Am J Health-Syst Pharm -- Selected Abstracts

Articles

Pharmacist involvement in antimicrobial use at rural community hospitals in four Western states

KB Stevenson, M Samore, J Barbera, E Hannah, JW Moore, JL Gerberding, and P Houck

PURPOSE: Pharmacist involvement in antimicrobial use at small rural hospitals in four Western states was studied. METHODS: Surveys were mailed in July 2000 to hospitals with a daily patient census of <150 in Idaho, Nevada, Utah, and eastern Washington. RESULTS: Seventy-seven (77%) of 100 hospitals returned completed surveys. Only 5% of the hospitals had onsite pharmacists 24 hours per day. An onsite pharmacist was present for a median of 26 hours per week in hospitals without 24-hour pharmacist coverage (range, 0-116 hr/wk). Many hospitals (71%) had policies for monitoring or controlling antimicrobial use, but only 28% had a system capable of monitoring compliance with such policies. Few hospitals had systems for recommending changes in antimicrobial selection on the basis of susceptibility test results (27%) or for monitoring physician compliance with dosage recommendations by pharmacists (21%). Onsite pharmacist hours were significantly associated with pharmacists being involved in the initial ordering of antibiotics and providing active oversight of antimicrobial use. There was a negative correlation between onsite pharmacist hours and use of third-generation cephalosporins and carbapenems. CONCLUSION: A survey showed that rural hospital pharmacists in four Western states spent relatively little time monitoring and influencing antimicrobial prescribing.

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Abstract 2 of 5 American Journal of Health-System Pharmacy, Vol 60, Issue 7, 666-674
Copyright © 2003 by American Society of Health-System Pharmacists

Articles

Pharmaceutical services in rural hospitals in Illinois--2001

G Schumock, S Walton, C Sarawate, and SY Crawford

The results of a survey characterizing pharmaceutical services in rural hospitals in Illinois are reported and compared with results of a similar survey conducted in 1991. A questionnaire was developed and mailed to pharmacy directors at rural hospitals in Illinois to obtain information about product-related services, the use of technology, clinical pharmacy services, and human resources data (including vacancies) for 2001. Of the 71 surveys that were mailed, 47 pharmacy directors (66%) responded. Respondent hospitals were smaller compared with those responding in 1991 (mean average daily census, 41.0 versus 51.2, respectively). As in 1991, nearly all respondents reported the provision of unit dose services and complete and comprehensive i.v. admixture programs (100% and 83%, respectively, for 2001). Three respondents (6%) reported having a cleanroom facility. The most commonly used technology reported was nursing-unit-based automated drug dispensing cabinets (35%). Nearly all hospitals reported providing drug therapy monitoring, patient education and counseling, pharmacokinetic consultations, and nutritional support. Consistent with national reports, staffing levels and vacancies increased between 1991 and 2001. In 2001, the mean number of full-time equivalents was 7.1, with a pharmacist to technician ratio of 1.0:1.08 and a ratio of pharmacists to occupied beds of 1.0:22.6. The overall vacancy rate was 8%, with a vacancy rate of 14% and 5% for pharmacists and pharmacy technicians, respectively. A 2001 survey of pharmacy departments in rural hospitals in Illinois showed progression in the provision of distributive and clinical pharmacy services since 1991. Employee vacancy rates in pharmacy departments were high in 2001, especially among pharmacist positions, but were lower than those reported for the general population of hospitals.

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Abstract 3 of 5 American Journal of Health-System Pharmacy, Vol 59, Issue 4, 349-354
Copyright © 2002 by American Society of Health-System Pharmacists

Articles

Use of patients' own medications in small hospitals

PE Norstrom and CM Brown

The prevalence, management, and adverse events associated with the use of a patient's personal medications in hospitals were studied. A questionnaire comprised of 17 questions was mailed in November 1999 to the pharmacy directors of a random sample of 300 small (< or = 200-bed capacity) hospitals selected from the American Hospital Association 1999 membership directory. A follow-up mailing was sent to nonrespondents in early December 1999. The total usable response rate was 54.6%. The mean bed capacity was 76.6, and 70.8% of facilities had < or = 100 beds. Most facilities provided acute care, were nonprofit organizations, and were located in rural areas. A majority (90%) of the pharmacy directors surveyed allowed patients to use their own medications in the hospital. Elderly patients were most likely to bring their personal medications to use in the hospital, and pharmacists were the health professionals most likely to identify patients' personal medications. Circumstances in which patients were allowed to use their own medication, provided there was a physician's order, included prepackaged courses of therapy or antimicrobial courses and nonformulary medications, excluding controlled substances. Loss of personal medication and medication errors were the most frequently identified problems with allowing patients to use personal medications. Most small hospitals allowed the use of patients' personal medications; however, there was a wide variation in the circumstances for which the use of these medications was allowed.

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Abstract 4 of 5 American Journal of Health-System Pharmacy, Vol 61, Issue 6, 603-607
Copyright © 2004 by American Society of Health-System Pharmacists

Articles

Outpatient medication assistance program in a rural setting

GN Harmon, J Lefante, W Roy, KH Ashby, D Jackson, D Barnard, A Smart, and L Webber

PURPOSE: Efforts to provide medication assistance to the rural poor in central Louisiana are described. SUMMARY: The Central Louisiana Medication Access Program (CMAP) began functioning in 2001 with the objective of providing medication assistance and medication education to the rural poor in the community. The program serves individuals who use the outpatient clinic at the state-run public hospital in central Louisiana. Patients receive prescription drugs for a variety of chronic conditions, paying only a processing fee of dollar 3 per prescription, with a maximum outlay of dollar 15 per visit. A pharmacist counsels the patients about their medications. The medications are funded both through the program and through assistance programs run by pharmaceutical companies. A total of 5307 patients were enrolled in the CMAP between May 2001 and March 2003, and they received over 140,000 prescriptions at a cost saving to them in excess of dollar 2.5 million. CONCLUSION: The CMAP has been able to provide prescription medications and medication counseling to needy patients in a rural environment at little cost to them.

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Abstract 5 of 5

[Reprint (PDF) Version of Young]