Marion Schaefer - Academia.edu (original) (raw)
Papers by Marion Schaefer
Pharmacy world & science : PWS, 2000
The aim of this study was to investigate the outcomes of self-medication in patients suffering fr... more The aim of this study was to investigate the outcomes of self-medication in patients suffering from dyspepsia by comparing changes in the Health related Quality of Life before and after self-medication of dyspeptic disorders. Another study objective was the quantitative and qualitative analysis of the pharmacist's advice-giving to patients with dyspepsia. Therefore the impact of the counselling by the pharmacist on the patient's health outcomes was surveyed and compared between study and control pharmacies. Moreover, the study analysed the influence of a special training on the services provided by the pharmacies with regard to self-medication. A beneficial effect of self-medication on the HRQoL of patients with dyspepsia on a weekly basis has been detected in the study. There is evidence that advice-giving and counselling by the pharmacists in self-medication have a measurable impact on self-medication outcomes. Moreover, the study reveals that patients value the informatio...
International journal of clinical pharmacy, 2012
The well-being of patients with Parkinson's disease may be improved by pharmaceutical care in... more The well-being of patients with Parkinson's disease may be improved by pharmaceutical care in community pharmacies. To investigate the effects of standardised pharmaceutical care on health outcomes and quality of drug treatment in patients with Parkinson's disease. Community pharmacies in Germany. An open-label, multicentre, longitudinal, parallel-group study was conducted in outpatients with idiopathic Parkinson's disease who were receiving anti-parkinsonian medication. Patients were recruited by 32 community pharmacists (pharmacy group) and local offices of the German Parkinson's disease patients' association (comparison group). All patients were assessed at baseline and at 8 months' follow-up. In the intervening period, the pharmacists provided patients in the pharmacy group with standardised pharmaceutical care. Mean change in symptom-related impairment of health status, assessed using the 23-item Parkinson's Scale Total Score. In total 235 patients w...
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2012
To compare the effect of two types of counselling brochure on knowledge, attitudes and intention ... more To compare the effect of two types of counselling brochure on knowledge, attitudes and intention towards combined oral contraceptives (COCs). Double-blind, parallel-group randomised trial conducted in Germany. Nulliparous women aged 18-24 years were randomly assigned to receive one of two comprehensive information brochures about COCs, their benefits and risks, and alternative contraceptive methods. The first brochure was based on standard recommendations for evidence-based patient information (EBPI). This was restructured and adapted according to the mental models approach (MMA) for the second brochure. The primary endpoint was the change in number of correct answers in a knowledge questionnaire administered directly after the intervention and three months later. The impact on attitudes and intention were secondary outcomes. Before the intervention, women answered 18.9 (standard deviation [SD] 4.2) of 39 knowledge items correctly. After the intervention, the EBPI group (n = 66; p =...
International journal of clinical pharmacy, 2011
Although Parkinson's disease is a common disorder in the elderly, there have been very few st... more Although Parkinson's disease is a common disorder in the elderly, there have been very few studies of the role of the pharmaceutical care services in detecting and reducing problems associated with drug treatment in community settings. The aim of this study was therefore to investigate the type and frequency of drug-related problems identified in patients with Parkinson's disease by community pharmacists over an 8-month period and to assess the pharmaceutical service interventions, the type and frequency of intervention outcomes and the clinical benefits for the patients. Community pharmacies in Germany. Thirty-two community pharmacists recruited 113 outpatients with idiopathic Parkinson's disease who were receiving anti-Parkinsonian medication. Drug-related problems. A total of 331 drug-related problems were identified by the pharmacists. Patients not receiving a medication, despite the presence of an indication or symptom, accounted for the highest proportion of drug-r...
