Prescription Services Research Articles

Provision of Primary Care Services and Cardioprotective Medication Prescriptions in Patients With Cardiovascular Diseases and Cancer: A Cross-sectional Study

Provision of Primary Care Services and Cardioprotective Medication Prescriptions in Patients With Cardiovascular Diseases and Cancer: A Cross-sectional Study

Fitting in or belonging: emerging findings from a realist evaluation of social prescribing link workers in primary care.

Social prescribing link workers are being employed in primary care through the Additional Roles Reimbursement Scheme. To understand and explain how the link worker role is being implemented and sustained in primary care. As part of a realist evaluation, we observed link workers in practices in different parts of England and interviewed patients and professionals. Data have been coded and are being developed into statements that explain how context interacts with mechanisms leading to intended and unintended outcomes. Our first work package (WP) involved data collection from seven sites in England. For this WP, we interviewed 61 patients and 94 professionals (link workers, GPs, and members of the voluntary-community sector). 'Boundaries' is a key concept within the data. It can describe whether and how link workers draw limits around their role. This can affect the breadth of their work, as they attempt to gain credibility and acceptance within a practice. Boundaries can shape how far link workers feel they belong rather than having to fit into a practice. This may shape their ability to support patients with their psychosocial needs. Dominance of a medical model approach to service delivery may not be conducive to uncovering and supporting people with their non-medical problems, or to promoting a wider understanding of health. Tensions between fitting into a setting dominated by medical discourse and practices, compared to feeling they belong, is something that link workers can encounter when providing social prescribing services in primary care.

Factors Affecting Waiting Time for Outpatient Prescription Services at Pukesmas Betoambari Baubau City

Background: Factors that can affect the waiting time are the number of prescriptions and the completeness of the prescription, the availability of human resources, the availability of drugs in accordance with the prescription, the standard operating procedures used.
 Objectives: The aims of this research is to determine the factors that influence the waiting time for outpatient prescription services at the Betoambari Health Center, Baubau City.
 Research Metodes: The research method used is analytic observational with a cross sectional study approach. The population of this study were all outpatients at the Betoambari Health Center. The number of samples is 358 respondents. The sampling technique used is Simple Random Sampling. The data analysis used was Univariate, Bivariate, and Multivariate Analysis.
 Results: The results of this study indicate that there is no effect of the number of prescriptions and prescription completeness with waiting time for prescription services (p value = 0.602 > = 0.25), there is an effect of availability of human resources with waiting time for prescription services (p value = 0.001 < = 0.25), and there is an effect of drug availability with waiting time for prescription services (p value = 0.153 < = 0.25).
 Conclusion: The conclusion of this study is that there is no influence between the number of prescriptions and the completeness of prescriptions, the availability of human resources, and the availability of drugs with the waiting time for prescription services.
 Keywords: drug prescription, outpatient, waiting time.

Primary care management post gestational diabetes in Australia.

Women with a history of gestational diabetes (GD) have a high risk of developing diabetes and subsequent cardiovascular disease (CVD). To assess whether diabetes screening and CVD risk screening occurred in general practice (GP) among postpartum women with GD. This is a retrospective study of clinical record data of women with GD, under active GP management, from the MedicineInsight programme, run by Australia's National Prescribing Service MedicineWise, with GP sites located in Australia from January 2015 to March 2021. Documentation of screening for diabetes, assessment of lipids and measurement of blood pressure (BP) was assessed using proportions and mixed-effects logistic regression with a log follow-up time offset. There were 10 413 women, with a mean age of 37.9 years (standard deviation, 7.6), from 406 clinics with a mean follow-up of 4.6 years (interquartile range, 1.8-6.2 years)A total of 29.41% (3062/10 413; 95% confidence interval [CI], 28.53-30.28) had not been assessed for diabetes, 37.40% (3894/10 413; 95% CI, 36.47-38.32) were not assessed for lipids and 2.19% (228/10 413; 95% CI, 1.91-2.47) had no BP documented. In total, 51.82% (5396/10 413; 95% CI, 50.86-52.78) were screened for all three (diabetes + lipids + BP) at least once. Obesity, comorbidities and dyslipidaemia were associated with increased likelihood of screening. New diabetes diagnosis was documented in 5.73% (597/10 413; 95% CI, 5.29-6.18) of the cohort. Screening for diabetes and hyperlipidaemia was suboptimal in this high-risk cohort of women with prior GD. Improved messaging that women with a GD diagnosis are at high cardiovascular risk may improve subsequent screening.

