***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: OBJECTIVE To evaluate a training workshop for community pharmacy personnel  to improve their counselling in smoking cessation based on the stage-of-change model . DESIGN A r and omised controlled trial of community pharmacies and pharmacy customers . SETTING All 76 non-city community pharmacies registered in Grampian , Scotl and , were invited to participate . Sixty-two pharmacies ( 82 % ) were recruited . SUBJECTS All the intervention pharmacy personnel were invited to attend the training ; 40 pharmacists and 54 assistants attended . A total of 492 customers who smoked ( 224 intervention , 268 controls ) were recruited during the 12-month recruitment period ( overall recruitment rate 63 % ) . MAIN OUTCOME MEASURES The perceptions of customers and pharmacy personnel of the pharmacy support and self-reported smoking cessation rates for the two groups of customers at one , four , and nine months . RESULTS The intervention customer respondents were significantly more likely to have discussed stopping smoking with pharmacy personnel , 85 % ( 113 ) compared with 62 % ( 99 ) of the controls ( p<0.001 ) . The former also rated their discussion more highly ; 34 % ( 45 ) of the intervention customers compared with 16 % ( 25 ) of the controls rated it as “ very useful ” ( p = 0.048 ) . Assuming non-responders had lapsed , one-month point prevalence of abstinence was cl aim ed by 30 % of intervention customers and 24 % of controls ( p = 0.12 ) ; four months ’ continuous abstinence was cl aim ed by 16 % of intervention customers and 11 % of controls ( p = 0.094 ) ; and nine months ’ continuous abstinence was cl aim ed by 12 % of intervention customers and 7 % of controls ( p = 0.089 ) . These trends in outcome were not affected by potential confounders ( sex , age , socioeconomic status , nicotine dependence , and type of nicotine replacement product used ) or adjustment for clustering . CONCLUSIONS The intervention was associated with increased and more highly rated counselling , and a trend toward higher smoking cessation rates , indicating that community pharmacy personnel have the potential to make a significant contribution to national smoking cessation targets OBJECTIVES Despite advances in recent years , asthma morbidity and mortality have been noted to be on the increase in the past decade . The present study examined the failures and recommendations of past studies and introduced a new milieu for asthma care -- the community pharmacy . The study incorporated a care protocol with the important ingredients of asthma education on medications , triggers , self-monitoring and an asthma plan , with pharmacists taking responsibility for outcomes , assessment of a patient 's readiness to change and tailoring education to that readiness , compliance monitoring and physician consultation to achieve asthma prescribing guidelines . METHODS Thirty-three pharmacists in British Columbia , specially trained and certified in asthma care , agreed to participate in a study in which experienced pharmacists would have asthma patients allocated to enhanced ( pharmaceutical ) care ( EC ) or usual care ( UC ) . Pharmacists less experienced were clustered by geography and had their pharmacies r and omized to two levels of care ; each pharmacy then had patients r and omized to EC versus control , UC versus control or EC versus UC depending on their pharmacy r and omization . Six hundred thirty-one patients provided consent , of which 225 in EC or UC were analyzed for all outcomes . Patients were followed for one year . RESULTS Compared with patients in the UC group , the results of those in the EC group were as follows : symptom scores decreased by 50 % ; peak flow readings increased by 11 % ; days off work or school were reduced by approximately 0.6 days/month ; use of inhaled beta-agonists was reduced by 50 % ; overall quality of life improved by 19 % , and the specific domains of activity limitations , symptoms and emotional function also improved ; initial knowledge scores doubled ; emergency room visits decreased by 75 % ; and medical visits decreased by 75 % . A patient satisfaction survey revealed that the population was extremely pleased with their pharmacy services . Cost analysis reinforces the EC model , which is more cost effective than UC in terms of most direct and indirect costs in asthma patients . CONCLUSION Specially trained community pharmacists in Canada , using a pharmaceutical care-based protocol , can produce impressive improvements in clinical , economic and humanistic outcome measures in asthma patients . The health care system needs to produce incentives for such care BACKGROUND Health professionals have a proven , positive impact on patients ' ability to quit smoking , yet few integrate cessation counseling into routine practice .The aim of this study was to evaluate the impact of continuing education training on physicians ' and pharmacists ' cessation counseling . METHODS A group-r and omized trial of health care providers ( 87 physicians and 83 pharmacists ) from 16 Texas communities compared smoking cessation training ( intervention group ) with skin cancer prevention training ( control group ) .  