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Fitzpatrick, Peter George. "Integrated skills reinforcement in pharmacy personnel management /." Access Digital Full Text version, 1992. http://pocketknowledge.tc.columbia.edu/home.php/bybib/11229391.
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Thesis (Ed.D.)--Teachers College, Columbia University, 1992.Includes tables. Typescript; issued also on microfilm. Sponsor: Carmine Paul Gibaldi. Dissertation Committee: L. Lee Knefelkamp. Includes bibliographical references (leaves 164-168).
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Hernandez, Carlos, and Marion Slack. "Self-management of Pain Among Pharmacy Students." The University of Arizona, 2016. http://hdl.handle.net/10150/613984.
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Class of 2016 AbstractObjectives: The purpose of this study is to determine if pharmacy students are more likely to use pharmacological agents to manage pain and if men and women are equally likely to use pharmacological agents. Methods: Questionnaires were administered after a regularly scheduled class for first, second and third year pharmacy students. Data collected included a pain intensity rating, whether pain was acute or chronic, how the pain was managed (medication, exercise, etc.) and if pain interfered with activities. Results: A total of 218 students (41% men, 71% aged 19-25) participated; 70% reported acute pain, 16%, chronic pain, and 14%, no pain. Pain intensity was greater in the chronic pain group (5.8 ± 1.7) than in the acute pain group (5.0 ± 2.1; p = 0.028). Chronic pain respondents were more likely to use prescription NSAIDs, muscle relaxers, physical therapy, transdermal electrical nerve stimulation, steroid injections and beta blockers (p < 0.02). There were few differences between men and women; women used OTC NSAIDs and acetaminophen at higher rates than men (p < 0.02). Women also used two non-pharmacological strategies (changed position and relaxation) at higher levels than men (p < 0.02). Students with chronic pain reported more pain interference with daily and leisure activities (p < 0.005) and work (p = 0.003) than students in the acute pain group. Conclusions: Different strategies were used for pain management between acute and chronic pain participants, and also between both men and women. Students with chronic pain reported more interference with activities than those with acute pain.
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Adams, Edries. "Independent community pharmacy : quo vadis?" Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/14640.
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Thesis (MBA)--University of Stellenbosch, 2011.On 16 January 2004, the Parliament of the Republic of South Africa published the Draft Regulations to the Medicines and Related Substances Act No. 101 of 1965 (Republic of South Africa, 2010a) for comments due by 16 April 2004. These regulations would change the retail pharmacy landscape that generations of pharmacists had become dependent on in supporting themselves and the communities that they served. These regulations proposed a single exit price (SEP) that manufacturers might charge pharmaceutical wholesalers, which included the distribution cost. The wholesaler in turn would sell the pharmaceutical to the pharmaceutical retailer at the listed SEP, thus prohibiting discounts and in the process creating transparency in the pharmaceutical industry. This transparency would ensure that all people would pay the same price for their medication with the aim of making it affordable and available to those in need. Preceding these draft regulations was the amendment to the Pharmacy Act No. 53 of 1974 (Republic of South Africa, 2010c) concerning pharmacy ownership, which allowed non-pharmacist and legal entities to own pharmacies as of 2003. This amendment posed the first external threat to the autonomy of pharmacists regarding independent pharmacy ownership. Pharmacists now had to compete not only amongst themselves but also with large corporate food and health shops with in-house pharmacies. The resources and capabilities inherent to independent community pharmacies given the events of the past few years proved inadequate in competing with the corporate retailers. These two amendments to acts that influenced the existing pharmacy landscape posed a real threat to the sustainability of independent pharmacy business models. This paper investigates the issues that independent community pharmacies in South Africa are facing and their strategic options in the pharmaceutical and services value chain.
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Babolmorad, Niloofar. "Business Plan for DANA Pharmacy." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10784861.
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Studies have revealed that bilingual individuals opt their native language as the first choice for consultation with health professionals. Moreover, a concordant cooperation between patient and pharmacist is significantly impaired where one party is applying a language with which both sides are not comfortable or confident. Accordingly, a multilingual pharmacy has the potential to remove language barriers for non-compliance among customers who need pharmacy services. On the other hand, in today’s competitive market, a pharmacy may guarantee its survival, and also high revenue, if it fills a sizable amount of Medicare patients’ prescriptions since a majority of these physician orders include at least three types of chronic-disease medications. However, there are still communication barriers with some of Medicare beneficiaries because of their limited proficiency in English.
DANA, a private community pharmacy, intends to remove aforementioned obstacles in the heart of Laguna Woods and its neighboring cities where they place prescriptions for a large number of Persian and Hispanic immigrants and serve a community with the highest density of elderly people in Southern California.
DANA’s mission is to deliver highly valued health care in a manner that ensures optimal medication therapy outcomes for the whole community by performing its trilingual Farsi-Spanish-English pharmacy service and being more attentive to elderly patients.
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Khan, Mohammed Akbar. "Buy24x7.com| An Online Pharmacy." Thesis, California State University, Long Beach, 2018. http://pqdtopen.proquest.com/#viewpdf?dispub=10747296.
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Buy24x7.com is an online pharmacy registered as a limited liability company with its head office in Los Angeles, CA. The sole purpose of Buy24x7.com is to provide prescription medicines at a reasonable price to its customers and we plan to achieve this by working efficiently and cutting down the operating cost. The company’s top three goals are to provide prescription medicines to the customers at a lower price in the market, make prescription medicines easily available to the customers and be known as Americas most reliable and trusted pharmacy. Buy24x7’s unique selling proposition is an overnight delivery system which promises to deliver drugs to the doorsteps. Additionally, there will be a discount for the customers within 5-km radius of the warehouse. This business plan will present an analysis of target market, company’s marketing goals and objectives and the strategies to attract customers, a SWOT analysis discussing the strengths, weaknesses, opportunities, and threats to the company, a birds-eye view of the legal and regulatory concerns surrounding the business, and finally a review of the financial viability
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Harrison, Donald Lee 1956. "Strategic planning by institutional pharmacy administrators." Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277297.
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The extent and quality of strategic planning by institutional pharmacy directors was assessed. Also examined was how the extent and quality of strategic planning, institutional characteristics, pharmacy characteristics, and pharmacy director characteristics might be associated with the pharmacy's overall level of performance in selected areas. The majority of institutional pharmacy directors reported utilizing strategic planning for their departments. The global quality of strategic planning reported by pharmacy directors was average. However, directors conducting strategic planning reported a high level of strategic planning. The directors' rated time available, knowledge, and importance of strategic planning were found to be significantly associated with pharmacy directors' rated quality of strategic planning. Additionally, pharmacy directors' rated quality of strategic planning was found to be significantly associated with pharmacy performance for clinical, distributive, and administrative services.
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Augustine, Jill. "Design and Development of Objective, Structured Management Examinations (OSMES) on Management Skills Among Pharmacy Students." Diss., The University of Arizona, 2016. http://hdl.handle.net/10150/612140.
