Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)最新文献

英文中文

National Observational Study of Prescription Dispensing Accuracy and Safety in 50 Pharmacies 全国50家药店处方调剂准确性和安全性观察研究

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480731

Elizabeth Allan Flynn PhD, Kenneth N. Barker PhD, Brian J. Carnahan PhD

Objectives

To measure dispensing accuracy rates in 50 pharmacies located in 6 cities across the United States and describe the nature and frequency of the errors detected.

Design

Cross-sectional descriptive study.

Settings

Chain, independent, and health-system pharmacies (located in hospitals or managed care organizations).

Participants

Pharmacy staff at randomly selected pharmacies in each city who accepted an invitation to participate.

Intervention

Observation by a pharmacist in each pharmacy for 1 day, with a goal of inspecting 100 prescriptions for dispensing errors (defined as any deviation from the prescriber's order).

Main Outcome Measure

Dispensing errors on new and refill prescriptions.

Results

Data were collected between July 2000 and April 2001. The overall dispensing accuracy rate was 98.3% (77 errors among 4,481 prescriptions; range, 87.2%-100.0%; 95.0% confidence interval, + 0.4%). Accuracy rates did not differ significantly by pharmacy type or city. Of the 77 identified errors, 5 (6.5%) were judged to be clinically important.

Conclusion

Dispensing errors are a problem on a national level, at a rate of about 4 errors per day in a pharmacy filling 250 prescriptions daily. An estimated 51.5 million errors occur during the filling of 3 billion prescriptions each year.

目的测量美国6个城市50家药店的调剂准确率，并描述检测到的错误的性质和频率。设计横断面描述性研究。环境:独立的、卫生系统药房(位于医院或管理式医疗机构)。参与者:在每个城市随机选择接受邀请的药店的工作人员。干预:由一名药剂师在每个药房进行为期1天的观察，目标是检查100张处方的配药错误(定义为与处方者的处方有任何偏差)。主要观察指标:新处方和补处方的配药错误。结果数据收集时间为2000年7月至2001年4月。总体调剂准确率为98.3%(4481张处方中有77张错误;范围87.2% - -100.0%;95.0%置信区间，+ 0.4%)。准确率在药店类型和城市之间没有显著差异。在鉴定出的77个错误中，5个(6.5%)被认为具有临床重要性。结论在全国范围内，配药差错是一个普遍存在的问题，某药房每天配药250张，平均每天发生4次差错。据估计，每年在填写30亿张处方时发生5150万次错误。

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引用次数: 158

Teaching Patients the ABCs of Preventing Melanoma 教给患者预防黑色素瘤的基础知识

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480803

Janet E. Shepherd MD, FACOG (Practicing Gynecologist)

引用次数: 2

New Antibody Approved for Treatment of Rheumatoid Arthritis 新抗体被批准用于治疗类风湿性关节炎

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480812

Peggy Piascik PhD (Associate professor of pharmacy practice and science)

Adalimumab joins free existing biologic agents for the treatment of RA. Its place among these therapeutic options is unclear until head-to-head studies are performed with adalimumab and other biologic DMARDs. Adalimumab is currently in clinical trials for additional therapeutic uses, namely Crohn's disease and coronary artery disease.

阿达木单抗加入了治疗类风湿性关节炎的免费现有生物制剂。在阿达木单抗和其他生物dmard进行正面研究之前，它在这些治疗方案中的地位尚不清楚。阿达木单抗目前正在临床试验中用于其他治疗用途，即克罗恩病和冠状动脉疾病。

引用次数: 5

APhA's Name Change Reflects Evolution of the Pharmacy Profession APhA的更名反映了药学专业的演变

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480650

Dan Kennedy, Bernard A. Sorofman PhD, Susan H. Staggs

引用次数: 1

Proving That Pharmaceutical Care Makes a Difference in Community Pharmacy 证明药物护理对社区药房的影响

