The Experts below are selected from a list of 70377 Experts worldwide ranked by ideXlab platform
Claire L Oreilly - One of the best experts on this subject based on the ideXlab platform.
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new roles for Pharmacists in community mental health care a narrative review
International Journal of Environmental Research and Public Health, 2014Co-Authors: Maria Rubiovalera, Timothy F Chen, Claire L OreillyAbstract:Medicines are a major treatment modality for many mental illnesses, and with the growing burden of mental disorders worldwide Pharmacists are ideally positioned to play a greater role in supporting people with a mental illness. This narrative review aims to describe the evidence for pharmacist-delivered services in mental health care and address the barriers and facilitators to increasing the uptake of pharmacist services as part of the broader mental health care team. This narrative review is divided into three main sections: (1) the role of the pharmacist in mental health care in multidisciplinary teams and in supporting early detection of mental illness; (2) the Pharmacists’ role in supporting quality use of medicines in medication review, strategies to improve medication adherence and antipsychotic polypharmacy, and shared decision making; and (3) barriers and facilitators to the implementation of mental health pharmacy services with a focus on organizational culture and mental health stigma. In the first section, the review presents new roles for Pharmacists within multidisciplinary teams, such as in case conferencing or collaborative drug therapy management; and new roles that would benefit from increased pharmacist involvement, such as the early detection of mental health conditions, development of care plans and follow up of people with mental health problems. The second section describes the impact of medication review services and other pharmacist-led interventions designed to reduce inappropriate use of psychotropic medicines and improve medication adherence. Other new potential roles discussed include the management of antipsychotic polypharmacy and involvement in patient-centered care. Finally, barriers related to Pharmacists’ attitudes, stigma and skills in the care of patients with mental health problems and barriers affecting pharmacist-physician collaboration are described, along with strategies to reduce mental health stigma.
Kevin W Garey - One of the best experts on this subject based on the ideXlab platform.
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frequency of and risk factors for medication errors by Pharmacists during order verification in a tertiary care medical center
American Journal of Health-system Pharmacy, 2015Co-Authors: Christy Gorbach, Linda Blanton, Beverly Lukawski, Alex C Varkey, Paige E Pitman, Kevin W GareyAbstract:Purpose The frequency of and risk factors for medication errors by Pharmacists during order verification in a tertiary care medical center were reviewed. Methods This retrospective, secondary database study was conducted at a large tertiary care medical center in Houston, Texas. Inpatient and outpatient medication orders and medication errors recorded between July 1, 2011, and June 30, 2012, were reviewed. Independent variables assessed as risk factors for medication errors included workload (mean number of orders verified per pharmacist per shift), work environment (type of day, type of shift, and mean number of Pharmacists per shift), and nonmodifiable characteristics of the pharmacist (type of pharmacy degree obtained, age, number of years practicing, and number of years at the institution). Results A total of 1,887,751 medication orders, 92 medication error events, and 50 Pharmacists were included in the study. The overall error rate was 4.87 errors per 100,000 verified orders. An increasing medication error rate was associated with an increased number of orders verified per pharmacist ( p = 0.007), the type of shift ( p = 0.021), the type of day ( p = 0.002), and the mean number of Pharmacists per shift ( p = 0.001). Pharmacist demographic variables were not associated with risk of error. The number of orders per shift was identified as a significant independent risk factor for medication errors ( p = 0.019). Conclusion An increase in the number of orders verified per shift was associated with an increased rate of pharmacist errors during order verification in a tertiary care medical center.
David A Mott - One of the best experts on this subject based on the ideXlab platform.