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The purpose of this study was to design, develop, and administer an Objective, Structured Management Exam (OSME) on management skills for pharmacy students. Pharmacy preceptors for the University of Arizona College of Pharmacy participated in focus groups that identified business, management, and human resource skills needed by pharmacy graduates. Once the skills were identified, gaps were identified for inclusion into the OSMEs. The OSMEs evaluated pharmacy students' performance on four skills: 1) managerial communication (oral and written); 2) conflict resolution; 3) decision-making; and 4) professionalism. The OSME consisted of a role-playing and a writing document. Both were graded using a developed scoring rubric. The role-playing scoring rubric contained 17 skills and the written document scoring rubric contained 8 skills. During the OSME, students interacted with a trained actor and were graded by a judge on their performance. Upon completion of the OSME, students completed a 29-question survey on a) their perceived ability and confidence to accomplish 8 selected skills; b) their opinion about the OSME and suggestions to improve the process in the future; and c) their background characteristics. Many-facet Rasch analysis provided detailed information with which to evaluate content validity and student performance taking into account difficulty of skills, rating scale function of the scoring rubric, judge leniency and severity. Rasch analysis provided detailed information on the scale performance and student ability and confidence. A step-wise linear regression was used to determine if any student characteristics predicted a higher OSME performance score. Ninety-six student pharmacists completed the OSME and ninety-five students completed the questionnaire. No student failed the role-playing scenario and 1 student did not complete the written document. Significant gaps were calculated between the easiest two skills, empty sounds and eye contact. Additionally, the seventeen items did not align with student performance measures. Finally, there were two separate groups of graders. The writing document scoring rubric had poor fit with the model and significant gaps were calculated. Student measures did not adequately align with item difficulty measures. For students' perceived ability, there was no significant change in overall mean student ability scores from before the educational lectures to after the OSME. However, 46% of students (n=44) had a significant change in ability scores. Three significant gaps were calculated between skills a) between decision-making and communication and between communication and active listening on the pre-educational lectures; and b) between decision-making and communication on after the OSMEs. Students appeared confident with their ability on the 8 skills. The overall mean student confidence measure did not significantly change between the three time points: 1) before the practice cases; 2) after the practice cases; and 3) after the OSMEs. However, 46% of students (n=44) had a significant change in their confidence from before the practice cases to after the completion of the OSMEs. Item difficult measures did not appropriately align with student confidence measures, meaning the items were too easy for students. Significant gaps were also calculated: a) between the motivation and communication items and between the communication and active listening items in the before the practice cases responses; b) between the motivation and decision-making items and between the communication and active listening items for the after the practice cases responses; and c) between the motivation and decision-making items; between the decision-making and communication items; and between the communication and active listening items for after the OSME responses. Based on the result of the regression, three characteristics predicted a higher performance score on the role-playing portion of the OSME: 1) previous management experience; 2) previous leadership experience; and 3) the total grade on the educational lecture quizzes. Three characteristics predicted a higher writing document score: 1) age between 26 and 28 years; 2) English as the primary language; and 3) previous pharmacy experience classified as "other" (i.e., pharmacy experience that was not hospital, community, or managed care). This was one of the first studies to develop a role-playing exercise on management skills in pharmacy education. The grading rubrics provided an initial structure for assessing student performance on these management skills. Some changes to the ability questions and the rubrics are suggested in order to improve the content validity. The findings provide the outline for the use of an OSME at schools/colleges of pharmacy as part of their curriculum. As exposure to management scenarios showed higher performance, educators should include these skills in the education of student pharmacists in order to prepare them for a future career in pharmacy.
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Holden, Greg, Steve Marty, Jared Thigpen, Dennis Turcotte, and Tol Dean Van. "Supply Chain Management at the National Naval Medical Center Pharmacy." Thesis, Monterey, California. Naval Postgraduate School, 2010. http://hdl.handle.net/10945/7061.
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EMBA Project ReportEXECUTIVE SUMMARY: Supply Chain Management at the National Naval Medical Center Pharmacy The National Naval Medical Center (NNMC) in Bethesda, Maryland is the U.S. Navy’s flagship of medical centers and is the Navy’s third-largest medical center.1 NNMC provides medical services to approximately 46,000 patients annually,2 and its pharmacy has an annual budget of $46M for drugs dispensed to NNMC patients.3 This consulting project, completed with the support of the NNMC Pharmacy Department Head and facilitated through the Naval Postgraduate School Executive MBA Program, applied operations management and supply chain management principles to the processes used by the NNMC pharmacy to find potential efficiency improvements. Specifically, the consultant team evaluated drug purchasing data from the Defense Medical Logistics Supply System (DMLSS) and dispensing data from the Composite Healthcare System (CHCS) for specific high-cost and high-volume drugs to identify optimal inventory levels and order points. The NNMC Pharmacy Staff selected the following six drugs for analysis: _ Arimedex (anastrozole) – a breast cancer prevention drug. _ Intelence (extravirine) – an HIV treatment drug. _ Procrit (epoetin alfa) – an anemia treatment drug. _ Seroquel (quetiapine) – depressive disorder (bipolar & schizophrenia) treatment drug. _ Topamax (topiramate) – an anti-seizure/epilepsy medication. _ Vfend (voriconazole) – fungus and yeast infection treatment drug. 1 NNMC Public Affairs Document “National Naval Medical Center at a Glance,” www.bethesda.med.navy.mil 2 Ibid. 3 Personal Interview with LT Bradley Gotto, 29 July 2010 After analyzing historical ordering and dispensing data for these drugs and touring the NNMC drug storage facilities, the consultant team’s primary recommendation is that NNMC pharmacy should adjust re-order points, re-order quantities, and safety stock for the subject drugs to reduce high levels of inventory and unnecessary safety stock. Since the NNMC pharmacy can obtain drugs at low cost with minimal (1 day) lead time, NNMC can reduce the average inventory of these drugs and shift the burden of inventory management to the drug suppliers. This has potential to simplify the restocking process at the NNMC pharmacy and reduce the manpower required to fill new orders. Other secondary recommendations to improve the NNMC Pharmacy operations include: _ Perform a full inventory of drugs held at the NNMC Pharmacy to develop a full accounting of all drugs on hand. _ Expand analysis to determine required safety stock for other drugs. _ Promote adoption of a consolidated system to replace DMLSS and CHCS to coordinate ordering and dispensing operations.
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Sisson, Evan M., McKenzie L. Calhoun, and Michael A. Crouch. "Dyslipidemia: Contemporary Evaluation and Management." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/6874.
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After much anticipation, new dyslipidemia guidelines have been published by the American College of Cardiology (ACC) and American Heart Association (AHA). The guidelines are a major shift from specific lipid goals to a focus on risk reduction. All pharmacists will need to be familiar with these guidelines in order to provide optimal patient care.
Like all ASHP eReports, this is a brief and straightforward presentation of what you need to know about dyslipidemia treatment, the new guidelines, and where you can turn for deeper understanding of the context. Dyslipidemia: Contemporary Evaluation and Management addresses pathophysiology, clinical presentation, diagnosis, and disease classification, general treatment principles, non-pharmacological treatments, pharmacotherapy, monitoring, clinical controversies, and future treatment, references, and web resources.
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Pham, Misty Mong-Xuan. "Flymed Pharmacy, LLC, Home Delivery Services a Business Plan." Thesis, California State University, Long Beach, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10601380.
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With advances in technology and science, life expectancy is increasing, but most of the elders must take care of themselves or live in assisted home. Between 2015 and 2060, the U.S. Census Bureau predicts that the population adult aged 65 to 84 will grow to 89%; meanwhile, the number of adult 85 and older are expected to more than triple and about 11 million people age sixty-five and older are predicted to live alone, which is almost a third of the American population. They may have problems to receive essential medications because they are unable to drive or do not have access to public transportations. The FlyMed Pharmacy will assist the elderly by providing home delivery services such as emergency or maintenance medications. Consultations and advice will be provided through a mobile app, DeliverMyMed.
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McGovern, Deirdre B. "The value of professional audit in community pharmacy practice." Thesis, Queen's University Belfast, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.388225.
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Khoza, Augustine. "Pharmacy Stores Profitability and Sustainability in Bulawayo, Zimbabwe." ScholarWorks, 2016. https://scholarworks.waldenu.edu/dissertations/3251.
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Zimbabwe's catastrophic economic decline resulted in a high unemployment rate (95%), declining socioeconomic indicators, pharmacy stores' unprofitability and lower sustainability. Profitable pharmacy stores play a fundamental role in ensuring public access to medication. Lack of pharmacy profitability leads to poor healthcare delivery, resulting in increased morbidity and mortality. A healthy population is panacea to economic growth and prosperity and enhances human dignity, social cohesion, and the quality of life. In this qualitative, descriptive multicase study design, using Porter's business strategies theory and the Deming process of quality assurance as conceptual frameworks, data from 11 pharmacy stores leaders in Bulawayo, Zimbabwe were collected during interviews with open-ended questions. Participants were assumed to have influence, knowledge, and a personal stake in the pharmacy sector and that their views and experiences could address the research question of lack of pharmacy profitability and sustainability. Data were explored, categorized, and tabulated to assist drawing empirical findings and conclusions that could answer the research question. Using software the data were analyzed and themes such as the centrality of strategy in running profitable pharmacies, customer care, reimbursements by medical insurance firms, the role of the legal and regulatory frameworks on pharmacies, and mergers of single-owner pharmacies emerged. Findings from the results might provide strategies for those in the pharmacy retail sector and individuals who intend to explore the sector. Individuals who read results of the study might be influenced to lobby government on behalf of the sector to relax prohibitive regulations.