Pretraining , posttraining , and extended follow-up surveys were collected from providers . Perceived ability , confidence , and intention ( ACI ) to address smoking with patients were assessed with a composite ACI index . Patient exit interviews ( at baseline , 1452 patients completed interviews ; after 12 months , 1303 completed interviews ) assessed counseling practice s. RESULTS There was a significant increase in the percentage of physicians with a high ACI index in the intervention group from pretraining to posttraining ( 27 % to 73 % ; P < .001 ) vs the control group ( 27 % to 34 % ; P = .42 ) and for pharmacists ( 4 % to 60 % ; P < .001 ) vs the control group ( 10 % to 14 % ; P = .99 ) . Similar results were seen from pretraining to extended follow-up . At baseline , fewer pharmacy patients reported being asked about smoking compared with patients seen by physicians ( 7 % vs 33 % ; P = .001 ) . There was an increase in assisting patients to quit ( 6 % to 36 % ; P = .002 ) by physicians ( baseline vs 12 months ) in the intervention group , but not in the control group . CONCLUSIONS Training led to significant and lasting improvement in counseling among physicians . Low levels of counseling were seen among pharmacists Background Sexually Transmitted diseases ( STD ) syndrome management has been one cornerstone of STD treatment . Persons with STD symptoms in many countries , especially those with limited re sources , often initially seek care in pharmacies . The objective of the study was to develop and evaluate an integrated network of physicians , midwives and pharmacy workers trained in STD syndromic management ( The PREVEN Network ) as part of a national urban community-r and omized trial of sexually transmitted infection prevention in Peru . Methods and Findings After a comprehensive census of physicians , midwives , and pharmacies in ten intervention and ten control cities , we introduced seminars and workshops for pharmacy workers , and continuing education for physicians and midwives in intervention cities and invited graduates to join the PREVEN Network . “ Prevention Salespersons ” visited pharmacies , boticas and clinicians regularly for educational support and collection of information on numbers of cases of STD syndromes seen at pharmacies and by clinicians in intervention cities . Simulated patients evaluated outcomes of training of pharmacy workers with respect to adequate STD syndrome management , recommendations for condom use and for treatment of partners . In intervention cities we trained , certified , and incorporated into the PREVEN Network the workers at 623 ( 80.6 % ) of 773 pharmacies and 701 ( 69.6 % ) of 1007 physicians and midwives in private practice . Extremely high clinician and pharmacy worker turnover , 13.4 % and 44 % respectively in the first year , dictated continued training of new pharmacy workers and clinicians . By the end of the intervention the Network included 792 pharmacies and 597 clinicians . Pharmacies reported more cases of STDs than did clinicians . Evaluations by simulated patients showed significant and substantial improvements in the management of STD syndromes at pharmacies in intervention cities but not in control cities . Conclusions Training pharmacy workers linked to a referral network of clinicians proved feasible and acceptable . High turn-over was challenging but over come OBJECTIVE To see whether the stages of change are useful for targeting a brief intervention to reduce smoking based on implementation intentions . A second objective was to rule out dem and characteristics as an alternative explanation for the findings of intervention studies based on the transtheoretical model and implementation intentions . DESIGN Participants ( N = 350 ) were r and omized to a passive control condition ( question naire only ) , active control condition ( question naire plus instruction to plan to quit ) , or experimental condition ( question naire , plan to quit , form an implementation intention ) . Their behavior and psychosocial orientation to quit were measured at baseline and at 2-month follow-up . MAIN OUTCOME MEASURES Theory of planned behavior variables , nicotine dependence , and quitting . RESULTS Significantly more people quit smoking in the experimental condition than in the control conditions , and the planning instructions changed intention to quit and perceived control over quitting , but not behavior . Stage of change moderated these effects such that implementation intentions worked best for individuals