Research in social & administrative pharmacy : RSAP
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Res Social Adm Pharm · Jul 2016
Identifying high risk medications causing potential drug-drug interactions in outpatients: A prescription database study based on an online surveillance system.
Drug-drug interactions (DDIs) are a significant cause for adverse drug events (ADEs). DDIs are often predictable and preventable, but their prevention and management require systematic service development. Most DDI studies focus on interaction rates in hospitalized patients. Less is known of DDIs in outpatients, particularly how community pharmacists could contribute to DDI management by applying their surveillance systems for identifying high-risk medications. ⋯ This study demonstrates that community pharmacies can actively contribute to DDI risk management and systematically use their surveillance systems for identifying patients having clinically significant DDIs. The findings also indicate that the majority of potentially serious interactions in outpatients involve a limited number of drugs, particularly NSAIDs, warfarin and methotrexate. Further research should focus on community pharmacists' involvement in DDI risk management in collaboration with local health care providers.
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Res Social Adm Pharm · May 2016
Exploring attitudes and opinions of pharmacists toward delivering prescribing error feedback: A qualitative case study using focus group interviews.
Prescribing error (PE) rates have been extensively reported in the literature. Various interventions at reducing PEs have been studied with some success, yet PEs continue to be a challenge for the health care system. Prescriber feedback has been proposed as one mechanism to reduce PEs in seminal studies. Pharmacists are viewed as an integral safety net in intercepting PEs and have been suggested as best placed to deliver feedback. However, there is very limited literature considering pharmacists; attitudes, views and opinions on facilitating PE feedback. ⋯ PE feedback should be delivered to prescribers with ward-based pharmacists best suited to the role. Both direct and indirect benefits of PE feedback were reported, although potential barriers to delivering PE feedback were also identified. Pharmacists reported additional anxieties that feedback could create tensions and compromise working relationships with prescribers. PE feedback could be considered an extension of a pharmacist's role and pharmacists welcomed formalization of feedback, but were cognizant of the potential impact on their workload and expressed the need for training in the delivery of feedback.
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Res Social Adm Pharm · May 2016
Promoting consistent use of prescription drug monitoring programs (PDMP) in outpatient pharmacies: Removing administrative barriers and increasing awareness of Rx drug abuse.
Prescription drug monitoring programs (PDMPs) are proving to be valuable resources in fighting the prescription drug abuse epidemic through improved access to patient drug histories. Ninety-four percent of Indiana pharmacists have heard of Indiana's PDMP (INSPECT), only 71% of them reported using the program in 2012. ⋯ Strategies to improve utilization of PDMPs should look for innovative ways to limit barriers and build outpatient pharmacists' awareness of prescription drug abuse and misuse within their community.
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Res Social Adm Pharm · Mar 2016
Integration of prescription drug monitoring programs (PDMP) in pharmacy practice: Improving clinical decision-making and supporting a pharmacist's professional judgment.
Pharmacists have shared responsibility to investigate the validity of controlled substance prescriptions (CSPs) that raise concerns, or red flags, and subsequently exercise their right to refuse to dispense a CSP if its validity cannot be verified. Improving access to clinical practice tools, such as prescription drug monitoring programs (PDMPs), may increase availability of a patient's drug history, which is critical to making informed clinical decisions about dispensing CSPs. ⋯ Integration of PDMPs in pharmacy practice may improve a pharmacist's ability to make informed clinical decisions and exercise sound professional judgment. Providing clinical practice tools to both prescribers and pharmacists is important to preventing drug diversion and prescription drug abuse. Future research should focus on understanding the barriers and challenges to successful integration of PDMPs in pharmacy practice.
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Res Social Adm Pharm · Jan 2016
An explanatory model of community pharmacists' support in the secondary prevention of cardiovascular disease.
Community pharmacists have faced ongoing challenges in the delivery of clinical pharmacy services. Various attitudinal and environmental factors have been found to be associated with the provision of general clinical pharmacy services or services which focus on a specific condition, including cardiovascular disease (CVD). However, the interrelationship and relative influence of explanatory factors has not been investigated. ⋯ Pharmacists' attitudes appeared to be the strongest predictor of CVD support provision. The TPB framework was useful in identifying "subjective norms" and "pharmacists' beliefs" as key constructs of community pharmacists' attitudes. Community pharmacies would be able to provide such an advanced clinical service if they strongly believed that this was an acknowledged part of their scope of practice, had adequate infrastructure and employed sufficient numbers of pharmacists with appropriate and relevant knowledge.