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Calhoun, McKenzie L., and Melaina Perry. "Lipid Management: Concepts and Controversies." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/6892.
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Hagemeier, Nicholas E., and Elvin T. Price. "Applying Patient-Centered Care in Pain Management." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5422.
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Learning Objectives: Describe the concept of patient ‐centered care from the pharmacist’s perspective. Summarize the science of patient ‐centered communication in pain management. Describe pharmacogenetic tests that are available to guide the use of opioids in pain management. Discuss research opportunities related to patient ‐centered care and genetic testing in pain management. Describe strategies used by pharmacists to implement genetic testing in clinical pharmacy practice.
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Al-Juffali, Lobna. "Exploring medication safety problems in community pharmacy in Saudi Arabia." Thesis, University of Aberdeen, 2017. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=235753.
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Introduction Community pharmacy in Saudi Arabia faces many challenges. There is a lack of empirical research about medication safety in community pharmacy from the perspective of different stakeholders. A holistic approach is needed to identify medication safety problems. Aim To explore factors associated with medication safety in this setting. Methods Three empirical studies were undertaken. Focus groups explored medication safety problems using the Human Factors Framework and a Delphi exercise prioritised these problems. Interviews were conducted with pharmacy users to explore their willingness to share information with pharmacists during consultations using the Self-Regulatory Model. Results Four focus groups and four interviews (n=35 participants) identified seven main themes: commercialism; illegal supply of medication; lack of enforcement of regulations; the healthcare system; self-medication; trust in pharmacists; and communication and information exchange. Consensus was achieved with 28/84 items identified during the Delphi study. The top five priorities were: lack of pharmacy facilities; pharmacists' communication between pharmacists and physicians; patient databases; post-registration education; and pharmacists' long working hours. The interview study (n=21) identified that trust in pharmacists was the main enabler in sharing information. Barriers were pharmacists' perceived attitudes towards counselling, workload, lack of motivation, patient proxies, type of questions asked, gender and lack of privacy. Both the focus group study and the interview study highlighted pharmacy users' consumerist behaviour. Conclusion This research has shown that community pharmacy is a complex system involving many interacting factors. Multifactorial interventions are needed at individual (patient, pharmacist), pharmacy and organisational level. The effect of consumerist behaviour that pharmacy users exercise in purchasing medication without utilising the pharmacist's expertise and not engaging in dialogue on patient safety should be studied. Further research is needed to analyse pharmacy users' interactions with pharmacists to identify the factors that encourage communication and sharing of all relevant information with pharmacists.
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Rosebraugh, Matthew Robert. "Optimization of anemia management in preterm infants." Diss., University of Iowa, 2012. https://ir.uiowa.edu/etd/3524.
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Premature infants develop anemia in their first few weeks of life. This is the result of heavy laboratory blood loss, shortened red blood cell lifespan, low plasma erythropoietin levels and inadequate erythropoiesis. As treatment for clinically significant anemia, approximately 80% of very low birth weight infants weighing less than 1.5kg at birth and 95% of extremely low birth weight infants weighing less than 1.0kg at birth receive one or more red blood cell transfusions. To reduce or eliminate red blood cell transfusions is important because they are expensive and associated with complications including infection, fluid overload, electrolyte imbalance, transfusion related acute lung injury and exposure to plasticizers, lead, and other toxins.
The primary objective of this thesis is to examine erythropoietin (Epo) dosing, laboratory phlebotomy reduction and the use of restrictive red blood cell transfusion criteria to determine the potential to reduce or eliminate the need for red blood cell transfusions in preterm infants. In order to accomplish this objective, data were obtained from 27 preterm infants including: erythropoietin concentrations, phlebotomy volumes, transfusion information and multiple hematologic indices. The data were analyzed and modeled according to pharmacokinetic and pharmacodynamic principles to determine, through simulation studies, the potential for avoiding blood transfusions in preterm infants. Results from this research suggests that Epo administration, phlebotomy reductions and the use of restrictive blood transfusion criteria all have the potential to reduce the need for blood transfusions in preterm infants. Specifically, a combination of the three interventions was predicted to make blood transfusions unnecessary in all infants with a birth weight between 1.0-1.5kg, and 45% of infants with a birth weight of <1.0kg. These findings are clinically important because avoiding transfusions may lead to better clinical outcomes. The results propose strategies to utilize in future clinical trials involving preterm infants.
The secondary objective of this thesis is to characterize the dynamic Epo receptor behavior in newborn sheep and determine a pharmacodynamic model which utilizes information from the Epo receptor dynamics. Results from this analysis show that the Epo receptor pool is an important predictor of red blood cell production. An Epo receptor based pharmacodynamic model is proposed that successfully predicted the red blood cell production in newborn sheep. Additionally, the optimal time for Epo administration was also determined in these newborn sheep based on the pharmacodynamic model. This optimal Epo administration time corresponded to approximately the time when the Epo receptor pool was the largest. Results from the Epo receptor based studies in newborn sheep suggest Epo clinical trials in preterm infants need to consider the dynamic Epo receptor behavior to produce the most optimal outcome.
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Hagemeier, Nicholas E. "HHS Pain Management Best Practices Interagency Task Force Report: Key Take-Aways." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7746.
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Calhoun, McKenzie L., Peter Blockhurst, and Jesse Gilbreath. "Transitional Care Management: One Practices Efforts." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/6890.
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Calhoun, McKenzie L. "Weight Management Strategies: Interventions and Implications." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/6891.
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Johnson, Jeffrey A. (Jeffrey Allen) 1964. "A comparison of satisfaction with pharmacy services between mail and traditional pharmacy patrons and an evaluation of the relationship with health status." Diss., The University of Arizona, 1996. http://hdl.handle.net/10150/290607.
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The aims of this research were to determine the level of satisfaction with pharmacy services among enrollees of a managed care organization, compare the level of satisfaction between mail pharmacy and traditional pharmacy patrons, and evaluate the relationship between satisfaction with pharmacy services and health status. Data was collected via telephone interviews with 1,362 enrollees of the managed care organization. The overall response rate was 65%. Satisfaction was measured using previously developed items for traditional pharmacy services, and newly developed, parallel items for mail pharmacy services. Scores were calculated for hypothesized multi-item dimensions of satisfaction. Health status was measured using the physical and mental health composite scores of the SF-12 Health Survey. Satisfaction with pharmacy services was compared between patron groups using ANOVA and ANCOVA models. Confirmatory factor analysis and structural equation modeling (SEM) were used to evaluate the dimensional structure of satisfaction with pharmacy services and the relationship between satisfaction with pharmacy services and health status. The results indicated that mail pharmacy patrons were more satisfied than traditional pharmacy patrons with their pharmacy services in general, and specifically with the financial aspects and technical quality of those services. When the comparisons were adjusted for general satisfaction with medical care and mental health status, mail pharmacy patrons still had greater levels of general satisfaction with pharmacy services. However, when these covariates were included in the comparison of satisfaction with financial aspects and technical quality of pharmacy services, dimension scores between the two patron groups were not significantly different. Internal consistency reliability coefficients for the multi-item dimensions of satisfaction were in the range of 0.53 to 0.77, with the exception of the Written Information dimension for mail pharmacy service, where the alpha coefficient was 0.37. A positive correlation between the dimension scores for general satisfaction with pharmacy services and general satisfaction with medical care lends support to the construct validity of the measurements. Additionally, it was concluded that, as expected, general satisfaction with pharmacy services was positively correlated with mental health status, but there was no significant relationship between physical health and satisfaction with pharmacy services.
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Nwambie, Alphonsus I. "Strategies for Pharmacy Managers to Increase Profit by Reducing Prescription Errors." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4877.
