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Effectiveness of patient drug record plans : An evaluation Waller, Ronald Henry

Abstract

An evaluation was undertaken to determine the effectiveness of patient record plans which had been in use in two community pharmacies for periods of 6 and 9 years. A retrospective study of potential tetracycline interactions demonstrated that, numerically, the nonprescription drugs represented the greatest potential danger. Although in the past, non-prescription medications were not routinely recorded, it is concluded that both prescribed and non-prescribed drugs should be entered on patient record charts and screened for potential interactions. The routine recording and screening of patient allergies and disease states on the patient record plan was shown to be of value in several instances in one pharmacy. A comparison of drug sensitivities 'flagged' on pharmacy records and physician's records showed that the pharmacist often had on record more allergies than did the physician. Using the patient record plan to determine the theoretical time of the last dose of an antibiotic, two surveys were undertaken to determine if a written reinforcement of verbal instructions and patient involvement in a follow-up interview could help improve self-administration habits in ambulatory patients. It was found that more patients did, in fact, follow, their dosage regimen and fewer patients discontinued their course of therapy without justification. Seventeen steps were defined in a dispensing procedure used in one of the pharmacies operating with a patient record plan. These could be further divided into those functions which could be performed by a non-professional assistant and those which were to be done only by a pharmacist. The time required for the individual pharmacist to perform all 17 steps was compared to the time required for a (pharmacist and non-professional assistant) team to do the same functions. Pharmacist time per prescription appeared to be reduced 40 to 50% by the team approach.

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