Full Text Available Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this. Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems. Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies. Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines. Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner. Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect
Full Text Available Background: Drug-related problems are known to be a major problem associated with pharmacotherapy. A broad range of studies, mainly in the area of prescription-only medicines, supports this fact. Only a few studies have evaluated drug-related problems with over-the-counter medicine and the role of community pharmacies in this.Purpose: To quantify drug-related problems in self-medication (use of over-the-counter medicine identified by community pharmacies in Denmark and to document the interventions by pharmacy staff in relation to the identified drug-related problems.Method: A descriptive study mapping drug-related problems in self-medication registered at the counter at a selected number of Danish community pharmacies.Results: Data for 3,868 consecutive customers with requests for over-the-counter (OTC medicines were registered at 39 community pharmacies. The pharmacies registered a total number of 4,324 OTC medicines requests, illustrating that a customer requested 1.1 OTC medicines on average. Drug-related problems (DRPs were identified for 813 customers, equivalent to DRPs for 21.0 % of all customers, presenting symptoms or requesting OTC medicines, and for 20 % of all over-the-counter medicines requests. 1,239 DRPs were registered, corresponding to an average of 1.5 DRPs per customer requesting OTC medicines.Community pharmacies estimated that they solved or partly solved 76.2 % of the detected DRPs; 73 % were solved without involving a general practitioner.Conclusions: DRPs were identified for 21.0 % of the pharmacy customers presenting a symptom or asking for an OTC medicine. The community pharmacy counselled the customers with DRPs more thoroughly than other customers by giving 2.4 pieces of professional advice, compared to an average of 2.1 to customers in general. It is not possible to determine the magnitude of the safety risk involved. Based on the most frequent categories of DRPs, there were risks of insufficient effect, unintended
Mygind, Anna; Espersen, Sacha; Nørgaard, Lotte Stig; Traulsen, Janine M
To explore the challenges that Danish community pharmacy staff encounter when serving non-Western immigrant customers. Special attention was paid to similarities and differences between the perceptions of pharmacists and pharmacy assistants. A questionnaire was distributed to one pharmacist and one pharmacy assistant employed at each of the 55 community pharmacies located in the five local councils in Denmark with the highest number of immigrant inhabitants. The total response rate was 76% (84/110). Most respondents found that the needs of immigrant customers were not sufficiently assessed at the counter (n = 55, 65%), and that their latest encounter with an immigrant customer was less satisfactory than a similar encounter with an ethnic Danish customer (n = 48, 57%) (significantly more pharmacists than assistants: odds ratio, OR, 3.19; 95% confidence interval, CI, 1.27-8.04). Forty-two per cent (n = 35) perceived that immigrant customers put pressure on pharmacy staff resources, while 27% (n = 23) found that the immigrant customer group make work more interesting. More pharmacists than assistants agreed on the latter (OR, 3.43; 95% CI, 1.04-11.33). Within the past 14 days, 86% (n = 72) experienced that their advice and counselling were not understood by immigrant customers, whereas 49% (n = 41) experienced lack of understanding by ethnic Danes; and 30% (n = 25) had consciously refrained from counselling an immigrant, whereas 19% (n = 16) had done so with an ethnic Dane. Use of under-aged children as interpreters during the past month was reported by 79% of respondents. Regarding suggestions on how to improve encounters with immigrant customers, most respondents listed interventions aimed at patients, general practitioners and pharmaceutical companies. Community pharmacy staff report poorer quality in their encounters with immigrant customers, including sub-optimal counselling and frequent use of under-aged children as
Kaae, Susanne; Saleem, Sahdia; Kristiansen, Maria
Background Counter counseling is an important part of community pharmacies service delivery. Difficulties arise because customers appear less interested than the staff in discussing their medicine. It is unclear how individual pharmacies differ with regard to overcoming these obstacles. Objective This study explores differences in the communication practices of pharmacies with regard to engaging customers in medicine dialogues. Methods The work of Stevenson et al. describing five types of interaction scenarios at the counter was used for structured overt non-participant observations of 100 encounters in each of five Danish pharmacies. Variation in pharmacies success in engaging customers in medicine dialogues were calculated using descriptive statistics, and the statistical significance of observed differences across pharmacies was analyzed using odds ratios (OR). Results Considerable differences between the pharmacies were identified. Differences exist in how often pharmacy staff attempts to encourage customers to participate in medication dialogues and how often they succeed. The pharmacies serving the most customers per day were the most successful. A possible link between a low number of refill customers offered counseling and ‘success rate’ was identified. Conclusions The pharmacies showed considerable variation in attempts to engage customers in medication dialogues at the counter and success in doing so. The reasons for the identified patterns are unclear. PMID:25243031
Kaae, Susanne; Saleem, Sahdia; Kristiansen, Maria
Counter counseling is an important part of community pharmacies service delivery. Difficulties arise because customers appear less interested than the staff in discussing their medicine. It is unclear how individual pharmacies differ with regard to overcoming these obstacles. This study explores differences in the communication practices of pharmacies with regard to engaging customers in medicine dialogues. The work of Stevenson et al. describing five types of interaction scenarios at the counter was used for structured overt non-participant observations of 100 encounters in each of five Danish pharmacies. Variation in pharmacies success in engaging customers in medicine dialogues were calculated using descriptive statistics, and the statistical significance of observed differences across pharmacies was analyzed using odds ratios (OR). Considerable differences between the pharmacies were identified. Differences exist in how often pharmacy staff attempts to encourage customers to participate in medication dialogues and how often they succeed. The pharmacies serving the most customers per day were the most successful. A possible link between a low number of refill customers offered counseling and 'success rate' was identified. The pharmacies showed considerable variation in attempts to engage customers in medication dialogues at the counter and success in doing so. The reasons for the identified patterns are unclear.
Kaae, Susanne; Mygind, Anna; Saleem, Sahdia
Community pharmacies have been trying to expand their core function by counseling customers at the counter. This has been challenging given that customers' interest in receiving counseling may be limited.......Community pharmacies have been trying to expand their core function by counseling customers at the counter. This has been challenging given that customers' interest in receiving counseling may be limited....
Mygind, Anna; Nørgaard, Lotte Stig; Traulsen, Janine M; El-Souri, Mira; Kristiansen, Maria
To present and discuss implementation experiences regarding the involvement of community pharmacists with ethnic minority backgrounds in a medication review intervention for ethnic minority poly-pharmacy patients in Denmark. Data sources include 1) reflection notes from an introductory seminar with pharmacists and the cross-disciplinary research team and 2) five individual interviews and one focus group interview with pharmacists. Data were thematically coded and synthesised to identify underlying rationales and challenges encountered when involving professionals with ethnic minority backgrounds in interventions for ethnic minorities. Informants perceived the need for interventions targeted at ethnic minority poly-pharmacy patients, and highlighted the potential of involving professionals with diverse ethnic backgrounds in such interventions. However, implementation created challenges, because the professional identity of the pharmacists reduced their options for serving as peers with the same ethnic background. Furthermore, issues related to organisational difficulties and overcoming language barriers in the intervention impacted on the potential of involving professionals with ethnic minority backgrounds. Involving healthcare professionals with ethnic minority backgrounds in encounters with ethnic minorities holds potential for the adaptation of services to ethnically diverse populations, thus improving access to and quality of care. However, it is important to ensure sufficient personal and organisational support and to acknowledge the delicate balance between simultaneously serving as a peer and as a professional.
Herborg, Hanne; Sørensen, Ellen Westh; Frøkjaer, Bente
OBJECTIVE: To review the current status of Danish community pharmacy in both practice and research and discuss future trends. FINDINGS: Denmark has a social welfare system that provides health care, social services, and pensions to its population. Medical care and surgery are free. Prescription...... medicines are reimbursed by an average of 56%. Community pharmacies are privately owned, but the health authorities regulate drug prices and the number of pharmacies. At present, Denmark has 322 pharmacies, corresponding to 1 pharmacy per 16,700 inhabitants. All pharmacies provide prescription and over......-the-counter products, advice about medicine use, dose dispensing, generic substitutions, and administration of individual reimbursement registers. Except for very simple processes, compounding is centralized at 3 pharmacies. Many pharmacies offer measurement of blood glucose, blood pressure, and cholesterol, and 60...
Conclusion: This study concludes that the current status of community pharmacy practice is below par. There is a need to involve more pharmacists at community level and develop awareness programs to counter patients′ routine drug issues and reducing the burden of disease from society.
Urbonas, Gvidas; Jakušovaitė, Irayda; Savickas, Arūnas
The main objective of this study was to analyze pharmacy specialists' attitudes toward the quality of pharmaceutical services at Lithuanian community pharmacies. Between April and June 2009, a total of 471 Lithuanian community pharmacy specialists completed a questionnaire designed to evaluate their attitudes toward the quality of pharmaceutical services at community pharmacies. The main dimensions of pharmaceutical service quality were extracted by principal component analysis. Two main dimensions of pharmaceutical service quality were extracted: pharmacotherapeutic aspects (provision of information about drug therapy, possible side effects, health promotion, the amount of time spent with a patient, and the ascertainment that a patient understood the provided information) and socioeconomic aspects (considering patient's needs and financial capabilities, making a patient confident with the services provided). Pharmacy specialists evaluated the quality of both dimensions positively, but the quality of the first dimension was rated significantly worse than that of the second dimension. The attitudes of pharmacy specialists working at independent pharmacies were more positive toward pharmacotherapeutic aspects as compared to the specialists working at chain or state pharmacies. Pharmacotherapeutic aspects were rated better by pharmacy specialists, aged ≥ 55 years, than those younger than 45 years. Moreover, the attitudes of 45-54-year-old pharmacy specialists toward the socioeconomic aspects were more positive as compared with those of 35-44-year olds. Pharmacists rated the socioeconomic aspects of pharmaceutical service quality worse as compared with pharmacy technicians. The attitudes of pharmacy specialists working at pharmacies with 6-9 specialists were more negative toward pharmacotherapeutic aspects than those of the pharmacies with 1-2 specialists. Pharmacy specialists working at pharmacies with ≥ 10 specialists reported lower scores of socioeconomic
Assessing Consumer Preference using Community Pharmacy Preference Evaluation Questionnaire (ComPETe): A Pilot Survey in a Malaysia City. ... a successful CP establishment. Keywords: Consumer Satisfaction, Community Pharmacy Preference, Prescription Filling, Over-the-counter Products, Financial Management ...
Pottegård, Anton; Hallas, Jesper; Søndergaard, Jens
International studies regarding pharmacists' interventions towards prescription problems produce highly variable results. The only peer-reviewed study in a Danish setting estimated an intervention rate of 2.3 per 1,000 prescriptions. With the introduction of a new tool for registration, we hypothesized that a better estimate could be obtained. We aimed to produce an up-to-date estimate of the extent and type of pharmacists' interventions towards prescription problems in a Danish pharmacy setting The study was conducted at Copenhagen Sønderbro Pharmacy, a large urban 24-hour pharmacy. Data were collected prospectively through an electronic form. All interventions were primarily classified as either clinical or administrative in nature, and further classified in a number of pre-determined subcategories. Furthermore, information about age, sex, time of day, the wording of the prescription, the performed intervention, the person performing the intervention and the type of prescriber were recorded. All entries were manually validated by a study pharmacist. The intervention rate, given as the number of interventions per 1,000 prescriptions. We found 599 validated interventions. Thirty-two percent of the interventions were clinical and 68% administrative by nature. Fifty-one percent of the administrative and 35% of the clinical interventions were regarding antibiotics. In the study period, a total of 55,522 prescriptions were filled out together with 3,069 dose-dispensing packages, giving a rate of 10.2 (9.4-11.1) interventions per 1,000 prescriptions. We found an intervention rate substantially higher than reported in previous Danish studies.
Nitadpakorn, Sujin; Farris, Karen B; Kittisopee, Tanattha
The concept of customer engagement and devotion has been applied in various service businesses to keep the customers with business However, a limited number of studies were performed to examine the context of customer engagement and devotion in pharmacy business which focus on the impact of customer perceptions about pharmacists, perceived quality of pharmacy structure, medication price strategy on pharmacy engagement and pharmacy customer devotion in a pharmacy providing pharmaceutical care to the customers. This study aimed to assess a conceptual model depicting the relationships among customer perceptions about pharmacists, pharmacy quality structure, medication price, customer engagement, and customer devotion. And also aimed to assess and measure if there is a direct or indirect relationship between these factors. A quantitative study was conducted by using self-administered questionnaires. Two hundred and fifty three customers who regularly visited the pharmacy were randomly recruited from a purposively selected 30 community pharmacies in Bangkok. The survey was completed during February to April 2016. A structural equation model (SEM) was used to assess the direct and indirect relationships between constructs. A total of 253/300 questionnaires were returned for analysis, and the response rate was 84%. Only perceptions about pharmacist in customers receiving professional pharmacy services was statically significant regarding relationship with pharmacy engagement (beta=0.45). Concurrently, the model from empirical data fit with the hypothetical model (p-value = 0.06, adjusted chi-square (CMIN/DF)=1.16, Goodness of Fit Index (GFI)=0.93, Comparatively Fit Index (CFI)=0.99, and Root Mean Square Error Approximation (RMSEA)=0.03). The study confirmed the indirect positive influence of customer perceptions about pharmacist on pharmacy customer devotion in providing pharmacy services via pharmacy engagement It was customer perceptions about pharmacist that influenced
This thesis deals with the development of patient education in the community pharmacy. The research questions concentrate on the determinants of technicians patient education behavior and the effects of a one-year lasting intervention program on the patient education activities in the pharmacy.
Nitadpakorn, Sujin; Kittisopee, Tanattha
Background: The concept of customer engagement and devotion has been applied in various service businesses to keep the customers with business However, a limited number of studies were performed to examine the context of customer engagement and devotion in pharmacy business which focus on the impact of customer perceptions about pharmacists, perceived quality of pharmacy structure, medication price strategy on pharmacy engagement and pharmacy customer devotion in a pharmacy providing pharmaceutical care to the customers. Objective: This study aimed to assess a conceptual model depicting the relationships among customer perceptions about pharmacists, pharmacy quality structure, medication price, customer engagement, and customer devotion. And also aimed to assess and measure if there is a direct or indirect relationship between these factors. Methods: A quantitative study was conducted by using self-administered questionnaires. Two hundred and fifty three customers who regularly visited the pharmacy were randomly recruited from a purposively selected 30 community pharmacies in Bangkok. The survey was completed during February to April 2016. A structural equation model (SEM) was used to assess the direct and indirect relationships between constructs. Results: A total of 253/300 questionnaires were returned for analysis, and the response rate was 84%. Only perceptions about pharmacist in customers receiving professional pharmacy services was statically significant regarding relationship with pharmacy engagement (beta=0.45). Concurrently, the model from empirical data fit with the hypothetical model (p-value = 0.06, adjusted chi-square (CMIN/DF)=1.16, Goodness of Fit Index (GFI)=0.93, Comparatively Fit Index (CFI)=0.99, and Root Mean Square Error Approximation (RMSEA)=0.03). Conclusion: The study confirmed the indirect positive influence of customer perceptions about pharmacist on pharmacy customer devotion in providing pharmacy services via pharmacy engagement It was
Full Text Available Background: The concept of customer engagement and devotion has been applied in various service businesses to keep the customers with business However, a limited number of studies were performed to examine the context of customer engagement and devotion in pharmacy business which focus on the impact of customer perceptions about pharmacists, perceived quality of pharmacy structure, medication price strategy on pharmacy engagement and pharmacy customer devotion in a pharmacy providing pharmaceutical care to the customers. Objective: This study aimed to assess a conceptual model depicting the relationships among customer perceptions about pharmacists, pharmacy quality structure, medication price, customer engagement, and customer devotion. And also aimed to assess and measure if there is a direct or indirect relationship between these factors. Methods: A quantitative study was conducted by using self-administered questionnaires. Two hundred and fifty three customers who regularly visited the pharmacy were randomly recruited from a purposively selected 30 community pharmacies in Bangkok. The survey was completed during February to April 2016. A structural equation model (SEM was used to assess the direct and indirect relationships between constructs. Results: A total of 253/300 questionnaires were returned for analysis, and the response rate was 84%. Only perceptions about pharmacist in customers receiving professional pharmacy services was statically significant regarding relationship with pharmacy engagement (beta=0.45. Concurrently, the model from empirical data fit with the hypothetical model (p-value = 0.06, adjusted chi-square (CMIN/DF=1.16, Goodness of Fit Index (GFI=0.93, Comparatively Fit Index (CFI=0.99, and Root Mean Square Error Approximation (RMSEA=0.03. Conclusion: The study confirmed the indirect positive influence of customer perceptions about pharmacist on pharmacy customer devotion in providing pharmacy services via pharmacy
Max Joseph Herman
Full Text Available ABSTRACT Background: Up to now there are more than 60 schools of pharmacy with a variety of accreditation level in lndonesia. Previous study found that the standard of pharmaceutical services at various service facilities (hospitals, primary health care and community pharmacy can not be fully implemented because of the limited competency of pharmacist. This study was conducted to identify the qualification of pharmacist who delivers services in community pharmacy in compliance with the Indonesian Health Law No. 36 of 2009. As mandated in the Health Law No. 36 of 2009, the government is obliged to establish minimum requirements that must be possessed. Methods: This cross sectional study was conducted in 2010 at 2 community pharmacies in each of 3 cities, i.e. Bandung, DI Yogyakarta and Surabaya. Other than ten pharmacists delivering services in community pharmacies, there were pharmacists as informants from 4 institutions in each city selected, i.e. six pharmacists from two Schools of Pharmacy, three pharmacists from three Regional Indonesian Pharmacists Association,six pharmacists from three District Health Offices and three Provincial Health Offices. Primary data collection through in-depth interviews and observation as well as secondary data collection concerning standard operating procedures, monitoring documentation and academic curricula has been used. Descriptive data were analysed qualitatively Results: The findings indicate that pharmacists' qualification to deliver services in a community pharmacy in accordance with the Government Regulation No. 51 of 2009, Standards of Pharmacy Services in Community Pharmacy and Good Pharmaceutical Practices (GPP was varied. Most pharmacists have already understood their roles in pharmacy service, but to practice it in accordance with the standards or guidelines they are still having problems. It is also acknowledged by pharmacists in other institutions, including School of Pharmacy, Regional
Thai, Loc P; Vitry, Agnes I; Moss, John R
There are many medicines listed on the Australian Pharmaceutical Benefits Scheme (PBS) in which point of sale price is less than the level of the general patient co-payment. In these circumstances, the patient covers the total cost of the medicine from their own pocket with no government subsidy. The aim of the present study was to compare the consumer prices of under general co-payment prescription medicines between banner group pharmacies with open discounting policies and community pharmacies without; and to assess the impact of the April 2012 PBS price disclosure policies on the discounts offered. The consumer prices of 31 under co-payment medicines were collected from banner group pharmacy websites and individual pharmacies both before and after April 2012. PBS maximum prices were obtained from the PBS website. Absolute and relative price differences between PBS and pharmacy groups were calculated. Before April 2012, banner group pharmacies provided discounts to patients of around 40% per prescription, whereas other pharmacies provided discounts of around 15%. Total price savings were on average $9 per prescription at banner group pharmacies and $3.50 at other pharmacies. Percentage discounts did not change greatly after April 2012, when price decreases occurred on the PBS. Banner group pharmacies with pricing strategies are able to provide greater discounts to patients compared with other pharmacies. Community pharmacies still have the ability to provide substantial discounts after the April 2012 price reductions. WHAT IS KNOWN ABOUT THE TOPIC?: There is currently little known about the under co-payment medicines market in Australia and the price discounts available to patients. WHAT DOES THIS PAPER ADD?: This research shows that patients who purchase under co-payment medicines are able to save money if they purchase from pharmacies with openly advertised discounting policies. Price reductions related to the implementation of the price disclosure policy had a
Method: Sixty (60) pre-tested questionnaires were randomly administered to community pharmacists. Forty-three (43) questionnaires were retrieved for analysis. Results: The study revealed that the use of community pharmacies as places where routine immunization services can be provided is feasible as shown by 95.3% ...
By law, medical faculties are mandated to have a designated partner hospital for the purposes of student practical training. In contrast, pharmacy faculties do not have such a legal requirement for student training in a community pharmacy setting. Nevertheless, there are several public and private universities that do have community pharmacies. However, there is no national university that has established both an educational hospital and a community pharmacy. When Kanazawa University (KU) established a graduate school with a clinical pharmacy course, the faculty of KU deemed it necessary to set up an independent community pharmacy for the purpose of practical training. Thus, in 2003, the Acanthus Pharmacy was set up as the first educational community pharmacy in Japan, managed by a nonprofit organization, with the permission of the Ishikawa Pharmaceutical Association and local community pharmacists. Since that time, Acanthus has managed a clinical pharmacy practice for students from both the undergraduate and graduate schools of KU. From 2006, the undergraduate pharmacy program was changed to a 6-year program, and the Acanthus Pharmacy has continued its roles in educating undergraduate pharmaceutical students, medical students, and as a site of early exposure for KU freshmen. From our experience, it is important to have a real clinical environment available to university pharmacy faculty and students, especially in training for community pharmacy practices.
Jennifer L. Rodis, Pharm.D., B.C.P.S.
Full Text Available Purpose: As community pharmacies are implementing increasingly more clinical services they are faced with a new challenge of marketing these services. This article discusses The Ohio State University College of Pharmacy Clinical Partners Program’s (Clinical Partners experiences in marketing clinical services to patients, barriers encountered through these experiences, and presents suggestions for future marketing of services.Experience: Clinical Partners developed two targeted marketing projects and evaluated impact on patient enrollment in services. In January 2008, the pharmacy ran a series of radio advertisements, newspaper print advertisements, and face to face marketing in the community with the focus of each being patient care services. During this project five individuals expressed interest in Clinical Partners’ services. Four indicated that they heard about Clinical Partners through the radio ad and one through the pharmacy website, though none chose to enroll in services. In 2009 Clinical Partners focused on marketing MTM in the form of a comprehensive medication review to current patients already enrolled in its anticoagulation management service. Following a three month period, 6 patients (8% of the 71 patients receiving the marketing intervention chose to enroll in MTM. Four additional patients have enrolled in MTM since conclusion of the project.Discussion: These projects and a review of available literature revealed barriers that pharmacies encounter when marketing clinical services to patients in an outpatient setting including patients’ unawareness of the role a pharmacist can play outside dispensing medications, patients’ belief they do not need clinical services, and patients’ unwillingness to pay a pharmacist out of pocket for services.Future Implications: To overcome these identified challenges, community pharmacies should consider integration of marketing techniques such as tailoring marketing to a target
Kristina D. Wood
Full Text Available Purpose: As community pharmacies are implementing increasingly more clinical services they are faced with a new challenge of marketing these services. This article discusses The Ohio State University College of Pharmacy Clinical Partners Program's (Clinical Partners experiences in marketing clinical services to patients, barriers encountered through these experiences, and presents suggestions for future marketing of services. Experience: Clinical Partners developed two targeted marketing projects and evaluated impact on patient enrollment in services. In January 2008, the pharmacy ran a series of radio advertisements, newspaper print advertisements, and face to face marketing in the community with the focus of each being patient care services. During this project five individuals expressed interest in Clinical Partners' services. Four indicated that they heard about Clinical Partners through the radio ad and one through the pharmacy website, though none chose to enroll in services. In 2009 Clinical Partners focused on marketing MTM in the form of a comprehensive medication review to current patients already enrolled in its anticoagulation management service. Following a three month period, 6 patients (8% of the 71 patients receiving the marketing intervention chose to enroll in MTM. Four additional patients have enrolled in MTM since conclusion of the project. Discussion: These projects and a review of available literature revealed barriers that pharmacies encounter when marketing clinical services to patients in an outpatient setting including patients' unawareness of the role a pharmacist can play outside dispensing medications, patients' belief they do not need clinical services, and patients' unwillingness to pay a pharmacist out of pocket for services. Future Implications: To overcome these identified challenges, community pharmacies should consider integration of marketing techniques such as tailoring marketing to a target population
Purpose: To assess the consumer preference for community pharmacy (CP) for filling prescription, and ... For OTC products, preference among consumers was almost the same among. CPs and local stores. With regard to health supplements and screening test kits, most ..... MARA, Malaysia for financial support for this.
Norris, Pauline; Horsburgh, Simon; Sides, Gerald; Ram, Sanya; Fraser, John
Geographic access to community pharmacies is an important aspect of access to appropriate medicines. This study aimed to explore changes in the number and location of pharmacies in New Zealand and determine whether some populations have poor geographical access to pharmacies. Pharmacy numbers in New Zealand have been declining since the mid-1980s, and, adjusted for population growth, there are now only half the number there was in 1965. While the urbanisation of pharmacies has been matched by loss of population in rural areas, the loss of pharmacies from smaller rural towns leaves many people with poor access to pharmacy services. Copyright © 2014 Elsevier Ltd. All rights reserved.
Ho, Certina; Hung, Patricia; Lee, Gary; Kadija, Medina
Incident reporting offers insight into a variety of intricate processes in healthcare. However, it has been found that medication incidents are under reported in the community pharmacy setting. The Community Pharmacy Incident Reporting (CPhIR) program was created by the Institute for Safe Medication Practices Canada specifically for incident reporting in the community pharmacy setting in Canada. The initial development of key elements for CPhIR included several focus-group teleconferences with pharmacists from Ontario and Nova Scotia. Throughout the development and release of the CPhIR pilot, feedback from pharmacists and pharmacy technicians was constantly incorporated into the reporting program. After several rounds of iterative feedback, testing and consultation with community pharmacy practitioners, a final version of the CPhIR program, together with self-directed training materials, is now ready to launch. The CPhIR program provides users with a one-stop platform to report and record medication incidents, export data for customized analysis and view comparisons of individual and aggregate data. These unique functions allow for a detailed analysis of underlying contributing factors in medication incidents. A communication piece for pharmacies to share their experiences is in the process of development. To ensure the success of the CPhIR program, a patient safety culture must be established. By gaining a deeper understanding of possible causes of medication incidents, community pharmacies can implement system-based strategies for quality improvement and to prevent potential errors from occurring again in the future. This article highlights key features of the CPhIR program that will assist community pharmacies to improve their drug distribution system and, ultimately, enhance patient safety.
Chui, Michelle A; Stone, Jamie A
Background A handoff is the process of conveying necessary information in order to transfer primary responsibility for providing safe and effective drug therapy to a patient from one community pharmacist to another, typically during a shift change. The handoff information conveyed in pharmacies has been shown to be unstructured and variable, leading to pharmacist stress and frustration, prescription delays, and medication errors. Objective The purpose of this study was to describe and categorize the information hazards present in handoffs in community pharmacies. Methods A qualitative research approach was used to elicit the subjective experiences of community pharmacists. Community pharmacists who float or work in busy community pharmacies were recruited and participated in a face to face semi-structured interview. Using a systematic content data analysis, the study identified five categories of information hazards that can lead to information chaos, a framework grounded in human factors and ergonomics. Results Information hazards including erroneous information and information overload, underload, scatter, and conflict, are experienced routinely by community pharmacists during handoff communication and can result in information chaos. The consequences of information chaos include increased mental workload, which can precipitate problematic prescriptions “falling between the cracks”. This can ultimately impact patient care and pharmacist quality of working life. Conclusions The results suggest that handoffs in community pharmacies result in information hazards. These information hazards can distract pharmacists from their primary work of assessing prescriptions and educating their patients. Further research on how handoffs are conducted can produce information on how hazards in the system can be eliminated. PMID:23665076
Pottegård, Anton; Kviesgaard, Ann-Katrine; Hesse, Ulrik
BACKGROUND: Use of over-the-counter (OTC) high-dose acetylsalicylic acid (ASA) is a risk factor for experiencing gastric bleeding. However, more detailed knowledge on the characteristics of users of OTC ASA is needed. OBJECTIVE: To characterise users of OTC high-dose ASA in a Danish pharmacy sett...
community pharmacies and pharmacists in Harare, Zimbabwe. Forty three percent of the customers visited the pharmacy less than once a month. The majority of respondents (91 %) visited the pharmacy to purchase medicines recommended by their doctor. Most of the respondents (61.2 %) were not loyal to any particular ...
Pottegård, Anton; Hallas, Jesper; Søndergaard, Jens
International studies regarding pharmacists' interventions towards prescription problems produce highly variable results. The only peer-reviewed study in a Danish setting estimated an intervention rate of 2.3 per 1,000 prescriptions. With the introduction of a new tool for registration, we...
Christensen, Søren Troels; Søndergaard, Birthe; Honoré, Per Hartvig
of pharmacists in ADR reporting, although varies significantly among countries. Pharmacists in community pharmacies are in a unique position for detection of experienced ADRs by the drug users. The study reports from a study on community pharmacy internship students' proactive role in ADR detection through...
Pattin, Anthony J; Kelling, Sarah E; Szyskowski, Jim; Izor, Michelle L; Findley, Susan
Pharmacy internships provide students with practical experiences that lead to enhancement of clinical skills and personal growth. To describe the design and implementation of a structured 10-week summer pharmacy internship program in a supermarket chain pharmacy. The pharmacy leadership team developed and piloted a new format of the pharmacy internship during the summer of 2013. Pharmacy students in professional year 1 (P1), 2 (P2), and 4 (P4) were invited to apply for a paid internship. Pharmacy students were recruited from all colleges of pharmacy in the state of Michigan. The goal of the new program was to create a focused learning opportunity that encouraged students to develop knowledge, skills, and abilities about patient care, pharmacy management, and working within a team. A total of 19 interns were recruited (P1 = 7, P2 = 7, and P4 = 5). Students practiced 40 hours per week and participated in the medication dispensing process and employee biometrics screening program. Interns provided approximately 500 assessments on pharmacy employees and all P1 and P2 interns completed a patient care project. The restructured internship program provided pharmacy students with a 10-week program that exposed them to many aspects of community pharmacy practice. The program needs future refinement and assessment measures to verify interns improve skills throughout the program. © The Author(s) 2015.
Corelli, Robin L; Chai, Tiffany; Karic, Alda; Fairman, Melinda; Baez, Karina; Hudmon, Karen Suchanek
To characterize the extent to which state and national professional pharmacy associations have implemented formal policies addressing the sale of tobacco and alcohol products in community pharmacies. To determine existence of tobacco and alcohol policies, national professional pharmacy associations (n = 10) and state-level pharmacy associations (n = 86) affiliated with the American Pharmacists Association (APhA) and/or the American Society of Health-System Pharmacists (ASHP) were contacted via telephone and/or e-mail, and a search of the association websites was conducted. Of 95 responding associations (99%), 14% have a formal policy opposing the sale of tobacco products in pharmacies and 5% have a formal policy opposing the sale of alcohol in pharmacies. Of the associations representing major tobacco-producing states, 40% have a formal policy against tobacco sales in pharmacies, significantly more than the 8% of non-tobacco state associations with such policies. Among national professional pharmacy associations, only APhA and ASHP have formal policy statements opposing the sale of both tobacco and alcohol in pharmacies. Most state-level professional pharmacy associations affiliated with these two national organizations have no formal policy statement or position.
Weidmann, Anita Elaine; MacLure, Katie; Marshall, Sarah; Gray, Gwen; Stewart, Derek
Obesity has reached pandemic levels with more than 1.4 billion adults affected worldwide. While there is a need to systematically develop and evaluate community pharmacy based models of weight management, it is imperative to describe and understand the perspectives of pharmacy staff. In the UK, trained and accredited community pharmacy medicines counter assistants (MCAs) are commonly the front line staff involved in patient consultations and sale of over-the-counter medicines. To explore the beliefs and experiences of pharmacists and MCAs in the North-East of Scotland on community pharmacy weight management. All 135 community pharmacies in the North-East of Scotland. A qualitative approach of semi-structured telephone interviews with 31 pharmacists and 20 MCAs in the North-East of Scotland. The semi-structured interview schedule was developed with reference to key domains describing professional practice (i.e. awareness and knowledge, skills, practicalities, motivation, acceptance and beliefs) and contextualised with policy documents and published research on community pharmacy based weight management. Interviews were audio-recorded, transcribed and analysed thematically. Pharmacists' and MCAs' beliefs and experiences with delivering weight management services in community pharmacy. There were mixed responses from pharmacists and MCAs around pharmacy based weight management services from positive views of providing the service in community pharmacy to those more reticent who would always favour patients visiting their physician. While all described similar services e.g. measurement of weight, healthy eating advice, supply of products, they acknowledged that support was often opportunistic at the request of customers, with little integration of other providers. Roles described varied from pharmacist only functions to any staff member. While pharmacists generally felt comfortable and confident, MCAs gave more diverse responses. Both Pharmacist and MCAs highlighted
Malewski, David F; Ream, Aimrie; Gaither, Caroline A
Patient satisfaction with pharmaceutical care can be a strong predictor of medication and other health-related outcomes. Less understood is the role that location of pharmacies in urban or suburban environments plays in patient satisfaction with pharmacy and pharmacist services. The purpose of this study was to serve as a pilot examining urban and suburban community pharmacy populations for similarities and differences in patient satisfaction. Community pharmacy patients were asked to self-administer a 30-question patient satisfaction survey. Fifteen questions addressed their relationship with the pharmacist, 10 questions addressed satisfaction and accessibility of the pharmacy, and five questions addressed financial concerns. Five urban and five suburban pharmacies agreed to participate. Data analysis included descriptive statistics and chi-square analysis. Most patients reported high levels of satisfaction. Satisfaction with pharmacist relationship and service was 70% or higher with no significant differences between locations. There were significant differences between the urban and suburban patients regarding accessibility of pharmacy services, customer service and some patient/pharmacist trust issues. The significant differences between patient satisfaction in the suburban and urban populations warrant a larger study with more community pharmacies in other urban, suburban and rural locations to better understand and validate study findings. Copyright © 2015 Elsevier Inc. All rights reserved.
Sobota, Kristen Finley; Barnes, Jeremiah; Fitzpatrick, Alyse; Sobota, Micah J
The Ohio Northern University American Society of Consultant Pharmacists chapter provides students the opportunity to apply classroom knowledge with learning through community service. One such program took place at the Lima Towers Apartment Community from September 18, 2014, to October 2, 2014, in Lima, Ohio. Three evening educational sessions focused on a different health topic: 1) mental health, 2) medication adherence/brown bag, and 3) healthy lifestyle choices/nutrition/smoking cessation. All three programs were structured identically, starting with dinner, followed by educational intervention, survey, blood pressure checks, and medication reviews. Two pharmacists and 16 pharmacy students implemented the program. Participants completed a total of 76 satisfaction surveys for the three programs, which were included in the data analysis. The average age of the participants was 65 years; 82% (n = 63) were female. Data demonstrated that 94% (n = 72) "learned something new," while 96% (n = 74) would "recommend the program to a friend/family member." The collected data showed the vast majority of participants from the surrounding community found value in the presentations performed by students, especially with regard to the new information they received and its perceived benefits. In light of such successes, we encourage other student chapters to implement similar community outreach events. ASCP student members can make a strong, positive impact in the community while learning in a nontraditional environment.
Martins, Sílvia Filipa; van Mil, J W Foppe; da Costa, Filipa Alves
The role of the pharmacist has undergone profound changes over the recent years. In most European countries, the tendency seems to be that pharmacists are moving from being product-oriented to service-oriented. An interesting series of papers describing care related services of pharmacy in various countries has been published in 2006, but much has changed since then. This paper aims to provide an updated view on the overall health care sector in Europe, with a special focus on services in community pharmacy. To list and compare health care and community pharmacy structure in Europe; and to discuss the facilitators and barriers that can be found in health care systems and may promote or hinder the implementation of new community pharmacy services. European community pharmacy practice. A cross-sectional study was undertaken where data were collected using an online survey sent to a purposive sample of representatives from 27 European countries. Main outcome measure variation in professional community pharmacy services across Europe. Data were obtained from 22 respondents in 19 countries (70.4%). Health care is mainly provided by a form of public National Health Services in 17 of the 19 countries. Demographic criteria for founding new pharmacies were present in 17 countries. Medicines are exclusively available in pharmacies in approximately one third of the countries. Smoking cessation (93.8%), drug waste management (81.3%) and pharmaceutical care programmes for specific diseases (77.8%) were reported as the most widely disseminated services in European pharmacies. There are still major differences between community pharmacy practice in Europe. Differences are mostly due to the legal framework and remuneration issues, which impact on the range of services available from pharmacies to the community of each country.
Jahn, Michelle A; Caldwell, Barrett S
As the expansion and utilisation of community pharmacy systems increases, so does the risk for an adverse drug event to occur. In attempts to mitigate this risk, many community pharmacies implement health information technology (IT); however, there are challenges in integrating the wider systems components necessary for a successful implementation with minimal unintended consequences. The purpose of this paper is to introduce a Community Health Integration through Pharmacy Process and Ergonomics Redesign (CHIPPER) framework, which explores the multiple angles of health IT integration to support medication delivery processes in community pharmacy systems. Specifically, CHIPPER identifies the information flows that occur between different parts of the system (initiation, upstream, midstream and downstream) with varying end-users and tasks related to medication delivery processes. In addition to the justification and presentation of the CHIPPER model, this paper reviews several broad applications for CHIPPER and presents two example studies that demonstrate the CHIPPER framework. Practitioner Summary: Most medication delivery in the US occurs through outpatient-based community pharmacy practice. Community pharmacies are challenged by inconsistent and incomplete information flow and technology integration between providers, pharmacy practitioners and patients. This paper presents a framework for improved healthcare systems engineering analysis of pharmacy practice, with case study examples.
James, Tess H; Helms, Margaret L; Braund, Rhiannon
There are many causes of medication waste, including excess supply, treatment changes, and patient nonadherence to therapy. Investigating medication returns may indicate areas for targeting interventions to reduce waste. To identify and quantify the types and amounts of medications returned to community pharmacies and, specifically, to quantify the percentage of medication returned from the original dispensing, its therapeutic category, and reasons for not being used. Unsolicited medication returned for disposal to the 24 community pharmacies in the Taranaki region (approximately 37,000 households) of New Zealand over a 6-week period was analyzed. The results were entered into a database, recording medication, amount originally issued (if known), date of issue, Anatomical Therapeutic Chemical (ATC) classification, and reason for nonuse. Cross-tabulation of ATC category versus percentage returned as well as ATC category versus reason for returns was performed. Adjusted standardized residuals were investigated to determine specific cells that were in excess of the expected counts. Complete information was available for 2704 items. The majority (51%) of returns contained 75-100% of the original dispensed amount of medication. For the respiratory category, 77% of the returns were in the 75-100% group, significantly more than for any other therapeutic group. Reasons for returns were recorded as bereavement (22%), surplus to requirements (17%), expired (8%), medication change (11%), dose change (3%), and unknown (39%). The cardiovascular group and respiratory groups had a higher rate of returned drugs due to medication changes and surplus to requirements, respectively. The majority of returned medications contained greater than 75% of the original amount issued. Identification of therapeutic groups having higher rates of returns due to medication changes or surplus to requirements may suggest areas to target to reduce medication waste.
Timothy McPherson, PhD, RPh
Full Text Available Leaders in the profession of pharmacy have articulated a vision of pharmacists as providers of patient-centered care (PCC services and the Doctor of Pharmacy was established as the required practice degree to achieve this vision. Pharmacist-provided PCC services have been shown to reduce medication costs and improve patient compliance with therapies. While community pharmacists are capable of, and are ideally placed for, providing PCC services, in fact they devote most of their time to prescription dispensing rather than direct patient care. As professionals, community pharmacists are charged with protecting society by providing expert services to help consumers manage risks associated with drug therapies. Historically pharmacists fulfilled this responsibility by accurately dispensing prescription medications, verifying doses, and allergy checking. This limited view of pharmacy practice is insufficient in light of the modern view of pharmacists as providers of PCC. The consumers’ view of community pharmacy as a profession represents a barrier to transforming the basis of community pharmacy from product distribution to providing PCC services. Community pharmacists are conferred with social authority to dictate the manner in which their professional services are provided. Pharmacists can therefore facilitate the transition to PCC as the primary function of community pharmacy by exercising their social authority to engage consumers in their roles in the new patient-pharmacist relationship. Each pharmacist must decide to provide PCC services. Suggestions for initiating PCC services in community pharmacy are offered.
Wang, Junling; Munshi, Kiraat D.; Hong, Song Hee
Background Since 2009, pharmacists in all 50 states in the U.S. have been authorized to administer vaccinations. Objectives This study examined racial and ethnic disparities in the reported receipt of influenza vaccinations within the past year among noninstitutionalized community pharmacy patients and non-community pharmacy respondents. Methods The 2009 Medical Expenditure Panel Survey was analyzed. The sample consisted of respondents aged 50 years or older, as per the 2009 recommendations by the Advisory Committee on Immunization Practices. Bivariate and multivariate logistic regression analyses were conducted to examine the influenza vaccination rates and disparities in receiving influenza vaccinations within past year between non-Hispanic Whites (Whites), non-Hispanic Blacks (Blacks) and Hispanics. The influenza vaccination rates between community pharmacy patients and non-community pharmacy respondents were also examined. Results Bivariate analyses found that among the community pharmacy patients, a greater proportion of Whites reported receiving influenza vaccinations compared to Blacks (60.9% vs. 49.1%; P < 0.0001) and Hispanics (60.9% vs. 51.7%; P < 0.0001). Among non-community pharmacy respondents, differences also were observed in reported influenza vaccination rates among Whites compared to Blacks (41.0% vs. 24.3%; P < 0.0001) and Hispanics (41.0% vs. 26.0%; P < 0.0001). Adjusted logistic regression analyses found significant racial disparities between Blacks and Whites in receiving influenza vaccinations within the past year among both community pharmacy patients (odds ratio [OR]: 0.81; 95% CI: 0.69–0.95) and non-community pharmacy respondents (OR: 0.66; 95% CI: 0.46–0.94). Sociodemographic characteristics and health status accounted for the disparities between Hispanics and Whites. Overall, community pharmacy patients reported higher influenza vaccination rates compared to non-community pharmacy respondents (59.0% vs. 37.2%; P < 0.0001). Conclusion
Marković-Peković, Vanda; Grubiša, Nataša
Self-medication with antibiotics adds to the global risk of increased spread of bacterial resistance. Attitudes and behavior of health professionals also may reinforce self-medication with antibiotics. The aim of this study was to determine whether self-medication with antibiotics is possible in our community pharmacies and to what extent, and to evaluate the behavior and service of pharmacy health professionals regarding non-prescription antibiotic dispensation. An observational, cross-section study was conducted, and pseudo-patient methodology was used to establish the kind of professional service provided in case of patient's explicit demand to buy an antibiotic for treatment of self-diagnosed upper respiratory tract infection. Of the total 318 community pharmacies, 131 (41%) were visited and included in the study. Non-prescription antibiotics were dispensed in 76 (58%) pharmacies. Counseling and symptomatic therapy was offered in 88 (67%) pharmacies. In 25% of pharmacies, no symptomatic therapy was offered; instead, only an antibiotic was sold. Amoxicillin was sold in 85% of cases and, mostly, the one of 1.30 Euro per pack. Both oral and written use instructions were given in 78% cases, whereas none was given in 3% of cases. Self-medication with antibiotics occurs in our community pharmacies, despite being illegal. Pharmacy staff behavior can be a factor that puts patients at risk for self-medication with antibiotics. Community pharmacies are failing their tasks in enhancing rational use of antibiotics. Such a practice may be a consequence of weak enforcement and control over the legislation and professional standards. Copyright © 2012 John Wiley & Sons, Ltd.
Pharmacy practice has transcended from largely a dispensary practice to pharmaceutical care practice. The capacity of community pharmacies to deliver pharmaceutical care was studied using pretested self survey methods. Ninety five percent (95%) of the respondents always educated customers on drug related needs, ...
Gyawali, Sudesh; Rathore, Devendra Singh; Adhikari, Kishor; Shankar, Pathiyil Ravi; K C, Vikash Kumar; Basnet, Suyog
Community pharmacies in Nepal serve as the first point of contact for the public with the health care system and provide many services, including administering injections. However, there is a general lack of documented information on pharmacy practice and injection use in these pharmacies. This study aims to provide information about pharmacy practice in terms of service and drug information sources, and injection use, including the disposal of used injection equipment. A mixed method, cross-sectional study was conducted in 54 community pharmacies in Pokhara city. Data was collected using a pre-tested, semi-structured questionnaire, and also by the direct observation of pharmacy premises. Interviews with pharmacy supervisors (proprietors) were also conducted to obtain additional information about certain points. Interviews were carried out with 54 pharmacy supervisors/proprietors (47 males and 7 females) with a mean age and experience of 35.54 and 11.73 years, respectively. Approximately a half of the studied premises were operated by legally recognized pharmaceutical personnel, while the remainder was run by people who did not have the legal authority to operate pharmacies independently. About a quarter of pharmacies were providing services such as the administration of injections, wound dressing, and laboratory and consultation services in addition to medicine dispensing and counseling services. The 'Current Index of Medical Specialties' was the most commonly used source for drug information. Almost two-thirds of patients visiting the pharmacies were dispensed medicines without a prescription. Tetanus Toxoid, Depot-Medroxy Progesterone Acetate, and Diclofenac were the most commonly-used/administered injections. Most of the generated waste (including sharps) was disposed of in a municipal dump without adhering to the proper procedures for the disposal of hazardous waste. Community pharmacies in Pokhara offer a wide range of services including, but not limited to
Naik Panvelkar, Pradnya; Saini, Bandana; Armour, Carol
The aim of this review is to conduct an in-depth analysis of the available literature in order to identify and evaluate studies measuring patient satisfaction with pharmacy services delivered by pharmacists in a community setting. An extensive literature search was conducted in five databases (Medline, Scopus, Embase, Psychinfo, International Pharmaceutical Abstracts) using the search terms "patient/client/consumer satisfaction" AND "community pharmacy/pharmacies" AND "pharmacy service/pharmaceutical services/pharmacy program/intervention/intervention studies". Only those articles where the main focus was measuring patient satisfaction with services delivered in community pharmacies were included in the review. Patient satisfaction was explored with three different levels of pharmacy services -- general services, intervention services and cognitive services. Twenty-four articles measuring patient satisfaction with community pharmacy services were retrieved. Of these, eleven measured patient satisfaction with general services, six measured satisfaction with intervention services and seven measured satisfaction with cognitive services. The majority of studies reviewed had adopted and measured satisfaction as a multidimensional construct. None of the studies reviewed tested any theoretical models of satisfaction. Further a lack of consistent instruments measuring patient satisfaction was observed, with most of the reviewed studies using self developed, non-validated or ad hoc instruments with items from various previously published papers. The review also observed high levels of patient satisfaction with pharmacy services be they general, intervention or cognitive services. This review found that patient satisfaction has been measured within the community pharmacy context to a certain degree. Further research is needed to develop and test instruments based on theoretical frameworks, to test satisfaction pre and post hoc and in well designed randomized controlled
Saengcharoen, Woranuch; Lerkiatbundit, Sanguan
To describe practice behavior and understanding among pharmacy personnel, both pharmacists and non-pharmacist staff, in the management of mild and moderate migraines. Migraine is recognized as a prevalent and chronic neurological disorder. In developing countries, such as Thailand, community pharmacies are a widely used source of health care for various illnesses including migraine. However, the quality of migraine management and knowledge among pharmacy personnel is unclear. Cross-sectional study. The sample comprised 142 randomly selected community pharmacies in a city in the south of Thailand. Simulated clients visited the pharmacies twice, at least 1 month apart, to ask for the treatment of mild and moderate migraines. After the encounters, question asking, drug dispensing, and advice giving by pharmacy staff were recorded. Subsequently, the providers in 135 pharmacies participated in the interview to evaluate their knowledge in migraine management. The majority of pharmacy personnel were less likely to ask questions in cases of mild migraine when compared with moderate attack (mean score [full score = 12] 1.8 ± 1.6 vs 2.6 ± 1.5, respectively, P knowledge on migraine management. Pharmacists had better knowledge on question asking (mild migraine 5.1 ± 2.1 vs 3.1 ± 1.3, respectively, P knowledge on advice giving but poorer drug dispensing in moderate migraine according to the guidelines, relative to non-pharmacists (20.5% vs 40.3%, P = .014). A large number of community pharmacists and non-pharmacist staff had inappropriate practice behavior and understanding. Continuing education and interventions are important to improve the practice and knowledge of pharmacy personnel, particularly the pharmacists. © 2013 American Headache Society.
Jennifer L. Rodis, Pharm.D., BCPS
Full Text Available Objective: To discuss the experience of sharing an experiential model of education and practice development between two colleges of pharmacy and to provide a framework to guide faculty in this type of collaboration.Case Study: The Ohio State University College of Pharmacy (OSU COP Partner for Promotion (PFP program was developed in response to the need for advancing practice in the community pharmacy setting. After successful implementation of this program, the PFP program design and materials were shared, adapted, and implemented at the University of Utah College of Pharmacy (Utah COP. Collaborating faculty developed a framework based on lessons learned through this experience which proposes key guiding strategies as considerations to address prior to embarking on sharing any aspect of an educational program or model between institutions. Each step of the framework is described and applied to the process followed by The OSU COP and Utah COP in sharing the PFP program. Additional considerations related to transfer of educational models are discussed.Results/Conclusion: Sharing the education model and materials associated with the PFP program between institutions has enhanced experiential opportunities for students and helped develop residency training sites in the community setting. In addition, the relationship between the two colleges has contributed to faculty development, as well as an increase in community pharmacy service development with community pharmacy partners at each institution. It is hoped this experience will help guide collaborations between other colleges of pharmacy to enhance education of future pharmacists while positively impacting pharmacy practice, teaching, and research by faculty.
BackgroundViolence in community pharmacies in Ireland is thought to be common but underreported. The frequency and consequences of violence has not been studied previously.AimsTo establish the frequency and nature of violence in community pharmacies over 12 months, and to investigate the impact of violence on employees and possible consequence for the industry.MethodsA two-part survey was distributed to community pharmacies in Ireland in 2011 (n = 200). The first part related to pharmacy demographics, the frequency of various violent events (verbal abuse, threats etc.), the respondents\\' worry regarding violence and its impact on their co-workers. The second part concerned individual employees\\' subjective response to a violent event, using the Impact of Event Scale-Revised (IES-R).ResultsFifty-seven per cent of the pharmacies responded, with 77% reporting some violent event (verbal or physical), over the past year. Eighteen per cent reported physical assault, and 63% were worried about workplace violence. There was no association between late night opening hours or pharmacy size and violence frequency. Positive statistically significant correlations were present between all types of violence and absenteeism and employee fear levels. An IES-R score could be calculated for 75 respondents; the median IES-R score was 8 with 19% reporting clinically significant scores.ConclusionsViolence is common in Irish community pharmacies and impacts on employees and the industry.
White, Lesley; Klinner, Christiane
Although various instruments have been developed to measure customer satisfaction with community pharmacy services, there is limited research regarding pharmacy staffs' understanding of service quality and its determinants. This study aimed to explore the perceptions of pharmacy staff regarding the factors that constitute a high level of service quality using the service quality determinants proposed by the Conceptual Model of Service Quality. Structured interviews were conducted with 27 pharmacy assistants and 6 pharmacists in 3 community pharmacies in Sydney. The interview questions focused on the participants' perceptions of consumer expectations, the translation of these perceptions into service quality specifications, the actual service delivery, and the communication to customers. From the pharmacy staff perspective, service quality is significantly limited by insufficient internal communication and control processes that impede role clarity and the resolution of conflicting role expectations among customer service personnel. Participants indicated that these problems could be alleviated through the implementation of more transparent, realistic, measurable, and accepted quality specifications by pharmacy management. The study indicates that the extent to which pharmacy management sets, maintains, and communicates service quality specifications to staff directly affects role clarity, role conflict, and organizational commitment among customer service staff, which in turn directly influence the level of service quality provided to the customers. Copyright © 2012 Elsevier Inc. All rights reserved.
Cavaye, Diana; Lehnbom, Elin C; Laba, Tracey-Lea; El-Boustani, Elise; Joshi, Rohina; Webster, Ruth
Given time pressures on primary care physicians, utilising pharmacists for chronic disease management is of great interest. However, limited data are available on the current workflow in community pharmacies to guide these discussions. This study aimed to test the feasibility of collecting workflow data from Australian community pharmacies using the Work Observation Method By Activity Timing (WOMBAT) software and provide preliminary data on Australian pharmacy workflow. Data were collected from three pharmacies and four variables were recorded: what the pharmacist did, with whom, where and how. All tasks were timed and data were analysed to identify total number of tasks, median time per task, proportion of time per task, and common task combinations. Pharmacists' main tasks consisted of counselling, dispensing and management activities (27%, 21% and 17% respectively of the overall number of tasks) and these tasks also took the majority of their time. Tasks were frequent but short, with the average time per task ranging from 0.55 to 8.46 min and most time was spent in areas without the capacity for patient interaction (51% in the dispensing/compounding area and 6% in the back office). Pharmacies are dynamic environments with the average task taking 1-2 min. Longer interventions may not be easily integrated into current pharmacy workflow. Copyright © 2018 Elsevier Inc. All rights reserved.
Kälvemark Sporrong, Sofia; Nordén-Hägg, Annika
pharmacies prior to and after the 2009 changes in regulation of the Swedish community pharmacy market. Methods: Questionnaires targeted at pharmacy staff before and after the changes in regulation (in 2008, 2011/12, and 2012/13 respectively) used four identical items, making comparisons of some aspects......Background: All changes in the regulation of pharmacies have an impact on the work carried out in pharmacies and also on patient safety, regardless of whether this is the intention or not. Objective: To compare staff apprehension regarding some aspects of patient safety and quality in community......, in order to counteract conceivable decline in factors including patient safety and working conditions....
Sabater-Hernández, Daniel; Azpilicueta, Inés; Sánchez-Villegas, Pablo; Amariles, Pedro; Baena, María I; Faus, María J
To investigate whether the measurement of blood pressure in the community pharmacy is a valuable method to diagnose hypertension, to assess the need and the effectiveness of anti-hypertensive treatments, or, in general, to make clinical decisions. Information has been extracted from articles published in English and in Spanish, from January 1989 to December 2009, in indexed magazines in MEDLINE and EMBASE. To perform the search, multiple and specified terms related to the community pharmacy setting, to blood pressure measurement and to the comparison and agreement between blood pressure measurement methods were used. Selected articles were those that: (1) compared and/or measured the agreement (concordance) between community pharmacy blood pressure measurements obtained in repeated occasions, or (2) compared and/or measured the agreement between the community pharmacy blood pressure measurement method and other measurement methods used in clinical practice for decision-making purposes: blood pressure measurement by a physician, by a nurse and home or ambulatory blood pressure monitoring. Articles were included and analyzed by two investigators independently, who essentially extracted the main results of the manuscripts, emphasizing the assessment of the blood pressure measurement methods used and the completed statistical analysis. Only three studies comparing the community pharmacy blood pressure measurement method with other methods and one comparing repeated measurements of community pharmacy blood pressure were found. Moreover, these works present significant biases and limitations, both in terms of method and statistical analysis, which make difficult to draw consistent conclusions. Further research of high quality is needed, which results can guide the clinical decision-making based on the community pharmacy blood pressure measurement method.
