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Texto completo SciELO España
Id: 202384
Autor: Pham, Katherine.
Título: Alternative payment approaches for advancing comprehensive medication management in primary care
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020. tab.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2238.
Resumen: The increasing prevalence of complex, chronic conditions has profound implications on the growing demand and cost of health care. The Center for Medicare and Medicaid Innovation is testing data-driven approaches to care delivery and payment that are drawn from innovative practices of health care providers and other partners in the health care community. The shift from fee-for-service to value-based care and performance-based payment places increased priority on improved outcomes at lower costs. To advance comprehensive medication management, pharmacists need to understand the opportunities in the evolving value-based payment models and align medication optimization with the specific goals and incentives of these models

No disponible
Descriptores: servicios farmacéuticos/economía
servicios farmacéuticos/organización & administración
enfermedad crónica/farmacoterapia
enfermedad crónica/economía
seguro de servicios farmacéuticos
Medicare
Medicaid
atención primaria de la salud
-Estados Unidos
Límites: seres humanos
Responsable: BNCS


  2 / 662 IBECS  
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Texto completo SciELO España
Id: 202383
Autor: Blanchard, Carrie M; Livet, Melanie.
Título: Ensuring intervention success: assessing fit as an overlooked step of the implementation process
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2235.
Resumen: Ensuring fit between a service and the implementing context is a critical but often overlooked precursor of implementation success. This commentary proposes five key considerations that should be evaluated when exploring fit: alignment with needs and metrics; alignment with organizational resources and capabilities; alignment with organizational priorities and culture; alignment with reimbursement mechanisms for long-term sustainability; and alignment with the regulatory environment. Successful uptake and implementation hinges on careful planning and, most importantly, appropriate fit between the service and the implementing environment

No disponible
Descriptores: servicios farmacéuticos/organización & administración
mecanismo de reembolso
cultura organizacional
innovación organizacional
Límites: seres humanos
Responsable: BNCS


  3 / 662 IBECS  
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Texto completo SciELO España
Id: 202382
Autor: Burnworth, Melinda J; Pettinger, Tracy K; Medina, Melissa S; Niemczyk, Mary.
Título: Preceptor tips for navigating generational differences with introductory and advanced pharmacy practice experience students
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020. tab.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2176.
Resumen: Ideally, precepting during introductory and advanced pharmacy practice experiences should be tailored to meet the individualized needs of learners. Understanding generational similarities and differences that exist between both learners and educators will facilitate meaningful interaction and improve learning outcomes. A common pitfall among preceptors is to judge the values of their pharmacy learners based on the stereotypes of the generations. This tends to be more evident when the preceptor's generation differs from the generation of the learner. The following article describes generational attributes that influence experiential learning with general tips for how preceptors can use this information to enhance their interactions with learners. By comparing and contrasting the predominant generations in the current pharmacy education landscape (Baby Boomers, Generation X, and Millennials), the article will demonstrate how multi-generational interactions impact pharmacy education. As Millennials are the majority of experiential learners, the focus will be on their learning preferences and how preceptors can help engage these learners. Practical advice and tools on engaging Millennial learners will be reviewed. Case vignettes will demonstrate how to identify ways to tailor precepting to meet the needs of the learner, avoid common pitfalls, facilitate meaningful interaction, and, ultimately, improve learning outcomes

No disponible
Descriptores: educación en farmacia
internado no médico
estudiantes de farmacia
mentores
aprendizaje
relaciones intergeneracionales
Límites: seres humanos
Tipo de Publicación: revisión
Responsable: BNCS


