Research in Social & Administrative Pharmacy最新文献

Background: Community pharmacists are underutilized in assisting patients with cardiovascular diseases within pharmacy settings. Monitoring and controlling cardiovascular risks could prevent deaths globally and save public health expenses. The aim of this study is to verify how self-care can impact the quality of life of patients with cardiovascular diseases.

Methods: A quasi-experimental study lasting 12 months was designed, involving pharmacist intervention. The intervention provided to patients involved personalized guidance tailored to their activation level. This included recommendations for lifestyle changes aimed at improving their quality of life, as assessed using research tools. Key biochemical variables, such as cholesterol levels, cardiovascular risk scores, blood pressure, and patient activation, were measured alongside the patients' perceived quality of life.

Results: Activation level increased significantly after 12 months (from 2.81 ± 1.02 to 3.25 ± 0.78; p = 0.09), and quality of life by 9.9 points out of 100 (p = 0.02). In terms of total cholesterol levels, a decrease was observed between the beginning and the end of the study of 18.7 mg/dL (p = 0.04) and in diastolic pressure by 21.1 mm Hg (p = 0.02). In addition, there is a protective factor against cholesterol increase in those patients with a high activation level (PAM level above 3; RR = 0.273; 95%CI = 0.104-0.716), and with an improvement in quality of life (β = 0.761; p = 0.011); and a lower diastolic pressure when activation was higher (β = -0.351; p = 0.025).

Conclusion: Community pharmacists have an impact on improving self-care behaviors among patients with cardiovascular diseases. Community pharmacists, through their proactive involvement and tailored care approaches, are identified as key agents in chronic disease management, empowering patients towards healthier outcomes in the face of ongoing health challenges.

Background: The management of pharmacy services within healthcare institutions presents significant challenges, particularly in ensuring the rational use of medications. These challenges include managing complex medication regimens and ensuring patient safety amidst a growing number of drug interactions.

Objective: This study aimed to construct a hospital pharmacy service competence assessment model focused on the promoting the rational use of medications so as to enable hospitals to assess their pharmacy services more accurately and efficiently.

Methods: A three-step methodology was employed to identify the indicators for assessing hospital pharmacy service capabilities. First, the Delphi method was used to select the initial indicators. Second, an assessment model was developed through principal component analysis (PCA) by incorporating the selected indicators. Third, this model was applied in a comprehensive field assessment involving our hospital and 194 others throughout the Shanxi province, China.

Results: The screening process identified 10 primary indicators and 53 secondary indicators encompassing key areas such as rational clinical medication management, informatics, infrastructure development, and the expansion of pharmacy services. The resulting hospital pharmacy service competence assessment model was applied to 195 hospitals of varied tiers, with the assigned scores (x‾ = 36.12) employed to conduct a comprehensive evaluation and identify areas requiring targeted intervention to optimize pharmacy services in each hospital.

Conclusion: We established a comprehensive assessment model that reflects the competency of hospital pharmacy services from a management perspective. The model integrates the strategic approach of rational medication use, providing robust support for healthcare organizations in assessing pharmacy service capacity and improving the management of rational use.

Introduction: High use of psychotropic medications continues to be common in residential aged care homes despite the risk of harm and limited efficacy in people living with dementia. Research has shown that the organizational culture of aged care homes influences psychotropic medication use in residents with dementia. The Psychotropic medicines use in Residents And Culture: Influencing Clinical Excellence (PRACTICE) tool was developed to evaluate the organizational culture of aged care homes specific to the use of psychotropic medications.

Objectives: To evaluate the comprehensibility, relevance, and comprehensiveness of the PRACTICE tool among end-users.

Method: Cognitive interviews were conducted with participants representing a broad range of health disciplines across Australia. Interviews were performed using a combination of the think-aloud technique and verbal probing. Interviews were transcribed and content coded for participants' perceptions of the PRACTICE tool. Items were modified based on findings from the cognitive interviews, participants' suggestions for rewording of items and discussions with the research team.

Results: A total of 20 cognitive interviews were conducted. Based on the cognitive interviews, 48 out of 63 items were modified. Reasons for modification were categorized into three themes: 1) Items changed to align with the aged care home staff's scope of practice; 2) Items adjusted to prevent unintended blame from reading the items; and 3) Items modified to prevent potential misinterpretation of their intended meaning. Three items were added to improve the comprehensiveness of the tool. Most participants reported that they understood the items and considered them as relevant and acceptable for the evaluation of organizational culture and use of psychotropic medication in aged care homes.

Conclusion: This study confirms that the PRACTICE tool is a comprehensive tool appropriate for the assessment of organizational culture specific to psychotropic medication use and is important for aged care home settings.