P369 Electronic prescribing: A service improvement project

To implement the NHS electronic prescription service (EPS) currently used in primary care within the Cystic Fibrosis (CF) team, for patients assessed by the team either remotely or in the community. This allows acute prescriptions to be sent directly to a nominated community pharmacy, removing the need for the patient to travel to the hospital site or to involve a general practitioner (GP) who has not seen the patient.

Social prescribing practices and learning across the North West Coast region: essential elements and key challenges to implementing effective and sustainable social prescribing services

IntroductionSocial prescribing has become an important feature of the UK primary care offer. However, there remains limited evidence on how best to implement and deliver social prescribing programmes to maximise effectiveness and long-term sustainability.AimTo explore social prescribing practices and experience of implementing social prescribing programmes across National Institute for Health and Social Care Research (NIHR) Collaborative Leadership for Applied Health and Care Research (CLAHRC) North West Coast (NWC) and NIHR Applied Research Collaboration (ARC) NWC region to identify key learning points that can be applied to other settings.MethodWe held a learning exchange workshop attended by practitioners and Public Advisors who had been involved in implementing and evaluating eight different social prescribing programmes with the support of NIHR CLAHRC NWC. We followed this with an online survey of social prescribing practice and priorities within the NIHR ARC NWC area. We used the findings from the workshop and survey to develop an initial model of the elements needed to successfully implement and sustain a working social prescribing programme.FindingsWe identified three core essential elements for a successful social prescribing programme: a personalised approach; meaningful service-user and community involvement; and whole systems working. These core elements need to be supported with adequate resources in the form of continuity of funding and adequate community resources to refer people to, capacity building and appropriate evaluation.ConclusionWe were able to use a learning exchange workshop to both facilitate learning between practitioners and begin the process of identifying the ingredients needed for a successful social prescribing programme, which may be built on with further research.

Alpha-Stim AID cranial electrotherapy stimulation (CES) anxiety treatment: anxiety, depression and health-related quality-of-life outcomes in primary health-care social prescribing services

PurposeThis study aims to evaluate the effect of Alpha-Stim Anxiety, Insomnia and Depression (AID) cranial electrotherapy stimulation (CES) on anxiety, depression and health-related quality of life for primary care social prescribing service patients with anxiety symptoms.Design/methodology/approachOpen-label patient cohort design with no control group. A total of 33 adult patients (average age 42 years) completed six weeks of Alpha-Stim AID use. Pre- and post-intervention assessment with participant self-report measures: Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7) and European Quality of Life Five Dimension (EQ-5D-5L).FindingsReliable improvement and remission rates, respectively, were 53.39% and 33.3% for GAD-7; 46.7% and 29.5% for PHQ-9. There was a significant improvement in GAD-7 and PHQ-9 with large effect sizes. EQ-5D-5L results showed significant improvements in health-related quality of life. Perceived quality of life increased by 0.17 on the health index score, with the intervention adding 1.68 quality-adjusted life years (QALYs).Practical implicationsAlpha-Stim AID can be delivered through a primary health-care social prescribing service and most patients will use as prescribed and complete treatment course. Alpha-Stim AID CES may be an effective anxiety and depression treatment for people with anxiety symptoms. The widespread roll-out of Alpha-Stim AID in health-care systems should be considered.Originality/valueTo the best of the authors’ knowledge, this is the first study to respond to the UK’s National Institute for Health and Care (NICE) request for the collection of real-world data to understand better Alpha-Stim AID in relation to people’s treatment uptake, response rates and treatment completion rates (NICE, 2021).