  4 / 662 IBECS  
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Texto completo SciELO España
Id: 202381
Autor: Henman, Martin C.
Título: Primary Health Care and Community Pharmacy in Ireland: a lot of visions but little progress
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2224.
Resumen: Ireland is small country with a population of 4.8M which spent 6.9% of its gross domestic product on healthcare in 2018. Health services are provided through a twin track approach - all public services are largely free to those eligible (32.44% in 2019) and private patients pay for most services. Most of the expenditure on medicines is paid by the government while visits to General Practitioners (GPs) are an out-of-pocket expense for private patients under 70 years of age, and private health insurance provides cover for most hospital services. Healthcare professionals in the primary care sector contract to provide public services with the Health Services Executive (HSE) which is responsible for the day-to-day running of the service. Primary care teams began to be formed in 2001 to try to link and integrate the provision of care but since these are led by GPs neither community pharmacists nor dentists joined these teams. The focus of policy remained the primary care team until a proposal to create a public health service to provide universal health coverage called Sláintecare was agreed in 2017. However, implementation of Sláintecare has been slow and piecemeal. The government regularly devises policies to control prescribing and the HSE, together with other regulators has implemented generic substitution and preferred drugs and limited access to expensive drugs through schemes for particular patient groups. A programme called Healthy Ireland has taken on the health promotion policies but pharmacists have been excluded from most programmes although some campaigns have included them. Community pharmacy organisations have tried to develop pharmacy services and while a few which are targeted at specified patient groups, such as opioid substitution, emergency administration of certain drugs, emergency hormonal contraception and seasonal influenza vaccination have been remunerated for public patients by the HSE, other services have not. GP organisations defend their members' scope of practice and seek to influence policy makers to channel schemes and services through general practice. There is no professional body to represent pharmacists that is independent of any trade union responsibilities and this has weakened the profession's advocacy. Pharmacists are one of the most trusted group of professionals in Ireland and have maintained their practices throughout periods of recession and declining income from government. Whether pharmacists can argue that the optimisation of a patient's medicines depends upon their contribution and will benefit the health service remains an open question

No disponible
Descriptores: servicios farmacéuticos
atención primaria de la salud
prestación de atención de salud integrada
Servicios de Salud Comunitaria
práctica profesional
-Irlanda
Límites: seres humanos
Responsable: BNCS


  5 / 662 IBECS  
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Texto completo SciELO España
Id: 202380
Autor: Basheti, Iman A; Mhaidat, Nizar M; Al-Qudah, Rajaa; Nassar, Razan; Othman, Bayan; Mukattash, Tareq L.
Título: Primary health care policy and vision for community pharmacy and pharmacists in Jordan
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2184.
Resumen: Jordan is considered a low middle-income country with a population of 9.956 million in 2018. It is considered the training center for healthcare professions in the region, as the Jordanian healthcare sector has seen remarkable development. In 2017, the expenditure on health as a percentage of Gross Domestic Product (GDP) was estimated to be around 8%. The healthcare sector is divided into two main sectors; the public and the private sector with both including hospitals, primary care clinics and pharmacies. The Jordanian government has a strong commitment to health and educational programs; hence, an increase in the number of pharmacy schools and pharmacy graduates has occurred in the past few years. Health authorities, such as the Jordan Food and Drug Association (JFDA) and the Jordan Pharmaceutical Association (JPA) have played an important role in ensuring the availability and affordability of medications, and has influenced the practice of pharmacists. Protecting the pharmaceutical market and professional interests, preserving pharmacists' rights, building needed cooperation with the internal federation, and maintaining professional ethics are some of the objectives for the JPA. Hence, the integration of community pharmacists into the primary healthcare system is considered vital to the different health authorities in Jordan, emphasizing the fact that community pharmacists are the most trusted, accessible, and affordable healthcare providers in the country. There have been many developments in the pharmacy practice in the past recent years, including the establishment of 'Good Pharm. pract', new curricular development based on the international accreditation (the ACPE), a new immunization program, and health services research aimed to save patients' lives, influence expenses, and improve patients' quality of life. Although these developments in pharmacy practice are promising, challenges continue to exist, specifically the establishment of an evidence base for pharmaceutical care services such as the medication management review service

No disponible
Descriptores: atención primaria de la salud
prestación de atención de salud integrada
Servicios de Salud Comunitaria
servicios farmacéuticos
práctica profesional
política sanitaria
-Jordania
Límites: seres humanos
Responsable: BNCS