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national pharmacist workforce study npws description of 2019 survey methods and assessment of nonresponse bias
Pharmacy (Basel Switzerland), 2021Co-Authors: Matthew J Witry, Jon C Schommer, David A Mott, Caroline A Gaither, David H Kreling, Vibhuti Arya, Brianne K Bakken, William R DoucetteAbstract:National Pharmacist Workforce Studies (NPWS) have been conducted in the U.S. every five years since 2000. This article describes the online survey methods used for the latest NPWS conducted in 2019 and provides an assessment for nonresponse bias. Three waves of emails containing a link to the online survey were sent to a random sample of about 96,000 Pharmacists licensed in the United States. The survey asked about pharmacist employment, work activities, work-life balance, practice characteristics, pharmacist demographics and training. A total of 5467 usable responses were received, for a usable response rate of 5.8%. To assess for nonresponse bias, respondent characteristics were compared to the population of U.S. Pharmacists and a benchmark, while a wave analysis compared early and late respondents. The pharmacist sample-population comparison and the benchmark comparison showed that the NPWS respondents had a higher percentage of female Pharmacists and a lower proportion of young Pharmacists compared to the population of U.S. Pharmacists and the benchmark sample. In some contrast, the wave analysis showed that the early respondents had a higher percentage of males and older Pharmacists compared to the late respondents. Both the wave analysis and the benchmark comparison showed that the NPWS respondents (and early respondents) had a lower percent of Pharmacists with a PharmD degree than did the late respondents and the benchmark group. These differences should be considered when interpreting the findings from the 2019 NPWS.
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characteristics of unmet demand for Pharmacists a survey of rural community pharmacies in wisconsin
Journal of The American Pharmacists Association, 2008Co-Authors: Abhijit S Gadkari, David A Mott, David H Kreling, Joseph K BonnarensAbstract:Abstract Objectives To measure and describe the level of unmet demand for Pharmacists in rural Wisconsin community pharmacies and to examine determinants of the level of unmet demand in these pharmacies. Design Cross-sectional descriptive study. Setting Community pharmacies (n = 279) located in rural Wisconsin counties in fall 2005. Participants Key informants (managers/owners) identified for all sampled pharmacies. Interventions A one-page participation form and an eight-page survey instrument were used to collect primary data about the level of unmet demand for Pharmacists and internal pharmacy factors. Secondary data sources were used to extract information on external pharmacy factors. Main outcome measures Presence of pharmacist vacancy, number of fulltime equivalent (FTE) pharmacist positions vacant, and vacancy rate. Internal pharmacy characteristics included wage, prescription volume, prescription workload/pharmacist, dispensing-aiding technologies, technicians per pharmacist, practice setting, pharmacist FTE requirement, and pharmacist satisfaction. External pharmacy characteristics included population per pharmacy, seniors per pharmacy, per capita income, and rurality. The internal and external pharmacy characteristics were regressed on whether a vacancy was present and the vacancy rate (percentage of pharmacist FTEs unfilled). Results Overall response rate to the survey was 43.9%. One-third of the respondent pharmacy sites reported a pharmacist vacancy, most often 1.0 or less FTE. Pharmacist FTE requirement had a significant positive association with the presence of any pharmacist vacancy at a site. Prescription workload per pharmacist was positively related to the vacancy rate, while daily prescription volume and pharmacist satisfaction were negatively related to the vacancy rate. Conclusion Overall, for rural community pharmacies in Wisconsin, a greater need for Pharmacists at a site appears to make that site more likely to have a pharmacist vacancy. Pharmacist vacancies appear to have a greater impact on pharmacies that have a lower number of FTE pharmacist positions compared with pharmacies with higher FTE Pharmacists because, potentially, fewer Pharmacists are present to redistribute the workload.
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pharmacist participation in the workforce 1990 2000 and 2004
Journal of The American Pharmacists Association, 2006Co-Authors: David A Mott, William R Doucette, Caroline A Gaither, David H Kreling, Craig A Pedersen, Jon C SchommerAbstract:Objective: To examine work variables for licensed Pharmacists for 1990, 2000, and 2004. Design: Three cross-sectional, descriptive studies. Setting: United States. Participants: Licensed Pharmacists: 1,623 in 1990; 2,092 in 2000; and 1,564 in 2004. These numbers of usable responses to the three respective surveys represented 54.0%, 42.7%, and 33.8% of those receiving surveys. Intervention: Mailed survey from the 2004 National Pharmacist Workforce Survey; data from the national studies of the pharmacist workforce conducted in 1990 and 2000. Main Outcome Measures: Characteristics of Pharmacists; work setting, work position and age distribution of actively practicing Pharmacists. Work status of licensed Pharmacists; proportion actively practicing pharmacy. Proportion of Pharmacists working part-time overall and by age group, weekly hours worked by actively practicing Pharmacists, and full-time equivalents (FTEs) by age group. Proportion of Pharmacists with secondary pharmacy employment; work setting, hours worked, and weeks worked in secondary pharmacy employment. Results: In each year studied, more than 86% of licensed Pharmacists were actively practicing pharmacy. In 2004, the largest proportion of actively practicing women Pharmacists was between the ages of 31 and 45, and the largest proportion of actively practicing men Pharmacists was between the ages of 46 and 60. Across the survey years, the proportion of all actively practicing Pharmacists working part-time increased, and the proportion of women working part-time was at least double that of men except in 2004. In 2004, the FTE contribution for women was 0.81 and 0.91 for men. Conclusion: The decrease in FTE contributions by all Pharmacists and the aging of the male pharmacist population raise concerns about the adequacy of current and future pharmacist supply. As the demand for Pharmacists continues to evolve, pharmacy must continue to monitor the pharmacist workforce to show how Pharmacists react to changes to better inform projections of the pharmacist workforce.