Promoting Social Prescribing in Psychiatry—Using Shared Decision-Making and Peer Support

This Viewpoint discusses shared decision-making and peer support to promote prescription of nonclinical services based on patients’ preferences, goals, and needs as well as locally available services.

Patient perspectives of antiretroviral pharmacy services: A cross-sectional cohort study.

Adherence to antiretroviral therapy (ART) remains the main predictor of sustained HIV virologic suppression for people with HIV (PWH). Mail-order pharmacy services are often offered to patients as an alternative option to traditional pharmacy services. Some payers mandate ART to be dispensed from specific mail-order pharmacies regardless of patient choice complicating ART adherence for patients affected by social disparities. Yet, little is known about patient perspectives regarding mail-order mandates. Eligible patients of the HIV program at University of Nebraska Medical Center with experience receiving ART from both a local and mail-order pharmacy were invited to complete a 20-question survey with three core sections: experiences/perspectives on local and mail-order pharmacy settings; pharmacy attributes rankings; and pharmacy preference. Paired t-tests and Mann-Whitney tests were used to compare the agreement scores of pharmacy attributes. Sixty patients (N = 146; 41.1%) responded to the survey. Mean age was 52 years. Most were male (93%) and White (83%). The majority of participants were on ART for HIV treatment (90%) and 60% were using mail-order pharmacies for their prescription services. Significant scoring differences (p<0.05) were observed for all pharmacy attributes favoring local pharmacies. Refilling ease was the most important attribute noted. More respondents (68%) preferred local pharmacies versus mail-order pharmacies. Payer associated mail-order pharmacy mandates were experienced by 78% with half believing the mandates impacted their medical care negatively. In this cohort study, respondents preferred local pharmacies compared to mail-order pharmacy for ART prescription services and noted ease of refilling as the most important pharmacy attribute. Two-thirds of respondents believed mail-order pharmacy mandates negatively affected their health. Insurance payers should consider the removal of mail-order pharmacy mandates to allow patient choice of pharmacy, which may help remove barriers to ART adherence and improve long-term health outcomes.

Development and application of a sports health cloud management platform model based on internet of things technology

AbstractThe real‐time sports and physical sign data display of various intelligent sports equipment and software can provide help for professional athletes to formulate sports strategies. However, for those who do not have any special knowledge, visual data cannot help them to make correct sports plans. Based on the above problems, this paper designed and implemented a cloud computing platform that can collect the user's movement and physical sign information, so as to provide personalized sports prescription service for them. In the performance test of the platform, the experimental results showed that the 50% line response time value and 90% line response time value were the maximum when the number of test threads reaches 1000 and 900, and the maximum value was 2896 and 3136 ms respectively; when the number of test threads was 200, the minimum value was 86 and 132 ms. Therefore, it is very necessary to develop and apply the sports health CMP based on the Internet of Things (IoT) technology.

Pharmacist-led hormonal contraceptive prescribing service in a Federally Qualified Health Center: Initial implementation outcomes

BackgroundThe United States has a higher rate of unintended pregnancy than many other developed countries, and Indiana’s unintended pregnancy rate is above the national average. Unintended pregnancy rates are highest among low-income women. Federally Qualified Health Centers (FQHC) provide care for the underserved and uninsured patient population. ObjectiveTo determine the acceptability, adoption, appropriateness, and feasibility of a pharmacist-led hormonal contraception prescribing service within a FQHC through a collaborative drug therapy management protocol. MethodsAn explanatory mixed methods analysis included surveys followed by semistructured interviews. A survey was created and distributed to all patients who received the service and all providers (physicians and nurse practitioners) employed at the FQHC during service implementation. Semistructured interviews were conducted with a subset of patients and providers. ResultsA total of 11 patients and 8 providers completed the survey between January 1, 2022 and June 10, 2022. Of these participants, 4 patients and 4 providers completed an interview between May 1, 2022 and June 30, 2022. Both patients and providers perceived the service as acceptable and appropriate, and providers perceived implementation of the service within clinic as feasible. Ten patients received a prescription from the pharmacist; 1 patient was referred to a provider as the pharmacist was unable to prescribe the medication requested. ConclusionImplementation of pharmacist prescribed hormonal contraception was perceived as acceptable, appropriate, and feasible by patients and providers. Pharmacists are perceived by patients and providers as an additional resource for hormonal contraception prescribing within a FQHC due to their clinical knowledge, efficiency, and attention paid to patients’ concerns.