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480669

L. Michael Posey

two important events helped shape the profession of pharmacy. First, the 1984 Pharmacy in the 21st Century Conference explored whether the profession faced a future of growth or stagnation.1 Then, the following year at the Hilton Head Conference, Doug Hepler first verbalized the notion that pharmacy could have the kind of covenantal relationship exemplified by medical or nursing care.2 We now find ourselves in the 21st century, and pharmaceutical care has become a dominant form of practice for thousands of pharmacists around the globe. Yet, for the average patient, the concept of pharmaceutical care remains an enigma, primarily because it is not provided on a broad scale and in an identifiable manner in the community pharmacies where most people encounter pharmacists. Is it possible for pharmacy to complete its transformation from a commodity-based, mercantile operation into a clinical profession in the community pharmacies of the United States and around the world? The publication of shortand long-term outcomes from the Asheville Project in this issue of JAPhA provides an opportunity to review the pharmaceutical care track record of community pharmacists and identify elements that have afforded or impeded success.

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引用次数: 17

The Asheville Project: Participants' Perceptions of Factors Contributing to the Success of a Patient Self-Management Diabetes Program 阿什维尔项目:参与者对促进患者自我管理糖尿病项目成功的因素的看法

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480722

Daniel G. Garrett MS, FASHP, Leslie A. Martin MBA

Objective

To ascertain patients', providers', and managers' perceptions of the factors that contributed to the success of the Asheville Project.

Design

One-time focus groups of patients and diabetes care providers and individual interviews with managers involved in the project.

Setting

The City of Asheville and Mission-St. Joseph's Health System (MSJ), Asheville, N.C.

Patients and Other Participants

Twenty-one patients with diabetes who were employees of the two self-insured employers participating in the Asheville Project; four specially trained pharmacists who provided diabetes-related pharmaceutical care and one diabetes educator, all of whom received reimbursement for their services; six managers employed by the City of Asheville or MSJ who were involved in the project.

Intervention

A trained facilitator conducted four focus groups and six manager interviews in September 2001. Each session lasted 60 to 90 minutes, and the facilitator used a standard list of open-ended questions. The focus group sessions were recorded for subsequent analysis.

Main Outcome Measures

Perceptions of focus group participants and managers of how the Asheville Project enabled patients with diabetes to become more responsible and successful in self-managing their condition.

Results

Focus group participants and managers were enthusiastic about their experiences with the project. Patients valued the relationships they established with their pharmacist or diabetes educator; as a result of these providers' support, patients felt more in control of their lives and were healthier. The waived co-payments for diabetes medications and related supplies was the decisive incentive for getting many patients to enroll in the project. For the providers, the project was a source of professional growth and satisfaction. Managers felt the project helped them fulfill their healthcare responsibilities to their employees, reduced overall costs, enhanced their organizations' reputations in healthcare delivery, and resulted in less absenteeism.

Conclusion

Patients, providers, and managers in the Asheville Project believed that aligned incentives and community-based resources that provide health care services to patients with diabetes offer a practical, patient-empowering, and cost-effective solution to escalating health care costs.

目的了解患者、提供者和管理者对促成阿什维尔项目成功的因素的看法。一次性对患者和糖尿病护理人员进行焦点小组调查，并对参与项目的管理人员进行单独访谈。背景:阿什维尔市和宣教街患者和其他参与者21名糖尿病患者，他们是参与Asheville项目的两家自我保险雇主的雇员;提供糖尿病相关药学服务的四名受过专门培训的药剂师和一名糖尿病教育工作者，他们都获得了服务报销;阿什维尔市或MSJ雇佣的六名经理参与了这个项目。2001年9月，一位训练有素的调解员进行了四个焦点小组和六个经理访谈。每次会议持续60到90分钟，主持人使用一份标准的开放式问题清单。将焦点小组会议记录下来以供后续分析。焦点小组参与者和管理者对Asheville项目如何使糖尿病患者在自我管理病情方面变得更负责任和成功的看法。结果:焦点小组的参与者和管理者对他们在项目中的经历充满热情。患者重视他们与药剂师或糖尿病教育工作者建立的关系;由于这些服务提供者的支持，患者感到更能控制自己的生活，也更健康。免除糖尿病药物和相关用品的共同支付是吸引许多患者参加该项目的决定性激励因素。对于供应商来说，这个项目是专业成长和满意度的源泉。管理人员认为该项目帮助他们履行了对员工的医疗保健责任，降低了总体成本，提高了组织在医疗保健服务方面的声誉，并减少了缺勤率。结论:Asheville项目的患者、提供者和管理者认为，为糖尿病患者提供医疗保健服务的激励机制和基于社区的资源为不断上升的医疗保健成本提供了一种实用的、患者授权的、具有成本效益的解决方案。

