Abstract:
BACKGROUND:Community pharmacists are well positioned to support patients' minor ailments. The objective was to evaluate the clinical and humanistic impact of a minor ailment service (MAS) in community pharmacy compared with usual pharmacist care (UC). METHODS:A cluster randomised controlled trial was conducted. Intervention patients received MAS, which included a consultation with the pharmacist. MAS pharmacists were trained in clinical pathways and communication systems mutually agreed with general practitioners and received monthly support. Control patients received UC. All patients were followed up by telephone at 14 days. Clinical and humanistic impact were defined by primary (appropriate referral rate and appropriate non-prescription medicine rate) and secondary outcomes (clinical product-based intervention rate, referral adherence, symptom resolution, reconsultation and EuroQol EQ-5D visual analogue scale (VAS)). RESULTS:Patients (n=894) were recruited from 30 pharmacies and 82% (n=732) responded to follow-up. Patients receiving MAS were 1.5 times more likely to receive an appropriate referral (relative rate (RR)=1.51; 95% CI 1.07 to 2.11; p=0.018) and were five times more likely to adhere to referral, compared with UC (RR=5.08; 95%CI 2.02 to 12.79; p=0.001). MAS patients (94%) achieved symptom resolution or relief at follow-up, while this was 88% with UC (RR=1.06; 95% CI 1 to 1.13; p=0.035). MAS pharmacists were 1.2 times more likely to recommend an appropriate medicine (RR 1.20, 95% CI 1.1 to 1.3; p=0.000) and were 2.6 times more likely to perform a clinical product-based intervention (RR=2.62, 95% CI 1.28 to 5.38; p=0.009), compared with UC. MAS patients had a greater mean difference in VAS at follow-up (4.08; 95% CI 1.23 to 6.87; p=0.004). No difference in reconsultation was observed (RR=0.98; 95% CI 0.75 to 1.28; p=0.89). CONCLUSION:The study demonstrates improved clinical and humanistic outcomes with MAS. National implementation is a means to manage minor ailments more effectively in the Australian health system. TRIAL REGISTRATION NUMBER:ACTRN12618000286246.
journal_name
BMJ Qual Safjournal_title
BMJ quality & safetyauthors
Dineen-Griffin S,Benrimoj SI,Rogers K,Williams KA,Garcia-Cardenas Vdoi
10.1136/bmjqs-2019-010608subject
Has Abstractpub_date
2020-11-01 00:00:00pages
921-931issue
11eissn
2044-5415issn
2044-5423pii
bmjqs-2019-010608journal_volume
29pub_type
杂志文章abstract::This paper aims to draw attention to the social and micropolitical dimensions of attempting to implement improvements within healthcare organisations. It is argued that quality improvement initiatives, like other forms of organisational innovation, will fail unless they are conceived and implemented in such a way as t...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2010.046482
更新日期:2011-04-01 00:00:00
abstract:OBJECTIVE:Hospital care comprises nearly a third of US healthcare expenditures. Fifteen to 20 per cent of this spending is considered to be potentially preventable. Risk prediction models have suboptimal accuracy and typically exclude patient experience data. No studies have explored patient perceptions of the likeliho...
journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-000945
更新日期:2013-06-01 00:00:00
abstract:AIM:To evaluate the effectiveness of a 'Do not interrupt' bundled intervention to reduce non-medication-related interruptions to nurses during medication administration. METHODS:A parallel eight cluster randomised controlled study was conducted in a major teaching hospital in Adelaide, Australia. Four wards were rando...
journal_title:BMJ quality & safety
pub_type: 杂志文章,随机对照试验
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abstract:OBJECTIVES:In order to improve its quality-assurance programme based on ISO 9001, the Central Sterile Supply Department of a public university hospital has performed a prospective risk analysis using the Preliminary Risk Analysis method (PRA). The objectives were the achievement of a global risk mapping related to the ...
journal_title:BMJ quality & safety
pub_type: 杂志文章
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abstract:BACKGROUND:Outcome benefits of using the WHO Surgical Safety Checklist rely on compliance with checklist administration. OBJECTIVE:To evaluate engagement of operating room (OR) subteams (anaesthesia, surgery and nursing), and compliance with administering checklist domains (Sign In, Time Out and Sign Out) and checklis...
journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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更新日期:2019-01-01 00:00:00
abstract:BACKGROUND:Patient and family engagement (PFE) in healthcare is an important element of the transforming healthcare system; however, the prevalence of various PFE practices in the USA is not known. OBJECTIVE:We report on a survey of hospitals in the USA regarding their PFE practices during 2013-2014. RESULTS:The resp...
journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2015-004839
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abstract:BACKGROUND:Recent research suggests that hospital rates of postoperative venous thromboembolism (VTE) are subject to surveillance bias: the more hospitals 'look for' VTE, the more VTE they find. However, little is known about what drives variation in hospital VTE imaging rates. We conducted an observational study to ex...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2014-003150
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Interest in human factors has increased across healthcare communities and institutions as the value of human centred design in healthcare becomes increasingly clear. However, as human factors is becoming more prominent, there is growing evidence of confusion about human factors science, both anecdotally and ...
journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-001450
更新日期:2013-10-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs.2010.047159
更新日期:2011-04-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2020-01-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
doi:10.1136/bmjqs-2012-001011
更新日期:2013-05-01 00:00:00
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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journal_title:BMJ quality & safety
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更新日期:2012-12-01 00:00:00
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更新日期:2015-03-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2020-04-01 00:00:00
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journal_title:BMJ quality & safety
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更新日期:2015-12-01 00:00:00
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journal_title:BMJ quality & safety
pub_type: 杂志文章
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更新日期:2013-08-01 00:00:00
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journal_title:BMJ quality & safety
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更新日期:2011-08-01 00:00:00
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更新日期:2011-11-01 00:00:00
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更新日期:2020-11-01 00:00:00
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journal_title:BMJ quality & safety
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更新日期:2019-11-01 00:00:00