  6 / 662 IBECS  
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Texto completo SciELO España
Id: 202379
Autor: Armando, Pedro D; Uema, Sonia A; Vega, Elena M.
Título: Integration of Community pharmacy and pharmacists in primary health care policies in Argentina
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2173.
Resumen: Argentina is a federal republic with approximately 44 million people, divided into 23 provinces and an autonomous city, Buenos Aires. The health system is segmented into public, social security and private subsystems. The social security and private sectors cover more than 60% of the population. Total health expenditure in 2017 was 9.4% of gross domestic product. Primary health care (PHC) was considered as the principal strategy for universal coverage policy for health system reform in Latin America at the end of 20th century. The most remarkable characteristics of the Argentinian health system are its fragmentation and disorganization. An increase of public sector demands, due to a socioeconomic crisis, led to the subsequent collapse of the system, caused primarily by a sustained lack of investment. First care level decentralization to the Integral Health Service Delivery Networks (IHSDN) becomes the cornerstone of a PHC-based system. Pharmacists and community pharmacies are not formally mentioned in PHC policies or IHSDN. However, pharmacies are recognized as healthcare establishments as part of the first care level. Community pharmacists are the only health care professional whose profit comes from the margin on product sales. Contracts with social security and private insurances provide small margins which reduce the viability of community pharmacies. There is a preference by community pharmacies to diversify product sales instead of providing professional services. This is driven by marketing and economic pressures rather than patient care and health policies. Dispensing is the main professional activity followed by management of minor illness and associated product recommendations. Currently, there are no national practice guidelines or standard operating procedures for the provision of pharmaceutical services and there is no nationally agreed portfolio of services. National pharmacy organizations appear to have no official strategic statements or plans which would guide community pharmacies. There are some isolated experiences in community pharmacies and in public first care level pharmacies that demonstrate the possibilities and opportunities for implementing pharmaceutical services under the PHC approach. There is a real lack of integration of community pharmacies and pharmacists in the healthcare system

No disponible
Descriptores: atención primaria de la salud
prestación de atención de salud integrada
Servicios de Salud Comunitaria
servicios farmacéuticos
práctica profesional
política sanitaria
-Argentina
Límites: seres humanos
Responsable: BNCS


  7 / 662 IBECS  
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Texto completo SciELO España
Id: 202378
Autor: Raiche, Taylor; Pammett, Robert; Dattani, Shelita; Dolovich, Lisa; Hamilton, Kevin; Kennie-Kaulbach, Natalie; McCarthy, Lisa; Jorgenson, Derek.
Título: Community pharmacists' evolving role in Canadian primary health care: a vision of harmonization in a patchwork system
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020. ilus.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2171.
Resumen: Canada's universal public health care system provides physician, diagnostic, and hospital services at no cost to all Canadians, accounting for approximately 70% of the 264 billion CAD spent in health expenditure yearly. Pharmacy-related services, including prescription drugs, however, are not universally publicly insured. Although this system underpins the Canadian identity, primary health care reform has long been desired by Canadians wanting better access to high quality, effective, patient-centred, and safe primary care services. A nationally coordinated approach to remodel the primary health care system was incited at the turn of the 21st century yet, twenty years later, evidence of widespread meaningful improvement remains underwhelming. As a provincial/territorial responsibility, the organization and provision of primary care remains discordant across the country. Canadian pharmacists are, now more than ever, poised and primed to provide care integrated with the rest of the primary health care system. However, the self-regulation of the profession of pharmacy is also a provincial/territorial mandate, making progress toward integration of pharmacists into the primary care system incongruent across jurisdictions. Among 11,000 pharmacies, Canada's 28,000 community pharmacists possess varying authority to prescribe, administer, and monitor drug therapies as an extension to their traditional dispensing role. Expanded professional services offered at most community pharmacies include medication reviews, minor/common ailment management, pharmacist prescribing for existing prescriptions, smoking cessation counselling, and administration of injectable drugs and vaccinations. Barriers to widely offering these services include uncertainties around remuneration, perceived skepticism from other providers about pharmacists' skills, and slow digital modernization including limited access by pharmacists to patient health records held by other professionals. Each province/territory enables pharmacists to offer these services under specific legislation, practice standards, and remuneration models unique to their jurisdiction. There is also a small, but growing, number of pharmacists across the country working within interdisciplinary primary care teams. To achieve meaningful, consistent, and seamless integration into the interdisciplinary model of Canadian primary health care reform, pharmacy advocacy groups across the country must coordinate and collaborate on a harmonized vision for innovation in primary care integration, and move toward implementing that vision with ongoing collaboration on primary health care initiatives, strategic plans, and policies. Canadians deserve to receive timely, equitable, and safe interdisciplinary care within a coordinated primary health care system, including from their pharmacy team