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2011
This pilot study aimed at identifying counselling topics relevant to young women, at comparing th... more This pilot study aimed at identifying counselling topics relevant to young women, at comparing their perceived and actual knowledge about combined oral contraceptives (COCs), and at determining the appropriate scope of counselling material about benefits and risks of COCs. Thirty women aged 18-24 completed an online questionnaire assessing information needs and knowledge about 25 medical conditions under consideration as potential counselling items (benefits, risks and myths) and preferences about counselling material. Respondents were unable to identify non-contraceptive benefits of COCs or potential severe health risks and had some misconceptions. They rated their knowledge of specific COC effects significantly lower than their corresponding interest in the effect. In contrast, the assessment of how well participants felt they were informed about benefits and risks was rated predominantly as 'rather well'. Eleven items were identified as relevant to patients, the most rele...
Value in Health, 2001
Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year perio... more Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year period. Results were driven by the impact of ICS on quality of life, rather than on mortality. Findings were stable over most input data ranges. However, at efficacy levels below 3% and toxicity rates greater than 2.9%, the cost-effectiveness estimate exceeded $100,000/QALY. CONCLUSION: Results suggest that inhaled steroids deliver good comparative value in mild-to-moderate adult asthma. More research is needed, however, on the impact of ICS toxicity on patient preferences.
Quality of Life Research, 2005
Background and objectives: Menopause is a physiological event occurring in women at about the age... more Background and objectives: Menopause is a physiological event occurring in women at about the age of 50. It signals the end of the reproductive years and is associated with signs of estrogen deficiency having a considerable impact on women's health-related quality of life (HRQoL). The most common form of treatment is hormone replacement therapy (HRT). Studies have shown negative events can arise from longterm use of HRT. The aim of this review is to determine if there are any HRQoL instruments that address the impact of menopausal symptoms including positive and negative effects of HRT. Methods: The following eight instruments were identified: Greene Climacteric Scale, Women's Health Questionnaire (WHQ), Qualifemme, Menopause-Specific QOL Questionnaire (MENQOL), Menopausal Symptoms List (MSL), Menopause Rating Scale (MRS), Menopausal Quality of Life Scale (MQOL), and the Utian Quality of Life Scale (UQOL). Results: All instruments reviewed proved to be reasonably structured and have their place in applied research. None were found that addressed all aspects of the impact of HRT on HRQoL. Conclusion: In order to capture the possible short-term side effects of HRT on HRQoL, it is necessary to modify one or more of the existing instruments or develop a new instrument applicable in many different countries and languages.
Psychology & Health, 2012
Communication regarding the benefits and risks of combined oral contraceptives (COCs) remains a c... more Communication regarding the benefits and risks of combined oral contraceptives (COCs) remains a challenge in view of persistent misconceptions about the 'pill'. The aim of this study was to investigate how women understand the benefits and risks of COCs, comparing their assessments with an expert model created from literature- and guideline-based research and reviewed by a sample of gynaecologists using the mental models approach. Two qualitative studies were conducted in Germany - a questionnaire-based study involving 30 gynaecologists with a mean of 218 COC prescriptions on average per month, and in-depth interviews (plus the use of a questionnaire) with 21 women aged 18-24 years. As expected, women reported only a few concepts of benefits and risks unprompted, but further prompting revealed beliefs of many other associations. The women stated an overall positive valence even if the number of negative concepts predominated indicating a latent cognitive dissonance. The major differences compared with the expert model included: (a) a negative association with weight gain, subfertility and teratogenicity, (b) only a partial association of COC intake with thromboembolic conditions, (c) a confusing, rather negative perception of a COC-related effect on cancer and (d) a partial lack of basic knowledge of the active ingredients, time to excretion and mode of action of COCs. Appropriate COC counselling should cover these discrepancies.
