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      Physicians’ and patients’ valuation of pharmaceutical care implementation in Poznan (Poland) community pharmacies

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          Abstract

          Implementation of pharmaceutical care (PC) in Poland is of great importance to patients, who, on the one hand, often follow complex pharmacological treatment regimens recommended by several physicians of different specialties, and, on the other, take up the decision on self-treatment due to availability of OTC medications. The aim of the present study was to assess the opinion of both patients and physicians about implementation of PC service in Polish community pharmacies.

          A cross sectional study was carried out from September 2009 to September 2010 by a pharmacist (author of the study) on the basis of an anonymous questionnaire, where demand of physicians ( n = 104) and patients ( n = 202) for implementation of PC in a community pharmacy was assessed. The study was planned to determine the relationship between implementation of PC, cost and time of this service and patients’ and physicians’ socio-economic information.

          Responding patients (85.64%) and physicians (76.92%) unanimously confirmed the need for implementation of PC. Most people convinced of the service implementation were 88.89% of physicians under the age of 35 and all the respondents were over 65 years of age ( p = 0.027), just as 93.33% with service lesser than 5 years and 73.68% of respondents working a maximum of 20 years ( p = 0.023). Mainly according to 90.00% of physicians with specialty in internal medicine and 92.59% of physicians of the group “Others” ( p = 0.012), PC should be implemented in pharmacies. Women more frequently than men reckoned that appointments with a pharmacist should last up to 15 min ( p = 0.012). According to 77.78% of the youngest physicians and 83.33% of the oldest ones, appointments should last from 5 to 15 min ( p = 0.049), and a similar opinion was shared by 80.77% of physicians without specialty and 77.78% of physicians of the group “Others” ( p = 0.0009). According to patients, the mean cost of the visit should be USD 7. Physicians most often assessed the mean cost of the appointment at USD 14.

          This study provides new data about implementation of PC in Poland. The increased patients’ and physicians’ willingness to benefit from this service provides pharmacists with opportunities to develop PC in community pharmacies.

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          Influence of pharmaceutical care on health outcomes in patients with Type 2 diabetes mellitus.

          To examine the influence of a pharmaceutical care programme on disease control and health-related quality of life in Type 2 diabetes patients in the United Arab Emirates. A total of 240 Type 2 diabetes patients were recruited into a randomized, controlled, prospective clinical trial with a 12-month follow-up. A range of clinical measures, medication adherence and health-related quality of life (Short Form 36) were evaluated at baseline and up to 12 months. Intervention group patients received pharmaceutical care from a clinical pharmacist, whereas control group patients received their usual care from medical and nursing staff. The primary outcome measure was change in HbA(1c). British National Formulary and Framingham scoring methods were used to estimate changes in 10-year coronary heart disease risk scores in all patients. A total of 234 patients completed the study. Significant reductions (P < 0.001) in mean values (baseline vs. 12 months; 95% confidence interval) of HbA(1c)[8.5% (8.3, 8.7) vs. 6.9% (6.7, 7.1)], systolic [131.4 mmHg (128.1, 134.7) vs. 127.2 mmHg (124.4, 130.1)] and diastolic blood pressure [85.2 mmHg (83.5, 86.8) vs. 76.3 mmHg (74.9, 77.7)] were observed in the intervention group; no significant changes were noted in the control group. The mean Framingham risk prediction score in the intervention group was 10.56% (9.7, 11.4) at baseline; this decreased to 7.7% (6.9, 8.5) (P < 0.001) at 12 months but remained unchanged in the control group. The pharmaceutical care programme resulted in better glycaemic control and reduced cardiovascular risk scores in Type 2 diabetes patients over a 12-month period.
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            Pharmaceutical care, European developments in concepts, implementation, teaching, and research: a review.