Patient satisfaction with waiting time for outpatient prescription services based on sharia characteristics in the pharmacy installation Prof. Dr. Soerojo Hospital Magelang

Including pharmaceutical services, service quality improvement must be carried out appropriately, quickly, and with a sense of security. Hospital pharmacy services can be evaluated based on five criteria, namely reliability, responsiveness, assurance, dependability, and empathy. One of the pharmaceutical service factors that must meet the minimum requirements for hospital services is the waiting time for prescription filling. 1) Objective: to assess satisfaction of the duration of the outpatient prescription service wait based on sharia characteristics in RSJ. Prof. Dr. Soerojo Magelang; 2) Methods: descriptively with a cross-sectional design using accidental sampling techniques on questionnaires that were analyzed univariately and bivariately using SPSS; 3) Results: a questionnaire with a total of 30 respondents showed that the patient satisfaction category was very satisfied from the five measurement dimensions (77%, 57%, 73%, 67%, 54%) and satisfied (23%, 43%, 27%, 33% , 46%) with a prescription service wait time not more than 30 minutes for non-concoction and less than 60 minutes for concoction; 4) Conclusion: based on sharia characteristics of the five dimensions of satisfaction, the results are very satisfied and satisfied and the outpatient prescription waiting time service meets the minimum standards of hospital services.

Analisis Waktu Tunggu Pelayanan Resep Rawat Jalan di RSJD Dr. Arif Zainudin Surakarta

Pharmaceutical service is a direct and responsible service to patients related to pharmaceutical preparations. Waiting time is one of the minimum service standards in the pharmacy sector in hospitals. The minimum standard of waiting time set by the Ministry of Health is 30 minutes for non-combined prescriptions and 60 minutes for compound prescriptions. This study aims to determine the average waiting time for outpatient prescription services for both finished and concoction drugs at RSJD dr. Arif Zainudin Surakarta compared to the Hospital Pharmacy Minimum Service Standards. This research was conducted with a descriptive cross-sectional method. Primary data was collected through direct observation and recording of waiting times prescription services in July 2022. The data were taken as many as 100 outpatient prescriptions consisting of 25 concoctions and 75 non-concoctions. The research data was processed using Microsoft Excel. In this study, the average waiting time for non-concoction prescription services was 24,7 minutes and for concoction recipes 41,08 minutes. Based on the results of the study, it was found that the average waiting time for prescription services at the Regional Mental Hospital dr. Arif Zainudin Surakarta has met the requirements according to the minimum service standards in hospitals is 30 minutes for non-combined prescriptions and 60 minutes for compound prescriptions

Medical use and combination drug therapy among US adult users of central nervous system stimulants: a cross-sectional analysis

ObjectiveExamine patterns of adult medical use of amphetamine and methylphenidate stimulant drugs, classified in the USA as Schedule II controlled substances with a high potential for psychological or physical dependence.DesignCross-sectional...

Implementation of Patient Drug Prescription Services in Hospital Pharmacy Installations: Has It Been Managed Properly to Reduce Waiting Time?

