Notice bibliographique
Résumé
Last issue, I introduced you to 3 recent pharmacy graduates who we’ll be following through the ups and downs of becoming new pharmacists. As you’ll recall, all 3 were hired specifically to provide patient-centred care rather than the traditional product-focused (distribution) role. Let’s check in with them a few months into their new jobs. Reid McDonald and Anita Cumbleton have settled into their positions at Fyfe’s Friendly Pharmacy in Barrhead, Alberta. They report that things have been going well. They’ve been busy performing 3 to 5 medication reviews every day. Relationships with the local physicians have been very good, although not all support what they are doing. Their main challenge has been that patients seem unaware of what their pharmacists can do for them. Sometimes patients say “my physician can do that” and dismiss their offer of a medication review. Anita and Reid have changed their approach to patients by making the medication reviews less formal, starting to engage patients more casually by asking them a few questions about their medications. When patients realize how little they know about their medications, it seems to lead them to want to talk more. Another thing that seems to work is to start engaging them while they are waiting for their prescription (rather than after it’s ready). Bryan Gray has been aggressively pursuing MedsCheck reviews for his patients as well at Shoppers Drug Mart in Thunder Bay, Ontario. Early on he had a disturbing experience. He conducted a review for a 75-year-old patient who had been receiving hormone replacement therapy for 20 years. She had not had any menopausal symptoms in over 10 years, and they discussed breast cancer risk. Bryan wrote a letter to her gynecologist, citing the evidence for increased risk of breast cancer. The physician sent back his letter with the following comments: “Please mind your own business” and “PS, You are also poorly informed. There [have been] follow-up studies since the WHI [Women’s Health Initiative].” Bryan was alerted to this response by his boss, who expressed concern that he had “pissed off Dr. X” and that they’d better talk. Not surprisingly, Bryan’s first reaction was that of anger at the unprofessionalism of the physician. He thought of going to his office and confronting him. He also had second thoughts about his decision to intervene in this case. In the end, he explains, “If this was my mother or grandmother, I wouldn’t let this slide, therefore I can’t let it slide for my patients.” Indeed, patient care trumps all. Bryan has changed his approach. He is no longer “cold faxing” but rather phoning the physician first. He reports that this tactic has worked well. Some physicians are very appreciative, while others seem taken aback that he is calling, but are still okay. As you might expect, our new pharmacists have received a good “loading dose” of reality. What impresses me is that despite some barriers, they have shown us that persistence towards the goal of advocating for their patients is more important than their own pride or feelings. Rather than recoiling from the challenges, they are sharpening their resolve. They are learning new tactics to apply their care, and we shall continue to follow along, learning from them (and cheering them on). ■
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,004 | 0,021 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,007 | 0,003 |
| Communication savante | 0,011 | 0,010 |
| Science ouverte | 0,002 | 0,006 |
| Intégrité de la recherche | 0,011 | 0,017 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,187 | 0,087 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».