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evaluation of community pharmacy service mix evidence from the 2004 national pharmacist workforce study
Journal of The American Pharmacists Association, 2006Co-Authors: William R Doucette, Jon C Schommer, David A Mott, Caroline A Gaither, David H Kreling, Craig A PedersenAbstract:ABSTRACT Objectives To describe the mix of pharmacy services being offered in different types of community pharmacy practices and to identify factors associated with a community pharmacy offering pharmacy services. Design Cross-sectional study. Setting Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies). Participants Pharmacists practicing full-time or part-time who worked in community pharmacies and responded to the 2004 National Pharmacist Workforce Survey. Intervention Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled Pharmacists and supplemental surveys that included workplace questions for a selected subsample of Pharmacists. Main Outcome Measures Type and frequency of pharmacy services being offered in a community pharmacy, including dispensing and product-related services (e.g., specialty compounding), and pharmacist care services (e.g., immunizations, smoking cessation, health screening, medication therapy management, wellness screening, nutritional support, and disease management services). Results Four pharmacist care services were reported as being offered at more than 10% of community pharmacy practices: immunizations, smoking cessation, health screening, and diabetes management. The number of pharmacist care services offered at a community pharmacy was positively associated with having at least three Pharmacists on duty, innovativeness of the pharmacy, status as an independent pharmacy, and status as a supermarket pharmacy. More than one half of the community pharmacy practices did not offer any of the eight pharmacist care services included in a pharmacy service index. Conclusion Pharmacy services were reported at relatively few community pharmacies, and were associated with pharmacy innovativeness, pharmacist staffing levels, and pharmacy setting. Some community pharmacies are offering pharmacy services as part of their business strategy, while others are dedicated to dispensing services. Continued study of pharmacy service availability in community pharmacies is needed to improve our understanding of our capacity to deliver such services, including medication therapy management services.
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community Pharmacists work environments evidence from the 2004 national pharmacist workforce study
Journal of The American Pharmacists Association, 2006Co-Authors: David H Kreling, David A Mott, William R Doucette, Caroline A Gaither, Craig A Pedersen, Jon C SchommerAbstract:ABSTRACT Objectives To describe characteristics of community Pharmacists' current practice environments and Pharmacists perceptions' about aspects of their work environments. Design Cross-sectional study. Setting Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies) in the United States. Participants 1,564 actively practicing Pharmacists. Intervention Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled Pharmacists and supplemental surveys that included workplace questions for a selected subsample of Pharmacists. Main Outcome Measures Hours the pharmacy was open; staffing; workload, perceptions of workload, and impact of the current workload on them and their work; equipment and technology available and used; and impact of equipment and technology at the practice site. Responses were compared with those from the 2000 National Pharmacist Workforce Survey. Results Hours of operation varied across practice settings in 2004 and were similar to those reported in 2000. Pharmacist and technician staffing varied somewhat across settings, but overall Pharmacists were working with more technicians in 2004 compared with 2000. The number of prescriptions personally dispensed daily (personal workload) increased for Pharmacists in all practice settings from 2000 to 2004. When Pharmacists reported the impact of their current workload, motivation to work at the pharmacy and job satisfaction were rated most positive, and opportunity to take adequate breaks were rated most negative. Equipment used for facilitating the dispensing process was more common in pharmacies than equipment related to patient care activities. More than one half of Pharmacists reported that equipment and technology increased their level of productivity, quality of care, financial performance, and job satisfaction in the pharmacy. Conclusion Pharmacists' work environments tend to be oriented toward traditional dispensing roles and activities. Staff, equipment, and information technology resources are available to facilitate both dispensing and patient care activities, and these resources have increased productivity, quality of care, and Pharmacists' satisfaction.
