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Objectives To investigate older patient, physician and pharmacist perspectives about the pharmacists’ role in pharmacist-patient interactions. Methods Design Eight focus group discussions. Settings Senior centers, community pharmacies, primary care physician offices. Participants Forty-two patients aged 63 and older, 17 primary care physicians, and 13 community pharmacists. Measurements Qualitative analysis of focus group discussions. Results Participants in all focus groups indicated that pharmacists are a good resource for basic information about medications. Physicians appreciated pharmacists’ ability to identify drug interactions, yet did not comment on other specific aspects related to patient education and care. Physicians noted that pharmacists often were hindered by time constraints that impede patient counseling. Both patient and pharmacist participants indicated that patients often asked pharmacists to expand upon, reinforce, and explain physician-patient conversations about medications, as well as to evaluate medication appropriateness and physician treatment plans. These groups also noted that patients confided in pharmacists about medication-related problems before contacting physicians. Pharmacists identified several barriers to patient counseling, including lack of knowledge about medication indications and physician treatment plans. Conclusions Community-based pharmacists may often be presented with opportunities to address questions that can affect patient medication use. Older patients, physicians and pharmacists all value greater pharmacist participation in patient care. Suboptimal information flow between physicians and pharmacists may hinder pharmacist interactions with patients and detract from patient medication management. Interventions to integrate pharmacists into the patient healthcare team could improve patient medication management.

OBJECTIVES-To investigate older patient, pharmacist, and physician perspectives about what information is essential to impart to patients receiving new medication prescriptions and who should provide the information. DESIGN-Qualitative focus group discussions.SETTINGS-Senior centers, retail pharmacies, and primary care physician offices. PARTICIPANTS-Forty-two patients aged 65 and older, 13 pharmacists, and 17 physicians participated in eight focus groups.MEASUREMENT-Qualitative analysis of transcribed focus group interviews and consensus through iterative review by multidisciplinary auditors.RESULTS-Patient, pharmacist, and physician groups all affirmed the importance of discussing medication directions and side effects and said that physicians should educate about side effects and that pharmacists could adequately counsel about certain important issues. However, there was substantial disagreement between groups about which provider could communicate which critical elements of medication-related information. Some pharmacists felt that they were best equipped to © 2009, Copyright the Authors Address correspondence to Derjung Mimi Tarn, David Geffen School of Medicine at UCLA, Department of Family Medicine, 10880 Wilshire Blvd., Suite 1800, Los Angeles, CA 90024. E-mail: dtarn@mednet.ucla.edu. Author Contributions: Derjung M. Tarn and Neil S. Wenger: study concept and design, acquisition of subjects and data, analysis and interpretation of data, manuscript preparation. Debora A. Paterniti and Bradley R. Williams: study concept and design, analysis and interpretation of data, manuscript preparation. Camille S. Cipri: analysis and interpretation of data, manuscript preparation. Conflict of Interest:The editor in chief has reviewed the conflict of interest checklist provided by the authors and has determined that the authors have no financial or any other kind of personal conflicts with this manuscript.This work was presented at the 2008 American Geriatrics Society Annual Scientific Meeting. All participants had to speak English and be able to hear conversations in a group setting. NIH Public AccessPatients aged 65 and older were recruited from two senior centers through flyers in main areas of the senior centers and information sessions about the study before senior center group activities. Pharmacists were recruited using telephone calls to all retail pharmacies within a 5-mile radius of the focus group locations. A primary care physician (DMT) telephoned primary care physicians working in community-based groups or private practices within a 5-mile radius of the focus group locations (as listed on the Web site Web MD). Patients and providers received $25 and $100 gift cards, respectively, for their participation.Before the focus group, all participants provided written informed consent and completed a brief demographic questionnaire. Providers were queried about their training and practice characteristics. A health professional trained in focus group moderation was present at each focus group (DMT, NSW) a...

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Nuchal translucency screening can be effectively and equitably delivered to a multiethnic population. Although there are significant differences in nuchal translucency measurement between ethnic groups, these differences are too small to require correction when nuchal translucency is used to screen for Down's syndrome.

ABSTRACTwhat thiS Study addS A substantial positive association was seen between use of warfarin with glipizide/glimepiride and hospital admission/emergency department visits for hypoglycemia and related diagnoses, particularly in patients starting warfarin. The findings suggest the possibility of a significant drug interaction between these medications.

The Guideline recommendations provide a framework to inform and improve medical care for AD by primary health care providers.

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