Denise Hansford

A classification system for issues identified in pharmaceutical care practice

Objective — To investigate the usefulness of a system for classifying pharmaceutical care issues (PCIs), defined in Scottish practice guidelines as “an element of a pharmaceutical need which is addressed by the pharmacist,” which were identified during the delivery of pharmaceutical care in a primary care setting.

Enzymatic synthesis and evaluation of new novel ω-pentadecalactone polymers for the production of biodegradable microspheres

Two novel co-polymers based on ω-pentadecalactone were enzymatically synthesized by a combination of ring-opening polymerization and polycondensation. Modified literature procedures enabled the production of the semi-crystalline materials with suitable molecular weights and melting characteristics. Microspheres were produced using an emulsion solvent evaporation method over a range of variables including manufacturing temperature, stirring speed and duration, surfactant concentration, continuous and disperse phase volume and polymer amount to establish how each variable affected the morphological characteristics of the microspheres. Results demonstrated that changes in emulsion viscosity influenced microsphere size. For polymer SH-L333, the microsphere surface was either smooth or porous depending on the manufacturing temperature used. For polymer SH-L334 the microsphere surface was rough or porous regardless of manufacturing temperature. This was possibly due to several combined factors including molecular weight and the greater hydrophilic nature of SH-L334. These new polymers have the potential for the manufacture of drug-loaded biodegradable microspheres for modified release drug delivery.

Preparation and evaluation of microspheres prepared from novel polyester-ibuprofen conjugates blended with non-conjugated ibuprofen

A novel polyester, poly(glycerol-adipate-co-ω-pentadecalactone) (PGA-co-PL), was conjugated with a model drug, ibuprofen, through the free hydroxyl groups of the former and the free carboxyl group of the latter at various levels of substitution. The conjugated material was processed into microspheres by both emulsion solvent evaporation and spray-drying methods. Samples of conjugated material were also blended with non-conjugated drug and the microspheres produced were evaluated by various methods. Morphologically, the microspheres produced were satisfactory. However, there was some initial burst drug release from all samples, probably due to the presence of non-conjugated drug. Subsequent drug release was very slow due to the relative stability of the covalent bonding of the drug–polyester conjugate. Stability tests showed that storage at high relative humidity resulted in increased burst release.

Synthesis and Evaluation of Novel Polyester-Ibuprofen Conjugates for Modified Drug Release

Ibuprofen was conjugated at different levels to a novel polyester, poly(glycerol-adipate-co-ω-pentadecalactone) (PGA-co-PL), via an ester linkage to form a prodrug. The conjugates were characterized by differential scanning calorimetry (DSC), nuclear magnetic resonance (NMR), infrared (IR), gel permeation chromatography (GPC), ultraviolet (UV), and high-performance liquid chromatography (HPLC). The conjugates had a molecular weight between 18 and 24 kDa, and there was a suppression of the free hydroxyl groups within the conjugated polymer. DSC scans showed a lowering of the melting point (Tm) when compared with the polyester alone and a difference in the number and area of Tm peaks. Drug release studies showed an initial burst release (13–18%) followed thereafter by very slow release (maximum 35% after 18 days). Continuous work may produce ester-linked conjugates that are sufficiently labile to allow for complete release of ibuprofen over the time period studied.

Community pharmacists' views, attitudes and early experiences of over-the-counter simvastatin.

AimTo describe community pharmacists’ views, attitudes and early experiences of OTC simvastatin.MethodA cross-sectional postal questionnaire survey of the main pharmacist in 2000 randomly selected community pharmacy premises in Great Britain (approximately 15%).Main outcome measureThe questionnaire comprised items on: attitudes to OTC simvastatin; continuing education; sales; and general views and experiences. Data were analysed using descriptive statistics and content analysis of responses to open questions.ResultsQuestionnaires were returned by 1,156 community pharmacists (57.8%). Nine hundred and fifty-six respondents (82.7%) reported no sales of simvastatin in the previous fourteen days. Eighty-two (7.1%) sold one pack, 40 (3.5%) sold two packs and 18 (1.6%) sold three packs or more (60 did not answer). Almost all respondents (1,086, 93.9%) stated that they had participated in continuing education. Most (691/1,148, 60.1%) strongly agreed or agreed that they were entirely confident about selling simvastatin and that community pharmacists could make an appropriate risk assessment for the use of simvastatin (898/1,149, 78.2%). Responses to the open question identified a number of themes including: need for access to clinical information; cost as a barrier to supply; those purchasing were least likely to benefit; and the lack of an evidence base for the OTC dose.ConclusionCommunity pharmacists surveyed had undertaken an array of continuing education and felt confident to undertake cardiovascular risk assessment. However, very few sales of OTC simvastatin had been made and a variety of issues were identified, particularly relating to the evidence base, access to clinical information, cost and the product licence.

Are customers requesting medicines by name less likely to be advised or referred? Provision of over-the-counter H2-receptor antagonists and alginate products from pharmacies

Objectives To identify selected factors which may influence the provision of over‐the‐counter alginate and H2‐receptor antagonist (H2RA) products, advice and referral from community pharmacies, and to establish if referrals of customers with dyspepsia made by pharmacy staff were in line with published referral guidelines.

Is hospital admission a sufficiently sensitive outcome measure for evaluating medication review services? A descriptive analysis of admissions within a randomised controlled trial

Objective The aims of the study were: to describe and assess hospital admissions occurring during a randomised controlled trial (RCT) of a pharmacist‐led medication review service; to describe the admissions in terms of emergency status and main cause; to estimate the potential contribution of pharmaceutical care issues (PCIs) to admission; and to assess the proportion of admissions that could be influenced by a pharmacist intervention.

Medication compliance devices in primary care: activities of community-based nurses

Objective — To investigate the workload, training and views of community‐based nurses in relation to medication compliance devices.

Effect of incentives on recruitment and response rate in a community-based pharmacy practice study

Objectives — To study the feasibility of carrying out a community pharmacy‐based drug utilisation study of H2 antagonists and alginate‐containing preparations, and to study the effect of two methodological variations — payment of pharmacists and the free issue of medicines — on recruitment rates and response rates.

Exploring opportunities for providing pharmacists with feedback on their practice and performance around the electronic Minor Ailments Service in Scotland.

The electronic Minor Ailments Service (e‐MAS), implemented in all community pharmacies in Scotland since 2006, allows pharmacists to manage minor ailments at no charge to patients including provision of medication, advice or referral. E‐MAS is supported through an electronic network, ‘E‐pharmacy’, which is managed by National Health Service Scotland. E‐pharmacy has the capacity to remotely record e‐MAS activities, such as details of medicines supply and patient registration allowing provision of feedback to community pharmacies.