Subi R Zachariah - One of the best experts on this subject based on the ideXlab platform.
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impact of pharmacist interventions on cost avoidance in an ambulatory cancer center
Journal of Oncology Pharmacy Practice, 2018Co-Authors: Laura A Randolph, Cheri K Walker, Ann T Nguyen, Subi R ZachariahAbstract:Objective To provide a foundation to justify the presence of a full-time clinical pharmacist in the ambulatory cancer center in addition to an existing centralized pharmacist through cost avoidance calculation and patient and staff satisfaction surveys. Methods The prospective, pilot study took place in an ambulatory cancer center over four weeks in 2014. Cost avoidance values were assigned to interventions performed by a pharmacy resident, who was present in the ambulatory cancer center during clinic hours, along with a centralized oncology pharmacist routinely working with the cancer center. Anonymous patient and staff satisfaction surveys based on a 5-point Likert scale were distributed to assess the perceived benefit of a pharmacist located in the ambulatory cancer center. Results Data collection took place over approximately one month. After evaluation of 962 interventions from both Pharmacists, the estimated cost avoidance was US$282,741 per pharmacist per year, yielding a net benefit of US$138,441. The most common interventions made by the resident included chemotherapy regimen review (n = 290, 69%) and patient counseling (n = 102, 24%), while the majority of the centralized pharmacist's interventions was chemotherapy regimen review (n = 525, 97%). Results from the anonymous patient and staff surveys revealed an overall positive perception of the pharmacy resident while in the ambulatory cancer center. Conclusion A full-time clinical pharmacist in an ambulatory cancer center is both financially beneficial and positively perceived by patients and staff.
Grace M Kuo - One of the best experts on this subject based on the ideXlab platform.
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drug errors and related interventions reported by united states clinical Pharmacists the american college of clinical pharmacy practice based research network medication error detection amelioration and prevention study
Pharmacotherapy, 2013Co-Authors: Grace M Kuo, Daniel R Touchette, Jacqueline S MarinacAbstract:Objective To describe and evaluate drug errors and related clinical pharmacist interventions. Design Cross-sectional observational study with an online data collection form. Setting American College of Clinical Pharmacy practice-based research network (ACCP PBRN). Participants A total of 62 clinical Pharmacists from the ACCP PBRN who provided direct patient care in the inpatient and outpatient practice settings. Intervention Clinical pharmacist participants identified drug errors in their usual practices and submitted online error reports over a period of 14 consecutive days during 2010. Measurements and Main Results The 62 clinical Pharmacists submitted 924 reports; of these, 779 reports from 53 clinical Pharmacists had complete data. Drug errors occurred in both the inpatient (61%) and outpatient (39%) settings. Therapeutic categories most frequently associated with drug errors were systemic antiinfective (25%), hematologic (21%), and cardiovascular (19%) drugs. Approximately 95% of drug errors did not result in patient harm; however, 33 drug errors resulted in treatment or medical intervention, 6 resulted in hospitalization, 2 required treatment to sustain life, and 1 resulted in death. The types of drug errors were categorized as prescribing (53%), administering (13%), monitoring (13%), dispensing (10%), documenting (7%), and miscellaneous (4%). Clinical pharmacist interventions included communication (54%), drug changes (35%), and monitoring (9%). Approximately 89% of clinical pharmacist recommendations were accepted by the prescribers: 5% with drug therapy modifications, 28% due to clinical pharmacist prescriptive authority, and 56% without drug therapy modifications. Conclusion This study provides insight into the role clinical Pharmacists play with regard to drug error interventions using a national practice-based research network. Most drug errors reported by clinical Pharmacists in the United States did not result in patient harm; however, severe harm and death due to drug errors were reported. Drug error types, therapeutic categories, and clinical pharmacist interventions varied between the inpatient and outpatient settings. Nearly half of reported errors were prevented by clinical Pharmacists before the drugs reached the patients. The majority of clinical pharmacist recommendations were accepted by prescribers.
