| 1. |
- Bardage, Cecilia, et al.
(författare)
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Non-prescription medicines for pain and fever : A comparison of recommendations and counseling from staff in pharmacy and general sales stores
- 2013
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 110:1, s. 76-83
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The purpose of this study is to map and analyze the content and quality of theencounter when customers buy non-prescription medicines for pain and fever.Methods: 297 pharmacies and 801 general sales stores (GSS) in Sweden were selected. A"Mystery shopper" exercise was conducted. Three scenarios were used and a total of 366units were selected for each scenario. There were in total 625 observers: 208 in the childwith fever scenario, 225 in the Reliv scenario, and 192 in the painkiller during pregnancyscenario. Data collection: 21st September to 20th November 2011.Results: In two out of three visits to GSS, the staff proposed a medicine for a heavily pregnantwoman. The staff suggested in 9% of the visits a medicine that is inappropriate in latepregnancy. The corresponding percentage in pharmacies was 1%.Both pharmacies and GSS proposed, in 6% a medicine that is inappropriate for babies toa feverish child. Only 16% of the pharmacists and 14% of the staff in GSS asked for the ageof the child.General sales staff recommended in 10% ibuprofen and in 4% an acetylsalicylic acid productwhen an acetaminophen preparation was requested. The corresponding percentage inthe pharmacy were 4% ibuprofen, 2% diclofenac, and 1% an acetylsalicylic acid product.Conclusions: The staff in GSS and pharmacies do not pay sufficient attention to the heterogeneityof painkillers, which lead to inappropriate recommendations.
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| 2. |
- Beckman, A, et al.
(författare)
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The difficulty of opening medicine containers in old age : a population-based study
- 2005
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Ingår i: Pharmacy World & Science. - : Springer Science and Business Media LLC. - 0928-1231 .- 1573-739X. ; 27:5, s. 393-398
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: To investigate elderly people's ability to open medicine containers, and how this ability correlates to some common disorders that may cause functional or cognitive impairment. Methods: Cross-sectional study of older people age 81 years and older, from the second follow-up (1994-1996) of the Kungsholmen project, a population based study of very old people in an urban area of Stockholm, Sweden. Six hundred and four persons (mean age 86.7 years) were tested for their ability to open three types of medicine containers. The disorders studied were rheumatoid arthritis, stroke, Parkinson's disease, cognitive impairment (measured by mini-mental state examination, MMSE) and impaired vision. Results: We found that 14% were unable to open a screw cap bottle, 32% a bottle with a snap lid, and 10% a blister pack. Female gender, higher age, living in an institution, Parkinson's disease, rheumatoid arthritis, cognitive impairment and impaired vision were all associated with a decreased ability to open the containers. Less than half of the elderly people who were unable to open one or more of the containers received help with their medication. Among those living in their own homes only 27% received help. Conclusion: Older peoples' ability to open medicine containers is impaired by several conditions affecting physical and cognitive functioning. Many elderly people who are unable to open medicine containers do not receive help with their medication, particularly those living in their own homes.
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| 3. |
- Bernsten, Cecilia, et al.
(författare)
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A comparative analysis of remuneration models for pharmaceutical professional services
- 2010
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Ingår i: Health Policy. - : Elsevier BV. - 0168-8510 .- 1872-6054. ; 95:1, s. 1-9
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Forskningsöversikt (refereegranskat)abstract
- Objectives: Pharmacists provide a wide range of professional services to support the appropriate use of medicines by patients. This study aims to conduct an international, comparative analysis of remuneration models for pharmaceutical professional services. Methods: Information about remuneration models was derived from a literature review and a semi-structured questionnaire completed by experts. Results: Remuneration models differ in the way that pharmacists are paid for professional services beyond dispensing medicines. Also, the scope of services that are remunerated varies. The majority of countries regulate remuneration for services only when the medicine is paid for under the reimbursement scheme. Remuneration of services implies a commitment to assure their quality in some countries. Collaborative practice models have been set up where pharmacists work together with other health care professionals to deliver diagnosis-specific services or services based on the patient's use of medicines. The remuneration of services is influenced by the value of services. budgetary constraints, the payer perspective, and the attitude of physicians, pharmacists and patients. Conclusions: Professional organisations need to formulate a clear strategy for developing and gaining remuneration for pharmaceutical professional services. This implies that pharmacists not only demonstrate the value of services, but also assure their quality. (C) 2009 Elsevier Ireland Ltd. All rights reserved.