Pohjanoksa-Mäntylä, Marika K; Kulovaara, Heidi; Bell, J Simon; Enäkoski, Marianne; Airaksinen, Marja S
The importance of email as a mode of communication between medication users and pharmacists is likely to increase. However, little is known about the email medication counseling practices of community pharmacies. To determine the prevalence of email medication counseling services in Finland and to assess the accuracy and comprehensiveness of responses by pharmacies providing the opportunity for email medication counseling to inquiries related to use of antidepressants. An inventory was made of all Finnish community pharmacies that provided the opportunity for email medication counseling. Data related to the accuracy and comprehensiveness of responses were collected, using a virtual pseudo-customer method with 3 scenarios related to common concerns of patients on antidepressants. Two inquiries were emailed to each pharmacy that provided the opportunity for email medication counseling in January and February 2005. The responses were content analyzed by 2 researchers, using a prestructured scoring system. Almost one-third (30%, n = 182) of Finnish community pharmacies maintained a working Web site, and 94% of those provided the opportunity for email medication counseling. An online "ask-the-pharmacist" service was offered by 13% (n = 23) of the pharmacies with a Web site. Pharmacies responded to 54% of the email inquiries sent by the virtual pseudo-customers. The response rate and the content score ratio between mean and maximum scores varied among the scenarios. The content score ratio was highest for the scenarios concerning the adverse effects of fluoxetine (0.53, n = 55) and interactions with mirtazapine (0.52, n = 63) and lowest for the scenario related to sexual dysfunction and weight gain associated with citalopram (0.38, n = 52). Community pharmacies are potential providers of email medication counseling services. However, more attention should be directed to responding to consumer inquiries and to the content of these responses.
Mohamed E Amin
Results: The simulated client visited 104 pharmacies and was sold an antibiotic at 68 pharmacies in total. A cold group with one or more antibiotic pills was provided in 31 pharmacies. Upon request for two antibiotic pills, 2-8 antibiotic pills were provided in 30 pharmacies whereas an antibiotic carton was provided in three pharmacies. In four pharmacies, the simulated client was sold a cold group containing an antibiotic as well as another antibiotic upon request. Beta-lactam antibiotics comprised 76% of antibiotics provided. In five encounters, the simulated client was told that the cold group contained an antibiotic when, in fact, it did not. Conclusions: Subtherapeutic doses of antibiotics are provided at dangerous rates in Alexandria’s community pharmacies. Interventions are urgently needed to tackle different factors contributing to this dangerous practice. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties Type: Original Research
Gadkari, Abhijit S.; Mott, David A.; Kreling, David H.; Bonnarens, Joseph K.
Context: Higher prevalence of chronic diseases and reduced access to other health professionals in rural areas suggest that rural Medicare enrollees will benefit from pharmacist-provided drug therapy services (DTS). Purpose: The purpose of this study was to describe non-metropolitan community pharmacy sites in Wisconsin, the provision of DTS at…
Purpose: To analyze community pharmacy based research in Arab countries. Methods: Comprehensive review of the literature indexed by Scopus was conducted. Data from Jan 01, 2003 till December 31, 2013 was searched for documents with specific words pertaining to “community pharmacy” in any one of the 13 Middle ...
Purpose: To describe the current role played by pharmacists in delivering pharmaceutical care (PC) in community pharmacies in Jordan (current activities and practices undertaken in the community and extent of provision of PC standards), pharmacists' perspectives on PC implementation and barriers to implementing PC ...
Kaae, Susanne; Aarup, Kristine Hallberg Friis; Sporrong, Sofia Kälvemark
BACKGROUND: The value of counseling in community pharmacy depends on its ability to help patients improve their use of medicine and thereby health status, by their adherence to recommendations. Studies showing how patients respond to daily pharmacy counseling are, however, scarce. The aim...... of this study was therefore to investigate how patients respond to medical advice given by pharmacy staff. METHODS: A heterogeneous sample of patients who received the 'Inhaler Technique Assessment Service' (ITAS) in Denmark were interviewed, using a semi-structured schedule. Meaning condensation...... proposed by pharmacy staff. CONCLUSIONS: ITAS recommendations seemed important to adhere with for patients despite experiencing difficulties when doing so and secondly not feeling an immediate improvement of health. Reasons for this appear to be connected with the concept of meaningfulness. Hence...
Burson, Randall C.; Buttenheim, Alison M.; Armstrong, Allison; Feemster, Kristen A.
ABSTRACT Vaccine-preventable deaths among adults remain a major public health concern, despite continued efforts to increase vaccination rates in this population. Alternative approaches to immunization delivery may help address under-vaccination among adults. This systematic review assesses the feasibility, acceptability, and effectiveness of community pharmacies as sites for adult vaccination. We searched 5 electronic databases (PubMed, EMBASE, Scopus, Cochrane, LILACS) for studies published prior to June 2016 and identified 47 relevant articles. We found that pharmacy-based immunization services (PBIS) have been facilitated by state regulatory changes and training programs that allow pharmacists to directly provide vaccinations. These services are widely accepted by both patients and pharmacy staff, and are capable of improving access and increasing vaccination rates. However, political and organizational barriers limit the feasibility and effectiveness of vaccine delivery in pharmacies. These studies provide evidence to inform policy and organizational efforts that promote the efficacy and sustainability of PBIS. PMID:27715409
Twigg, Michael J.; Wright, David; Kirkdale, Charlotte L.; Desborough, James A.; Thornley, Tracey
Introduction The UK government advocates person-centred healthcare which is ideal for supporting patients to make appropriate lifestyle choices and to address non-adherence. The Community Pharmacy Future group, a collaboration between community pharmacy companies and independents in the UK, introduced a person-centred service for patients with multiple long-term conditions in 50 pharmacies in Northern England. Objective Describe the initial findings from the set up and delivery of a novel com...
Department of Homeland Security — Pharmacies in the United States and Territories A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under...
Roberts, Alison S; Benrimoj, Shalom I; Chen, Timothy F; Williams, Kylie A; Aslani, Parisa
There has been an increasing international trend toward the delivery of cognitive pharmaceutical services (CPS) in community pharmacy. CPS have been developed and disseminated individually, without a framework underpinning their implementation and with limited knowledge of factors that might assist practice change. The implementation process is complex, involving a range of internal and external factors. To quantify facilitators of practice change in Australian community pharmacies. We employed a literature review and qualitative study to facilitate the design of a 43-item "facilitators of practice change" scale as part of a quantitative survey instrument, using a framework of organizational theory. The questionnaire was pilot-tested (n = 100), then mailed to a random sample of 2000 community pharmacies, with a copy each for the pharmacy owner, employed pharmacist, and pharmacy assistant. The construct validity and reliability of the scale were established using exploratory factor analysis and Cronbach's alpha, respectively. A total of 735 (37%) pharmacies responded, with 1303 individual questionnaires. Factor analysis of the scale yielded 7 factors, explaining 48.8% of the total variance. The factors were: relationship with physicians (item loading range 0.59-0.85; Cronbach's alpha 0.90), remuneration (0.52-0.74; 0.82), pharmacy layout (0.52-0.79; 0.81), patient expectation (0.52-0.85; 0.82), manpower/staff (0.49-0.66; 0.80), communication and teamwork (0.37-0.65; 0.77), and external support/assistance (0.47-0.69; 0.74). All of the factors demonstrated good reliability and construct validity and explained approximately half of the variance. Implementing CPS requires support not only with the clinical aspects of service delivery, but also for the process of implementation itself, and remuneration models must reflect this. The identified facilitators should be used in a multilevel strategy to integrate professional services into the community pharmacy business
Koster, Ellen S; Blom, Lyda; Philbert, Daphne; Rump, Willem; Bouvy, Marcel L
Practice-based networks can serve as effective mechanisms for the development of the profession of pharmacists, on the one hand by supporting student internships and on the other hand by collection of research data and implementation of research outcomes among public health practice settings. This paper presents the characteristics and benefits of the Utrecht Pharmacy Practice network for Education and Research, a practice based research network affiliated with the Department of Pharmaceutical Sciences of Utrecht University. Yearly, this network is used to realize approximately 600 student internships (in hospital and community pharmacies) and 20 research projects. To date, most research has been performed in community pharmacy and research questions frequently concerned prescribing behavior or adherence and subjects related to uptake of regulations in the pharmacy setting. Researchers gain access to different types of data from daily practice, pharmacists receive feedback on the functioning of their own pharmacy and students get in depth insight into pharmacy practice.
Crawford, Natalie D; Amesty, Silvia; Rivera, Alexis V; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M
Structural interventions may help reduce racial/ethnic disparities in HIV. In 2009 to 2011, we randomized pharmacies participating in a nonprescription syringe access program in minority communities to intervention (pharmacy enrolled and delivered HIV risk reduction information to injection drug users [IDUs]), primary control (pharmacy only enrolled IDUs), and secondary control (pharmacy did not engage IDUs). Intervention pharmacy staff reported more support for syringe sales than did control staff. An expanded pharmacy role in HIV risk reduction may be helpful.
Kevrekidis, Dimitrios Phaedon; Minarikova, Daniela; Markos, Angelos; Malovecka, Ivona; Minarik, Peter
Background: Within the competitive pharmacy market environment, community pharmacies are required to develop efficient marketing strategies based on contemporary information about consumer behavior in order to attract clients and develop customer loyalty. Objectives: This study aimed to investigate the consumers’ preferences concerning the selection of pharmacy and over-the-counter (OTC) medicines, and to identify customer segments in relation to these preferences. Methods: A cross-sect...
Odukoya, Olufunmilola K.; Stone, Jamie A.; Chui, Michelle A.
Background The use of e-prescribing is increasing annually, with over 788 million e-prescriptions received in US pharmacies in 2012. Approximately 9% of e-prescriptions have medication errors. Objective To describe the process used by community pharmacy staff to detect, explain, and correct e-prescription errors. Methods The error recovery conceptual framework was employed for data collection and analysis. 13 pharmacists and 14 technicians from five community pharmacies in Wisconsin participated in the study. A combination of data collection methods were utilized, including direct observations, interviews, and focus groups. The transcription and content analysis of recordings were guided by the three-step error recovery model. Results Most of the e-prescription errors were detected during the entering of information into the pharmacy system. These errors were detected by both pharmacists and technicians using a variety of strategies which included: (1) performing double checks of e-prescription information; (2) printing the e-prescription to paper and confirming the information on the computer screen with information from the paper printout; and (3) using colored pens to highlight important information. Strategies used for explaining errors included: (1) careful review of patient’ medication history; (2) pharmacist consultation with patients; (3) consultation with another pharmacy team member; and (4) use of online resources. In order to correct e-prescription errors, participants made educated guesses of the prescriber’s intent or contacted the prescriber via telephone or fax. When e-prescription errors were encountered in the community pharmacies, the primary goal of participants was to get the order right for patients by verifying the prescriber’s intent. Conclusion Pharmacists and technicians play an important role in preventing e-prescription errors through the detection of errors and the verification of prescribers’ intent. Future studies are needed
Ferreri, Stefanie P; Greco, Angelo J; Michaels, Natasha M; O'Connor, Shanna K; Chater, Rebecca W; Viera, Anthony J; Faruki, Hawazin; McLeod, Howard L; Roederer, Mary W
OBJECTIVE To determine the feasibility of implementing a pharmacogenomics service in a community pharmacy. SETTING A single community pharmacy that is part of a regional chain known for offering innovative pharmacy services. PRACTICE DESCRIPTION Community pharmacists at the project site routinely provide clinical pharmacy services, including medication therapy management, immunizations, point-of-care testing, blood pressure monitoring, and diabetes education. PRACTICE INNOVATION The implementation of a pharmacogenomic testing and interpretation service for the liver isoenzyme cytochrome P450 2C19. PARTICIPANTS 18 patients taking clopidogrel, a drug metabolized by CYP2C19. MAIN OUTCOME MEASURES Rate of patient participation, rate of prescriber acceptance of pharmacist recommendation, time to perform genetic testing service, and number of claims submitted to and paid by insurance. RESULTS Of 41 patients taking clopidogrel and meeting project criteria, 18 (43.9%) enrolled and completed testing and interpretation of pharmacogenomic results. The mean time pharmacists spent completing all stages of the project with each participant was 76.6 minutes. The mean time to complete participation in the project (time between person's first and second visit) was 30.1 days. Nine patients had wild-type alleles, and pharmacists recommended continuation of therapy as ordered. Genetic variants were found in the other nine patients, and all pharmacist recommendations for modifications in therapy were ultimately accepted by prescribers. Overall, 17 patients consented to filing of reimbursement claims with their insurers. Five were not able to be billed due to submission difficulties. Of the remaining 12, none was paid. CONCLUSION A pharmacogenomics service can be an extension of medication therapy management services in a community pharmacy. Prescribers are receptive to having community pharmacists conduct pharmacogenomics testing, but reimbursement is a challenge.
Gavilan, Diana; Avello, Maria; Abril, Carmen
Changes that have occurred over the past few decades in retailing and in the health care sector--namely, a drastic reduction in drug profit-margins, and a more critical use of health services by patients--have created a scenario characterized by rising competitiveness. This new context is necessitating community pharmacies (hereafter, pharmacies) to improve their business model through new strategies. Shopper marketing has proven invaluable in other retail settings and therefore, could be a critical element for new practices in pharmacies. First, to analyze how shopping experiences in pharmacies based on new practices in shopper marketing affect shopping behavior. Second, to study the mediating effect of customer satisfaction on the relationship between shopping experiences and shopping behavior. A self-reported questionnaire was developed to measure four concepts: hedonic experience (enjoyable), functional experience (goal-oriented), customer satisfaction and shopping behavior. Data were collected from 28 different pharmacies dispersed throughout Spain. Structural equation modeling (SEM) was used to test the relationships in the theoretical model. First, the measurement model was estimated to assess model fit, reliability, convergent and discriminant validity. Then, the parameters of the structural model were estimated and the mediation effects were subsequently tested. Functional experience and hedonic experience each significantly and positively correlate with consumer satisfaction and with customer shopping behavior (purchases and loyalty). Moreover, the effects of each type of experience on shopping behavior are partially mediated by customer satisfaction. The results suggest that even in Spanish pharmacies, which have traditionally been considered as strictly functional retailers, ensuring customer satisfaction and enhancing shopping behavior now demand more than just functional experiences. Moreover, a customer's experience at a pharmacy can itself trigger a
Mirzaei, Ardalan; Carter, Stephen R; Schneider, Carl R
Community pharmacy ownership requires engaging with marketing strategies to influence consumer behaviour. There is a plethora of information from trade journals, expert opinion, and published discussion surrounding this issue. Despite this, evidence relating to the efficacy of marketing activity within the pharmacy sector is scant. To review how marketing activity has been conceptualised in the community pharmacy sector and to determine the evidence for the effect of marketing activity. Seven databases were systematically searched using a scoping review framework with the reporting protocol of PRISMA-P. The search yielded 33 studies that were analysed for year of publication, journal, country of focus, and framework of marketing. The majority of marketing research papers focused on the United States and were published in healthcare journals. These were various marketing strategy elements, including; segmentation, targeting, differentiation, and positioning. Also evident was research regarding marketing mix, which predominately involved the "4Ps" model. Actual marketing activity comprised little of the research. Research into marketing activity in community pharmacy is limited, and little evidence is available to show the effects of such activities. Future research needs to demonstrate the causality for the effect of marketing activities on consumer behaviour and economic outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.
Whitehouse, Anne; Simon, Anna; French, Simone A; Wolfson, Julian
The purpose of the present study was to measure the availability of energy-dense foods and sugar-sweetened beverages in pharmacies and to examine differences by pharmacy type and presence of a food policy. Trained research staff visited pharmacies (n 37) to measure shelf space and variety of snacks, candy and sugar-sweetened beverages available within 10 ft (3·05 m) of the pharmacy register. Community clinic, hospital and commercial pharmacies in Minneapolis, MN, USA. Employees were interviewed regarding pharmacy food policies. Approximately 60 % of pharmacies had foods and/or sugar-sweetened beverages available for purchase within 10 ft (3·05 m) of the pharmacy register. Total shelf space (P = 0·02) and variety (P = 0·0003) differed significantly by pharmacy type and were greatest among community clinic pharmacies. Over half of pharmacies had no food policy (58·3 %). Pharmacies with food policies were less likely to have foods/beverages available within 10 ft (3·05 m) of the pharmacy register than pharmacies with no food policies (P = 0·03). Candy, snacks and sugar-sweetened beverages are highly available in the pharmacy environment. Presence of a policy is associated with less food availability within 10 ft (3·05 m) of the pharmacy register and represents an important potential intervention strategy.
Full Text Available A pharmacy degree in Finland includes a six-month obligatory internship. The internship is integrated with theoretical studies and adds up to 30 European Credit Transfer and Accumulation System (ECTS credits of the BSc (Pharm degree. Learning is supported by reflective assignments from the university. The preceptors have an important role in organizing the internship and tutoring students successfully in community pharmacy settings. Objective: to assess whether the preceptors of University of Helsinki’s teaching pharmacies need pedagogic support in tutoring and if so, in which core pharmaceutical tasks or tutoring skills. Methods: The survey was sent to all preceptors of University of Helsinki´s teaching pharmacies (n=326 in 2011 (response rate 58%, n=190. The data was analyzed statistically using Excel (version 12.3.6. The open-ended questions were analyzed by qualitative content analysis. Results: The majority of preceptors found their skills in tutoring the students mainly good. However, assessment of learning (27% of the respondents, giving feedback (23% and organizing the learning situations supportive for learning (23% were the areas in which the preceptors mostly indicated a need for support. Teaching current care guidelines and pharmaceutical care (36% and multi-professional collaboration (28% were the areas in which the preceptors expressed that they needed to update their skills. Conclusions: The faculty should focus the support on the pedagogic skills of preceptors, particularly in improving their skills in assessment of learning and in reflective dialogue. In addition, their skills in teaching clinical and patient care aspects of pharmacy practice should be enhanced. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings
Hickey, Lisa M; Farris, Karen B; Peterson, N Andrew; Aquilino, Mary L
To determine whether the population demographics of the location of pharmacies were associated with tobacco sales in pharmacies, when controlling for pharmacy type. Retrospective analysis. Iowa. All retailers in Iowa that obtained tobacco licenses and all pharmacies registered with the Iowa Board of Pharmacy in 2003. MAIN OUTCOME MEASURE AND INTERVENTIONS: Percentage of pharmacies selling tobacco (examined by pharmacy type using chi-square analysis); median income and distribution of race/ethnicity in the county for pharmacies that did or did not sell tobacco (t tests); predictors of whether a pharmacy sold tobacco (logistic regression using the independent variables county-level demographic variables and pharmacy characteristics). County gender composition, race/ethnicity make-up, and income levels were different for tobacco-selling and -nonselling pharmacies. Logistic regression showed that whether a pharmacy sold tobacco was strongly dependent on the type of pharmacy; compared with independent pharmacies (of which only 5% sold tobacco products), chain pharmacies were 34 times more likely to sell tobacco products, mass merchandiser outlets were 47 times more likely to stock these goods, and grocery stores were 378 times more likely to do so. Pharmacies selling tobacco were more likely to be located in counties with significantly higher numbers of multiracial groups. The best predictor of whether an Iowa pharmacy sells tobacco products is type of pharmacy. In multivariable analyses, population demographics of the county in which pharmacies were located were generally not predictive of whether a pharmacy sold tobacco.
Full Text Available Objective: Identify characteristics of Kentucky community pharmacists and community pharmacists’ practice environment associated with utilization of the Kentucky All Schedule Prescription Electronic Reporting Program (KASPER. Methods: Surveys were mailed to all 1,018 Kentucky pharmacists with a KASPER account and an additional 1,000 licensed pharmacists without an account. Bivariate analyses examined the association between KASPER utilization and practice type (independent or chain and practice location (rural or urban. A multivariate Poisson regression model with robust error variance estimated risk ratios (RR of KASPER utilization by characteristics of pharmacists’ practice environment. Results: Responses were received from 563 pharmacists (response rate 27.9%. Of these, 402 responses from community pharmacists were included in the analyses. A majority of responding pharmacists (84% indicated they or someone in their pharmacy had requested a patient’s controlled substance history since KASPER’s inception. Bivariate results showed that pharmacists who practiced in independent pharmacies reported greater KASPER utilization (94% than pharmacists in chain pharmacies (75%; p<0.001. Multivariate regression results found utilization of KASPER varied significantly among practice environments of community pharmacists with those who practiced in an urban location (RR: 1.11; [1.01–1.21] or at an independent pharmacy (RR: 1.27; [1.14–1.40] having an increased likelihood of KASPER utilization. Conclusion: Utilization of KASPER differs by community pharmacists’ practice environment, predominantly by practice type and location. Understanding characteristics of community pharmacists and community pharmacists’ practice environment associated with PDMP use is necessary to remove barriers to access and increase utilization thereby increasing PDMP effectiveness.
Hallit, Souheil; Zeenny, Rony M; Sili, Georges; Salameh, Pascale
To evaluate the current community pharmacists' interventions and job satisfaction, secondary to the alteration in the financial rewards. A cross-sectional study was carried out, using a proportionate random sample of Lebanese community pharmacy owners from all districts of Lebanon. Out of 1618 distributed questionnaires, 1465 (90.5%) were collected back from pharmacy owners. Our study results showed that the monthly sales and profit decreased significantly in the last decade as well as the number of loyal customers (psituation was better 10 years ago compared to nowadays. Most Lebanese community pharmacists are not financially satisfied; their financial situation deteriorated in the last decade. The ministry of Health along with the Order of Pharmacists in Lebanon should cooperate together to resolve this problem since they are two entities responsible for the patient's health.
Jon C. Schommer
Full Text Available Questions within and outside of the pharmacy profession frequently arise about a community pharmacy's capacity to provide patient-care services and maximize contributions to public health. It is surmised that community pharmacy locations must possess specific attributes and have identifiable resources within the location to effectively initiate and optimize their capacity to deliver patient care services in conjunction with medication distribution and other services. The purpose of this paper is to describe three research domains that can help pharmacies make the transition from "traditional" business models to "patient care centered" practices: (1 Work System Design, (2 Entrepreneurial Orientation, and (3 Organizational Flexibility. From these research domains, we identified 21 Work System Design themes, 4 dimensions of Entrepreneurial Orientation, and 4 types of Organizational Flexibility that can be used in combination to assist a practice location in transforming its business model to a "patient care centered" practice. The self-assessment tools we described in this paper could help realign an organization's activities to initiate and optimize capacity for patient care. Type: Idea Paper
Moreno-Royo, Lucrecia; Climent, María Teresa; Vilaplana, Ana María; Arnedo, Alberto; Vilar, José
Frequency of cognitive impairment among people over 65 years old in community pharmacy. Study of asssociated factors, referral of cases to the specialist and inclusion in a program of health education. Cross-sectional study of prevalence, frequency, conducted in four pharmacies (two urban and two rural pharmacies) in the Autonomous Community of Valencia. people over 65 years old who come to the pharmacy and who agree to participate in the study after signing an informed consent. It is used as the initial screening test, the Short Portable Mental State Questionnaire of Pfeiffer. Pfeiffer positive cases undergo a second test (Mini-Mental State Examination, NORMACODEM version). A questionnaire designed specifically for the study has been used to collect information. It includes questions to gain demographic data, questions on lifestyle and chronic diseases. We used analysis logistic regression multilevel. 245 patients have participated (76% of respondents). 12.65% were detected to have cognitive impairment. In the Logistic regression analysis multivariate there is a relation between cognitive impairment and some variables: age, lack of reading habit, unusual reading habit, sleeping less than 6 or more than 8 hours a day. Only 12.9% wanted to be referred for clinical evaluation and 42% were included in a cognitive training program. There are asssociation between lifestyle habits that are modifiable and cognitive impairment.
Ernst, M E; Chalstrom, C V; Currie, J D; Sorofman, B
To increase accessibility of influenza vaccine in a rural community by establishing a community pharmacy-based influenza vaccination program. An independent pharmacy in a rural eastern Iowa community of 5,000 people. Protocols for identification and screening of patients, administration of vaccine, and treatment of emergencies were developed by the pharmacist and approved by the county health department medical director. Administration of vaccine began October 15, 1996, and was completed on December 6, 1996. Patients were prospectively and retrospectively identified to receive the vaccination. Informed consent was obtained. Vaccine was administered by the pharmacist after screening for contraindications and counseling the patient. Weekly vaccination records were forwarded to the collaborating physician to update patient charts. To determine whether accessibility of influenza vaccine in the community was increased through pharmacist administration, the proportion of patients immunized in the pharmacy who were not vaccinated the previous year was determined. The pharmacist administered 343 doses of vaccine. Two-thirds of the immunized patients (67.9%) reported also being immunized the previous year. These patients were generally older (65 years of age +/- 13) than the previously nonimmunized patients (54 years of age +/- 16). However, 60.8% of the patients not immunized the previous year reported either they would not have gone elsewhere for the immunization (45.3%), or were unsure (25.5%). The data collected suggest that pharmacist administration of influenza vaccination in a rural community pharmacy increases access and, possibly, immunization rates. This may be especially true among high-risk younger adults who are often overlooked and would not normally have received the immunization.
Kevrekidis, Dimitrios Phaedon; Minarikova, Daniela; Markos, Angelos; Malovecka, Ivona; Minarik, Peter
Within the competitive pharmacy market environment, community pharmacies are required to develop efficient marketing strategies based on contemporary information about consumer behavior in order to attract clients and develop customer loyalty. This study aimed to investigate the consumers' preferences concerning the selection of pharmacy and over-the-counter (OTC) medicines, and to identify customer segments in relation to these preferences. A cross-sectional study was conducted between February and March 2016 on a convenient quota sample of 300 participants recruited in the metropolitan area of Thessaloniki, Greece. The main instrument used for data collection was a structured questionnaire with close-ended, multiple choice questions. To identify customer segments, Two-Step cluster analysis was conducted. Three distinct pharmacy customer clusters emerged. Customers of the largest cluster (49%; 'convenience customers') were mostly younger consumers. They gave moderate to positive ratings to factors affecting the selection of pharmacy and OTCs; convenience, and previous experience and the pharmacist's opinion, received the highest ratings. Customers of the second cluster (35%; 'loyal customers') were mainly retired; most of them reported visiting a single pharmacy. They gave high ratings to all factors that influence pharmacy selection, especially the pharmacy's staff, and factors influencing the purchase of OTCs, particularly previous experience and the pharmacist's opinion. Customers of the smallest cluster (16%; 'convenience and price-sensitive customers') were mainly retired or unemployed with low to moderate education, and low personal income. They gave the lowest ratings to most of the examined factors; convenience among factors influencing pharmacy selection, whereas previous experience, the pharmacist's opinion and product price among those affecting the purchase of OTCs, received the highest ratings. The community pharmacy market comprised of distinct
Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B
The increasing prevalence of obesity and overweight adults creates a significant public health burden and there is great potential for pharmacists to be involved in the provision of weight management services, other than the mundane supply of commercial products. In order to provide optimal services that can be integrated into the healthcare system, a best practice model for weight management services in community pharmacy should be in place. We sought experts' and key stakeholders' opinions on this matter. (1) To identify components of a best practice model of a weight management service feasible in Australian community pharmacy. (2) To identify the role of pharmacists and the training requirements to up-skill pharmacists to competently provide weight management services. (3) To elicit any practical suggestions that would contribute to successful implementation of weight management services in pharmacy. Australian primary care sector. Semi-structured interviews were conducted with a purposive sample of 12 participants including Australian experts in obesity and representatives of main Australian professional organisations in pharmacy. Interviews were digitally recorded, transcribed verbatim and thematically analysed using the framework approach. Recommended components of pharmacy-based weight management services and training requirements. Participants perceived two potential roles for pharmacists involved in weight management: health promotion and individualised service. Multi-component interventions targeting all three areas: diet, physical activity and behaviour change were emphasised. Physical assessment (e.g. weight, waist circumference measurements), goal setting, referral to allied healthcare professionals and on-going support for weight maintenance were also proposed. Participants suggested pharmacists should undergo formal training and identified various training topics to improve pharmacists' knowledge, attributes and skills to acquire competencies
Petkova, Valentina B
There are different kinds of arthritis, widely spread among the population, that make them a clinical problem with social, psychological and economic burden. Different education programs have been developed in order to improve patients' disease management, medication compliance and from there patients' quality of life. To develop and implement a community pharmacy-based educational program for patients with arthritis. Improvements in pain, medication compliance, decrease in general practitioner's visits and hospitalizations are expected. Prospective, randomized, controlled trial. The sample consisted of 43 individuals, with different stages of arthritis (aged 15 - 71), attending pharmacies - intervention group; and 43 individuals - control group. A 4-month education was conducted on the following topics: what causes arthritis and what are the factors that can intensify it; pain management and physical activities; self-management and prevention; pharmacotherapy and possible adverse drug reactions. Patient's health-related quality of life was assessed in the beginning and at the end of the survey. PARAMETERS ASSESSED DURING THE FOUR STAGES OF THE PROGRAM WERE: frequency of severe pain, frequency of general practitioner's visits, frequency of urgent medical aid calls, compliance with therapy, satisfaction with pharmacy services. Improvement in patients' health-related quality of life was observed and also: decrease in the severity of patients' pain, decrease in the physician's visits, and increase in satisfaction overall care. Positive results from the educational approach in pharmacy conditions were demonstrated. These consequences have a potential to increase arthritis patient's quality of life.
O'Neal, Katherine S; Crosby, Kimberly M; Miller, Michael J; Murray, Kelly A; Condren, Michelle E
The Agency for Healthcare Research and Quality (AHRQ) developed the tool, "Is Our Pharmacy Meeting Patients' Needs? Pharmacy Health Literacy Assessment Tool" to evaluate health literacy preparedness of pharmacy environments from patient, staff, and environmental perspectives. The tool was designed at a clinic-based, outpatient pharmacy of a large, urban, public hospital. Despite the ready availability of this tool and the encouragement of AHRQ to adapt it to other environments, there is no published literature on the dissemination and translation of this tool in the community pharmacy environment. The five objectives of this study were to: (1) pilot the AHRQ tool "Is Our Pharmacy Meeting Patients' Needs? Pharmacy Health Literacy Assessment Tool" in a community pharmacy environment; (2) evaluate and adapt the tool; (3) describe the use of health literacy practices from patient, staff, and independent auditor perspectives using the revised tool; (4) evaluate the effect of a low-intensity educational health literacy awareness program; and (5) identify opportunities to improve health literacy-sensitive practices in the community pharmacy environment. The study employed a mixed method, posttest-only control group design using community pharmacies in the Tulsa, OK area. Participants included community pharmacists, staff, patients, and independent auditors. Select pharmacy staff members were invited to receive a health literacy training program delivered by a nationally-recognized health literacy expert to raise awareness of health literacy issues. Approximately eight months after the program, pharmacy staffs were surveyed using a written instrument, patients were interviewed by telephone, and the study investigators performed independent environmental audits in each of the selected pharmacies. Results from auditor evaluations, staff survey responses, and patient interviews were compared for similarities and differences to provide a multidimensional perspective about
Aquilino, Mary L; Farris, Karen B; Zillich, Alan J; Lowe, John B
To examine community pharmacy practice with regard to providing smoking-cessation counseling. Mailed survey. Iowa community pharmacies. A stratified random sample of pharmacists statewide. Descriptive statistics were computed for all study variables. Fisher exact test or chi2 analysis was performed on selected variables to determine the relationship of each item with pharmacists routinely offering smokers suggestions for quitting. Responses from 129 (38.2%) of 338 pharmacists indicated that although most felt it is important to offer smoking-cessation counseling, about half actually offer this service. Most pharmacists indicated they are prepared to provide counseling, but fewer than 25% had received formal training or were aware of national clinical practice guidelines. Those who had received specific training (p=0.020) or recently attended an educational program (p=0.014) on smoking cessation were more likely to counsel smokers. Primary barriers to providing counseling were lack of time, inability to identify smokers, low patient demand, and lack of reimbursement. Our findings suggest that opportunities exist for improving pharmacist education and reducing practice barriers in order to bridge the gap between pharmacists' knowledge and attitudes related to smoking-cessation counseling and their provision of patient counseling in community pharmacy practice.
Kho, Boon P; Hassali, Mohamed A; Lim, Ching J; Saleem, Fahad
The provision of professional pharmacy services by community pharmacists continues to be limited, particularly in low and middle income countries. It was postulated that multiple management challenges faced by community pharmacists contribute to this situation. The primary aim of the research was to determine the challenges faced in the management of community pharmacies in Sarawak (the largest state in Malaysia), and practical strategies to cope and overcome the challenges. Semi-structured interviews were carried out with community pharmacists practising in Sarawak. Purposive and snowball sampling were employed to ensure a diverse group of informants. The interviews were audio-recorded and transcribed verbatim, with the resultant data analysed using thematic analysis. Data collection, coding, interpretation were carried out iteratively until theoretical saturation. Twenty respondents from different demographic characteristics were recruited. Six major themes were identified. Management challenges faced by community pharmacists traverse five major domains: market competition, legislative issues, customers' knowledge and expectations, macroeconomic impacts and operational challenges. Most of these challenges require government intervention to be resolved. In the meantime, improving customer service and expanding the range of professional services were seen as the most viable strategies to cope with existing challenges. The main concern is that current legislative and economic landscape may hinder these strategies. Enactment of dispensing separation and more protective measures against market competition were suggested to alleviate the challenges faced. Numerous management challenges faced by community pharmacists that distract them from delivering professional pharmacy services have been highlighted. Urgent affirmative actions by the government are warranted in supporting community pharmacists to realise and maximise their potentials.
Kälvemark Sporrong, Sofia; Nordén-Hägg, Annika
All changes in the regulation of pharmacies have an impact on the work carried out in pharmacies and also on patient safety, regardless of whether this is the intention or not. To compare staff apprehension regarding some aspects of patient safety and quality in community pharmacies prior to and after the 2009 changes in regulation of the Swedish community pharmacy market. Questionnaires targeted at pharmacy staff before and after the changes in regulation (in 2008, 2011/12, and 2012/13 respectively) used four identical items, making comparisons of some aspects possible. All four items demonstrated a significant decrease in the first survey after the changes as compared to before. In the second survey significant differences were found on the two items representing safety climate whereas the items representing team climate and management showed no significant differences. The comparison carried out in this study indicates a negative effect in Swedish community pharmacies on safety and quality issues, as experienced by pharmacy staff. It is recommended that the possible effects of healthcare reforms are assessed before implementation, in order to counteract conceivable decline in factors including patient safety and working conditions.
Jon C. Schommer, Ph.D.
Full Text Available Questions within and outside of the pharmacy profession frequently arise about a community pharmacy’s capacity to provide patient-care services and maximize contributions to public health. It is surmised that community pharmacy locations must possess specific attributes and have identifiable resources within the location to effectively initiate and optimize their capacity to deliver patient care services in conjunction with medication distribution and other services. The purpose of this paper is to describe three research domains that can help pharmacies make the transition from “traditional” business models to “patient care centered” practices: (1 Work System Design, (2 Entrepreneurial Orientation, and (3 Organizational Flexibility. From these research domains, we identified 21 Work System Design themes, 4 dimensions of Entrepreneurial Orientation, and 4 types of Organizational Flexibility that can be used in combination to assist a practice location in transforming its business model to a “patient care centered” practice. The self-assessment tools we described in this paper could help realign an organization’s activities to initiate and optimize capacity for patient care.
Bindoff, Ivan; Ling, Tristan; Bereznicki, Luke; Westbury, Juanita; Chalmers, Leanne; Peterson, Gregory; Ollington, Robert
To provide a computer-based learning method for pharmacy practice that is as effective as paper-based scenarios, but more engaging and less labor-intensive. We developed a flexible and customizable computer simulation of community pharmacy. Using it, the students would be able to work through scenarios which encapsulate the entirety of a patient presentation. We compared the traditional paper-based teaching method to our computer-based approach using equivalent scenarios. The paper-based group had 2 tutors while the computer group had none. Both groups were given a prescenario and postscenario clinical knowledge quiz and survey. Students in the computer-based group had generally greater improvements in their clinical knowledge score, and third-year students using the computer-based method also showed more improvements in history taking and counseling competencies. Third-year students also found the simulation fun and engaging. Our simulation of community pharmacy provided an educational experience as effective as the paper-based alternative, despite the lack of a human tutor.
Kildemoes, Helle Wallach; Toft Sørensen, Henrik; Hallas, Jesper
), contains information on dispensed prescriptions, including variables at the level of the drug user, the prescriber, and the pharmacy. Validity and coverage: Reimbursement-driven record keeping, with automated bar-code-based data entry provides data of high quality, including detailed information......Introduction: Individual-level data on all prescription drugs sold in Danish community pharmacies has since 1994 been recorded in the Register of Medicinal Products Statistics of the Danish Medicines Agency. Content: The register subset, termed the Danish National Prescription Registry (DNPR...
Vogler, Sabine; Habimana, Katharina; Arts, Danielle
To analyse the impact of deregulation in community pharmacy on accessibility of medicines, quality of pharmacy services and costs. We analysed and compared community pharmacy systems in five rather deregulated countries (England, Ireland, the Netherlands, Norway, Sweden) and four rather regulated countries (Austria, Denmark, Finland, Spain). Data were collected by literature review, a questionnaire survey and interviews. Following a deregulation, several new pharmacies and dispensaries of Over-the-Counter (OTC) medicines tended to be established, predominantly in urban areas. Unless prevented by regulation, specific stakeholders, e.g. wholesalers, were seen to gain market dominance which limited envisaged competition. There were indications for an increased workload for pharmacists in some deregulated countries. Economic pressure to increase the pharmacy turnover through the sale of OTC medicines and non-pharmaceuticals was observed in deregulated and regulated countries. Prices of OTC medicines were not found to decrease after a deregulation in pharmacy. Access to pharmacies usually increases after a deregulation but this is likely to favour urban populations with already good accessibility. Policy-makers are recommended to take action to ensure equitable accessibility and sustainable competition in a more deregulated environment. No association between pharmaceutical expenditure and the extent of regulation/deregulation appears to exist. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.
Corelli, Robin L.; Zillich, Alan J.; de Moor, Carl; Giuliano, Margherita R.; Arnold, Jennifer; Fenlon, Christine M.; Douglas, Cami L.; Magnusson, Brooke; Zbikowski, Susan M.; Prokhorov, Alexander V.; Hudmon, Karen Suchanek
Background Community pharmacies have the potential to reduce the prevalence of tobacco use, yet most pharmacies do not integrate cessation activities into routine practice. Acquiring participation of community pharmacies is difficult. Strategies detailing requirements by researchers to elicit such participation have not been established. Objectives The objective of this study was to describe the recruitment strategy and participant yield for a two-state, randomized trial evaluating two intervention approaches for increasing pharmacy-based referrals to tobacco quitlines. Methods Detailed study recruitment tracking forms were used to document all contact attempts between the study investigators and each potential study site. These data were analyzed to characterize the overall recruitment and consent process for community pharmacies and pharmacy personnel (pharmacists, technicians). Results Achieving the target sample size of 64 study sites required contacting a total of 150 pharmacies (84 independent and 66 chain). Excluding 22 ineligible pharmacies, participation rates were 49% (32 of 65) for independent pharmacies and 51% (32 of 63) for chain pharmacies (50% overall). Across the 64 participating pharmacies, a total of 124 pharmacists (of 171; 73%) and 127 pharmacy technicians (of 215; 59%) were enrolled in the study. Pharmacies that chose not to participate most often cited time constraints as the primary reason. Overall, combining both the recruitment and consent process, a median of 5 contacts were made with each participating pharmacy (range, 2–19; IQR, 4–7), and the median overall duration of time elapsed from initial contact to consent was 25 days (range, 3–122 days; IQR, 12–47 days). Conclusions Results from this study suggest that pharmacy personnel are willing to provide brief tobacco cessation interventions in a community pharmacy setting and are receptive to participation in multi-site clinical research trials. However, execution of a
Fakih, Souhiela; Marriott, Jennifer L; Hussainy, Safeera Y
The objectives of this study were to investigate how pharmacists, pharmacy assistants and women feel about community pharmacy involvement in weight management, and to identify what pharmacists, pharmacy assistants and women want in weight management educational resources. Three homogenous and one heterogeneous nominal group (NG) sessions of up to 120-min duration were conducted with nine women, ten pharmacists and eight pharmacy assistants. The NG technique was used to conduct each session to determine the most important issues that should be considered surrounding community pharmacy weight management services and development of any educational resources. The heterogeneous NG session was used to finalise what women, pharmacists and pharmacy assistants want in educational resources. Overall, pharmacists, pharmacy assistants and women believe that pharmacy staff have an important role in the management of overweight and obesity because of their accessibility, trust and the availability of products in pharmacy. Regarding the most suitable healthcare professional(s) to treat overweight and obesity, the majority of participants believed that no one member of the healthcare team was most suitable and that overweight and obesity needs to be treated by a multidisciplinary team. The importance of having weight management educational resources for pharmacy staff and women that come from trustworthy resources without financial gain or commercialisation was also emphasised. Pharmacists, pharmacy assistants and women feel that community pharmacies have a definite role to play in weight management. Pharmacy-specific weight management educational resources that are readily available to pharmacy staff and women are highly desirable. © 2015 Royal Pharmaceutical Society.
Schommer, Jon C; Yusuf, Akeem A; Hadsall, Ronald S
An understanding of community pharmacy market dynamics is important for monitoring access points for pharmacist services. The purpose of this study was to describe (1) changes in pharmacy mix (independent versus chain) between 1992 and 2002 and between 2002 and 2012 for 87 counties in Minnesota (state in U.S.) and (2) the number (and proportion) of community pharmacies in Minnesota for the years 1992, 2002, and 2012 using a new categorization method developed specifically for this study. Data included licensure records for 1992, 2002, and 2012 from the State of Minnesota Board of Pharmacy and county level demographics for 1990, 2000 and 2010 from the US Census Bureau. Descriptive statistics were used to summarize findings over time and to describe associations between study variables. The ratio of independent pharmacies to chain pharmacies changed from approximately 2:1 in 1992 to 1:2 in 2012. The primary market factors associated with changes in the number of community pharmacies per county were (1) the metropolitan designation of the county and (2) whether the population density (persons/square mile) was increasing or decreasing. The face of community pharmacy in Minnesota changed between 1992 and 2012. By 2012, pharmacies were located in traditional retail pharmacies, mass merchandiser outlets, supermarkets, and clinics/medical centers. Furthermore, specialty pharmacies grew in proportion to meet patient needs. Between 1992 and 2012, the market dynamics of community pharmacies in Minnesota was characterized by vigorous market entry and exit. In light of recent health reform that is exhibiting characteristics such as continuity-of-care models, performance-based payment, technology advances, and the care of patients becoming more "ambulatory" (versus in-patient), we suggest that the market dynamics of community pharmacies will continue to exhibit vigorous market entry and exit in this new environment. It is proposed that the community pharmacy categories developed
Thomas L. Lenz
Full Text Available Chronic diseases continue to be a significant burden to the health care system. Pharmacists have been able to show that drug therapy for patients with chronic diseases can be improved through medication therapy management (MTM services but have yet to become significantly involved in implementing lifestyle modification programs to further control and prevent chronic conditions. A novel and innovative lifestyle medicine program was started by pharmacists in a community pharmacy in 2008 to more comprehensively prevent and manage chronic conditions. The lifestyle medicine program consists of designing seven personalized programs for patients to address physical activity, nutrition, alcohol consumption, weight control, stress management, sleep success, and tobacco cessation (if needed. The lifestyle medicine program complements existing MTM services for patients with hypertension, dyslipidemia, and/or diabetes. This program is innovative because pharmacists have developed and implemented a method to combine lifestyle medicine with MTM services to not only manage chronic conditions, but prevent the progression of those conditions and others. Several innovative tools have also been developed to enhance the effectiveness of a lifestyle medicine program. This manuscript describes the program's pharmacy setting, pharmacy personnel, participants and program details as well as the tools used to integrate a lifestyle medicine program with MTM services. Type: Clinical Experience
Wisell, Kristin; Kälvemark Sporrong, Sofia
Community pharmacies are balancing between business (selling medicines and other products) and healthcare (using the pharmacists’ knowledge in order to improve drug utilization). This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim...... of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who...... are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks...
Full Text Available There are different kinds of arthritis, widely spread among the population, that make them a clinical problem with social, psychological and economic burden. Different education programs have been developed in order to improve patients’ disease management, medication compliance and from there patients’ quality of life.Objective: To develop and implement a community pharmacy-based educational program for patients with arthritis. Improvements in pain, medication compliance, decrease in general practitioner’s visits and hospitalizations are expected.Methods: Prospective, randomized, controlled trial. The sample consisted of 43 individuals, with different stages of arthritis (aged 15 - 71, attending pharmacies – intervention group; and 43 individuals – control group. A 4-month education was conducted on the following topics: what causes arthritis and what are the factors that can intensify it; pain management and physical activities; self-management and prevention; pharmacotherapy and possible adverse drug reactions. Patient's health-related quality of life was assessed in the beginning and at the end of the survey. Results: Parameters assessed during the four stages of the program were: frequency of severe pain, frequency of general practitioner’s visits, frequency of urgent medical aid calls, compliance with therapy, satisfaction with pharmacy services. Improvement in patients’ health-related quality of life was observed and also: decrease in the severity of patients’ pain, decrease in the physician’s visits, and increase in satisfaction overall care.Conclusions: Positive results from the educational approach in pharmacy conditions were demonstrated. These consequences have a potential to increase arthritis patient’s quality of life.
DiDonato, Kristen L; Liu, Yifei; Lindsey, Cameron C; Hartwig, David Matthew; Stoner, Steven C
To determine patient perceptions of using a demonstration application (app) of mobile technology to improve medication adherence and to identify desired features to assist in the management of medications. A qualitative study using key informant interviews was conducted in a community pharmacy chain for patients aged 50 and older, on statin therapy and owning a smart device. Three main themes emerged from 24 interviews at four pharmacy locations, which included benefits, barriers and desired features of the app. Benefits such as accessibility, privacy, pros of appearance and beneficiaries were more likely to lead to usage of the app. Barriers that might prevent usage of the app were related to concerns of appearance, the burden it might cause for others, cost, privacy, motivation and reliability. Specific features patients desired were categorized under appearance, customization, communication, functionality, input and the app platform. Patients provided opinions about using a mobile app to improve medication adherence and assist with managing medications. Patients envisioned the app within their lifestyle and expressed important considerations, identifying benefits to using this technology and voicing relevant concerns. App developers can use patient perceptions to guide development of a mobile app addressing patient medication-related needs. © 2015 Royal Pharmaceutical Society.
Dimitrios Phaedon Kevrekidis
Full Text Available Background: Within the competitive pharmacy market environment, community pharmacies are required to develop efficient marketing strategies based on contemporary information about consumer behavior in order to attract clients and develop customer loyalty. Objectives: This study aimed to investigate the consumers’ preferences concerning the selection of pharmacy and over-the-counter (OTC medicines, and to identify customer segments in relation to these preferences. Methods: A cross-sectional study was conducted between February and March 2016 on a convenient quota sample of 300 participants recruited in the metropolitan area of Thessaloniki, Greece. The main instrument used for data collection was a structured questionnaire with close-ended, multiple choice questions. To identify customer segments, Two-Step cluster analysis was conducted. Results: Three distinct pharmacy customer clusters emerged. Customers of the largest cluster (49%; ‘convenience customers’ were mostly younger consumers. They gave moderate to positive ratings to factors affecting the selection of pharmacy and OTCs; convenience, and previous experience and the pharmacist’s opinion, received the highest ratings. Customers of the second cluster (35%; ‘loyal customers’ were mainly retired; most of them reported visiting a single pharmacy. They gave high ratings to all factors that influence pharmacy selection, especially the pharmacy’s staff, and factors influencing the purchase of OTCs, particularly previous experience and the pharmacist’s opinion. Customers of the smallest cluster (16%; ‘convenience and price-sensitive customers’ were mainly retired or unemployed with low to moderate education, and low personal income. They gave the lowest ratings to most of the examined factors; convenience among factors influencing pharmacy selection, whereas previous experience, the pharmacist’s opinion and product price among those affecting the purchase of OTCs
Rapport, F L; Doel, M A; Jerzembek, G S
This paper presents a novel, qualitative, bio-photographic study with intertextual analysis highlighting the relationship between community pharmacy workspace and practice. Sixteen pharmacists working across pharmacy types such as independent shops, large and small pharmacy chains and multiple pharmacies such as those in supermarkets participated in data capture and feedback consultation. Findings disclosed workspaces unfit for purpose and a workforce ill at ease with their new professional identity, involving increasingly complex tasks in health provision and retail. There was conflict between delegating to others and taking personal responsibility, and there were pressures from a demanding public within the context of a target-driven, litigious society. The study highlights that innovative, mixed methods in this context reveal nuanced, rich data.
Gebremedhin Beedemariam Gebretekle
Full Text Available Abstract Background Over the counter sale of antibiotics is a global problem and it is increasingly recognized as a source of antibiotic misuse and is believed to increase treatment costs, adverse effects of treatment and emergence of resistance. The increasing trend of over the counter sale of antibiotics in Ethiopia calls for exploration of why such dispensing is practiced. This study aims to explore reasons for over the counter sale of antibiotics in the community pharmacies of Addis Ababa, Ethiopia. Methods A phenomenological qualitative study was conducted in five randomly selected community pharmacies of Addis Ababa. One pharmacy professional from each pharmacy were interviewed at the spot using semi-structured, open-ended interview checklist. Besides, observation of professionals’ dispensing practice was made for at least one hour in the same community pharmacies using an observation checklist. Findings were categorized into specific themes that were developed following the objectives. This was facilitated by use of OpenCode 3.6 software. Results All participants pointed out that antibiotics were frequently dispensed without prescription and contend that the trend of such dispensing has been increasing. The findings indicated that the nonprescription sales of antibiotics were common for Amoxicillin, Ciprofloxacin and Cotrimoxazole. The poor, less educated and younger groups of the population were reported to frequently request antibiotics without prescription. The main reasons for nonprescription sale of antibiotics by pharmacy professionals were found to be related to pharmacy owner’s influence to maximize revenue, customer’s pressure, weak regulatory mechanism and professional conflicts of interest. Conclusion The study shows that nonprescription sale of antibiotics was common practice at least in Addis Ababa. The main reasons for this malpractice were the need to maximize revenue and weak regulatory mechanism. Hence, strong
Brata, Cecilia; Fisher, Colleen; Marjadi, Brahmaputra; Schneider, Carl R; Clifford, Rhonda M
Research has shown that the current practice of pharmacy staff when providing self-medication consultations in Indonesia is suboptimal. To improve the performance of pharmacy staff when providing self-medication consultations in community pharmacies, the factors that influence current practice need to be understood. The aim of this study is to identify the factors that influence current practice of pharmacy staff when handling self-medication consultations in Eastern Indonesian community pharmacies. Fifteen in-depth interviews were conducted with pharmacists, pharmacy technicians, pharmacy owners, and counter attendants. Thematic analysis was used to generate findings. The current practice of pharmacy staff when handling self-medication consultations is directly influenced by the professionalism of pharmacy staff and patient responses to the consultations. These factors are in turn affected by the organisational context of the pharmacy and the external pharmacy environment. The organisational context of the pharmacy includes staffing, staff affordability, and the availability of time and facilities in which to provide consultations. The external pharmacy environment includes the number of trained pharmacy staff in the research setting, the relevance of pharmacy education to the needs of pharmacy practice, the support offered by the Indonesian Pharmacists Association, a competitive business environment, and the policy environment. Complex and inter-related factors influence the current practice of pharmacy staff when providing self-medication consultations in community pharmacies in this research setting. Multiple strategies will be required to improve consultation practices.
Thomas, Renee Ahrens
The recent growth in the number of pharmacy schools across the nation has resulted in the need for high-quality community advanced pharmacy practice experience (APPE) sites. A vital part of a student's education, these APPEs should be structured and formalized to provide an environment conducive to student learning. This paper discusses how to use a calendar, structured-learning activities, and scheduled evaluations to develop students' knowledge, skills, and abilities in a community pharmacy...
Thomas, Renee Ahrens
The recent growth in the number of pharmacy schools across the nation has resulted in the need for high-quality community advanced pharmacy practice experience (APPE) sites. A vital part of a student's education, these APPEs should be structured and formalized to provide an environment conducive to student learning. This paper discusses how to use a calendar, structured-learning activities, and scheduled evaluations to develop students' knowledge, skills, and abilities in a community pharmacy setting.
Watson, Margaret C; Blenkinsopp, Alison
Excessive consumption of alcohol is a major public health concern. The use of community pharmacies and pharmacists as sources of public health information and services is gaining greater recognition. The objective of this review was to provide an overview of the evidence on the feasibility, effectiveness and acceptability of providing community pharmacy-based services to address the excessive consumption of alcohol. Electronic databases were searched for the period 1996-2007 to identify relevant evidence. Searches were also conducted of relevant pharmacy and addiction journals. Information was sought from key contacts in pharmacy and alcohol research. Studies were included if they were conducted in a community pharmacy setting. The review comprised three feasibility studies which included 14 pharmacies and 500 customers. Non-significant reductions in alcohol consumption were reported with two studies following brief interventions by pharmacists. Between 30% and 53% of pharmacy customers were identified as having hazardous or harmful drinking behaviour. Customer opinion of the pharmacy-based alcohol services was not reported. There has been little empirical evaluation of the effectiveness of community pharmacy-based services for alcohol misuse. The evidence presented in this review suggests that community pharmacy-based screening is feasible. Organisations and individuals involved with tackling excessive alcohol consumption should consider the inclusion of community pharmacies and pharmacists as part of their strategies to address this problem. Large-scale studies are needed to evaluate the short- and long-term effects and cost-effectiveness of community pharmacy-based interventions to reduce excessive alcohol consumption, as well as to explore the acceptability of the service to
Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J
Mental health-related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole.