Pharmacoepidemiology and Drug Safety, 2007
Purpose There is currently a lack of detailed information concerning drug related problems in the... more Purpose There is currently a lack of detailed information concerning drug related problems in the outpatient treatment of Parkinson's disease. Methods Problems associated with drug treatment communicated anonymously in Parkinson's disease online forums were therefore retrospectively searched and documented for 1 year. Results Based on postings concerning 12 drugs for the treatment of Parkinson's disease, a total of 238 drug related problems were identified and categorised using the Problem Intervention Documentation (PI-Doc). Of these, 153 were adverse drug reactions. Adverse drug reactions associated with the skin were relatively common, but central effects such as cognitive or psychiatric changes, effects on the sleep/waking system and other problems like headache and dizziness accounted for the highest percentage of adverse events. A comparison with data from scientific literature revealed a number of differences. This means that an analysis of online forums detected a number of drug related problems that were otherwise largely invisible. These were mainly associated with the qualitative aspects of treatment such as medication handling, dosage and individual problems concerning adverse events. In addition, the described method of identifying and classifying drug related problems in Internet forums may also be seen as a contribution to the international discussion about consumer reports and pharmacovigilance. The information about adverse drug reactions given by Internet users can be seen as a valuable adjunct to clinical trial data and as being very timely with regard to the event itself. Conclusion Online forums may be considered as a suitable source of observational information to complement data from randomised clinical trials.
Neuropsychiatric Disease and Treatment, 2011
Implementation of guidelines can improve clinical practice. The aim in this study was to investig... more Implementation of guidelines can improve clinical practice. The aim in this study was to investigate whether neurologists in Germany adhered to the national Parkinson's disease guideline. Data were obtained from a cross-sectional survey of 60 neurologists. Analyses were performed on 320 patients with idiopathic Parkinson's disease with either low grades of functional impairment (Hoehn and Yahr stage I) or higher grades of functional impairment (stage II-V) but without motor complications. The sample was divided into four groups depending on age and grade of functional impairment. For each group, a biometric parameter on the use of dopamine agonists and L-dopa was defined based on the guideline. In patients aged ,70 years, the recommendation to use dopamine agonists without L-dopa (parameter 1) was observed in 53% of patients with lower grades of functional impairment, whilst recommended use of dopamine agonists in more functionally impaired patients (parameter 2) was followed to a greater extent (84%). In patients aged $70 years, recommendations to use L-dopa without dopamine agonists were adhered to in only 50% of less functionally impaired (parameter 3) and 52% of more functionally impaired (parameter 4) patients. In conclusion, our results indicated there was moderate but not full adherence to the guideline.
Epilepsy Research, 2011
Purpose: To obtain better understanding of the effect of lacosamide (LCM) in clinical practice, l... more Purpose: To obtain better understanding of the effect of lacosamide (LCM) in clinical practice, laboratory and clinical data of 17 patients under treatment with LCM as an add-on antiepileptic drug (AED) were retrospectively evaluated. Methods: Total LCM serum concentrations were obtained at hourly intervals for up to 5 h and 8 h after morning dose. Adverse drug reactions (ADR) were assessed. Results: LCM serum concentrations showed high fluctuations during the day with a steep increase within the first 3 h after intake (mean 87.8%; range: 44.4-149.0%) under b.i.d. Mean trough and peak concentrations of LCM were 5.0 g/ml (range: 1.8-9.5 g/ml) and 9.7 g/ml (range: 4.0-18.3 g/ml), respectively; mean dose 353 mg/d (range: 200-600 mg/d). Twelve patients showed ADRs. After conversion to t.i.d. or dose reduction LCM serum concentration showed lower fluctuations during the day and a lower increase after intake (mean: 50.0%, range: 27.1-66.7%); peak LCM was 9.4 g/ml (range: 4.7-11.6 g/ml), mean dose 388 mg/d (range: 300-500 mg/d). These interventions led to amelioration of the ADR. Conclusion: Changing the dose regimen from two to three times daily could reduce fluctuations of LCM during the day and improve tolerability of LCM in patients with ADR.
Annals of Pharmacotherapy, 2004
Una clasificación de los PRMs en atención farmacéutica no permite ni valorar las actividades que ... more Una clasificación de los PRMs en atención farmacéutica no permite ni valorar las actividades que ha realizado el farmacéutico ni destinar los recursos necesarios para dicha actividad. Por tanto, es necesaria una clasificación de la gravedad de los PRMs.