No disponible
Descriptores: atención primaria de la salud
prestación de atención de salud integrada
Servicios de Salud Comunitaria
servicios farmacéuticos
práctica profesional
política sanitaria
-Canadá
Límites: seres humanos
Responsable: BNCS


  8 / 662 IBECS  
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Texto completo SciELO España
Id: 202377
Autor: Amariles, Pedro; Ceballos, Mauricio; Gonzalez-Giraldo, Cesar.
Título: Primary health care policy and vision for community pharmacy and pharmacists in Colombia
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020. graf.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2159.
Resumen: Colombia is a decentralized republic with a population of 50 million, constituted by 32 departments (territorial units) and 1,204 municipalities. The health system provides universal coverage and equal access to health care services to 95% of the population. Primary health care is seen as a practical approach that guarantees the health and well-being of whole-of-society. The National Pharmaceutical Policy (NPP, 2012) goal is "to develop strategies that enable the Colombian population equitable access to effective medicines, through quality pharmaceutical services (PS)". There are 4,351 providers certified to deliver PS: 3,699 (85%) ambulatory and 652 (15%) hospital care. The goals for PS are: a) promoting healthy lifestyles; b) preventing risk factors arising from medication errors; c) promoting rational use of medicines; and d) implementing Pharmaceutical Care. There are a number of ways that ambulatory patients access medications: through intermediary private companies, public and private hospitals pharmacies, and retail establishments (drugstores and pharmacies). Intermediary private companies are similar to Pharmaceutical Benefits Management in the U.S. health system, and act as intermediaries between health insurers, pharmaceutical laboratories, and patients. Pharmacists are being employed by these companies and in health insurance companies managing, auditing and delivering rational use of medicines programs. In 2014 there were approximately 20,000 pharmacies and drugstores, (private establishments) where a significant number of prescription-only medicines are sold without medical prescription. Colombian laws allow personal without pharmacy education to be a "director" in these establishments, so the training and education of persons working in drugstores and pharmacies is an important challenge. There about 8,000 registered pharmaceutical chemists with 25% to 30% working in patient care. Since the 90's, there are more favorable conditions for pharmacist's participation and contribution to health system and patient's health outcome. These environmental facilitators include: a) laws and regulations regarding pharmaceutical services (2005-2007), b) establishment of a NPP (2012), and c) opportunities associated with the consolidation of private health management companies providing health services with an interest in pharmaceutical services (since 1995). Finally, telepharmacy, comprehensive care routes for pharmaceutical services, and further strengthen of postgraduate training in pharmacy practice are future strategies to improve the pharmacy profession in Colombia. They provide an opportunity to influence the recognition and value of the pharmacist as the health care professional

No disponible
Descriptores: atención primaria de la salud
prestación de atención de salud integrada
Servicios de Salud Comunitaria
servicios farmacéuticos
práctica profesional
política sanitaria
-Colombia
Límites: seres humanos
Responsable: BNCS


  9 / 662 IBECS  
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Texto completo SciELO España
Id: 202376
Autor: Suwannaprom, Puckwipa; Suttajit, Siritree; Eakanunkul, Suntara; Supapaan, Teeraporn; Kessomboon, Nusaraporn; Udomaksorn, Khunjira; Sakulbumrungsil, Rungpetch.
Título: Development of pharmacy competency framework for the changing demands of Thailand's pharmaceutical and health services
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020. tab, graf.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2141.
Resumen: BACKGROUND: In Thailand, pharmacists are responsible for all activities to ensure access to medicines throughout pharmaceutical supply chain. Competency framework (CF) is an important guidance for professional development and workforce planning. OBJECTIVE: This study aimed to explore needs for pharmacy services in pharmaceutical supply chain and competencies of pharmacists to serve those needs. It was the first step for developing evidence-based pharmacy CF within the context of Thailand in 2026. METHODS: A qualitative method using in-depth interviews to gain rich data from practitioners and leaders in all area of practices. 99 key informants from 56 workplaces in Thailand were interviewed during January and March 2016. Data was transcribed verbatim, and thematic analysis was used. Competencies were extracted, followed by several rounds of group discussion among team members to develop an initial framework. The competencies and CF were presented, and recommendations were gained from professional leaders for refining the findings. RESULTS: The key informants agreed that pharmacist's works and responsibilities have gradually been drifted to support changes in healthcare and pharmaceutical systems. The upcoming pharmaceutical services call for higher standards of practice, larger number of personnel, and skillful pharmacists who have strong foundation in pharmaceutical knowledge as well as an ability to integrate knowledge into practices. Two sets of CFs were established. The general CF comprises five core domains: product focus, patient focus, healthcare system focus, community focus, and personal focus for self-improvement. These general competencies allow practitioners to perform basic professional tasks, including providing information, dispensing, and compounding. The service-specific competency is the integration of general competencies tailored into specific area of practice. CONCLUSIONS: Regarding the professional goal to evolve pharmacists from generalists to specialists for providing higher quality of professional services, the pharmacists are required to demonstrate general competencies and service-specific competencies. The findings serve as the need-based evidence for developing a national CF for pharmacists in Thailand