Scahill, Shane; Fowler, Jane L; Hattingh, H Laetitia; Kelly, Fiona; Wheeler, Amanda J
Objective: Mental health–related problems pose a serious issue for primary care, and community pharmacy could make a significant contribution, but there is a dearth of information. Methods: This article reports synthesis of the literature on mental health interventions across a range of pharmacy models, and pharmacy services in contexts beyond mental health. To best inform the design of a community pharmacy medication support intervention for mental health consumers, the literature was reported as a conceptual schema and subsequent recommendations for development, implementation and evaluation of the service. A broad conceptualisation was taken in this review. In addition to mental health and community pharmacy literature, policy/initiatives, organisational culture and change management principles, and evaluative processes were reviewed. Key words were selected and literature reviews undertaken using EMBASE, PubMed, CINAHL and Web of Science. Results: Recommendations were made around: medication support intervention design, consumer recruitment, implementation in community pharmacy and evaluation. Surprisingly, there is a scarce literature relating to mental health interventions in community pharmacy. Even so, findings from other pharmacy models and broader medicines management for chronic illness can inform development of a medication support service for mental health consumers. Key learnings include the need to expand medicines management beyond adherence with respect to both intervention design and evaluation. Conclusion: The conceptual framework is grounded in the need for programmes to be embedded within pharmacies that are part of the health system as a whole. PMID:26770802
Boyle, Todd A; Bishop, Andrea C; Mahaffey, Thomas; Mackinnon, Neil J; Ashcroft, Darren M; Zwicker, Bev; Reid, Carolyn
Given the demanding nature of providing pharmacy services, coupled with the expanded scope of practice of the professions in jurisdictions around the world, greater commitment to continuous quality improvement through adoption of quality-related event (QRE) reporting is necessary to ensure patient safety. Pharmacy regulatory authorities (PRAs) are in a unique position to enhance QRE reporting and learning through the standardization of expected practice. This study was aimed to gain a better understanding of the perceived roles of PRAs in enhancing QRE reporting and learning in community pharmacies, and identifying regulatory best practices to execute such roles. A purposive case sampling approach was used to identify PRA staff members from two groups (Deputy registrars and pharmacy inspectors) in 10 Canadian jurisdictions to participate in focus groups in the fall of 2011. Focus groups were used to explore perceptions of the role of PRAs in enhancing and promoting QRE reporting and learning, and perceived barriers to effective implementation in practice. Thematic analysis was used to analyze the qualitative data. Two focus groups were conducted, one with seven Deputy registrars/Practice managers, and one with nine pharmacy inspectors. Five themes were identified, including (1) defining QRE reporting and compliance, (2) navigating role conflict, (3) educating for enhanced QRE reporting and learning, (4) promoting the positive/removing the fear of QREs, and (5) tailoring QRE reporting and learning consistency. Overall, participants perceived a strong role for PRAs in enhancing QRE reporting and learning and providing education for pharmacies to support their compliance with reporting standards. However, PRAs must navigate the conflict inherent in both educating and promoting a process for achieving a standard while simultaneously inspecting compliance to that standard. Ensuring pharmacies have autonomy in operationalizing standards may help to mitigate this conflict
Fredericks, Ian; Hollingworth, Samantha; Pudmenzky, Alex; Rossato, Laurence; Kairuz, Therése
Australians are among the highest users of antibiotics in the developed world. The primary aim was to determine the 'age' of antibiotic prescriptions at the time of dispensing as a possible contributor to antibiotic misuse and ultimately, resistance. The secondary aim was to test customised software to permit extraction and de-identification of dispensing records for analysis. Data were extracted and de-identified from computerised dispensing systems in three community pharmacies in Brisbane, Australia, according to a strict ethical protocol. All prescription records dispensed between 1 January 2010 and 31 December 2012 were merged to form a complete dataset of 1 158 871 de-identified dispensing records which were analysed using Microsoft Excel ® . A retrospective drug utilisation study was conducted on a subset of 100 573 antibiotic records. In a substudy conducted at a single pharmacy site, all antibiotic records dispensed over a 4-month (winter) period were examined to determine the age of prescriptions. Nearly one in ten antibiotics (9.0%) was dispensed from prescriptions that were more than a month old, and over one in five (22.1%) were dispensed from a repeat prescription. Health system factors may contribute to inappropriate antibiotic use in Australia, including availability and validity of repeat antibiotic prescriptions. Government health departments, prescribers, pharmacists, other health professionals and consumers have to share the responsibility of ensuring that antibiotics are used appropriately. © 2016 Royal Pharmaceutical Society.
Guhl, Dennis; Blankart, Katharina E; Stargardt, Tom
A patient's perception of the service provided by a health care provider is essential for the successful delivery of health care. This study examines the value created by community pharmacies-defined as perceived customer value-in the prescription drug market through varying elements of service quality. We develop a path model that describes the relationship between service elements and perceived customer value. We then analyze the effect of perceived customer value on customer satisfaction and loyalty. We use data obtained from 289 standardized interviews on respondents' prescription fill in the last six months in Germany. The service elements personal interaction (path coefficient: 0.31), physical aspect (0.12), store policy (0.24), and availability (0.1) have a positive significant effect on perceived customer value. Consultation and reliability have no significant influence. We further find a strong positive interdependency between perceived customer value, customer satisfaction (0.75), and customer loyalty (0.71). Thus, pharmacies may enhance customer satisfaction and loyalty if they consider the customer perspective and focus on the relevant service elements. To enhance benefit, personal interaction appears to be most important to address appropriately.
Tveden-Nyborg, Svend; Misfeldt, Morten; Boelt, Birte
Danish agriculture and seed science have a history of successful collaboration spanning more than a hundred years. In this study, we interviewed 26 growers, consultants, and scientists from the Danish seed community focusing on their current knowledge status and on their views on improving scient......, as only the innovative growers prioritized time allocation for additional knowledge search. To improve scientific knowledge dissemination and interdisciplinary collaboration among Danish seed-CoP we recommend a combination of face-to-face and online communication processes....... scientific knowledge communication. Theoretically, we consider these actors participants in different communities of practice relating to the production of seeds (Seed-CoP), and we conclude that strong network collaboration is present among Danish seed-CoP effectuated by the valuable work undertaken...... by the consultants. We discovered a divergence in knowledge dissemination among the growers – an innovative group of growers with a high demand for new scientific knowledge versus a majority of growers content with the level of knowledge provided by the consultants. ‘Time’ was recognized as an important parameter...
Waltering, Isabel; Schwalbe, Oliver; Hempel, Georg
A current medication plan was identified as important patient safety factor. Information is needed on how many patients possess such a plan and what problems can be identified with its use. This study tried to define factors that influence accuracy of medication plans and to detect discrepancies from planned and actually administered medication in polypharmacy patients. Participants of the 'Apo-AMTS' course in Germany evaluated medication plans from their patients during performing medication reviews in community pharmacies. Discrepancies were defined as additional or missing drugs and deviations in dosage and drug names for Rx drugs and missing or additional self-medication. Eighty per cent of the patients possessed a medication plan mainly written by general practitioners. Only 6.5% of the plans showed no discrepancies. Most discrepancies were seen on medication plans written by medical specialists and general practitioners, mainly name aberrations (41%) followed by additional drugs taken (30%) and prescribed drugs no longer taken (18%). Dosage variance was seen in 11% of all discrepancies. Deviations from the plan were observed frequently with antihypertensives (31.4%), analgesics (11.3%) and antidepressants/hypnotics as well as lipid-lowering drugs (6.7%). Four hundred thirty-three OTC drugs were not listed, mainly analgesics, mineral supplements and laxatives. Many patients possess a medication plan but most of these plans showed discrepancies which limits the use as patient safety indicator. Community pharmacies offering medication reviews have an essential position to use the medication plan as a central link between patients and their prescribers, and therefore improve patient safety. © 2015 John Wiley & Sons, Ltd.
Evans, Andrew M; Wood, Fiona C; Carter, Ben
Influenza is a significant cause of morbidity and excess mortality, yet vaccine coverage in the UK remains below target. Community pharmacies are increasingly being promoted as an alternative to vaccination by GPs. To explore and verify the factors that influence the relative performance of pharmacies providing NHS influenza vaccinations. A mixed methods study utilising qualitative, semi-structured interviews and quantitative analysis of predictors of vaccination numbers in community pharmacies in Wales. Interviews were conducted with 16 pharmacists who participated in the Welsh national pharmacy influenza service in 2013-2014. A purposive sampling strategy was used. Qualitative findings were analysed using framework analysis. Potential predictors of vaccination numbers were identified from interviews and a literature review, and included in a multivariable regression model. The contribution of community pharmacies towards vaccination in Wales is small. Findings suggest that community pharmacies reach younger at-risk individuals, in whom vaccine uptake is low, in greater proportion than influenza vaccination programmes as a whole. Extended opening hours and urban locations were positively associated with the number of vaccinations given, although pharmacists reported that workload, vaccine costs, unforeseen delays, lack of public awareness, and GPs' views of the service limited their contribution. Pharmacists, aware of the potential for conflict with GPs, moderated their behaviour to mitigate such risk. Before community pharmacies take greater responsibility for delivering healthcare services, obstacles including increasing pharmacist capacity, vaccine procurement, health service delays, managing GP-pharmacy relationships, and improving public awareness must be overcome. © British Journal of General Practice 2016.
Teeter, Benjamin S; Fox, Brent I; Garza, Kimberly B; Harris, Stanley G; Nau, David P; Owensby, Justin K; Westrick, Salisa C
The star rating system implemented by Medicare has the potential to positively affect patient health and may have financial implications for community pharmacies. Learning from owners of community pharmacies with high performance on these quality measures may help us to identify and further understand factors contributing to their success. This study described high-performing community pharmacy owners' current awareness and knowledge of star ratings, attitudes toward star ratings and performance measurement, and initiatives being offered in pharmacies that aim to improve the quality of care. Qualitative interviews with owners of independent community pharmacies were conducted in Spring 2015. Fifteen community pharmacies with high performance on the star rating measures were invited to participate. Recruitment did not end until the saturation point had been reached. All interviews were transcribed verbatim. Interview data were analyzed with the use of ATLAS.ti by 2 coders trained in thematic analysis. Krippendorf's alpha was calculated to assess intercoder reliability. Ten high-performing pharmacy owners participated. Analysis identified 8 themes, which were organized into the following categories: 1) current awareness and knowledge (i.e., superficial or advanced knowledge); 2) attitudes toward star ratings (positive perceptions, skeptical of performance rewards, and lack a feeling of control); and 3) pharmacy initiatives (personal patient relationships, collaborative employee relationships, and use of technology). Intercoder reliability was good overall. Interviews with high-performing pharmacies suggested that awareness of the star rating measures, overall positive attitudes toward the star ratings, the relationships that pharmacy owners have with their patients and their employees, and the use of technology as a tool to enhance patient care may contribute to high performance on the star rating measures. Future research is needed to determine if and how these
Full Text Available Janice Pringle,1 Kim C Coley2 1Program Evaluation and Research Unit, Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA; 2Department of Pharmacy and Therapeutics, School of Pharmacy, University of Pittsburgh, Pittsburgh, PA, USA Abstract: Evidence supports that patient medication adherence is suboptimal with patients typically taking less than half of their prescribed doses. Medication nonadherence is associated with poor health outcomes and higher downstream health care costs. Results of studies evaluating pharmacist-led models in a community pharmacy setting and their impact on medication adherence have been mixed. Community pharmacists are ideally situated to provide medication adherence interventions, and effective strategies for how they can consistently improve patient medication adherence are necessary. This article suggests a framework to use in the community pharmacy setting that will significantly improve patient adherence and provides a strategy for how to apply this framework to develop and test new medication adherence innovations. The proposed framework is composed of the following elements: 1 defining the program's pharmacy service vision, 2 using evidence-based, patient-centered communication and intervention strategies, 3 using specific implementation approaches that ensure fidelity, and 4 applying continuous evaluation strategies. Within this framework, pharmacist interventions should include those services that capitalize on their specific skill sets. It is also essential that the organization's leadership effectively communicates the pharmacy service vision. Medication adherence strategies that are evidence-based and individualized to each patient's adherence problems are most desirable. Ideally, interventions would be delivered repeatedly over time and adjusted when patient's adherence circumstances change. Motivational interviewing principles are particularly well
Khandelwal, Nikhil; Duncan, Ian; Rubinstein, Elan; Ahmed, Tamim; Pegus, Cheryl
Pharmacy benefit management (PBM) companies promote mail order programs that typically dispense 90-day quantities of maintenance medications, marketing this feature as a key cost containment strategy to address plan sponsors' rising prescription drug expenditures. In recent years, community pharmacies have introduced 90-day programs that provide similar cost advantages, while allowing these prescriptions to be dispensed at the same pharmacies that patients frequent for 30-day quantities. To compare utilization rates and corresponding costs associated with obtaining 90-day prescriptions at community and mail order pharmacies for payers that offer equivalent benefits in different 90-day dispensing channels. We performed a retrospective, cross-sectional investigation using pharmacy claims and eligibility data from employer group clients of a large PBM between January 2008 and September 2010. We excluded the following client types: government, third-party administrators, schools, hospitals, 340B (federal drug pricing), employers in Puerto Rico, and miscellaneous clients for which the PBM provided billing services (e.g., the pharmacy's loyalty card program members). All employer groups in the sample offered 90-day community pharmacy and mail order dispensing and received benefits management services, such as formulary management and mail order pharmacy, from the PBM. We further limited the sample to employer groups that offered equivalent benefits for community pharmacy and mail order, defined as groups in which the mean and median copayments per claim for community and mail order pharmacy, by tier, differed by no more than 5%. Enrollees in the sample were required to have a minimum of 6 months of eligibility in each calendar year but were not required to have filled a prescription in any year. We evaluated pharmacy costs and utilization for a market basket of 14 frequently dispensed therapeutic classes of maintenance medications. The proportional share of claims for
Westerlund, T; Almarsdóttir, Anna Birna; Melander, A
This study analyzes relationships between the number of drug-related problems detected in community pharmacy practice and the educational level and other characteristics of pharmacy personnel and their work sites. Random samples of pharmacists, prescriptionists and pharmacy technicians were drawn....... The results of this study indicate the importance of education and training of pharmacy personnel in detection of drug-related problems. This findings speaks in favor of increasing the pharmacist to other personnel ratio, provided the higher costs will be offset by societal benefits....
Yegenoglu, Selen; Sozen, Bilge; Aslan, Dilek; Calgan, Zeynep; Cagirci, Simge
The objective of this study was to find all the existing Web sites of Turkish community pharmacies and evaluate their "quality" in terms of Health on the Net (HON) Code of conduct principles. Multiple Internet search engines were used (google.com, yahoo.com, altavista.com, msn.com). While searching on the Internet, "eczane (pharmacy)" and "eczanesi (pharmacy of)" key words were used. The Internet search lasted for 2 months starting from March 1, 2007 until May 1, 2007. SPSS ver. 11.5 statistical program (SPSS, Inc., Chicago, IL) was used for data entry and analysis. At the end of the Internet search via all the indicated search engines, a total of 203 (all different from each other) community pharmacy Web sites were determined; of these, 14 were under construction and 6 were not accessible. As a result, 183 community pharmacy Web sites were included in the study. All of the Web sites could be accessed (100%). However, the availability of some characteristics of the pharmacies were quite poor. None of the pharmacies met all of the HON principles. Only 11 Web sites were appropriate in terms of complementarity (6.0%). Confidentiality criteria was met by only 14 pharmacies (7.7%). Nine pharmacies (4.9%) completed the "attribution" criteria. Among 183 pharmacy Web sites, the most met HON principle was the "transparency of authorship" (69 pharmacy Web sites; 37.7%). Because of the results of our study, the Turkish Pharmacists Association can take a pioneer role to apply some principles such as HON code of conduct in order to increase the quality of Turkish community pharmacists' Web sites.
Full Text Available Brittany L Melton, Zoe Lai Department of Pharmacy Practice, University of Kansas, Lawrence, KS, USA Objective: The aim of this review was to assess pharmacist and pharmacy services being provided and identify opportunities to improve patient satisfaction.Methods: Studies published between January 2006 and July 2016 examining patient satisfaction with pharmacy and pharmacist services, which were written in English, were identified in PubMed. Studies were excluded if they only looked at pharmacy student-provided services.Key findings: A total of 50 studies were ultimately included in the review. Of these studies, 28 examined services traditionally provided by community pharmacists such as dispensing and counseling, while 16 examined a new in-person service being offered by a pharmacy, and the remaining six involved a new technology-assisted service. While study findings were generally positive for patient satisfaction of pharmacy services, several opportunities were identified for pharmacies to improve.Conclusion: Overall, patient satisfaction is high across pharmacy services; however, this satisfaction is related to prior patient exposure to services and their level of expectation. Pharmacists have multiple opportunities to improve the services they provide, and there are additional services pharmacists may consider offering to expand their role within the health care system. Keywords: pharmacy, services, community, patient satisfaction
McCarthy, Lisa M; Brown, Thomas E R; Crown, Natalie; Jobanputra, Neil; Lui, Michelle; Laporte, Leigha; Taylor, Valerie H
To assess the feasibility of a medication sampling program involving community pharmacists. A community pharmacy dispensed samples after receiving a voucher given to patients by prescribers. Surveys explored prescribers' and patients' views about sampling and patients' experiences with the program. Half of prescribers reported providing samples, yet 15 patients redeemed 18 vouchers over 1 year. Patients expressed favourable views towards sampling and pharmacist involvement, despite more than half (n = 8/15, 53%) feeling that visiting the pharmacy was less convenient. A voucher-based medication sampling program based in a community pharmacy is a model integrating pharmacist care. © 2017 Royal Pharmaceutical Society.
Full Text Available Albert T Bach, Jeffery A Goad School of Pharmacy, Chapman University, Irvine, California, USA Abstract: Community pharmacy-based provision of immunizations in the USA has become commonplace in the last few decades, with success in increasing rates of immunizations. Community pharmacy-based vaccination services are provided by pharmacists educated in the practice of immunization delivery and provide a convenient and accessible option for receiving immunizations. The pharmacist's role in immunization practice has been described as serving in the roles of educator, facilitator, and immunizer. With a majority of pharmacist-provided vaccinations occurring in the community pharmacy setting, there are many examples of community pharmacists serving in these immunization roles with successful outcomes. Different community pharmacies employ a number of different models and workflow practices that usually consist of a year-round in-house service staffed by their own immunizing pharmacist. Challenges that currently exist in this setting are variability in scopes of immunization practice for pharmacists across states, inconsistent reimbursement mechanisms, and barriers in technology. Many of these challenges can be alleviated by continual education; working with legislators, state boards of pharmacy, stakeholders, and payers to standardize laws; and reimbursement design. Other challenges that may need to be addressed are improvements in communication and continuity of care between community pharmacists and the patient centered medical home. Keywords: immunization, pharmacy practice, pharmacists, continuity of care
Westerlund, Tommy; Almarsdóttir, Anna Birna; Melander, Arne
the interventions made by pharmacy personnel with patients and prescribers. Method. Random samples of pharmacists, prescriptionists and pharmacy technicians were drawn nationwide in Sweden; 144 (63 per cent) of the employees fulfilling the inclusion criteria agreed to take part. The participants documented drug...... of the patients. The median number of problems identified per 100 patients was greater for pharmacists (6.1) than for prescriptionists (2.6) and pharmacy technicians (1.1). About one in three problems was presented to the participants by their patients, while two thirds were detected by the pharmacy staff. One...
Cooper, Richard J; Tsoneva, Jo
Healthy Living Pharmacies (HLP) were introduced in the United Kingdom (UK) in a further attempt to deliver public health benefits in community pharmacy settings. Central to the initiative are staff trained as Healthy Living Champions (HLC) and this study sought to explore HLC perceptions of positive and negative aspect of their work and the wider scheme. A qualitative study was undertaken with a purposive sample of HLCs working in pathfinder HCPs in the Sheffield area in 2014. Participants were recruited by email to either a focus group (n = 7) held at a training event or later semi-structured one-to-one interviews in pharmacies (n = 6). Four stages of interpretative phenomenological analysis were used to code and identify themes. Four main themes emerged relating to the positive workforce development impact HLPs had upon HLCs themselves and on perceived customer and patient engagement and benefits. Tensions were identified with existing commercial business demands and negative views overall of the pharmacy setting with a perceived lack of not only integration with other services but also awareness among the public and health care staff. HLCs felt empowered and more confident in initiating conversation about health issues with patients, but identified barriers relating to workload, a lack of time to perform their role, isolation, tensions with non-HLC staff and logistical barriers such as poor Internet access. Delivering public health activities through the HLC role in UK pharmacies is associated with several perceived benefits for different stakeholders, but may be threatened by well recognised barriers in UK pharmacies related to the commercial setting. © 2016 Royal Pharmaceutical Society.
Atkinson, Jeffrey; de Paepe, Kristien; Sánchez Pozo, Antonio; Rekkas, Dimitrios; Volmer, Daisy; Hirvonen, Jouni; Bozic, Borut; Skowron, Agnieska; Mircioiu, Constantin; Marcincal, Annie; Koster, Andries; Wilson, Keith; van Schravendijk, Chris; Wilkinson, Jamie
This paper looks at the opinions of 241 European academics (who provide pharmacy education), and of 258 European community pharmacists (who apply it), on competences for pharmacy practice. A proposal for competences was generated by a panel of experts using Delphi methodology. Once finalized, the proposal was then submitted to a large, European-wide community of academics and practicing pharmacists in an additional Delphi round. Academics and community pharmacy practitioners recognized the importance of the notion of patient care competences, underlining the nature of the pharmacist as a specialist of medicines. The survey revealed certain discrepancies. Academics placed substantial emphasis on research, pharmaceutical technology, regulatory aspects of quality, etc., but these were ranked much lower by community pharmacists who concentrated more on patient care competences. In a sub-analysis of the data, we evaluated how perceptions may have changed since the 1980s and the introduction of the notions of competence and pharmaceutical care. This was done by splitting both groups into respondents 40 years old. Results for the subgroups were essentially statistically the same but with some different qualitative tendencies. The results are discussed in the light of the different conceptions of the professional identity of the pharmacist. PMID:28970385
Full Text Available This paper looks at the opinions of 241 European academics (who provide pharmacy education, and of 258 European community pharmacists (who apply it, on competences for pharmacy practice. A proposal for competences was generated by a panel of experts using Delphi methodology. Once finalized, the proposal was then submitted to a large, European-wide community of academics and practicing pharmacists in an additional Delphi round. Academics and community pharmacy practitioners recognized the importance of the notion of patient care competences, underlining the nature of the pharmacist as a specialist of medicines. The survey revealed certain discrepancies. Academics placed substantial emphasis on research, pharmaceutical technology, regulatory aspects of quality, etc., but these were ranked much lower by community pharmacists who concentrated more on patient care competences. In a sub-analysis of the data, we evaluated how perceptions may have changed since the 1980s and the introduction of the notions of competence and pharmaceutical care. This was done by splitting both groups into respondents < 40 and > 40 years old. Results for the subgroups were essentially statistically the same but with some different qualitative tendencies. The results are discussed in the light of the different conceptions of the professional identity of the pharmacist.
Information technology (IT) has transformed the practice of pharmacy worldwide. This study was undertaken to determine the pharmacists\\' IT use, utilization patterns and their opinions regarding IT use. The majority of pharmacies had networked computers (71.7%) and internet connections (60.9%). Pharmacists had poor ...
Rosenquist, Ashley; Best, Brookie M; Miller, Teresa A; Gilmer, Todd P; Hirsch, Jan D
Pharmacist-provided medication therapy management services (MTMS) have been shown to increase patient's adherence to medications, improve health outcomes and reduce overall medical costs. The purpose of this study was to describe a pilot programme that provided pharmacy-based MTMS for patients with HIV/AIDS in the state of California, USA. Pharmacists from the 10 pilot pharmacies were surveyed using an online data collection tool. Information was collected to describe the types of MTMS offered, proportion of patients actively using specific MTMS, pharmacist beliefs regarding effect on patient outcomes and barriers to providing MTMS, ability to offer MTMS without pilot programme funding and specialized pharmacist or staff training. Each responding pharmacy (7 of 10) varied in the number of HIV/AIDS patients served and prescription volume. All pharmacists had completed HIV/AIDS-related continuing education programmes, and some had other advanced training. The type of MTMS being offered varied at each pharmacy with 'individualized counselling by a pharmacist when overuse or underuse was detected' and 'refill reminders by telephone' being actively used by the largest proportion of patients. Most, but not all, pharmacists cited reimbursement as a barrier to MTMS provision. Pharmacists believed the MTMS they provide resulted in improved satisfaction (patient and provider), medication usage, therapeutics response and patient quality of life. The type of MTMS offered, and proportion of patients actively using, varied among participating pilot pharmacies. © 2010 Blackwell Publishing Ltd.
Devine, Joshua W
.... These clinics, which are staffed by physicians' assistants or nurse practitioners, often are located directly within community pharmacies offering rapid diagnosis and treatment for a limited number of health problems...
Yazed Sulaiman Al-Ruthia
Full Text Available Background: Patients with mental disorders, such as depression and anxiety, who seek medical care in private psychiatric clinics in Riyadh, Saudi Arabia, have recently expressed concerns to doctors about difficulty in filling psychotropic medications, such as Amitriptyline and Aripiprazole, at retail community pharmacies. Objectives: The aim of this study was to investigate whether there is a shortage of some commonly prescribed psychotropic medications in retail community pharmacies in Saudi Arabia, and if so, to explore the possible reasons behind the shortage of these medications. Methods: The availability of 28 commonly prescribed psychotropic medications was checked in multiple retail community pharmacies in 4 different regions of Saudi Arabia. Further, potential reasons behind the shortage of some psychotropic medications in retail community pharmacies were also explored. Results: Amitriptyline, Amoxapine, Aripiprazole, Bupropion, Buspirone, Duloxetine, Haloperidol, Hydroxyzine, Lithium, Prochlorperazine, Procyclidine, Promethazine, Thioridazine, Trazodone, and Trifluoperazine were unavailable in over half of the 248 community pharmacies surveyed. Four possible reasons behind the shortage of these medications were reported by 31 pharmacists working in different retail community pharmacies’ purchasing departments, with a majority (58.06% reporting the primary reason for a shortage of these medications that they are slow-moving items with low profit margins. Conclusions: The findings of this study should expedite the reform process in both the Ministry of Health and the Saudi Food and Drug Authority (SFDA to publish and enforce an essential list of medications for retail community pharmacies, which should include the most commonly prescribed psychotropic medications.
To evaluate the status of community pharmacies, their staff, and practices toward dispensing antibiotics. Cross-sectional, prospective. Community pharmacies in two districts of central Nepal, from March 2016 to May 2016. A systematic random sampling approach was adopted to sample 161 community pharmacies. Data on the registration status of pharmacies, qualification or training of dispensing staff, and the practice of dispensing antibiotics were collected using a pre-tested questionnaire. Face to face interviews were carried out by a previously trained interviewer. Data were analyzed for descriptive and inferential statistics using IBM SPSS Statistics 21. Among 161 community pharmacies, 25% were not registered and most of them were located in rural areas. It was typical (66.5%) to dispense antibiotics without prescription and most (91.4%) of the staffs involved in dispensing were non-pharmacists. Furthermore, the study revealed common practices of replacing one brand of antibiotic with other brands (66%), dispensing incomplete courses of antibiotics (73%), and not giving any advice regarding antibiotic use (39%) or completion of a full course of therapy (80%). There were significant (p < 0.001) relationships between the location of pharmacies (rural vs urban) and the qualifications of the pharmacy staff. Dispensing antibiotics without prescription and by non-pharmacists are common in this region. The study also found several issues regarding the irrational use of antibiotics. Thus, there is an urgent need to address these issues and promote the informed use of antibiotics.
Félix, Jorge; Ferreira, Diana; Afonso-Silva, Marta; Gomes, Marta Vargas; Ferreira, César; Vandewalle, Björn; Marques, Sara; Mota, Melina; Costa, Suzete; Cary, Maria; Teixeira, Inês; Paulino, Ema; Macedo, Bruno; Barbosa, Carlos Maurício
Community pharmacies are major contributors to health care systems across the world. Several studies have been conducted to evaluate community pharmacies services in health care. The purpose of this study was to estimate the social and economic benefits of current and potential future community pharmacies services provided by pharmacists in health care in Portugal. The social and economic value of community pharmacies services was estimated through a decision-model. Model inputs included effectiveness data, quality of life (QoL) and health resource consumption, obtained though literature review and adapted to Portuguese reality by an expert panel. The estimated economic value was the result of non-remunerated pharmaceutical services plus health resource consumption potentially avoided. Social and economic value of community pharmacies services derives from the comparison of two scenarios: "with service" versus "without service". It is estimated that current community pharmacies services in Portugal provide a gain in QoL of 8.3% and an economic value of 879.6 million euros (M€), including 342.1 M€ in non-remunerated pharmaceutical services and 448.1 M€ in avoided expense with health resource consumption. Potential future community pharmacies services may provide an additional increase of 6.9% in QoL and be associated with an economic value of 144.8 M€: 120.3 M€ in non-remunerated services and 24.5 M€ in potential savings with health resource consumption. Community pharmacies services provide considerable benefit in QoL and economic value. An increase range of services including a greater integration in primary and secondary care, among other transversal services, may add further social and economic value to the society.
Odukoya, Olufunmilola K; Chui, Michelle A
To characterise the safety hazards related to e-prescribing in community pharmacies. The sociotechnical systems framework was used to investigate the e-prescribing technology interface in community pharmacies by taking into consideration the social, technical and environmental work elements of a user's interaction with technology. This study focused specifically on aspects of the social subsystem. The study employed a cross-sectional qualitative design and was conducted in seven community pharmacies in Wisconsin. Direct observations, think aloud protocols and group interviews were conducted with 14 pharmacists and 16 technicians, and audio recorded. Recordings were transcribed and subjected to thematic content analysis guided by the sociotechnical systems' theoretical framework. Three major themes that may increase the potential for medication errors with e-prescribing were identified and described. The three themes included: (1) increased cognitive burden on pharmacy staff, such as having to memorise parts of e-prescriptions or having to perform dosage calculations mentally; (2) interruptions during the e-prescription dispensing process; and (3) communication issues with prescribers, patients and among pharmacy staff. Pharmacy staff reported these consequences of e-prescribing increased the likelihood of medication errors. This study is the first of its kind to identify patient safety risks related to e-prescribing in community pharmacies using a sociotechnical systems framework. The findings shed light on potential interventions that may enhance patient safety in pharmacies and facilitate improved e-prescribing use. Future studies should confirm patient safety hazards reported and identify ways to use e-prescribing effectively and safely in community pharmacies.
Stefanie Ferreri, PharmD, CDE, BCACP, FAPhA1
Full Text Available Objective: To assess patient perceptions of a North Carolina community pharmacy-based warfarin monitoring service. Methods: Prospective study of patients 18 years of age and older, who filled a prescription for warfarin, in one of five Raleigh area community pharmacies, between May 1, 2010 and October 31, 2010. A 14 item survey, along with a self-addressed stamped envelope, was mailed to 330 identified patients. The survey inquired about details of current anticoagulation monitoring services, interest in utilizing a local community pharmacy for this service, and confidence in a pharmacist-managed program. Results: 26% of surveys were returned. 48% of surveyed individuals responded that they would be interested in having their warfarin monitoring performed by a trained pharmacist in a community pharmacy setting. Conclusion: Many participants responded that the community pharmacy would be more convenient than or as convenient as their current location. This may be a new clinical service that could be offered in certain community pharmacies.
Full Text Available Objective: To assess patient perceptions of a North Carolina community pharmacy-based warfarin monitoring service. Methods: Prospective study of patients 18 years of age and older, who filled a prescription for warfarin, in one of five Raleigh area community pharmacies, between May 1, 2010 and October 31, 2010. A 14 item survey, along with a self-addressed stamped envelope, was mailed to 330 identified patients. The survey inquired about details of current anticoagulation monitoring services, interest in utilizing a local community pharmacy for this service, and confidence in a pharmacist-managed program. Results: 26% of surveys were returned. 48% of surveyed individuals responded that they would be interested in having their warfarin monitoring performed by a trained pharmacist in a community pharmacy setting. Conclusion: Many participants responded that the community pharmacy would be more convenient than or as convenient as their current location. This may be a new clinical service that could be offered in certain community pharmacies. Type: Original Research
Full Text Available Reports of regulatory and evidentiary gaps have raised concerns about the marketing and use of natural health products (NHPs. The majority of NHPs offered for sale are purchased at a community pharmacy and pharmacists are "front-line" health professionals involved in the marketing and provision of NHPs. To date, the involvement of pharmacists in pharmacy care involving NHPs and the degree to which concerns over the safety, efficacy, marketing and regulation of NHPs are addressed in pharmacy care in Canada have not been studied.Using Qualtrics, a web-based data collection and analysis software, and a study instrument made up of fifteen (15 open-ended, closed and rating scale questions, we surveyed the attitudes and practices of 403 community pharmacists in the Canadian province of Alberta regarding NHPs offered for sale in community pharmacies.The majority of pharmacists surveyed (276; 68% recommend NHPs to clients sometimes to very often. Vitamin D, calcium, multivitamins, prenatal vitamins, probiotics and fish oil and omega-3 fatty acids were the most frequently recommended NHPs. The most common indications for which NHPs are recommended include bone and musculoskeletal disorders, maintenance of general health, gastrointestinal disorders and pregnancy. Review articles published in the Pharmacist's Letter and Canadian Pharmacists Journal were the primary basis for recommending NHPs. The majority of pharmacists surveyed (339; 84% recommend the use of NHPs concurrently with conventional drugs, while a significant number and proportion (125; 31% recommend alternative use. Pharmacists in the study overwhelmingly reported providing counselling on NHPs to clients based on information obtained mainly from the Natural Medicines Comprehensive Database.The study findings indicate a high prevalence of pharmacy care relating to NHPs among study participants. Although pharmacists' practices around NHPs are consistent with the existing licensing framework, we
Michael J Twigg
Full Text Available The UK government advocates person-centred healthcare which is ideal for supporting patients to make appropriate lifestyle choices and to address non-adherence. The Community Pharmacy Future group, a collaboration between community pharmacy companies and independents in the UK, introduced a person-centred service for patients with multiple long-term conditions in 50 pharmacies in Northern England.Describe the initial findings from the set up and delivery of a novel community pharmacy-based person-centred service.Patients over fifty years of age prescribed more than one medicine including at least one for cardiovascular disease or diabetes were enrolled. Medication review and person-centred consultation resulted in agreed health goals and steps towards achieving them. Data were collated and analysed to determine appropriateness of patient recruitment process and quality of outcome data collection. A focus group of seven pharmacists was used to ascertain initial views on the service.Within 3 months of service initiation, 683 patients had baseline clinical data recorded, of which 86.9% were overweight or obese, 53.7% had hypertension and 80.8% had high cardiovascular risk. 544 (77.2% patients set at least one goal during the first consultation with 120 (22.1% setting multiple goals. A majority of patients identified their goals as improvement in condition, activity or quality of life. Pharmacists could see the potential patient benefit and the extended role opportunities the service provided. Allowing patients to set their own goals occasionally identified gaps to be addressed in pharmacist knowledge.Pharmacists successfully recruited a large number of patients who were appropriate for such a service. Patients were willing to identify goals with the pharmacist, the majority of which, if met, may result in improvements in quality of life. While challenges in delivery were acknowledged, allowing patients to identify their own personalised goals was
Gastelurrutia, Miguel Angel; Fernández-Llimos, Fernando; Benrimoj, Shalom I; Castrillon, Carla Cristina; Faus, María José
To identify and assess barriers for dissemination, implementation, and sustainability of different cognitive services in Spanish community pharmacies. Qualitative study through semi-structured interviews followed by a descriptive analysis. Two groups of experts related to Spanish community pharmacy were chosen. One with 15 community pharmacists with a relevant professional activity, while the other group (n=18) was related to pharmacy strategists. The lack of university clinical oriented learning, lack of pharmacists' attitude towards change and some uncertainty over their professional future were identified as barriers at the pharmacists' level. In relation to pharmacy as an organization the lack of clear messages by their leaders and the small volume of Spanish pharmacies were identified as barriers. In the category of pharmacy profession, the current reimbursement system, the lack of university clinical education, and the lack of leadership by current representative organizations were the barriers found. The lack of real involvement by health authorities, the lack of knowledge about the objectives of pharmacy cognitive services, and the lack of demand of these services by patients where also identified as barriers. Finally, 12 barriers were identified and grouped into 6 categories. These barriers fit in with the barriers identified in other countries.
Full Text Available Levonorgestrel emergency contraception and other contraceptive methods are available over-the-counter (OTC; however youth continue to face a number of barriers in accessing healthcare services, including lack of knowledge of the method, fear of loss of privacy, difficulties in finding a provider, and cost. A descriptive, nonexperimental, cross-sectional study of a sample of 112 community pharmacies in San Diego, California was conducted between December 2009 and January 2010 to assess community pharmacy practices related to the availability and accessibility of family planning health pharmacy services and products, particularly to youth. A majority (n = 79/112, 70.5% of the pharmacies carried a wide selection of male condoms; however, the other OTC nonhormonal contraceptive products were either not available or available with limited selection. A majority of the pharmacies sold emergency contraception (n = 88/111, 78.6%. Most patient counseling areas consisted of either a public or a semi-private area. A majority of the pharmacy sites did not provide materials or services targeting youth. Significant gaps exist in providing family planning products and services in the majority of community pharmacies in San Diego, California. Education and outreach efforts are needed to promote provision of products and services, particularly to the adolescent population.
Chisholm-Burns, Marie A; Gatwood, Justin; Spivey, Christina A; Dickey, Susan E
Objective. To compare the net cumulative income of community pharmacists, hospital pharmacists, and full-time pharmacy faculty members (residency-trained or with a PhD after obtaining a PharmD) in pharmacy practice, medicinal chemistry, pharmaceutics, pharmacology, and social and administrative sciences. Methods. Markov modeling was conducted to calculate net projected cumulative earnings of career paths by estimating the costs of education, including the costs of obtaining degrees and student loans. Results. The economic model spanned 49 years, from ages 18 to 67 years. Earning a PharmD and pursuing an academic career resulted in projected net cumulative lifetime earnings ranging from approximately $4.7 million to $6.3 million. A pharmacy practice faculty position following public pharmacy school and one year of residency resulted in higher net cumulative income than community pharmacy. Faculty members with postgraduate year 1 (PGY1) training also had higher net income than other faculty and hospital pharmacy career paths, given similar years of prepharmacy education and type of pharmacy school attended. Faculty members with either a PharmD or PhD in the pharmacology discipline may net as much as $5.9 million and outpace all other PhD graduates by at least $75 000 in lifetime earnings. Projected career earnings of postgraduate year 2 (PGY2) trained faculty and PharmD/PhD faculty members were lower than those of community pharmacists. Findings were more variable when comparing pharmacy faculty members and hospital pharmacists. Conclusion. With the exception of PGY1 trained academic pharmacists, faculty projected net cumulative incomes generally lagged behind community pharmacists, likely because of delayed entry into the job market as a result of advanced training/education. However, nonsalary benefits such as greater flexibility and autonomy may enhance the desirability of academic pharmacy as a career path.
Wibowo, Yosi; Sunderland, Bruce; Hughes, Jeffery
To explore perspectives of physicians and pharmacists on diabetes service delivery within community pharmacies in Indonesia. In depth interviews were conducted with 10 physicians and 10 community pharmacists in Surabaya, Indonesia, using a semi-structured interview guide. Nvivo version 9 was used to facilitate thematic content analysis to identify barriers/facilitators for community pharmacists to provide diabetes services. The identified themes indicating barriers/facilitators for diabetes service delivery within Indonesian community pharmacies included: (1) pharmacist factors - i.e. positive views (facilitator) and perceived lack of competence (barrier); (2) pharmacist-physician relationships - i.e. physicians' lack of support and accessibility (barriers); (3) pharmacist-patient relationships - i.e. perceived patients' lack of support and accessibility (barriers); (4) pharmacy environment - i.e. business orientation (barrier), lack of staff and poor pharmacist availability (barriers), and availability of supporting resources, such as counselling areas/rooms, procedures/protocols and IT systems for labelling and patient records (facilitators); and (5) external environment - i.e. a health system to support pharmacist roles, remuneration, marketing and professional assistance (facilitators). Issues related to the pharmacist-physician-patient relationships, pharmacy environment and external environment need to be addressed before Indonesian community pharmacists can provide additional pharmacy services for type 2 diabetes patients. Collaboration between the Government, Ikatan Apoteker Indonesia (Indonesian Pharmacists Association) and Ikatan Dokter Indonesia (Indonesian Medical Association) is required to improve the pharmacy professional environment and facilities. © 2015 Royal Pharmaceutical Society.
Friesner, Daniel L; Scott, David M; Rathke, Ann M; Peterson, Charles D; Anderson, Howard C
To evaluate the differences in medication dispensing errors between remote telepharmacy sites (pharmacist not physically present) and standard community pharmacy sites (pharmacist physically present and no telepharmacy technology; comparison group). Pilot, cross-sectional, comparison study. North Dakota from January 2005 to September 2008. Pharmacy staff at 14 remote telepharmacy sites and 8 comparison community pharmacies. The Pharmacy Quality Commitment (PQC) reporting system was incorporated into the North Dakota Telepharmacy Project. A session was conducted to train pharmacists and technicians on use of the PQC system. A quality-related event (QRE) was defined as either a near miss (i.e., mistake caught before reaching patient; pharmacy discovery), or an error (i.e., mistake discovered after patient received medication; patient discovery). QREs for prescriptions. During a 45-month period, the remote telepharmacy group reported 47,078 prescriptions and 631 QREs compared with 123,346 prescriptions and 1,002 QREs in the standard pharmacy group. Results for near misses (pharmacy discovery) and errors (patient discovery) for the remote and comparison sites were 553 and 887 and 78 and 125, respectively. Percentage of "where the mistake was caught" (i.e., pharmacist check) for the remote and comparison sites were 58% and 69%, respectively. This study reported a lower overall rate (1.0%) and a slight difference in medication dispensing error rates between remote telepharmacy sites (1.3%) and comparison sites (0.8%). Both rates are comparable with nationally reported levels (1.7% error rate for 50 pharmacies).
Full Text Available Abstract Background Naturopaths and Western herbal medicine (WHM practitioners were surveyed to identify their extent, experience and roles within the community pharmacy setting and to explore their attitudes to integration of complementary medicine (CM practitioners within the pharmacy setting. Method Practising naturopaths and WHM practitioners were invited to participate in an anonymous, self-administered, on-line survey. Participants were recruited using the mailing lists and websites of CM manufacturers and professional associations. Results 479 practitioners participated. 24% of respondents (n = 111 reported they had worked in community pharmacy, three-quarters for less than 5 years. Whilst in this role 74% conducted specialist CMs sales, 62% short customer consultations, 52% long consultations in a private room and 51% staff education. This was generally described as a positive learning experience and many appreciated the opportunity to utilise their specialist knowledge in the service of both customers and pharmacy staff. 14% (n = 15 did not enjoy the experience of working in pharmacy at all and suggested pharmacist attitude largely influenced whether the experience was positive or not. Few practitioners were satisfied with the remuneration received. 44% of the total sample provided comment on the issue of integration into pharmacy, with the main concern being the perceived incommensurate paradigms of practice between pharmacy and naturopathy. Of the total sample, 38% reported that they would consider working as a practitioner in retail pharmacy in future. Conclusions The level of integration of CM into pharmacy is extending beyond the mere stocking of supplements. Naturopaths and Western Herbalists are becoming utilised in pharmacies
Bradley, Fay; Willis, Sarah C; Noyce, Peter R; Schafheutle, Ellen I
Broadening the range of services provided through community pharmacy increases workloads for pharmacists that could be alleviated by reconfiguring roles within the pharmacy team. To examine pharmacists' and pharmacy technicians (PTs)' perceptions of how safe it would be for support staff to undertake a range of pharmacy activities during a pharmacist's absence. Views on supervision, support staff roles, competency and responsibility were also sought. Informed by nominal group discussions, a questionnaire was developed and distributed to a random sample of 1500 pharmacists and 1500 PTs registered in England. Whilst focused on community pharmacy practice, hospital pharmacy respondents were included, as more advanced skill mix models may provide valuable insights. Respondents were asked to rank a list of 22 pharmacy activities in terms of perceived risk and safety of these activities being performed by support staff during a pharmacist's absence. Descriptive and comparative statistic analyses were conducted. Six-hundred-and-forty-two pharmacists (43.2%) and 854 PTs (57.3%) responded; the majority worked in community pharmacy. Dependent on agreement levels with perceived safety, from community pharmacists and PTs, and hospital pharmacists and PTs, the 22 activities were grouped into 'safe' (n = 7), 'borderline' (n = 9) and 'unsafe' (n = 6). Activities such as assembly and labeling were considered 'safe,' clinical activities were considered 'unsafe.' There were clear differences between pharmacists and PTs, and sectors (community pharmacy vs. hospital). Community pharmacists were most cautious (particularly mobile and portfolio pharmacists) about which activities they felt support staff could safely perform; PTs in both sectors felt significantly more confident performing particularly technical activities than pharmacists. This paper presents novel empirical evidence informing the categorization of pharmacy activities into 'safe,' 'borderline' or 'unsafe
Yohanna Kambai Avong
Full Text Available The landscape of Human Immunodeficiency Virus (HIV epidemic control is shifting with the United Nations Programme on HIV/AIDS (UNAIDS 90-90-90 benchmarks for epidemic control. Community-based Antiretroviral Therapy (CART models have improved treatment uptake and demonstrated good clinical outcomes. We assessed the feasibility of integrating community pharmacy as a task shift structure for differentiated community ART in Abuja-Nigeria.Stable patients on first line ART regimens from public health facilities were referred to community pharmacies in different locations within the Federal Capital Territory, Abuja for prescription refills and treatment maintenance. Bio-demographic and clinical data were collected from February 25, 2016 to May 31st, 2017 and descriptive statistics analysis applied. The outcomes of measure were prescription refill and patient retention in care at the community pharmacy.Almost 10% of stable patients on treatment were successfully devolved from eight health facilities to ten community pharmacies. Median age of the participants was 35 years [interquartile range (IQR; 30, 41] with married women in the majority. Prescription refill was 100% and almost all the participants (99.3% were retained in care after they were devolved to the community pharmacies. Only one participant was lost-to-follow-up as a result of death.Excellent prescription refill and high retention in care with very low loss-to-follow-up were associated with the community pharmacy model. The use of community pharmacy for community ART is feasible in Nigeria. We recommend the scale up of the model in all the 36 states of Nigeria.
Evans, Andrew M; Wood, Fiona C; Carter, Ben
Background Influenza is a significant cause of morbidity and excess mortality, yet vaccine coverage in the UK remains below target. Community pharmacies are increasingly being promoted as an alternative to vaccination by GPs. Aim To explore and verify the factors that influence the relative performance of pharmacies providing NHS influenza vaccinations. Design and setting A mixed methods study utilising qualitative, semi-structured interviews and quantitative analysis of predictors of vaccination numbers in community pharmacies in Wales. Method Interviews were conducted with 16 pharmacists who participated in the Welsh national pharmacy influenza service in 2013–2014. A purposive sampling strategy was used. Qualitative findings were analysed using framework analysis. Potential predictors of vaccination numbers were identified from interviews and a literature review, and included in a multivariable regression model. Results The contribution of community pharmacies towards vaccination in Wales is small. Findings suggest that community pharmacies reach younger at-risk individuals, in whom vaccine uptake is low, in greater proportion than influenza vaccination programmes as a whole. Extended opening hours and urban locations were positively associated with the number of vaccinations given, although pharmacists reported that workload, vaccine costs, unforeseen delays, lack of public awareness, and GPs’ views of the service limited their contribution. Pharmacists, aware of the potential for conflict with GPs, moderated their behaviour to mitigate such risk. Conclusion Before community pharmacies take greater responsibility for delivering healthcare services, obstacles including increasing pharmacist capacity, vaccine procurement, health service delays, managing GP–pharmacy relationships, and improving public awareness must be overcome. PMID:26965025
Japan's Ministry of Health, Labour and Welfare published "the required function and the desired operating form of a pharmacy" and proposed that "a pharmacy should demonstrate a positive role for the promotion of self-medication". In the future, it will be indispensable to pharmacies that pharmacists play a role not only in dispensing medicine but also in serving a central health-station role in the community, including promoting the self-selection of proper OTC medications for the maintenance of health. My pharmacy in a traditional area in Tokyo carries OTC drugs, health and nursing care goods, medical supplies, etc. besides dispensing medicine by prescription. Moreover, a "sample measurement room" where a person can conduct a blood test by self-puncture was prepared in April of 2014. In addition, my pharmacy has held "health consultation meetings" for patients in collaboration with a registered dietitian, as well as "meetings for briefing sessions on how to better take or administer medicines" for parents of infants, etc. These activities have been useful to local residents in the prevention of lifestyle-related diseases and in promoting a better understanding of medicine. Moreover, on-site student trainees from schools of pharmacy are helping with planning, data collection, and explanation on the days of these meetings. For trainees from schools of pharmacy, participating in these activities is important to becoming a pharmacist trusted at the community level in the future.
Sara I V C Lima
Full Text Available Although there is a conflict between the treatment benefits for a single individual and society, restrictions on antibiotic use are needed to reduce the prevalence of resistance to these drugs, which is the main result of irrational use. Brazil, cataloged as a pharmemerging market, has implemented restrictive measures for the consumption of antibiotics. The objective of this study was to investigate the quality of antimicrobial prescriptions and user knowledge of their treatment with these drugs.A two-stage cross-sectional, combined and stratified survey of pharmacy users holding an antimicrobial prescription was conducted in the community between May and November 2014. A pharmacist analyzed each prescription for legibility and completeness, and applied a structured questionnaire to the users or their caregivers on their knowledge regarding treatment and user sociodemographic data. An estimated 29.3% of prescriptions had one or more illegible items, 91.3% had one or more missing items, and 29.0% had both illegible and missing items. Dosing schedule and patient identification were the most commonly unreadable items in prescriptions, 18.81% and 12.14%, respectively. The lack of complete patient identification occurred in 90.53% of the prescriptions. It is estimated that 40.3% of users have used antimicrobials without prescription and that 46.49% did not receive any guidance on the administration of the drug.Despite the measures taken by health authorities to restrict the misuse of antimicrobials, it was observed that prescribers still do not follow the criteria of current legislation, particularly relating to items needed for completion of the prescription. Moreover, users receive little information about their antimicrobial treatment.
Lima, Sara I V C; Diniz, Rodrigo S; Egito, Eryvaldo S T; Azevedo, Paulo R M; Oliveira, Antonio G; Araujo, Ivonete B
Although there is a conflict between the treatment benefits for a single individual and society, restrictions on antibiotic use are needed to reduce the prevalence of resistance to these drugs, which is the main result of irrational use. Brazil, cataloged as a pharmemerging market, has implemented restrictive measures for the consumption of antibiotics. The objective of this study was to investigate the quality of antimicrobial prescriptions and user knowledge of their treatment with these drugs. A two-stage cross-sectional, combined and stratified survey of pharmacy users holding an antimicrobial prescription was conducted in the community between May and November 2014. A pharmacist analyzed each prescription for legibility and completeness, and applied a structured questionnaire to the users or their caregivers on their knowledge regarding treatment and user sociodemographic data. An estimated 29.3% of prescriptions had one or more illegible items, 91.3% had one or more missing items, and 29.0% had both illegible and missing items. Dosing schedule and patient identification were the most commonly unreadable items in prescriptions, 18.81% and 12.14%, respectively. The lack of complete patient identification occurred in 90.53% of the prescriptions. It is estimated that 40.3% of users have used antimicrobials without prescription and that 46.49% did not receive any guidance on the administration of the drug. Despite the measures taken by health authorities to restrict the misuse of antimicrobials, it was observed that prescribers still do not follow the criteria of current legislation, particularly relating to items needed for completion of the prescription. Moreover, users receive little information about their antimicrobial treatment.
Mielczarek, Artur Tomasz
Activated sludge treatment plants are the most used wastewater treatment systems worldwide for biological nutrient removal from wastewater. Nevertheless, the treatment systems have been for many years operated as so called “black-box”, where specific process parameters were adjusted without...... was devoted into detailed analysis of almost fifty full-scale treatment plants (Microbial Database over Danish Wastewater Treatment Plants.) in order to learn more about the activated sludge communities and the rules that govern their presence and growth. This is one of the first such comprehensive long......-term investigations of the microbial community in full-scale wastewater treatment plants, where conventional identification, molecular identification by quantitative Fluorescent In Situ Hybridization and extensive process information related to treatment plant design and process performance have been compiled...
Alshammari, Thamir M; Alhindi, Salman A; Alrashdi, Ahmed M; Benmerzouga, Imaan; Aljofan, Mohamad
To assess the compliance of community pharmacies with the regulations that prohibit the dispensing of prescription-only medications in the absence of a physician prescription in Saudi Arabia. A cross-sectional study was conducted in the period between October 2014 and January 2015. A list of 10 prescription-only medications were selected to be studied. 150 community pharmacies were visited across 6 major regions in Saudi Arabia to assess the prevalence of non-compliance among community pharmacies. Pharmacies were selected in random and researchers (disguised as patients) requested to purchase prescription-only medications in the absence of a prescription. Not all medications were purchased at once. Data were recorded per pharmacy, where pharmacies that approved dispense of the selected drug were scored as non-compliant and the pharmacies that rejected dispense of the selected drug were scored as compliant. Compliance rate was calculated per region per drug. Pharmacies based in governmental hospitals were visited in parallel. A total of 20 were visited. Data and statistical analysis were performed using Statistical Analyses Software (SAS 9.3). A total of 150 pharmacies were visited over a period of 3 months. On average, the percent approved dispense of prescription-only drugs across 6 regions in Saudi Arabia is 63% and the percent rejected dispense is 37% representing a significant non-compliance rate regarding the selected list of medications in this study. The frequency of dispense per medication across 6 major regions in Saudi Arabia is as follows: Isosorbide dinitrate (86%), Enoxaparin (82%), nitroglycerin (74%), Propranolol (73%), Verapamil (70%), Warfarin (65%), Methyldopa (64%), Ciprofloxacin (57%) and Codeine (4%). Non-compliance of community pharmacies with the law of pharmaceutical practice is at an alarming rate in the Kingdom of Saudi Arabia and authoritative figures must intervene to impede and combat such activities .