who were in the preparation stage at baseline . CONCLUSION Harnessing both motivational and volitional processes seems to enhance the effectiveness of smoking cessation programs , although further work is required to clarify inconsistencies in the literature using the stages of change OBJECTIVES To test the feasibility of implementing ask-advise-refer ( AAR ) tobacco cessation counseling approach in community chain pharmacies serving low socioeconomic areas and to assess the effectiveness of a multimodal intervention on short-term implementation of AAR . DESIGN R and omized controlled trial . SETTING South- central Wisconsin from July 2008 through March 2009 . PARTICIPANTS Pharmacists and technicians from 16 community chain pharmacies .  INTERVENTION Training to implement AAR , workflow integration recommendations , tobacco cessation poster to create awareness , and a support visit . MAIN OUTCOME MEASURES Number of pharmacy patrons asked about tobacco use , number of tobacco users advised to quit , number of tobacco users enrolled in the quit line , and number of quit line cards given . RESULTS As hypothesized , the multimodal intervention significantly predicted the number of patrons asked to quit ( estimate 4.84 , incidence rate ratio 127.2 , P < 0.001 ) , number of tobacco users advised to quit ( 2.12 , 8.33 , P < 0.01 ) , number of tobacco users enrolled in the quit line ( 2.31 , 10.13 , P < 0.001 ) , and number of quit line cards given ( 1.04 , 2.82 , P < 0.05 ) . CONCLUSION This trial demonstrates the feasibility of implementing AAR in routine community pharmacy practice . This trial also supports the short-term effectiveness of the multimodal intervention in facilitating AAR in partnership with other public health systems . More research is needed to evaluate the generalizability , effectiveness , and sustainability of AAR , including factors influencing adoption and the impact on cessation BACKGROUND To optimize positive outcomes , the design of new pharmacy services should consider the preferences of consumers with chronic condition(s ) and their carers . OBJECTIVES ( i ) To evaluate the relative importance of community pharmacy service characteristics , from the perspective of consumers with chronic condition(s ) and carers ; ( ii ) To compare consumer and carer preferences to health professional beliefs about ideal service characteristics for consumers . METHOD A discrete choice experiment was completed by consumers with chronic condition(s ) and /or carers ( n = 602 ) and health professionals ( n = 297 ) , recruited from four regions in Australia . Participants were each r and omized to one survey version containing four ( from a total 72 ) different choices between two new pharmacy services .  Consumer and carer participants were also given an ' opt out ' alternative of current service . Each service was described using six attributes related to pharmacy service characteristics : continued medicines supply , continuity and coordinated care , location , medication management , education and information , and cost . RESULTS Consumers and carers placed highest priority on continued medicines supply by a pharmacist for regular and symptom flare up medicines ( 100 priority points ) , a pharmacy located within a ' one-stop ' health center ( 61 points ) and home delivery of medicines ( 52 points ) . Although continued medicines supply was most important for consumers and carers , pharmacy location was perceived by health professionals to be the most important characteristic for consumers . Participants were less inclined to choose new services if their current pharmacy offered high quality services that were person-centered , easy to access and responsive to their needs . Younger , more highly educated and employed participants , and those with established condition(s ) were more likely to choose new services . CONCLUSIONS Person-centered care is a fundamental tenet for pharmacy services . The provision of continued medicines supply ( e.g. through pharmacist prescribing ) , convenient and coordinated care delivered through a one stop health centre , and home delivery of medicines , should be prioritized when planning pharmacy services to best assist consumers to manage chronic conditions Pharmacists may be effective health care practitioners to deliver smoking cessation interventions . This paper examines the short-term outcomes of smokers r and omized to one of two models of a pharmacist-led smoking cessation intervention . Methods : An open-label pragmatic r and omized trial compared two models of a pharmacist-led behavioral inter 
    Output:
    
Most studies had been undertaken in the field of pharmacy practice ( pharmacists study ing what pharmacists do ) and demonstrated the success of pharmacist training in improving confidence , knowledge and ( in many but not all studies ) patient outcomes .