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引用次数: 60

Training Experiences of Current and Former Community Pharmacy Residents, 1986-2000 1986-2000年社区药房在职及离职人员的培训经验

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480740

Whitney L. Unterwagner PharmD, Mario M. Zeolla PharmD, CDM, Anne L. Burns

Objective

To identify why current and former community pharmacy residents chose a community pharmacy residency program (CPRP), what factors in the program were emphasized and not emphasized, what opportunities were available to them postresidency, and, for former residents, what skills learned during their residency have been most useful in their careers to date.

Design

Mail survey.

Participants

1999-2000 residents and former residents dating back to 1986.

Main Outcome Measures

Reasons residents chose a CPRP over other residency or employment opportunities and respondents' ratings of the emphasis placed on a variety of skills and activities in their training programs.

Results

A total of 44 surveys were included in the final analysis, 18 (41%) of which were completed by 1999-2000 CPRP residents performing their residency at the time of the survey. The most common reasons for choosing a CPRP over other types of programs were opportunities for developing innovative services and direct patient interaction. Communication skills, clinical skills, and level of patient interaction were reported as being most highly emphasized. Management of the distribution system was most frequently cited as having "low" or "no" emphasis in their residency. Respondents listed marketing skills as the most common area requiring improvement or additional focus in their residency. Former residents cited leadership skills and the development of patient care services as the factors in their residency having the greatest impact on their careers to date. Postresidency opportunities most frequently sought included faculty, staff pharmacist, and clinical pharmacist positions.

Conclusion

Candidates are drawn to CPRPs because of the opportunities such residencies offer to develop innovative services and provide direct patient care. Residents feel that many programs fail to provide adequate training in the areas of marketing services and obtaining reimbursement. Residency program directors should consider these findings when evaluating and marketing their programs.

目的确定为什么现在和以前的社区药房居民选择社区药房住院医师项目(CPRP)，项目中哪些因素被强调和不被强调，实习期后他们可以获得哪些机会，以及对于以前的居民来说，他们在实习期所学到的技能对他们的职业生涯迄今为止最有用。DesignMail调查。参与者为1999-2000年的居民和1986年的前居民。主要结果测量居民选择CPRP而不是其他居住或就业机会的原因以及受访者对培训计划中各种技能和活动的重视程度的评分。结果共纳入44份调查，其中18份(41%)是由1999-2000年CPRP住院医师在调查时完成的。选择CPRP而不是其他类型项目的最常见原因是开发创新服务和直接与患者互动的机会。沟通技巧、临床技能和患者互动水平被认为是最重要的。分配系统的管理最常被引用为“低”或“没有”强调他们的居住地。受访者将营销技能列为他们居住中最需要改进或额外关注的领域。前住院医生认为，到目前为止，领导能力和病人护理服务的发展对他们的职业生涯影响最大。实习后最常寻求的机会包括教师、员工药剂师和临床药剂师职位。结论CPRPs吸引了候选人，因为这些住院医师提供了开发创新服务和提供直接患者护理的机会。居民们认为，许多项目未能在营销服务和获得报销方面提供足够的培训。住院医师项目主管在评估和营销他们的项目时应该考虑这些发现。

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引用次数: 15

2003 Abstracts of Contributed Papers 2003年投稿论文摘要

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480795

引用次数: 0

Lil' Red (2002)/Lionel Milton (b. 1973) 《小红》(2002)/莱昂内尔·米尔顿(生于1973)

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480830

Ron Teeter (Senior Editor, Japha)

引用次数: 0

The Asheville Project: Short-Term Outcomes of a Community Pharmacy Diabetes Care Program 阿什维尔项目:社区药房糖尿病护理项目的短期结果

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

Pub Date : 2003-03-01 DOI: 10.1331/108658003321480696

Carole W. Cranor PhD, Dale B. Christensen PhD

Objectives

To assess short-term clinical, economic, and humanistic outcomes of pharmaceutical care services (PCS) for patients with diabetes in community pharmacies.

