Research articles
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Evaluation of the Royal Cornwall Hospitals NHS Trust community pharmacy transfer of care around medicines service Subscription
This study aims to retrospectively analyse the Royal Cornwall Hospitals NHS Trust community pharmacy transfer of care in medicines service to describe the type of medication-related problems identified during pharmacist consultations with patients and the services provided.
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Pharmacist contributions to consultant-led post-take ward rounds: a service evaluation Subscription
A study carried out at Imperial College Healthcare NHS Trust shows that pharmacists’ contributions on post-take ward rounds are highly valued, with their interventions leading to a reduction in prescribing errors and potential for harm.
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Community pharmacist-led influenza vaccination: a service evaluation Subscription
The results of an evaluation of a seasonal influenza vaccination service in a community pharmacy setting, conducted with 485 patients across 55 pharmacies following the 2019/2020 season, that assessed person-centredness, professionalism and privacy, to make recommendations for improvements for the 2020/2021 season.
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Evaluation of a pharmacist-led virtual thiopurine clinic Subscription
This study at Barnsley Hospital NHS Foundation Trust aimed to determine the clinical impact of a pharmacist-led virtual thiopurine clinic on drug monitoring, safety and quality of service in a cohort of inflammatory bowel disease and autoimmune hepatitis patients.
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Evaluating pharmacist interventions using the Simpler tool in Malaysian patients with type 2 diabetes Subscription
An evaluation of using a Simpler tool in Malaysian patients with type 2 diabetes mellitus to assess the types and effectiveness of interventions conducted by pharmacists and the impact on quality of life.
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Evaluation of the impact of pharmacist polypharmacy reviews within the Govan Social and Healthcare Integration Partnership (SHIP) project Subscription
Providing pharmacist-led medicines reviews to patients in one of the most deprived areas in Scotland to reduce the health inequality gap.
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Providing medicines adherence support to areas of high deprivation in England: community pharmacists’ experience Subscription
Semi-structured interviews assessing pharmacists’ experiences of providing interventions, products and services that support medicines adherence.
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Local implementation of national guidance on management of common infections in primary care in England Subscription
Local adoption and adaptation of national antimicrobial prescribing guidance in primary care.
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Reducing inappropriate polypharmacy in primary care through pharmacy-led interventions Subscription
A pharmacy-led medicines optimisation team in a GP surgery setting reduced inappropriate polypharmacy, achieved cost savings of £103,975 and improved quality of prescribing for patients.
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Evaluation of the Portsmouth medicines advice at home service Subscription
A Portsmouth-based medicines advice at home service highlights the impact of pharmacist-led interventions.
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Opioid use disorder: adherence to prescribed medicines in community pharmacy Subscription
A cross-sectional survey assessing adherence medication-assisted treatment for opioid use disorder, and the predictors of risk of poor adherence.
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Pharmaceutical care to medical patients in the emergency department: a service evaluation Subscription
An evaluation of a new hospital pharmacy service that introduces pharmaceutical care earlier after admission to the emergency department.
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Responding to disruptions in the pharmaceutical supply chain Subscription
Economic, manufacturing and regulatory factors can affect drug shortages and supply chain disruption. By using a mixed-methods approach involving an online survey, semi-structured interviews and three targeted focus groups aimed at acute care hospitals in England, Wales, Northern Ireland and Ireland, this study determined that over half of the responding acute care hospitals did not have 76–100% of medicine lines fulfilled within 8 weeks of a disruption in the supply chain.
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Impact of including clinical indications on inpatient prescriptions Subscription
The appropriate use of medicines is dependant on the accurate use of clinical indications on inpatient paper and electronic prescriptions. This mixed-methods study involving semi-structured interviews with 64 chief pharmacists, 11 focus groups from three NHS trusts and a medical documentation review of 89 patients determined both positive and negative implications of including clinical indications on healthcare professionals’ clinical workflow.
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Identifying modifiable risk factors to reduce inpatient hypoglycaemia Subscription
Through analysing a randomly selected sample of patients with low blood glucose and diabetes over a course of a year, this prospective study found that a significant number of hypoglycaemia episodes were not treated to established protocol.
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Testing annual asthma reviews for those who fail to attend: proof-of-concept study Subscription
Asthma is one of the most common respiratory conditions in the UK. Around 30% of asthma patients fail to attend their annual asthma review, which leads to an increase in the number of preventable asthma-related hospital admissions. By using SIMPLE methodology and the PharmOutcomes® web-based system on 27 patients, it was determined that the community pharmacy asthma review service would enhance patient care through close collaboration with GP surgeries.
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Point-of-care C-reactive protein testing in community pharmacy to deliver appropriate interventions in respiratory tract infections Subscription
This pilot study sought to evaluate the potential use of point-of-care (POC) C-reactive protein (CRP) testing for respiratory tract infections (RTIs) in a rural community pharmacy in North Staffordshire, UK, in conjunction with local GP practices. The study found that the use of POC CRP testing in community pharmacies has the potential to reduce the number of GP appointments caused by RTIs and, therefore, may help reduce unnecessary antibiotic prescribing.
