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1.  Pharmacists Connect and CARE 
Canadian Pharmacists Journal : CPJ  2014;147(3):149-153.
doi:10.1177/1715163514530098
PMCID: PMC4025885  PMID: 24847366
2.  What elements of the patient–pharmacist relationship are associated with patient satisfaction? 
Background
Optimal medication management requires an effective relationship between the patient and health care professional. As pharmacists move from the traditional dispensing role to become more actively involved in patient care, factors influencing their relationship with patients need to be identified. A better understanding of these factors will facilitate more effective relationships.
Objective
To explore the effect of patient-perceived pharmacist expertise on relationship quality, self-efficacy, patient satisfaction, and relationship commitment.
Methods
This was a cross-sectional study conducted in five community pharmacies within the province of Alberta, Canada. A total of 500 patients were asked to complete a set of validated, self-administered questionnaires that measured perceived pharmacist expertise, relationship quality, self-efficacy, patient satisfaction, and relationship commitment. Hierarchical multiple regression was used to examine the associations between variables.
Results
A total of 112 surveys were returned. Internal consistency ranged from 0.86–0.92, suggesting good reliability, except for the relationship commitment scale. There was a significant, positive correlation between patient-perceived pharmacist expertise and quality of the relationship (0.78; P < 0.001). There were also significant, positive correlations between perceived expertise and patient satisfaction (0.52; P < 0.001) and relationship commitment (0.47; P < 0.001). These associations remained significant but the magnitude of correlation decreased when relationship quality was taken into account (0.55; P < 0.001 and 0.56; P < 0.001, respectively). On the other hand, there was no significant association between either patient-perceived pharmacist expertise or relationship quality and medication self-efficacy (0.06; P = 0.517 and 0.10; P = 0.292, respectively).
Conclusion
Patient-perceived pharmacist expertise is an independent determinant of relationship quality, patient satisfaction, and relationship commitment. Relationship quality also appears to mediate the effect of perceived expertise on patient satisfaction and relationship commitment.
doi:10.2147/PPA.S35688
PMCID: PMC3461603  PMID: 23055699
relationship quality; pharmacist expertise; self-efficacy; relationship commitment; satisfaction
3.  Factors influencing pharmacists’ adoption of prescribing: qualitative application of the diffusion of innovations theory 
Background
In 2007, Alberta became the first Canadian jurisdiction to grant pharmacists a wide range of prescribing privileges. Our objective was to understand what factors influence pharmacists’ adoption of prescribing using a model for the Diffusion of Innovations in healthcare services.
Methods
Pharmacists participated in semi-structured telephone interviews to discuss their prescribing practices and explore the facilitators and barriers to implementation. Pharmacists working in community, hospital, PCN, or other settings were selected using a mix of random and purposive sampling. Two investigators independently analyzed each transcript using an Interpretive Description approach to identify themes. Analyses were informed by a model explaining the Diffusion of Innovations in health service organizations.
Results
Thirty-eight participants were interviewed. Prescribing behaviours varied from non-adoption through to product, disease, and patient focused use of prescribing. Pharmacists’ adoption of prescribing was dependent on the innovation itself, adopter, system readiness, and communication and influence. Adopting pharmacists viewed prescribing as a legitimization of previous practice and advantageous to instrumental daily tasks. The complexity of knowledge required for prescribing increased respectively in product, disease and patient focused prescribing scenarios. Individual adopters had higher levels of self-efficacy toward prescribing skills. At a system level, pharmacists who were in practice settings that were patient focused were more likely to adopt advanced prescribing practices, over those in product-focused settings. All pharmacists stated that physician relationships impacted their prescribing behaviours and individual pharmacists’ decisions to apply for independent prescribing privileges.
Conclusions
Diffusion of Innovations theory was helpful in understanding the multifaceted nature of pharmacists’ adoption of prescribing. The characteristics of the prescribing model itself which legitimized prior practices, the model of practice in a pharmacy setting, and relationships with physicians were prominent influences on pharmacists’ prescribing behaviours.
doi:10.1186/1748-5908-8-109
PMCID: PMC3847669  PMID: 24034176
4.  Evaluation of Structured Patient Interactions: The Diabetes Check 
Objectives
To evaluate a structured patient intervention, the Diabetes Check, in which pharmacy students ask patients with diabetes about 3 clinical targets: A1c, blood pressure, and low-density lipoprotein (LDL) cholesterol (ABC) levels. Specific objectives were to: (1) describe the effect of patients' reactions on pharmacy students; (2) describe pharmacy students' confidence and role beliefs; and (3) determine predictors of pharmacy students' intention to use the Diabetes Check in the future.
Methods
After training, pharmacy students were asked to perform 10 diabetes checks and complete an evaluation. Data from the evaluations described pharmacy students' reactions, role beliefs, and confidence. Linear regression was performed to predict intention of using the Diabetes Check in future.
Results
One-hundred twenty-eight pharmacy students used the Diabetes Check tool with over 1000 patients. Most pharmacy students were encouraged by patients' reactions (56%). Pharmacy students' perceptions of patients' reaction and pharmacy students' role beliefs about monitoring ABCs significantly predicted pharmacy students' reported intention to use a Diabetes Check (r-squared = 0.52).
Conclusions
Pharmacy students' perceptions of patient reactions and role beliefs about the importance of monitoring predicted their reported intention of performing a Diabetes Check in the future.
PMCID: PMC1636955  PMID: 17136177
student pharmacist; diabetes; role beliefs; patient interaction; self-efficacy
5.  Safety and Efficacy of High-Dose Interleukin-2 Therapy in Patients With Brain Metastases 
Summary
The authors determined the safety and efficacy of recombinant high-dose interleukin-2 administration in patients with brain metastases. This retrospective review included 1,069 patients with metastatic melanoma or renal cell carcinoma who received high-dose interleukin-2 alone or in combination with other immunotherapy or chemotherapy from July 1985–July 2000. All patients were evaluated for both toxicity and response. Only the first exposure to interleukin-2 was considered. Parameters evaluated among the groups included toxicity profiles, reasons for stopping treatment, number of interleukin-2 doses per cycle, and response to therapy. Three patient groups were compared. Group 1 (n = 27) comprised patients with previously treated brain metastases (surgery or radiation), group 2 (n = 37) comprised patients with untreated brain metastases, and group 3 (n = 1,005) comprised patients without brain metastases. For most comparisons between patients with brain metastases and those without, no significant differences were noted in toxicity profiles or reasons for stopping interleukin-2 therapy. Patients with previously treated brain metastases received fewer interleukin-2 doses per cycle (median, 6.5) than patients with previously untreated brain metastases (median, 7.5) or patients without brain metastases (median, 7.5). Patients with previously treated brain metastases demonstrated an 18.5% overall clinical response to interleukin-2 treatment. However, patients with evaluable (previously untreated) brain metastases had an overall 5.6% response rate, which was less than the 19.8% response rate of patients without brain metastases. Two of thirty-six patients with evaluable brain metastases demonstrated objective regression of intracranial and extracranial disease after receiving interleukin-2. Carefully selected patients with brain metastases can safely receive high-dose interleukin-2, and some can experience a response to treatment at intracranial and extracranial disease sites.
PMCID: PMC2424228  PMID: 11924913
Interleukin; 2; Melanoma; Brain metastases; Safety

Results 1-5 (5)