Olufunmilola K. Odukoya, BPharm, MS
Full Text Available Introduction: Think aloud protocol has rarely been used as a method of data collection in community pharmacies.Purpose: The aim of the report is to describe how think aloud protocols were used to identify issues that arise when using e-prescribing technology in pharmacies. In this paper, we report on the benefits and challenges of using think aloud protocols in pharmacies to examine the use of e-prescribing systems.Methods: Sixteen pharmacists and pharmacy technicians were recruited from seven community pharmacies in Wisconsin. Data were collected using direct observation alongside think aloud protocol. Direct observations and think aloud protocols took place between January-February, 2011. Participants were asked to verbalize their thoughts as they process electronic prescriptions.Results: Participants identified weaknesses in e-prescribing that they had previously not conceived. This created heightened awareness for vigilance when processing e-prescriptions. The main challenge with using think aloud protocols was due to interruptions in the pharmacies. Also, a few participants found it challenging to remember to continue verbalizing their thought process during think aloud sessions.Conclusion: The use of think aloud protocols as method of data collection is a new way for understanding the issues related to technology use in community pharmacy practice. Think aloud protocol was beneficial in providing objective information on e-prescribing use not solely based on pharmacist’s or technician’s opinion of the technology. This method provided detailed information on a wide variety of real time challenges with e-prescribing technology use in community pharmacies. Using this data collection method can help identify potential patient safety issues when using e-prescribing and suggestions for redesign.
Harvey, Jasmine; Avery, Anthony J; Barber, Nick
To explore attitudes and perceptions of early adopters of the Electronic Prescription Service (release two) in England (EPS2). EPS2 is information technology that allows community pharmacies to download and dispense electronically written prescriptions from general practices. When the prescriber writes a prescription electronically, it is sent and stored on a national central database, commonly called the Spine. The community pharmacy that the patient nominates is then able to download the prescription and dispense to the patient. In-depth interviews were conducted with professionals from eight early adopter community pharmacies in the midlands and north of England, and 56 hours of non-participant observations were recorded as field notes. Each interview transcript was coded using a line-by-line approach. Overall, 37 200 words were analysed from 10 transcripts using a 'bottom up' approach to identify key perceptions. Field notes from the observation were analysed thematically and were used to verify interview findings. Findings follow a narrative which shows that (a) early adopter pharmacies had to cope with challenges such as missing EPS2 prescriptions, (b) despite this, they perceived EPS2 as helpful in streamlining pharmacy workflow and (c) were therefore keen to retain EPS2. Initial user perception of EPS2 provides a key message on the likelihood of the system being adopted beyond these eight pharmacies. Our findings provide key information for other pharmacies in the adoption process, and policymakers on the potential of EPS2 to achieve its goals and become sustainable in terms of its value to community pharmacies. © 2014 Royal Pharmaceutical Society.
Full Text Available Objective: To obtain a multi-stakeholder perspective of community pharmacy practice change. Design: Qualitative study. Setting: Community pharmacy in rural Mississippi. Participants: Fourteen key stakeholders of the patient care practice including pharmacists (n=4, support staff (n=2, collaborating providers (n=4, patients (n=3, and a payer (n=1. Intervention: Semi-structured interviews and participant-observation techniques were used. Main outcome measures: Description of the community pharmacy's practice and business model and identification of practice change facilitators. Results: Change facilitators for this practice included: a positive reputation in the community, forming solid relationships with providers, and convenience of patient services. Communication in and outside of the practice, adequate reimbursement, and resource allocation were identified as challenges. Conclusions: This case study is a multi-stakeholder examination of community pharmacy practice change and readers are provided with a real-world example of a community pharmacy's successful establishment of a patient care practice. Type: Case Study
Bach, Albert T; Goad, Jeffery A
Community pharmacy-based provision of immunizations in the USA has become commonplace in the last few decades, with success in increasing rates of immunizations. Community pharmacy-based vaccination services are provided by pharmacists educated in the practice of immunization delivery and provide a convenient and accessible option for receiving immunizations. The pharmacist's role in immunization practice has been described as serving in the roles of educator, facilitator, and immunizer. With a majority of pharmacist-provided vaccinations occurring in the community pharmacy setting, there are many examples of community pharmacists serving in these immunization roles with successful outcomes. Different community pharmacies employ a number of different models and workflow practices that usually consist of a year-round in-house service staffed by their own immunizing pharmacist. Challenges that currently exist in this setting are variability in scopes of immunization practice for pharmacists across states, inconsistent reimbursement mechanisms, and barriers in technology. Many of these challenges can be alleviated by continual education; working with legislators, state boards of pharmacy, stakeholders, and payers to standardize laws; and reimbursement design. Other challenges that may need to be addressed are improvements in communication and continuity of care between community pharmacists and the patient centered medical home.
Kho, Boon Phiaw; Hassali, Mohamed Azmi; Lim, Ching Jou; Saleem, Fahad
The aims of this research were to determine extra-organisational challenges (e.g. market competition, governing policies) faced by community pharmacies in Sarawak, the coping strategies employed to deal with these challenges and explore potential legislative changes that can attenuate the intensity of these challenges. Survey questionnaires (n = 184) were posted to all eligible community pharmacies in Sarawak, Malaysia. The questionnaire included sections on participants' demographic data, extra-organisational challenges faced, coping strategies employed and proposals to improve community pharmacy legislations. Items were constructed based on the findings of a prior qualitative research supplemented with relevant literature about these issues. High levels of homogeneity in responses were recorded on various extra-organisational challenges faced, particularly those economy-oriented. Strategic changes to counter these challenges were focused on pricing and product stocked, rather than services provision. Highly rated strategies included increasing discounts for customers (n = 54; 68%) and finding cheaper suppliers (n = 70; 88%). Legislative changes proposed that might increase their share of the pharmaceutical market were strongly supported by respondents, particularly about making it compulsory for general practitioners to provide patients the option to have their medicines dispensed in community pharmacies (n = 72; 90%). Current legislative conditions and Malaysian consumer mindset may have constrained the strategic choices of community pharmacies to deal with the strong extra-organisational challenges. A long-term multipronged approach to address these issues and increased involvement of community pharmacists themselves in this agenda are required to influence practice change. © 2018 Royal Pharmaceutical Society.
Berger, K; Eickhoff, C; Schulz, M
To investigate a new method for evaluating counselling performance of staff in community pharmacies and to assess the quality of patient counselling. Trained pseudo customers, instructed to play their role according to two different self-medication scenarios, visited voluntarily participating community pharmacies in Berlin. After documenting the counselling process, immediately after each visit, outside the pharmacy on an assessment form, the pseudo customer re-entered the pharmacy and gave detailed performance feedback to the counsellor and the pharmacist in charge in order to provide support for improving counselling skills and practice behaviour, when appropriate. This was followed with a written summary of the general performance of all participating pharmacies and additional individual feedback and suggestions for improvement. Educational needs were identified for subsequent performance-based educational strategies such as group-workshops, team-training and on-site team-coaching. Forty-nine community pharmacies in Berlin volunteered to participate in this pilot study. Ninety-eight per cent of the participating pharmacies offered advice. However, in 36% of the cases, advice was only given on request. The different types of scenarios--presentation of a symptom or request for a specific product--made a great difference to the spontaneity of questions and advice. At least one question to check on accuracy of self-diagnosis was asked in 95% of the cases of symptom presentation but in only 47% of the cases of specific product request. Information on appropriate self-medication was provided on at least one item in 74% of pseudo customer visits, but most of the time the information was not sufficient. Communication skills (nonverbal elements, comprehensibility etc.) were very good or good in 54% of the visits. Potential for improvement was mainly in relation to the use of open-ended questions to gain more information and on counselling about appropriate self
Spinks, Jean; Jackson, John; Kirkpatrick, Carl M; Wheeler, Amanda J
Pharmacy workforce planning has been relatively static for many decades. However, like all industries, health care is exposed to potentially disruptive technological changes. Automated dispensing systems have been available to pharmacy for over a decade and have been applied to a range of repetitive technical processes which are at risk of error, including record keeping, item selection, labeling and dose packing. To date, most applications of this technology have been at the local level, such as hospital pharmacies or single-site community pharmacies. However, widespread implementation of a more centralized automated dispensing model, such as the 'hub and spoke' model currently being debated in the United Kingdom, could cause a 'technology shock,' delivering industry-wide efficiencies, improving medication accessibility and lowering costs to consumers and funding agencies. Some of pharmacists' historical roles may be made redundant, and new roles may be created, decoupling pharmacists to a certain extent from the dispensing and supply process. It may also create an additional opportunity for pharmacists to be acknowledged and renumerated for professional services that extend beyond the dispensary. Such a change would have significant implications for the organization and funding of community pharmacy services as well as pharmacy workforce planning. This paper discusses the prospect of centralized automated dispensing systems and how this may impact on the pharmacy workforce. It concludes that more work needs to be done in the realm of pharmacy workforce planning to ensure that the introduction of any new technology delivers optimal outcomes to consumers, insurers and the pharmacy workforce. Copyright © 2016 Elsevier Inc. All rights reserved.
Edson Hipólito Júnior
Full Text Available ABSTRACT Pharmacists and their pharmacies have been evolving in their roles as health promoters in Brazil. Some examples are the recent legislation reaffirming the role of Brazilian pharmacies as health institutions, rather than having only a commercial profile, giving greater clarity to pharmacists about their roles as health care providers. This evolution came with the recognition that is already seen in other developed countries, confirming the need for the pharmacist as a health promoter, and not simply a dispenser of drugs in society. This study has obtained the profile and activities of community pharmacists, as well as the quality indicators of private community pharmacies throughout the State of Paraná through the application of an online survey sent to pharmacists in the state. Out of all pharmacists surveyed, 533 were part of the final analysis, being the pharmacists to complete the survey in full. Participants were mostly female (69.4% and were, on average, 35.2 ± 9.2 years old. Of these, 60% worked in pharmacy chains and just 37% of all pharmacist respondents were issuing the Declaration of Pharmaceutical Services. The current study showed that many pharmaceutical services are not adopted by pharmacies as these services bring no significant financial reward. Regarding the structure, the Paraná State showed that pharmacies present a good overall structure. The kind of pharmacy (chain or independent influenced the pharmaceutical services provided and the available structure, where the independent pharmacies provide a wider range of services and have better structure. This study was able to identify the profile and behaviors of pharmacists and also the quality indicators of pharmacies in Paraná State.
Pagano, Gina M; Groves, Brigid K; Kuhn, Catherine H; Porter, Kyle; Mehta, Bella H
To describe the development and implementation of a structured patient identification model for medication therapy management (MTM) services within traditional dispensing activities of a community pharmacy to facilitate pharmacist-provided completion of MTM services. A daily clinical opportunity report was developed as a structured model to identify MTM opportunities daily for all MTM-eligible patients expecting to pick up a prescription. Pharmacy staff was trained and the standardized model was implemented at study sites. One hundred nineteen grocery store-based community pharmacies throughout Ohio, West Virginia, and Michigan. A structured patient identification model in a community pharmacy consists of reviewing a clinical opportunity report, identifying interventions for MTM-eligible patients, and possibly collaborating with an interdisciplinary team. This model allows pharmacists to increase MTM cases performed by providing a structured process for identifying MTM-eligible patients and completing MTM services. The development and implementation of a structured patient identification model in the community pharmacy was completed and consists of pharmacists reviewing a clinical opportunity report to identify MTM opportunities and perform clinical interventions for patients. In a 3-month pre- and post-implementation comparison, there was a 49% increase in the number of MTM services provided by pharmacists (P < 0.001). A structured patient identification model in the community pharmacy was associated with an increase in the amount of MTM services provided by pharmacists. This method could be a useful tool at a variety of community pharmacies to solve challenges associated with MTM completion. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
Hindi, Ali M K; Schafheutle, Ellen I; Jacobs, Sally
The United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. However, patient and public awareness of community pharmacy services has been limited. To identify and synthesize the research literature pertaining to patient and public perspectives on: existing community pharmacy services, extended pharmacist roles and strategies to raise awareness of community pharmacy services. Systematic search of 8 electronic databases; hand searching of relevant journals, reference lists and conference proceedings. UK studies investigating patient or public views on community pharmacy services or pharmacist roles from 2005 to 2016. Data were extracted into a grid and subjected to narrative synthesis following thematic analysis. From the 3260 unique papers identified, 30 studies were included. Manual searching identified 4 additional studies. Designs using questionnaires (n = 14, 41%), semi-structured interviews (n = 8, 24%) and focus groups (n = 6, 18%) made up the greatest proportion of studies. Most of the studies (n = 28, 82%) were published from 2010 onwards and covered perceptions of specific community pharmacy services (n = 31). Using a critical appraisal checklist, the overall quality of studies was deemed acceptable. Findings were grouped into 2 main themes "public cognizance" and "attitudes towards services" each with 4 subthemes. Patients and the public appeared to view services as beneficial. Successful integration of extended pharmacy services requires pharmacists' clinical skills to be recognized by patients and physicians. Future research should explore different approaches to increase awareness. © 2017 The Authors. Health Expectations published by John Wiley & Sons Ltd.
Hermansyah, Andi; Sainsbury, Erica; Krass, Ines
The development of health and healthcare systems in South-East Asia has influenced the practice of community pharmacy. Over the years, community pharmacy in the region has striven to expand services beyond dispensing to encompass more involvement in public health issues. Searches were conducted in Scopus, EMBASE, MEDLINE and PubMed for articles published between January 2000 and December 2014, with 21 studies in five countries meeting the inclusion criteria. The findings showed increasing interest in research into the delivery of pharmacy services and public health initiatives. Overall, the review found that provision of some health services in pharmacies was common; however, most public health initiatives appeared to be poorly implemented, had limited evidence and were not demonstrated to be sustainable across the sector. This indicates that the practice of community pharmacy in the region has not significantly changed over the past 14 years with respect to the scope and quality of pharmacy services provided, and fundamental policy changes are necessary to improve this situation. © 2015 John Wiley & Sons Ltd.
Hudmon, Karen Suchanek; Elkhadragy, Nervana; Kusynová, Zuzana; Besançon, Luc; Brock, Tina Penick; Corelli, Robin L
To estimate the proportion of countries/territories that allow sales of tobacco products and electronic nicotine delivery systems (ENDS) in community pharmacies. International Pharmaceutical Federation (FIP) member organisations were contacted by email and asked to respond to a two-item survey assessing whether their country/territory allowed sales of (a) tobacco products and (b) ENDS in community pharmacies. Of 95 countries/territories contacted, responses were received from 60 (63.2%). Seven countries (11.7%) reported that tobacco products were sold in community pharmacies, and 11 countries (18.3%) reported that ENDS were sold in community pharmacies. Among the FIP member organisations, there are few countries that allow the sale of tobacco products and ENDS in community pharmacies, with ENDS being more likely than tobacco products to be sold. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Cavaco, Afonso Miguel; Krookas, Anette Aaland
One key indicator of the quality of health practitioners-patient interaction is the encounters' duration. Automation have been presented as beneficial to pharmacy staff work with patients and thus with a potential impact on pharmacists' and technicians' job satisfaction. To compare the interaction length between pharmacy staff and patients, as well as their job satisfaction, in community pharmacies with and without automation. Portuguese community pharmacies with and without automation. This cross-sectional study followed a quasi-experimental design, divided in two phases. In the first, paired community pharmacies with and without automation were purposively selected for a non-participant overt observation. The second phase comprised a job satisfaction questionnaire of both pharmacists and technical staff. Practitioners and patients demographic and interactional data, as well as job satisfaction, were statistically compared across automation. Interaction length and job satisfaction. Sixty-eight practitioners from 10 automated and non-automated pharmacies produced 721 registered interaction episodes. Automation had no significant influence in interaction duration, controlling for gender and professional categories, being significantly longer with older patients (p = 0.017). On average, staff working at the pharmacy counter had 45 % of free time from direct patient contact. The mean overall satisfaction in this sample was 5.52 (SD = 0.98) out of a maximum score of seven, with no significant differences with automation as well as between professional categories, only with a significant lower job satisfaction for younger pharmacists. As with previous studies in other settings, duration of the interactions was not influenced by pharmacy automation, as well as practitioners' job satisfaction, while practitioners' time constrains seem to be a subjective perception.
Carroll, Norman V
Medicare Part D provides insurance coverage for prescription drugs to elderly and disabled consumers. Part D accounted for 24% of prescriptions dispensed by independent pharmacies in the first year of the program (2006). To date, the impact of Part D on independent pharmacies has been explored only in small, qualitative, or non-peer-reviewed studies. To develop preliminary estimates of the impact of Part D on independent pharmacies' profitability. A financial model was built to examine the impact of Part D on pharmacy profitability. A key input value was the gross margin percentage for Part D; the midpoint of estimates reported in the literature was used as the base-case input value. The remaining model inputs were derived from 2 non-peer-reviewed published sources: (a) the National Community Pharmacist Association (NCPA)'s survey of independent pharmacies, which provided financial data for the year prior to Part D implementation (2005); and (b) IMS Health national market research data, which provided information about changes in prescription drug utilization from 2005 to 2006. Model estimates represented a "typical" independent pharmacy, defined using mean values for financial measures in 2005 as reported by NCPA. The model examined the impact of Part D on the proportion of prescriptions reimbursed by other sources (private third-party insurance, Medicaid, and cash payments by patients); pharmacies' overall prescription gross margin; the number of Part D-induced prescriptions; the number of prescriptions lost to mail-order pharmacies; and net income before taxes. Key values and assumptions were subjected to one-way and probabilistic sensitivity analyses. The model indicated that implementation of Part D resulted in a mean (SD) 22% (4%) decrease in net income before taxes. This change was primarily the result of an absolute 0.7% decline in the gross margin for all prescriptions. The lower overall gross margin resulted from lower reimbursement on Part D
Full Text Available Community pharmacies are balancing between business (selling medicines and other products and healthcare (using the pharmacists’ knowledge in order to improve drug utilization. This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks. Political organization representatives generally had a more business-oriented view, where competition in the market was believed to be the main driving force for development. A third dimension in which competition was not stressed also emerged; that community pharmacies should primarily distribute medicines. This dimension was most prevalent among the political and patient organization representatives. One conclusion to be drawn is that no stakeholder seemed to have a clear vision or was willing to take the lead for the development of the community pharmacy sector.
Wisell, Kristin; Sporrong, Sofia Kälvemark
Community pharmacies are balancing between business (selling medicines and other products) and healthcare (using the pharmacists’ knowledge in order to improve drug utilization). This balance could be affected by regulations decided upon by politicians, but also influenced by others. The aim of this study was to explore important stakeholders’ views on community pharmacy and community pharmacists in Sweden. The method used was that of semi-structured qualitative interviews. Political, professional, and patient organization representatives were interviewed. The results show that informants who are pharmacists or representatives of a professional pharmacist organization generally have a healthcare-centered view on community pharmacy/pharmacists. However, different views on how this orientation should be performed were revealed, ranging from being specialists to dealing with uncomplicated tasks. Political organization representatives generally had a more business-oriented view, where competition in the market was believed to be the main driving force for development. A third dimension in which competition was not stressed also emerged; that community pharmacies should primarily distribute medicines. This dimension was most prevalent among the political and patient organization representatives. One conclusion to be drawn is that no stakeholder seemed to have a clear vision or was willing to take the lead for the development of the community pharmacy sector. PMID:28970376
Taha, Nur Akmar; Tee, Ooi Guat
Objectives: Tobacco cessation is the primary goal of tobacco control measures. Community pharmacists are possible providers of tobacco cessation counselling due to their close contact with the public and the availability of non-prescription nicotine replacement therapies in pharmacies. However, community pharmacists often do not provide tobacco…
Forty (40), 20 and 70 percent of the pharmacies had neat physical appearance, adequate parking spaces and consistent professional signs respectively, while 53% had a private consulting area. ... There is need for professional reengineering to build pharmaceutical care practice and demonstrate its value to our society.
(DOAJ), African Journal Online, Bioline International, Open-J-Gate and Pharmacy Abstracts. INTRODUCTION. Pharmaceutical care (PC) is .... customers, such as drug indications, dosage forms, counselling on adherence and side ..... adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies.
Combinations of professional and commercial communication are typically very controversial, particularly in health care communication on the Internet. Websites of licensed community pharmacies on the other hand tend to raise remarkably little controversy, although they typically contain controversial combinations of clinical and commercial services previously unprecedented in professional health care communication. The aim of this study was to fill the void of knowledge about the combination of clinical and commercial services presented on the websites of licensed community pharmacies. A content analysis of clinical and commercial services presented in a random sample of 200 licensed community pharmacy websites from Great Britain, the Netherlands, the Canadian provinces British Columbia and Manitoba, and the Australian states New South Wales and Western Australia was conducted. The top five specific services mentioned on the community pharmacy websites were cosmetic products (126/200, 63.0%), medication refill request options (124/200, 62.0%), over-the-counter medicine (115/200, 57.5%), complementary and alternative medicine (107/200, 53.5%), and home medical aids (98/200, 49.0%). On average, 72.5% (145/200) of the community pharmacy websites across the 4 countries included a combination of clinical and commercial services. A combination of clinical and commercial services was more often present on chain pharmacy websites (120/147, 82.8%) than single pharmacy websites (25/53, 47%; Ppharmacy websites, followed by the Australian, British, and Dutch pharmacy websites, respectively (Ppharmacies' homepages contained a combination of clinical and commercial images (107/200, 53.5%), and almost half of the homepage menus contained a combination of clinical and commercial items (99/200, 49.5%). The latter were, again, more common on chain pharmacy than single pharmacy websites (Ppharmacies in Great Britain, the Netherlands, Canada, and Australia combine clinical services
Fridy, Kimberly; DeHart, Renee M; Monk-Tutor, Mary R
To evaluate financial terms and legal wording in insurance contracts and negotiate their terms with companies to improve an independent pharmacy's financial position and to determine the time required to negotiate a contract and translate that time into a salary cost. An independent pharmacy in a small town in Alabama with a population of approximately 6,000. The prescription department accounts for two-thirds of the pharmacy's sales and dispenses approximately 70,000 prescriptions each year. Insurance companies paid for over 59% of these prescriptions in 2000. The pharmacy is open 7 days a week with one full-time pharmacist and a second pharmacist who works 2 days a month. A contract negotiation form was developed that addressed factors that might affect a pharmacy's decision to accept or reject a contract; the form included an area for recording the time involved in negotiating each contract. Insurance companies selected by the pharmacy owner were faxed copies of an Insurer Demographics Collection Form. Upon collection of all data and finalization of proposed changes, a copy of the contract with the proposed changes marked, along with a letter explaining and justifying the changes, was sent to the insurance company. If no response was received from the company, the contact person was called and negotiations proceeded over the telephone. Primary end points were the percentage of companies that would negotiate and the average increase in reimbursement achieved. Secondary end points included the time involved in negotiations and the translation of that time into a salary cost. None of the nine participating companies accepted any of the changes proposed. The time to negotiate each contract ranged from 28 minutes to 74 minutes, taking an average of 48.4 minutes. Depending on the division of work between the pharmacist and the technician, the salary cost for the negotiations ranged from $14.68 to $18.73 per contract. This study provides a realistic description of
Full Text Available Erika L Abramson Departments of Pediatrics and Healthcare Policy and Research, Weill Cornell Medical College, New York, NY, USA Abstract: Major national policy forces are promoting the adoption and use of health information technology (health IT to improve the quality, safety, and efficiency of health care delivery. One such health IT is electronic prescribing (e-prescribing, which is the direct transmission of prescription information from a provider to a pharmacy. Given research showing that handwritten prescriptions are unsafe and associated errors can lead to tremendous inefficiency for patients and pharmacists, e-prescribing has many potential benefits. However, as with the introduction of any new technology, unintended, adverse consequences may result. The purpose of this review is to explore the causes and consequences of e-prescribing errors in community pharmacies, which are pharmacies not affiliated with a hospital or clinic. Many new types of errors – including provider order entry errors, transcription errors, and dispensing errors – appear to result from e-prescribing. These lead to important consequences for pharmacies, including safety threats to patients, reduced efficiency for pharmacists, processing delays, and increased pharmacy cost. Increased attention to system design and pharmacist training, as well as additional research in this area, will be critical to realize the full benefits of e-prescribing. Keywords: electronic prescribing, medication errors, community pharmacies
Westerlund, T; Almarsdóttir, A B; Melander, A
This study analyzes relationships between the number of drug-related problems detected in community pharmacy practice and the educational level and other characteristics of pharmacy personnel and their work sites. Random samples of pharmacists, prescriptionists and pharmacy technicians were drawn...... by each professional. The regression analysis showed the educational level of the professional to have a statistically significant effect on the detection rate, with pharmacists finding on average 2.5 more drug-related problems per 100 patients than prescriptionists and about 3.6 more than technicians....... The results of this study indicate the importance of education and training of pharmacy personnel in detection of drug-related problems. This findings speaks in favor of increasing the pharmacist to other personnel ratio, provided the higher costs will be offset by societal benefits....
Bajorek, Beata V; LeMay, Kate S; Magin, Parker J; Roberts, Christopher; Krass, Ines; Armour, Carol L
To explore patients' perspectives and experiences following a trial of a pharmacist-led service in hypertension management. A qualitative study comprising individual interviews was conducted. Patients of a community pharmacy, where a pharmacist-led hypertension management service had been trialled in selected metropolitan regions in Sydney (Australia), were recruited to the study. Emergent themes describing patients' experiences and perspectives on the service were elicited via thematic analysis (using manual inductive coding). Patients' (N = 18) experiences of the service were extremely positive, especially around pharmacists' monitoring of blood pressure and provision of advice about medication adherence. Patients' participation in the service was based on their trust in, and relationship with, their pharmacist. The perception of working in a 'team' was conveyed through the pharmacist's caring style of communication and the relaxed atmosphere of the community pharmacy. Patients felt that the community pharmacy was an obvious place for such a service because of their regular contact with the pharmacist, but was limited because the pharmacists were not able to prescribe medication. Patients were extremely positive about the role of, and their experience of, the pharmacy-based hypertension management service. Factors contributing to the patients' positive experiences provide important insights for community pharmacy practice. Good rapport with the pharmacist and a long-term relationship underpin patient engagement in such services. Restrictions on the pharmacists' scope of practice prevent their expertise, and the benefits of their accessibility as a primary point of contact, from being fully realised. © 2016 Royal Pharmaceutical Society.
Steltenpohl, Emily A; Barry, Brandon K; Coley, Kim C; McGivney, Melissa S; Olenak, Julie L; Berenbrok, Lucas A
Clinical Laboratory Improvement Amendments (CLIA)-waived tests allow for quick, accurate, and noninvasive laboratory testing. Community pharmacists utilize CLIA-waived tests to provide clinical services such as point-of-care (POC) testing to help manage chronic disease and acute illness. To identify key themes in the successful delivery of POC testing services by community pharmacists in Pennsylvania. An initial search identified 51 Pennsylvania pharmacies with a CLIA waiver. Of these, five independent pharmacies met inclusion criteria, three of which completed interviews. The remaining 38 chain pharmacies were represented by three interviews. In total, five key themes were identified as essential to POC testing services: (1) utilize state resources and professional connections to navigate federal and state regulations, (2) establish relationships with physician partners (3) offer tests that are meaningful to patients and their physicians, (4) evaluate financial impact, workflow adaptations, and marketing approaches when implementing POC testing services, and (5) focus on individualized attention and convenience of community pharmacy-based POC testing to improve patient satisfaction. Successful POC testing services in community pharmacy practice rely on utilizing resources, partnering with known physicians, selecting meaningful tests for patients, and analyzing finances, workflow, and marketing to provide individualized attention and convenient care.
Um, Irene S; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B
Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia's obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers' needs is vital to the development of any new services or the evaluation of existing services. To explore Australian consumers' perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy-based service. An online cross-sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open-ended and closed questions exploring consumers' experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. A total of 403 consumers from New South Wales, Australia, completed the survey. The majority of respondents had previously not sought a pharmacist's advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy-based services in the future. Most consumers considered pharmacists' motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Although Australian consumers were willing to seek pharmacists' advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. © 2012 John Wiley & Sons Ltd.
Ishibashi, Masaaki; Ishii, Masakazu; Nagano, Miku; Kiuchi, Yuji; Iwamoto, Sanju
Previous reports suggested that sharing outpatient information during chemotherapy is very important for managing pharmaceutical usage between community pharmacies and hospitals. We herein examined using a questionnaire survey whether pharmaceutical management for outpatient chemotherapy is desired by community and hospital pharmacists. The response rates were 44.3% (133/300) for pharmacists in community pharmacies and 53.7% (161/300) for pharmacists in hospitals. Prescriptions for outpatients during chemotherapy were issued at 88.2% of the hospitals. Currently, 28.9% of hospital pharmacists rarely provide pharmaceutical care, such as patient guidance and adverse effect monitoring, for outpatients receiving oral chemotherapy. Furthermore, whereas 93.7% of hospital pharmacists conducted prescription audits based on the chemotherapy regimen, audits were only performed by 14.8% of community pharmacists. Thus, outpatients, particularly those on oral regimens, were unable to receive safe pharmaceutical care during chemotherapy. Community pharmacists suggested that hospital pharmacists should use "medication notebooks" and disclose prescription information when providing clinical information to community pharmacists. They also suggested sending clinical information to hospital pharmacists by fax. On the other hand, hospital pharmacists suggested the use of "medication notebooks" and electronic medical records when providing clinical information to community pharmacists. In addition, they suggested for community pharmacists to use electronic medical records when providing clinical information to hospital pharmacists. As there may be differences in opinion between community and hospital pharmacists, mutual preliminary communication is important for successful outpatient chemotherapy.
Krass, I; Mitchell, B; Clarke, P; Brillant, M; Dienaar, R; Hughes, J; Lau, P; Peterson, G; Stewart, K; Taylor, S; Wilkinson, J; Armour, C
To compare the efficacy and cost-effectiveness of two methods of screening for undiagnosed type 2 diabetes in Australian community pharmacy. A random sample of 30 pharmacies were allocated into two groups: (i) tick test only (TTO); or (ii) sequential screening (SS) method. Both methods used the same initial risk assessment for type 2 diabetes. Subjects with one or more risk factors in the TTO group were offered a referral to their general practitioner (GP). Under the SS method, patients with risk factors were offered a capillary blood glucose test and those identified as being at risk referred to a GP. The effectiveness and cost-effectiveness of these approaches was assessed. A total of 1286 people were screened over a period of 3 months. The rate of diagnosis of diabetes was significantly higher for SS compared with the TTO method (1.7% versus 0.2%; p=0.008). The SS method resulted in fewer referrals to the GP and a higher uptake of referrals than the TTO method and so was the more cost-effective screening method. SS is the superior method from a cost and efficacy perspective. It should be considered as the preferred option for screening by community based pharmacists in Australia.
De Bolle, Leen; Mehuys, Els; Christiaens, Thierry; Van Tongelen, Inge; Remon, Jean-Paul; Boussery, Koen
To characterise patient encounters during routine drug dispensing in community pharmacies. Cross-sectional survey in community pharmacies (Belgium). Fifty-four per cent of all encounters (N = 1650) concerned patients carrying a prescription, of which 39% were prescriptions for new medication and 61% were repeat prescriptions. In 62% of all encounters, patients asked for non-prescribed medication. Almost one-third of self-medication requests related to special patient populations (mainly children and elderly). CONCLUSIONS : Many encounters related to self-medication, and a substantial number of these self-medication requests concerned vulnerable patient populations. © 2014 Royal Pharmaceutical Society.
Blackburn, David F; Gill, Munpreet; Krol, Ed; Taylor, Jeff
The allure of natural products has captivated humans for centuries. Although they can be compatible with evidence-based care, attitudes surrounding natural products can seem almost mystical and may even be accompanied by contempt toward Western medicine. Considering the high volumes of natural products sold in community pharmacies, pharmacists can inject balanced information to minimize the mysticism and help patients make informed decisions. The aim of this article is to argue for standardized guidelines pertaining to the management of natural products in community pharmacy practice.
Scahill, Shane L; Carswell, Peter; Harrison, Jeff
The barriers to moving forward and meeting the expectations of policy makers and professional pharmacy bodies appear to relate to the organizational culture of community pharmacy. Despite the importance of cultural change for business transformation, organizational culture has largely gone unnoticed in community pharmacy practice research. To perform an organizational culture gap analysis in 6 New Zealand community pharmacies. Mean scores from a cultural rating survey (n=47) were calculated for 8 cultural clusters and mapped onto a typical and a beneficial pattern match (ladder diagram) for each case site. These ladder diagrams provide an understanding of the gap between the 2 ratings based on the gradient of the lines joining cultural clusters-the rungs of the ladder. Software can be used to generate a Pearson correlation describing the strength of the relationship between the typical and beneficial ratings. Eight cultural clusters were mapped: "leadership and staff management"; "valuing each other and the team"; "free-thinking, fun and, open to challenge"; "trusted behavior"; "customer relations"; "focus on external integration"; "provision of systematic advice"; and the "embracing of innovation." Analysis suggested a high level of correlation between the means of the typical and beneficial ratings. Although the variance between average ratings might be quite small, the relative difference can still be meaningful to participants in the cultural setting. The diagrams suggest a requirement for external integration, the provision of systematic advice, and the embracing of innovation to become more typical in most pharmacies. Trusted behavior is the most typical and most beneficial cultural dimension in most pharmacies, whereas valuing each other and the team is the least beneficial. Gaps in organizational culture have been identified through the use of a rating survey. The dimensions of focus on external integration, providing systematic advice, and embracing
Lapeyre-Mestre, Maryse; Gony, Mireille; Carvajal, Alfonso; Macias, Diego; Conforti, Anita; D'incau, Paola; Heerdink, Rob; Van Der Stichele, Robert; Bergman, Ulf
Aim: To identify prescription drugs involved in falsified prescriptions in community pharmacies in 6 European countries. Methods: A cross-sectional survey among 2,105 community pharmacies in Belgium, France, Italy, the Netherlands, Spain and Sweden was carried out to collect all suspect prescription
Marques, Iuri; Willis, Sarah Caroline; Schafheutle, Ellen Ingrid; Hassell, Karen
Purpose Organisational culture (OC) shapes individuals' perceptions and experiences of work. However, no instrument capable of measuring specific aspects of OC in community pharmacy exists. The purpose of this paper is to report the development and validation of an instrument to measure OC in community pharmacy in Great Britain (GB), and conduct a preliminary analysis of data collected using it. Design/methodology/approach Instrument development comprised three stages: Stage I: 12 qualitative interviews and relevant literature informed instrument design; Stage II: 30 cognitive interviews assessed content validity; and Stage III: a cross-sectional survey mailed to 1,000 community pharmacists in GB, with factor analysis for instrument validation. Statistical analysis investigated how community pharmacists perceived OC in their place of work. Findings Factor analysis produced an instrument containing 60 items across five OC dimensions - business and work configuration, social relationships, personal and professional development, skills utilisation, and environment and structures. Internal reliability for the dimensions was high (0.84 to 0.95); item-total correlations were adequate ( r=0.46 to r=0.76). Based on 209 responses, analysis suggests different OCs in community pharmacy, with some community pharmacists viewing the environment in which they worked as having a higher frequency of aspects related to patient contact and safety than others. Since these aspects are important for providing high healthcare standards, it is likely that differences in OC may be linked to different healthcare outcomes. Originality/value This newly developed and validated instrument to measure OC in community pharmacy can be used to benchmark existing OC across different pharmacies and design interventions for triggering change to improve outcomes for community pharmacists and patients.
Urbonas, Gvidas; Kubilienė, Loreta
Community pharmacies have an increasing role in self-medication and community health is dependent on the quality of counselling services provided to patients. Some studies show that pharmacists' job satisfaction affects their work quality; other studies found that higher involvement in clinical services increases pharmacists' job satisfaction. To test the relationship between job satisfaction and over-the-counter counselling practice at community pharmacies. Community pharmacies in Lithuania. A convenience sample (n = 305) of community pharmacists participated in the cross-sectional survey where they expressed satisfaction with job and reported on their over-the-counter counselling behaviour on self-report scales. The Partial Least Squares Structural Equation Modelling approach was employed for data analysis. The strength of the relationship between job satisfaction and over-the-counter counselling service. A bidirectional relationship between job satisfaction and over-the-counter counselling service was found. In addition, job satisfaction and over-the-counter counselling quality depended on pharmacists' age. Organizations were recommended to create a counselling friendly environment that would increase pharmacists' job satisfaction and, in return, counselling quality. Also, additional motivation of the retired pharmacists, as well as development of counselling skills of the younger pharmacy workforce, were seen as a means to improve both organizational climate and counselling quality over the counter.
Full Text Available Abstract Background Outpatient drugs are dispensed through both community and mail order pharmacies. There is no empirical evidence that substitution of community pharmacy with mail order reduces overall drug expenditures. The need for evaluating the potential effects on utilization and costs of the possible extension of mail order services in Medicaid provides the rationale for conducting this study. This study compares drug utilization and drug product cost in community vs. mail order pharmacy dispensing services in a Medicaid population. Methods This study is a retrospective cohort study comparing utilization and cost patterns in community vs. mail order pharmacy. A simulation model was employed to assess drug utilization and cost in mail order pharmacy using community pharmacy claim data. The model assumed that courses of drug therapy (CDT in mail order pharmacy would have utilization patterns similar to those found in community pharmacy. A 95% confidence interval surrounding changes in average utilization and average cost were estimated using bootstrap analysis. A sensitivity analysis was performed by varying drug selection criteria and supply, fill point, and medication possession ratio (MPR. Sub-analyses were performed to address differences between mail order and community pharmacy related to therapeutic class and dual-eligible patients. Data for the study derived from pharmacy claims database of Ohio Medicaid State program for the period January 2000-September 2004. Drug claims were aggregated to obtain a set of CDTs representing unique patient IDs and unique drug products. Drug product cost estimates excluded dispensing fees and were used to estimate the cost reduction required in mail order to become cost neutral in comparison with community pharmacy. Results The baseline model revealed that the use of mail order vs. community pharmacy would result in a 5.5% increase in drug utilization and a 5.4% cost reduction required in mail order
Dameh, Majd; Green, James; Norris, Pauline
The aim of this study is to investigate over-the-counter sale of antibiotics from community pharmacies in Abu Dhabi city, focusing on the extent, demographic and socioeconomic determinants of this practice. The study was conducted in the capital of the United Arab Emirates, Abu Dhabi, and involved 17 randomly selected private pharmacies. A cross-sectional design using structured observations of 30 clients purchasing antibiotics from a pharmacy staff (either a pharmacist or pharmacy assistant) at each selected pharmacy. A total of 510 interactions were observed. Statistical analysis was performed using SPSS. The extent and types of antibiotics sold over-the-counter in Abu Dhabi city as observed in the selected sample of community pharmacies, and the demographic and socioeconomic factors that contributed to this practice. Sixty eight percent (68.4%) of the observed antibiotic sales were sold over-the-counter without prescriptions. Injection antibiotics constituted 2.2% of the antibiotics sold, 45.5% of which were sold over-the-counter. Combination of penicillins including β-lactamase inhibitors (34.0%), penicillins with extended spectrum (22.3%) and second generation cephalosporins (11.2%) were the mostly commonly sold antibiotic groups. Respiratory conditions (63.1%) were the most frequent reason for purchasing antibiotics. Over-the-counter sales of antibiotics were related to client ethnicity and age, gender of pharmacy staff and health complaint. Our study revealed high sales of over-the-counter antibiotics, despite this being illegal. The ineffectiveness of antibiotics in treating respiratory conditions of viral origin and effects of such practice on the emergence of bacterial resistance necessitates prompt action.
Boyle, Todd A; Ho, Certina; Mackinnon, Neil J; Mahaffey, Thomas; Taylor, Jeffrey M
Standardized continuous quality improvement (CQI) programs combine Web-based technologies and standardized improvement processes, tools, and expectations to enable quality-related events (QREs) occurring in individual pharmacies to be shared with pharmacies in other jurisdictions. Because standardized CQI programs are still new to community pharmacy, little is known about how they impact medication safety. This research identifies key aspects of medication safety that change as a result of implementing a standardized CQI program. Fifty-three community pharmacies in Nova Scotia, Canada, adopted the SafetyNET-Rx standardized CQI program in April 2010. The Institute for Safe Medication Practices (ISMP) Canada's Medication Safety Self-Assessment (MSSA) survey was administered to these pharmacies before and 1 year into their use of the SafetyNET-Rx program. The nonparametric Wilcoxon signed-rank test was used to explore where changes in patient safety occurred as a result of SafetyNETRx use. Significant improvements occurred with quality processes and risk management, staff competence, and education, and communication of drug orders and other information. Patient education, environmental factors, and the use of devices did not show statistically significant changes. As CQI programs are designed to share learning from QREs, it is reassuring to see that the largest improvements are related to quality processes, risk management, staff competence, and education.
Aboneh, Ephrem A; Look, Kevin A; Stone, Jamie A; Lester, Corey A; Chui, Michelle A
The U.S. Agency for Healthcare Research and Quality (AHRQ) developed a hospital patient safety culture survey in 2004 and has adapted this survey to other healthcare settings, such as nursing homes and medical offices, and most recently, community pharmacies. However, it is unknown whether safety culture dimensions developed for hospitals can be transferred to community pharmacies. The aim of this study was to assess the psychometric properties of the Community Pharmacy Survey on Patient Safety Culture. The survey was administered to 543 community pharmacists in Wisconsin, USA. Confirmatory factor analysis was used to assess the fit of our data with the proposed AHRQ model. Exploratory factor analysis was used to determine the underlying factor structure. Internal consistency reliabilities were calculated. A total of 433 usable surveys were returned (response rate 80%). Results from the confirmatory factor analysis showed inadequate model fit for the original 36 item, 11-factor structure. Exploratory factor analysis showed that a modified 27-item, four-factor structure better reflected the underlying safety culture dimensions in community pharmacies. The communication openness factor, with three items, dropped in its entirety while six items dropped from multiple factors. The remaining 27 items redistributed to form the four-factor structure: safety-related communication, staff training and work environment, organisational response to safety events, and staffing, work pressure and pace. Cronbach's α of 0.95 suggested good internal consistency. Our findings suggest that validation studies need to be conducted before applying safety dimensions from other healthcare settings into community pharmacies. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Conclusion: The study underscores the need for regulatory efforts to manage pregabalin abuse, through the addition of pregabalin containing products to the controlled drug list which can’t be purchased without a prescription. Also, pharmacists and customers must be educated at a community pharmacy level regarding potential hazards of pregabalin abuse.
Johnson, Charisse L; Crawford, Stephanie Y; Lin, Swu-Jane; Salmon, J Warren; Smith, Miriam Mobley
To determine the availability of experiential learning opportunities in culturally diverse areas and to identify opportunities and barriers to attract and sustain sites for the University of Illinois at Chicago College of Pharmacy. Utilizing variables of census tract income, racial/ethnicity composition and crime index, data analyses included descriptive statistics and multivariate logistic regression. Faculty members involved in experiential education were interviewed to identify other factors influencing site placement and selection for community-based advanced pharmacy practice experiences (APPEs). Median family income and Asian population were significantly higher and black population was significantly lower in census tracts with community APPE sites than in census tracts without APPE sites (p managers, and strategic initiatives were critical considerations in site establishment and overall sustainability. Advanced community pharmacy practice sites were fairly well distributed across metropolitan Chicago, indicating that exposure to diverse populations during the advanced community practice experiences parallels with strategic College objectives of expanding and diversifying experiential sites to enhance pharmacy students' abilities to meet emerging patient care challenges and opportunities.
Barris Blundell D
Full Text Available Objectives: To identify postmenopausal women with risk of osteoporosis through quantitative ultrasound imaging (QUI and to value the medical intervention after the determination of the bone mineral density (BMD. Methods: Cross-sectional descriptive study developed in a community pharmacy. During the month of June of 2005 the community pharmacy enrolled postmenopausal women into the study. Women in treatment with calcium, vitamin D, hormone replacement therapy, estrogen receptor modulators, calcitonin or biphosphonates were considered criteria for exclusion. To all the women that consent to participate, the pharmacist measured BMD with the device Sahara Hologic Ultrasound Bone Densitometer at right calcaneus. Following the World Health Organization, women were classified as osteoporotic if their T-Score was less than -2.5 and as osteopenic if their T-Score ranged between -2.5 and -1.0. Results: Of the 100 women screened, 11 (11% presented risk of osteoporosis and 61 (61% of osteopenia. The 18.5% postmenopausal women with body mass index lesser than 30 presented risk of osteoporosis and the 63.0% osteopenia. Conclusions: The QUI constitutes a useful tool in community pharmacy for the screening of osteoporosis and it supposes a greater integration of the community pharmacy within the health care.
Lecher, Shirley Lee; Shrestha, Ram K; Botts, Linda W; Alvarez, Jorge; Moore, James H; Thomas, Vasavi; Weidle, Paul J
To document the cost of implementing point-of-care (POC) human immunodeficiency virus (HIV) rapid testing in busy community pharmacies and retail clinics. Providing HIV testing services in community pharmacies and retail clinics is an innovative way to expand HIV testing. The cost of implementing POC HIV rapid testing in a busy retail environment needs to be documented to provide program and policy leaders with adequate information for planning and budgeting. Cost analysis from a pilot project that provided confidential POC HIV rapid testing services in community pharmacies and retail clinics. The pharmacy sites were operated under several different ownership structures (for-profit, nonprofit, sole proprietorship, corporation, public, and private) in urban and rural areas. We included data from the initial six sites that participated in the project. We collected the time spent by pharmacy and retail clinic staff for pretest and posttest counseling in an activity log for time-in-motion for each interaction. Pharmacists and retail clinic staff. HIV rapid testing. The total cost was calculated to include costs of test kits, control kits, shipping, test supplies, training, reporting, program administration, and advertising. The six sites trained 22 staff to implement HIV testing. A total of 939 HIV rapid tests were conducted over a median time of 12 months, of which 17 were reactive. Median pretest counseling time was 2 minutes. Median posttest counseling time was 2 minutes for clients with a nonreactive test and 10 minutes for clients with a reactive test. The average cost per person tested was an estimated $47.21. When we considered only recurrent costs, the average cost per person tested was $32.17. Providing POC HIV rapid testing services required a modest amount of staff time and costs that are comparable to other services offered in these settings. HIV testing in pharmacies and retail clinics can provide an additional alternative venue for increasing the
Full Text Available Background: The incidence of serotonin syndrome is increasing due to the widening use of serotonergic drugs. Identification of serotonin syndrome is challenging as the manifestations are diverse. Misdiagnosis can lead to delay in care and inappropriate treatment. Objectives: The objectives of this study were to determine if staff of community pharmacies in Australia could identify the symptoms of serotonin syndrome in simulated patients and recommend an appropriate course of action. Methods: Agents acting on behalf of a simulated patient were trained on a patient scenario that reflected possible serotonin syndrome due to an interaction between duloxetine and recently prescribed tramadol. They entered 148 community pharmacies in Australia to ask for advice about a 60 year old male simulated patient who was ‘not feeling well’. The interaction was audio recorded and analysed for degree of access to the pharmacist, information gathered by pharmacy staff, management advice given and pharmacotherapy recommended. Results: The simulated patient’s agent was consulted by a pharmacist in 94.0% (139/148 of cases. The potential for serotonin syndrome was identified by 35.1% (52/148 of pharmacies. Other suggested causes of the simulated patient’s symptoms were viral (16.9%; 25/148 and cardiac (15.5%; 23/148. A total of 33.8% (50/148 of pharmacies recommended that the simulated patient should cease taking tramadol. This advice always came from the pharmacist. Immediate cessation of tramadol was advised by 94.2% (49/52 of pharmacists correctly identifying serotonin syndrome. The simulated patient was advised to seek urgent medical care in 14.2% (21/148 of cases and follow up with a doctor when possible in 68.2% (101/148 of cases. The majority of pharmacies (87.8%; 130/148 did not recommend non-prescription medicines. Conclusion: While not identifying the cause of the simulated patient’s symptoms in the majority of cases, community pharmacies
Full Text Available Objective: To evaluate diabetes patients’ self-monitoring of blood glucose using a community pharmacy-based quality assurance procedure, to investigate whether the procedure improved the quality of the patient performance of self monitoring of blood glucose, and to examine the opinions of the patients taking part in the study. Methods: The results of patient blood glucose measurements were compared to the results obtained with HemoCue Glucose 201+ by pharmacy employees in 16 Norwegian community pharmacies. Patient performance was monitored using an eight item checklist. Patients whose blood glucose measurements differed from pharmacy measurements by more than 20% were instructed in the correct use of their glucometer. The patients then re-measured their blood glucose. If the results were still outside the set limits, the control procedure was repeated with a new lot of glucometer strips, and then with a new glucometer. The patients returned for a follow-up visit after three months. Results: During the first visit, 5% of the 338 patients had measurements that deviated from pharmacy blood glucose values by more than 20% and user errors were observed for 50% of the patients. At the second visit, there was no significant change in the analytical quality of patient measurements, but the percentage of patients who made user errors had decreased to 29% (p < 0.001. Eighty-five percent of the patients reported that they used their blood glucose results to adjust medication, exercise or meals. Fifty-one percent of the patients reported a greater trust in their measurements after the second visit. Eighty percent of patients wished to have their measurements assessed yearly. Of these patients, 83% preferred to have the assessment done at the community pharmacy. Conclusion: A community pharmacy-based quality assessment procedure of patients’ self monitoring of blood glucose significantly reduced the number of user errors. The analytical quality of the
Hersberger, Kurt E; Messerli, Markus
The role of the community pharmacist in primary care has been undergoing change in Switzerland in parallel to international developments: it has become more clinically and patient oriented. Special services of community pharmacists to older patients taking long-term or multiple medications, discharged from hospitals or experiencing cognitive impairment or disability have been developed. These services require more clinical knowledge and skills from community pharmacists and are based on, for example, 'simple or intermediate medication reviews' focused primarily to improve medication adherence and rational drug use by a patient. Reflecting the new role of community pharmacies, this article describes the current services provided by community pharmacies in Switzerland, e.g., 'polymedication check', 'weekly pill organizer', and 'services for chronic patients', as well as new Swiss educational and reimbursement systems supporting development of these services. In the international context, involvement of community pharmacists in patient-oriented care is growing. This review summarizes positive and negative experiences from implementation of community pharmacy services in Switzerland and provides examples for the development of such services in other countries.
The sale of over-the-counter (OTC) medicines from community pharmacies offers important opportunities for members of the public to access medicines and self-treat conditions. They are increasingly recognised, however, as having the potential for abuse and harm despite their perceived relative safety. This study reports on a qualitative study that explored the experiences and views of community pharmacy staff in relation to current practices and concerns, management and support relating to OTC medicine abuse. Semi-structured interviews were undertaken with a purposive sample of ten pharmacists and seven medicines counter assistants in the United Kingdom. Analysis of interviews indicated that a range of medicines was implicated, including opiates, sedative antihistamines, laxatives and decongestants. A surveillance role was apparent for assistants, who placed emphasis on regulations, procedure and monitoring frequency of purchases to manage abuse, with referral on to pharmacists. Frequency of purchase was central to assistants' definition of those suspected of OTC medicine abuse, which pharmacists also utilised as well as a distinction between intentional abuse and unintentional medicine misuse. A lack of information about customers, easy access to, and poor communication between community pharmacies were emergent barriers to pharmacists providing more support. Many appeared uncertain of referral options or how pharmacists could effectively stop the problem of abuse. The commercial environment was a particular concern, in relation to customer expectations, medicine advertising and easy access to different community pharmacies. A key tension emerged between providing medicine supplies that permitted consumer freedom, with the needs of healthcare professionals to understand more about those consumers qua patients. Policy implications include the need for improved knowledge for community pharmacy staff about signposting to relevant services, increased awareness of who
Gheewala, Pankti A; Peterson, Gregory M; Zaidi, Syed Tabish R; Jose, Matthew D; Castelino, Ronald L
Patient satisfaction is an important determinant of the feasibility and sustainability of community pharmacy screening services. However, few studies have evaluated this, with no such study performed for a chronic kidney disease risk assessment service. The aim was to determine patient satisfaction with a chronic kidney disease risk assessment service performed in community pharmacies. Community pharmacies in the state of Tasmania, Australia. An anonymous nine-item satisfaction survey, with Likert-type scales, was developed following a literature review of existing surveys. Reliability of the nine-item scale was determined using Cronbach's alpha. Patients were asked an additional question on willingness to pay, with choices of amount from $5 to $25. The satisfaction survey was mailed to 389 patients who participated in the chronic kidney disease risk assessment study. Patient level of satisfaction with and willingness to pay for the chronic kidney disease service. Responses from 143 participants were included in the final analysis. Cronbach's alpha for the nine-item satisfaction scale was 0.87. The majority of participants agreed that the time required to undergo the risk assessment process was justified (90.2%); overall, they were satisfied with the chronic kidney disease risk assessment service (90.0%) and they felt comfortable with the pharmacist referring their results to their doctor (88.9%). Of 136 participants who answered the question on willingness to pay, 62.9% indicated that they would pay for the chronic kidney disease service. Of these, 29.2, 25.8 and 19.1% were willing to pay $20, $10 and $5, respectively. Patient satisfaction with the community pharmacy-based chronic kidney disease risk assessment was high. These findings provide support for the implementation of the service within community pharmacy practice.
Full Text Available Background: In many developing countries, pharmacists are facing many challenges while they try to enhance the quality of services provided to patients approaching community pharmacies. Objective: To explore perception of community pharmacists in Dubai regarding the obstacles to enhanced pharmacy services using a part of the results from a nation-wide quantitative survey. Methods: A questionnaire was distributed to 281 full-time licensed community pharmacists in Dubai. The questionnaire had 5 inter-linked sections: demographic information, information about the pharmacy, interaction with physicians, pharmacists’ current professional role, and barriers to enhanced pharmacy services. Results: About half of the respondents (45.4%, n=90 agreed that pharmacy clients under-estimate them and 52.5% (n=104 felt the same by physicians. About 47.5% (n=94 of the respondents felt that they are legally unprotected against profession’s malpractice. Moreover, 64.7% (n=128 stated that pharmacy practice in Dubai turned to be business-focused. In addition, 76.8% (n=252 found that one of the major barriers to enhanced pharmacy services is the high business running cost. Pharmacists screened tried to prove that they are not one of the barriers to optimized pharmacy services as 62.7% (n=124 disagreed that they lack appropriate knowledge needed to serve community and 67.7% (n=134 gave the same response when asked whether pharmacy staff lack confidence when treating consumers or not. Conclusions: Although being well established within the community, pharmacists in Dubai negatively perceived their own professional role. They stated that there are number of barriers which hinder optimized delivery of pharmacy services like under-estimation by pharmacy clients and other healthcare professionals, pressure to make sales, and high running cost.