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The costs attributed to prescription errors negatively affect the profits of retail pharmacy businesses. The U.S. prescription error rate since 2010 was 0.1%, yet with more than 3.5 billion prescriptions filled annually in the United States, the outcome is more than 3.5 million prescription-dispensing errors and an annual cost of more than $16 billion. Using the performance prism theory, the purpose of this multiple case study was to explore strategies retail pharmacy managers used to increase profit by reducing prescription errors. Using purposeful sampling, 5 retail pharmacy managers in Miami, Florida, were selected as participants because they had implemented strategies to reduce prescription errors. Data were collected using semistructured, face-to-face interviews with 5 pharmacy managers, and company records consisting of quality improvement incident reports, income statements, and balance sheets. Data analysis occurred using methodological triangulation and following Yin's 5-step process of compiling, disassembling, reassembling, interpreting, and concluding the data. The 3 emergent themes were prescription error reducing strategy, profitability improvement strategy through reduced prescription errors, and technology strategy for reducing prescription error. The findings indicated that prescription error reducing strategies are essential for pharmacy managers to increase profits. The implications for positive social change include the potential for retail pharmacy managers to reduce the cost of health care in their communities, prevent prescription error-related hospitalizations and deaths, and improve employment conditions and economic activity in their communities.
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Swanepoel, Deon Andre. "An evaluation of the leadership effectiveness among production supervisors at selected pharmaceutical organisations in Port Elizabeth." Thesis, Port Elizabeth Technikon, 2001. http://hdl.handle.net/10948/62.
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Effective leadership is one of the most important factors that influence the performance of an organisation. Effective leadership together with supervision are similar in terms of their influence of others towards achieving the goals of the organisation. Therefore, effective leadership and supervision are principal activities through which organisational goals and objectives are achieved. The main objectives of this study are firstly to evaluate the leadership effectiveness of production supervisors at Lennon and Intramed. Secondly, to suggest recommendations to management to improve or eliminate shortcomings in the leadership effectiveness of the production supervisors at Lennon and Intramed. In this way, a contribution to the overall leadership effectiveness of the production supervisors at Lennon and Intramed is achieved. In order to achieve the said objectives, the following methodology was employed: Firstly, guidelines for effective leadership were identified by means of evaluating existing literature and theory. This was achieved by critically examining existing leadership theories and models. The major contributions, disadvantages, and advantages of each of these theories and models were evaluated which resulted in the list of guidelines for effective leadership. Secondly, the pharmaceutical industry and the theory surrounding supervision were critically examined and discussed. Attention was given to the pharmaceutical industry in South Africa, with special reference to Lennon and Intramed. The theory of supervision was examined with special focus on the skills, functions, power, and responsibilities of the supervisor. Thirdly, a postal questionnaire was used to gather the required empirical information. The response obtained from the questionnaire was critically evaluated against the guidelines for effective leadership and effective supervision, and the results were graphically represented in a company leadership profile. Lennon and Intramed were evaluated separately, and the major differences and similarities between the two organisations were critically evaluated. Lastly, the main findings and recommendations were formulated in order to remedy the shortcomings that were identified. The following recommendations may lead to more effective leadership among production supervisors at Lennon and Intramed: It is necessary that this study be made available to the supervisors at Lennon and Intramed, as it will give them insight into the theory of leadership and what effective leadership is about. It will furthermore give the supervisors an insight into the way that their subordinates view their leadership behaviour and effectiveness. It is further recommended that the information from this study be made available through sensitisation sessions where the necessary information is presented to a group or individual supervisors. Leadership training and development is required as it can make a meaningful contribution to equip supervisors with the necessary leadership skills to practise effective leadership. This leadership training and development can be done by means of short courses presented by a formal training institution, or by a suitably qualified in-house presenter. The last recommendation to leadership effectiveness involves the implementation of a performance management system and incentive scheme to further motivate and drive the supervisor’s leadership behaviour towards effective leadership.
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Jaffray, Mariesha A. "The MEDMAN study : implementing change at the community pharmacy/general practice interface." Thesis, University of Aberdeen, 2010. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=158336.
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Introduction Management of coronary heart disease (CHD), a major cause of mortality and morbidity in the UK, in primary care, remains sub-optimal. This work aimed to: evaluate impact of a community pharmacy-led intervention on appropriateness of treatment and quality of life of CHD patients; describe opinions and experiences of community pharmacists and GPs and use management of change literature as an explanatory framework for the findings. Methods The thesis comprises: two literature reviews (pharmacy-led interventions for CHD and NHS-based studies using change theories); an RCT evaluating the service; questionnaire surveys and qualitative interviews with community pharmacists and GPs, and comparison of a new model of change with two change theories. Results Review of pharmacy interventions revealed only small-scale studies demonstrating benefit for CHD patients. The change review revealed use of change management theories to implement change and as explanatory frameworks for change initiatives, in the NHS, but not in the pharmacy setting. The RCT recruited 1493 patients (980 intervention, 513 control), 70 pharmacies (102 pharmacists) and 48 practices (208 GPs). No significant differences were found in primary outcomes (appropriateness of treatment or quality of life). Questionnaires revealed positive attitudes to the service but need for pharmacist access to patient records and improved GP/community pharmacist relationships. Qualitative interviews indicated more divergent views. Attitudes were influenced by understanding and previous experience of medicines management, change drivers and implementation processes. Themes conceptualised into a ‘change readiness’ model, had similarities with Lewin’s planned change approach and Pettigrew’s receptivity model. All three models identified areas of sub-optimal intervention implementation and delivery. The new service did not improve appropriateness of treatment or quality of life because it was implemented and delivered sub-optimally. There is a need for greater use of an evidence based systematic approach to introduce new services, but research is required to confirm this approach would confer the hypothesised benefits.
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Cowan, Vanessa. "The management and pharmacoepidemiology of diabetes mellitus." Thesis, Queen's University Belfast, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337685.
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Goeller, Adrienne, and Sushma Patel. "Evaluation of the Didactic Pain Management Curriculum at the University of Arizona College of Pharmacy." The University of Arizona, 2007. http://hdl.handle.net/10150/624397.
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Class of 2007 AbstractObjectives: This study evaluated the didactic pain management curriculum from 2003 to 2006 at the University of Arizona College of Pharmacy in comparison to a compilation of current published standards. Methods: The study design was a utilization-focused evaluation conducted by two doctor of pharmacy candidates. The eleven domains of cognitive and affective abilities used for analysis were compiled from the International Association for the Study of Pain (IASP) guidelines and from published expert-panel competencies in the American Journal of Pain Management (AJPM). These documents were chosen for comparison because they were created with the purpose of developing competent and proficient pharmacy clinicians. Results: The analysis revealed that the University of Arizona College of Pharmacy was unsuccessful in meeting the recommended standards for pain management competencies. Instruction in pain management was poorly integrated, incomplete, and sporadic throughout the coursework. Conclusions: Pain management was insufficiently addressed in coursework at the University of Arizona. Separating pain from other topics, integrating pain entirely into the therapeutics course, creating a course devoted to pain management, and/or fulfilling standards through a required clerkship may improve the current curriculum. The results of the assessment will be used to provide recommendations to improve the curriculum concerning pain management.
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Tan, Jr Roy, Katy Lee, and Janet Cooley. "Improved Safety and Patient Satisfaction: A Pilot Medication Therapy Management Program in a Community Pharmacy." The University of Arizona, 2015. http://hdl.handle.net/10150/614138.
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Class of 2015 AbstractObjectives: Quantify how many interventions were made during a pilot MTM program at a Costco pharmacy and assess patients’ attitudes towards MTM services offered at their local pharmacy. Methods: Contacted patients by phone and offered MTM services over 10 weeks. The patients are insured patients referred by Outcomes MTM and filled at least 50% of medications at Costco. Successful interventions were tallied and questionnaires administered to collect data on patients’ background knowledge of MTM, rating of how helpful and beneficial MTM services conducted by local pharmacy were, how frequent patients would like such services, how much they were willing to pay for such services, and demographic information. Results: Due to low response rate no meaningful statistical differences were able to be observed. However interesting trends started to emerge; more adherence related interventions, adequate compensation for a dedicated MTM pharmacist, and that MTM is unknown to most patients but do find it useful. Additionally we were able to observe challenges and difficulties with implementing MTM services at a store level. Conclusions: The original aim of the study was not able to be adequately achieved due to low response rate. However the trends that emerged let us make some subjective conclusions; adherence related interventions were fairly common, a dedicated MTM pharmacist may be a feasible in a community setting, most patients are unaware of what MTM is but do find it useful after the service, and challenges to implementing an MTM service from the store level.