Annals of Pharmacotherapy, 2004
To provide an overview of and critically appraise classifications of drug-related problems (DRPs)... more To provide an overview of and critically appraise classifications of drug-related problems (DRPs) for use during the pharmaceutical care process and research in pharmacy. A literature search was conducted using MEDLINE and Yahoo (January 2003) and manually. The search terms included DRP, drug-related problem, drug-therapy problem, and medicine-related problem. English- and German-language articles on pharmaceutical care and DRPs were reviewed. Most classifications of DRPs were identified through searching publications on pharmaceutical care and DRPs. Fourteen classifications with different focuses were found. Some classifications were hierarchical, categorized into main groups and subgroups. Various terminologies and definitions for DRPs were revealed, as well as guidelines for an optimal DRP classification. Classifications were assessed according to a clear definition, published validation method, and results reflecting process and outcomes, usability in pharmaceutical care practice, and a hierarchical structure with main groups and subgroups. Finding DRP classifications by computerized search of the biomedical literature with the help of PubMed proved to be difficult. No classification could be found that met all of our criteria for an optimal system. Few classifications have been validated. Three have been tested as to their usability in practice and internal consistency. The Pharmaceutical Care Network Europe system Version 4 comes closest to the defined requirements.
Pharmacy World & Science, 2010
Objective To investigate the provision of pharmaceutical care by community pharmacists across Eur... more Objective To investigate the provision of pharmaceutical care by community pharmacists across Europe and to examine the various factors that could affect its implementation. Methods A questionnaire-based survey of community pharmacies was conducted within 13 European countries. The questionnaire consisted of two sections. The first section focussed on demographic data and services provided in the pharmacy. The second section was a slightly adapted version of the Behavioral Pharmaceutical Care Scale (BPCS) which consists of three main dimensions (direct patient care activities, referral and consultation activities and instrumental activities). Results Response rates ranged from 10-71% between countries. The mean total score achieved by community pharmacists, expressed as a percentage of the total score achievable, ranged from 31.6 (Denmark) to 52.2% (Ireland). Even
Pharmacy world & science : PWS, 2000
The aim of this study was to investigate the outcomes of self-medication in patients suffering fr... more The aim of this study was to investigate the outcomes of self-medication in patients suffering from dyspepsia by comparing changes in the Health related Quality of Life before and after self-medication of dyspeptic disorders. Another study objective was the quantitative and qualitative analysis of the pharmacist's advice-giving to patients with dyspepsia. Therefore the impact of the counselling by the pharmacist on the patient's health outcomes was surveyed and compared between study and control pharmacies. Moreover, the study analysed the influence of a special training on the services provided by the pharmacies with regard to self-medication. A beneficial effect of self-medication on the HRQoL of patients with dyspepsia on a weekly basis has been detected in the study. There is evidence that advice-giving and counselling by the pharmacists in self-medication have a measurable impact on self-medication outcomes. Moreover, the study reveals that patients value the informatio...
International journal of clinical pharmacy, 2012
The well-being of patients with Parkinson's disease may be improved by pharmaceutical care in... more The well-being of patients with Parkinson's disease may be improved by pharmaceutical care in community pharmacies. To investigate the effects of standardised pharmaceutical care on health outcomes and quality of drug treatment in patients with Parkinson's disease. Community pharmacies in Germany. An open-label, multicentre, longitudinal, parallel-group study was conducted in outpatients with idiopathic Parkinson's disease who were receiving anti-parkinsonian medication. Patients were recruited by 32 community pharmacists (pharmacy group) and local offices of the German Parkinson's disease patients' association (comparison group). All patients were assessed at baseline and at 8 months' follow-up. In the intervening period, the pharmacists provided patients in the pharmacy group with standardised pharmaceutical care. Mean change in symptom-related impairment of health status, assessed using the 23-item Parkinson's Scale Total Score. In total 235 patients w...