Jacobs, Sally; Ashcroft, Darren; Hassell, Karen
The aim of this paper is to report on the findings of a systematic literature review-seeking to elicit existing evidence of the nature of organisational culture in community pharmacy organisations. This review takes a novel approach to systematically identifying and synthesising the peer-reviewed research literature pertaining to organisational culture in this setting, its antecedents and outcomes. The review provides an overview of the scope of and research methods used in the identified literature, together with a narrative synthesis of its findings, framed within five dimensions of organisational culture: the professional-business role dichotomy; workload, management style, social support and autonomy; professional culture; attitudes to change and innovation; and entrepreneurial orientation. There is a need for more detailed and holistic exploration of organisational culture in community pharmacy, using a greater diversity of research methods and a greater focus on patient-related outcomes. This paper demonstrates that, whilst little research has explicitly investigated organisational culture in this context, there exists a range of evidence describing aspects of that culture, some of the environmental and organisational factors helping to shape it, and its impact on the pharmacy workforce, services delivered and business outcomes. It highlights the importance of the business-professional role dichotomy in community pharmacy; the influence of individual pharmacists' characteristics and organisational setting; and the impact on pharmacists' wellbeing and job satisfaction and the services delivered. It provides less evidence of the impact of organisational culture on the quality and safety of service provision.
Cochran, Gerald; Gordon, Adam J.; Field, Craig; Bacci, Jennifer; Dhital, Ranjita; Ylioja, Thomas; Stitzer, Maxine; Kelly, Thomas; Tarter, Ralph
Background: Prescription opioid misuse is a major public health concern in the US. Few resources exist to support community pharmacists engaging patients who misuse or are at risk for misuse. Objectives: This report describes the results of the execution of the ADAPT-ITT model (a model for modifying evidence-based behavioral interventions to new populations and service settings) to guide the development of a behavioral health framework for opioid medication misuse in the community pharmacy se...
Al-Arifi, Mohamed N
The purpose of this study is to identify the community pharmacist perceptions and attitudes toward ethical issues at community pharmacy setting in Saudi Arabia. A cross-sectional, descriptive, and qualitative survey of community pharmacists was conducted and the survey questions were pre-tested by a pharmacist with extensive experience in ethical issues. Based on the result of a pilot study the questionnaire was used with some modifications and the final questionnaire was sent to the participants by handing over in person, mail or Email. 45.7% Often discuss ethical issues with their patients, while only 2.1% never discuss it. 40.6% often record the ethical concern whereas only 1.9% of them never do so. 31.5% reported that patients initiate ethical issues. 28.3% of the pharmacists initiate the discussion. The barriers that limit discussing ethical issues with their patients were lack of time due to other obligations assigned to the community pharmacist (69.2%), lack of reliable resources (10.7%), not interested in the subject (10.1%), lack of knowledge on ethical issues (4.8%), and other reasons (5.3%). Recourses are books (37.7%), internet web sites (31.1%), and brochures (26.8%). Only a minority of respondents had access to computer databases (15.8%) and other resources (1.3%). Most perceived ethical problems were: being asked for hormonal contraception, dispensing a drug for unreported indication (69.2%), dispensing dose of medicine for a child that is outside the SNF limits (68.9%), unwanted professional behavior about controlled drugs (66.6%), a colleague insisting on unethical behavior (65.0%), a colleague has done something unethical for the first time (64.7%), suspecting that a child is being abused (63.3%) prescribing on private scripts for suspected medications of possible abuse (60.7%) and terminally ill patient asks for a diagnosis or prognosis (52.9%). The findings of this study assured the need of Saudi health authorities to implement a code of ethics
Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.
Abstract Background Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services. Objective To explore Australian consumers’ perspectives regarding weight management services in the community pharmacy setting, including their past experiences and willingness to pay for a specific pharmacy‐based service. Design An online cross‐sectional consumer survey was distributed through a marketing research company. The survey instrument comprised open‐ended and closed questions exploring consumers’ experiences of and preferences for weight management services in pharmacy. It also included an attitudinal measure, the Consumer Attitude to Pharmacy Weight Management Services (CAPWMS) scale. Setting and participants A total of 403 consumers from New South Wales, Australia, completed the survey. Results The majority of respondents had previously not sought a pharmacist’s advice regarding weight management. Those who had previously consulted a pharmacist were more willing to pay for and support pharmacy‐based services in the future. Most consumers considered pharmacists’ motivations to provide advice related to gaining profit from selling a product and expressed concerns about the perceived conflicts of interest. Participants also perceived pharmacists as lacking expertise and time. Conclusion Although Australian consumers were willing to seek pharmacists’ advice about weight management, they perceived several barriers to the provision of weight management services in community pharmacy. If barriers are addressed, community pharmacies could be a viable and accessible setting to manage obesity. PMID:22646843
Pringle, Janice; Coley, Kim C
Evidence supports that patient medication adherence is suboptimal with patients typically taking less than half of their prescribed doses. Medication nonadherence is associated with poor health outcomes and higher downstream health care costs. Results of studies evaluating pharmacist-led models in a community pharmacy setting and their impact on medication adherence have been mixed. Community pharmacists are ideally situated to provide medication adherence interventions, and effective strategies for how they can consistently improve patient medication adherence are necessary. This article suggests a framework to use in the community pharmacy setting that will significantly improve patient adherence and provides a strategy for how to apply this framework to develop and test new medication adherence innovations. The proposed framework is composed of the following elements: 1) defining the program's pharmacy service vision, 2) using evidence-based, patient-centered communication and intervention strategies, 3) using specific implementation approaches that ensure fidelity, and 4) applying continuous evaluation strategies. Within this framework, pharmacist interventions should include those services that capitalize on their specific skill sets. It is also essential that the organization's leadership effectively communicates the pharmacy service vision. Medication adherence strategies that are evidence-based and individualized to each patient's adherence problems are most desirable. Ideally, interventions would be delivered repeatedly over time and adjusted when patient's adherence circumstances change. Motivational interviewing principles are particularly well suited for this. Providing effective training and ensuring that the intervention can be delivered with fidelity within a specified workflow process are also essential for success. Utilizing this proposed framework will lead to greater and consistent success when implementing pharmacist-led medication adherence
Radford, Andrea; Slifkin, Rebecca; King, Jennifer; Lampman, Michelle; Richardson, Indira; Rutledge, Steve
Purpose: To document sole community pharmacists' involvement with other local health care organizations, these pharmacies' current financial status, and to determine whether financial position was associated with the provision of pharmacy services to other local health care providers. Methods: We conducted semistructured interviews with…
Full Text Available As a means to work across settings and geography, @WePharmacists is a volunteer-led online social-media group open to anyone, with particular relevance to those operating in or with pharmacy teams in the UK. The goal of WePharmacists is to pursue better patient care and outcomes from medicines through shared learning and a connected pharmacy team. The core offering is facilitated tweet chats, on topics suggested by the community. Resources to aid members in connecting with others, finding information and using technology have been developed, along with materials to help members recognize the learning that occurs with social media use. Community members report the value of feeling part of a wider community, along with the benefit of learning from one another. Type: Commentary
Perepelkin, Jason; Dobson, Roy Thomas
Ownership of community pharmacies is increasingly being controlled by a relatively small number of corporate entities. The influence of this ownership type should not be ignored, because ownership has the ability to impact pharmacy practice. To examine the relationship between ownership type and community pharmacy managers with regard to role orientation, role affinity, and role conflict. This study consisted of a cross-sectional survey of community pharmacy managers in Canada by means of a self-administered postal questionnaire sent to a stratified sample of community pharmacies. Statistical analysis consisted of exploratory factor analysis with reliability testing on identified constructs. Frequencies, 1-way analyses of variance, and Scheffe post hoc tests were used to determine significant differences among groups, including ownership structure, on each of the constructs. A total of 646 completed questionnaires were received (32.9% response rate). Most of the respondents were males (60.8%), with slightly less than half of the respondents identifying their practice type as an independent pharmacy (44.6%). There were 5 multi-item scale constructs (professional orientation, business orientation, professional affinity, business affinity, and role conflict) arising from the data, which were analyzed against the pharmacy ownership structure (independent, franchise, corporate) independent variable. Analysis revealed significant differences for 3 of the 5 constructs; however, no differences were seen regarding the 2 professionally focused constructs. Community pharmacy managers/owners are generally oriented to their professional role; however, those working in a corporate pharmacy environment are less oriented to their business role when compared with those working in an independent or franchise pharmacy environment. Further research is needed to identify different practice cultures that may exist in various practice settings and the extent to which these cultures
Fuentes Albarrán, Katherine; Villa Zapata, Lorenzo
Self-medication refers to using drugs which have not been prescribed, recommended or controlled by a licensed health care specialist. Marketing, in Chile only admitted for over-the-counter medications, influences the practice of self-medication and extends it to prescription drugs. Thus, a complex self-medication process is started, due to reuse of a previous prescription, using drugs purchased directly at the pharmacy or drugs coming from family first-aid kits. The purpose of this study is to determine the frequency of self-medication, the type of medications involved, the dosages used, and the reasons for this practice. An observation-based cross-sectional study was carried out at three pharmacies belonging to a pharmacy chain in the city of Valdivia (southern Chile). In addition, a previously validated form was used. Customers who requested over-the-counter medications were surveyed to identify the patterns that foster the self-medication practice. Of 909 surveyed customers, 75% self-medicate. Of these, 31% stated that they commonly self-medicate due to suffering from light symptoms, such as headaches (19%), the common cold (8.8%), sore muscles (6.7%), and bone pains (5.3%). The group of medications most requested in this study was nonsteroidal anti-inflammatory drugs (NSAIDs) (33%), with diclofenac sodium being the most used (14%). Influence from other people did not exceed 20% and reusing prior prescriptions reached 46%. There were significant differences when assessing consumer knowledge, reading of information leaflets, and opinions about self-medication at each surveyed pharmacy (P pharmacies use medications without proper knowledge of their benefits, treatment method, and duration. Drug dispensing at community pharmacies should include active pharmacist involvement to divulge the sensible use of drugs.
Boyle, Todd A; Mahaffey, Thomas; Mackinnon, Neil J; Deal, Heidi; Hallstrom, Lars K; Morgan, Holly
Evidence suggests that the underreporting of medication errors and near misses, collectively referred to as medication incidents (MIs), in the community pharmacy setting, is high. Despite the obvious negative implications, MIs present opportunities for pharmacy staff and regulatory authorities to learn from these mistakes and take steps to reduce the likelihood that they reoccur. However, these activities can only take place if such errors are reported and openly discussed. This research proposes a model of factors influencing the reporting, service recovery, and organizational learning resulting from MIs within Canadian community pharmacies. The conceptual model is based on a synthesis of the literature and findings from a pilot study conducted among pharmacy management, pharmacists, and pharmacy technicians from 13 community pharmacies in Nova Scotia, Canada. The purpose of the pilot study was to identify various actions that should be taken to improve MI reporting and included staff perceptions of the strengths and weaknesses of their current MI-reporting process, desired characteristics of a new process, and broader external and internal activities that would likely improve reporting. Out of the 109 surveys sent, 72 usable surveys were returned (66.1% response rate). Multivariate analysis of variance found no significant differences among staff type in their perceptions of the current or new desired system but were found for broader initiatives to improve MI reporting. These findings were used for a proposed structural equation model (SEM). The SEM proposes that individual-perceived self-efficacy, MI process capability, MI process support, organizational culture, management support, and regulatory authority all influence the completeness of MI reporting, which, in turn, influences MI service recovery and learning. This model may eventually be used to enable pharmacy managers to make better decisions. By identifying risk factors that contribute to low MI
Urwin, Heidi; Wright, David; Twigg, Michael; McGough, Norma
Setting Fifteen community pharmacies in the UK. Objective Proof of concept study to test the use of community pharmacies for active case finding of patients with coeliac disease. Methods Customers accessing over-the counter and prescription medicines indicated in the treatment of possible symptoms of coeliac disease over a 6 month period were offered a free point of care test. All patients were given advice regarding the test results and those who tested positive were advised to make an appointment with their general practitioner. Patients and pharmacists involved in service provision were asked to complete a satisfaction survey. Pharmacists were additionally invited to undertake interviews to better understand their views on the service. Main outcome measures Feasibility of service, acceptability to stakeholders and proportion testing positive for coeliac disease. Results Of the 551 individuals tested, 52 (9.4 %) tested positive. 277 (50.3 %) were tested for accessing irritable bowel syndrome treatment, 142 (25.8 %) due to presenting for diarrhoea. The proportion of patients testing positive with different symptoms or for different treatments were similar. Of 43 customers who returned the satisfaction survey, all would recommend the service to others, believing the community pharmacy to be a suitable location. Community pharmacists believed that it enabled them to improve relationships with their customers and that medical practices were receptive to the service. Conclusion This proof of concept study has shown that community pharmacies using a point of care test can effectively recognise and refer patients for confirmatory coeliac disease testing with high levels of customer and service provider satisfaction.
Vo, T H; Bardet, J-D; Charpiat, B; Leyrissoux, C; Gravoulet, J; Allenet, B; Conort, O; Bedouch, P
The French Society of Clinical Pharmacy (SFPC) asked a group of experts to adapt the SFPC hospital pharmacists' interventions reporting tool for use in community pharmacy practice. This study aimed to develop and validate a tool for the routine reporting of pharmacists' interventions in French community settings. Two groups of community pharmacists coded reports of 60 typical pharmacists' interventions. One group was "experts" (n = 4) who had participated in the development of the tool (internal validation) and the other were "external" community pharmacists (n = 6), naïve to the tool (external validation). The Kappa coefficient was used to assess the inter-reliability of classification between participants. A 4-level Likert scale was used to evaluate ease of use and acceptability. The tool we developed for recording and classifying PIs has 19 items; 11 non-ordered categories describing drug-related problems; and 7 items describing interventions. Two tables of definitions were provided to help community pharmacists in the classification. The mean κ statistic was (i) 0.63 for experts and 0.73 for external community pharmacists in categorizing drug-related problems and (ii) 0.69 for experts and 0.75 for external community pharmacists in categorizing interventions. A specific tool for the documentation of pharmacists' interventions in community pharmacies is now available in French. Besides being useful to describe pharmacists' interventions in studies in community settings, it can be used to document the pharmaceutical patient record and to support the traceability process. © 2017 John Wiley & Sons Ltd.
Olufunmilola K. Odukoya
Full Text Available Objectives: It has been reported that supportive personnel, such as pharmacy technicians, are key participants in the use of health information technology. The purpose of this study was to describe how pharmacy technicians use e-prescribing and to explore the characteristics of technicians that support pharmacists in ensuring patient safety. Methods: This was a qualitative study that used observations, interviews, and focus groups to understand the role of pharmacy technicians in e-prescribing. Fourteen pharmacy technicians and 13 pharmacists from five community pharmacies participated. Observations lasted about nine hours in each pharmacy. Follow-up interviews and two separate focus groups were later conducted. Observation field notes and audio recordings were transcribed and thematically analyzed. Results: Pharmacy technicians were primarily responsible for all steps leading up to pharmacist review of the e-prescription and dispensing of medications to the patient. Technician characteristics, including experience, certification status, and knowledge of appropriate medication use, were reported as important factors in supporting a pharmacist’s role in ensuring patient safety with the use of e-prescribing. Conclusion: Study findings indicate that pharmacy technicians have an important role in supporting pharmacists to prevent medication errors. Certain characteristics of pharmacy technicians were identified with the potential to improve the e-prescription medication dispensing process and decrease patient harm through the identification and resolution of errors.
Fornos-Pérez, José Antonio; Andrés-Rodríguez, N Floro; Andrés-Iglesias, J Carlos; Luna-Cano, Reyes; García-Soidán, Javier; Lorenzo-Veiga, Blanca; Mera-Gallego, Rocío; García-Riestra, Rosario
The aim of this study was to detect people at risk of suffering diabetes or changes in carbohydrate metabolism and to refer them for possible diagnosis to health care centres. The number of diagnoses and costs for the pharmacy were recorded. A cross-sectional, observational study was conducted in community pharmacies in Pontevedra in September-October of 2014. The Findrisc questionnaire was completed by pharmacy users over 18 years old. If Findrisc score was ≥ 15, capillary blood glucose was measured, and the participant was referred to a physician if the value was ≥110mg/dL. The main variables included score in the Findrisc questionnaire, number of diabetes diagnosed, and cost of the service. Differences between the groups were calculated using a Chi-squared test, a Student's t test, and/or a Wilcoxon test. This study was conducted in 180 pharmacies on a sample of 4,222 users, including 992 (23.5%) with a high or very high risk of diabetes (F≥15). In the 1,060 basal capillary blood glucose tests performed, mean glucose level was 110.2 (SD=20.4)mg/dL (56-254). The Galician Health Service sent information about 83 of the 384 (9.1%) subjects referred to a physician: 28 (33.7%) of them were diagnosed with diabetes (3.1% of the sample), and 26 (31.3%) were diagnosed with prediabetes (2.8% of the sample). Cost per diagnosed subject was € 184.22 per subject with diabetes and € 96.86 per subject with prediabetes. The proportion of subjects with new diagnosis of diabetes (3.1%) shows the high efficiency of a screening program for hidden diabetics implemented at community pharmacies as the one presented here. Copyright © 2016 SEEN. Publicado por Elsevier España, S.L.U. All rights reserved.
Leia M. Minaker
Full Text Available Abstract Background Sugar-sweetened beverage consumption is associated with morbidity and mortality. The retail food environment influences food and beverage purchasing and consumption. This study assesses the impact of a community pharmacy’s removal of sweet beverages on overall community sales of carbonated soft drinks (CSD in a rural setting. We also examined whether the pharmacy intervention affected CSD sales in the town’s other food stores. Methods Weekly CSD sales data were acquired from the three food retailers in the town of Baddeck, Nova Scotia (January 1, 2013 to May 8, 2015, n = 123 weeks. Autoregressive integrated moving average (ARIMA analysis was used to analyse the interrupted time series data and estimate the impact of the pharmacy intervention (September 11, 2014 on overall CSD sales at the community level. Data were analysed in 2015. Results Before the intervention, the pharmacy accounted for approximately 6 % of CSD sales in the community. After the intervention, declines in total weekly average community CSD sales were not statistically significantly. CSD sales at the other food stores did not increase after the pharmacy intervention. Conclusions This study was among the first to examine the impact of a restrictive retail food environment intervention, and found a non-significant decline in CSD sales at the community level. It is the first study to examine a retail food environment intervention in a community pharmacy. Pharmacies may have an important role to play in creating healthy retail food environments.
Phillips, J H
Each stage of a product's life cycle requires marketing strategy modifications in response to changing demand levels. The purpose of this study was to investigate changes in ambulatory care center (ACC) operational characteristics indicative of product, market, and distribution channel adjustments that could have a competitive impact upon community pharmacy practice. A questionnaire was mailed to a national sample of 325 ACC managers. Evidence of new product feature additions includes increased emphasis on continued care and increased prevalence of prescription drug dispensing. Expansion into new market segments and distribution channels was demonstrated by increased participation in HMO and employer relationships. The observed adjustments in ACC marketing strategies present obvious challenges as well as less obvious opportunities for community pharmacy practice.
Hess, Karl M; Dai, Chih-Wei; Garner, Brian; Law, Anandi V
To describe the acceptance and refusal rates of travel-related vaccine and medication recommendations in a pharmacist-run travel health clinic, to evaluate the change in patient understanding of travel-related issues, to determine patient satisfaction with this clinic, and to determine factors influencing both patient acceptance and satisfaction. Southern California (Claremont) between July 2007 and October 2008. Hendricks Pharmacy is an independently owned community pharmacy that is part of the Good Neighbor Pharmacy Provider Network. The pharmacy offers a range of services including home delivery, compounding, and blood glucose, blood pressure, and cholesterol screenings. Comprehensive pharmacist-run travel health clinic. Patient acceptance and refusal rates of pharmacist-made recommendations, changes in patient understanding of travel-related issues resulting from pharmacist counseling, and patient satisfaction with this travel health clinic. In a sample of 283 patients, overall patient acceptance of pharmacist-made recommendations was 84.7%. The primary reason for patient refusal of a recommendation was self-perceived low risk for infection. A subsample of patients (n = 82) completing a patient satisfaction survey found that 96% were satisfied with their overall visit. Patient satisfaction with the clinic and pharmacist services was correlated with overall patient acceptance. The high rate of patient acceptance and satisfaction with this clinic supports adoption of pharmacists as nontraditional providers of travel health services.
Jacobs, Sally; Johnson, Sheena; Hassell, Karen
Background Workplace stress in community pharmacy is increasing internationally due, in part, to pharmacists’ expanding roles and escalating workloads. Whilst the business case for preventing and managing workplace stress by employers is strong, there is little evidence for the effectiveness of organisational stress management interventions in community pharmacy settings.Aim To identify and synthesise existing evidence for the effectiveness of organisational solutions to workplace stress from...
Andrés Iglesias JC
Full Text Available Only one study evaluated the scientific activity in community pharmacies in Spain, and it was restricted to articles published in just two journals.Objective: To assess the scientific activity in community pharmacies in Spain through a bibliometric analysis of the original papers published during the years 1995-2005.Methods: IPA, MEDLINE, CSIC database and the journals Seguimiento Farmacoterapéutico y Pharmaceutical Care España were used as data sources. Production indicators, consumption indicators and the impact factor (IF as a repercussion index were analyzed. Results: 122 articles were included in the review. The articles were published in 12 journals, 78.7% of them in Pharmaceutical Care España and Seguimiento Farmacoterapéutico. The mean number of authors per article was 4.2 (SD=2.1. The transitivity index was 71.3%. The total number of references cited in the articles was 2110. The mean number of references per article was 17.3 SD=9.3. The value of the insularity index was 57.6%. Self citation was 6.8% and the Price index was 66.5%. No impact factor was available for 6 journals.Conclusions: Publication of articles on community pharmacy-based research in Spain has undergone an important increase in the last 5 years. The existence of authors who publish very few studies, the high insularity index and the lack of randomized, controlled trials may be considered as negative indicators in community pharmacy-based research in Spain.
Yaghoubifard, Saeed; Rashidian, Arash; Kebriaeezadeh, Abbas; Sheidaei, Ali; Varmaghani, Mehdi; Hashemi-Meshkini, Amir; Zekri, Hedieh-Sadat
Objective: To develop a valid and reliable instrument in the Persian language for evaluating patient satisfaction with services provided in community pharmacies. Methods: We selected a valid and reliable instrument from the literature and translated it to the Persian language. Some new items were added to the first draft based on the special characteristics of the Iranian health system. Then, the feasibility of utilizing the new instrument was assessed. In the third step, we conducted a forma...
Saini, Bandana; Filipovska, Julija; Bosnic-Anticevich, Sinthia; Taylor, Susan; Krass, Ines; Armour, Carol
To compare the effect of a pharmacist-delivered rural asthma management service (RAMS) on health outcomes for people with asthma in a rural/regional area with 'standard care' delivered through community pharmacies. A parallel group controlled repeated measures study. Community pharmacies in Central West New South Wales. Standardised protocols and resources based on national asthma management guidelines, delivered by specially trained community pharmacists. Patients visited the pharmacy at baseline and 1, 3 and 6 months after baseline in the intervention group and at baseline plus 6 months after baseline in the control group. The intervention pharmacists (n = 12) were trained to deliver the RAMS model, while control pharmacists (n = 8) provided standard asthma care to their recruited patients. Fifty-one and 39 patients were recruited by intervention and control pharmacists. Asthma severity score which was a composite score based on recency, frequency and severity of asthma symptoms, and asthma history. Data compared at the final visit between groups indicated that the RAMS patient group demonstrated a significant reduction in the asthma severity scores (7.9 +/- 2.6 versus 10.4 +/- 2.6, P < 0.001); a reduction in the risk of non-adherence to medication scores (1.6 +/- 0.7 versus 2.3 +/- 1.1, P < 0.001); and an increase in the proportion of patients owning a written action plan (50% versus 23%, P = 0.04). These results indicated that the community pharmacy-based RAMS model can improve asthma outcomes for patients in rural settings, and similar models for asthma and other chronic diseases should be tested rigorously and adopted in rural primary care practice.
C. Batista; C. Pinho; M. Castel-Branco; M. Caramona; I. Figueiredo
Phytotherapy has always played a leading role in therapeutics. However, a strong knowledge of the risk-benefit relationship of herbal products by patients and health professionals is necessary. The goals of this study were to characterize the consumption pattern of medicinal plants in patients in a community pharmacy, identify potential herb-drug interactions, and establish a list of recommendations for health professionals and/or patients in order to prevent/minimize negative outcomes arisin...
Olenik, Nicole L; Gonzalvo, Jasmine D; Snyder, Margie E; Nash, Christy L; Smith, Cory T
A paucity of studies exists that have assessed community pharmacy preferences of Spanish-speaking patients living in areas of the U.S. with rapidly growing Hispanic populations. The qualitative approach to this research affords a unique opportunity to further explore perceptions of the Spanish-speaking population. To identify perceptions of Spanish-speaking patients living in the U.S. with a focus on the care provided in community pharmacies, as well as to determine their satisfaction with community pharmacies. Participants were recruited after weekly Spanish-speaking church services for approximately one month. Qualitative, semi-structured individual interviews to identify perceived unmet patient care needs were conducted in Spanish and transcribed/translated verbatim. Qualitative thematic analysis was used to summarize findings. A written questionnaire was administered to collect patient satisfaction and demographic information, summarized using descriptive statistics. Twelve interviews were conducted by the principal investigator. Primary themes included lack of insurance coupled with high medical care costs serving as a barrier for acquisition of health care, difficulty accessing timely and convenient primary care, perceived negative attitudes from pharmacy personnel, lack of Spanish-speaking health care providers, and the provision of verbal and written medication information in English. The results of this study suggest a great need for health care providers, including pharmacists, to expand outreach services to the Spanish-speaking community. Some examples derived from the interview process include increasing marketing efforts of available services in the Spanish language, hiring Spanish-speaking personnel, and offering medical terminology education classes to Spanish-speaking patients. Copyright © 2015 Elsevier Inc. All rights reserved.
Harvey, Jasmine; Avery, Anthony J.; Ashcroft, Darren; Boyd, Matthew; Phipps, Denham L.; Barber, Nicholas
Background Identifying risk is an important facet of a safety practice in an organization. To identify risk, all components within a system of operation should be considered. In clinical safety practice, a team of people, technologies, procedures and protocols, management structure and environment have been identified as key components in a system of operation. Objectives To explore risks in relation to prescription dispensing in community pharmacies by taking into account relationships betwe...
Grunert, Suzanne C.; Thøgersen, John
Results from a study conducted in two Danish communities with different waste handling systems are reported: Whereas one community introduced in the beginning of 1993 a system of combining economic incentives with structural improvements to promot separation, the other started in spring 1994...
Full Text Available This study determined the degree of adherence to medications for glaucoma among patients refilling prescriptions in community pharmacies. Methods: Data abstracted from the dispensing records for 3615 adult patients (18 years or older, predominantly over 45 receiving glaucoma medications from two retail pharmacy chains (64 stores in total were analyzed. From a 24-month historic data capture period, the 12-month levels of adherence were determined using standard metrics, the proportion of days covered (PDC and the medication possession ratio (MPR. The overall 12-month mean PDC was only 57%, and the mean MPR was 71%. Using a criterion by which 80% coverage was considered satisfactory adherence, only 30% had satisfactory overall 12-month PDC coverage, and only 37% had satisfactory overall 12-month MPR coverage. Refill adherence increased with age and was highest in the 65-and-older age group (p < 0.001. Differential adherence was found across medication classes, with the highest satisfactory coverage seen for those taking alpha2-adrenergic agonists (PDC = 36.0%; MPR = 47.6% down to those taking direct cholinergic agonists (PDC = 25.0%; MPR = 31.2% and combination products (PDC = 22.7%; MPR = 31.0%. Adherence to glaucoma medications in the community setting, as measured by pharmacy refill data, is very poor and represents a critical target for intervention. Community pharmacists are well positioned to monitor and reinforce adherence in this population.
Kirkdale, C L; Nebout, G; Megerlin, F; Thornley, T
Seasonal influenza is a major cause of excess winter deaths and increased hospital admissions. There is a high level of economic burden associated with the infection. Although vaccination targets have been set to tackle this international issue, many countries struggle to reach these coverage targets for their at-risk populations using traditional delivery methods. Traditional providers include family doctors and nurses; however, pharmacist-led influenza vaccination has become a more commonly utilised aid to support vaccination targets. Community pharmacies are convenient and widely accessible and evaluations consistently demonstrate that patients are satisfied with pharmacist-led vaccinations. Allowing community pharmacists to administer influenza vaccination as an alternative option for delivery helps to increase the coverage rate of vaccination. In addition, commissioning community pharmacists to provide this service has been shown to contribute to achieving targets for those at-risk. Pharmacist-led influenza vaccination services can create value for payors and reduce pressure on health systems. This review aims to demonstrate the success of pharmacy-led influenza vaccinations, and the impact it has had in driving up immunisation rates within other countries. Experiences of countries such as England, Portugal and the United States provide evidence to demonstrate the benefit to both the patient and the health system. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.
Sheridan, Janie; Smart, Ros; McCormick, Ross
Community pharmacists have successfully been involved in brief interventions in many areas of health, and also provide services to substance misusers. There has been recent interest in community pharmacists providing screening and brief interventions (SBI) to problem drinkers. The aim of this study was to develop a method for measuring prevalence of risky drinking among community pharmacy customers and to explore acceptability of this method to participating pharmacists. Forty-three pharmacies (from 80 randomly selected) in New Zealand agreed to participate in data collection. On a set, single, randomly allocated day during one week, pharmacies handed out questionnaires about alcohol consumption, and views on pharmacists providing SBI, to their customers. At the end of the data collection period semi-structured telephone interviews were carried out with participating pharmacists. Pharmacists were generally positive about the way the study was carried out, the support and materials they were provided with, and the ease of the data collection process. They reported few problems with customers and the majority of pharmacists would participate again. The method developed successfully collected data from customers and was acceptable to participating pharmacists. This method can be adapted to collecting data on prevalence of other behaviours or medical conditions and assessing customer views on services. © 2010 The Authors. IJPP © 2010 Royal Pharmaceutical Society of Great Britain.
Hoan Linh Banh
Full Text Available Purpose: Type 2 diabetes is a major condition impacting morbidity, mortality, and health care costs in Canada. Pharmacists are very accessible and are in an ideal position to promote public health education. The primary goal of this study was to incorporate public health promotion and education into a community pharmacy experiential education rotation for fourth year pharmacy students to screen for the risk of pre-diabetes/diabetes in adults. A secondary goal was to determine the frequency of common risk factors for pre-diabetes/diabetes in adults in the community setting. Method: Fourth year pharmacy students were invited to recruit all adults 25 years or older attending community pharmacies to complete a pre-diabetes/diabetes risk assessment questionnaire. If the participants were at risk, the participants were provided education about risk reduction for developing pre-diabetes/diabetes. Results: A total of 340 participants completed a risk assessment questionnaire. Over 90% of people approached agreed to complete a risk assessment questionnaire. The common risk factors were overweight (154/45%, hypertension (102/30%, taking medications for hypertension (102/30%, and having symptoms of diabetes (111/33%. The ethnic minorities have 2.56 (confidence interval = 1.48–44.1 times greater odds of having a family history of diabetes compared to non-minority subjects. Conclusion: Pharmacy students are able to screen community-based patients for pre-diabetes/diabetes risks. The most common risk factors presented were overweight, hypertension, and taking medications for hypertension.
Al-Worafi, Yaser Mohammed; Kassab, Yaman Walid; Alseragi, Wafa Mohammed; Almutairi, Masaad Saeed; Ahmed, Ali; Ming, Long Chiau; Alkhoshaiban, Ali Saleh; Hadi, Muhammad Abdul
Objective The aim of this study was to compare the knowledge, attitude and barriers of pharmacy technicians and pharmacists toward pharmacovigilance, adverse drug reactions (ADRs) and ADR reporting in community pharmacies in Yemen. Methods This cross-sectional survey was conducted among community pharmacists and pharmacy technicians in the capital of Yemen, Sana’a. A total of 289 community pharmacies were randomly selected. The validated and pilot-tested questionnaire consisted of six sections: demographic data, knowledge about pharmacovigilance, experience with ADR reporting, attitudes toward ADR reporting, and the facilitators to improve ADR reporting. Results A total of 428 pharmacy technicians and pharmacists were contacted and 179 went on to complete a questionnaire (response rate: 41.8%). Of the 179 respondents, 21 (11.7%) were pharmacists and 158 (88.3%) were pharmacy technicians, of which, 176 (98.3%) were male and 3 (1.7%) were female. The mean age of the respondents was 25.87±2.63 years. There was a significant difference between the pharmacists and pharmacy technicians in terms of knowledge scores (PYemen to increase their awareness and participation in ADR reporting. PMID:28924350
Lei Burton, Deborah; LeMay, Kate S; Saini, Bandana; Smith, Lorraine; Bosnic-Anticevich, Sinthia; Southwell, Phillipa; Cooke, Julie; Emmerton, Lynne; Stewart, Kay; Krass, Ines; Reddel, Helen; Armour, Carol
To investigate the reliability and the utility of spirometry generated by community pharmacists participating in two large asthma intervention trials of 892 people. The Pharmacy Asthma Care Program (PACP) and the Pharmacy Asthma Management Service (PAMS) involved up to four visits to the pharmacy over 6 months for counseling and goal setting. Pharmacists performed spirometry according to ATS/ERS guidelines to inform management. The proportion of A-E, F quality tests, as per EasyOne QC grades, were recorded. Lung function results between visits and for participants referred/not referred to their general practitioner on the basis of spirometry were compared. Complete data from 2593 spirometry sessions were recorded, 68.5% of spirometry sessions achieved three acceptable tests with between-test repeatability of 150 ml or less (A or B quality), 96% of spirometry sessions included at least one test that met ATS/ERS acceptability criteria. About 39.1% of participants had FEV1/FVC values below the lower limit of normal (LNN), indicating a respiratory obstruction. As a result of the service, there was a significant increase in FEV1 and FEV1/FVC and asthma control. Lung function values were significantly poorer for participants referred to their general practitioner, compared with those not referred, on the basis of spirometry. Community pharmacists are able to reliably achieve spirometry results meeting ATS/ERS guidelines in people with asthma. Significant improvements in airway obstruction were demonstrated with the pharmacy services. Pharmacists interpreted lung function results to identify airway obstruction for referral, making this a useful technique for review of people with asthma in the community.
Kashyap, Krishneeta C; Nissen, Lisa M; Smith, Simon S; Kyle, Greg
To evaluate the current management of over-the-counter (OTC) insomnia complaints in Australian community pharmacies using standardized patient methodology. Trained standardized patients visited a sample of 100 randomly selected South East Queensland community pharmacies in June 2011. The standardized patients enacted two OTC insomnia scenarios: a direct product request (DPR) (n = 50) and a symptom-based request (SBR) (n = 50). Results of the interactions were documented immediately after each visit and evaluated using the Pharmaceutical Society of Australia's WHAT STOP GO protocol as a standard comparison. Of all DPRs, 30% were handled entirely by the pharmacist, 70% of staff enquired about specific symptoms and 28% investigated the cause of insomnia. No staff investigated the frequency of product use. The DPR scenario resulted in a 92% supply of the requested doxylamine product (Restavit). In the SBR scenario, 18% of requests were handled entirely by the pharmacist, 58% of staff enquired about specific symptoms and 44% investigated the cause of insomnia. Staff recommended medicated products (38%), or herbal (78%) or non-drug techniques (18%). Investigation into smoking and alcohol intake was not undertaken in DPR or SBR interactions, while questioning on caffeine intake was undertaken in 2 and 14% of cases respectively. There were no significant differences found in the handling of sleep requests by pharmacists compared to pharmacy assistants. The standardized patient methodology was a successful way to assess the community pharmacy counselling provided with OTC sleep requests and suboptimal staff responses were found when compared with recommended practice standards. © 2013 Royal Pharmaceutical Society.
Boyle, Todd A; Bishop, Andrea C; Duggan, Kellie; Reid, Carolyn; Mahaffey, Thomas; MacKinnon, Neil J; Mahaffey, Amelia
Given the significant potential of continuous quality improvement (CQI) programs in enhancing overall levels of patient safety, community pharmacies in North America are under increasing pressure to have a formal and documented CQI program in place. However, while such initiatives may seem great on paper, in practice the outcomes of such programs to community pharmacy practice remain unclear. To explore the perceived outcomes identified by community pharmacies that adopted and actively used a standardized (i.e., common across pharmacies) CQI program for at least 1 year and to develop a framework for how such outcomes were achieved. A multi-site study of SafetyNET-Rx, a standardized and technologically sophisticated (e.g., online reporting of medication errors to a national database) CQI program, involving community pharmacies in Nova Scotia, Canada, was performed. During the summer and fall of 2011, 22 interviews were conducted with the CQI facilitators in 12 Nova Scotia community pharmacies; equally split between independent/banners and corporate chains. Of the CQI facilitators, 14 were pharmacists, while the remaining eight were pharmacy technicians. Thematic analysis following the procedures presented by Braun and Clarke was adopted to identify and explore the major outcomes. Results of the thematic analysis highlighted a number of perceived outcomes from the use of a standardized CQI program in community pharmacies, specifically: (1) perceived reduction in the number of medication errors that were occurring in the pharmacy, (2) increased awareness/confidence of individual actions related to dispensing, (3) increased understanding of the dispensing and related processes/workflow, (4) increased openness to talking about medication errors among pharmacy staff, and (5) quality and safety becoming more entrenched in the workflow (e.g., staff is more aware of their roles and responsibilities in patient safety and confident that the dispensing processes are safe and
Fraeyman, Jessica; Foulon, Veerle; Mehuys, Els; Boussery, Koen; Saevels, Jan; De Vriese, Carine; Dalleur, Olivia; Housiaux, Marie; Steurbaut, Stephane; Naegels, Marc; De Meyer, Guido Ry; De Loof, Hans; Van Hal, Guido; Van den Broucke, Stephan
In October 2013, a New Medicines Service (NMS) was introduced in community pharmacies in Belgium to support asthma patients who are novice users of inhaler devices with corticosteroids. The protocol-based intervention used the Asthma Control Test (ACT) and the Medication Adherence Report Scale (MARS) to assess asthma control and medication adherence. The NMS is the first initiative that puts advanced pharmaceutical care into practice in Belgium. The present study evaluated the degree to which the NMS program is delivered as intended, drawing on the concept of implementation fidelity (IF). The main dimensions of IF and potential moderating and facilitating factors for the implementation of NMS in community pharmacies were evaluated using telephone interviews with pharmacists (n = 497), semi-structured interviews with patients eligible for NMS (n = 30), focus groups among general practitioners (n = 72) and lung specialists (n = 5), and a work system analysis in community pharmacies (n = 19). The uptake of NMS in Belgian community pharmacies remains low. In addition to practical barriers, pharmacists found it difficult to identify new asthmatic patients when they were not informed about the diagnosis. A lack of commitment from physicians, patients and pharmacists was noted in the early start-up phase of the program. Many pharmacists did not see how NMS differed from existing pharmaceutical care. Physicians considered this service as part of their own tasks and discouraged ACT for asthma follow-up in the community pharmacy. The introduction of the NMS program was not sufficiently embedded in the Belgian health care organization, causing low uptake and resistance to its implementation by pharmacists, patients, and other health care professionals. To increase the uptake of this type of service and its possible extension to other patient groups, more collaboration among the different health care professionals during design and implementation is necessary, as
Hohmeier, Kenneth C; Loomis, Benjamin; Gatwood, Justin
Point-of-care testing (POCT) is a specialty of laboratory medicine that occurs at the bedside or near the patient when receiving health services. Despite its clinical utility, POCT implementation in the community pharmacy setting is slow due to uncertainty about the market for this novel service and remuneration for services rendered. To identify 1) demographics and 2) willingness-to-pay preferences of the market niche of consumers who prefer to receive POCT services in the community pharmacy. A sample of 188 participants matched to the U.S. population were surveyed in February of 2016 utilizing a self-explicated conjoint analysis survey model. Age groups differed between the community pharmacy consumer niche and the entire sample. The largest age group of the pharmacy niche consumer group were between 20 and 34 years old. Of those who preferred the community pharmacy setting to receive POCT services, 75% indicated they would be willing to pay $50 or more compared to 79% of the entire sample who preferred to pay $50 or less. There exists a latent and niche group of consumers interested in community pharmacy provided POCT services. This market niche is younger, and in general willing-to-pay more than the general population for these tests. Copyright © 2017 Elsevier Inc. All rights reserved.
De Vera, Mary A; Campbell, Natasha K J; Chhina, Harpreet; Galo, Jessica S; Marra, Carlo
While prior research identified barriers to conducting research in community pharmacies, there remains a need to better understand facilitators to ensure successful collaborations between academic researchers and pharmacists. Our objective was to determine the experiences and perspectives of community pharmacists who have recently conducted a pharmacy practice-based research study to gain in-depth understanding of challenges as well as facilitators and identify strategies and solutions. We conducted a qualitative study involving one-on-one semi-structured telephone interviews with community pharmacists following the completion of a practice-based research study in their pharmacies. Interview transcripts were analysed using inductive content analysis involving open coding, creating categories and abstraction into final themes. Eleven pharmacists participated in the qualitative interviews. We identified six major themes including: (1) barriers (e.g. time constraints); (2) facilitators (e.g. ideal pharmacy layout); (3) support and resources from academic researchers (e.g. helpfulness of training, easy-to-use study materials); (4) pharmacist-initiated strategies for conducting research (beyond prior suggestions from researchers); (5) suggestions for future pharmacy practice research; and (6) motivation for conducting pharmacy practice research. These findings informed practical strategies targeted at academic researchers and pharmacists, respectively, to facilitate the conduct of research in community pharmacists across various stages of the research process. Our study adds to better understanding of community pharmacists' perspectives on conducting research and identifies practical solutions that can be readily implemented by academic researchers and pharmacists participating in research. © 2017 Royal Pharmaceutical Society.
Carpenter, Delesha M; Abraham, Olufunmilola; Alexander, Dayna S; Horowitz, Katherine
To characterize community pharmacists' interactions with children and their caregivers. This observational study was conducted over a 14-day period in 3 community pharmacies. Trained researchers used an observation guide to document information about prescriptions that were picked up for children 7 to 17 years of age. Research assistants recorded: 1) when the prescription was picked up; 2) who picked up the prescription; 3) who was counseled by the pharmacist; 4) which pharmacy staff members interacted with the family; 5) pick-up location; 6) wait time; 7) how many questions the child or caregiver asked pharmacy staff; and 8) caregiver gender. Additional details such as the child's age, sex, and medication information were obtained from the prescription. One hundred sixteen prescriptions were dispensed to 97 families. Most families picked up prescriptions on weekdays (84%) and after school (53%). Fifty-four percent of prescriptions were refills, and most (38%) were for mental health conditions. Only 28 children (29%) accompanied their caregivers to pick up their prescription. Nineteen caregivers (20%) received counseling; children were never counseled separately by pharmacists. Families with younger children were more likely to receive counseling than older children (β = -0.28; P = 0.01). Children infrequently accompany their parents to pick up their prescriptions, which limits pharmacists' opportunities to counsel children about their medications. Even when children are present, they rarely receive counseling from pharmacists. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
Kirk, O; Glenthøj, Jonathan Peter; Dragsted, Ulrik Bak
INTRODUCTION: We report on the outcome of a study of patients hospitalised with community acquired pneumonia (HCAP) at a Danish university hospital. METHODOLOGY: In a retrospective study of 243 consecutive patients with radiographically verified HCAP, data on clinical and laboratory findings.......3%, respectively, p = 0.94, and the readmission rate 20.3%, 24.0%, and 14.8%, respectively; p = 0.63. CONCLUSION: Patients treated for community-acquired pneumonia at a Danish university hospital had clinical outcomes fully at height with findings from other countries, and half of the patients were successfully...
Hussain, Azhar; Ibrahim, Mohamed Izham M
Pharmacies are managed by a variety of dispensers in terms of qualification, knowledge and experience in Pakistan. The study aimed to document the state of knowledge, experience and qualification of dispensers working at community pharmacies in Pakistan. A comparative cross sectional study was conducted at a randomly selected sample of 371 pharmacies in the three cities of Pakistan. A structured questionnaire for data collection was developed and finalized by focused group discussions and pilot testing. The data was coded, entered and analyzed by using SPSS Version 16. Kruskal-Wallis and Mann-Whitney tests (p≤0.05) were performed to find out differences. Out of total sample of 371 pharmacies, 31.8 % (118) were in Islamabad, 32.4 % (120) in Peshawar and 35.8 % (133) were in Lahore. Fifty percent of the respondents had correct knowledge of range of room temperature at which medicines should be stored. Only 11.1% (41) of the respondents knew about OTC (over the counter drugs) which can be sold without prescription while 5.9 % (22) of the respondents were aware of POM (prescription only medicines) which can be only sold on a valid prescription. While 87.6% (325), 88.1% (327), 58.7% (318) and 95.7 % (355) of the respondents did not know the meaning of the dispensing abbreviations such as 'h.s', 'q.d', 'sos' and 'p.r.n'. The respondents did not know correctly the status of Deltacortil® (Prednisolone), Septran® (Sulfamethoxazole) and Fansidar® (Pyrimethamine and Sulfadoxine) either as OTC or POM in 26.7% (99), 64.2% (238), and 44.5 % (165) of the cases, respectively. There was a significant difference (p≤0.05) in knowledge of dispensers regarding storage temperature, prescription terminologies and status of medicines having different level of qualification and experience. The overall knowledge and training of dispensers working at community pharmacies is inadequate in Pakistan. However, pharmacists had relatively better knowledge regarding storage temperature
Khan, Natasha S; Norman, Ian J; Dhital, Ranjita; McCrone, Paul; Milligan, Peter; Whittlesea, Cate M
Studies indicate that community pharmacy-based alcohol brief intervention (BI) is feasible. However, few studies report significant reductions in post-BI alcohol consumption and customer experience. Cost-effectiveness has not been previously examined. This 5 month study adopted a single group pre- and post-experimental design to: (1) assess uptake of the community pharmacy alcohol BI service; (2) establish post-BI changes in alcohol consumption for hazardous drinkers; (3) report the acceptability of the service to customers who received it; and (4) undertake a preliminary economic evaluation of the service through establishing whether pharmacy-based alcohol BI affected health and social care costs, including lost employment costs, and whether it was cost-effective. 26 community pharmacies in south London, UK. Trained pharmacists used the AUDIT-C and a retrospective 7-day Drinking Diary to identify risky drinkers and inform feedback and advice. Harmful drinkers were referred to their general practitioner and/or specialist alcohol services. A confidential service feedback questionnaire was completed by alcohol BI recipients. Baseline and 3-month follow-up telephone interviews were conducted with hazardous and low risk drinkers to assess post-BI alcohol use change and service cost-effectiveness. AUDIT-C, 7-day alcohol unit consumption, drinking days, cost utilisation data. Of the 663 eligible customers offered alcohol BI, 141 (21 %) took up the service. Three-quarters of customers were identified as risky drinkers. Follow-up interviews were conducted with 61 hazardous/low risk drinkers (response rate = 58 %). Hazardous drinkers were found to significantly reduce their 7-day alcohol unit consumption and drinking days, but not AUDIT-C scores. The majority of harmful drinkers (91 %, n = 10) who were contactable post-BI had accessed further alcohol related services. Customer feedback was generally positive. Over 75 % of customers would recommend the service to others. The
Harvey, Jasmine; Avery, Anthony J; Ashcroft, Darren; Boyd, Matthew; Phipps, Denham L; Barber, Nicholas
Identifying risk is an important facet of a safety practice in an organization. To identify risk, all components within a system of operation should be considered. In clinical safety practice, a team of people, technologies, procedures and protocols, management structure and environment have been identified as key components in a system of operation. To explore risks in relation to prescription dispensing in community pharmacies by taking into account relationships between key components that relate to the dispensing process. Fifteen community pharmacies in England with varied characteristics were identified, and data were collected using non-participant observations, shadowing and interviews. Approximately 360 hours of observations and 38 interviews were conducted by the team. Observation field notes from each pharmacy were written into case studies. Overall, 52,500 words from 15 case studies and interview transcripts were analyzed using thematic and line-by-line analyses. Validation techniques included multiple data collectors co-authoring each case study for consensus, review of case studies by members of the wider team including academic and practicing community pharmacists, and patient safety experts and two presentations (internally and externally) to review and discuss findings. Risks identified were related to relationships between people and other key components in dispensing. This included how different levels of staff communicated internally and externally, followed procedures, interacted with technical systems, worked with management, and engaged with the environment. In a dispensing journey, the following categories were identified which show how risks are inextricably linked through relationships between human components and other key components: 1) dispensing with divided attention; 2) dispensing under pressure; 3) dispensing in a restricted space or environment; and, 4) managing external influences. To identify and evaluate risks effectively, an
Yeong, S W; Choong, Y C
We investigated the knowledge and characteristics of herbal supplement usage of the customers of community pharmacies in a Malaysian population. Self-administered questionnaires (in English, Malay, or Chinese) were provided to customers at three community pharmacies in Malaysia (Ipoh, Perak). Questionnaire validation and translation validation were performed. A pilot study was conducted before actual questionnaire distribution. Informed consent was obtained from all participants. Total number of participants was 270 (99 males and 171 females) with majority from the 31-50 age group (41.5%). Among the participants, 45.6% were herbal users. The most commonly used herbal supplements were evening primrose oil (17.9%), ginkgo biloba (13.0%), and milk thistle (8.5%). The participants seemed to have sufficient knowledge regarding herbal supplements including safety, quality, and indication of use from medical literature. Participants obtained information about herbal supplements from pharmacists (26.9%), package inserts (25.2%), friends (20.5%), and the Internet (13.3%) more often than from their doctors (9.8%). Most herbal users did not inform their doctors about their usage of herbal supplements (68.3%) or the side effects (61.5%). Herbal supplement users also tended to be women, >50-year-old, and those with higher monthly household incomes. Community pharmacists have a vital role in educating their customers about the safe use of herbal supplements. The participants had sufficient knowledge about herbal supplement usage; therefore, customers of these community pharmacies may have benefitted from the advice of the pharmacists. Further studies could be carried out in future on the knowledge, skills and roles of community pharmacists in the safe use of herbal supplements. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available Background: Community pharmacies are considered as ideal settings to provide cardiovascular risk screening (CRS. However, little is known about pharmacists’ views on providing such services in developing countries including Iran. In the present study, we evaluated the pharmacists’ attitudes and perceived barriers to providing CRS services. Methods:In a cross-sectional study, a questionnaire in three sections was developed by the investigators (attitudes, perceived barriers, and demographics. Five likert items (5 points bipolar scale were designed to evaluate pharmacists’ attitudes about their professional role in providing CRS services in community pharmacies. Seven likert items were designed to assess the pharmacists’ perceived importance of possible barriers to providing the services. The study tool was distributed among a convenient sample of 500 pharmacists, who had participated in a national continuing education event. Results:The response rate was 44% and descriptive statistics and Chi squared test were used to analyze data. Results showed that 70.4% participants had an overall positive attitude to providing CRS services. Pharmacists who were pharmacy owner and pharmacist-in-charge simultaneously were more positive about providing CRS services. Lack of regulatory policy and compensation mechanism, limited physical space in pharmacy and time limitation were reported to be the most important barriers to providing CRS services (> 50% rated as highly important. Low human resource and time limitation were significantly associated with negative attitudes (P: 0.02 and 0.001, respectively.Conclusion:The Iranian pharmacists’ attitudes seem to be positive about providing CRS services; however, their perceived barriers should be addressed prior to CRS service implementation.