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Van, Ostrand Rita A. "A computerized working environment for retail pharmacists." Virtual Press, 1987. http://liblink.bsu.edu/uhtbin/catkey/484763.
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The purpose of this study was to investigate how well the computer hardware/software industry was meeting the needs of the retail pharmacist. The needs were determined by a survey of 1000 Indiana pharmacists. A reply rate of 22% revealed that the most important problems pharmacists were facing with their computer systems were slow access of the data, the length of backup time, no drug interaction check, and no multitasking. Hardware and software means of meeting these problems were studied. Also the currently available systems were evaluated in terms of these problems. It was found that while most systems were adequately meeting some of these problems no system was addressing all of them. Some of the systems were multitasking but were much too expensive for the small pharmacy. A system can be designed that meets all of these needs without neglecting the basic needs of pharmacists and at a very reasonable cost.
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Hussain, Manir. "Therapeutic management of the elderly in nursing and residential homes." Thesis, Cardiff University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297902.
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Cosgrove, Aidan Patrick. "Botulinum toxin A in the management of cerebral palsy." Thesis, Queen's University Belfast, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.317529.
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Royek-Purtee, Kelly. "A Descriptive Study of the Impact of a Pharmacist Run Diabetes Management Clinic." The University of Arizona, 2009. http://hdl.handle.net/10150/623974.
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Class of 2009 AbstractOBJECTIVES: The purpose of this study is to determine if a pharmacist run diabetes management clinic assists patients in the successful management of type 1 or type 2 diabetes. METHODS: Patients must have been enrolled and participated in at least one visit to the pharmacist run diabetes management program at North Country Health Care Clinic (“NCHCC”). A retrospective chart review was completed to determine patient outcomes. RESULTS: A total of 82 charts were reviewed and 49 patients were qualified for the study. A total of 19 men (mean age 42.1; SD 12.1) and 30 females (mean age 55.0; SD 14.4) completed at least one visit to the pharmacist run diabetes management program. HbA1c levels were significantly lower after one or more visits to the pharmacist run diabetes clinic (p=<0.001) for all patients. CONCLUSIONS: Patients who participate in the pharmacist run diabetes management clinic appear to successfully lower HbA1c values after at least one visit to the program.
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Luevorasirikul, Kanokrat. "Body image and weight management : young people, internet advertisements and pharmacists." Thesis, University of Nottingham, 2007. http://eprints.nottingham.ac.uk/10296/.
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Media promotion of the ideal body as slimness for women and muscularity for men, has led to increasing numbers of both genders reporting dissatisfaction with their bodies and trying to change using weight control products. It has been suggested that pharmacists can play a key role in promoting healthy lifestyles and weight management. The main aim of the research study was to examine the impact of media on body image perception and to investigate the role of pharmacists in weight management. This thesis consists of three studies: an evaluation of weight control websites, a body image survey of young adults and interviews with pharmacists. The results from the evaluation study showed that the quality of most weight loss (64%) and weight gain product advertisements (80%) was generally poor, principally due to the use of misleading claims and a lack of useful information. These data complement the survey that university students reported rarely being influenced by weight control product adverts and hardly considered using these products as a method for changing weight. The survey also showed that most participants of both genders (71%) felt satisfied with their body image. However, the findings in this study indicated that there was a relationship between a high level of body image concern and self-perception of being overweight and the attempt to lose weight. Interviews with pharmacists showed that they were unlikely to be actively involved in reducing obesity problems and promoting healthy lifestyles in the community. Although the prevalence of body dissatisfaction and the use of weight control products among these young adults may not be as high as has been reported elsewhere, healthcare professionals, including pharmacists, need to be aware of this problem when providing advice or consultations for young adults. Healthcare professionals should promote the benefits of healthy lifestyles as well as providing information about potential problems of harmful weight control strategies. The effect of ethnicity and culture on body image concern warrants further. The availability of weight control products and quality of information provided should also be further examined.
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Benström, Stig. "Prehospital pain management of traumatically injured adult patients." Thesis, Uppsala universitet, Institutionen för farmaceutisk biovetenskap, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-418917.
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Title Prehospital pain management of traumatically injured adult patients Authors Benström S Institute Uppsala University, Uppsala, Sweden Background and objective Traumatic injuries are a major cause behind moderate and severe pain in a prehospital setting. Therefore, the aim of this study is to evaluate prehospital use of analgesics among adult traumatically injured patients treated within Tartu Ambulance Foundation by analysing how ambulance personnel evaluates and treats pain. Secondary aim is to map prehospital factors influencing the process. Setting and Method A retrospective, single-centre service evaluation study with the primary selection of 7526 electronic patient records (EPR) with the main diagnosis of S00-T98 (ICD-10) was conducted and a polyvariant logistic regression model was created to map factors that influence pain management. Main outcome measures Primary outcome measures were prevalence of pain evaluation and the use of analgesics. Secondary outcome measures were significant changes in odds ratios for prehospital-related factors that affected primary outcome measures. Results Mean age of the study population was 54 years (SD 22) and 775 (58.9%) were male. Out of all the patients in this study 529 (40.3%) received analgesics. Pain assessment before administrating analgesics was documented on 15.9% of EPRs. Nurses assessed pain 3.3 times (95% CI 2.0-5.3; p<0.001) more likely than physicians. The odds for receiving analgesics were 2.3 (95% CI 1.68-3.08; p < 0,001) times smaller when patients had consumed alcohol. Brief assignment (0-10 min) and hospitalisation reduced the odds of using analgesics by 3.6 times (95% CI 1.9-6.8; p<0,001) and 1.59 times (95% CI 1.13-2.24; p<0.007) respectively while lengthy assignments (>50 min) increased the odds by 3.4 times (95% CI 1.9-6.5; p<0,001). Monotherapy was chosen for 73.2% of patients while 24.6% received a combination of 2 and 2.2% a combination of 3 analgesics. Conclusions Current study showed that although nurses as brigade leaders are more likely to assess pain the overall prevalence remains low. Alcohol consumption among patients, short assignment times, and hospitalization decreased the odds for pharmacological pain management. Longer assignment times on the contrary were associated with increased odds. Improvements in pain management can be made in choosing between specific therapeutic options.
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Audu, Bridget. "The contribution of pharmacy to the management of HIV patients at Maitama District Hospital, Abuja, Nigeria." Thesis, University of Wolverhampton, 2013. http://hdl.handle.net/2436/298242.
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Human immunodeficiency virus (HIV) is a worldwide problem, with more than 34 million people infected with HIV/AIDS in 2011. At the end of 2011, in Nigeria, an estimated 3.7% of the adult population were living with HIV/AIDS. HIV services in Nigeria are secondary-care led, involving multidisciplinary teams and access to free antiretroviral. However, evaluations of service provision from both patient and healthcare professional perspectives, especially, pharmacists in Nigeria have never been conducted, and are the aims of this research. This study involved grounded theory methodology, using In-depth semi-structured interviews with adults infected with HIV, pharmacists, and administrators involved in the management and care of those patients at Maitama District Hospital in Abuja. HIV pharmacists working for the NHS in the UK were interviewed for comparative purposes. Thirty-five patients were interviewed. Five concepts were identified that influenced how they accessed hospital services after diagnosis. These include faith in God and antiretroviral, social issues with emphasis on HIV stigma and discrimination, patient journeys at the hospital with delays and repeat visits, obstacles such as ARV unavailability and their expectations. Also, five concepts were identified from the pharmacists’ interviews which include clinical service, impressions of service provided, social issues the patients encountered, the obstacles faced with clinical service provided and expectations for improvement. Ten patients were shadowed on their clinic days to observe the patient journey articulated. Furthermore, the administrators interviewed re-affirmed the opinions of the patients and pharmacists about many patients attending HIV clinic, few staff attending to patients, medicines unavailability, especially ARV drugs, and lack of working space for staff. Delays, few pharmacists/many patients and shortage of ART as barriers to service provision ii emerged as dominant themes across the three groups of interviewees in Nigeria. Also, it has been found that there is a wide gap between HIV patients’ hospital management in the UK and Nigeria as regards availability of antiretroviral, staff strength, number of patients in attendance on clinic days and weekly clinic days. Pharmacy was found to have a substantial role in the management of HIV/AID patients but it appears from this study that service improvements, both human and material resources are needed. Twenty three recommendations, which are further synthesised into six potential areas, are made, which, if implemented, would dramatically improve the service provision for HIV/AIDS patients at Maitama District Hospital.