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Improving medicines optimisation for care home residents: Wigan Borough CCG’s approach Subscription
Although clinical commissioning groups (CCGs) are not responsible for monitoring or regulating care homes, Wigan Borough’s approach demonstrates that it is possible for CCG staff to work collaboratively with care home and social care teams to improve outcomes for patients.
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NHS Grampian project: treating uncomplicated lower urinary tract infection in community pharmacy Subscription
Urinary tract infections (UTIs) are one of the most common conditions seen in female patients in general practice (GP) and account for 1–3% of all GP consultations each year in the UK. Over-the-counter (OTC) treatments for UTIs currently available in community pharmacy only attempt to relieve symptoms, and do not address the bacterial infection. The Grampian project was developed to provide treatment of uncomplicated UTIs through community pharmacies by means of a Patient Group Direction ...
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Evaluating a point-of-care C-reactive protein test to support antibiotic prescribing decisions in a general practice Subscription
C-reactive protein (CRP) is a marker of infection and inflammation. It is high in bacterial infections but very low or close to zero in viral infections. The National Institute for Health and Care Excellence (NICE), England and Wales’s health technology assessment body, has issued guidance on pneumonia in adults; it recommends point-of-care (POC) CRP analysers when clinical assessment is inconclusive. If the CRP level is less than 20mg/L, no antibiotics ...
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Assessing the impact of a targeted pharmacist-led anticoagulant review clinic Subscription
Local guidance, supported by the 2014 National Institute for Health and Care Excellence (NICE) guideline CG180 for atrial fibrillation (AF), recommends that patients receiving inadequate anticoagulation with a vitamin K antagonist (VKA), including time in therapeutic range (TTR) of <65%, should be reassessed. These patients were identified by the anticoagulation monitoring service (AMS) and highlighted to GPs for review. However, up to 59.3% of patients received ...
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Integrating community pharmacy testing for hepatitis C with specialist care Subscription
Many patients with hepatitis C virus (HCV) infection lie undiagnosed and a significant proportion of patients that have been identified are disengaged from specialist services. The Isle of Wight (IOW) typifies this issue, with an estimated 200 undiagnosed patients with HCV infection and a small number of known cases engaged with specialist services. Aim: To reduce the burden of undiagnosed HCV on the IOW and link new diagnoses directly ...
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Pharmacy at home: service for frail older patients demonstrates medicines risk reduction and admission avoidance Subscription
The Exeter Cluster Pharmacy team is part of an integrated community health and social care service, providing domiciliary medicines optimisation to around 145,000 people.
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How useful are medicines helplines for patients discharged from hospital? Subscription
This paper suggests that patient helplines support medicines optimisation by ensuring patients have easy access to pharmacy experts to discuss concerns about their medicines and improve the quality of their pharmaceutical care.
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The package user test: a method for improving medicines packaging Subscription
This paper describes a new performance-based package user test that has the potential to improve drug package design and therefore reduce drug selection errors.
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We are all part virus — the role of human endogenous retroviruses Subscription
Viruses lurk in our genome and science is only now starting to understand the important role that they might play in health and disease. Kalliopi Dodou and Paul Whiteley explain.
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Integrated examinations: supporting students with team-based learning Subscription
Jason Hall and colleagues explain how Manchester Pharmacy School is applying team-based learning to the MPharm course to integrate science and practice modules.
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A review of Controlled Drug incidents reported to the NRLS over seven years Subscription
To describe the number and types of patient safety incidents involving Controlled Drugs reported to the National Reporting and Learning System (NRLS) and the role of Accountable Officers for CDs (AOs) in incident reporting and learning.
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The clinical impact of pharmacist interventions in an emergency unit Subscription
This paper suggests that interventions of clinical pharmacists significantly improve patient outcomes by reducing the risk of harm in most cases
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Intervention monitoring in paediatrics as a strategy to improve prescribing Subscription
To describe a system of regular intervention monitoring among paediatric patients and how the information is used to inform the content of different strategies aimed at improving prescribing practice.
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A study of pharmacy services provided to hospital admission units in Wales Subscription
To ascertain the provision of pharmacy services to hospital admission units across Wales. The principles and processes used were based on those devised in a previous all-Wales study, where trainee pharmacists submitted data as part of the audit process. Comparison of data was facilitated by using a uniform method.
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Reducing missed medicine doses in preoperative surgical inpatients Subscription
Aim: To decrease the frequency of missed medicines doses in preoperative general surgical patients.
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Antimicrobial stewardship in primary care — what are pharmacists doing? Subscription
Abstract AimTo ascertain what medicines managers in English primary care trusts were doing to promote antimicrobial stewardship.DesignOnline surveySubjects and settingAll medicines managers of PCTs in England.
