Jeanine K. Mount

Nursing Home Resources and Tranquilizer Use among the Institutionalized Elderly

Objective. To examine the relationship between selected resident and facility characteristics and the frequency and quality of tranquilizer prescribing and use in skilled nursing facilities.

Chronic Benzodiazepine Use in Nursing Homes: Effects of Federal Guidelines, Resident Mix, and Nurse Staffing

OBJECTIVES: To assess the overall prescribing and chronic use of benzodiazepines (BZs) in nursing homes before and after implementation of BZ guidelines by the Health Care Finance Administration (HCFA). A second aim was to identify facility predictors of BZ prescribing and chronic use after guideline implementation.

Evaluation of written prescription information provided in community pharmacies: a study in eight states.

OBJECTIVES To develop three tools for assessing the quality of written information provided with new prescriptions in community pharmacies and to identify pharmacy, pharmacist, and patient characteristics associated with the dissemination and quality of that information. DESIGN Observational study. Regression techniques were used to analyze the influence of pharmacy, pharmacist, and shopper (acting as patient) characteristics on outcome measures. PARTICIPANTS Trained shoppers (acting as patients) visited 306 randomly selected pharmacies in 8 states. Each shopper presented three prescriptions, answered questions according to a standard scenario, accepted the information offered, and paid for the prescriptions. MAIN OUTCOME MEASURES Percentage of shoppers receiving any written information; quality of written information as judged by an expert panel using explicit criteria. RESULTS Shoppers received an information leaflet with 87% of the 918 prescriptions dispensed. Although most leaflets provided unbiased information, leaflet length and quality of information varied greatly. A majority of leaflets did not include adequate information about contraindications, precautions, and how to avoid harm. Shoppers were more likely to receive leaflets in chain pharmacies and pharmacies with more staff. Information quality also was higher in chain pharmacies. Shopper and pharmacist demographic characteristics were unrelated to the level or quality of written information after controlling for other factors. CONCLUSION The provision of patient leaflets is becoming a routine practice in the states studied. However, most leaflets do not meet quality criteria. It is important for pharmacists to become familiar with criteria for evaluating these leaflets and to take necessary action to improve their quality.

Community pharmacy involvement in vaccine distribution and administration.

This study identified the type and number of doses of vaccine purchased, distributed, and administered in community pharmacies. Telephone interviews were conducted with 1704 community pharmacies in 17 states (response rate=69.1%). The 17-state population-level projections reveal that about 10% of hepatitis A, hepatitis B, meningococcal, MMR, and tetanus-containing vaccines for adults were administered in pharmacies and 90% were distributed to other sources for administration during July 2004-June 2005. Further, 24.1% of diphtheria-tetanus-pertussis for children (DTaP), 30.4% of influenza, 36.2% of pneumococcal polysaccharide, and 68.1% of travel vaccines in pharmacy inventory were administered in pharmacies, while the rest of vaccine doses were distributed to other immunizers.