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Luder, Heidi R. "TransitionRx: Impact of a Community Pharmacy Post-Discharge Medication Therapy Management Program on Hospital Readmission Rate." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1367937238.
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Ashby, Jade. "Academic and Training Requirements in Advertisements for Pharmacy Management and Clinical Director Positions: A Follow up." The University of Arizona, 2008. http://hdl.handle.net/10150/624295.
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Class of 2008 AbstractObjectives: A follow-up analysis of academic and training requirements found in advertisements for pharmacy management, assistant director, and clinical pharmacy director positions. Methods: Advertisements appearing in the American Journal of Hospital Pharmacy (AJHP) were analyzed for academic and training criteria that were either preferred or required for pharmacy management, assistant director, or clinical pharmacy director positions. Included advertisements were for pertinent positions found in AJHP between January 2002 and December 2007. Some of the requirements or preferences that appeared in the advertisements that were analyzed included the type of pharmacy or other degree, postgraduate training including residencies and/or fellowships, board certification, and experience qualifications. Results: There was a total of 426 advertisements that met inclusion criteria. Results were listed in percentages of advertisements either requiring or preferring a certain qualification. A significant portion of ads sought applicants who had completed a residency (24% - pharmacy manager/director, 50% - clinical director, 47% - assistant/associate manager). Preferences and requirements of the PharmD or MS degree qualification decreased in percent from a previous study. However there was an increase in the relative number of ads pertaining to the MBA preference (9%, n=27). Conclusions: Many of the results from this study were similar to previous studies which looked at job qualifications in pharmacy manager and clinical directors. It remains evident that education, training, and experience play a major role in meeting the qualifications associated with obtaining a job as a pharmacy manager, clinical director, or associate director.
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Patel, S., and McKenzie L. Calhoun. "CHADS2 versus CHA2DS2-VASc Utilization for Medication Management by Providers (CHUMP) Study." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/6899.
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Bossaer, John B., Stephen A. Geraci, and Kanishka Chakraborty. "Cardiovascular Toxicity and Management of Targeted Cancer Therapy: An Overview for Generalists." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/2324.
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The advent of effective oral, molecular-targeted drugs in oncology has changed many incurable malignancies such as chronic myeloid leukemia into chronic diseases similar to coronary artery disease and diabetes mellitus. Oral agents including monoclonal antibodies, kinase inhibitors and hormone receptor blockers offer cancer patients incremental improvements in both overall survival and quality of life. As it is imperative to recognize and manage side effects of platelet inhibitors, beta blockers, statins, HIV drugs, and fluoroquinolones by all healthcare providers, the same holds true for these newer targeted therapies, patients may present to their generalist or other subspecialist with drug-related symptoms. Cardiovascular adverse events are among the most frequent, and potentially serious, health issues in outpatient clinics, and among the most frequent side effects of targeted chemotherapy. Data support improved patient outcomes and satisfaction when primary care and other providers are cognizant of chemotherapy side effects, allowing for earlier intervention and reduction in morbidity and health care costs. With the implementation of accountable care and pay-for-performance, improved communication between generalists and subspecialists is essential to deliver cost-effective patient care.
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Hagemeier, Nicholas E., Tandy Branham, and Nasar Ansari. "Personal Finance Beliefs and Behaviors: A Longitudinal Analysis of Pharmacy Graduates." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1443.
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Objectives: 1) Describe personal finance (PF) perceptions of the East Tennessee State University (ETSU) Gatton College of Pharmacy Class of 2014 upon and 1-year post-graduation; 2) Examine the association between PF elective course completion during pharmacy school and post-graduation PF behaviors. Method: Students enrolled in the ETSU Class of 2014 completed a self-administered questionnaire that assessed student characteristics (e.g, participation in a PF elective during school), PF characteristics (e.g., student loan indebtedness), perceptions (e.g., confidence in ability to manage PF), and behaviors (e.g., monthly budgeting) one week prior to graduation and 18 months post-graduation. Paired and independent samples statistical analyses were conducted to examine changes in responses over time and PF course participation. Results: Sixty percent of the cohort completed both questionnaires. Students reported an average student loan debt balance of $155,571 (±$83,853) 18 months post-graduation and average loan term length of 17.3 (±8) years. Students’ concerns about their student loan debt were significantly higher prior to graduation as compared to 18 months post (p=0.01). No significant differences were noted for student loan debt amount or student loan term length across PF elective participation. Students who took the personal finance elective were significantly more likely to develop monthly budgets (p=0.01) and report positive career satisfaction as compared to students who did not (p=0.04) 18 months post-graduation. Implications: To our knowledge, this is the first study to track PF perceptions and behaviors of pharmacy graduates longitudinally. Continued tracking and analysis will inform PF curricular integration and alumni personal and professional development.
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Abukhalil, Imad Eldin Husni. "The role of danazol in the management of the premenstrual syndrome." Thesis, Keele University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.362168.
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Bossaer, John B., and Sarah T. Melton. "Max Dose Opioids: How High Can You Go?" Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/2333.
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Learning Objectives: Describe the rationale for the belief that opioids have no maximum dose Describe the data supporting the rationale that high doses of opioids increase toxicity Describe the data supporting the rationale that high doses of opioids do not improve outcomes Identify potential safety concerns with patients taking high doses of opioids
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Moen, Kjetil. "Fra monopol til konkurranse EØS, norsk legemiddelpolitikk og Norsk Medisinaldepot /." Universitetet i Oslo Institutt for statsvitenskap, 1999. http://www.ub.uio.no/ubit/hopp/publ/moen/.
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Ranchod, Shameem Roshnee. "Public sector pharmacists' perception of the public sector performance management system." Thesis, Nelson Mandela Metropolitan University, 2006. http://hdl.handle.net/10948/596.
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Performance Management aims to develop the employee and ensure that the work which the employee does is in line with organisational goals. However, many managers and employees do not like performance management systems and very often, for this reason, such a system does not succeed in meeting the organisation’s goals. The aim of this study was to determine the perceptions towards the performance management system of pharmacists working in the public sector. A questionnaire was compiled and pharmacists working in all public sector hospitals, provincial and municipal clinics and medical depots were asked to complete the questionnaire. The response rate was 66 percent. Seventy three percent of respondents had never undergone a performance evaluation, 75 percent stated it did not motivate them, 62.5 percent felt it did not improve poor performance, 90.6 percent felt the Performance Appraisal System did not reward good performance sufficiently and 63.6 percent felt it did not help with career progression. Seventy eight percent believed that the Performance Appraisal System did not effectively measure the pharmacists’ performance, and 82 percent felt that the System needed to be developed further. At least four evaluations should have been completed per year, yet 85 percent of respondents had experienced three or fewer evaluations since the System had been introduced. The analysis of the responses indicated that there was great dissatisfaction with the current performance management system. A few of the reasons are that the system in place did not effectively measure the pharmacists performance, that additional work done was not recognised, and that the process was extremely time-consuming. It may be concluded that the government needs to address the current problems being experienced with this system, as at present, it is not meeting the objectives it was intended to meet.
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Abdi, Yasin. "The appropriateness of clinical microbiology laboratory investigations : a retrospective study of the cost and clinical relevance of specimen management and processing." Thesis, University of Portsmouth, 2011. https://researchportal.port.ac.uk/portal/en/theses/the-appropriateness-of-clinical-microbiology-laboratory-investigations(b1f5faea-580b-4dad-b033-8ecc2407ff97).html.