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2012
To compare the effect of two types of counselling brochure on knowledge, attitudes and intention ... more To compare the effect of two types of counselling brochure on knowledge, attitudes and intention towards combined oral contraceptives (COCs). Double-blind, parallel-group randomised trial conducted in Germany. Nulliparous women aged 18-24 years were randomly assigned to receive one of two comprehensive information brochures about COCs, their benefits and risks, and alternative contraceptive methods. The first brochure was based on standard recommendations for evidence-based patient information (EBPI). This was restructured and adapted according to the mental models approach (MMA) for the second brochure. The primary endpoint was the change in number of correct answers in a knowledge questionnaire administered directly after the intervention and three months later. The impact on attitudes and intention were secondary outcomes. Before the intervention, women answered 18.9 (standard deviation [SD] 4.2) of 39 knowledge items correctly. After the intervention, the EBPI group (n = 66; p =...
International journal of clinical pharmacy, 2011
Although Parkinson's disease is a common disorder in the elderly, there have been very few st... more Although Parkinson's disease is a common disorder in the elderly, there have been very few studies of the role of the pharmaceutical care services in detecting and reducing problems associated with drug treatment in community settings. The aim of this study was therefore to investigate the type and frequency of drug-related problems identified in patients with Parkinson's disease by community pharmacists over an 8-month period and to assess the pharmaceutical service interventions, the type and frequency of intervention outcomes and the clinical benefits for the patients. Community pharmacies in Germany. Thirty-two community pharmacists recruited 113 outpatients with idiopathic Parkinson's disease who were receiving anti-Parkinsonian medication. Drug-related problems. A total of 331 drug-related problems were identified by the pharmacists. Patients not receiving a medication, despite the presence of an indication or symptom, accounted for the highest proportion of drug-r...
The European journal of contraception & reproductive health care : the official journal of the European Society of Contraception, 2011
This pilot study aimed at identifying counselling topics relevant to young women, at comparing th... more This pilot study aimed at identifying counselling topics relevant to young women, at comparing their perceived and actual knowledge about combined oral contraceptives (COCs), and at determining the appropriate scope of counselling material about benefits and risks of COCs. Thirty women aged 18-24 completed an online questionnaire assessing information needs and knowledge about 25 medical conditions under consideration as potential counselling items (benefits, risks and myths) and preferences about counselling material. Respondents were unable to identify non-contraceptive benefits of COCs or potential severe health risks and had some misconceptions. They rated their knowledge of specific COC effects significantly lower than their corresponding interest in the effect. In contrast, the assessment of how well participants felt they were informed about benefits and risks was rated predominantly as 'rather well'. Eleven items were identified as relevant to patients, the most rele...
Value in Health, 2001
Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year perio... more Abstracts study of 100 adult asthmatics. RESULTS: The table reports outcomes over a 10-year period. Results were driven by the impact of ICS on quality of life, rather than on mortality. Findings were stable over most input data ranges. However, at efficacy levels below 3% and toxicity rates greater than 2.9%, the cost-effectiveness estimate exceeded $100,000/QALY. CONCLUSION: Results suggest that inhaled steroids deliver good comparative value in mild-to-moderate adult asthma. More research is needed, however, on the impact of ICS toxicity on patient preferences.
Quality of Life Research, 2005
Background and objectives: Menopause is a physiological event occurring in women at about the age... more Background and objectives: Menopause is a physiological event occurring in women at about the age of 50. It signals the end of the reproductive years and is associated with signs of estrogen deficiency having a considerable impact on women's health-related quality of life (HRQoL). The most common form of treatment is hormone replacement therapy (HRT). Studies have shown negative events can arise from longterm use of HRT. The aim of this review is to determine if there are any HRQoL instruments that address the impact of menopausal symptoms including positive and negative effects of HRT. Methods: The following eight instruments were identified: Greene Climacteric Scale, Women's Health Questionnaire (WHQ), Qualifemme, Menopause-Specific QOL Questionnaire (MENQOL), Menopausal Symptoms List (MSL), Menopause Rating Scale (MRS), Menopausal Quality of Life Scale (MQOL), and the Utian Quality of Life Scale (UQOL). Results: All instruments reviewed proved to be reasonably structured and have their place in applied research. None were found that addressed all aspects of the impact of HRT on HRQoL. Conclusion: In order to capture the possible short-term side effects of HRT on HRQoL, it is necessary to modify one or more of the existing instruments or develop a new instrument applicable in many different countries and languages.
