The Assessment, Development, Assurance Pharmacist's Tool (ADAPT) for ensuring quality implementation of health promotion programs.
To develop and validate the Assessment, Development, Assurance Pharmacist's Tool (ADAPT), an instrument for pharmacists and student pharmacists to use in developing and implementing health promotion programs.
The 36-item ADAPT instrument was developed using the framework of public health's 3 core functions (assessment, policy development, and assurance) and 10 essential services. The tool's content and usage was assessed and conducted through peer-review and initial validity testing processes.
Over 20 faculty members, preceptors, and student pharmacists at 5 institutions involved in planning and implementing health promotion initiatives reviewed the instrument and conducted validity testing. The instrument took approximately 15 minutes to complete and the findings resulted in changes and improvements to elements of the programs evaluated.
The ADAPT instrument fills a need to more effectively plan, develop, implement, and evaluate pharmacist-directed public health programs that are evidence-based, high-quality, and compliant with laws and regulations and facilitates documentation of pharmacists' contributions to public health.
Heart failure assessment at the community pharmacy level: a feasibility pilot study.
A key element missing in disease-management programs for heart failure (HF) is participation of the community pharmacist. The purpose of this study is to determine if a simple and efficient clinical tool will allow community pharmacists to identify patients at risk for worsening HF.
The One Minute Clinic for Heart Failure (TOM-C HF) was developed as a simple six-item symptom screening tool to be used during routine patient/customer interactions.
Ten community pharmacies located in the upper Midwest.
Self-identified HF patients.
121 unique patients were evaluated over a 12-month period. The application of this clinical tool took between 1 and 5 minutes in over 80% of the interactions. Seventy-five patients (62%) had one or more signs or symptoms of worsening HF. The most common symptoms detected included edema (39%) and increased shortness of breath (17%). Self-reported weight gain of more than 5 pounds was seen in 19% of patients.
The TOM-C HF tool was used to identify patients in a time-efficient manner in the community pharmacy setting who appear to be developing worsening HF. Inclusion of the community pharmacists as an early screen for HF decompensation may be an important link in disease-management programs to help reduce hospital readmission rates.
Attitudes and interests of pharmacists regarding independent pharmacy ownership.
To examine the beliefs, attitudes, and interests of Texas pharmacists at different career stages with respect to independent pharmacy ownership.
Non-experimental, cross-sectional study.
Texas in November-December 2004.
180 practicing pharmacists.
MAIN OUTCOME MEASURES
Pharmacists' self-reported attitudes (ranging from -90, unfavorable, to +90, favorable) about and interest (-3, very unlikely, to +3, very likely) in independent pharmacy ownership.
Pharmacists reported an overall favorable attitude toward independent pharmacy ownership (mean [+/- SD] 18.6 +/- 28, range -63.0 to 90.0). Beliefs that ownership would increase their business autonomy, professional autonomy, and ability to establish patient loyalty made the largest contributions to overall attitude. Pharmacists' attitudes toward ownership differed by career stage (F = 3.12, df = 2, P = 0.047), with middle- (age 36-49 years) and early- (age < or = 35 years) career-stage pharmacists reporting the most and least favorable attitudes, respectively. Pharmacists reported a low interest in pursuing ownership (-2.2 +/- 1.6, -3.0 to +3.0). Financial rewards (r = 0.26, P < 0.001) and the need for business/managerial skills (r = 0.25, P < 0.001) were most highly correlated with pharmacists' interest in pursuing ownership. Multivariate findings indicated that pharmacists with a higher interest in pursuing ownership and those with advanced training certifications had significantly more favorable attitudes toward ownership than their counterparts. In addition, interest in pursuing pharmacy ownership was higher in pharmacists who offered compounding services, could obtain financial resources, practiced in rural locations, and had more favorable attitudes toward ownership.
Overall, pharmacists indicated favorable attitudes toward independent pharmacy ownership but low interest in pursuing ownership. Their attitudes differed based on career stage, and more favorable attitudes--grounded especially in beliefs about autonomy and patient loyalty--were associated with a greater interest in ownership. Strategies to stimulate pharmacy ownership should be varied and targeted to influence beliefs that are driving pharmacists' attitudes at various career stages.