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Each year, NHS clinical laboratories carry out more than 700 million laboratory tests, of which 50 million are microbiology investigations. Several studies have shown that between 25% and 40% of all tests sent to the laboratory are unnecessary, and up to 46% of ordered microbiology tests are inappropriate. In light of these accounts, the present study was undertaken to evaluate the process of microbiology specimen management in order to assess microbiology test utilisation and the appropriateness of the test ordering processes. The study focussed on respiratory tract specimens using sputum microbiology as a model for the microbiology service inappropriate test utilisation. The overall main aim of this study was to determine the appropriateness of clinical microbiology test utilisation, its clinical relevance and cost-effectiveness, hence recommend better utilisation strategies. A total of 15,941 respiratory tract samples from Barts and The London NHS Trust were randomly selected from the years 2004/05 and analysed retrospectively. Seven hundred microbiology laboratory request forms from patients for whom respiratory tract cultures were requested over a three month period were examined in detail. These requests were derived from 511 sputum specimens, 100 throat swabs, 63 ear swabs and 76 samples from other respiratory tract sites. 641 (91%) of microbiology test requisition forms were completed, provided all requested details by the service users and were therefore considered as appropriate microbiology test requisitions. 660 (94%) of those examined stated the patient’s clinical diagnosis and only in 65 (13%) of these patients was the stated diagnosis as respiratory tract infection. Sixty percent of sputum specimens examined were considered as poor quality. Forty percent of respiratory specimens were reported as culture positive, based on the local hospital criteria of microbiology test reporting. In sputum culture, 39% was reported as culture positive; however, less than 18% were positive with recognised respiratory pathogens, whilst 27% of throat swabs were reported as culture positive, of which 67% had throat pathogens. From the beginning of this study and before, there were no microbiology test comments and interpretation of test results provided with the test result reporting. The test turnaround time of respiratory microbiology results reported within three days in 2004/2005 was only 20%. The total inappropriate respiratory specimens processed locally were 9,575. Extrapolating from our results, this suggests that 2,153,977 nationally were inappropriate in NHS hospitals in 2004/2005. The total cost of inappropriate respiratory microbiology test use was approximately £152,000 in local NHS hospitals. Extrapolating from our results, this suggests that £23,900, 000 nationally was the total cost of inappropriate tests in the NHS hospitals. Following implementation of this study, follow up studies in 2006 and onwards indicated that there has been an improvement in the quality of the microbiology service. The number of good quality sputum specimens was 69% compared to 40% in 2004/2005. While the total microbiology test turnaround time that was reported within three days in 2009/2010 was more than 94%. From mid 2006 onwards, test interpretation comments have been used in all microbiology test result reporting. The total workload of respiratory tract microbiology activity decreased from 18,915/year to 16,651/year over the years 2004/2005 to 2007/2008, which is down nearly 8%. Analysis of the findings showed that the usefulness of culture results was limited by the collection of inappropriate specimens, and lack of clinical information on the microbiology request form. The crucial importance of the role of clinical and nursing staff is stressed if the clinical relevance of sputum culture is to be maximised. The increasing introduction of electronic pathology test requests gives new opportunities to restrict the collection of inappropriate specimens and make substantial savings in resources, both in the ward and the laboratory. This type of study and audit can give invaluable information about the rationale behind testing, and the appropriateness of sampling and transport time. Appropriate measures for corrective actions can be identified.
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Omerza, Kevin Edward. "The Economic Impact of a Pharmacy-Based Hybrid Medication Adherence Model in Patients with Metabolic Syndrome." University of Toledo Health Science Campus / OhioLINK, 2015. http://rave.ohiolink.edu/etdc/view?acc_num=mco1430521410.
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Witt, Teresa A. "Leadership characteristics contributing to outstanding global leadership in the pharmaceutical industry." Thesis, Indiana Wesleyan University, 2013. http://pqdtopen.proquest.com/#viewpdf?dispub=3567732.
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The pace of globalization continues to accelerate, which is demanding new approaches to leadership. One area where global mergers, acquisitions, alliances, and partnerships have become commonplace is in the pharmaceutical industry. This growing globalization has made it significantly more important to understand how culture impacts and influences effective leadership. Outstanding global leadership will continue to be a business imperative for the future.
This study used a mixed-method approach to identify the characteristics and behaviors that contribute to outstanding global leadership and to recommend methods for developing these characteristics. For the quantitative portion of the study, the GLOBE Research Survey was administered to mid-level leaders in a global pharmaceutical company. The qualitative portion of the study included semi-structured interviews with a smaller set of participants from the original sample group.
The quantitative survey indicated that the characteristics of integrity, performance-oriented, inspirational, visionary, and decisive strongly contribute to outstanding global leadership. The qualitative interviews supported these findings and offered recommendations on how to develop these characteristics, including the implementation of role models, feedback, coaching, learning environments, and culturally diverse opportunities.
This study provides preliminary evidence that there are specific characteristics that contribute to outstanding global leadership. The results of this study may be used to contribute to the success of global corporations, specifically in the pharmaceutical industry.
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Hamilothoris, Achilles J. Barker Kenneth N. "A comparison of dispensing error detection methods for the Department of Defense." Auburn, Ala, 2008. http://repo.lib.auburn.edu/EtdRoot/2008/SUMMER/Pharmacy_Care_Systems/Thesis/Hamilothoris_Achilles_23.pdf.
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Bricker, Bryce, and Lisa Munson. "Survey of Chronic Pain Specialists and Their Experiences with Pharmacies in Managing Chronic Pain." The University of Arizona, 2011. http://hdl.handle.net/10150/623566.
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Class of 2011 AbstractOBJECTIVES: The purpose of this study was to survey prescribers who manage patients with chronic pain to evaluate how pharmacy services are perceived to affect patients’ quality of life. METHODS: Surveys were sent to prescribers who manage patients with chronic pain. Prescribers rated pharmacy services on a scale of 0 – 5 (0 being not important at all, and 5 being extremely important) to the quality of life of patients with chronic pain. RESULTS: Surveys were completed by 23 subjects. Prescribers ranked pharmacy services as follows: the pharmacy fills opioid prescriptions for all pain conditions (mean = 4.2; SD = 1.0), the patient is able to obtain the entire quantity of pain medication (mean = 4.1; SD = 1.5), the pharmacy treats the patient as dependent on, not addicted to opioids (mean = 3.9; SD = 1.6), the pharmacy collaborates with the prescriber to manage opiate therapy (mean = 3.9; SD = 1.5), the pharmacy stocks new and recently approved pain medications (mean = 3.8; SD = 1.1), the pharmacy provides the patient with information on adverse effects of pain medications (mean = 3.8; SD = 1.5), the pharmacy is able to use manufacturer co-pay cards to minimize out-of-pocket costs (mean = 3.5; SD = 1.7), the patient can have prescriptions delivered to their home (mean = 2.1; SD = 1.8) and the patient can obtain a prescription without having to wait a specified time period determined by their pharmacy (mean = 1.8; SD = 1.5). CONCLUSION: Prescribers in this study felt that certain pharmacy services are very important in the treatment of patients with chronic pain. Pharmacies may improve patients’ quality of life in the management of their chronic pain by providing these services.
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Bossaer, John B. "Opioid Patient Education: What You Don’t Know Could Kill." Digital Commons @ East Tennessee State University, 2012. https://dc.etsu.edu/etsu-works/2334.
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Heunis, C. "A comparative study of the pharmacy business models with specific reference to Nuclicks and Pick 'n Pay." Thesis, Stellenbosch : Stellenbosch University, 2003. http://hdl.handle.net/10019.1/53233.
