| 1. |
- Marklund, Bertil, 1945, et al.
(författare)
-
Referrals of dyspeptic self-care patients from pharmacies to physicians, supported by clinical guidelines.
- 2003
-
Ingår i: Pharmacy world & science : PWS. - 0928-1231. ; 25:4, s. 168-172
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: It is important that self-medication customers with potentially serious diseases are correctly referred from pharmacies to physicians. The aim of this study was to determine the appropriateness of pharmacy practitioners in referring customers suffering from dyspepsia to a general practitioner (GP). METHOD: Practitioners in 12 pharmacies, supported by clinical guidelines and training, recorded information regarding the dyspeptic customers they referred to a physician on a data collection card. The card was sent to a GP participating in the study, who did a regular medical history of the referred customer over the phone and assessed whether the referral was appropriate or not. RESULTS: Out of 133 referred customers with dyspepsia, 132 completed the study. The GPs found that 119 (90%) needed a medical examination and/or prescription drugs and thus assessed these referrals as appropriate. In three cases (2%) the referral was doubtful and in ten cases (8%) not adequate, as the symptoms were more likely to come from an irritable bowel syndrome than dyspepsia. CONCLUSION: The results confirm the role of pharmacy practitioners as important members of the primary health care team. Provided with the appropriate referral guidelines and training, they are in a position to operate as 'filters', promoting the adequate use of other primary care services
|
|
| 2. |
- Westerlund, Tommy, 1952, et al.
(författare)
-
Evaluation of a model for counseling patients with dyspepsia in Swedish community pharmacies.
- 2003
-
Ingår i: American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists. - 1079-2082. ; 60:13, s. 1336-1341
-
Tidskriftsartikel (refereegranskat)abstract
- The outcomes of a counseling model designed to help pharmacists care for customers seeking nonprescription treatment for dyspepsia in Swedish community pharmacies were studied. A protocol containing 10 key questions based on clinical guidelines about dyspepsia symptoms and on studies of drug-related problems (DRPs) was implemented in six community pharmacies in Sweden. During two weeks in April 2002, all adult customers seeking self-care for dyspepsia were asked to participate in the interview. Depending on a customer's answers, pharmacy personnel gave advice, intervened for DRPs, or referred the customer to a physician. Customers who received advice or intervention were followed up by telephone. A total of 319 customers who met the study criteria agreed to participate. Of these, 183 (57%) received self-care advice, 37 (12%) had DRPs, and 39 (12%) were referred to a physician because of their symptoms. Of the 198 customers fulfilling the criteria for a follow-up interview, 130 (66%) participated. Nearly all of these customers were satisfied with their visit to the pharmacy, and 9 in 10 were pleased with the advice received. Eighty-five percent claimed they had followed the self-care advice, and two in three said they felt better. DRPs were resolved in 19 (86%) of the 22 customers with DRPs who were followed up. Only one customer in five who was advised to see a physician actually did so. A counseling model designed to discover and resolve problems related to symptoms and drug use appeared to have a favorable impact on outcomes in customers with dyspepsia seeking nonprescription drug treatment in Swedish pharmacies.
|
|
| 3. |
- Westerlund, Tommy, 1952, et al.
(författare)
-
Nonprescription drug-related problems and pharmacy interventions.
- 2001
-
Ingår i: The Annals of pharmacotherapy. - 1060-0280. ; 35:11, s. 1343-1349
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To document the number and types of drug-related problems (DRPs) identified in customers purchasing nonprescription products in Swedish pharmacies; describe the distribution of DRPs by customer's gender, age, underlying ailment, and class of drug; determine whether problems are identified to the same extent in pharmacies with staffed nonprescription self-service departments as in pharmacies with over-the-counter sales; and document the number and types of pharmacy interventions to prevent or resolve DRPs, including reasons for drug switches and referrals to physicians. METHODS: A computerized instrument for documentation of DRPs and pharmacy interventions was developed. The study was conducted in 45 volunteer pharmacies in Sweden during ten weeks in late 1999. RESULTS: A total of 1425 problems and 2040 interventions were recorded by 308 pharmacy practitioners. Relatively fewer DRPs were documented in pharmacies with self-service departments. The most common DRPs were uncertainty about the indication for the drug (33.5%) and therapy failure (19.5%). Dyspepsia was the most frequently specified symptom (11.4%). Consumers of dermatologic products had significantly higher rates of problems than expected in relation to sales volume. The most common ways of responding to a problem were with consumer drug counseling (61.1%), switching of drugs (43.9%), and referral to a physician (27.5%). CONCLUSIONS: The study has demonstrated a need for more professional attention and intervention by pharmacy staff to prevent and rectify DRPs in nonprescription consumers. It seems especially important to make sure that consumers receive the appropriate drugs for their current ailments.
|
|
| 4. |
- Westerlund, Tommy, 1952, et al.
(författare)
-
Pharmacy practitioners' views on computerized documentation of drug-related problems.
- 2003
-
Ingår i: The Annals of pharmacotherapy. - 1060-0280. ; 37:3, s. 354-360
-
Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate the practice by community pharmacy practitioners of computerized documentation of drug-related problems (DRPs) and pharmacy interventions in nonprescription drug consumers. METHODS: A questionnaire was administered in December 1999 to pharmacy practitioners in 45 community pharmacies of different sizes and locations across Sweden to survey their attitudes and experiences after participation in a 10-week period of computerized DRP documentation. RESULTS: The participants (n = 376, response rate 84%) found the development of computerized documentation of DRPs and pharmacy interventions to be very important. The instrument was perceived as easy to learn and to work well in daily practice. The documentation made many practitioners more attentive to the drug-related needs of self-care consumers and changed their perception of good quality in self-care counseling. The weighted multiple linear regression analysis showed no correlation between the proportion of practitioners experiencing time constraints and the DRP documentation rate of their work site. However, the magnitude of interest in the documentation practice had a significant effect on the documentation rate, regardless of the extent of the time constraints experienced (p = 0.004). CONCLUSIONS: The positive findings of the evaluation speak in favor of an expanded implementation of computerized documentation of DRPs and pharmacy interventions. Commitment among participating pharmacy practitioners to the new practice is essential and appears to overcome possible time constraints.
|
|