&lt;p align="center"&gt;&lt;strong&gt;&lt;em&gt;Abstract&lt;/em&gt;&lt;/strong&gt;&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;The hospital pharmacy installation plays an essential role in the hospital, where the hospital pharmacy installation manages the management and distribution of drugs. The achievement of quality indicators related to the waiting time for concoction and non-concoction drug services at the Outpatient Pharmacy Installation of X Kendal Hospital still needs to be consistent. Patients also complain about long waiting times. This study aims to determine whether the implementation of patient drug prescription services in the Hospital Outpatient Pharmacy Installation has been appropriately managed or needs improvement. This research is qualitative research with a phenomenological approach. Purposive sampling researchers selected the research subjects. The subjects in this study consisted of four primary informants and two triangulation informants. The results of the in-depth interviews found that during no initial check was made on the identity of the patient or the prescription received because due to the habit of piling up prescriptions, the dose given by the doctor was not correct. Hence, it had to be recalculated, the amount of drug stock in the system was not correct always the same as the available physical stock, lack of pharmaceutical staff during the drug preparation process, and there were medication errors in the drugs that had been prepared so that the staff had to re-prepare them, and errors in the drug delivery process due to staff negligence, causing longer waiting times for prescription services. Therefore, it was concluded that the implementation of prescription services at hospital X in Kendal district had not been managed optimally or appropriately. Hospitals still need to evaluate and improve the process of implementing prescription services to reduce waiting times.&lt;/p&gt;&lt;p&gt;&lt;em&gt; &lt;/em&gt;&lt;/p&gt;&lt;strong&gt;&lt;em&gt;Keyword: Drug Prescription, Pharmacy Installation, Service&lt;/em&gt;&lt;/strong&gt;

Analysis Of Waiting Time For Patient Services Of Disease Polyclinic At Hkbp Balige General Hospital

Waiting time for prescription services is a minimum standard for pharmaceutical services, with fast waiting times it can improve the quality of pharmaceutical services. The waiting time for non-concoction or concoction prescription services is the time period from when the patient submits the prescription to receiving non-concoction or concoction drugs with a length of time ≤ 30 minutes for non-concoction drugs and ≤ 60 minutes. This study aims to determine the waiting time for prescription services at the Outpatient Internal Medicine Polyclinic at HKBP Balige General Hospital. The design used in this study was descriptive, the population was all outpatient prescriptions at the Internal Medicine Polyclinic. The research sample was 80 recipes taken by accidental sampling. The instrument used is the prescription service waiting time observation sheet. Based on data analysis, 16 recipes (20%) met the requirements and 64 recipes (80%) did not meet the requirements and were non-concoction recipes. The results of this study indicate that the waiting time for prescription services is not up to standard. It is hoped that the management of the HKBP General Hospital will add Pharmacy Technical Personnel to the Pharmacy Installation so that the waiting time for prescription services will be faster.

Upaya Peningkatan Keamanan Obat Diabetes Mellitus di Klinik Pratama Swasta dengan Pendekatan Action Research

Medication safety is one of the patient safety criteria that must be met in healthcare facilities. However, research on medication safety in private primary care remains limited. This study aimed to increase medication safety initiatives for Diabetes Mellitus (DM) patients and healthcare recipients’ (patients') knowledge of medication safety. A cycle of action research (diagnosing, planning, action, and evaluation) was used in a private clinic (PKU Muhammadiyah Srandakan Clinic, Yogyakarta Special Region). The involvement level of research subjects was co-learning. The diagnosing phase was conducted by in-depth interviews and questionnaires distribution with clinical leaders and staff (n=11). The planning stage was completed through medication prescription standard operational (SPO) procedure review and the educational media preparation for patients. In the action stage, in-house training for clinic staff about medication safety and the educational intervention with a quasi-experimental (without control, non-randomization) on PROLANIS DM participants (total sampling, n=50) were conducted. Study results showed that the diagnosing phase exposes the clinic staff's adequate understanding of medication safety. There were obstacles to implementing prescribing services from the patient, staff, operational, and infrastructure aspects. A revised SPO for Prescription Medication Services and educational media were created during the planning stage. There was a significant increase in patients’ knowledge between the pre-test and post-test in the action and evaluation stage (p=0.000), and there was no patient safety incident related to medication safety during this research. In conclusion, staff knowledge was good, there was a significant increase after health education was provided to patients, and complex obstacles need to be resolved comprehensively and continuously.