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| 4. |
- Bernsten, Cecilia, et al.
(författare)
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Improving the well-being of elderly patients via community pharmacy-based provision of pharmaceutical care : a multicentre study in seven European countries
- 2001
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Ingår i: Drugs & Aging. - 1170-229X .- 1179-1969. ; 18:1, s. 63-77
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Tidskriftsartikel (refereegranskat)abstract
- Objective: This study aimed to measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients: (greater than or equal to 65 years of age) by community pharmacists in a multicentre international study performed in 7 European countries. Design and setting: The study was a randomised, controlled. longitudinal, clinical trial with repeated measures performed over an Is-month period. A total of 104 intervention and 86 control pharmacy sites participated in the research and 1290 intervention patients and 1164 control patients were recruited into the study. Main outcome measures and results: A general decline in health-related quality of lift: over time was observed in the pooled data; however, significant improvements were achieved in patients involved in the pharmaceutical care programme in some countries. Intervention patients reported better control of their medical conditions as a result of the study and cost savings associated with pharmaceutical care provision were observed in most countries. The new structured service was well accepted by intervention patients and patient satisfaction with the services improved during the study. The pharmacists involved in providing pharmaceutical care had a positive opinion on the new approach, as did the majority of general practitioners surveyed. The positive effects appear to have been achieved via social and psychosocial aspects of the intervention, such as the increased support provided by community pharmacists, rather than via biomedical mechanisms. Conclusions: This study is the first large-scale, multicentre study to investigate the effects of pharmaceutical care provision by community pharmacists to elderly patients. Future research methodology and implementation will be informed by the experience gained from this challenging trial.
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| 5. |
- Björkman, Ingeborg, et al.
(författare)
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Author reply
- 2009
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Ingår i: Research in Social and Administrative Pharmacy : RSAP. - : Elsevier BV. - 1551-7411. ; 5:1, s. 3-3
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Tidskriftsartikel (refereegranskat)
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| 6. |
- Björkman, Ingeborg, et al.
(författare)
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Care ideologies reflected in 4 conceptions of pharmaceutical care
- 2008
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Ingår i: Research in Social and Administrative Pharmacy. - : Elsevier BV. - 1551-7411. ; 4:4, s. 332-342
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Tidskriftsartikel (refereegranskat)abstract
- Background: Different ways to practice pharmaceutical care have been developed. One expression of this fact is the existence of many different classification systems to document drug-related problems (DRPs). Evidence suggests that classification systems have different characteristics and that these characteristics reflect different conceptions of pharmaceutical care. To increase the understanding of conceptions of pharmaceutical care, underlying values and beliefs (ideologies) can be explored. Objective: To explore various conceptions of pharmaceutical care to identify the care ideologies on which these conceptions are based. Methods: Representatives of 4 selected conceptions of pharmaceutical care were interviewed in face-to-face meetings. During the interviews, 4 basic questions were asked. Three were focused on pharmaceutical care and 1 on DRPs. Interview transcripts were analyzed by an inductive method inspired by grounded theory. The conceptions studied were Strand, Granada-II, PCNE v5.0, and Apoteket. Results: In Strand, patients are given a more active role in the pharmaceutical care process, as compared to Granada-II, PCNE v5.0, and Apoteket. Pharmacists in all the conceptions of pharmaceutical care assume they have special knowledge that patients benefit from. However, they use their knowledge in different ways in the various pharmaceutical care conceptions. In Strand, individual goals of drug therapy are established together with the patient, whereas in Granada-II, PCNE, and Apoteket goals are not explicitly discussed. The identified differences correspond to different care ideologies. Conclusions: The pharmaceutical care conceptions are based on different care ideologies. The ideology is expressed in how therapy goals are set and patient needs defined. Strand is based on a patient-centered ideology; patient therapy goals and needs are defined by the patient together with the practitioners. Granada-II, PCNE, and Apoteket are based on an evidence-based medicine approach; patient therapy goals and needs are defined by the practitioners, based on available scientific knowledge.
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| 7. |
- Björkman, Ingeborg, et al.