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Thesis (MBA)--Stellenbosch University, 2003.ENGLISH ABSTRACT: The purpose of this report is to create a better understanding of the new pharmacy initiatives in the South African market, with specific reference to the Nuclicks and Pick 'n Pay groups. In order to understand the respective business concepts better the following abstracts from each chapter of the study is given. Chapter one is basically the introduction to the study and describes the events that lead to the above mentioned corporate retailers to enter the pharmacy market place. An introduction to Hamel's business model theory is also discussed and identified as a possible means of evaluating the corporate retailers' business concepts. In Chapter two the strategic analysis of the South African retail pharmacy industry is performed. This analysis is performed to create an understanding of the different forces at work in the industry. Some of the key findings in this chapter are that changes to the pharmacy act and the way dispensing licences are going to be awarded creates uncertainty. The profit outlook of retail pharmacy, though on the decline, still compares favourably to other retailers. In chapter three the core concepts of Hamel's business model are presented in more detail and applied to the retail pharmacy environment. In his view, a strategy needs to change the industry rules. This chapter ends with the concept of wealth potential based on Hamel's teachings. The wealth potential concept is about creating cash flow and profits. A business model that is able to create customer benefits well below the cost of the competitors is regarded as efficient. By utilising the Hamel way the Nuclicks (chapter four) and Pick 'n Pay (chapter five) business concepts is unpacked. Both Nuclicks and Pick 'n Pay pharmacy business models are presented within the corporate framework of the groups. Nuclicks bought an established pharmacy franchise while Pick 'n Pay launched Healthpharm. Nuclicks creates a possible choke point by buying UPD. The Nuclicks pharmacy strategy is a more comprehensive health strategy, while Pick 'n Pay follows a more cautious approach. As franchising will playa major role in both pharmacy concepts, the theory of franchising is presented in chapter six. Telephonic interviews with Link franchisees are conducted and the possible reasons for the ambiguity that crept into the Link business model are discussed. As the Healthpharm franchise is a new concept, it is evaluated based on information gathered from press releases and the Healthpharm web-site. In chapter seven universal conclusions and recommendations, based upon the literature study and this investigation, are presented. One of the key findings are, success in the face of changes requires more than the current way of doing business. It requires an innovative thinking process. New business models have to be formulated that allows retail pharmacists to establish a focused and well-differentiated value proposition. This value proposition needs to be meaningful for consumers and must strengthen a pharmacy outlet's competitive position.
AFRIKAANSE OPSOMMING: Die doel van hierdie verslag is om 'n beter begrip vir die nuwe apteek inisiatiewe in die Suid-Afrikaanse mark te ontwikkel, met spesifieke verwysing na die Nuclicks en Pick 'n Pay groepe. Om die onderskeie besiqheidskonsepte beter te verstaan, word die volgende opsomming van elke hoofstuk van die studie uiteengesit. Hoofstuk een is 'n inleiding tot die studie en beskryf die gebeure wat aanleiding gegee het tot die bogenoemde korporatiewe kleinhandelaars se toetrede tot die apteek mark. 'n Inleiding van Hamel se besigheidsmodel teorie is ook bespreek en is geïdentifiseer as evaluering van die korporatiewe kleinhandelaars se besigheidskonsepte. Hoofstuk twee bied 'n strategiese analise van die Suid-Afrikaanse kleinhandelaars apteek industrie. Hierdie analise is geskep om beter begrip te ontwikkel vir die verskillende kragte wat inwerk in die industrie. Van die bevindinge in die hoofstuk is die veranderinge in die apteek wetgewing en die wyse waarop resepteer lisensies toegeken gaan word, en hoeveel onsekerhede dit tot gevolg het. Die wins vooruitsigte van kleinhandelaars apteke, alhoewel aan die afneem, vergelyk steeds gunstig met ander kleinhandelaars. In Hoofstuk drie is die kern konsepte van Hamel se besigheidsmodel in meer detail uiteengesit en toegepas op die kleinhandelaar apteek omgewing. Uit sy oogpunt, is 'n strategie nodig om veranderinge te weeg te bring in die industrie reëls. Hierdie hoofstuk eindig met die konsep van waarde potensiaal wat gebaseer is op Hamel se teorie. Hierdie waarde potensiaal konsep is gebaseer op die skep van kontantvloei en 'n Besigheidsmodel wat in staat is om die kliënt te begunstig heelwat laer as die koste van die teenstander, word beskou as effektief. Hamel se teorie is gebruik om Nuclicks (hoofstuk vier) en Pick 'n Pay (hoofstuk vyf) se besigheidskonsepte te analiseer. Beide Nuclicks en Pick 'n Pay se besigheidsmodelle word aangebied binne die korporatiewe raakwerke van die groepe. Nuclicks het 'n gevestigde apteek konsessie gekoop terwyl Pick 'n Pay vir Healthpharm begin het. Nuclicks het 'n moontlike 'wurgpunt" geskep deur die aankoop van UPD. Die Nuclicks apteek strategie is 'n meer omvattende gesondheidstrategie, terwyl Pick 'n Pay 'n meer versigtige benadering volg. Aangesien besigheid konsessie 'n belangrike rol speel in beide apteek konsepte, word die teorie van konsessie in hoofstuk ses behandel. Telefoniese onderhoude is gevoer met Link konsessiehouers en die moontlike redes vir die twyfelagtigheid van die Link besigheidsmodel word bespreek. Aangesien die Healthpharm konsessie 'n nuwe konsep is, word dit geëvalueer op grond van inligting wat versamel is uit die media en die Healthpharm webtuiste. In Hoofstuk sewe word universele afleidings en aanbevelings, gebaseer op die literatuurstudie en die ondersoek, uiteengesit. Een van die hoof bevindings was dat sukses benodig meer as die huidige manier van besigheid doen. Nuwe besigheidsmodelle moet geformuleer word, wat dit vir kleinhandelaar apteke moontlik sal maak om 'n gefokusde en goed gedifferensieerde waarde voorstel tot stand te bring. Hierdie voorstel moet betekenisvol wees vir die verbruiker en moet die apteek kompeterende posisie versterk.
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Chai, Jim. "Patients' lived-experience of using insulin treatment for type 2 diabetes mellitus management." Thesis, University of Nottingham, 2015. http://eprints.nottingham.ac.uk/28039/.
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The prevalence of Type 2 diabetes mellitus (T2DM) has increased dramatically over the past 10 years in Malaysia due to the modernisation of the country. The most recent national health survey revealed that more than 15.2% of Malaysian adults are suffering from the diseases. Insulin treatment has been demonstrated to play a clinically significant role to improve glycaemic control among selected Type 2 diabetes mellitus (T2DM) patients. However, studies from several local hospitals showed that more than half of T2DM patients are reluctant to initiate insulin treatment. There is an increasing trend for the Malaysian healthcare sector to invest in understanding patients’ health experiences. This qualitative study focused on T2DM patients’ insights about their lived-experience of using insulin treatment as part of their diabetes management. This study aimed to understand the facilitators, which encourage patients to accept insulin treatment and also the psychological, social and behavioural barriers to effective diabetes management. Drawing on interview data with 37 participants, the three main barriers to initiate insulin treatment were worries about inability to handle using insulin, a sense of personal failure and negative perceptions of injections due to past experiences. The facilitators that encourage patients to accept insulin treatment were prior exposure to insulin injections, better side effect profile and wanting a better quality of life. However, there were many obstacles faced by T2DM patients when coping with insulin treatment such as the restriction of lifestyle and concerns about social acceptance. In general, knowledge of T2DM and insulin treatment are still lacking among the Malaysians interviewed in this study. There are still many distorted beliefs and misconceptions about insulin among T2DM patients. At the same time, patients’ concerns and beliefs regarding insulin use are greatly influenced by their experience and support from others. Many participants felt embarrassed and self-conscious when self-injecting insulin in public places. They felt that the Malaysian public often associate the use of injections to drug abuse. Social stigma is one key point, which leads to poor adherence to insulin treatment. Thus it is crucial to increase public awareness about insulin treatment in order to help these patients to be more comfortable about injecting, and also to encourage other people to be more open minded towards insulin treatment. Apart from raising public awareness, there is a need to empower T2DM patients with adequate knowledge through early, simplified, tailored education focusing on the disease nature and the role of insulin. Making them more aware of their health condition and the uses of modern insulin devices at an early stage will better prepare them mentally for insulin therapy.