Evaluation Of Waiting Time For Pediatric Patients At HKBP Balige General Hospital

According to the Decree of the Minister of Health of the Republic of Indonesia Number 129 of 2008 concerning Minimum Hospital Service Standards that for mixed prescriptions is ≤ 60, and for non-concocted prescriptions is ≤ 30. This study was conducted to determine the average waiting time for mixed and non-concocted prescription services. for pediatric patients at HKBP Balige General Hospital with Minimum Service Standards of the Indonesian Ministry of Health. This research is a descriptive study using the observational method of concoction prescriptions and non-concoctions prescriptions for outpatients at the Pharmacy Installation of RSU HKBP Balige for the period of July 2022. The average result of waiting time for the fastest concoction prescription is 41 minutes and the longest is 60 minutes, while the average result waiting for the fastest non-concoction recipe is 22 minutes and the longest is 36 minutes. The waiting time for mixed and non-concoction prescription services for pediatric patients at the Pharmacy Installation of HKBP Balige General Hospital has met the specified requirements. For future researchers, this can be supplemented by the level of patient satisfaction with the quality of drug prescription services based on waiting time.

An Overview of the Use of Antihypertensive Drugs at the Outpatient Pharmacy of Tarakan "X" Hospital in 2022

Hypertension is a global health problem often encountered, and the appropriate use of antihypertensive drugs is very important for optimal blood pressure control. Therefore, it is necessary to research the description of the use of antihypertensive drugs in various health facilities. The purpose of this study was to describe the prescription of antihypertensive drugs in patients at "X" hospital in the outpatient department. The research data obtained were digital data from prescription services from January-December 2022. This study used retrospective data by accessing computer service data at the "X" hospital outpatient pharmacy to track the history of past hypertensive patients’ treatment. The sampling technique used is total sampling. The results showed that the most prescribed antihypertensive drugs were amlodipine, with 13,203 prescription items. Bisoprolol with 10,704 prescription items, and candesartan with 9,885 prescription items. The frequency of prescribing the antihypertensive drug class the most was calcium channel blockers, as much as 13,784 (23.41%), while for the drug class which was the least prescribed, namely alpha-2 agonists, there were 68 drugs (0.12%). Based on the study results, it can be concluded that the most widely prescribed antihypertensive drugs at the outpatient pharmacy at "X" hospital are amlodipine, bisoprolol, and candesartan.

Trends and correlated outcomes in population-level prescription opioid and transdermal fentanyl use in Israel

BackgroundIn the last twenty years, there was a documented increase in prescription opioid procurement in Israel. However, there is still little evidence of the association between opioid procurement rates, health service utilisation in secondary care, and enrollment rates to substance use disorder treatment programmes. In this study, we show trends in the reports of opioid-related hospitalisations, emergency department visits, enrollment to community-based outpatient treatment for Prescription Opioid Use Disorder and opioid-related mortality rates. Additionally, we examine potential correlations between these health service utilisation rates and prescription opioid procurement rates at the population level, with a focus on transdermal fentanyl.MethodsA longitudinal study at the population level. We used seven-year data on indicators of opioid-related morbidity, prescription opioid procurement data for 2015–2021, and six-year opioid-related mortality data for 2015–2020. We measure the correlation between procurement rates of prescription opioids in Oral Morphine Equivalent per capita, and aggregated rates obtained from hospital administrative data for hospitalisations, emergency department visits, and patient enrolment in specialised prescription opioid use disorder outpatient treatment in the community setting.ResultsBetween 2015 and 2021, procurement rates in primary care per capita for all prescription opioids increased by 85%, while rates of transdermal fentanyl procurement increased by 162%. We found a significant positive correlation at the population level, between annual opioid procurement rates, and rates per population of opioid-related visits to emergency departments (r = 0.96, p value < 0.01, [CI 0.74–0.99]), as well as a positive correlation with the rates per population of patient enrolment in specialised prescription opioid use disorder outpatient treatment (r = 0.93, p value = 0.02, [CI 0.58–0.99]). Opioid-related mortality peaked in 2019 at 0.31 deaths per 100,000 but decreased to 0.20 deaths per 100,000 in 2020.ConclusionData shows that all-opioid and transdermal fentanyl procurement has increased yearly between 2015 and 2021. This increase is positively correlated with a growing demand for community-based Prescription Opioid Use Disorder outpatient treatment. Efforts to reduce opioid-related morbidity may require effective approaches toward appropriate prescribing, monitoring, and further increasing access to prescription opioid outpatient treatment.