Nature and frequency of prescription modifications in community pharmacies: A nationwide study in the Netherlands.

Aims: To investigate the nature and frequency of prescription modifications in Dutch community pharmacies.

Methods: In this cross-sectional study, Dutch community pharmacists documented prescription modifications in their pharmacy during 1 predetermined day. Pharmacists from all Dutch community pharmacies were invited to participate.

Alignment of CanMEDS-based Undergraduate and Postgraduate Pharmacy Curricula in The Netherlands.

In this article the design of three master programs (MSc in Pharmacy) and two postgraduate specialization programs for community or hospital pharmacist is described. After a preceding BSc in Pharmacy, these programs cover the full pharmacy education capacity for pharmacists in primary and secondary health care in the Netherlands. All programs use the CanMEDS framework, adapted to pharmacy education and specialization, which facilitates the horizontal integration of pharmacists' professional development with other health care professions in the country.

The effect of smear layer on bacterial penetration through roots obturated using zinc oxide eugenol-based sealer.

Background: Smear layer removal has been shown to reduce bacterial penetration through root canal obturations when resin-based endodontic sealer is used. The purpose of this in vitro study was to test this effect when a non-resin-based sealer is used.

Material And Methods: Thirty root segments were assigned to the following groups: Smear layer removed (n = 8); smear layer retained (n = 8); negative controls (n = 10; 5 with smear layer, 5 without); and positive controls (n = 4; 2 with smear layer, 2 without).

Development of a Postgraduate Community Pharmacist Specialization Program Using CanMEDS Competencies, and Entrustable Professional Activities.

To develop and implement a postgraduate, workplace-based curriculum for community pharmacy specialists in the Netherlands, conduct a thorough evaluation of the program, and revise any deficiencies found. The experiences of the Dutch Advisory Board for Postgraduate Curriculum Development for Medical Specialists were used as a guideline for the development of a competency-based postgraduate education program for community pharmacists. To ensure that community pharmacists achieved competence in 10 task areas and seven roles defined by the Canadian Medical Education Directions for Specialists (CanMEDS), a two-year workplace-based curriculum was built.

Missed drug therapy alerts as a consequence of incomplete electronic patient records in Dutch community pharmacies.

Background: Complete and up-to-date medical and pharmaceutical information in the electronic patient record (EPR) is a prerequisite for risk management in community pharmacy.

Objectives: To analyze which information is missing in the EPR and which drug therapy alerts, therefore, fail to appear.

Methods: Pharmacy students selected patients who were dispensed a prescription drug and enlisted for >3 months in the participating pharmacies.

NSAID-antihypertensive drug interactions: which outpatients are at risk for a rise in systolic blood pressure?

Background: Management guidelines for drug-drug interactions between non-steroidal anti-inflammatory drugs (NSAIDs) and antihypertensives recommend blood pressure monitoring in hypertensive patients. We measured the short-term effect of initiating NSAIDs on systolic blood pressure (SBP) in users of antihypertensives, aiming to investigate which outpatients are at risk for an increase in SBP in daily clinical practice.

Design: A cohort study with a nested case-control design in Dutch community pharmacies.

Clarity and applicability of drug-drug interaction management guidelines: a systematic appraisal by general practitioners and community pharmacists in the Netherlands.

Background: Despite the availability and daily use of computerized drug-drug interaction surveillance systems, exposure to potentially relevant drug-drug interactions (DDIs) continues. DDI management guidelines are often inadequate and clear management options are lacking, which attributes to overriding of DDI signals. Although general criteria for the development and reporting of high-quality clinical practice guidelines have been identified, it appears these have not yet been applied to DDI management guidelines.

Documentation quality in community pharmacy: completeness of electronic patient records after patients' first visits.

Background: When patients visit a community pharmacy for the first time, the creation of an electronic patient record (EPR) with relevant and up-to-date data is a prerequisite for adequate medication surveillance and patient counseling.

Objective: To investigate the level of completeness of documentation in the EPR after a patient's first visit to a Dutch community pharmacy.

Methods: In each participating pharmacy, newly enlisted (<3 mo) patients to whom at least one medication had been dispensed were enrolled in this survey.

Prevalence and determinants of pharmacy shopping behaviour.

Background And Objective: Discontinuity of care bears the risk of medication errors and poor clinical outcomes. Little is known about the continuity of care related to pharmacies. Therefore, we studied the prevalence and determinants of pharmacy shopping behaviour in the Netherlands.

Compliance with national guidelines for the management of drug-drug interactions in Dutch community pharmacies.

Background: Pharmacists contribute to the detection and prevention of drug therapy-related problems, including drug-drug interactions. Little is known about compliance with pharmacy practice guidelines for the management of drug-drug interaction alerts.

Objective: To measure the compliance of community pharmacists with Dutch guidelines for the management of drug-drug interactions and to determine patient- and prescriber-related determinants for noncompliance.

Clinical risk management in Dutch community pharmacies: the case of drug-drug interactions.

Background: The prevention of drug-drug interactions requires a systematic approach for which the concept of clinical risk management can be used. The objective of our study was to measure the frequency, nature and management of drug-drug interaction alerts as these occur in daily practice of Dutch community pharmacies.

Methods: In total, 63 Dutch pharmacies collected all drug-drug interaction alerts during 153 research days (on average 2.

Drug related problems identified by European community pharmacists in patients discharged from hospital.

