their diagnosis of breast cancer...
2018: Patient Preference and Adherence
L Franco-Trigo, J Tudball, D Fam, S I Benrimoj, D Sabater-Hernández
BACKGROUND: Collaboration between relevant stakeholders in health service planning enables service contextualization and facilitates its success and integration into practice. Although community pharmacy services (CPSs) aim to improve patients' health and quality of life, their integration in primary care is far from ideal. Key stakeholders for the development of a CPS intended at preventing cardiovascular disease were identified in a previous stakeholder analysis. Engaging these stakeholders to create a shared vision is the subsequent step to focus planning directions and lay sound foundations for future work...
February 21, 2018: Research in Social & Administrative Pharmacy: RSAP
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