Oral contraceptive use: interview data versus pharmacy records.
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BACKGROUND: If women tend to forget and underreport their past oral contraceptive (OC) use, but the recall among cases is enhanced by the presence of disease, recall bias may explain some reported health effects of OC use. METHODS: Two different sources of information on lifetime OC use were compared for 427 (84%) of a community-based sample of 511 women aged 20-34: (i) structured interviews, using a life event calendar and picture display as memory aids, and (ii) a register of all prescriptions dispensed by pharmacies in the county since 1970. RESULTS: Interview data and pharmacy records showed high levels of agreement for any OC use, current use, time since first and last use, total duration of use, and for duration of use in different 'time windows'. But there was a tendency to under-report specific kinds of OC used in the past. CONCLUSION: Underreporting of OC use among non-cases would usually introduce little or no bias (as compared to pharmacy records) for this kind of interview and women. However, it may be preferable to use interviews for current OC use, and pharmacy records for specific kinds of OC used in the past. (+info)
The emerging role of psychiatric pharmacists.
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The concept of pharmaceutical care has greatly expanded the role of the pharmacist, from that of strictly a drug dispenser to a more integrated member of a patient's healthcare team. In order for pharmaceutical care practice to succeed, the pharmacist must assume a more proactive role, using his or her knowledge of drug therapy and behavioral medicine to assume more responsibility in achieving improvement in patient health outcomes. The pharmacist must also develop open, professional relationships with patients, their families/caregivers, and other members of the healthcare team. Pharmaceutical care comprises 4 components: education, medical-legal issues, drug therapy knowledge, and communication. Through these efforts, and because pharmacists offer greater access to patients and a broader view of patient outcomes, pharmaceutical care affords the opportunity for these professionals to become patient advocates and prevent line-item decision making. Special considerations exist for psychiatric pharmacists practicing pharmaceutical care, especially in documentation and formulary decisions. Psychiatric pharmacists can ensure that patients have access to the safest, most efficacious (and cost-effective) drugs by considering more than just acquisition costs. (+info)
Applying the desiderata for controlled medical vocabularies to drug information databases.
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Medication history has always been an integral part of the patient's medical record. With the advent of the computerized medical record and the longitudinal clinical data repository, having the medication history has enabled the development of clinical decision support system that alerts for drug to drug interactions and drug allergies. Furthermore, medication data is increasingly being analyzed from a utilization and clinical outcomes standpoint. For these activities to occur, a controlled pharmacy vocabulary akin to a controlled medical vocabulary is essential. Drug information databases are well-established sources of information for pharmacy-related data and products. However, do they measure up as a controlled vocabulary? Recent experience reviewing drug information databases and integrating pharmacy-related information into a data dictionary in real-time clinical use at multiple health care institutions have revealed several challenges and issues. These are discussed according to Cimino's desiderata for controlled medical vocabularies. (+info)
Nuclear pharmacy, Part I: Emergence of the specialty of nuclear pharmacy.
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OBJECTIVE: Nuclear pharmacy was the first formally recognized area in pharmacy designated as a specialty practice. The events leading to nuclear pharmacy specialty recognition are described in this article. After reading this article the nuclear medicine technologist or nuclear pharmacist should be able to: (a) describe the status of nuclear pharmacy before recognition as a specialty practice; (b) describe the events that stimulated pharmacists to organize a professional unit to meet the needs of nuclear pharmacists; and (c) identify the steps by which nuclear pharmacists become board certified in nuclear pharmacy. (+info)
Nuclear pharmacy, Part II: Nuclear pharmacy practice today.
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OBJECTIVE: Nuclear pharmacy is a specialty within the profession of pharmacy that focuses on the proper use of radiopharmaceuticals. This article reviews various features of contemporary nuclear pharmacy practice. After reading this article the nuclear medicine technologist should be able to: (a) describe nuclear pharmacy training and certification; (b) discuss nuclear pharmacy practice settings; (c) discuss nuclear pharmacy practice activities; (d) list professional organizations; and (e) describe activities associated with job satisfaction. In addition, the reader should be able to discuss regulatory issues of current concern. (+info)
Progress and problems in the prescribing/dispensing split and "divided package sales" by wholesalers.
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Given the rapid progress of the prescribing/dispensing split, the ability of pharmacies to obtain and stock a small quantity of pharmaceuticals is seen as essential. Toho Yakuhin's experience in "divided package sales" (wholesalers open an original package supplied by the manufacturer and sell only a part of the contents) shows that the number of orders and sales amount, and the number of pharmacies ordering in sales have remarkably increased. One or two kinds of pharmaceuticals were ordered in 73% cases, and one or two units in about 50%. This implies that "divided package sales" are utilized to obtain rarely prescribed drugs. On the other hand, five or more kinds of pharmaceuticals were ordered in 10% of cases, and ten or more units in 17%. "Divided package sales" were more used for low-price drugs. These indicated that "divided package sales" seemed to be looked upon by pharmacies as a means of obtaining a small quantity of pharmaceuticals, and seemed to be used not only in an emergency but also routinely. There are several problems for wholesalers in operating "divided package sales", such as frequent delivery, delivery cost and information supply. Pharmacies should obtain a small quantity of pharmaceuticals by the routine delivery and should share the delivery cost. Pharmaceutical manufacturers' cooperation in printing necessary information on each immediate container will be useful. Though there could be alternative ways of obtaining a small quantity of pharmaceuticals, all of them have the matter of delivery. We believe "divided package sales" will contribute to this situation. (+info)
Building a retrospective collection in pharmacy: a brief history of the literature with some considerations for U.S. health sciences library professionals.
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This paper argues that historical works in pharmacy are important tools for the clinician as well as the historian. With this as its operative premise, delineating the tripartite aspects of pharmacy as a business enterprise, a science, and a profession provides a conceptual framework for primary and secondary resource collecting. A brief history and guide to those materials most essential to a historical collection in pharmacy follows. Issues such as availability and cost are discussed and summarized in checklist form. In addition, a glossary of important terms is provided as well as a list of all the major U.S. dispensatories and their various editions. This paper is intended to serve as a resource for those interested in collecting historical materials in pharmacy and pharmaco-therapeutics as well as provide a history that gives context to these classics in the field. This should provide a rationale for selective retrospective collection development in pharmacy. (+info)
Pathways for inappropriate dispensing of antibiotics for rhinosinusitis: a randomized trial.
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We evaluated the extent of and factors that determine the inappropriate use of antibiotics that are obtained without a physician's prescription. Ninety-eight Greek pharmacists were visited by actress-researchers who played clients requesting antibiotics without a physician's prescription. Pharmacists were randomly challenged in a scenario that involved simulated cases of acute uncomplicated rhinosinusitis with either low fever (38.5 degrees C) or high fever (40 degrees C). Antibiotics were offered by 34 (69%) of 49 pharmacists who were presented with the high-fever scenario and by 42 (86%) of 49 pharmacists who were presented with the low-fever scenario (risk difference, 16.3%; P = .05). Thirty-two (65%) and 35 (71%) pharmacists in the high- and low-fever study arms, respectively, agreed to sell the actress-researchers broad-spectrum antibiotics. Only 28 (57%) and 17 (35%) pharmacists, respectively, recommended that the patient visit a physician (P = .03). Inappropriate recommendations regarding antibiotic use were very common in the studied setting. Antibiotics were more likely to be offered to persons who did not have a prescription when they were less likely to be clinically indicated. (+info)