Browsing by Subject "effects"
Now showing items 1-2 of 2
-
(2009)Sustainable forestry has been the primary principle of Finnish forest policy for decades. However the concept has extended to areas of ecological and socio-cultural sustainability alongside with the more usual economic sustainability. Goals for the use of forests have multiplied and made an impact on forest legislation and policy programmes. Timber production remains as the main objective of forest policy but other objectives, such as carbon sequestration and preservation of forest biodiversity, have also reached the policy agenda. The co-production of material and immaterial goods in forests is not straightforward and the conflicts can prevent a consistent implementation of sustainable forestry. The purpose of the study is to develop a comprehensive evaluation matrix (or table) in order to determine the logic and structure of forest policy instruments. The matrix comprises the evaluation of goals, motivation, effects and effectiveness of instruments. Theories considering process and impact evaluations are used in the analysis. Furthermore, the table is tested in practice by examining the following three policy instruments: 10§ of the Forest Act, public funding for tending of young stands and public forest planning. Content analysis was used in examining the data set of policy documents. The evaluation matrix enables a systematic assessment of policy instruments. It provides information on the consistency of the aim and effects of the instrument. Certain points in the table were sometimes difficult to fill in, but the reason can be in the structure of the instrument that public documents provide rather than in the structure of the matrix. In general, more detailed information on policy goals and motivation of the instruments would make public forest policy more transparent. In addition, the use of indicators that measure effectiveness should be further increased for easier evaluation of policy effectiveness.
-
(2016)In the United States pharmacists have prescribed medicines and managed patient's drug therapy since the 1970s, and in the United Kingdom pharmacists have been authorization to prescribe medications since 2003. The discussion about the right of Masters of Science in Pharmacy will be renewed prescriptions during the last decade in Finland but few Finnish studies have been published from the subject. In the document Medicines Policy 2020 published by Ministry of Social Affairs and Health states that by prescribing should be used cost-effective modes of operation. The knowledge about pharmacist prescribing benefits and costs, and also prescribing practice in Finland, is needed to evaluate the cost-effectiveness of pharmacists' authorization to prescribe and to support the decision-making concerning pharmacist prescribing. The aim of this master's thesis is to gather all existing knowledge about the economic and other effects of pharmacist prescribing using a systematic literature review method. The aim of theoretical part of this master's thesis is to explain the Finnish prescribing, the participation of pharmacists in drug therapy management in Finland and internationally pharmacist prescribing. The empirical part of this master's thesis is also to assess the quality of the studies of pharmacist prescribing benefits and costs using quality assessment checklists. In addition, this thesis describes the principles of the cost and benefit analyses, economic evaluations and systematic literature reviews. As a result of the literature search were found 1825 references. Based on the inclusion and exclusion criteria, 17 studies were selected to include in the systematic review. Of these studies three were economic assessments, 8 randomized controlled trials and 6 observational studies. The quality of these studies was assessed using four quality assessment checklists. On the basis of a systematic literature review pharmacist prescribing has been studied in the treatment of type 2 diabetes, hypertension, dyslipidemia, anticoagulation, chronic pain, emergency contraception and minor ailments and renewal of long-term medicines. Pharmacists reduced blood pressure by providing follow-up care with prescribing compared with the usual care, but not compared with the case management, which does not include prescribing. In addition, the follow-up care was to improve the treatment results of type II diabetes. The results obtained in the care of dyslipidemia were partly unclear. In the clinic follow-up care with prescribing could be reduced LDL-cholesterol, but not the risk of cardiovascular disease compared with the control group. In the pharmacy follow-up care had no effect on the treatment of patients with LDL-cholesterol compared with the control group. In addition, pharmacist prescribing improved how well patients stayed within INR target range. Pharmacist medication review with pharmacist prescribing achieved in the care of chronic pain patients differed few from the results of pharmacist medication review with feedback for a general practitioner. Pharmacist prescribing could reduce errors in inpatient medication compared with usual care. Much uncertainty is connected to the results of the study. The limited amount of studies, heterogeneity of the studies and methodological quality make the evaluation of real effects more difficult. The included studies of pharmacist prescribing were so heterogeneous. In addition treated disease, assessed benefits and scope of working environment were varied in included studies. Pharmacist prescribing was often studied as part of other care or pharmaceutical service, such as chronic disease management or medication review. The quality assessment of the included studies revealed several sources of bias. The available research information is the insufficient reliable evaluation of economic and other effects of pharmacist prescribing and the need for the further research is big.
Now showing items 1-2 of 2