Full Text Available Background Like other health professionals, community pharmacists are exposed to stress factors (being efficient, avoiding mistakes and bearing emotional load, but they are also under the pressure of entrepreneurial responsibilities. The main objective was to assess the level of work-related stress in French community pharmacies. The other objectives of the study were to assess the associated comorbidities and causes of work-related stress. Methods This observational cross-sectional study was sent to all French community pharmacies by email. The survey was anonymous and designed to collect the following items: socio-demographic factors, professional status, characteristics of community pharmacy, work-related stress (visual analogic scale—VAS, fatigue (VAS, sleep disturbances (questions, anxiety and depression symptoms (hospital anxiety and depression scale, medical consultation for work-related stress, medication use for work related stress, psychoactive drug-use and causes of work-related stress. Participants were included in the survey if they were pharmacists (owner or assistant or pharmacy technicians working in a community pharmacy at the time of the survey. Exclusion criteria were defined as follows: pharmacy students or other professionals involved in a community pharmacy (e.g. dietician, beautician and lack of professional status information. There was no age limitation. Results After three months of data collection, 1,339 participants answered the survey and 1,272 participants were included in conformity with the inclusion and exclusion criteria, and to avoid missing data on the primary endpoint. Work-related stress was detected in 32.8% (417/1,272 of individuals (scores ≥70/100. Men were significantly more affected than women and there was no difference between professional statuses and no relation with the age of the participants. Work-related stress was significantly associated with anxiety, depression, fatigue, sleep
Pereira, Bruno; Virot, Julie; Lambert, Céline; Collin, Aurore; Alapini, David; Gagnaire, Jean-Marc; Authier, Nicolas; Cuny, Damien; Vennat, Brigitte
Background Like other health professionals, community pharmacists are exposed to stress factors (being efficient, avoiding mistakes and bearing emotional load), but they are also under the pressure of entrepreneurial responsibilities. The main objective was to assess the level of work-related stress in French community pharmacies. The other objectives of the study were to assess the associated comorbidities and causes of work-related stress. Methods This observational cross-sectional study was sent to all French community pharmacies by email. The survey was anonymous and designed to collect the following items: socio-demographic factors, professional status, characteristics of community pharmacy, work-related stress (visual analogic scale—VAS), fatigue (VAS), sleep disturbances (questions), anxiety and depression symptoms (hospital anxiety and depression scale), medical consultation for work-related stress, medication use for work related stress, psychoactive drug-use and causes of work-related stress. Participants were included in the survey if they were pharmacists (owner or assistant) or pharmacy technicians working in a community pharmacy at the time of the survey. Exclusion criteria were defined as follows: pharmacy students or other professionals involved in a community pharmacy (e.g. dietician, beautician) and lack of professional status information. There was no age limitation. Results After three months of data collection, 1,339 participants answered the survey and 1,272 participants were included in conformity with the inclusion and exclusion criteria, and to avoid missing data on the primary endpoint. Work-related stress was detected in 32.8% (417/1,272) of individuals (scores ≥70/100). Men were significantly more affected than women and there was no difference between professional statuses and no relation with the age of the participants. Work-related stress was significantly associated with anxiety, depression, fatigue, sleep disturbances, medical
Heywood Peter J
Full Text Available Abstract Background In England and Wales, the Department of Health introduced a primary prevention programme, NHS Health Checks, to provide screening for cardiovascular risk amongst people aged 40-74. The aim of this programme is to offer treatment and advice to those identified with an increased risk of cardiovascular diseases (CVD. The North East of England has some of the highest rates of CVD in the UK and prevention is therefore a priority. NHS Tees funded this programme of work under the local branding of Healthy Heart Checks (HHC. These were initially implemented principally through GP practices from October 2008 but, in order to mitigate the possibility that some hard to reach communities would be reluctant to engage with some primary care settings, plans were also developed to deliver the programme through workplace settings and through community pharmacies. This paper reports specifically on the findings from the evaluation in respect of the setting up of HHCs in community pharmacies and aims to offer some lessons for other service settings where this option is seen as a way of providing low threshold services which will minimise inequalities in intervention uptake. Methods In assessing the community pharmacy component of HHCs, a selection of staff having direct involvement in the process was invited to take part in the evaluation. Interviews were carried out with representatives from community pharmacy, staff members from the commissioning Primary Care Trusts and with Local Pharmaceutical Committee members. Results Evaluation and analysis identified challenges which should be anticipated and addressed in initiating HHC in community pharmacies. These have been categorised into four main themes for discussion in this paper: (1 establishing and maintaining pharmacy Healthy Heart Checks, (2 overcoming IT barriers, (3 developing confident, competent staff and (4 ensuring volume and through flow in pharmacy. Conclusions Delivering NHS health
Balayssac, David; Pereira, Bruno; Virot, Julie; Lambert, Céline; Collin, Aurore; Alapini, David; Gagnaire, Jean-Marc; Authier, Nicolas; Cuny, Damien; Vennat, Brigitte
Like other health professionals, community pharmacists are exposed to stress factors (being efficient, avoiding mistakes and bearing emotional load), but they are also under the pressure of entrepreneurial responsibilities. The main objective was to assess the level of work-related stress in French community pharmacies. The other objectives of the study were to assess the associated comorbidities and causes of work-related stress. This observational cross-sectional study was sent to all French community pharmacies by email. The survey was anonymous and designed to collect the following items: socio-demographic factors, professional status, characteristics of community pharmacy, work-related stress (visual analogic scale-VAS), fatigue (VAS), sleep disturbances (questions), anxiety and depression symptoms (hospital anxiety and depression scale), medical consultation for work-related stress, medication use for work related stress, psychoactive drug-use and causes of work-related stress. Participants were included in the survey if they were pharmacists (owner or assistant) or pharmacy technicians working in a community pharmacy at the time of the survey. Exclusion criteria were defined as follows: pharmacy students or other professionals involved in a community pharmacy (e.g. dietician, beautician) and lack of professional status information. There was no age limitation. After three months of data collection, 1,339 participants answered the survey and 1,272 participants were included in conformity with the inclusion and exclusion criteria, and to avoid missing data on the primary endpoint. Work-related stress was detected in 32.8% (417/1,272) of individuals (scores ≥70/100). Men were significantly more affected than women and there was no difference between professional statuses and no relation with the age of the participants. Work-related stress was significantly associated with anxiety, depression, fatigue, sleep disturbances, medical consultations, medication use
Phipps, Denham L.; Tam, W. Vanessa; Ashcroft, Darren
OBJECTIVES: To explore the combined use of a critical incident database and work domain analysis to understand patient safety issues in a health-care setting. METHOD: A retrospective review was conducted of incidents reported to the UK National Reporting and Learning System (NRLS) that involved community pharmacy between April 2005 and August 2010. A work domain analysis of community pharmacy was constructed using observational data from 5 community pharmacies, technical documentation, and a ...
Arya, Vibhuti; Medina, Eric; Scaccia, Allison; Mathew, Cathleen; Starr, David
Hurricane Sandy was one of the most severe natural disasters to hit the Mid-Atlantic States in recent history. Community pharmacies were among the businesses affected, with flooding and power outages significantly reducing services offered by many pharmacies. The objectives of our study were to assess the impact of Hurricane Sandy on community pharmacies, both independently owned and chain, in the severely affected areas of New York City (NYC), including Coney Island, Staten Island, and the Rockaways, using qualitative methods, and propose strategies to mitigate the impact of future storms and disasters. Of the total 52 solicited pharmacies, 35 (67 percent) responded and were included in our analysis. Only 10 (29 percent) of the pharmacies surveyed reported having a generator during Hurricane Sandy; 37 percent reported being equipped with a generator at the time of the survey approximately 1 year later. Our findings suggest that issues other than power outages contributed more toward a pharmacy remaining operational after the storm. Of those surveyed, 26 (74 percent) suffered from structural damage (most commonly in Coney Island). Most pharmacies (71 percent) were able to reopen within 1 month. Despite staffing challenges, most pharmacies (88 percent) had enough pharmacists/staff to resume normal operations. Overall, 91 percent were aware of law changes for emergency medication access, and 81 percent found the information easy to obtain. This survey helped inform our work toward improved community resiliency. Our findings have helped us recognize community pharmacists as important stakeholders and refocus our energy toward developing sustained partnerships with them in NYC as part of our ongoing preparedness strategy.
Full Text Available This paper describes the design, implementation and evaluation of a course in international service learning and community engagement for pharmacy undergraduate students. The course offered students opportunities to cultivate cultural competency in an international setting foreign to their own—Sub-Saharan Africa. The experience consisted of pre-departure preparation seminars followed by subsequent community immersion to experience, explore and confront personal attitudes and perceptions. A key feature of this course was its emphasis on a continuing cycle of learning, community engagement and reflection. Three students participated, a near-maximum cohort. Their daily self-reflections were qualitatively analyzed to document the impact of their cultural learning and experiences and revealed meaningful learning in the domains of self-assessment and awareness of their personal and professional culture, exposure to a participatory health delivery model involving the patient, the community and a multidisciplinary team and opportunities to engage in patient care in a different cultural setting. This proof-of-concept course provided students with experiences that were life-changing on both personal and professional levels and confirmed the viability and relevance of international service learning for the pharmacy field within its university-wide mandate.
Jacobs, Sally; Hassell, Karen; Ashcroft, Darren; Johnson, Sheena; O'Connor, Elinor
To describe the levels of workplace stress that community pharmacists perceive and to examine associations with individual, organizational and job characteristics. A cross-sectional mailed survey of 2000 randomly selected community pharmacists practising in England incorporating a validated organizational stress screening tool (ASSET). Response rate was 48%. Community pharmacists reported significantly higher levels of stress than other health care workers for seven out of eight work-related stressors. Regression analyses demonstrated significant associations between a number of individual, organizational and job characteristics and stress. Long working days, being a pharmacy manager and working for large multiples were associated with higher reported levels of stress across a number of work-related stressors including work overload, control and the job itself. However, self-reported measures of workload (such as dispensing volume) were not associated with higher stress levels. The growth in corporate ownership of community pharmacies, which is associated with more stressful working environments, together with current economic pressures could have consequences not only for the future well-being of pharmacists but also for patient safety.
Feletto, Eleonora; Lui, Grace Wan Ying; Armour, Carol; Saini, Bandana
This study aimed to investigate the application of a research-based change-management tool, the Pharmacy Change Readiness Wheel (PCRW), in practice, and the impact it had on the implementation of an asthma service (Pharmacy Asthma Management Service or PAMS). All pharmacists implementing the PAMS in the state of New South Wales, Australia, were provided training using a custom-designed module explaining change readiness as it applied to the PAMS. This training and a self-administered PCRW checklist were completed before PAMS implementation. Following PAMS service delivery, semi-structured phone interviews were conducted with the pharmacists and any additional staff involved regarding their experiences of change management. Interviews were transcribed verbatim and content analysed. Thirty seven of the forty five pharmacies who delivered PAMS returned the PCRW checklist (82% response rate) and participants from 29 pharmacies were interviewed (29 pharmacists and six additional staff). Perception of readiness for change before service delivery was remarkably high. From the interviews conducted after service delivery it was evident that systematic management of the practice change using theoretical concepts had not really been undertaken and that many challenges were faced in the implementation of practice change (PAMS). The results of the content analysis from the interviews revealed that factors external or internal to the pharmacy or those related to the individual pharmacist could affect implementation of practice change. Change is not as straightforward as it may appear and is a multi-step process over time. Pharmacists were unaware of this. A change-management framework should be applied to specific services with enough flexibility so that pharmacists can individualise them for their pharmacies. © 2012 The Authors. IJPP © 2012 Royal Pharmaceutical Society.
Full Text Available Hypertension is a modifiable risk factor for cardiovascular disease. Despite this, patients often cannot or inaccurately estimate their risk factors.Objectives: In order to improve pharmacist interventions, we sought to: 1 find out patients’ knowledge about blood pressure (BP and their self- monitoring behaviors and 2 identify the relationships between these two elements. Specifically, if evaluation of BP control were related to knowledge of one’s BP level and self-monitoring habits, and if knowledge of one’s target and BP level varied with monitoring habits. Methods: Final year pharmacy students were trained and interviewed patients in community pharmacies as a required exercise in their pharmacy clerkship. Each student recruited a convenience sample of 5-10 patients who were on hypertension medication, and surveyed them regarding their BP targets, recent BP levels as well as monthly and home BP monitoring practices. Results: One third of the 449 patients interviewed were able to report a blood pressure target with 26% reporting a JNC 7 recognized target. Three quarters of patients who reported a blood pressure target were able to report a blood pressure level, with 12% being at their self- reported target. Roughly two thirds of patients perceived their BP to be “about right”, and slightly less than a third thought it to be “high”. Sixty percent of patients monitor their BP monthly, but less than 50% of patients practice home BP monitoring. Conclusions: This study along with others before it point to the knowledge and self-management gaps in patients with chronic conditions. Furthermore, pharmacy students were able to use a brief intervention to screen patients during routine care. Pharmacists can help improve patient understanding and promote increased self-management through regular BP monitoring.
Reed-Kane, Dana; Vasquez, Kellie; Pavlik, Aaron; Peragine, Johanna; Sandberg, Michelle
Despite apparent benefits, electronic prescribing systems still face numerous challenges. Errors associated with electronic prescriptions can often lead to workflow disruptions. This may be particularly disruptive in smaller, independent community pharmacies that may not have the staffing resources to adequately cope with an increase in required correspondence with prescriber offices. The objective of this study was to follow-up on a 2012 quality-improvement project evaluating electronic prescription error type, error rate, and time between error discovery and resolution in an independent compounding pharmacy. The study design was quality improvement with descriptive data. Data were collected over a four-week period during which time the pharmacists completed a data collection form for each electronic prescription received that contained an error. Percentages were calculated for error type, error rate, and error resolution type. Using range, mean, and standard deviation, time until error resolution was reported. In the four-week study period an e-prescribing error rate of 23.2% was identified (32 errors identified in 138 e-prescriptions). The most frequent error was an invalid electronic prescription signature for a controlled substance (31.3%, n = 10). The most commonly used error resolution method was a phone call to the physician (59%, n = 19). The average time to resolve the most frequent error type was 10.30 hours with a standard deviation of 18.18 hours. The results show a 40% decrease in the number of e-prescription errors identified compared to the quality-improvement evaluation done in the same pharmacy one year ago. E-prescription errors continue to disrupt workflow and impede patient care but perhaps at a lower rate. Pharmacies should implement a quality-improvement review process to help identify solutions to systems issues.
Gilliam, Laura; Gulløv, Eva
In this paper we discuss, how the formative work with children, as it occurs in the everyday practices of Danish schools, relates to broader cultural ideals of personhood, citizens and societies developed in Denmark since the Second World War. Through analysis of one empirical case, we show how...... hand upbringing in child-institutions reflect broader cultural ideals and visions, but on the other hand, through the vast institutionalisation of children in Denmark, the framework and conditions of everyday life in these institutions has also made a large impact on the very ideas of proper...
Crnjanski, Tatjana; Krajnovic, Dusanka; Tadic, Ivana; Stojkov, Svetlana; Savic, Mirko
Many problems that arise when providing pharmacy services may contain some ethical components and the aims of this study were to develop and validate a scale that could assess difficulties of ethical issues, as well as the frequency of those occurrences in everyday practice of community pharmacists. Development and validation of the scale was conducted in three phases: (1) generating items for the initial survey instrument after qualitative analysis; (2) defining the design and format of the instrument; (3) validation of the instrument. The constructed Ethical Issue scale for community pharmacy setting has two parts containing the same 16 items for assessing the difficulty and frequency thereof. The results of the 171 completely filled out scales were analyzed (response rate 74.89%). The Cronbach's α value of the part of the instrument that examines difficulties of the ethical situations was 0.83 and for the part of the instrument that examined frequency of the ethical situations was 0.84. Test-retest reliability for both parts of the instrument was satisfactory with all Interclass correlation coefficient (ICC) values above 0.6, (for the part that examines severity ICC = 0.809, for the part that examines frequency ICC = 0.929). The 16-item scale, as a self assessment tool, demonstrated a high degree of content, criterion, and construct validity and test-retest reliability. The results support its use as a research tool to asses difficulty and frequency of ethical issues in community pharmacy setting. The validated scale needs to be further employed on a larger sample of pharmacists.
Full Text Available Background: A correct selection of drugs prescribed, but also the choice of the appropriate inhaler device, is crucial for the control of respiratory diseases. Objective: To evaluate the inhaler technique and identify potential errors of patients when treated with inhalers by testing a routinary procedure to be implemented in any community pharmacy. Methods: Adults with asthma/COPD and under inhalation therapy were invited to demonstrate how they use their inhalers. After direct observation it was registered whether all the sequential steps included in the summary of product characteristics (SmPC were performed. Results: The study involved 67 patients from 4 community pharmacies (Portugal central region: 34 (50.7% males, 65.4 (SD=18.28 years old, 42 (62.7% with COPD, and 23 (34.3% using more than one inhaler. The 67 patients used 95 inhalers, comprising: 57 (60.0% multiple dose DPI (dry powder inhalers, 18 (18.9% single dose DPI, 16 (16.8% pMDI (pressurized metered dose inhalers, 2 (2.1% pMDI+spacer and 2 (2.1% SMI (soft mist inhalers. No errors were made only by 9 (13.4% patients. In the 75 DPIs techniques, the most frequent errors were ‘no previous forced expiration’ (46=61.3% and ‘no 10s apnea after inhalation’ (51=68.0%; in the 16 pMDIs techniques common errors were ‘lack of hand-lung coordination’ (7=43.8 %, ‘no previous forced exhalation’ (8=50.0% and ‘no apnea after inhalation’ (10=62.5%. After inhaling from 56 devices containing corticosteroids, 34 (60.7% of the patients did not wash their mouth. Conclusion: The study demonstrated the possibility of performing this procedure routinely in Portuguese community pharmacies and also its utility, since 58 (87% of patients had at least one error during the inhalers use.
Grainger-Rousseau, T J; Miralles, M A; Hepler, C D; Segal, R; Doty, R E; Ben-Joseph, R
To design a pharmaceutical care model, and develop and field test a set of community pharmacy guidelines and practice support materials--Therapeutic Outcomes Monitoring (TOM) modules. Concept interviews with pharmacists, physicians, and patients; development and field testing of practice guidelines. Community pharmacies. Five independent, five chain, and two clinic site pharmacies. A prototype TOM module for asthma was developed through a seven-step process. Concept interviews were held with pharmacists, physicians, and patients to determine the desirability and feasibility of the TOM concept, prototype, and materials. Two field tests were completed and modifications made. Results were gathered through further concept interviews at the completion of the second field tests. Participants' opinions and experiences. Pharmacists, physicians, and patients expressed favorable attitudes about community pharmacists' participation in this pharmaceutical care model. Of the 12 participating pharmacists, 7 successfully implemented TOM in their practice sites and participated in the project throughout the testing; 49 patients were recruited into the study; and 22 patients remained in the program at the end of the second field test. In providing TOM services to these patients, the two most problematic areas for the pharmacists were in documenting care and reporting to physicians. A final phase of the TOM project has not been conducted in the United States because of insufficient numbers of patients for evaluating patient outcomes. The TOM project was successful from a technical but not a marketing perspective. Useful practice guidelines can be written and taught to pharmacists. Enrollment of patients was difficult, and the concept is not likely to spread spontaneously within the existing market for pharmaceutical services.
Frail, Caitlin K; Cooper, Susan; Gallagher, Tim; Sarkis, Josh; Topor, Laura; Bruzek, Richard J
To assess the impact of a health plan and community pharmacy partnership to improve blood pressure control. A midwestern health plan and a regional community pharmacy chain. Health plan members with a hypertension diagnosis and attributed to the pharmacy chain based on prescription claims were invited to participate. Interested patients enrolled in the program at their pharmacies and were assigned a "smart card" for use with a blood pressure kiosk in the pharmacy. When the card was used at the kiosk, individual patient readings were linked directly to their electronic pharmacy record and an online patient portal. Pharmacists intervened with patients and prescribers as necessary to address adherence issues and adjust therapy as needed. Before and after blood pressure readings were assessed to determine the impact of patient self-monitoring and pharmacist intervention for patients with 1) uncontrolled blood pressure at first reading and 2) multiple readings throughout the pilot period. Fifty-six of 276 eligible patients (20%) were enrolled in the program. Fourteen patients qualified for before and after assessments, having uncontrolled blood pressure on initial reading and multiple readings throughout the pilot. These patients demonstrated a mean reduction in systolic blood pressure of 12 mm Hg and diastolic blood pressure of 8 mm Hg. Nine of 16 eligible pharmacy locations enrolled patients at their sites. Challenges faced in the initiative included gaining adequate pharmacist and patient engagement. The pilot demonstrated promising early results in a model that has potential to improve blood pressure monitoring and management in a community pharmacy setting. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
The focus of this article is to draw attention to the presence and importance of travelling ideas, knowledge, and practices in Danish history of educational test- ing. The article introduces and employs a spatial methodological approach in relation to the connections between the international...... testing community and the emerging Danish practice of intelligence testing in the interwar years. The arti- cle represents a contribution to an investigation of the social and cultural exchange of educational ideas between the Anglo-Saxon world and Scandinavia, in general, and Denmark in particular....... Moreover, the article argues for the posi- tive gains of drawing on a spatial frame of interpretation when dealing with national educational history....
Full Text Available Suzanne G Bollmeier, Theresa R ProsserSt Louis College of Pharmacy, St Louis, MO, USAAbstract: Achieving and maintaining asthma control and improving patients’ quality of life are cornerstones of asthma management. This review summarizes the current literature related to services provided by community pharmacists to patients with asthma. Comprehensive asthma programs provided by community pharmacists have improved patients’ knowledge of the disease, device technique skills, patient adherence, and quality of life. One study shows such comprehensive programs are cost effective in patients with severe or uncontrolled asthma, which cannot be extrapolated to all programs. Targeted interventions by pharmacists could be provided to a larger population of patients. Pharmacists have identified that lack of time, resources, and training are barriers to implementing asthma programs. In addition, optimal models are needed to integrate interventions into the dispensing workflow. Optimal training programs should include skills in problem solving, device technique, and counseling. A movement towards “institutionalizing” routine asthma interventions or patient encounters is necessary if consistent services are to be given to all patients, and appropriate compensation is provided for pharmacist services.Keywords: community, pharmacy, pharmacist, asthma, education
Nationality underwrites a great deal of the Danish asylum process, and of the refugee regime as a whole. The housing and care of asylum seekers, handled by the Danish Red Cross, is based on classifications by nationality. Bending a phrase from Benedict Anderson, these might be called "appointed...... communities". While the Danish asylum system in principle performs individual determination procedures for asylum seekers, granting refugee status on a case-by-case basis, in practice those identified as Iraqi or Afghani have had a very high acceptance rate. However, it is clearly the case that not all asylum...... seekers have citizenship of the countries they claim to come from, or indeed feel they come from the countries of which they have citizenship. In this context, we must enquire about the mechanics of determining nationality and about how asylum seekers themselves relate to national identities. I argue...
Feehan, M; Ranker, L; Durante, R; Cooper, D K; Jones, G J; Young, D C; Munger, M A
Non-adherence to controller asthma medications is an important public health problem. It is estimated to occur in 30-70% of individuals and is a significant risk factor for asthma morbidity and mortality. The aim of this study was to determine the level of adherence, as indicated by refill rates, to controller asthma medications in a community pharmacy setting. Secondary analyses of a community pharmacy dispensing database in 15 locations throughout Utah. The dispensing records of 2193 patients who received controller medications for asthma in a 12-month period, and had a minimum of 6-month potential coverage (180 days) from the date of their first receipt of a controller medication in that period, were examined. Using standard metrics to gauge adherence, the proportion of days covered (PDC) and the medication possession ratio (MPR), the average coverage for controller asthma medications across a 6-month period (180 days) was poor, averaging less than 50% of days' availability. Standard cut-offs (≥80% medication availability) indicated that only 14-16% of patients had 'satisfactory' adherence over their 6-month follow-on period. Females and older patients had significantly greater satisfactory adherence. Medication adherence was significantly greater with inhaled corticosteroid (ICS)-long-acting β 2 -agonist (LABA) combinations than with ICS alone. This study confirms the considerable scope of the asthma therapy non-adherence problem. Therefore, it is imperative to conduct survey-based research linked directly to pharmacy-based dispensing data to derive patient behavioural, attitudinal and environmental factors that may contribute to the issue, and then pilot and evaluate interventions for change. © 2015 John Wiley & Sons Ltd.
Cohen, Michael R; Smetzer, Judy L; Westphal, John E; Comden, Sharon Conrow; Horn, Donna M
To determine whether sociotechnical probabilistic risk assessment can create accurate approximations of detailed risk models that describe error pathways, estimate the incidence of preventable adverse drug events (PADEs) with high-alert medications, rank the effectiveness of interventions, and provide a more informative picture of risk in the community pharmacy setting than is available currently. Developmental study. 22 community pharmacies representing three U.S. regions. Model-building group: six pharmacists and three technicians. Model validation group: 11 pharmacists; staff at two pharmacies observed. A model-building team built 10 event trees that estimated the incidence of PADEs for four high-alert medications: warfarin, fentanyl transdermal systems, oral methotrexate, and insulin analogs. Validation of event tree structure and incidence of defined PADEs with targeted medications. PADEs with the highest incidence included dispensing the wrong dose/strength of warfarin as a result of data entry error (1.83/1,000 prescriptions), dispensing warfarin to the wrong patient (1.22/1,000 prescriptions), and dispensing an inappropriate fentanyl system dose due to a prescribing error (7.30/10,000 prescriptions). PADEs with the lowest incidence included dispensing the wrong drug when filling a warfarin prescription (9.43/1 billion prescriptions). The largest quantifiable reductions in risk were provided by increasing patient counseling (27-68% reduction), conducting a second data entry verification process during product verification (50-87% reduction), computer alerts that can't be bypassed easily (up to 100% reduction), opening the bag at the point of sale (56% reduction), and use of barcoding technology (almost a 100,000% increase in risk if technology not used). Combining two or more interventions resulted in further overall reduction in risk. The risk models define thousands of ways process failures and behavioral elements combine to lead to PADEs. This level of
Mak, Pey Wen; Singleton, Judith
The past decade has seen a rapid change in the climate system with an increased risk of extreme weather events. On and following the 3rd of January 2013, Tasmania experienced three catastrophic bushfires, which led to the evacuation of several communities, the loss of many properties, and a financial cost of approximately AUD$80 million. To explore the impacts of the 2012/2013 Tasmanian bushfires on community pharmacies. Qualitative research methods were undertaken, employing semi-structured telephone interviews with a purposive sample of seven Tasmanian pharmacists. The interviews were recorded and transcribed, and two different methods were used to analyze the text. The first method utilized Leximancer ® text analytics software to provide a birds-eye view of the conceptual structure of the text. The second method involved manual, open and axial coding, conducted independently by the two researchers for inter-rater reliability, to identify key themes in the discourse. Two main themes were identified - 'people' and 'supply' - from which six key concepts were derived. The six concepts were 'patients,' 'pharmacists,' 'local doctor,' 'pharmacy operations,' 'disaster management planning,' and 'emergency supply regulation.' This study identified challenges faced by community pharmacists during Tasmanian bushfires. Interviewees highlighted the need for both the Tasmanian State Government and the Australian Federal Government to recognize the important primary care role that community pharmacists play during natural disasters, and therefore involve pharmacists in disaster management planning. They called for greater support and guidance for community pharmacists from regulatory and other government bodies during these events. Their comments highlighted the need for a review of Tasmania's three-day emergency supply regulation that allows pharmacists to provide a three-day supply of a patient's medication without a doctor's prescription in an emergency situation. Copyright
Full Text Available Objectives: The use of inhaled corticosteroids is the standard maintenance therapy in asthma therapy and as adjunct therapy in moderate to severe chronic obstructive pulmonary disease. A dose-related increase in fracture risk is associated with inhaled corticosteroid use; there is an inverse relationship between bone mineral density and duration and cumulative dose of inhaled corticosteroid. Adequate intake of calcium and vitamin D are cornerstones of osteoporosis prevention. The objectives are to assess whether the proportion of patients receiving inhaled corticosteroids are taking calcium and vitamin D; the association between long-term inhaled corticosteroid use and abnormal bone mineral density or fractures; and how many qualified patients received bone mineral density scans. Methods: Patients who filled a prescription for inhaled corticosteroids at selected community pharmacies across Alberta were recruited for a survey of their osteoporosis prevention activities. Results: A total of 256 patients from 12 community pharmacies were included. The average age was 60 ± 17.4 years with 65% female. There were 21%, 51%, and 28% of patients on high, medium, and low dose inhaled corticosteroids, respectively. Only 17% of patients >50 years old received recommended calcium and vitamin D supplementation and 87 (73% of the qualified patients received bone mineral density scan. Conclusion: Osteoporosis prevention in inhaled corticosteroid users is currently poorly addressed. More promotion is needed to raise pharmacist awareness of the risks of inhaled corticosteroids.
Gascoyne, Alexandra; Beyene, Kebede; Stewart, Joanna; Aspden, Trudi; Sheridan, Janie
The practice of medication sharing, the lending (giving) or borrowing (taking) of prescription medicines, has been reported increasingly in the literature. This study aimed to investigate prescription medication sharing practices among adults in Auckland, New Zealand. Community pharmacies in Auckland. A cross-sectional survey was conducted in ten community pharmacies in Auckland during March, 2012. Clients were invited to complete an anonymous questionnaire to assess their medication sharing practices. Proportion of respondents reporting lending or borrowing; information provided or received. Of all participants (N = 642), 25.5% reported borrowing, and 24.1% reported lending prescribed medicines in the past year. Furthermore, 14.8% of participants reported ever giving a child's prescribed medicine to another child in their care, and 49.8% reported having leftover prescription medicines at home. Of those who borrowed medicines (n = 164), 56.1% received written medication instructions from the lender, and of the lenders (n = 155), 47.1% provided verbal instructions with the lent medicines. The sharing of prescription medicines in Auckland appears to be similar to that reported in other developed countries, and it is now clear that information provision while sharing does not always occur. Approaches to reduce harm resulting from sharing medicines should be explored.
Brata, Cecilia; Marjadi, Brahmaputra; Schneider, Carl R; Murray, Kevin; Clifford, Rhonda M
Gathering sufficient information when handling self-medication requests in community pharmacies is an important factor in assisting patients to obtain appropriate health outcomes. Common types of information usually gathered include patient identity, signs and symptoms, action taken, medical history, and current medications being used. The aims of the study were (1) to describe the types and amount of information gathered by Eastern Indonesian community pharmacy staff when handling self-medication requests, and (2) to identify factors associated with the reported amount of information gathered. Patient simulation and pharmacy staff interviews were used. First, patient simulation was conducted using 2 cough scenarios and 1 diarrhoea scenario. Second, a structured interview was administered to eligible pharmacy staff in the setting. The types and amount of information gathered during patient simulation encounters and reported during pharmacy staff interviews were noted. A regression analysis was performed to identify factors associated with the amount of information gathered from the interview data. The most frequent types of information gathered in patient simulation encounters were the nature of symptoms (88% in one of the cough scenarios) and patient identity (96% in the diarrhoea scenario). Other types of information were gathered in 90% of the 173 interviewees reported that they gathered information on patient identity, nature of symptoms, and associated symptoms. Information on medical history and medication used was gathered by 20% and 26% respectively of the 173 interviewees. The majority of pharmacy staff asked 0 to 2 questions in the patient simulation encounters compared to 5 questions pharmacy staff reported as their usual practice during the interviews. Being qualified as a pharmacist or a pharmacy technician was one of the factors positively associated with the reported amount of information gathered. There were deficits in the types of information
Refer-to-Pharmacy is the first fully integrated hospital to community pharmacy referral system. This article explains the importance of these referrals for patients and health economies to improve medicines optimisation, and how Refer-to-Pharmacy works in both hospital and community pharmacies.
Chinthammit, Chanadda; Rupp, Michael T; Armstrong, Edward P; Modisett, Tara; Snead, Rebecca P; Warholak, Terri L
The importance of creating and sustaining a strong culture of patient safety has been recognized as a critical component of safe medication use. This study aims to assess changes in attitudes toward patient safety culture and frequency of quality-related event (QRE) reporting after guided implementation of a continuous quality improvement (CQI) program in a panel of community pharmacies in the United States (U.S.). Twenty-one community pharmacies volunteered to participate in the project and were randomly assigned to intervention or control groups. Pharmacy staff in the intervention group received guided training to ensure full implementation of a CQI program while those in the control group partially implemented the program. Pharmacy staff in both groups completed retrospective pre-post safety culture questionnaires and reported medication errors and near misses that occurred in their practices. Rasch analysis was applied to assess questionnaire validity and reliability and to confirm if the ordinal level data approximated interval level measures. Paired t-tests and repeated measure analysis of covariance tests were subsequently used to compare observed changes in the attitudes of subjects and frequency of QREs reporting in intervention and control groups. Sixty-nine employees completed the questionnaire, a 43.9% response rate. Improvement in attitudes toward patient safety was statistically significant in the intervention group in six domains: staff, training, and skill ( p = 0.017); patient counseling ( p = 0.043); communication about mistakes ( p continuous improvement ( p < 0.001); and overall patient safety perceptions ( p = 0.033). No significant differences were observed in QRE reporting rates between intervention and control groups. However, differences were observed in the types of QREs reported (e.g., incorrect safety cap) and the point in the prescription processing workflow where a QRE was detected (e.g., partner check station, and drug
McMillan, Sara S; Kelly, Fiona; Hattingh, H Laetitia; Fowler, Jane L; Mihala, Gabor; Wheeler, Amanda J
Mental illness is a worldwide health priority. As medication is commonly used to treat mental illness, community pharmacy staff is well placed to assist consumers. To evaluate the effectiveness of a multifaceted, community pharmacy medication support service for mental health consumers. Pharmacists and pharmacy support staff in three Australian states were trained to deliver a flexible, goal-oriented medication support service for adults with mental illness over 3-6 months. Consumer-related outcome measures included perceptions of illness and health-related quality of life, medication beliefs, treatment satisfaction and medication adherence. Fifty-five of 100 trained pharmacies completed the intervention with 295 of the 418 recruited consumers (70.6% completion rate); 51.2% of consumers received two or more follow-ups. Significant improvements were reported by consumers for overall perceptions of illness (p mental health domain of quality of life (p medication (p = 0.001) and global satisfaction with medication (p medication adherence (p = 0.005). A community pharmacy mental health medication support service that is goal-oriented, flexible and individualised, improved consumer outcomes across various measures. While further research into the cost-effectiveness and sustainability of such a service is warranted, this intervention could easily be adapted to other contexts.
Full Text Available The Community Pharmacy of the Department of Ambulatory Care and Community Medicine (Policlinique Médicale Universitaire, PMU, University of Lausanne, developed and implemented an interdisciplinary medication adherence program. The program aims to support and reinforce medication adherence through a multifactorial and interdisciplinary intervention. Motivational interviewing is combined with medication adherence electronic monitors (MEMS, Aardex MWV and a report to patient, physician, nurse, and other pharmacists. This program has become a routine activity and was extended for use with all chronic diseases. From 2004 to 2014, there were 819 patient inclusions, and 268 patients were in follow-up in 2014. This paper aims to present the organization and program’s context, statistical data, published research, and future perspectives.
Full Text Available Work-related stress and burnout syndromes are unfortunately common comorbidities found in health professionals. However, burnout syndrome has only been partly and episodically assessed for community pharmacists whereas these professionals are exposed to patients' demands and difficulties every day. Prevalence of burnout, associated comorbidities and coping strategies were assessed in pharmacy teams (pharmacists and pharmacy technicians in French community pharmacies.This online survey was performed by emails sent to all French community pharmacies over 3 months. The survey assessed the prevalence of burnout (Maslach Burnout Inventory-MBI-questionnaire, anxiety, depression and strategies for coping with work-related stress.Of the 1,339 questionnaires received, 1,322 were completed and useable for the analysis. Burnout syndrome was detected in 56.2% of respondents and 10.5% of them presented severe burnout syndrome. Severe burnout syndrome was significantly associated with men, large urban areas and the number of hours worked. Depression and anxiety were found in 15.7% and 42.4% of respondents, respectively. These co-morbidities were significantly associated with severe burnout syndrome. Higher MBI scores were significantly associated with medical consultations and medicinal drug use. Conversely, respondents suffering from burnout syndrome declared they resorted less to non-medical strategies to manage their work-related stress (leisure, psychotherapy, holidays and time off.This study demonstrated that community pharmacists and pharmacy technicians presented high prevalence of burnout syndrome, such as many healthcare professionals. Unfortunately, burnout syndrome was associated with several comorbidities (anxiety, depression and alcohol abuse and the consumption of health resources. The psychological suffering of these healthcare professionals underlines the necessity to deploy a strategy to detect and manage burnout in community pharmacy.
Balayssac, David; Pereira, Bruno; Virot, Julie; Collin, Aurore; Alapini, David; Cuny, Damien; Gagnaire, Jean-Marc; Authier, Nicolas; Vennat, Brigitte
Work-related stress and burnout syndromes are unfortunately common comorbidities found in health professionals. However, burnout syndrome has only been partly and episodically assessed for community pharmacists whereas these professionals are exposed to patients' demands and difficulties every day. Prevalence of burnout, associated comorbidities and coping strategies were assessed in pharmacy teams (pharmacists and pharmacy technicians) in French community pharmacies. This online survey was performed by emails sent to all French community pharmacies over 3 months. The survey assessed the prevalence of burnout (Maslach Burnout Inventory-MBI-questionnaire), anxiety, depression and strategies for coping with work-related stress. Of the 1,339 questionnaires received, 1,322 were completed and useable for the analysis. Burnout syndrome was detected in 56.2% of respondents and 10.5% of them presented severe burnout syndrome. Severe burnout syndrome was significantly associated with men, large urban areas and the number of hours worked. Depression and anxiety were found in 15.7% and 42.4% of respondents, respectively. These co-morbidities were significantly associated with severe burnout syndrome. Higher MBI scores were significantly associated with medical consultations and medicinal drug use. Conversely, respondents suffering from burnout syndrome declared they resorted less to non-medical strategies to manage their work-related stress (leisure, psychotherapy, holidays and time off). This study demonstrated that community pharmacists and pharmacy technicians presented high prevalence of burnout syndrome, such as many healthcare professionals. Unfortunately, burnout syndrome was associated with several comorbidities (anxiety, depression and alcohol abuse) and the consumption of health resources. The psychological suffering of these healthcare professionals underlines the necessity to deploy a strategy to detect and manage burnout in community pharmacy.
Jacobs, Sally; Johnson, Sheena; Hassell, Karen
Workplace stress in community pharmacy is increasing internationally due, in part, to pharmacists' expanding roles and escalating workloads. Whilst the business case for preventing and managing workplace stress by employers is strong, there is little evidence for the effectiveness of organisational stress management interventions in community pharmacy settings. To identify and synthesise existing evidence for the effectiveness of organisational solutions to workplace stress from the wider organisational literature which may be adaptable to community pharmacies. A secondary synthesis of existing reviews. Publications were identified through keyword searches of electronic databases and the internet; inclusion and exclusion criteria were applied; data about setting, intervention, method of evaluation, effectiveness and conclusions (including factors for success) were extracted and synthesised. Eighteen reviews of the stress management and prevention literature were identified. A comprehensive list of organisational interventions to prevent or manage workplace stress, ordered by prevalence of evidence of effectiveness, was produced, together with an ordered list of the benefits both to the individual and employing organisation. An evidence-based model of best practice was derived specifying eight factors for success: top management support, context-specific interventions, combined organisational and individual interventions, a participative approach, clearly delineated tasks and responsibilities, buy-in from middle management, change agents as facilitators and change in organisational culture. This literature review provides community pharmacy organisations with evidence from which to develop effective and successful stress management strategies to support pharmacists and pharmacy staff. Well-designed trials of stress management interventions in community pharmacy organisations are still required. © 2017 Royal Pharmaceutical Society.
Naik-Panvelkar, Pradnya; Armour, Carol; Rose, John M; Saini, Bandana
Specialized community pharmacy services, involving the provision of disease state management and care by pharmacists, have been developed and trialled and have demonstrated very good health outcomes. Most of these services have been developed from a healthcare professional perspective. However, for the future uptake and long-term sustainability of these services as well as for better and sustained health outcomes for patients, it is vital to gain an understanding of patients' preferences. We can then structure healthcare services to match these preferences and needs rather than around clinical viewpoints alone. The aim of this study was to elicit patient preferences for pharmacy-based specialized asthma services using a discrete choice experiment and to explore the value/importance that patients place on the different attributes of the asthma service. The existence of preference heterogeneity in the population was also investigated. The study was conducted with asthma patients who had recently experienced a specialized asthma management service at their pharmacy in New South Wales, Australia. Pharmacists delivering the asthma service mailed out the discrete choice questionnaires to participating patients at the end of 6 months of service provision. A latent class (LC) model was used to investigate each patient's strength of preference and preference heterogeneity for several key attributes related to asthma service provision: frequency of visits, access to pharmacist, interaction with pharmacy staff, availability of a private area for consultation, provision of lung function testing, type and depth of advice provision, number of days with asthma symptoms and cost of service. Eighty useable questionnaires (of 170 questionnaires sent out) were received (response rate 47.1%). The study identified various key elements of asthma services important to patients. Further, the LC analysis revealed three classes with differing patient preferences for levels of asthma service
Meagen M. Rosenthal
Full Text Available The integration of advanced pharmacy services into community pharmacy practice is not complete. According to implementation research understanding professional culture, as a part of context, may provide insights for accelerating this process. There are three objectives in this study. The first objective of this study was to validate an adapted version of an organizational culture measure in a sample of United States’ (US community pharmacists. The second objective was to examine potential relationships between the cultural factors identified using the validated instrument and a number of socialization and education variables. The third objective was to examine any relationships between the scores on the identified cultural factors and the provision of MTM services. This study was a cross-sectional online survey for community pharmacists in the southeastern US. The survey contained questions on socialization/education, respondents’ self-reported provision of medication therapy management (MTM services, and the organizational culture profile (OCP. Analyses included descriptive statistics, a principle components analysis (PCA, independent samples t-test, and multivariate ordinal regression. A total of 303 surveys were completed. The PCA revealed a six-factor structure: social responsibility, innovation, people orientation, competitiveness, attention to detail, and reward orientation. Further analysis revealed significant relationships between social responsibility and years in practice, and people orientation and attention to detail and pharmacists’ training and practice setting. Significant positive relationships were observed between social responsibility, innovation, and competitiveness and the increased provision of MTM services. The significant relationships identified between the OCP factors and community pharmacist respondents’ provision of MTM services provides an important starting point for developing interventions to improve the
Gregório, João; Russo, Giuliano; Lapão, Luís Velez
The current financial crisis is pressing health systems to reduce costs while looking to improve service standards. In this context, the necessity to optimize health care systems management has become an imperative. However, little research has been conducted on health care and pharmaceutical services cost management. Pharmaceutical services optimization requires a comprehensive understanding of resources usage and its costs. This study explores the development of a time-driven activity-based costing (TDABC) model, with the objective of calculating the cost of pharmaceutical services to help inform policy-making. Pharmaceutical services supply patterns were studied in three pharmacies during a weekday through an observational study. Details of each activity's execution were recorded, including time spent per activity performed by pharmacists. Data on pharmacy costs was obtained through pharmacies' accounting records. The calculated cost of a dispensing service in these pharmacies ranged from €3.16 to €4.29. The cost of a counseling service when no medicine was supplied ranged from €1.24 to €1.46. The cost of health screening services ranged from €2.86 to €4.55. The presented TDABC model gives us new insights on management and costs of community pharmacies. This study shows the importance of cost analysis for health care services, specifically on pharmaceutical services, in order to better inform pharmacies' management and the elaboration of pharmaceutical policies. Copyright © 2016 Elsevier Inc. All rights reserved.
van de Pol, Jeroen M; Geljon, Jurjen G; Belitser, Svetlana V; Frederix, Geert W J; Hövels, Anke M; Bouvy, Marcel L
The nature of community pharmacy is changing, shifting from the preparation and distribution of medicines to the provision of cognitive pharmaceutical services (CPS); however, often the provision of traditional services leaves little time for innovative services. This study investigated the time community pharmacists spend on the tasks and activities of daily practice and to what extent they are able to implement CPS-related services in daily practice. Self-reporting work sampling was used to register the activities of community pharmacists. A smartphone application, designed specifically for this purpose, alerted participants to register their current activity five times per working day for 6 weeks. Participants also completed an online survey about baseline characteristics. Ninety-one Dutch community pharmacists provided work-sampling data (7848 registered activities). Overall, 51.5% of their time was spent on professional activities, 35.4% on semi-professional activities, and 13.1% on non-professional activities. The proportion of time devoted to CPS decreased during the workweek, whereas the time spent on traditional task increased. This study shows it is feasible to collect work-sampling data using smartphone technology. Community pharmacists spent almost half of their time on semi-professional and non-professional activities, activities that could be delegated to other staff members. In practice, the transition to CPS is hampered by competing traditional tasks, which prevents community pharmacists from profiling themselves as pharmaceutical experts in daily practice. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.
Zehnder, Simon; Bruppacher, Rudolf; Ruppanner, Hans; Hersberger, Kurt E
There are multiple ways in which community pharmacies can present themselves on the Internet, e.g., as a platform for drug information or as an advertising platform for their services. To estimate the number of Swiss community pharmacies on the Internet over the period of 32 months (2000-2003), to describe their current e-commerce services, and to explore the experiences and plans these pharmacies have with regard to their Internet presence. A longitudinal study was performed to determine the number of Swiss German pharmacies on the Internet by conducting Internet searches in 2000, 2001, and 2003. In April 2002, a cross-sectional Internet-based survey was administered to explore the pharmacies' experiences and plans regarding their Web sites. As of April 2003, 373 (44%) of 852 community pharmacies from the German speaking part of Switzerland were on the Internet. One hundred eighty four listed an e-mail address and were asked to complete a questionnaire. Of the 107 pharmacies answering the survey questions (58% response rate): 46% had been on the Internet for 1 to 2 years; 33% of the Web sites are part of a pharmacy group's Web portal; 31% of the pharmacies plan to expand their Internet appearance in the future; 74% provide e-commerce services, with 81% of those pharmacies filling five or less orders per month; and 12% plan on expanding their e-commerce services in the future. The number of community pharmacies offering Internet services steadily increased over 32 months. Given the importance of the Internet as a tool for information, communication, and advertising for pharmacy products and services, it can be expected that the increase will continue. Pharmacy-group portals are important promoters of pharmacies on the Internet. For many community pharmacies, Internet portals that provide an Internet presence for the pharmacies and provide regularly-updated content (e.g., health news, tips, drug information) seem to be the most effective solutions. Even though 40
Bruppacher, Rudolf; Ruppanner, Hans; Hersberger, Kurt E
Background There are multiple ways in which community pharmacies can present themselves on the Internet, e.g., as a platform for drug information or as an advertising platform for their services. Objective To estimate the number of Swiss community pharmacies on the Internet over the period of 32 months (2000-2003), to describe their current e-commerce services, and to explore the experiences and plans these pharmacies have with regard to their Internet presence. Methods A longitudinal study was performed to determine the number of Swiss German pharmacies on the Internet by conducting Internet searches in 2000, 2001, and 2003. In April 2002, a cross-sectional Internet-based survey was administered to explore the pharmacies' experiences and plans regarding their Web sites. Results As of April 2003, 373 (44%) of 852 community pharmacies from the German speaking part of Switzerland were on the Internet. One hundred eighty four listed an e-mail address and were asked to complete a questionnaire. Of the 107 pharmacies answering the survey questions (58% response rate): 46% had been on the Internet for 1 to 2 years; 33% of the Web sites are part of a pharmacy group's Web portal; 31% of the pharmacies plan to expand their Internet appearance in the future; 74% provide e-commerce services, with 81% of those pharmacies filling five or less orders per month; and 12% plan on expanding their e-commerce services in the future. Conclusions The number of community pharmacies offering Internet services steadily increased over 32 months. Given the importance of the Internet as a tool for information, communication, and advertising for pharmacy products and services, it can be expected that the increase will continue. Pharmacy-group portals are important promoters of pharmacies on the Internet. For many community pharmacies, Internet portals that provide an Internet presence for the pharmacies and provide regularly-updated content (e.g., health news, tips, drug information) seem to
Lombardo, Simona; Cosentino, Marco
The Internet is increasingly used as a source of health-related information, and a vast majority of Internet users are performing health-related searches in the United States and Europe, with wide differences among countries. Health information searching behavior on the Internet is affected by multiple factors, including demographics, socioeconomic factors, education, employment, attitudes toward the Internet, and health conditions, and their knowledge may help to promote a safer use of the Internet. Limited information however exists so far about Internet use to search for medical information in Italy. The objective of this study was to investigate the use of the Internet for searching for information on medicines and disease in adult subjects in Northern Italy. Survey in randomly selected community pharmacies, using a self-administered questionnaire, with open and multiple choices questions, was conducted. A total of 1008 participants were enrolled (59.5% women; median age: 43 years; range: 14-88 years). Previous use of the Internet to search for information about medicines or dietary supplements was reported by 26.0% of respondents, more commonly by women (30.00% vs 20.10% men, P<.001), unmarried subjects (32.9% vs 17.4% widowed subjects, P=.022), and employed people (29.1% vs 10.4% retired people, P=.002). Use was highest in the age range of 26 to 35 (40.0% users vs 19.6% and 12.3% in the age range ≤25 and ≥56, respectively, P<.001) and increased with years of education (from 5.3% with 5 years, up to 41.0% with a university degree, P<.001). Previous use of the Internet to search for information about disease was reported by 59.1% of respondents, more commonly by women (64.5% vs 51.0% males, P<.001), unmarried subjects (64.2% vs 58.5% married or divorced subjects and 30.4% widowed subjects, P=.012), unemployed people (66.7% vs 64.0% workers and 29.9% retired people, P<.001). Use was highest in the age range of 26 to 35 (70.1% vs 64.4% in both 36-45 and 46
Cavaco, Afonso Miguel; Arslan, Miray; Şar, Sevgi
Alternative and complementary therapy systems, such as homeopathy, have long been used around the world. Since 1995 homeopathy has been officially recognized in Europe as a system of medicine or a medical specialty. Portuguese community pharmacists have long-standing experience with homeopathic products. By contrast, healthcare professionals in Turkey are less experienced with homeopathic practice although there is a new regulatory setting in place. There are a limited number of studies addressing pharmacists' role within the homeopathic system. To investigate the attitudes (knowledge, feelings and behaviour) of experienced Portuguese pharmacy practitioners who deal with homeopathy, and thus to inform Turkish pharmacy practice and policy on homeopathy-related success factors. A qualitative cross-sectional design was followed, using semi-structured and face-to-face individual interviews with purposively selected Portuguese pharmacists experienced with homeopathic medicines. Audio-recordings were transcribed verbatim and the transcriptions imported into QSR NVivo v10 software for qualitative coding and analysis. Using a thematic content approach, the extracted codes were grouped and indexed by recurrent themes through a reflective procedure and constant comparison. Six general themes emerged, the most relevant being participants' feelings of gratitude for the ability to work in homeopathy; other themes were a helpful regulatory body, clear practice boundaries, scientific support and product quality assurance. Specialized homeopathic education was considered the most important factor for success. This was related to patients' positive perceptions and acceptance, suggesting an increase in public awareness through the pharmacy network. Portuguese pharmacists' attitudes towards their homeopathic practices highlighted the key elements for success in a field that is usually distant from traditional pharmaceutical education and practice. The present findings provide
Cornér, Solveig; Pyhältö, Kirsi; Peltonen, Jouni
. The results showed that, both Danish and Finnish doctoral students, emphasized researcher community support over supervisory support. The Danish students, however, reported higher levels of researcher community support and experienced lower levels of friction than their Finnish counter partners. The results......-time/full-time status, d) attrition intentions, and e) engagement in international research activities? (3) What forms of support the Danish and Finnish doctoral students report? (4) How do the Danish and Finnish doctoral students perceive the support fit? Altogether, 356 doctoral students within the humanities...... indicated that the only form of support in which the students expressed more matched support than mismatched support was informational support. Further, Danish students reported a high level of mismatch in emotional support than their Finnish counter partners. The findings imply that seemingly similar...
Boyle, Todd A.; Bishop, Andrea C.; Mahaffey, Thomas; MacKinnon, Neil J.; Ashcroft, Darren; Zwicker, Bev; Reid, Carolyn
Background Given the demanding nature of providing pharmacy services, coupled with the expanded scope of practice of the professions in jurisdictions around the world, greater commitment to continuous quality improvement through adoption of quality related event (QRE) reporting is necessary to ensure patient safety. Pharmacy regulatory authorities (PRAs) are in a unique position to enhance QRE reporting and learning through the standardization of expected practice Objective This study aims to better understand the perceived roles of PRAs in enhancing QRE reporting and learning in community pharmacies and identifying regulatory best practices to execute such roles. Methods A purposive case sampling approach was used to identify PRA staff members from two groups (deputy registrars and pharmacy inspectors) in 10 Canadian jurisdictions to participate in focus groups in the fall of 2011. Focus groups were used to explore perceptions of the role of PRAs in enhancing and promoting QRE reporting and learning, and perceived barriers to effective implementation in practice. Thematic analysis was used to analyze the qualitative data. Results Two focus groups were conducted, one with seven deputy registrars/practice managers and one with nine pharmacy inspectors. Five themes were identified, including (1) defining QRE reporting and compliance, (2) navigating role conflict, (3) educating for enhanced QRE reporting and learning, (4) promoting the positive/removing the fear of QREs, and (5) tailoring QRE reporting and learning consistency. Conclusions Overall, participants perceived a strong role for PRAs in enhancing QRE reporting and learning and providing education for pharmacies to support their compliance with reporting standards. However, PRAs must navigate the conflict inherent in both educating and promoting a process for achieving a standard while simultaneously inspecting compliance to that standard. Ensuring pharmacies have autonomy in operationalizing standards may
Watkins, Kim; Wood, Helen; Schneider, Carl R; Clifford, Rhonda
The clinical role of community pharmacists is expanding, as is the use of clinical guidelines in this setting. However, it is unclear which strategies are successful in implementing clinical guidelines and what outcomes can be achieved. The aim of this systematic review is to synthesise the literature on the implementation of clinical guidelines to community pharmacy. The objectives are to describe the implementation strategies used, describe the resulting outcomes and to assess the effectiveness of the strategies. A systematic search was performed in six electronic databases (Medline, EMBASE, CINAHL, Web of Science, Informit, Cochrane Library) for relevant articles. Studies were included if they reported on clinical guidelines implementation strategies in the community pharmacy setting. Two researchers completed the full-search strategy, data abstraction and quality assessments, independently. A third researcher acted as a moderator. Quality assessments were completed with three validated tools. A narrative synthesis was performed to analyse results. A total of 1937 articles were retrieved and the titles and abstracts were screened. Full-text screening was completed for 36 articles resulting in 19 articles (reporting on 22 studies) included for review. Implementation strategies were categorised according to a modified version of the EPOC taxonomy. Educational interventions were the most commonly utilised strategy (n = 20), and computerised decision support systems demonstrated the greatest effect (n = 4). Most studies were multifaceted and used more than one implementation strategy (n = 18). Overall outcomes were moderately positive (n = 17) but focused on process (n = 22) rather than patient (n = 3) or economic outcomes (n = 3). Most studies (n = 20) were rated as being of low methodological quality and having low or very low quality of evidence for outcomes. Studies in this review did not generally have a well thought
Full Text Available INTRODUCTION: Automated dose dispensing (ADD is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals. METHODS: The medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR reporting system were selected and characterized independently by two researchers. MAIN OUTCOME MEASURES: Person discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident. RESULTS: From January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4% incidents from community pharmacies and 11,428 (75.6% incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8% were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2% were related to ADD than in hospitals (41/11,428 = 0.4%. The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag. CONCLUSION: A proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an
Kirk, O; Glenthøj, Jonathan Peter; Dragsted, Ulrik Bak
INTRODUCTION: We report on the outcome of a study of patients hospitalised with community acquired pneumonia (HCAP) at a Danish university hospital. METHODOLOGY: In a retrospective study of 243 consecutive patients with radiographically verified HCAP, data on clinical and laboratory findings...... three months was 12% and the readmission rate within three months was 20%. The three treatment groups were comparable with respect to most demographic and clinical criteria at baseline. No significant differences in outcome between the groups were found: the mortality was 12.5%, 13.0%, and 10.......3%, respectively, p = 0.94, and the readmission rate 20.3%, 24.0%, and 14.8%, respectively; p = 0.63. CONCLUSION: Patients treated for community-acquired pneumonia at a Danish university hospital had clinical outcomes fully at height with findings from other countries, and half of the patients were successfully...