            This article discusses the concept of pharmaceutical care especially from the European perspective. It tries to clarify the current status of pharmaceutical care research and implementation, and if and how it can be part of the practice of pharmacy. Pharmaceutical care basically means improving the medication use process in order to improve outcomes, including the patients' quality of life, and that involves a focus change for pharmacy from product to patient. This change in focus also implies that the pharmacy curriculum should be adapted, in order for the pharmacist to be able to acquire new knowledge and skills. In most countries this change currently is taking place but not in very deliberate or structured manner. Some basic decisions have to be made, in order to guarantee that every patient receives pharmaceutical care when needed.
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              How much do elders with chronic conditions know about their medications?

              Background Patients with chronic diseases often undertake multiple medication regimes to manage their condition, prevent complications and to maintain their quality of life. A patient’s medication knowledge has been defined as the awareness of drug name, purpose, administration schedule, adverse effects or side-effects and special administration instructions. Poor medication knowledge can have a negative impact on medication adherence and patient safety and, in increasing the use of medical resources. The objective of the study is to assess the medication knowledge of elderly patients with chronic disease conditions and the factors affecting this knowledge. Methods A cross-sectional survey was conducted in patients aged ≥60 with chronic disease conditions or their caregivers were recruited from two general outpatient clinics and two medical outpatient clinics in the public sector. Participants were approached by trained interviewers to complete a semi-structured questionnaire to assess their understanding of the instructions and information relating to their regular medications, which included medication name, regimen, purpose and common side-effects and precautions. Results A total of 412 patients were recruited with the mean age of 72.86 ± 7.70. Of those, 221 (54.2%) were male and 226 (55.4%) were of primary school educational level or below. The mean number of medications taken per patient was 3.75 ± 1.93. Overall, 52.7% of patients felt that healthcare staff or clinic pharmacists had very clearly explained the administration instruction of the prescribed medications whilst 47.9% had very clear explanations of drug purpose but only 11.4% felt they had very clear explanations of side-effects. 396 patients (96.1%) failed to recall any side effects or precautions of each of their prescribed medications, although 232 patients (58.4%) would consult a doctor if they encountered problems with their medications. Logistic regression analysis showed that for every additional medication prescribed, the likeliness of patients to recall side-effects of all the medications prescribed was significantly lowered by 35% (OR = 0.65; 95% CI = 0.44-0.94; P = 0.023). In addition, those who finished secondary school or higher education were likely to possess more knowledge of side-effects (OR = 9.88; 95% CI = 2.11-46.25; P = 0.004). Conclusions Patients who take medications for their chronic diseases generally lack knowledge on side-effects of their medications which could potentially affect medication compliance and medication safety.
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                Author and article information

                Contributors
                Journal
                Saudi Pharm J
                Saudi Pharmaceutical Journal : SPJ
                1319-0164
                2213-7475
                13 March 2014
                13 March 2014
                December 2014
                : 22
                : 6
                : 537-544
                Affiliations
                [a ]Department of Pharmaceutical Technology, Pharmacy Practice Division, Poznan University of Medical Sciences, 70 Bukowska Street, 60-812 Poznan, Poland
                [b ]1st Department of Surgical Oncology and General Surgery, Wielkopolska Cancer Center, 15 Garbary Street, 61-866 Poznan, Poland
                [c ]Department of Pathophysiology, Poznan University of Medical Sciences, 6 Swiecickiego Street, 70-781 Poznan, Poland
                Author notes
                [* ]Corresponding author. Tel.: +48 61 854 72 06; fax: +48 61 854 72 08. mwaszyk@ 123456ump.edu.pl
                Article
                S1319-0164(14)00025-5
                10.1016/j.jsps.2014.02.012
                4281582
                25561866
                36c4ce04-39b9-4642-ada5-9fb808d9b804
                © 2014 King Saud University. Production and hosting by Elsevier B.V. All rights reserved.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

                History
                : 3 February 2014
                : 28 February 2014
                Categories
                Original Article

                pc, pharmaceutical care.,pharmaceutical care,community pharmacy,willingness to pay,willingness to spend time

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