Introduction: Drug related problems (DRPs) are perceived to occur frequently when patients are discharged from the hospital. Community pharmacists' interventions to detect, prevent and solve DRPs in this population are scarcely studied.

Objective: To examine the nature and frequency of DRPs in community pharmacies among patients discharged from hospitals in several countries, and to examine several variables related to these drug related problems.

Evaluation of the clinical value of pharmacists' modifications of prescription errors.

Aims: Our objective was to examine the clinical value of pharmacists' interventions to correct prescription errors.

Methods: In this study, we reviewed a random sample of prescriptions that had been modified in pharmacies. These prescriptions were collected on one predetermined day between 25th February and 12th March 1999 from 141 Dutch community pharmacies.

Reduction in the therapeutic intensity of abortive migraine drug use during ACE inhibition therapy--a pilot study.

Introduction: Since a few case reports have demonstrated some beneficial effects of angiotensin converting enzyme (ACE) inhibitors in migraine prevention, we were interested in studying the impact of ACE inhibitors and angiotensin II receptor antagonists (Ang II) on the consumption of specific abortive migraine drugs and, therefore, indirectly on the frequency of migraine attacks.

Methods: Data from a large prescription database involving 95 patients initiating a specific abortive migraine drug (ergotamine or a triptan) and subsequently treated with either an ACE inhibitor or angiotensin receptor antagonist (index group: ACE/Ang II) or diuretic (reference group) were analysed. The effects of ACE/Ang II inhibition as well as diuretic therapy on reducing the frequency of migraine attacks were assessed by measuring the mean consumption of abortive migraine drug use, in DDDs per month ('therapeutic intensity'), before, during and after ACE/Ang II or diuretic therapy.

Determinants for successful smoking cessation with bupropion in daily practice.

Objective: To describe the patterns of use of bupropion in daily clinical practice and factors which determine successful smoking cessation.

Methods: Retrospective follow-up study in 36 pharmacies in the Netherlands. Patients who received at least one prescription for bupropion between January and April, 2000 were included.

Incidence and determinants of antidepressant drug use in migraine patients.

The purpose of this retrospective, follow-up study was to characterise the use of antidepressant medication in a defined migraine population and evaluate the determinants thereof. Data was obtained from the PHARMO-RLS prescription database. Our migraine population (2,517 people) included patients having commenced specific migraine drugs, ergotamine or sumatriptan, for the first time from January 1 1992 to December 31 1998.

Drug therapy for prevention of recurrent myocardial infarction.

Objective: To provide an evidence-based overview of drug treatment for long-term secondary prevention of myocardial infarction (MI).

Data Sources: We conducted searches of MEDLINE (1966-August 2002), the Cochrane Controlled Trial Register, and the reference list of each identified study.

Study Selection/data Extraction: Trials and meta-analyses were included using the following criteria: (1) randomized trials, (2) description of identification procedure, inclusion criteria, outcome measures, and statistical methods, (3) confirmed MIs, (4) treatment continued for at least 1 month, and (5) all-cause mortality as primary outcome; other events as secondary outcomes.

Migraine prophylactic medication usage patterns in The Netherlands.

This study aims to investigate usage patterns of specific migraine prophylactic medications in ergotamine and triptan patients commencing this treatment for the first time during 1 January 1992 until 31 December 1998. Usage patterns of specific migraine prophylactic drugs were evaluated for each patient by accessing data from a large prescription database and were characterized as continued, switch or stop use during the patient observation period. Several patient and medication-related factors were explored in order to identify a possible relationship with the specific usage pattern defined.

Single use of sumatriptan: a patient interview study.

Objective: To investigate the possible reasons associated with the use of a single prescription of sumatriptan.

Background: A few population-based studies concerning the usage patterns of sumatriptan have revealed a relatively high incidence (approximately 40%) of sumatriptan users who utilize only a single prescription of the drug.

Design And Methods: Using automated prescription data from 11 community pharmacies, we identified single and multiple sumatriptan prescription recipients.

Incidence and determinants of migraine prophylactic medication in the Netherlands.

Objective: To estimate and examine the incidence and determinants of initiation of migraine-prophylactic therapy as well as the corresponding drug of choice over a period of 5 years following the use of specific abortive migraine drugs.

Methods: By accessing data from a large prescription database, an identification of patients treated with ergotamine or a triptan from 1 January 1994 to 31 December 1998 was made. The cumulative incidence of initiation of migraine-prophylactic drugs (beta-blockers, serotonin antagonists, specific calcium antagonists, amitriptyline, clonidine and valproic acid) was estimated in patients following the use of ergotamine or a triptan.

Laxative prescribing in relation to opioid use and the influence of pharmacy-based intervention.

Introduction: Opioid-induced constipation is a common problem and can cause serious complications. It is widely advised that laxatives should be started concurrently with opiates, unless there is a clear indication not to do so.

Objective: This study was undertaken to estimate how often laxatives were started concurrently with opiates and to describe the effect of pharmacy-based interventions to promote the use of laxatives in patients starting opioids.

Reduction in the intensity of abortive migraine drug use during coumarin therapy.

Objective: To investigate the impact of coumarin therapy on migraine attack frequency.

Background: Sporadic case reports and clinical studies have described beneficial effects of coumarin therapy on migraine severity.

Design And Methods: A retrospective follow-up study based on a prescription database covering a population of 450 000 was conducted.