Psychology & Health, 2012
Communication regarding the benefits and risks of combined oral contraceptives (COCs) remains a c... more Communication regarding the benefits and risks of combined oral contraceptives (COCs) remains a challenge in view of persistent misconceptions about the 'pill'. The aim of this study was to investigate how women understand the benefits and risks of COCs, comparing their assessments with an expert model created from literature- and guideline-based research and reviewed by a sample of gynaecologists using the mental models approach. Two qualitative studies were conducted in Germany - a questionnaire-based study involving 30 gynaecologists with a mean of 218 COC prescriptions on average per month, and in-depth interviews (plus the use of a questionnaire) with 21 women aged 18-24 years. As expected, women reported only a few concepts of benefits and risks unprompted, but further prompting revealed beliefs of many other associations. The women stated an overall positive valence even if the number of negative concepts predominated indicating a latent cognitive dissonance. The major differences compared with the expert model included: (a) a negative association with weight gain, subfertility and teratogenicity, (b) only a partial association of COC intake with thromboembolic conditions, (c) a confusing, rather negative perception of a COC-related effect on cancer and (d) a partial lack of basic knowledge of the active ingredients, time to excretion and mode of action of COCs. Appropriate COC counselling should cover these discrepancies.
Pharmacoepidemiology and Drug Safety, 2007
Purpose There is currently a lack of detailed information concerning drug related problems in the... more Purpose There is currently a lack of detailed information concerning drug related problems in the outpatient treatment of Parkinson's disease. Methods Problems associated with drug treatment communicated anonymously in Parkinson's disease online forums were therefore retrospectively searched and documented for 1 year. Results Based on postings concerning 12 drugs for the treatment of Parkinson's disease, a total of 238 drug related problems were identified and categorised using the Problem Intervention Documentation (PI-Doc). Of these, 153 were adverse drug reactions. Adverse drug reactions associated with the skin were relatively common, but central effects such as cognitive or psychiatric changes, effects on the sleep/waking system and other problems like headache and dizziness accounted for the highest percentage of adverse events. A comparison with data from scientific literature revealed a number of differences. This means that an analysis of online forums detected a number of drug related problems that were otherwise largely invisible. These were mainly associated with the qualitative aspects of treatment such as medication handling, dosage and individual problems concerning adverse events. In addition, the described method of identifying and classifying drug related problems in Internet forums may also be seen as a contribution to the international discussion about consumer reports and pharmacovigilance. The information about adverse drug reactions given by Internet users can be seen as a valuable adjunct to clinical trial data and as being very timely with regard to the event itself. Conclusion Online forums may be considered as a suitable source of observational information to complement data from randomised clinical trials.
Neuropsychiatric Disease and Treatment, 2011
Implementation of guidelines can improve clinical practice. The aim in this study was to investig... more Implementation of guidelines can improve clinical practice. The aim in this study was to investigate whether neurologists in Germany adhered to the national Parkinson's disease guideline. Data were obtained from a cross-sectional survey of 60 neurologists. Analyses were performed on 320 patients with idiopathic Parkinson's disease with either low grades of functional impairment (Hoehn and Yahr stage I) or higher grades of functional impairment (stage II-V) but without motor complications. The sample was divided into four groups depending on age and grade of functional impairment. For each group, a biometric parameter on the use of dopamine agonists and L-dopa was defined based on the guideline. In patients aged ,70 years, the recommendation to use dopamine agonists without L-dopa (parameter 1) was observed in 53% of patients with lower grades of functional impairment, whilst recommended use of dopamine agonists in more functionally impaired patients (parameter 2) was followed to a greater extent (84%). In patients aged $70 years, recommendations to use L-dopa without dopamine agonists were adhered to in only 50% of less functionally impaired (parameter 3) and 52% of more functionally impaired (parameter 4) patients. In conclusion, our results indicated there was moderate but not full adherence to the guideline.