Armour, Carol; Bosnic-Anticevich, Sinthia; Brillant, Martha; Burton, Debbie; Emmerton, Lynne; Krass, Ines; Saini, Bandana; Smith, Lorraine; Stewart, Kay
Despite national disease management plans, optimal asthma management remains a challenge in Australia. Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current standards of best practice. The impact of the Pharmacy Asthma Care Program (PACP) on asthma control was assessed using a multi-site randomised intervention versus control repeated measures study design. Fifty Australian pharmacies were randomised into two groups: intervention pharmacies implemented the PACP (an ongoing cycle of assessment, goal setting, monitoring and review) to 191 patients over 6 months, while control pharmacies gave their usual care to 205 control patients. Both groups administered questionnaires and conducted spirometric testing at baseline and 6 months later. The main outcome measure was asthma severity/control status. 186 of 205 control patients (91%) and 165 of 191 intervention patients (86%) completed the study. The intervention resulted in improved asthma control: patients receiving the intervention were 2.7 times more likely to improve from "severe" to "not severe" than control patients (OR 2.68, 95% CI 1.64 to 4.37; p<0.001). The intervention also resulted in improved adherence to preventer medication (OR 1.89, 95% CI 1.08 to 3.30; p = 0.03), decreased mean daily dose of reliever medication (difference -149.11 microg, 95% CI -283.87 to -14.36; p=0.03), a shift in medication profile from reliever only to a combination of preventer, reliever with or without long-acting beta agonist (OR 3.80, 95% CI 1.40 to 10.32; p=0.01) and improved scores on risk of non-adherence (difference -0.44, 95% CI -0.69 to -0.18; p=0.04), quality of life (difference -0.23, 95% CI -0.46 to 0.00; p=0.05), asthma knowledge (difference 1.18, 95% CI 0.73 to 1.63; p<0.01) and perceived control of asthma questionnaires (difference -1.39, 95% CI -2.44 to -0.35; p<0.01). No significant change in spirometric measures occurred in either group. A pharmacist
Armour, Carol; Bosnic‐Anticevich, Sinthia; Brillant, Martha; Burton, Debbie; Emmerton, Lynne; Krass, Ines; Saini, Bandana; Smith, Lorraine; Stewart, Kay
Background Despite national disease management plans, optimal asthma management remains a challenge in Australia. Community pharmacists are ideally placed to implement new strategies that aim to ensure asthma care meets current standards of best practice. The impact of the Pharmacy Asthma Care Program (PACP) on asthma control was assessed using a multi‐site randomised intervention versus control repeated measures study design. Methods Fifty Australian pharmacies were randomised into two groups: intervention pharmacies implemented the PACP (an ongoing cycle of assessment, goal setting, monitoring and review) to 191 patients over 6 months, while control pharmacies gave their usual care to 205 control patients. Both groups administered questionnaires and conducted spirometric testing at baseline and 6 months later. The main outcome measure was asthma severity/control status. Results 186 of 205 control patients (91%) and 165 of 191 intervention patients (86%) completed the study. The intervention resulted in improved asthma control: patients receiving the intervention were 2.7 times more likely to improve from “severe” to “not severe” than control patients (OR 2.68, 95% CI 1.64 to 4.37; p<0.001). The intervention also resulted in improved adherence to preventer medication (OR 1.89, 95% CI 1.08 to 3.30; p = 0.03), decreased mean daily dose of reliever medication (difference −149.11 μg, 95% CI −283.87 to −14.36; p = 0.03), a shift in medication profile from reliever only to a combination of preventer, reliever with or without long‐acting β agonist (OR 3.80, 95% CI 1.40 to 10.32; p = 0.01) and improved scores on risk of non‐adherence (difference −0.44, 95% CI −0.69 to −0.18; p = 0.04), quality of life (difference −0.23, 95% CI −0.46 to 0.00; p = 0.05), asthma knowledge (difference 1.18, 95% CI 0.73 to 1.63; p<0.01) and perceived control of asthma questionnaires (difference −1.39, 95% CI −2.44 to −0.35; p<0
previously. In order to improve the public health services provided in community pharmacy, training must aim to increase pharmacists' confidence in providing these services. Confident, well trained pharmacists should be able to offer public health service more proactively which is likely to have a positive impact on customer attitudes and health. PMID:21777456
Ferguson Jill S
conducted nearly 10 years previously. In order to improve the public health services provided in community pharmacy, training must aim to increase pharmacists' confidence in providing these services. Confident, well trained pharmacists should be able to offer public health service more proactively which is likely to have a positive impact on customer attitudes and health.
Joaquín Salmerón Rubio
Full Text Available The scope of this article is to determine patients' knowledge about the medication they take. For this purpose, a cross-sectional, observational and descriptive study was conducted. Knowledge was measured by a valid and reliable questionnaire (CPM-PT-PT, given to the patients attending community pharmacies participating in the study, who had prescriptions for one or more drugs in the Lisbon Metropolitan Area. Knowledge was assessed in four dimensions: therapeutic objective, process of use, safety and maintenance of the medications that the patient takes. Thirty-five pharmacies participated, and 633 valid patients were obtained. Fully 82.5% (95% CI: 79.3% -85.3% were uninformed about the nature of the drug they use. In all items, there was a high percentage of patients with incorrect knowledge, with emphasis on precautions (44.7%. The dimension that the patients were least aware of was "drug safety" (1.9%. Eight out of 10 patients in the population do not know what drug they use. The highest lack of correct information was with respect to the "safety" of the medication.
Thompson, David C; Nuffer, Wesley; Brown, Kristen
To determine those characteristics that are most valued by members of the pharmacy practice community when hiring a new pharmacist. A survey instrument describing 20 characteristics that a pharmacy graduate may possess was created and sent to pharmacists licensed in Colorado. Respondents were asked to select and prioritize the top 5 characteristics considered most important in hiring a new graduate pharmacist. Responses were segregated by practice (retail vs. institutional) and/or by pharmacist role (manager vs. staff). Three hundred eighteen survey instruments were received. Having good/strong communication skills was the characteristic ranked highest by all groups. Professional behavior and being adaptable were also ranked highly. The characteristics of using the literature and punctuality ranked low overall. Differences were identified in how the groups valued some characteristics. Characteristics preferred in a new pharmacist varied depending on practice site and the managerial responsibilities of the potential employer. Some characteristics, such as communication skills and professional behavior, were considered of high value by all pharmacist groups.
Full Text Available Context: Self-medication is the use of unprescribed drugs; this means that people obtain drugs on their own initiative and without the assistance of health professionals. This is an increasingly common practice among the population that can cause numerous problems, becoming a public health problem. Aims: To determine the patterns of self-medication in customers who frequented a community pharmacy in the city of Antofagasta. Methods: A survey was conducted to 297 users over 18 years and with adequate mental and communicative power to answer the questions, and attending the pharmacy to buy a drug without a prescription. Results: The study revealed that of the 297 people who practiced self-medication, 41% do it with a frequency of at least once a month. The woman practiced in 64% and the men in 36%. The range of age of the studied group was between 31-50 years. The main reason to practice the self medication was to recognize symptoms (33%, within the most notable was the headache (11%. The therapeutic group of the most requested medicines was the NSAIDs (20%, and of them the paracetamol was the most used. Conclusions: The results reveal that a high percentage of customers surveyed self-medicate, which shows this practice as a real problem, so it is necessary to educate people.
Klepser, Donald G.; Xu, Liyan; Ullrich, Fred; Mueller, Keith J.
Purpose: Medicare Part D provided 3.4 million American seniors with prescription drug insurance. It may also have had an unintended effect on pharmacy viability. This study compares trends in the number of pharmacies and rate of pharmacy closures before and after the implementation of Medicare Part D. Methods: This retrospective observational…
Atkinson, Jeffrey; De Paepe, Kristien; Pozo, Antonio Sánchez; Rekkas, Dimitrios; Volmer, Daisy; Hirvonen, Jouni; Bozic, Borut; Skowron, Agnieska; Mircioiu, Constantin; Marcincal, Annie; Koster, Andries|info:eu-repo/dai/nl/070975558; Wilson, Keith; van Schravendijk, Chris; Wilkinson, Jamie
Do community pharmacists coming from different educational backgrounds rank the importance of competences for practice differently—or is the way in which they see their profession more influenced by practice than university education? A survey was carried out on 68 competences for pharmacy practice
Full Text Available Krishneeta C Kashyap,1 Lisa M Nissen,1 Simon S Smith,2 James A Douglas,3 Greg J Kyle41School of Pharmacy, University of Queensland, Woolloongabba, Queensland, Australia; 2Centre for Accident Research and Road Safety, Queensland University of Technology, Kelvin Grove, Queensland, Australia; 3The Prince Charles Hospital, Chermside, Queensland, Australia; 4School of Pharmacy, University of Canberra, Bruce, Canberra, AustraliaBackground: When experiencing sleep problems for the first time, consumers may often approach community pharmacists for advice as they are easily accessible health care professionals in the community. In Australian community pharmacies there are no specific tools available for use by pharmacists to assist with the assessment and handling of consumers with sleep enquiries.Objective: To assess the feasibility of improving the detection of sleep disorders within the community through the pilot of a newly developed Community Pharmacy Sleep Assessment Tool (COP-SAT.Method: The COP-SAT was designed to incorporate elements from a number of existing, standardized, and validated clinical screening measures. The COP-SAT was trialed in four Australian community pharmacies over a 4-week period.Key findings: A total of 241 community pharmacy consumers were assessed using the COP-SAT. A total of 74 (30.7% were assessed as being at risk of insomnia, 26 (10.7% were at risk of daytime sleepiness, 19 (7.9% were at risk of obstructive sleep apnea, and 121 (50.2% were regular snorers. A total of 116 (48.1% participants indicated that they consume caffeine before bedtime, of which 55 (47% had associated symptoms of sleep onset insomnia. Moreover, 85 (35% consumed alcohol before bedtime, of which 50 (58% experienced fragmented sleep, 50 (58% were regular snorers, and nine (10.6% had apnea symptoms. The COP-SAT was feasible in the community pharmacy setting. The prevalence of sleep disorders in the sampled population was high, but generally
Franko, Thomas S
To describe a novel setting and method for self-directed introductory pharmacy practice experiences (SD IPPE). Students presented health care information relative to the plot of a production at a local community theater throughout the season. Students developed a poster and handout that were presented in the theater lobby prior to each production. A six-question survey was provided to students after each presentation that identified their perceived benefit to play patrons and their overall experience using a 5-point Likert scale. Completing SD IPPE in a theater is a novel and innovative concept. Data suggest that students prefer presenting information in non-traditional settings. Students felt their work enhanced the theatrical experience of patrons. Results demonstrate that the theater is a viable setting for future presentations that benefit both students and public. Copyright © 2016 Elsevier Inc. All rights reserved.
Full Text Available Tadesse Melaku Abegaz,1 Sewunet Admasu Belachew,1 Tamrat Befekadu Abebe,1 Begashaw Melaku Gebresilassie,1 Fitsum Sebsibe Teni,2 Habtamu Gebremeskel Woldie3 1Department of Clinical Pharmacy, School of Pharmacy, Gondar University, Gondar, 2Department of Pharmaceutics and Social Pharmacy, School of Pharmacy, College of Health Sciences, Addis Ababa University, Addis Ababa, 3Department of Hospital Pharmacy, Debremarkos Teaching and Referral Hospital, Debremarkos, Ethiopia Background: Acute diarrhea is the major cause of child morbidity and mortality in low-income nations. It is the second most common cause of death among children <5 years of age globally. The indispensable role of community pharmacists is clearly observed in the prevention and treatment of diarrhea. However, there is a paucity of data on how community pharmacies manage acute childhood diarrhea cases in Ethiopia. This study aimed to evaluate the experience of community pharmacies in the management of acute diarrhea in northern Ethiopia.Methods: A simulated case-based cross-sectional study was conducted in community pharmacies from five towns of northern Ethiopia between April 2015 and September 2015. Convenience sampling technique was used to select sample towns. A structured questionnaire was organized to collect the information. Descriptive statistics, chi-squared test, one-way analysis of variance, and binary logistic regression were performed to describe, infer, and test for association between the variables. SPSS for Windows Version 21 was used to enter and analyze the data. A 95% confidence interval and P-value of 0.05 were set to test the level of significance.Results: Approximately 113 community pharmacies were visited to collect the required data from five towns. Majority (78, 69% of them were located away from hospitals and health care areas. Nine components of history taking were presented for dispensers. Regarding the patient history, “age” was frequently taken, (90
Fathima, Mariam; Saini, Bandana; Foster, Juliet M; Armour, Carol L
Mariam Fathima,1 Bandana Saini,1,2 Juliet M Foster,1 Carol L Armour1,3 1Woolcock Institute of Medical Research, Sydney Medical School, 2Faculty of Pharmacy, The University of Sydney, 3Central Sydney Area Health Service, Sydney, NSW, Australia Background and objective: Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case fin...
Aljadhey, Hisham; Assiri, Ghada A; Mahmoud, Mansour A; Al-Aqeel, Sinaa; Murray, Michael
To determine the prevalence of self-medication and assess the knowledge, attitudes, and perception of consumers toward self-medication. This cross-sectional survey was conducted over 4 weeks in May 2011 in Riyadh city, Kingdom of Saudi Arabia. Community pharmacies within 5 areas of the city (North, South, West, East, and Middle) were randomly selected for the study. All consumers were approached to participate in the study, with the exception of those buying cosmetic and medicinal equipments. A validated self-administered questionnaire was used to collect the data. A total of 538 out of 707 consumers attending community pharmacies in Riyadh city, agreed to participate in the study. Most responders were male (73%), 23-33 years old (35%), and college graduates (42%). A total of 285 medications were bought without a prescription. Of these, 149 (49%) medications should be dispensed by prescription only, and 155 (51%) were over the counter medications. The most common prescription medications dispensed without prescriptions were antibiotics (22%) and analgesics/antipyretics (19%). The most common reasons for buying medications without a prescription were that the symptoms were too minor to visit a doctor (54%), time saving (40%), and minor illnesses for which the participants knew the required treatment (40%). Overall, most participants had poor knowledge, and negative perceptions regarding self-medication. More than 68% of participants did not know whether the medicine they bought is a prescription-only or over the counter medication. Irresponsible self-medication is common in Saudi Arabia. Future studies should focus on improving the consumers' awareness of self-medication and the proper use of medications.
Newham, Rosemary; Bennie, Marion; Maxwell, David; Watson, Anne; de Wet, Carl; Bowie, Paul
A positive and strong safety culture underpins effective learning from patient safety incidents in health care, including the community pharmacy (CP) setting. To build this culture, perceptions of safety climate must be measured with context-specific and reliable instruments. No pre-existing instruments were specifically designed or suitable for CP within Scotland. We therefore aimed to develop a psychometrically sound instrument to measure perceptions of safety climate within Scottish CPs. The first stage, development of a preliminary instrument, comprised three steps: (i) a literature review; (ii) focus group feedback; and (iii) content validation. The second stage, psychometric testing, consisted of three further steps: (iv) a pilot survey; (v) a survey of all CP staff within a single health board in NHS Scotland; and (vi) application of statistical methods, including principal components analysis and calculation of Cronbach's reliability coefficients, to derive the final instrument. The preliminary questionnaire was developed through a process of literature review and feedback. This questionnaire was completed by staff in 50 CPs from the 131 (38%) sampled. 250 completed questionnaires were suitable for analysis. Psychometric evaluation resulted in a 30-item instrument with five positively correlated safety climate factors: leadership, teamwork, safety systems, communication and working conditions. Reliability coefficients were satisfactory for the safety climate factors (α > 0.7) and overall (α = 0.93). The robust nature of the technical design and testing process has resulted in the development of an instrument with sufficient psychometric properties, which can be implemented in the community pharmacy setting in NHS Scotland. © 2014 John Wiley & Sons, Ltd.
Odukoya, Olufunmilola K; Chui, Michelle A; Pu, Jia
To examine factors influencing the amount of time and information pharmacy personnel provide to patients at drive-through and walk-in counselling areas. On-site observational data collection in 22 community pharmacies by pharmacy students. Information included observable patient characteristics such as gender, age range, English proficiency and mobility impairment; encounter characteristics included type of prescription and whether the patient was acknowledged; and counselling characteristics included types of counselling information conveyed and length of time for each encounter. Patient-pharmacist encounters were documented at the drive-through and walk-in counselling areas 961 and 1098 times respectively. Pharmacists spent less time, and technicians more time, with patients at the drive-through counselling area. The amount of information provided to patients was significantly affected by whether the patient was receiving new versus refill prescriptions. Patients with a new prescription were twice as likely to receive more information from pharmacy personnel. There was a significant difference between the amount of counselling provided to patients at the drive-through and walk-in counselling area (rate ratio (RR) 0.92, 95% confidence interval (CI): 0.86-1.00). Patients at the drive-through received a lower amount of information relative to patients using the walk-in. Amount of information provided to patients was affected by the level of pharmacy busyness (RR 0.96, 95% CI: 0.95-0.99). Providing patient care at the drive-through counselling area may negatively influence quality of patient care. To improve quality of pharmacy drive-through services, standardization of drive-through services in pharmacies may be needed. © 2013 Royal Pharmaceutical Society.
Alaqeel, Sinaa; Abanmy, Norah O
that they usually or always tell the patient about the purpose of medicines or the diagnosis, 302 (86.2%) reported that they usually or always give patient information on how to use or apply the medicine; 299 (85.3%) said they were satisfied with their counselling practices. The present study highlights the current deficiencies in appropriate dispensing practices and medication counselling at community pharmacies in Saudi Arabia. Policy makers, stakeholders, and researchers should collaborate to design interventions to improve the current dispensing practices at community pharmacies across the country.
Salisa C. Westrick
Full Text Available Purpose: To determine parentsâ knowledge and attitudes regarding human papillomavirus (HPV vaccinations in their adolescent children and to describe parentsâ perceptions of adolescent vaccinations in community pharmacies. Methods: In-depth interviews were completed with parents or guardians of children ages 11â17 years from Alabama's Lee and Macon counties. One-hour long, open-ended telephonic or in-person interviews were conducted until the saturation point was reached. Using ATLAS.ti software and thematic analysis, interview transcripts were coded to identify themes. Results: Twenty-six parents were interviewed, most of whom were female (80.8% and white (50%. A total of 12 themes were identified. First, two themes emerged regarding elements facilitating children's HPV vaccination, the most common being positive perception of the HPV vaccine. Second, elements hindering children's vaccination contained seven themes, the top one being lack of correct or complete information about the HPV vaccine. The last topic involved acceptance/rejection of community pharmacies as vaccination settings, and the most frequently cited theme was concern about pharmacistsâ clinical training. Conclusions: Physician-to-parent vaccine education is important, and assurances of adequate pharmacy immunization training will ease parentsâ fears and allow pharmacists to better serve adolescents, especially those who do not see physicians regularly. Keywords: Human papillomavirus, Adolescent immunization, Community pharmacy, Cervical cancer prevention
Barnett, Mitchell J; Frank, Jessica; Wehring, Heidi; Newland, Brand; VonMuenster, Shannon; Kumbera, Patty; Halterman, Tom; Perry, Paul J
Although community pharmacists have historically been paid primarily for drug distribution and dispensing services, medication therapy management (MTM) services evolved in the 1990s as a means for pharmacists and other providers to assist physicians and patients in managing clinical, service, and cost outcomes of drug therapy. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA 2003) and the subsequent implementation of Medicare Part D in January 2006 for the more than 20 million Medicare beneficiaries enrolled in the Part D benefit formalized MTM services for a subset of high-cost patients. Although Medicare Part D has provided a new opportunity for defining the value of pharmacist-provided MTM services in the health care system, few publications exist which quantify changes in the provision of pharmacist-provided MTM services over time. To (a) describe the changes over a 7-year period in the primary types of MTM services provided by community pharmacies that have contracted with drug plan sponsors through an MTM administrative services company, and (b) quantify potential MTM-related cost savings based on pharmacists' self-assessments of the likely effects of their interventions on health care utilization. Medication therapy management claims from a multistate MTM administrative services company were analyzed over the 7-year period from January 1, 2000, through December 31, 2006. Data extracted from each MTM claim included patient demographics (e.g., age and gender), the drug and type that triggered the intervention (e.g., drug therapeutic class and therapy type as either acute, intermittent, or chronic), and specific information about the service provided (e.g., Reason, Action, Result, and Estimated Cost Avoidance [ECA]). ECA values are derived from average national health care utilization costs, which are applied to pharmacist self-assessment of the "reasonable and foreseeable" outcome of the intervention. ECA values are updated
Oliveira, Lara Tânia de Assumpção Domingues Gonçalves de; Silva, Camila Pontes da; Guedes, Maria das Vitorias; Sousa, Ana Célia de Oliveira; Sarno, Flávio
To describe indicators and processes developed and implemented for pharmaceutical assistance at the Einstein Program at Paraisópolis Community pharmacy. This was a descriptive study of retrospective data from January 2012 to December 2015. Data were obtained from spreadsheets developed for monitoring the productivity and care quality provided at the pharmacy. The evaluated variables were pharmaceutical assistance to prescription, pharmaceutical intervention, orientation (standard and pharmaceutical) and pharmaceutical orientation rate. The pharmacy assisted, on average, 2,308 prescriptions monthly, dispensing 4,871 items, including medications, materials and food supplements. Since March 2015, virtually, the pharmacist analyzed all prescriptions, prior to dispensing. In the analyzed period, there was an increase in monthly pharmaceutical interventions from 7 to 32 on average, and, although there was a decrease in the number of standard orientation, the pharmaceutical orientation had an increase, causing a rise of pharmaceutical orientation rate from 4 to 11%. The processes developed and implemented at the program pharmacy sought to follow the good pharmacy practice, and help patients to make the best use of their medications. Descrever os indicadores e os processos desenvolvidos e implantados para assistência farmacêutica na farmácia do Programa Einstein na Comunidade de Paraisópolis. Tratase de um estudo descritivo de dados retrospectivos de janeiro de 2012 a dezembro de 2015. Os dados foram obtidos de planilhas desenvolvidas para acompanhamento da produtividade e da qualidade de assistência prestada na farmácia. As variáveis avaliadas foram: atenção farmacêutica à prescrição, intervenção farmacêutica, orientação (padrão e farmacêutica) e taxa de orientação farmacêutica. A farmácia atendeu, em média, 2.308 prescrições ao mês, dispensando 4.871 itens, incluindo medicamentos, materiais e suplementos alimentares. Desde março de 2015
Scahill, S L; Harrison, J; Carswell, P
To develop a multi-constituent model of organizational effectiveness for community pharmacy. Using Concept Systems software, a project with 14 stakeholders included a three stage process: (i) face to face brainstorming to generate statements describing what constitutes an effective community pharmacy, followed by (ii) statement reduction and approval by participants, followed by (iii) sorting of the statements into themes with rating of each statement for importance. Primary care in a government-funded, national health care system. A multi-constituent group representing policy-makers and health care providers including; community pharmacy, professional pharmacy organizations, primary health care funders and policy-makers, general practitioners and general practice support organizations. Statement clusters included: 'has safe and effective workflows', 'contributes to the safe use of medicines', 'manages human resources and has leadership', 'has a community focus', 'is integrated within primary care', 'is a respected innovator', 'provides health promotion and preventative care', 'communicates and advocates'. These clusters fit into a quadrant model setting stakeholder focus against role development. The poles of stakeholder focus are 'internal capacity' and 'social utility'. The poles of role development are labelled 'traditional safety roles' and 'integration and innovation'. Organizational effectiveness in community pharmacy includes the internal and external focus of the organization and role development. Our preliminary model describes an effective community pharmacy and provides a platform for investigation of the factors that may influence the organizational effectiveness of individual community pharmacies now and into the future.
Laustrup, H; Voss, A; Green, A
Objectives: To determine the prevalence and annual incidence of definite systemic lupus erythematosus (D-SLE) and incomplete SLE (I-SLE) in a community-based lupus cohort of predominantly Nordic ancestry in an 8-year prospective study from 1995 to 2003, and also to calculate the annual transition......-years at risk [95% confidence interval (CI) 1.44-7.55]. Conclusions: Denmark is a low-incidence lupus area but lupus prevalence is increasing slowly. I-SLE is a disease variant that may eventually convert into D-SLE....
Full Text Available Background: Over 90% of pharmacy students’ work in pharmacies after graduation which needs both knowledge and skill, thus one of the most essential courses of their education is pharmacy clerkship. An important part of an educational program is the evaluation of the trainees. Different studies show that conventional written exams are not successful in evaluating the skills of the students and can mostly evaluate their knowledge. Thus Objective Structured Clinical Examination (OSCE is used to evaluate the students in different aspects.Methods: An OSCE and a conventional test were given to a group of students at the end of basic community pharmacy clerkship course. The OSCE test consisted of six different stations (reading prescriptions, identifying drugs, pharmacist’s recommendation, patient education, drug information resources, and drug usage instructions. Two questions were asked at each station by different examiners. The scores and results of these tests were compared and analyzed.Results: There was no significant correlation between OSCE final scores and written test scores (P: = 0.217. No significant correlation between each station’s score and the written test score was found.Conclusion: The absence of significant correlation between OSCE and conventional exams shows that the skills evaluated by OSCE cannot be evaluated by the best possible written tests. This type of examination is not commonly used in Iran’s pharmacy schools but due to the findings of this study, it seems that this multiform method, despite being more difficult to arrange, can be a more suitable and relevant way to evaluate basic community pharmacy clerkship compared to conventional written tests.
Karstoft, Karen-Inge; Armour, Cherie; Andersen, Søren B; Bertelsen, Mette; Madsen, Trine
In the years following military deployment, soldiers may experience problems integrating into the community. However, little is known about the nature and prevalence of these problems and if they relate to posttraumatic symptomatology. In a prospective, longitudinal study of Danish soldiers deployed to Afghanistan in 2009 (N = 743), we assessed community reintegration difficulties 2.5 years after home coming (study sample: N = 454). Furthermore, symptoms of posttraumatic stress disorder (PTSD) were assessed before, during, and after deployment. Trajectories of PTSD symptoms from a previously published latent growth mixture modeling analysis were used to address whether community reintegration difficulties differ as a result of course and level of PTSD symptoms. Between 3.6 and 18.0% reported to have some, a lot, or extreme difficulties in reintegration domains such as interpersonal functioning, productivity, community involvement, and self-care. Mean level of reintegration difficulties differed significantly across six PTSD symptom trajectories (range 6.35-36.00); with more symptomatic trajectories experiencing greater community reintegration difficulties. Reintegration difficulties after deployment are present in less than 20% of Danish soldiers who return from Afghanistan. Difficulties are greater in individuals who follow symptomatic PTSD trajectories in the first years following deployment than in those who follow a low-stable trajectory with no or few symptoms.
Cooper, R J; Bissell, P; Wingfield, J
Empirical ethics research is increasingly valued in offering insights into how ethical problems and decision-making occur in healthcare. In this article, the findings of a qualitative study of the ethical problems and decision-making of UK community pharmacists are presented, and it is argued that the identified themes of pharmacists' relative isolation from others and their subordination to doctors are ethically significant. Semi-structured interviews were conducted with 23 community pharmacists in England, UK. Analysis of interviews revealed that isolation involved separation of pharmacists from their peers, other healthcare professionals, patients and customers. Such isolation is argued to be inimical to ethical practice - impeding ethical discourse as understood by Habermas, resulting in a form of anomie that inhibits the transmission of professional values, leading to a lack of proximity between pharmacist and patient or customer that may impede ethical relationships and resulting, psychologically, in less ethical concern for those who are less close. Pharmacists' subordination to doctors not only precipitated some ethical problems but also allowed some pharmacists to shift ethical responsibility to a prescribing doctor, as in the case of emergency hormonal contraception. The emergence of atrocity stories further supports a culture of subordination that may cause ethical problems. The study has implications for community pharmacy practice in terms of supervision issues, developments such as prescribing responsibilities and how ethical values can be taught and communicated. The potential for isolation and subordination in other healthcare professions, and resultant ethical problems, may also need to be addressed and researched.
Timothy R. Ulbrich
Full Text Available Objective: To determine any differences in career paths and career attributes of pharmacists who have completed a PGY1 community pharmacy residency program (CPRP as compared to those that have not completed a PGY1 CPRP. Methods: A web-based survey evaluating various aspects of community pharmacists' careers was distributed to 274 CPRP graduates in addition to a random sample of 7,376 community pharmacists. The survey contained 32 questions evaluating various career attributes. Questions that assessed level of agreement were on a 6-point Likert-type Scale (1=strongly disagree; 6=strongly agree. Results: A total of 353 participants completed the survey, with 224 indicating that they had not completed a CPRP. Pharmacists who completed a CPRP responded that they spend significantly more time on patient care services, teaching, and research, and spend less time dispensing medications compared to those that have not completed a CPRP. Compared to those that did not complete a CPRP, CPRP graduates were less likely to agree that current level of workload negatively impacts job performance, motivation to work, job satisfaction, mental/emotional health, and physical health. Conclusion: Pharmacists completing a CPRP noted significant differences in their current employment and job responsibilities. Additional expansion and education regarding the importance of CPRPs should be considered. Type: Original Research
Full Text Available Abstract Background The majority of patients using antihypertensive medications fail to achieve their recommended target blood pressure. Poor daily adherence with medication regimens and a lack of persistence with medication use are two of the major reasons for failure to reach target blood pressure. There is no single intervention to improve adherence with antihypertensives that is consistently effective. Community pharmacists are in an ideal position to promote adherence to chronic medications. This study aims to test a specific intervention package that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications - Hypertension Adherence Program in Pharmacy (HAPPY. Methods/Design The HAPPY trial is a multi-centre prospective randomised controlled trial. Fifty-six pharmacies have been recruited from three Australian states. To identify potential patients, a software application (MedeMine CVD extracted data from a community pharmacy dispensing software system (FRED Dispense®. The pharmacies have been randomised to either 'Pharmacist Care Group' (PCG or 'Usual Care Group' (UCG. To check for 'Hawthorne effect' in the UCG, a third group of patients 'Hidden Control Group' (HCG will be identified in the UCG pharmacies, which will be made known to the pharmacists at the end of six months. Each study group requires 182 patients. Data will be collected at baseline, three and six months in the PCG and at baseline and six months in the UCG. Changes in patient adherence and persistence at the end of six months will be measured using the self-reported Morisky score, the Tool for Adherence Behaviour Screening and medication refill data. Discussion To our knowledge, this is the first research testing a comprehensive package of evidence-based interventions that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient
Jonjić, Danijela; Vitale, Ksenija
Croatian regulations mandate pharmacies to receive unused medicines from households. Pharmacies are considered as producers and holders of pharmaceutical waste and are obliged to finance this service. Model where pharmacies are responsible for financing disposal of unused medicines without reimbursement is not common in Europe. Present service was not tested before implementation. To investigate the elements of the pharmaceutical waste disposal service provided by pharmacies, and to gain insight into the factors that might influence the effectiveness of the service. Setting All pharmacies in the city of Zagreb. Each pharmacy was asked to weigh the collected waste from the public during a period of 30 days, between June 1st and July 10th of 2011, absent from any media advertisement and answer a specifically designed questionnaire that was exploring possible connections between the amount of collected waste, type of pharmacy ownership, discretion while disposing, location of the container, appropriate labeling and to compare the amount of collected waste between neighborhoods. Quantity of collected unused medicines from the public. Of 210 pharmacies, 91 participated completing the questionnaire (43 % response rate). The total amount of collected waste was 505 kg. Pharmacies owned by the city of Zagreb had higher response rate (74 %) than privately owned pharmacies (36 %), and collected significantly higher amount of waste. Anonymity when disposing influenced collected quantity, while labelling and location of the container did not. There were differences in the amount of collected waste between neighborhoods due to the demographic characteristics and number of pharmacies per capita. The effectiveness of the pharmacy service of collecting unused medicines in Croatia shows a number of weaknesses. The amount of collected medicines is below the European average. Functioning of the service seems to be negatively influenced by the type of pharmacy ownership, distribution
Steed, Liz; Sohanpal, Ratna; James, Wai-Yee; Rivas, Carol; Jumbe, Sandra; Chater, Angel; Todd, Adam; Edwards, Elizabeth; Macneil, Virginia; Macfarlane, Fraser; Greenhalgh, Trisha; Griffiths, Chris; Eldridge, Sandra; Taylor, Stephanie; Walton, Robert
To develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates. Following the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention. Phase I : We used information from qualitative studies in pharmacies, systematic literature reviews and the Capability, Opportunity, Motivation-Behaviour framework to inform design of the initial version of the intervention. Phase II : We then tested the acceptability of this intervention with smoking cessation advisers and assessed fidelity using actors who visited pharmacies posing as smokers, in a pilot study. Phase III : We reviewed the content and associated theory underpinning our intervention, taking account of the results of the earlier studies and a realist analysis of published literature. We then confirmed a logic model describing the intended operation of the intervention and used this model to refine the intervention and associated materials. Eight community pharmacies in three inner east London boroughs. 12 Stop Smoking Advisers. Two, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice. The pilot study confirmed acceptability of the intervention and showed preliminary evidence of benefit; however, organisational barriers tended to limit effective operation. The pilot data and realist review pointed to additional use of Diffusion of Innovations Theory to seat the intervention in the wider organisational context. We have developed and refined an intervention to promote smoking cessation services in community pharmacies, which we now plan to evaluate in a randomised controlled trial. UKCRN ID 18446, Pilot. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Goad, Jeffery A.; Taitel, Michael S.; Fensterheim, Leonard E.; Cannon, Adam E.
PURPOSE Approximately 50,000 adults die annually from vaccine-preventable diseases in the United States. Most traditional vaccine providers (eg, physician offices) administer vaccinations during standard clinic hours, but community pharmacies offer expanded hours that allow patients to be vaccinated at convenient times. We analyzed the types of vaccines administered and patient populations vaccinated during off-clinic hours in a national community pharmacy, and their implications for vaccination access and convenience. METHODS We retrospectively reviewed data for all vaccinations given at the Walgreens pharmacy chain between August 2011 and July 2012. The time of vaccination was categorized as occurring during traditional hours (9:00 am–6:00 pm weekdays) or off-clinic hours, consisting of weekday evenings, weekends, and federal holidays. We compared demographic characteristics and types of vaccine. We used a logistic regression model to identify predictors of being vaccinated during off-clinic hours. RESULTS During the study period, pharmacists administered 6,250,402 vaccinations, of which 30.5% were provided during off-clinic hours: 17.4% were provided on weekends, 10.2% on evenings, and 2.9% on holidays. Patients had significantly higher odds of off-clinic vaccination if they were younger than 65 years of age, were male, resided in an urban area, and did not have any chronic conditions. CONCLUSIONS A large proportion of adults being vaccinated receive their vaccines during evening, weekend, and holiday hours at the pharmacy, when traditional vaccine providers are likely unavailable. Younger, working-aged, healthy adults, in particular, a variety of immunizations during off-clinic hours. With the low rates of adult and adolescent vaccination in the United States, community pharmacies are creating new opportunities for vaccination that expand access and convenience. PMID:24019274
Goad, Jeffery A; Taitel, Michael S; Fensterheim, Leonard E; Cannon, Adam E
Approximately 50,000 adults die annually from vaccine-preventable diseases in the United States. Most traditional vaccine providers (eg, physician offices) administer vaccinations during standard clinic hours, but community pharmacies offer expanded hours that allow patients to be vaccinated at convenient times. We analyzed the types of vaccines administered and patient populations vaccinated during off-clinic hours in a national community pharmacy, and their implications for vaccination access and convenience. We retrospectively reviewed data for all vaccinations given at the Walgreens pharmacy chain between August 2011 and July 2012. The time of vaccination was categorized as occurring during traditional hours (9:00 am-6:00 pm weekdays) or off-clinic hours, consisting of weekday evenings, weekends, and federal holidays. We compared demographic characteristics and types of vaccine. We used a logistic regression model to identify predictors of being vaccinated during off-clinic hours. During the study period, pharmacists administered 6,250,402 vaccinations, of which 30.5% were provided during off-clinic hours: 17.4% were provided on weekends, 10.2% on evenings, and 2.9% on holidays. Patients had significantly higher odds of off-clinic vaccination if they were younger than 65 years of age, were male, resided in an urban area, and did not have any chronic conditions. A large proportion of adults being vaccinated receive their vaccines during evening, weekend, and holiday hours at the pharmacy, when traditional vaccine providers are likely unavailable. Younger, working-aged, healthy adults, in particular, a variety of immunizations during off-clinic hours. With the low rates of adult and adolescent vaccination in the United States, community pharmacies are creating new opportunities for vaccination that expand access and convenience.
McCann, Laura; Hughes, Carmel M; Adair, Colin G
Using a self-reported work sampling methodology this study investigated how community pharmacists utilised their time, and quantified how much time pharmacists devoted to specific activities. Community pharmacies (n = 30) in the Greater Belfast area. A classification system was developed to define all activities (professional, semi-professional, and non-professional tasks) which could potentially be performed by a community pharmacist in the course of a normal working day (from 9.00 to 6.00 pm). A random bleeper device was used which was programmed to bleep randomly approximately 13 times per day (over 12 days) at which time the pharmacist recorded their precise activity (using the classification system) at that time on a proforma. All completed data sheets for each pharmacy were entered into an Excel spreadsheet, where the number of observations for each activity was expressed as a proportion of the total number of observations per day. Statistical analysis was carried out in SPSS, comparing these data to similar data which had been collected in 1998. Pharmacists in this study were found to spend approximately 49% of their time engaged in professional activities, 31% in semi-professional activities and 20% involved in non-professional activities which was similar to that reported in 1998. Most time was spent on assembly and labelling of products, whilst staff training occupied the least amount of pharmacists' time. Pharmacists with a prescription volume of less than 1,499 per month spent significantly more time counselling patients on OTC medicines and responding to symptoms than those dispensing 1,500 items/month or more (P = 0.027). Pharmacists who employed a pre-registration student apportioned less time to the assembly and labelling of products compared to those without a student (P = 0.08). Pharmacists with three or more staff spent less time on coding and endorsing of prescriptions compared to those with less staff (P = 0.086). Pharmacists in this study are
Hedegaard Klausen, Henrik; Petersen, J; Lindhardt, T
OBJECTIVES: To evaluate regional differences in and risk factors for admission, length of stay, mortality, and readmission for community-acquired pneumonia in elderly Danish patients. METHODS: National registry study on elderly Danish citizens with an acute admission in 2009 owing to community....... RESULTS: A total of 11,332 elderly citizens were admitted with community-acquired pneumonia. Mortality during admission and 30-days from discharge were 11.6% and 16.2%, respectively. Readmission rates within 30 days of discharge were 12.3%. There were significantly differences between hospitals in length...
Pharmacy Satisfaction Running Head: IMPROVING PHARMACY CUSTOMER SATISFACTION Improving Pharmacy Customer Satisfaction at Reynolds Army Community...Pharmacy Satisfaction 7 Improving Pharmacy Customer Satisfaction The Military Healthcare System is a healthcare system intended to provide state of... customer satisfaction plays on healthcare is a relatively new concept to the Military Healthcare System. With the introduction of TRICARE, prudent
Sabater-Hernández, Daniel; Sabater-Galindo, Marta; Fernandez-Llimos, Fernando; Rotta, Inajara; Hossain, Lutfun N; Durks, Desire; Franco-Trigo, Lucia; Lopes, Livia A; Correr, Cassyano J; Benrimoj, Shalom I
Cardiovascular disease (CVD) is the leading cause of death worldwide and has a substantial impact on people's health and quality of life. CVD also causes an increased use of health care resources and services, representing a significant proportion of health care expenditure. Integrating evidence-based community pharmacy services is seen as an asset to reduce the burden of CVD on individuals and the health care system. To (a) identify community pharmacy evidence-based services designed to help prevent CVD and (b) provide fundamental information that is needed to assess their potential adaptation to other community pharmacy settings. This review used the DEPICT database, which includes 488 randomized controlled trials (RCT) that address the evaluation of pharmacy services. Articles reviewing these RCTs were identified for the DEPICT database through a systematic search of the following databases: MEDLINE, Scopus, SciELO (Scientific Electronic Library Online), and DOAJ (Directory of Open Access Journals). The DEPICT database was reviewed to identify evidence-based services delivered in the community pharmacy setting with the purpose of preventing CVD. An evidence-based service was defined as a service that has been shown to have a positive effect (compared with usual care) in a high-quality RCT. From each evidence-based service, fundamental information was retrieved to facilitate adaptation to other community pharmacy settings. From the DEPICT database, 14 evidence-based community pharmacy services that addressed the prevention of CVD were identified. All services, except 1, targeted populations with a mean age above 60 years. Pharmacy services encompassed a wide range of practical applications or techniques that can be classified into 3 groups: activities directed at patients, activities directed at health care professionals, and assessments to gather patient-related information in order to support the previous activities. This review provides pharmacy service
Fakih, Souhiela; Marriott, Jennifer L.; Hussainy, Safeera Y.
With the increase in the overweight and obese population, it is critical that pharmacy staff are able to provide weight management advice to women at different stages of their life. This study utilized case vignettes to identify pharmacists' and pharmacy assistants' current weight management recommendations to women of different ages, life stages…
Fuller, Joanne M; Saini, Bandana; Bosnic-Anticevich, Sinthia; Garcia Cardenas, Victoria; Benrimoj, Shalom I; Armour, Carol
Community pharmacists are well placed and evidence clearly demonstrates that they can be suitably trained to deliver professional services that improve the management of asthma patients in clinical, economic and humanistic terms. However the gap between this evidence and practice reality remains wide. In this study we measure the implementation process as well as the service benefits of an asthma service model. Using an effectiveness-implementation hybrid design, a defined implementation process (progression from Exploration through Preparation and Testing to Operation stages) supporting an asthma service (promoting asthma control and inhaler technique) was tested in 17 community pharmacies across metropolitan Sydney. Seven pharmacies reached the Operation stage of implementation. Eight pharmacies reached the Testing stage of implementation and two pharmacies did not progress beyond the Preparation stage of implementation. A total of 128 patients were enrolled in the asthma service with 110 patients remaining enrolled at the close of the study. Asthma control showed a positive trend throughout the service with the overall proportion of patients with 'poor' asthma control at baseline decreasing from 72% to 57% at study close. There was a statistically significant increase in the proportion of patients with correct inhaler technique from 12% at Baseline (Visit 1) to 33% at Visit 2 and 57% at study close. Implementation of the asthma service varied across pharmacies. Different strategies specific to practice sites at different stages of the implementation model may result in greater uptake of professional services. The asthma service led to improved patient outcomes overall with a positive trend in asthma control and significant change in inhaler technique. Copyright © 2017 Elsevier Inc. All rights reserved.
Olsson, Erika; Wallach-Kildemoes, Helle; Ahmed, Ban
OBJECTIVES: The objective was to study the relationship between the length and content of patient-pharmacist communication in community pharmacies, and generic substitution. METHODS: The study was conducted in six community pharmacies in Sweden. Non-participant observations with audio recordings...... and short structured interviews were conducted. Out of 32 pharmacists 29 agreed to participate (90.6%), as did 282 out of 407 patients (69.3%). Logistic regression analysis was applied to calculate odds ratio for occurrence of generic substitution. Linear regression (β-coefficients) was applied to test...... literacy. This study suggests that pharmacists need to further embrace their role in promoting rational use of medicines, not least when generic substitution occurs....
Full Text Available Do community pharmacists coming from different educational backgrounds rank the importance of competences for practice differently—or is the way in which they see their profession more influenced by practice than university education? A survey was carried out on 68 competences for pharmacy practice in seven countries with different pharmacy education systems in terms of the relative importance of the subject areas chemical and medicinal sciences. Community pharmacists were asked to rank the competences in terms of relative importance for practice; competences were divided into personal and patient-care competences. The ranking was very similar in the seven countries suggesting that evaluation of competences for practice is based more on professional experience than on prior university education. There were some differences for instance in research-related competences and these may be influenced, by education.
Atkinson, Jeffrey; De Paepe, Kristien; Sánchez Pozo, Antonio; Rekkas, Dimitrios; Volmer, Daisy; Hirvonen, Jouni; Bozic, Borut; Skowron, Agnieska; Mircioiu, Constantin; Marcincal, Annie; Koster, Andries; Wilson, Keith; van Schravendijk, Chris; Wilkinson, Jamie
Do community pharmacists coming from different educational backgrounds rank the importance of competences for practice differently—or is the way in which they see their profession more influenced by practice than university education? A survey was carried out on 68 competences for pharmacy practice in seven countries with different pharmacy education systems in terms of the relative importance of the subject areas chemical and medicinal sciences. Community pharmacists were asked to rank the competences in terms of relative importance for practice; competences were divided into personal and patient-care competences. The ranking was very similar in the seven countries suggesting that evaluation of competences for practice is based more on professional experience than on prior university education. There were some differences for instance in research-related competences and these may be influenced, by education. PMID:28975909
Atkinson, Jeffrey; De Paepe, Kristien; Pozo, Antonio Sánchez; Rekkas, Dimitrios; Volmer, Daisy; Hirvonen, Jouni; Bozic, Borut; Skowron, Agnieska; Mircioiu, Constantin; Marcincal, Annie; Koster, Andries; Wilson, Keith; van Schravendijk, Chris; Wilkinson, Jamie
Do community pharmacists coming from different educational backgrounds rank the importance of competences for practice differently-or is the way in which they see their profession more influenced by practice than university education? A survey was carried out on 68 competences for pharmacy practice in seven countries with different pharmacy education systems in terms of the relative importance of the subject areas chemical and medicinal sciences. Community pharmacists were asked to rank the competences in terms of relative importance for practice; competences were divided into personal and patient-care competences. The ranking was very similar in the seven countries suggesting that evaluation of competences for practice is based more on professional experience than on prior university education. There were some differences for instance in research-related competences and these may be influenced, by education.
Farris, Karen B; Aquilino, Mary L; Batra, Peter; Marshall, Vince; Losch, Mary E
Almost 50% of pregnancies in the United States are unwanted or mistimed. Notably, just over one-half of unintended pregnancies occurred when birth control was being used, suggesting inappropriate or poor use or contraceptive failure. About two-thirds of all women who are of reproductive age use contraceptives, and oral hormonal contraceptives remain the most common contraceptive method. Often, contraceptive products are obtained in community pharmacies. The purpose of this study was to determine whether a pharmacy-based intervention would impact sales of contraceptive products in pharmacies. This study was conducted in Iowa and used a quasi-experimental design including 55 community pharmacies (independent and grocery) in 12 counties as the intervention and 32 grocery pharmacies in 10 counties as a comparison group. The passive intervention was focused towards 18-30 year old women who visited community pharmacies and prompted those of childbearing age to "plan your pregnancy" and "consider using birth control". The intervention was delivered via educational tri-fold brochures, posters and 'shelf talkers.' Data sources for evaluation were contraceptive sales from intervention and comparison pharmacies, and a mixed negative binomial regression was used with study group*time interactions to examine the impact of the intervention on oral contraceptive and condom sales. Data from 2009 were considered baseline sales. From 2009 to 2011, condom sales decreased over time and oral contraceptives sales showed no change. Overall, the units sold were significantly higher in grocery pharmacies than in independent pharmacies for both contraceptive types. In the negative binomial regression for condoms, there was an overall significant interaction between the study group and time variables (p = 0.003), indicating an effect of the intervention, and there was a significant slowing in the drop of sales at time 3 in comparison with time 1 (p < 0.001). There was a statistically
Sheridan, Janie; Stewart, Joanna; Smart, Ros; McCormick, Ross
To estimate the prevalence of risky drinking among customers in community pharmacies and to explore customer attitudes towards screening and brief intervention (SBI). Cross-sectional, anonymous survey, using random selection of community pharmacies in New Zealand to collect data using self-completion questionnaires and an opportunity to enter a prize draw. Participants were customers/patients attending the community pharmacy on a specific, randomly selected day (Monday to Friday) in one set week. Alcohol Use Disorder Identification Test (AUDIT)-C using a cut-off score of 5 was used to measure risky drinking. Attitudes towards pharmacists engaging in SBI for risky drinkers were measured. 2384 completed customer/patient questionnaires from 43 participating pharmacies. Almost 84% ever drank alcohol and using a score of 5 or more as a cut-off, 30% of the sample would be considered as risky drinkers. Attitudes were generally positive to pharmacists undertaking SBI. Logistic regression with AUDIT-C positive or negative as the dependent variable found those taking medicines for mental health and liver disease being more likely to score negative on the AUDIT-C, and smokers and those purchasing hangover cures were more likely than average to have a positive AUDIT-C screen. This study indicates there is scope for community pharmacists to undertake SBI for risky drinking, and that customers find this to be acceptable. Targeted screening may well be useful, in particular for smokers. Further research is required to explore the effectiveness of SBI for risky drinkers in this setting. © 2011 Australasian Professional Society on Alcohol and other Drugs.
Full Text Available Background: Advertising is a crucial component of pharmaceutical industry promotion. Research indicates that information on advertisement materials might be inadequate, inaccurate, biased, and misleading. Objective: To analyse and critically assess the information presented in print pharmaceutical advertisements in Saudi Arabia.Methods: Pharmaceutical advertisements were collected from 280 community pharmacies in Riyadh city, Saudi Arabia. The advertisements were evaluated using criteria derived from the Saudi Food and Drug Authority (SFDA regulation, the World Health Organization (WHO ethical medicinal drug promotion criteria, and other principles reported in similar studies. The data were extracted independently by two of the researchers using a standardized assessment form. Results: One hundred eighty five printed advertisements were included in the final sample. Approximately half of the advertisements (n = 94, 51% were for over-the-counter (OTC medications, and 71 (38% were for prescription-only medication. Information such as the name of active ingredients was available in 168 (90.8% advertisements, therapeutic uses were mentioned in 156 (98.7% of analysed advertisements. Safety information related to side effects, precautions, and major interactions were stated in 53 (28.5%, 58 (31%, and 33 (16.5% advertisements, respectively. Only 119 advertisements (64% provided references for information presented. Conclusions: Our findings suggest that print advertisements do not convey all the information necessary for safe prescribing. These results have implications for the regulation of drug advertising and the continuing education of pharmacists.
Kirkdale, C L; Nebout, G; Taitel, M; Rubin, J; Jacinto, I; Horta, R; Megerlin, F; Thornley, T
Improving influenza vaccination coverage has been, and still remains a challenge internationally. There are now many examples where countries have pursued a pharmacist-led influenza vaccination service in order to enhance vaccination coverage of at-risk populations. England, Portugal and the United States are successful examples where their experience implementing this service can now be explored retrospectively and learnt from. This review aims to provide evidence to help overcome barriers to commissioning and implementation of such services in countries new to the experience. Implementation is influenced by differing regulatory frameworks underpinning the provision of pharmacist-led influenza vaccination, methods of remuneration, training, and operating procedures. Practical aspects such as the facilities required, how patient records are maintained and how patients and other healthcare professionals are engaged also have an impact. These examples illustrate how community pharmacists can be trained to deliver influenza vaccinations safely, and coupled with their accessibility and convenience, can provide a complementary service to that already provided by family doctors and nurses to deliver influenza vaccinations for the benefit of patients. Copyright © 2016 Académie Nationale de Pharmacie. Published by Elsevier Masson SAS. All rights reserved.
Marques dos Reis, Tiago; Guidoni, Camilo Molino; Girotto, Edmarlon; Guerra, Marisabelle Lima; de Oliveira Baldoni, André; Leira Pereira, Leonardo Régis
Objective. To summarize the effects of media methods used in continuing education (CE) programs on providing clinical community pharmacy services and the methods used to evaluate the effectiveness of these programs. Methods. A systematic review was performed using Medline, SciELO, and Scopus databases. The timeline of the search was 1990 to 2013. Searches were conducted in English, Portuguese, and Spanish. Results. Nineteen articles of 3990 were included. Fourteen studies used only one media method, and the live method (n=11) was the most frequent (alone or in combination). Only two studies found that the CE program was ineffective or partially effective; these studies used only the live method. Most studies used nonrobust, nonvalidated, and nonstandardized methods to measure effectiveness. The majority of studies focused on the effect of the CE program on modifying the knowledge and skills of the pharmacists. One study assessed the CE program’s benefits to patients or clients. Conclusion. No evidence was obtained regarding which media methods are the most effective. Robust and validated methods, as well as assessment standardization, are required to clearly determine whether a particular media method is effective. PMID:27402991
Cagirci, Simge; Yegenoglu, Selen; Uner, Mehmet Mithat
There is a great recognition that store interiors and exteriors can be designed to create feelings in potential customers which can have an important reinforcing effect on purchase. In this study it is mainly aimed to explore the behaviors of the community pharmacists related to their store's physical environment. Also we aimed to determine whether any difference exist between behaviors of pharmacists serving in high and low socio-economic regions. A total of 200 pharmacists that work socio-economically different regions were randomly selected from 1424 pharmacists registered in Ankara Chamber of Pharmacists. A uniform questionnaire was applied to the pharmacists by using a face-to-face interview technique. There are differences in terms of behavior between the pharmacists serving in high and low socio-economic regions within the context of putting importance to their stores' atmosphere. More pharmacists attach importance to the physical sight of their pharmacy serving in high socio-economic regions (90%) vs. pharmacists in low socio-economic regions (70%). Also pharmacists in high socio-economic regions indicated higher importance level of selection of the decoration equipments (84%) than pharmacists serving in high socio-economic regions (60%). Our study suggests that some pharmacists pay more attention to interior atmospheric elements and others do not. There is a difference in terms of attaching importance to some store atmospheric elements (i.e. physical site, decoration equipment, it's color, wall color, etc.) serving in high versus low socio-economic regions in this context.
Full Text Available Context: Hormone replacement therapy (HRT is the most widely used treatment for controlling the effects of menopause. This type of therapy causes some drug-related problems (DRP, which requires monitoring to control the negative effects and ensure patient adherence to therapy. Aims: Perform a pharmacotherapeutic monitoring and educate to menopausal patients in HRT of a community pharmacy from the city of Antofagasta. Methods: A 98-menopausal patients underwent a pharmaceutical intervention to identify the PRM and its resolution. It was applied to them a survey before and after educational activities about this disease and HRT to determine the knowledge on the subject. Results: During the pharmacotherapeutic monitoring was determined that 55% of patients using combined HRT. 62 DRPs were detected, of which 43 were resolved (69%; the most were Patient-Pharmacist (73%. The better resolution DRP were DRP 4(b “frequency of inadequate administration” and DRP 2(a “no medical indication”. At baseline, 90% had an inadequate level of knowledge about the disease and THR, 8% intermediate, and only 2% adequate. After the implementation of the education strategy, the level of knowledge increased, achieving at the end of the study only intermediate (10% and adequate (90% levels. Conclusions: The results confirm the importance of pharmaceutical intervention for the identification and resolution of DRP and the requirement to establish educational strategies to increase the knowledge about menopause and HRT in menopausal patients.
Full Text Available Phytotherapy has always played a leading role in therapeutics. However, a strong knowledge of the risk-benefit relationship of herbal products by patients and health professionals is necessary. The goals of this study were to characterize the consumption pattern of medicinal plants in patients in a community pharmacy, identify potential herb-drug interactions, and establish a list of recommendations for health professionals and/or patients in order to prevent/minimize negative outcomes arising from these interactions. In a sample of 25 patients, 24 cases of potential herb-drug interactions were detected. Most of the cases corresponded to the simultaneous use of a conventional medication with Ginkgo. The recommendation list involved monitoring the effectiveness and safety of conventional therapy associated with the use of medicinal plants, with particular focus on clinical and laboratory monitoring of the occurrence of bleeding, blood pressure, glycaemia and liver function. The results indicate that there is still a lack of knowledge about the possible risks of herbal products, which may adversely affect patient’s health. The pharmacist is in prime position to raise awareness in the population, avoiding harmful situations for the patient's health.