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Exploring pharmacists’ views about the responsible pharmacist role Subscription
This paper aims to investigate the views of non-contractor community pharmacists regarding the new responsible pharmacist role, before implementation, through a cross-sectional, anonymous self-completion postal survey.
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Applying “lean” principles to improve hospital chemotherapy services Subscription
Abstract Aim To address deficiencies in chemotherapy production and improve co-ordination between production, prescribing and clinic scheduling. Design Service review and redesign using ‘lean’, change management techniques. Setting An oncology unit at a district hospital.
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Managing risks arising from medicine shortages in NHS hospitals Subscription
AbstractAimTo identify and prioritise risks associated with medicine shortages in NHS hospitals, and describe how these risks can be managed more safely. Design A failure modes and effects analysis (FMEA)
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Students want more guidelines on Facebook and online professionalism Subscription
Abstract Aim: To investigate pharmacy students’ use of, and attitudes towards, Facebook and professionalism. Design: A quantitative, online anonymous surveySubjects and setting: 91 pharmacy students at a UK university completed the online survey Results: Most students completing the survey were female and most had a Facebook account which they logged onto daily. Results suggest pharmacy students ...
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Are reported drug allergies in children always properly diagnosed? Subscription
Abstract Aim To assess the prevalance of parent-reported drug allergy and determine whether the reported allergy had a confirmed diagnosis Design Examination of drug charts over a one-month period, followed by interview Subjects and setting A paediatric population in a London children’s hospital Results Of the 729 charts reviewed, ...
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Supplying unlicensed medicines for children — experiences from an LPF Subscription
This paper explores the experiences of pharmacists in supplying unlicensed medicines for children.
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Do community pharmacy counter staff have a public health role? Subscription
This article aims to evaluate how community pharmacy counter staff view their role as pharmacy healthy living advisers as part of a service evaluation to develop community pharmacy’s public health role.
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A credentialing process for advanced level pharmacists: participant feedback Subscription
This paper describes research suggesting that a credentialing process is feasible and useful for clinical pharmacists, and provides a good measure of competence performance.
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Beneficial check of unwanted medicines Subscription
The pharmacy contract stipulates that each pharmacy should participate in two clinical audits per year, at least one of which should be practice based and one determined by the local primary care trust. We have conducted an audit of interventions identified from NHS prescription repeat lists collected from a GP surgery (with patients’ consent).
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Effective audit can improve service quality and build the evidence base Subscription
Audit is vital for patient care and safety and for the development and improvement of pharmacy practice. In addition, the Government is keen to promote and expand clinical audit activity, particularly since it resonates with the current QIPP (quality, innovation, productivity and prevention) programme for services to become more efficient and
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Owed medicines: (1) Traditional audit Subscription
Prescription “owings” occur when there is insufficient stock to be able to dispense prescriptions. They were perceived to be a problem for the pharmacy where we undertook the service evaluation. It was a relatively new pharmacy where the prescription volumes had been steadily growing, further complicated by an electronic stock control system. The Community Pharmacy Contractual Framework “Essential service: clinical governance” document (available at www.psnc.org.uk) states in section ...
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Owed medicines: (2) IMPACT audit Subscription
This short report presents an example of the use of IMPACT, a new method of service evaluation, which was used to evaluate prescription owings in the same pharmacy described in part 1. IMPACT stands for the stages of the process: Issue, Method, Perspectives, Analysis of themes, Conclusion and Targets. It is based on a simplified methodology that was used to explore the interaction of prescribing policy and patient perspectives.
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Prescribing errors before and after introduction of electronic charts Subscription
Mistakes occur at all stages of prescribing, from the decision to use a medicine to writing it correctly and legibly — including calculating or selecting the correct dose or dosage form. At the decision stage, knowledge of the patient’s history of medicines use and any previous adverse drug events must be taken into account; if it is not then a prescribing error has been made.
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Ten years on, has e-prescribing of cancer regimens improved safety? Subscription
This study was conducted to assess whether or not introduction of an electronic system for prescribing cancer regimens improved patient safety.
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Integrated strategies will work best Subscription
In primary care, pharmacy interventions for older people on polypharmacy can reduce the number of medicines required, resolve pharmaceutical care issues and, in some cases, reduce prescribing costs. However, outcome data for pharmaceutical interventions (in primary and community care settings), in terms of reduced morbidity/mortality and even admissions avoidance, is lacking.
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Hospital staff knowledge of use of antibiotics in penicillin allergy: is there room for improvement? Subscription
This paper aims to evaluate the knowledge of hospital clinical staff on the safe use of antibiotics in penicillin allergy and to ascertain staff attitudes and beliefs towards penicillin-related medication errors.
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Improving the accuracy and timeliness of medication allergy documentation in the intensive care unit Subscription
This study aims to ascertain the adherence to allergy policy within the intensive care unit, to put in place robust processes to improve the timeliness and accuracy of allergy documentation, and to assess the impact of any interventions.
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