(författare)
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Comparing 4 classification systems for drug-related problems : Processes and functions
- 2008
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Ingår i: Research in Social and Administrative Pharmacy. - : Elsevier BV. - 1551-7411. ; 4:4, s. 320-31
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Tidskriftsartikel (refereegranskat)abstract
- Background Counseling patients on drug-related problems (DRPs) is a new enterprise for pharmacists. Accordingly, a variety of classification systems have been created to document DRPs. This aroused our interest in finding out how classification systems differ. Objective The objective is to explore and describe the characteristics of 4 classification systems for DRPs to understand their similarities and differences with regard to processes and functions. Methods Four established classification systems were selected; they were Strand, Granada-II, Pharmaceutical Care Network Europe v5.0, and Apoteket. To gain experience of the use of the systems, an existing database containing documented problems that were identified during patient counseling at community pharmacies was used. The entries in the database were classified using the 4 selected classification systems, one at a time. In the following analysis, focus was set on what issues were classified and how they were classified in each system. Based on similarities and differences, 8 themes were identified and characteristics of the 4 systems were listed according to these themes. Characteristics of each system were thoroughly scrutinized and interpreted. Results The processes of selecting classification categories were different in all 4 systems, and as a result the contents of categories in systems were different. The systems had different characteristics and a decisive characteristic was whether the patients were involved in the classification of problems or not. Because of the different characteristics the systems had different functions. Conclusions To understand the usefulness of a classification system, both structure of categories and work process must be considered. The studied systems had different functions that revealed different aims embedded in the systems. To develop the counseling role of pharmacists, a limited number of classification systems would be beneficial. To get there, common aims and common systems must be developed. Keywords: Pharmaceutical care; Drug-related problems; Classification systems
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| 8. |
- Björkman, Ingeborg, et al.
(författare)
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Developing the role of the drug and therapeutics committees : Perceptions of chairs
- 2007
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald. - 0952-6862. ; 20:2, s. 161-178
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – According to Swedish law, every county is required to have a local drug and therapeutics committee (DTC) to contribute to safe and cost-effective drug use. The law presents merely a framework and gives no detailed instructions addressing, for example, organisation and methods. The aim of this study is to explore the variation of conceptions of the role of the DTCs among committee Chairs and to compare the results with an earlier study. Design/methodology/approach – Data were collected by questionnaires and telephone interviews with committee chairs, which were analysed using a phenomenographic approach. Findings – Four conceptions were identified, namely: traditional, patient-aware, influential, holistic and cooperative, which all involved prescribers. In one conception the DTC acted as an expert to decision-makers. One conception included the notion that cooperation across the bureaucratic borders was important. Patients were involved in two conceptions. Comparison with the earlier study showed a trend toward higher patient awareness and a higher agreement on DTC goals with an increased focus on quality issues. Originality/value – This study demonstrates an alternative research method bringing in new perspectives when exploring activities within healthcare. Patient involvement in the work of the DTCs is increasing, but should be further explored and developed.
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| 9. |
- Björkman, Ingeborg, et al.
(författare)
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Drug-drug interactions in the elderly
- 2002
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Ingår i: The Annals of pharmacotherapy. - 1060-0280 .- 1542-6270. ; 36:11, s. 1675-1681
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Tidskriftsartikel (refereegranskat)
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| 10. |
- Björkman, Ingeborg, et al.
(författare)
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The role of drug and therapeutics committees : Perceptions of chairs and information officers
- 2005
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Ingår i: International Journal of Health Care Quality Assurance. - : Emerald. - 0952-6862. ; 18:4, s. 235-48
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Tidskriftsartikel (refereegranskat)abstract
- Purpose – Improved quality and safety in drug use is a public health goal of major importance. In Sweden, local drug and therapeutics committees (DTCs) have adopted the task of working for safe and rational drug use. This study aimed to explore how chairs conceived the role of the DTCs, to explore how information officers conceived their own role, and to determine whether the respondents included patients in their answers. Design/methodology/approach – Data were collected using questionnaires and the answers were analysed according to phenomenographic method to identify conceptions. “Patient awareness” was studied by content analysis. Findings – In both groups the prescribers were the focus of attention, and only a few respondents mentioned patients. A variation of four conceptions was found among chairs and three among information officers. It would be beneficial if DTCs used this knowledge in their development. Originality/value – The importance of “patient awareness” within DTCs must be further explored.
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