Epilepsy Research, 2011
Purpose: To obtain better understanding of the effect of lacosamide (LCM) in clinical practice, l... more Purpose: To obtain better understanding of the effect of lacosamide (LCM) in clinical practice, laboratory and clinical data of 17 patients under treatment with LCM as an add-on antiepileptic drug (AED) were retrospectively evaluated. Methods: Total LCM serum concentrations were obtained at hourly intervals for up to 5 h and 8 h after morning dose. Adverse drug reactions (ADR) were assessed. Results: LCM serum concentrations showed high fluctuations during the day with a steep increase within the first 3 h after intake (mean 87.8%; range: 44.4-149.0%) under b.i.d. Mean trough and peak concentrations of LCM were 5.0 g/ml (range: 1.8-9.5 g/ml) and 9.7 g/ml (range: 4.0-18.3 g/ml), respectively; mean dose 353 mg/d (range: 200-600 mg/d). Twelve patients showed ADRs. After conversion to t.i.d. or dose reduction LCM serum concentration showed lower fluctuations during the day and a lower increase after intake (mean: 50.0%, range: 27.1-66.7%); peak LCM was 9.4 g/ml (range: 4.7-11.6 g/ml), mean dose 388 mg/d (range: 300-500 mg/d). These interventions led to amelioration of the ADR. Conclusion: Changing the dose regimen from two to three times daily could reduce fluctuations of LCM during the day and improve tolerability of LCM in patients with ADR.
Annals of Pharmacotherapy, 2004
Una clasificación de los PRMs en atención farmacéutica no permite ni valorar las actividades que ... more Una clasificación de los PRMs en atención farmacéutica no permite ni valorar las actividades que ha realizado el farmacéutico ni destinar los recursos necesarios para dicha actividad. Por tanto, es necesaria una clasificación de la gravedad de los PRMs.
Annals of Pharmacotherapy, 2004
To provide an overview of and critically appraise classifications of drug-related problems (DRPs)... more To provide an overview of and critically appraise classifications of drug-related problems (DRPs) for use during the pharmaceutical care process and research in pharmacy. A literature search was conducted using MEDLINE and Yahoo (January 2003) and manually. The search terms included DRP, drug-related problem, drug-therapy problem, and medicine-related problem. English- and German-language articles on pharmaceutical care and DRPs were reviewed. Most classifications of DRPs were identified through searching publications on pharmaceutical care and DRPs. Fourteen classifications with different focuses were found. Some classifications were hierarchical, categorized into main groups and subgroups. Various terminologies and definitions for DRPs were revealed, as well as guidelines for an optimal DRP classification. Classifications were assessed according to a clear definition, published validation method, and results reflecting process and outcomes, usability in pharmaceutical care practice, and a hierarchical structure with main groups and subgroups. Finding DRP classifications by computerized search of the biomedical literature with the help of PubMed proved to be difficult. No classification could be found that met all of our criteria for an optimal system. Few classifications have been validated. Three have been tested as to their usability in practice and internal consistency. The Pharmaceutical Care Network Europe system Version 4 comes closest to the defined requirements.
Pharmacy World & Science, 2010
Objective To investigate the provision of pharmaceutical care by community pharmacists across Eur... more Objective To investigate the provision of pharmaceutical care by community pharmacists across Europe and to examine the various factors that could affect its implementation. Methods A questionnaire-based survey of community pharmacies was conducted within 13 European countries. The questionnaire consisted of two sections. The first section focussed on demographic data and services provided in the pharmacy. The second section was a slightly adapted version of the Behavioral Pharmaceutical Care Scale (BPCS) which consists of three main dimensions (direct patient care activities, referral and consultation activities and instrumental activities). Results Response rates ranged from 10-71% between countries. The mean total score achieved by community pharmacists, expressed as a percentage of the total score achievable, ranged from 31.6 (Denmark) to 52.2% (Ireland). Even