No disponible
Descriptores: práctica basada en pruebas
competencia profesional
servicios farmacéuticos
educación en farmacia
farmacéuticos
-investigación cualitativa
entrevistas como asunto
Tailandia
Límites: seres humanos
Responsable: BNCS


  10 / 662 IBECS  
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Texto completo SciELO España
Id: 202375
Autor: Varas-Doval, Raquel; Gastelurrutia, Miguel A; Benrimoj, Shalom I; García-Cárdenas, Victoria; Sáez-Benito, Loreto; Martinez-Martínez, Fernando.
Título: Clinical impact of a pharmacist-led medication review with follow up for aged polypharmacy patients: a cluster randomized controlled trial
Fuente: Pharm. pract. (Granada, Internet);18(4):0-0, oct.-dic. 2020. tab, graf.
Idioma: en.
doi: 10.18549/PharmPract.2020.4.2133.
Resumen: BACKGROUND: Medication review with follow-up (MRF) is a service where community pharmacists undertake a medication review with monthly follow-up to provide continuing care. The ConSIGUE Program assessed the impact and implementation of MRF for aged polypharmacy patients in Spanish Community Pharmacies. The present paper reports on the clinical impact evaluation phase of ConSIGUE. OBJECTIVE: The main objective of the study was to measure the effect of MRF on the primary outcome of the number of uncontrolled health problems. Secondary objectives were to analyze the drug-related problems (DRPs) identified as potential causes of ineffective or unsafe medications and the pharmacists' interventions implemented during MRF provision. METHODS: An open-label multi-centered cluster randomized study with comparison group (CG) was carried out in community pharmacies from 4 provinces in Spain during 6 months. The main inclusion criteria were patients over 64 years old, using 5 or more medicines. The intervention group (IG) received the MRF service (advanced medication review-type 3 MR) whereas patients in the CG received usual care. RESULTS: 178 pharmacies recruited 1403 patients (IG= 688 patients; CG= 715 patients). During the 6 months of the study 72 patients were lost to follow up. The adjusted multi-level random effects models showed a significant reduction in the number of uncontrolled health problems over the periods in the IG (-0.72, 95% CI: -0.80, -0.65) and no change in the CG (-0.03, 95%CI: -0.10, 0.04). Main DRPs identified as potential causes of failures of uncontrolled health problems' treatment were undertreated condition (559 DRPs; 35.81%), lack of treatment adherence (261 DRP; 16.67%) and risk of adverse effects (207 DRPs; 13.53%). Interventions performed by pharmacist to solve DRP mainly included the addition (246 interventions; 14.67%) and change (330 interventions; 19.68%) of a medicine and educational interventions on medicine adherence (231 interventions; 13.78%) and non-pharmacological interventions (369 interventions; 22.01%). CONCLUSIONS: This study provides evidence of the impact of community pharmacist on clinical outcomes for aged patients. It suggests that the provision of an MRF in collaboration with general medical practitioners and patients contributes to the improvement of aged polypharmacy patients' health status and reduces their problems related with the use of medicines

No disponible
Descriptores: polimedicación
conciliación de medicamentos
servicios farmacéuticos
cumplimiento y adherencia al tratamiento
-análisis por grupos
nivel educativo
Límites: seres humanos
masculino
femenino
anciano
ancianos de 80 o más años
Tipo de Publicación: ensayo clínico controlado aleatorizado
estudio multicéntrico
Responsable: BNCS



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