Design

Intention-to-treat, pre-post cohort-with-comparison group study.

Setting

Twelve community pharmacies in Asheville, N.C.

Patients and Other Participants

Eighty-five patients with diabetes who were employees, dependents, or retirees from two self-insured employers; community pharmacists who completed a diabetes certificate program and received reimbursement for PCS.

Interventions

Patients scheduled consultations with pharmacists over 7 to 9 months. Pharmacists provided education, self-monitored blood glucose (SMBG) meter training, clinical assessment, patient monitoring, follow-up, and referral. Group 1 patients began receiving PCS in March 1997, and group 2 patients began in March 1999.

Main Outcome Measures

Change from baseline in the two employer groups in glycosylated hemoglobin (A1c) values, serum lipid concentrations, health-related quality of life (HRQOL), satisfaction with pharmacy services, and health care utilization and costs.

Results

Patients used SMBG meters at home, stored all readings, and brought their meters with them to 87%; of the 317 PCS visits (3.7 visits per patient). Patients' A1c concentrations were significantly reduced, and their satisfaction with pharmacy services improved significantly. Patients experienced no change in HRQOL. From the payers' perspective, there was a significant $52 per patient per month increase in diabetes costs for both groups, with PCS fees and diabetes prescriptions accounting for most of the increase. In contrast, both groups experienced a nonsignificant but economically important 29%; decrease in nondiabetes costs and a 16%; decrease in all-diagnosis costs.

Conclusion

A clear temporal relationship was found between PCS and improved A1c, improved patient satisfaction with pharmacy services, and decreased all-diagnosis costs. Findings from this study demonstrate that pharmacists provided effective cognitive services and refute the idea that pharmacists must be certified diabetes educators to help patients with diabetes improve clinical outcomes.

目的评价社区药房为糖尿病患者提供药学服务(PCS)的短期临床、经济和人文效果。设计意向-治疗，前后队列-对照组研究。设置北卡罗来纳州阿什维尔的12家社区药房患者和其他参与者:85名糖尿病患者，他们是两个自我保险雇主的雇员、家属或退休人员;完成糖尿病证书课程并获得PCS报销的社区药剂师。干预措施患者在7至9个月内安排了与药剂师的会诊。药师提供教育、自我监测血糖(SMBG)仪培训、临床评估、患者监测、随访和转诊。第一组患者于1997年3月开始接受PCS治疗，第二组患者于1999年3月开始接受PCS治疗。主要观察指标:两组雇主在糖化血红蛋白(A1c)值、血脂浓度、健康相关生活质量(HRQOL)、药房服务满意度、医疗保健利用和成本方面与基线相比的变化。结果患者在家中使用SMBG仪，保存所有读数，并随身携带仪器至87%;在317次PCS就诊中(每位患者3.7次就诊)。患者糖化血红蛋白浓度显著降低，患者对药学服务的满意度显著提高。患者的HRQOL无变化。从支付方的角度来看，两组患者每个月的糖尿病费用都增加了52美元，其中PCS费用和糖尿病处方占了增加的大部分。相比之下，两组都经历了不显著但经济上重要的29%;非糖尿病患者成本降低16%;降低所有诊断费用。结论PCS与改善糖化血红蛋白、提高患者对药学服务的满意度、降低全诊费用有明显的时间关系。本研究结果表明，药剂师提供了有效的认知服务，并反驳了药剂师必须是经过认证的糖尿病教育者才能帮助糖尿病患者改善临床结果的观点。

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全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

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Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

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