Objective: Product Information Leaflets (PILs) are an important source of information for patients on their medication, but may cause confusion and questions. Patients then may seek clarification, for instance from pharmacy technicians. The aim of this study was to explore which questions pharmacy technicians get about PIL-related issues, why and when, and how they handle such questions. Methods: an online survey in a panel of 785 Dutch pharmacy technicians. Key results: Net response rate was 37%. PIL-related questions frequently concerned drug actions, problems with use, side effects, intolerances and pregnancy and lactation. Patients who received generic alternatives instead of the branded product they had received previously, also came more often to pharmacy staff with PIL-related questions. The requested information could not always be found in the PIL itself, not even by the pharmacy technicians themselves. They mentioned that the PIL is not easy to read, understand or recall. Conclusions: Pharmacy staff is often approached by patients having difficulties in understanding PILs. Even pharmacy technicians find PILs difficult to read and often use other sources of information. PIL layout and contents should become more standardized and easier to read and understand.
Alliance has been shown to predict treatment outcome in family-involved treatment for youth problems in several studies.However, meta-analytic research on alliance in family-involved treatment is scarce, and to date, no meta-analytic study on the alliance–outcome association in this field has paid attention to moderating variables. We included 28 studies reporting on the alliance–outcome association in 21 independent study samples of families receiving family-involved treatment for youth problems (N= 2126 families,Mage youth ranging from 10.6 to 16.1). We performed three multilevel meta-analyses of theassociations between three types of alliance processes and treatment outcome, and of several moderator variables. The quality of the alliance was significantly associated with treatment outcome (r= .183,p< .001). Correlations were significantly stronger when alliance scores of different measurement moments were averaged or added, when families were help-seekingrather than receiving mandated care and when studies included younger children. The correlation between alliance improvement and treatment outcome just failed to reached significance (r= .281,p= .067), and no significant correlation was found between split alliances and treatment outcome (r= .106,p= .343). However, the number of included studies reporting onalliance change scores or split alliances was small. Our findings demonstrate that alliance plays a small but significant role in the effectiveness of family-involved treatment. Future research should focus on investigating the more complex systemic aspects of alliance to gain fuller understanding of the dynamic role of alliance in working with families
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from Narcis.nl: "Background: Introducing a post-discharge community pharmacist home visit can secure continuity of care and prevent drug-related problems. Currently, this type of pharmaceutical care is not standard practice and implementation is challenging. Mapping the factors influencing the implementation of this new form of care is crucial to ensure successful embedding. Objective: To explore which barriers and facilitators influence community pharmacists' adoption of a post-discharge home visit. Methods: A mixed methods study was conducted with community pharmacists who had recently participated in a study that evaluated the effectiveness of a post-discharge home visit in identifying drug-related problems. Four focus groups were held guided by a topic guide based on the framework of Greenhalgh et al. After the focus groups, major barriers and facilitators were formulated into statements and presented to all participants in a scoring list to rank for relevance and feasibility in daily practice. Results: Twenty-two of the eligible 26 pharmacists participated in the focus groups. Twenty pharmacists (91%) returned the scoring list containing 21 statements. Most of these statements were perceived as both relevant and feasible by the responding pharmacists. A small number scored high on relevance but low on feasibility, making these potential important barriers to overcome for broad implementation. These were the necessity of dedicated time for performing pharmaceutical care, implementing the home visit in pharmacists' daily routine and an adequate reimbursement fee for the home visit. Conclusions: The key to successful implementation of a post-discharge home visit may lay in two facilitators which are partly interrelated: changing daily routine and reimbursement. Reimbursement will be a strong incentive, but additional efforts will be needed to reprioritize daily routines."
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