Luder, Heidi; Frede, Stacey; Kirby, James; King, Keith; Heaton, Pamela
The purpose of this study was to survey new enrollees in a community pharmacy, employer-based diabetes and hypertension coaching program to describe the characteristics, health beliefs, and cues to action of newly enrolled participants. A 70-question, 5-point Likert-type survey was developed using constructs from the Health Belief Model (HBM), Theory of Planned Behavior (TPB), and Theory of Reasoned Action (TRA). New enrollees in the coaching programs completed the survey. Survey responses between controlled and uncontrolled patients and patient demographics were compared. Between November 2011 and November 2012, 154 patients completed the survey. Patients were fairly well controlled with a mean hemoglobin A1C of 7.3% and a mean blood pressure of 134/82 mm Hg. The strongest cue to action for enrollment was the financial incentives offered by the employer (mean: 3.33, median: 4). White patients were significantly more motivated by financial incentives. More patients indicated they had not enrolled previously in the program because they were unaware it was available (mean: 2.89, median 3.0) and these patients were more likely to have an uncontrolled condition (P ≤ 0.050). A top factor motivating patients to enroll in a disease management coaching program was the receipt of financial incentives. Significant differences in HBM, TPB, and TRA responses were seen for patients with different demographics. © The Author(s) 2015.
Fredericks, Ian; Hollingworth, Samantha; Pudmenzky, Alex; Rossato, Laurence; Syed, Shahzad; Kairuz, Therése
Overuse of antibiotics is a global concern and the World Health Organisation (WHO) has warned of relapsing to an era with no effective antibiotics. In Australia, various national consumer campaigns had been running since 2000, and the concern was prioritised in 2011, when the need for a national approach to address antibiotic resistance was identified. The aim of this study was to explore consumer attitudes and knowledge about (upper respiratory tract) infections, colds and flu, and antibiotics, and to identify factors contributing to antibiotic misuse which could be addressed by tailored patient counselling. A community pharmacy in an area of Brisbane, Australia. A self-administered anonymous questionnaire was distributed among pharmacy consumers. Perceptions of, and knowledge about antibiotics were measured using a 5-point Likert-type scale of agreement/disagreement. The proportion of self-diagnosers and non self-diagnosers who agreed/disagreed with the attitude statement, "I know that I need antibiotics before I visit my doctor"; and the proportion of mistaken and non-mistaken who agreed/disagreed with the statement, "I will get better faster if I take antibiotics when I have a cold or flu". Over a third of the 252 participants believed that they would recover faster by taking antibiotics when suffering from a cold or flu, and nearly one-fifth felt that antibiotics would cure viral infections. More females (62.2 vs. 43.9 %) self-diagnosed (p = 0.002) although more males (42.1 vs. 30.8 %) were mistaken about the efficacy of antibiotics for treating colds and flus. Mistaken respondents were more likely than non-mistaken respondents to self-diagnose (p = 0.01). This study confirms a lack of knowledge among consumers about the efficacy of antibiotics in treating viral infections despite education campaigns. The findings strongly suggest there is a need for pharmacists and other health care professionals to elicit consumer beliefs and understanding about antibiotics
Laforest, Laurent; Licaj, Idlir; Devouassoux, Gilles; Chatté, Gérard; Belhassen, Manon; Van Ganse, Eric; Chamba, Geneviève
"Controllers-to-total asthma drug" ratios computed from claims data identify asthmatics at risk of exacerbations. Direct link of ratios to data obtained from patients, such as control and recent outcomes, would facilitate their interpretation. We studied the relationship between R1 ratio (inhaled corticosteroids (ICS)/total anti-asthma drug ratio) and the Asthma Control Test. Comparisons were also conducted for secondary outcomes (asthma-related hospital contacts, monthly medical contacts, use of oral corticosteroids, and perception of disease burden). Results with R1 ratio were compared with those obtained with a second ratio, "ICS-plus-leukotriene receptor antagonist/total asthma drug" (R2 = ICS + leukotriene receptor antagonist/total anti-asthma drugs). A survey was conducted in community pharmacies. Patients visiting with a prescription of anti-asthma drug and ≥12 months of drug dispensing recorded in the pharmacy were consecutively recruited. Dispensing data were linked to patient-reported outcomes. Asthma control and secondary outcomes were compared for both ratios between low-controller-ratio (R controller-ratio groups (R ≥ 50%), after excluding null values. Of the 919 eligible patients (mean age 37 years, 55% women), 90.2% and 92.4% had non-null values for R1 and R2, respectively. Compared with the low-controller-ratio groups, adjusted risks of being uncontrolled were significantly lower in the high-controller-ratio groups (RR = 0.64, 95%CI [0.54, 0.77] and RR = 0.57, 95%CI [0.47, 0.70], for R1 and R2 ratios, respectively). Likewise, fewer patients with secondary outcomes were observed in the high-controller-ratio groups, for both ratios. Asthma was better controlled among patients with high controller ratios, along with fewer asthma-related outcomes, for both R1 and R2 ratios. This confirms the utility of asthma/drug ratios in identifying patients at risk of exacerbations, notably in claims data. Copyright © 2014 John Wiley
Asayut, Narong; Sookaneknun, Phayom; Chaiyasong, Surasak; Saramunee, Kritsanee
Identify costs, outcomes and stakeholders' perspectives associated with incorporation of community pharmacy services into the Thai National Health Insurance System and their values to all stakeholders. Using a combination of search terms, a comprehensive literature search was performed using the Thai Journal Citation Index Centre, Health System Research Institute database, PubMed and references from recent reviews. Identified studies were published between January 2000 and December 2014. The review included publications in English and Thai on primary research undertaken in community pharmacies associated with the National Health Insurance System. Two independent authors performed study selection, data extraction and quality assessment. The literature search yielded 251 titles, with 18 satisfying the inclusion criteria. Clinical outcomes of community pharmacy services included control and reduction in blood pressure and blood sugar, improved adherence to medications, an increase in acceptance of interventions, and an increase in healthy behaviours. Thirty-three percentage of those at risk of diabetes and hypertension achieved normal blood sugar and blood pressure levels after being followed for 2-6 months by a community pharmacist. The cost of collaborative screening by community pharmacies and primary care units was US$ 4.5. Diabetes management costs were US$ 5.1-30.7. Community pharmacists reported high satisfaction rates. Stakeholders' perspectives revealed support for the community pharmacists' roles and the inclusion of community pharmacies as partners with the National Health Insurance System. Community pharmacy services improved outcomes for diabetic and hypertensive patients. This review supports the feasibility of incorporating community pharmacies into the Thai National Health System. © 2017 Royal Pharmaceutical Society.
Seubert, Liza J; Whitelaw, Kerry; Hattingh, Laetitia; Watson, Margaret C; Clifford, Rhonda M
Easy access to effective over-the-counter (OTC) treatments allows self-management of some conditions, however inappropriate or incorrect supply or use of OTC medicines can cause harm. Pharmacy personnel should support consumers in their health-seeking behaviour by utilising effective communication skills underpinned by clinical knowledge. To identify interventions targeted towards improving communication between consumers and pharmacy personnel during OTC consultations in the community pharmacy setting. Systematic review and narrative analysis. Databases searched were MEDLINE, EMBASE, Psycinfo, Cochrane Central Register and Cochrane Database of Systematic Reviews for literature published between 2000 and 30 October 2014, as well as reference lists of included articles. The search was re-run on 18 January 2016 and 25 September 2017 to maximise the currency. Two reviewers independently screened retrieved articles for inclusion, assessed study quality and extracted data. Full publications of intervention studies were included. Participants were community pharmacy personnel and/or consumers involved in OTC consultations. Interventions which aimed to improve communication during OTC consultations in the community pharmacy setting were included if they involved a direct measurable communication outcome. Studies reporting attitudes and measures not quantifiable were excluded. The protocol was published on Prospero Database of Systematic Reviews. Of 4978 records identified, 11 studies met inclusion criteria. Interventions evaluated were: face-to-face training sessions (n = 10); role-plays (n = 9); a software decision making program (n = 1); and simulated patient (SP) visits followed by immediate feedback (n = 1). Outcomes were measured using: SP methodology (n = 10) and a survey (n = 1), with most (n = 10) reporting a level of improvement in some communication behaviours. Empirical evaluation of interventions using active learning techniques
H. Laetitia Hattingh
Full Text Available Abstract Background Screening and brief interventions (SBI for alcohol related problems have been shown to be effective in health settings such as general practice or emergency departments. Recent data from the United Kingdom and New Zealand suggest that SBI can be delivered through community pharmacies, but this approach has not been tested in Australia. This study assesses the feasibility of delivering alcohol SBI via community pharmacists. Method We recruited five pharmacies and developed an SBI training package to be delivered by pharmacy staff, who screened consumers and delivered the brief intervention where appropriate. Consumers also completed a questionnaire on the process. At three months consumers were telephoned to enable ‘retention’ to be quantified. After completing recruitment, a semi-structured interview was conducted with pharmacists on the process of delivering the intervention, potential improvements and sustainability. Results Fifty consumer participants were screened, ten from each pharmacy. There were 28 (57 % men and 21 (43 % women with one not responding. Most (67 % were aged 25–55 years. Their AUDIT scores had a range of 0 to 39 (mean 10.9, SD 9.8 with 11 categorised as ‘hazardous (8–15’, four as ‘harmful (16–19’ and eight as ‘probably dependent (20+’ consumers of alcohol. Reactions to the process of SBI were generally favourable: for example 75 % agreed that it was either appropriate or very appropriate being asked about their alcohol consumption. With respect to follow-up interviews, 23 (46 % agreed that they could be contacted, including five from the highest AUDIT category. Subsequently 11 (48 % were contactable at three months. Three of the five non-low risk drinkers had reduced their level of risk over the three months. Ten pharmacists participated in semi-structured telephone interviews. Overall these pharmacists were positive about the intervention and five main themes emerged from the
Full Text Available Objective: To determine the direct financial impact for patients resulting from Medication Therapy Management (MTM interventions made by community pharmacists. Secondary objectives include evaluating the patient and physician acceptance rates of the community pharmacists’ recommended MTM interventions.Methods: This was a retrospective observational study conducted at 20 Price Chopper and Hen House grocery store chain pharmacies in the Kansas City metro area from January 1, 2010 to December 31, 2010. Study patients were Medicare Part D beneficiaries eligible for MTM services. The primary outcome was the change in patient out-of-pocket prescription medication expense as a result of MTM services.Results: Of 128 patients included in this study, 68% experienced no out-of-pocket financial impact on their medication expenses as a result of MTM services. A total of 27% of the patients realized a cost-savings (USD440.50 per year, (SD=289.69 while another 5% of patients saw a cost increase in out-of-pocket expense (USD255.66 per year, (SD=324.48. The net financial impact for all 128 patients who participated in MTM services was an average savings of USD102.83 per patient per year (SD=269.18, p<0.0001. Pharmacists attempted a total of 732 recommendations; 391 (53% were accepted by both the patient and their prescriber. A total of 341 (47% recommendations were not accepted because of patient refusal (290, 85% or prescriber refusal (51, 15%.Conclusions: Patient participation in MTM services reduces patient out-of-pocket medication expense. However, this savings is driven by only 32% of subjects who are experiencing a financial impact on out-of-pocket medication expense. Additionally, the majority of the pharmacists’ recommended interventions (53% were accepted by patients and prescribers.
Mehuys, E; Verrue, C; Van Borte, L; De Bolle, L; Van Tongelen, I; Remon, J P; De Looze, D
Upper gastrointestinal (GI) symptoms are a common reason for self-treatment with over-the-counter (OTC) medication. However, data on the typology of GI complaints for which individuals seek self-medication and, more importantly, on the prevalence of alarm symptoms in this population are scarce. This study aimed to investigate: (i) the nature of GI symptoms people intend to self-medicate, (ii) prevalence of alarm symptoms, (iii) compliance with referral advice given by the pharmacist, and (iv) self-reported efficacy and frequency of use of OTC medication for minor complaints. This descriptive study was performed in 63 community pharmacies. Participants (n=592, aged 18-80 y) completed a questionnaire to assess symptom characteristics and previous medical consulting. Based on this information, the pharmacist referred subjects to a physician or advised self-treatment. Four weeks later, participants were presented a follow-up questionnaire, evaluating compliance with referral advice or efficacy of self-treatment. The most frequently reported GI complaints were burning retrosternal discomfort (49.2%), acid regurgitation (53.2%) and bothersome postprandial fullness (51.2%). At least 1 alarm symptom was present in 22.4% of the individuals, difficulty in swallowing being the most prevalent one (15.4%). Although twenty-one percent of the customers were referred, only 51.7% of these actually contacted a physician. Almost all of the remaining customers who were advised self-treatment reported symptom relief with the obtained OTC drug (95.1%). Mild GI symptoms will mostly resolve with self-treatment. Yet, the value of pharmacist counselling on OTC treatment should be recognized, as community pharmacists can play an important role in
Mehuys, Els; Van Bortel, Luc; De Bolle, Leen; Van Tongelen, Inge; Remon, Jean-Paul; De Looze, Danny
Upper gastrointestinal (GI) symptoms are a common reason for self-treatment with over-the-counter (OTC) medication. However, data are scarce on the typology of GI complaints for which individuals seek self-medication and, more importantly, on the prevalence of alarm symptoms in this population. To investigate: (1) the nature of GI symptoms that people intend to self-medicate, (2) prevalence of alarm symptoms, (3) adherence to referral advice given by the pharmacist, and (4) self-reported efficacy and frequency of use of OTC medication for minor complaints. This descriptive study was performed in 63 community pharmacies. Participants (N = 592, aged 18-82 y) completed a questionnaire to assess symptom characteristics and previous medical consulting. Based on this information, the pharmacist referred subjects to a physician or advised self-treatment. Four weeks later, participants were presented a follow-up questionnaire evaluating their adherence to referral advice or efficacy of self-treatment. The most frequently reported GI symptoms were burning retrosternal discomfort (49.2%), acid regurgitation (53.2%), and bothersome postprandial fullness (51.2%). At least one alarm symptom was present in 22.4% of the individuals, with difficulty in swallowing being the most prevalent (15.4%). Although 21% of the customers were referred, only 51.7% of these contacted a physician. Almost all (95.1%) of the remaining customers who were advised self-treatment reported symptom relief with the OTC drug obtained. Mild GI symptoms will mostly resolve with self-treatment. Yet, the value of pharmacist counseling on OTC treatment should be recognized, as community pharmacists can play an important role in distinguishing symptoms that warrant further medical examination.
Franco-Trigo, L; Tudball, J; Fam, D; Benrimoj, S I; Sabater-Hernández, D
Collaboration between relevant stakeholders in health service planning enables service contextualization and facilitates its success and integration into practice. Although community pharmacy services (CPSs) aim to improve patients' health and quality of life, their integration in primary care is far from ideal. Key stakeholders for the development of a CPS intended at preventing cardiovascular disease were identified in a previous stakeholder analysis. Engaging these stakeholders to create a shared vision is the subsequent step to focus planning directions and lay sound foundations for future work. This study aims to develop a stakeholder-shared vision of a cardiovascular care model which integrates community pharmacists and to identify initiatives to achieve this vision. A participatory visioning exercise involving 13 stakeholders across the healthcare system was performed. A facilitated workshop, structured in three parts (i.e., introduction; developing the vision; defining the initiatives towards the vision), was designed. The Chronic Care Model inspired the questions that guided the development of the vision. Workshop transcripts, researchers' notes and materials produced by participants were analyzed using qualitative content analysis. Stakeholders broadened the objective of the vision to focus on the management of chronic diseases. Their vision yielded 7 principles for advanced chronic care: patient-centered care; multidisciplinary team approach; shared goals; long-term care relationships; evidence-based practice; ease of access to healthcare settings and services by patients; and good communication and coordination. Stakeholders also delineated six environmental factors that can influence their implementation. Twenty-four initiatives to achieve the developed vision were defined. The principles and factors identified as part of the stakeholder shared-vision were combined in a preliminary model for chronic care. This model and initiatives can guide policy
Hann, Mark; Schafheutle, Ellen I; Bradley, Fay; Elvey, Rebecca; Wagner, Andrew; Halsall, Devina; Hassell, Karen
Objectives This study aimed to identify the organisational and extraorganisational factors associated with existing variation in the volume of services delivered by community pharmacies. Design and setting Linear and ordered logistic regression of linked national data from secondary sources—community pharmacy activity, socioeconomic and health need datasets—and primary data from a questionnaire survey of community pharmacies in nine diverse geographical areas in England. Outcome measures Annual dispensing volume; annual volume of medicines use reviews (MURs). Results National dataset (n=10 454 pharmacies): greater dispensing volume was significantly associated with pharmacy ownership type (large chains>independents>supermarkets), greater deprivation, higher local prevalence of cardiovascular disease and depression, older people (aged >75 years) and infants (aged 0–4 years) but lower prevalence of mental health conditions. Greater volume of MURs was significantly associated with pharmacy ownership type (large chains/supermarkets>>independents), greater dispensing volume, and lower disease prevalence. Survey dataset (n=285 pharmacies; response=34.6%): greater dispensing volume was significantly associated with staffing, skill-mix, organisational culture, years open and greater deprivation. Greater MUR volume was significantly associated with pharmacy ownership type (large chains/supermarkets>>independents), greater dispensing volume, weekly opening hours and lower asthma prevalence. Conclusions Organisational and extraorganisational factors were found to impact differently on dispensing volume and MUR activity, the latter being driven more by corporate ownership than population need. While levels of staffing and skill-mix were associated with dispensing volume, they did not influence MUR activity. Despite recent changes to the contractual framework, the existing fee-for-service reimbursement may therefore not be the most appropriate for the delivery of
Full Text Available Mariam Fathima,1 Bandana Saini,1,2 Juliet M Foster,1 Carol L Armour1,3 1Woolcock Institute of Medical Research, Sydney Medical School, 2Faculty of Pharmacy, The University of Sydney, 3Central Sydney Area Health Service, Sydney, NSW, Australia Background and objective: Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case finding using microspirometry. The objective of this study was to assess the feasibility and effectiveness of COPD case-finding service provided by community pharmacists, utilizing a combination of risk assessment questionnaire and microspirometry. Methods: A 6-month service was conducted in 21 community pharmacies in Australia. Pharmacists trained in COPD case finding, including lung function test (LFT, invited their patients aged ≥35 years with a history of smoking and/or respiratory symptoms to participate. High-risk patients were identified via a COPD risk assessment questionnaire (Initial Screening Questionnaire [ISQ] and underwent LFT. Pharmacists referred patients with a forced expiratory volume in 1 second (FEV1/forced expiratory volume in 6 seconds (FEV6 ratio <0.75 to their general practitioner (GP for further assessment and diagnosis. Results: In all, 91 of 167 (54% patients had an ISQ score >3 indicating high COPD risk. Of the 157 patients who were able to complete LFT, 61 (39% had an FEV1/FEV6 ratio of <0.75 and were referred to their GP. Patients with high ISQ symptoms scores (>3 were at a significantly higher risk of an FEV1/FEV6 ratio of <0.75, compared to patients with fewer COPD symptoms. A total of 15 (10% patients were diagnosed with COPD by their GP. Another eight (5% patients were diagnosed with other medical conditions and 87% of these were initiated on treatment. Although only half of all screened patients lived in regional areas, 93
Witry, Matthew; Parry, Rachel; McDonough, Randal; Deninger, Michael
Medication nonadherence is a significant public health problem. Community pharmacists are positioned to intervene, however, the process is not well understood. To classify and quantify the reasons for nonadherence documented by community pharmacists. A retrospective content analysis of pharmacist notes related to nonadherence at a service oriented community pharmacy in the Midwest United States. Notes from the site's dispensing custom documentation software were obtained from September 1, 2014 through February 28, 2015 that were labeled "compliance", either prompted by proportion of days covered calculations or entered as a drug therapy problem. A code list was iterated for the notes based on the literature and by reading the notes and generating descriptive codes. A reliability analysis was calculated for two coders. Notes were coded, check-coded, and discrepancies were resolved using a consensus process. Frequencies were calculated for each code and representative text was selected. Pharmacists documented 3491 notes as part of their continuous medication monitoring process. Nineteen codes were developed. The reliability for the coders had a Cohen's Kappa of 0.749. The majority of notes (61.4%) documented the pharmacist evaluated the refill and had no concerns or would continue to follow. Also documented were specific reasons for out of range PDCs not indicative of a nonadherence problem. Only 2.2% of notes specifically documented a nonadherence problem, such as forgetfulness or cost. While pharmacists encountered many false positive nonadherence alerts, following up with patients led to hundreds of discussions and clarifications about how patients use their medications at home. These results suggest a small minority of late refills are judged by pharmacists as indicative of an adherence problem, contrary to the prevailing literature. Pharmacists may benefit from modifying their approach to nonadherence interviewing and documentation as they seek to address
Saini, Bandana; Krass, Ines; Armour, Carol
Pharmacists are uniquely placed in the healthcare system to address critical issues in asthma management in the community. Various programs have shown the benefits of a pharmacist-led asthma care program; however, no such programs have previously been evaluated in Australia. To measure the impact of a specialized asthma service provided through community pharmacies in terms of objective patient clinical, humanistic, and economic outcomes. A parallel controlled design, where 52 intervention patients and 50 control patients with asthma were recruited in 2 distinct locations, was used. In the intervention area, pharmacists were trained and delivered an asthma care model, with 3 follow-up visits over 6 months. This model was evaluated based on clinical, humanistic, and economic outcomes compared between and within groups. There was a significant reduction in asthma severity in the intervention group, 2.6 +/- 0.5 to 1.6 +/- 0.7 (mean +/- SD; p < 0.001) versus the control group, 2.3 +/- 0.7 to 2.4 +/- 0.5. In the intervention group, peak flow indices improved from 82.7% +/- 8.2% at baseline to 87.4% +/- 8.9% (p < 0.001) at the final visit, and there was a significant reduction in the defined daily dose of albuterol used by patients, from 374.8 +/- 314.8 microg at baseline to 198.4 +/- 196.9 microg at the final visit (p < 0.015). There was also a statistically significant improvement in perceived control of asthma and asthma-related knowledge scores in the intervention group compared with the control group between baseline and the final visit. Annual savings of $132.84(AU) in medication costs per patient and $100,801.20 for the whole group, based on overall severity reduction, were demonstrated. Based on the results of this study, it appears that a specialized asthma care model offers community pharmacists an opportunity to contribute toward improving asthma management in the Australian community.
Bryan, Amy R; Liu, Yifei; Kuehl, Peggy G
To evaluate whether the use of personal selling, in combination with other promotional techniques, could improve patient commitment to receive the targeted intervention of herpes zoster vaccine (Zostavax-Merck). Two locally owned grocery store chain pharmacies in the Kansas City, MO, metropolitan area (Price Chopper Pharmacy 11 [PC11] and Price Chopper Pharmacy 36 [PC36]). Price Chopper Pharmacy employs pharmacists who are able to administer vaccinations to patients within the dispensing workflow. Passive signage promoting zoster vaccine was placed at both PC11 and PC36. Personal selling by pharmacy staff to targeted patients was implemented at PC36, where patients were encouraged to receive zoster vaccine at prescription pick up and/or by personalized letter. Primary measures included comparison of the number committing to receive zoster vaccine at either pharmacy, comparison of patient perceptions regarding each pharmacy's promotion of zoster vaccine, and pharmacy staff time spent identifying targeted patients and performing personal selling activities. 90 of 745 targeted patients (12.1%) at PC36 made commitments to receive zoster vaccine compared with 9 of 614 (1.5%) at PC11 (P < 0.001). The barrier of "Dr. hasn't told me I need it" was reduced for PC36 patients (P < 0.05). Patients receiving vaccination had a more favorable attitude toward receiving zoster vaccine than unvaccinated patients (P < 0.01). Among unvaccinated patients, those at PC36 had a more favorable attitude toward receiving zoster vaccine after interacting with a pharmacist (P < 0.05). Personal selling increased patient commitment to receiving a targeted intervention significantly. By using personal selling, pharmacists resolved barriers to immunization.
Westrick, Salisa C; Hohmann, Lindsey A; McFarland, Stuart J; Teeter, Benjamin S; White, Kara K; Hastings, Tessa J
To determine parents' knowledge and attitudes regarding human papillomavirus (HPV) vaccinations in their adolescent children and to describe parents' perceptions of adolescent vaccinations in community pharmacies. In-depth interviews were completed with parents or guardians of children ages 11-17 years from Alabama's Lee and Macon counties. One-hour long, open-ended telephonic or in-person interviews were conducted until the saturation point was reached. Using ATLAS.ti software and thematic analysis, interview transcripts were coded to identify themes. Twenty-six parents were interviewed, most of whom were female (80.8%) and white (50%). A total of 12 themes were identified. First, two themes emerged regarding elements facilitating children's HPV vaccination, the most common being positive perception of the HPV vaccine. Second, elements hindering children's vaccination contained seven themes, the top one being lack of correct or complete information about the HPV vaccine. The last topic involved acceptance/rejection of community pharmacies as vaccination settings, and the most frequently cited theme was concern about pharmacists' clinical training. Physician-to-parent vaccine education is important, and assurances of adequate pharmacy immunization training will ease parents' fears and allow pharmacists to better serve adolescents, especially those who do not see physicians regularly. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.
According to the "Japan Revitalization Strategy" established in June 2013, "the government will promote better contributions of local pharmacies and pharmacists in encouraging self-medication of citizens by making pharmacies the community-based hub for providing information, giving advice on the proper use of non-prescription drugs, etc. and offering consultation and information service concerning health". In addition, the "Demanded Function and Ideal Form of Pharmacy," published in January 2014, requested a change, from pharmacies that specialized in dispensing medicines to pharmacies that serve as whole healthcare stations, providing pharmaceutical care based on patients' medical history, including the intake of dietary supplements. The medication fee was revised in April 2014 to enhance family pharmacy services and the management of pharmaceutical care. At that time, blood testing at a registered pharmacy was officially allowed under strict regulation. Revision of the "Pharmacist Law" in June 2014 included a request to pharmacists to provide pharmaceutical advice in addition to information. For the mitigation of drug-induced tragedies, the "Pharmaceutical Affairs Law" was amended to the "Pharmaceutical and Medical Device Act (PMD Act)" in November 2014, and proper use of medicines was imposed on healthcare professionals and other stakeholders. Patients were also requested to learn and understand the safety and harmful effects of medicines, and were requested to use medicines appropriately. As mentioned above, the status of pharmacies and pharmacists has dramatically changed in the past 2 years, and such changes over time are required.
Thøgersen, Marie Høgh; Morthorst, Britt; Nordentoft, Merete
Assertive community treatment (ACT) has been claimed to be paternalistic and coercive, yet little is known about how patients experience the assertive aspects of ACT. To explore views on--and perceptions of--coercion of patients in Danish assertive community teams. In-depth interviews were...... conducted with six purposefully selected patients and analysed using thematic analysis. Patients reported lack of influence on treatment process and a poor alliance with case-mangers, not being recognised as an autonomous person, and experiences of staff crossing the line and intruding privacy, as most...... central to perceptions of coercion. A collaborative and mutually trusting relationship, commitment, persistence and availability of staff, and recognition of the need for social support and help with everyday activities, were most important for counteracting such experiences. Perceptions of coercion were...
Nazar, Hamde; Nazar, Zachariah; Simpson, Jill; Yeung, Andre; Whittlesea, Cate
To demonstrate the contribution of community pharmacy from NHS 111 referrals out of hours (OOH) for emergency supply repeat medication requests via presentation of service activity, community pharmacist feedback and lean thinking transformation. Descriptive service evaluation using routine service activity data over the pilot period; survey of community pharmacists, and service redesign through lean thinking transformation. North East of England NHS 111 provider and accredited community pharmacies across the North East of England. Patients calling the North East of England NHS 111 provider during OOH with emergency repeat medication supply requests. NHS 111 referral to community pharmacies for assessment and if appropriate, supply of emergency repeat medication. Number of emergency repeat medication supply referrals, completion rates, reasons for rejections, time of request, reason for access, medication(s), pharmaceutical advice and services provided. Secondary outcomes were community pharmacist feedback and lean thinking transformation of the patient pathway. NHS 111 referred 1468 patients to 114 community pharmacies (15/12/2014-7/4/2015). Most patients presented on Saturdays, with increased activity over national holidays. Community pharmacists completed 951 (64.8%) referrals providing 2297 medications; 412 were high risk. The most common reason for rejecting referrals was no medication in stock. Community pharmacists were positive about the provision of this service. The lean thinking transformation reduced the number of non-added value steps, waits and bottlenecks in the patient pathway. NHS 111 can redirect callers OOH from urgent and emergency care services to community pharmacy for management of emergency repeat medication supply. Existing IT and community pharmacy regulations allowed patients to receive a medication supply and pharmaceutical advice. Community pharmacists supported integration into the NHS OOH services. Adopting lean thinking provided a
Tibaek, S; Holmestad-Bechmann, N; Pedersen, Trine B
OBJECTIVES: To establish reference values for maximum walking speed over 10m for independent community-dwelling Danish adults, aged 60 to 79 years, and to evaluate the effects of gender and age. DESIGN: Cross-sectional study. SETTING: Danish companies and senior citizens clubs. PARTICIPANTS: Two....../second, respectively. Significant differences (Pgender categories. Men were found to walk faster than women, and individuals aged 60 to 69 years walked faster than individuals aged 70 to 79 years. CONCLUSIONS: This study established the reference values for maximum walking speed...... over 10m among independent community-dwelling Danish adults aged 60 to 79 years. The study results showed significant differences in maximum walking speed for different ages and between men and women....
Harvey, Jasmine; Avery, Anthony J; Waring, Justin; Barber, Nick
The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2)) has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual model development process, we identified three
Lowrie, Richard; Johansson, Lina; Forsyth, Paul; Bryce, Stuart Lochhead; McKellar, Susan; Fitzgerald, Niamh
Heart failure (HF) is common, disabling and deadly. Patients with HF often have poor self-care and medicines non-adherence, which contributes to poor outcomes. Community pharmacy based cognitive services have the potential to help, but we do not know how patients view community-pharmacist-led services for patients with HF. We aimed to explore and portray in detail, the perspectives of patients receiving, and pharmacists delivering an enhanced, pay for performance community pharmacy HF service. Community pharmacies and community-based patients in Greater Glasgow and Clyde, Scotland. Focus groups with pharmacists and semi-structured interviews with individual patients by telephone. Cross sectional thematic analysis of qualitative data used Normalization Process Theory to understand and describe patient's reports. Experiences of receiving and delivering an enhanced HF service. Pharmacists voiced their confidence in delivering the service and highlighted valued aspects including the structured consultation and repeated contacts with patients enabling the opportunity to improve self care and medicines adherence. Discussing co-morbidities other than HF was difficult and persuading patients to modify behaviour was challenging. Patients were comfortable discussing symptoms and medicines with pharmacists; they identified pharmacists as fulfilling roles that were needed but not currently addressed. Patients reported the service helped them to enact HF medicines and HF self care management strategies. Both patients receiving and pharmacists delivering a cognitive HF service felt that it addressed a shortfall in current care. There may be a clearly defined role for pharmacists in supporting patients to address the burden of understanding and managing their condition and treatment, leading to better self management and medicines adherence. This study may inform the development of strategies or policies to improve the process of care for patients with HF and has implications for
Full Text Available Background: Non-steroid anti-inflammatory drugs (NSAIDs are a widely used therapeutic group in the world, and particularly in the Portuguese population. Objective: To compare NSAID’s use by prescription and self-medication acquisition and to determine the pattern of indication of NSAIDs, their usage profile and possible implications for patients’ safety. Methods: A cross-sectional design was used where individuals presenting at a community pharmacy requesting NSAIDs during the study period (one month were invited to answer a face-to-face interview where socio-demographic characteristics, the indication pattern and previous experience of side effects were assessed. A follow-up interview was performed one week later to assess the incidence of adverse effects. The study was ethically approved. Results: A sample of 130 NSAIDs users was recruited, comprising mostly women (n=87; 66.9%, actively employed (n=77; 59.2% and presenting a mean age of 49.5 years old (SD=20.49. An equal proportion of individuals acquired NSAIDs by self-medication and with medical prescription (n=65; 50%. Over 4/5 of patients (n=57; 87.7% acquiring NSAIDs without a prescription were self-medicated by their own initiative, and only 10.8% (n=7 had been advised by the pharmacist. The most commonly acquired active substances were ibuprofen and diclofenac. Self-medicated users more frequently resorted to topical NSAIDs following short term treatments. The major underlying condition motivating NSAIDs sought were musculoskeletal disorders (45.0%, regardless of the regimen. An important proportion of prevalent users of NSAIDs reported previous experience of adverse effects (11.3%. One week after initiating NSAID therapy, a small proportion of patients reported incidence of adverse effects. Conclusion: Self-medication with NSAIDs is sought for numerous medical conditions. Reported adverse effects (prevalent and incident confirm the need for a more rational use of NSAIDs and ongoing
Piecuch, Anna; Makarewicz-Wujec, Magdalena; Kozłowska-Wojciechowska, Małgorzata
Background An informed or shared decision-making model is desirable to support the choice of over-the-counter (OTC) medications in pharmacies: it respects patient empowerment in self-medication. Such a model is achievable provided that pharmacists are a credible, competent information source open to patient needs. Objective To study the dependencies among selected factors that may influence the provision of OTC medication information. The study was conducted from the perspective of a community pharmacist. Method The study consisted of an auditorium survey with a self-administered questionnaire. We attempted to determine the relationships among three selected constructs: patient centredness (four items), competence (four items), and provision of OTC medication information (six items) as latent variables. We analysed hypothetical relationships among the observable variables and latent variables using structural equation modelling. Main outcome measure Selected factors that may influence the provision of OTC medication information. Results In all, 1496 pharmacists took part in the study. The model demonstrated adequate fit (χ 2 = 198.39, df = 64). The patient-centredness construct was demonstrated to have a strong direct positive impact on the provision of OTC medication information construct (β = 0.77, P < 0.05). Provision of OTC medication information was also shown to have a strong direct effect on the competence variable (β = 0.90, P < 0.05). Conclusion If a pharmacist is patient centred, there is a greater possibility that they will provide information about OTC medicines; that may influence the pharmacist's feelings about their ability to cope with patient initiatives and enhance the pharmacist's selfperceived competence.
Nunes, Ana P; Costa, Isabel M; Costa, Filipa A
Non-steroid anti-inflammatory drugs (NSAIDs) are a widely used therapeutic group in the world, and particularly in the Portuguese population. To compare NSAID's use by prescription and self-medication acquisition and to determine the pattern of indication of NSAIDs, their usage profile and possible implications for patients' safety. A cross-sectional design was used where individuals presenting at a community pharmacy requesting NSAIDs during the study period (one month) were invited to answer a face-to-face interview where socio-demographic characteristics, the indication pattern and previous experience of side effects were assessed. A follow-up interview was performed one week later to assess the incidence of adverse effects. The study was ethically approved. A sample of 130 NSAIDs users was recruited, comprising mostly women (n=87; 66.9%), actively employed (n=77; 59.2%) and presenting a mean age of 49.5 years old (SD=20.49). An equal proportion of individuals acquired NSAIDs by self-medication and with medical prescription (n=65; 50%). Over 4/5 of patients (n=57; 87.7%) acquiring NSAIDs without a prescription were self-medicated by their own initiative, and only 10.8% (n=7) had been advised by the pharmacist. The most commonly acquired active substances were ibuprofen and diclofenac. Self-medicated users more frequently resorted to topical NSAIDs following short term treatments. The major underlying condition motivating NSAIDs sought were musculoskeletal disorders (45.0%), regardless of the regimen. An important proportion of prevalent users of NSAIDs reported previous experience of adverse effects (11.3%). One week after initiating NSAID therapy, a small proportion of patients reported incidence of adverse effects. Self-medication with NSAIDs is sought for numerous medical conditions. Reported adverse effects (prevalent and incident) confirm the need for a more rational use of NSAIDs and ongoing pharmacovigilance.
Phung, Alan; Luo, Lauren; Breik, Noor; Alessi-Severini, Silvia
At 17.3%, smoking rates in Manitoba continue to exceed the national average. In this province, a total health care spending of more than $200 million per year has been attributed to smoking. This study examined the use of smoking cessation agents, including nicotine replacement products and prescription medications, in a sample of smokers in the city of Winnipeg. A simple multiple-choice questionnaire was administered to willing individuals attending 2 community pharmacies in Winnipeg, Manitoba. Data on demographics, smoking habits, previous attempts of smoking cessation and previous and current use of over-the-counter and prescription smoking cessation products were collected anonymously. Of the 2237 individuals who were approached, 586 were smokers (26.2%) and 180 responded to the survey (30.7%); 48.9% were female. A majority of smokers (32.8%) reported smoking 16 to 25 cigarettes per day. More than 90% had smoked for more than 5 years, 27.2% had more than 5 previous quit attempts and 82.1% used smoking cessation products with the intention to quit. Self-motivation (44.4%) and family/friend advice (28.3%) were major reasons for quitting. Impact of health care practitioners' advice was low (6.4%). More than 80% of respondents reported that they had no insurance coverage for their smoking cessation products. Despite having the highest rate of use, both nicotine gum (33.3%) and patches (24.4%) were reported to have lower rates of perceived efficacy. Electronic cigarette (97.9%) and varenicline (70.6%) had the highest rates of reported effectiveness. Smokers wanting to quit undergo many attempts. Pharmacists should assume a key role in reaching out to smokers.
Erni, Pina; von Overbeck, Jan; Reich, Oliver; Ruggli, Martine
The Swiss Pharmacists Association has launched a new collaborative project, netCare. Community pharmacists provide a standard form with structured triage based on decision trees and document findings. As a backup, they can collaborate with physicians via video consultation. The aim of the study was to evaluate the impact of this service on the Swiss health care system. All pharmacists offering netCare completed two training courses, a course covering the most common medical conditions observed in primary health care and a specific course on all of the decision trees. The pharmacists were free to decide whether they would provide the usual care or offer netCare triage. The patient was also free to accept or refuse netCare. Pharmacists reported the type of ailment, procedure of the consultation, treatment, patient information and outcomes of the follow-up call on a standardized form submitted to the study center. Pharmacists from 162 pharmacies performed 4118 triages over a period of 21 months. A backup consultation was needed for 17% of the cases. In follow-up calls, 84% of the patients who were seen only by pharmacists reported complete relief or symptom reduction. netCare is a low-threshold service by which pharmacists can manage common medical conditions with physician backup, if needed. This study showed that a pharmacist could resolve a large proportion of the cases. However, to be efficient and sustainable, this service must be fully integrated into the health care system. Copyright © 2015 Elsevier Inc. All rights reserved.
Lam, Annie Y; Nguyen, Juliet K; Parks, Jason J; Morisky, Donald E; Berry, Donna L; Wolpin, Seth E
To test the effect of "Talking Pill Bottles" on medication self-efficacy, knowledge, adherence, and blood pressure readings among hypertensive patients with low health literacy and to assess patients' acceptance of this innovation. Longitudinal nonblinded randomized trial with standard treatment and intervention arms. Two community pharmacies serving an ethnically diverse population in the Pacific Northwest. Participants were consented patients with antihypertension prescriptions who screened positive for low health literacy based on the Test of Functional Health Literacy Short Form. Participants in the intervention arm received antihypertensive medications and recordings of pharmacists' counseling in Talking Pill Bottles at baseline. Control arm participants received antihypertensive medications and usual care instructions. Comparison and score changes between baseline and day 90 for medication knowledge test, Self-Efficacy for Appropriate Medication Use Scale (SEAMS), Morisky Medication Adherence Scale (MMAS-8), blood pressure, and responses to semistructured exit interviews and Technology Acceptance Model surveys. Of 871 patients screened for health literacy, 134 eligible participants were enrolled in the trial. The sample was elderly, ethnically diverse, of low income, and experienced regarding hypertension and medication history. In both arms, we found high baseline scores in medication knowledge test, SEAMS, and MMAS-8 and minimal changes in these measures over the 90-day study period. Blood pressure decreased significantly in the intervention arm. Acceptability scores for the Talking Pill Bottle technology were high. Our results suggest that providing audio-assisted medication instructions in Talking Pill Bottles positively affected blood pressure control and was well accepted by patients with low health literacy. Further research involving newly diagnosed patients is needed to mitigate possible ceiling effects that we observed in an experienced population
Fathima, Mariam; Saini, Bandana; Foster, Juliet M; Armour, Carol L
Case finding of patients at risk of COPD by community pharmacists could identify a substantial number of people with undiagnosed COPD, but little is known about the feasibility and effectiveness of pharmacy-based COPD case finding using microspirometry. The objective of this study was to assess the feasibility and effectiveness of COPD case-finding service provided by community pharmacists, utilizing a combination of risk assessment questionnaire and microspirometry. A 6-month service was conducted in 21 community pharmacies in Australia. Pharmacists trained in COPD case finding, including lung function test (LFT), invited their patients aged ≥35 years with a history of smoking and/or respiratory symptoms to participate. High-risk patients were identified via a COPD risk assessment questionnaire (Initial Screening Questionnaire [ISQ]) and underwent LFT. Pharmacists referred patients with a forced expiratory volume in 1 second (FEV 1 )/forced expiratory volume in 6 seconds (FEV 6 ) ratio 3 indicating high COPD risk. Of the 157 patients who were able to complete LFT, 61 (39%) had an FEV 1 /FEV 6 ratio of 3) were at a significantly higher risk of an FEV 1 /FEV 6 ratio of <0.75, compared to patients with fewer COPD symptoms. A total of 15 (10%) patients were diagnosed with COPD by their GP. Another eight (5%) patients were diagnosed with other medical conditions and 87% of these were initiated on treatment. Although only half of all screened patients lived in regional areas, 93% of those diagnosed with COPD were from regional areas. A brief community pharmacy-based COPD case-finding service utilizing the ISQ, LFT and GP referral is feasible and may lead to identification and diagnosis of a substantial number of people with COPD. This might be an important strategy for reducing the burden of COPD, particularly for those living in rural locations.
Skovse, Astrid Ravn
This presentation sets out to explore the relationship between geographical orientation, everyday mobility and linguistic practice among young people in a rural area in Southern Denmark. The Danish speech community as a whole presents a case of rather extensive dialect levelling due to processes...... dialect in their everyday (Monka and Hovmark, in press). There are, though, huge inter- as well as intraindividual differences among the participants in the study (28 young people aged 15-16 years at the time of the data collection). In general, boys use local features to a larger extent than girls......, although some girls use a large amount of local features, and some boys use a small amount (ibid.). Drawing on data from individual interviews and focus group conversations, as well as data from methods inspired by insights from human geography and urban sociology, I ask whether (and if so, how) we can...
Osler, Merete; Jorgensen, Torben; Gerdes, Lars Ulrik
AIM: Myocardial infarction incidence declined by 3-5% per year from 1982-92 in the Danish study population of the WHO MONICA project. This study examined whether psychosocial coronary risk factors changed in the population during this period. METHODS: Cross-sectional data from 6,695 Danish men...... or emotional distress. The changes in the psychosocial factors were the same in different educational groups. CONCLUSION: The socioeconomic position of the population improved at the individual and the community level during the study period. This was concurrent with the declining incidence of myocardial...
Full Text Available Yared Belete Belay Pharmacoepidemiology and Social Pharmacy Course and Research Team, Department of Pharmacy, Mekelle University, Mekelle, Ethiopia Introduction: Job satisfaction is a multidimensional, enduring, important, and much-researched concept in the field of organizational behavior and has been identified as recognition in one’s field of work, level of salary, opportunities for promotion, and achievement of personal goals. Job satisfaction directly affects the labor market behavior and economic efficiency by means of the impact on productivity and turnover of staff. The aim of this study was to assess the satisfaction level of pharmacy professionals in Mekelle city. Methods: This institution-based cross-sectional study was conducted as a survey and only included voluntary participants. Those participants who did not volunteer to participate were excluded from the study. A structured questionnaire was used as a data collection tool; it was developed from different literature in the English language, and then the original tool was translated to the local language for the purpose of understanding. Results: In Mekelle, ~100 pharmacy professionals work in private medicine retail outlets. From those, only 60 volunteered to participate in this study. Significant difference in job satisfaction and job stress were observed between those working full-time and part-time, with P-values of 0.031 and 0.021, respectively. Conclusion: From the findings of the current study, it can be concluded that around two-thirds of pharmacy professionals in Mekelle city were satisfied with their professional practice. Keywords: job satisfaction, pharmacy professionals and retail outlets
Hilt, Robert; Wolf, Christine; Koprowicz, Kent; Thomas, Elizabeth; Chandler, Mary; Hao, Xiao Lei; Russell, Matthew; Le, Tung; Hooks, Lee; King, Bryan
One thousand five hundred parents filling a psychiatric prescription for their 6-18 year old child with a multi-state retail pharmacy chain received a single mailed invitation to complete a detailed online survey. 276 parents responded (18.4%). 60% of children on medications had a parent rated CBCL scale score in the clinically significant range at enrollment (T score ≥65), with a similar frequency of clinically significant CBCL scores through 15 months of survey followup. 47% of medication regimens were noted to be causing persistent side effects. This simple community based data collection method can offer a unique way to investigate naturalistic treatment outcomes.
Heringa, Mette; Floor-Schreudering, Annemieke; De Smet, Peter A G M; Bouvy, Marcel L
OBJECTIVE: The aim was to investigate the management of drug therapy alerts on safe use of antibiotics in elderly patients with (potential) renal impairment and the contribution of optional creatinine point of care testing (PoCT) in community pharmacy practice. METHODS: Community pharmacists used a
Buurma, H.; Schalekamp, T.; Egberts, A.C.G.; Smet, P.A.G.M. de
BACKGROUND: Pharmacists contribute to the detection and prevention of drug therapy-related problems, including drug-drug interactions. Little is known about compliance with pharmacy practice guidelines for the management of drug-drug interaction alerts. OBJECTIVE: To measure the compliance of
Collins, Jack Charles; Schneider, Carl Richard; Naughtin, Clare Louise; Wilson, Frances; de Almeida Neto, Abilio Cesar; Moles, Rebekah Jane
To determine whether repeated mystery shopping visits with feedback improve pharmacy performance over nine visits and to determine what factors predict an appropriate outcome. Prospective, parallel, repeated intervention, repeated measures mystery shopping (pseudopatient) design. Thirty-six community pharmacies in metropolitan Sydney, Australia in March-October 2015. Sixty-one University of Sydney pharmacy undergraduates acted as mystery shoppers. Students enrolled in their third year of Bachelor of Pharmacy in 2015 were eligible to participate. Any community pharmacy in the Sydney metropolitan region was eligible to take part and was selected through convenience sampling. Repeated mystery shopping with immediate feedback and coaching. Outcome for each given scenario (appropriate or not) and questioning scores for each interaction. Five hundred and twenty-one visits were analysed, of which 54% resulted in an appropriate outcome. Questioning scores and the proportion of interactions resulting in an appropriate outcome significantly improved over time (PInvolvement of pharmacists, visit number, increased questioning score and the prescribed scenario were predictors of an appropriate outcome (P=0.008, P=0.022, Pinvolving a pharmacist had greater scores than those without (P<0.001). Repeated mystery shopping visits with feedback were associated with improved pharmacy performance over time. Future work should focus on the role of non-pharmacist staff and design interventions accordingly. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Hohmeier, Kenneth C; McDonough, Sharon L K; Wang, Junling
Point-of-care testing (POCT) is a specialty of laboratory medicine that occurs at the bedside or near the patient when receiving health services. Despite its established clinical utility and consumer demand in the community pharmacy, the implementation of POCT within this setting has remained modest for a variety of reasons. One possible solution to this problem is the concept of co-creation - the partnership between consumer and manufacturer in the development of value for a service or device. Using the theoretical underpinning of co-creation, this study aimed to investigate perceptions of point-of-care-testing (POCT) industry leadership on the community pharmacy market in the United States to uncover reasons for limited implementation within community pharmacies. Participants were recruited for this study through the use of snowball sampling. A series of semi-structured interviews were conducted with the participants via telephone. Interviews were recorded, transcribed, and entered into a qualitative analysis software program to summarize the data. Five key themes were uncovered: gaps in understanding, areas of positive impact, barriers to implementation, facilitators of implementation, and community pharmacy - a potential major player. Through uncovering gaps in perceptions, it may be possible to leverage the U.S. pharmacy industry's size, potential for scalability, and ease of patient access to further patient care. Copyright © 2016 Elsevier Inc. All rights reserved.
Minyaliwa, Collins; Bandawe, Chiwoza; Mwale, Richman James
To determine the knowledge of dispensers in hospital and community pharmacies within Blantyre on new malaria treatment guidelines. An interviewer administered questionnaire was used for data collection and the questions focused on the knowledge of dispensers on the new malaria treatment guidelines and whether the subjects were involved in the preparation or implementation of the guidelines or had undertaken any training on how to dispense the new anti-malarial medicines. None of the participants had been involved in the preparation of the treatment guidelines and only 45.5% of the participants had undertaken the pre-implementation training. Ninety percent of the interviewees had knowledge concerning the appropriate treatment of malaria in pregnancy. However, as many as 90.9% of the interviewed participants could not mention any possible five or more side-effects of LA and only 13.6% knew how to properly manage the possible effects. Only 27.3% knew the correct dose regimen of LA and none of them knew the condition of taking LA with a fatty meal for improved absorption. Lack of involvement of the pharmaceutical personnel working in hospital and community pharmacies, from the preparation of new malaria treatment guidelines to their implementation, inadequate training and qualifications of the dispensing personnel contributed to their lack of knowledge and skill on how to rationally dispense the medicines. Pharmaceutical personnel dispensing in the pharmacies need to be involved from the beginning in the preparation of treatment guidelines. Adequate training should be provided and followed by continuous professional education.
Full Text Available Objectives: ‘Self Care’ cards play a significant role in delivering health education via community pharmacies in Australia and New Zealand. The primary objective of this study was to evaluate whether such an initiative could have a similar impact in an Irish context. The secondary objective was to understand the importance of health literacy to this initiative.Methods: Ten cards were developed for the Irish healthcare setting and trialed as a proof of concept study. The pilot study ran in ten community pharmacies in the greater Cork area for a six-month period. Using a mixed methods approach (Questionnaires & focus group staff and patient reactions to the initiative were obtained. Concurrent to the pilot study, readability scores of cards (Flesch-Kincaid, Fry, SMOG methods and the Rapid Estimate of Adult Literacy in Medicine (REALM health literacy screening tool was administered to a sample of patients.Results: 88.7% of patient respondents (n=53 liked the concept of the ‘Self Care’ cards and 83% of respondents agreed that the use of the card was beneficial to their understanding of their ailment. Focus groups with Pharmacy staff highlighted the importance of appropriate training for the future development of this initiative. An emerging theme from designing the cards was health literacy. The pilot ‘Self Care’ cards were pitched at too high a literacy level for the general Irish public to understand as determined by readability score methods. It was found that 19.1% of a sample population (n=199 was deemed to have low health literacy skills.Conclusion: The ‘Self Care’ initiative has the potential to be Pharmacy’s contribution to health education in Ireland. The initiative needs to be cognizant of the health literacy framework that equates the skills of individuals to the demands placed upon them.
LeMay, Kate S; Armour, Carol L; Reddel, Helen K
Guidelines recommend basing asthma management on assessment of asthma control. Validated control tools, while suitable for clinical research, may not be feasible for routine use in primary care. To describe the performance of the Pharmacy Asthma Control Screening tool (PACS) compared with the Asthma Control Questionnaire (ACQ-6). Data were obtained from a multicentre study of a community pharmacy asthma management programme in Australia, with three or four visits over six months. Eligible participants had suboptimal asthma control or no recent visit to their doctor for asthma. Asthma control was assessed at baseline and at six months with the PACS tool and ACQ-6. A total of 570 patients were enrolled and 398 (70%) completed the programme. The average ACQ-6 score was 1.58±1.05 at baseline and 0.96±0.88 (n=392) after six months. Sensitivity and specificity of PACS 'poor control' for not well-controlled asthma (ACQ- 6 >1.0) were 0.92 and 0.66, respectively, at baseline and 0.76 and 0.83 at six months. Agreement between the two tools at six months was moderate (κ=0.54). Both tools showed highly significant change during the study (p<0.0001 for each), but agreement between the change in the two tools was only fair (κ=0.31). This study shows that a simple asthma control screening tool is feasible for use in community pharmacies and has good sensitivity for identifying patients with not well-controlled asthma. Screening tools are useful in primary care to identify patients who require more detailed assessment of their asthma status, whereas for monitoring asthma control over time, a continuous control measure is more appropriate.
Full Text Available Self-monitoring of blood glucose (SMBG is clearly correlated with increased life expectancy and quality of life in type 2 diabetic patients. Objective: The objective of our study was to record and assess the errors patients make in preparing, performing, and processing self-monitoring of blood glucose (SMBG. Furthermore, the study aimed to determine to what extent a single standardized SMBG instruction session in a community pharmacy might reduce the number of patients making errors or the number of errors per patient. Methods: Between May and October 2005, SMBG of 462 randomly selected patients with type 2 diabetes was monitored in 32 pharmacies specialized in diabetes care. The patients performed blood glucose self-tests using their own blood glucose meters. Self-testing was monitored using a standardized documentation sheet on which any error made during the performance of the test was recorded. If necessary, patients were instructed in the accurate operation of their meter and the use of the necessary equipment. Additionally, patients obtained written instructions. Six weeks later, assessment of the quality of patient’s SMBG was repeated.Results: During the first observation, 383 patients (83% made at least one mistake performing SMBG. By the time of the second observation, this frequency had fallen to 189 (41% (p<0.001. The average number of mistakes fell from 3.1 to 0.8 per patient. Mistakes that may potentially have led to inaccurate readings were initially recorded for 283 (61% and at study end for 110 (24% patients (p<0.001. Conclusion: It is important to periodically instruct type 2 diabetic patients in the proper SMBG technique in order to ensure accurate measurements. In this study it was shown that community pharmacies specialized in diabetes care can provide this service effectively.
Fittler, András; Bosze, Gergely; Botz, Lajos
As internet is now available to nearly everyone in Hungary, the accessibility of websites offering pharmaceutical products is also increasing. The national and international regulation of these sites is currently an unsolved problem worldwide, thus potentially harmful, counterfeit and prescription only medicines are easily accessible on the market. We aimed to measure and estimate the current situation of the ordering of online medicines. In 5 Hungarian cities 434 self-administered questionnaires were collected in community pharmacies. Our results show that 6.2% of the respondents have already ordered drugs or dietary supplements online and approximately same amount of people are considering this option in the near future. Based on our survey mostly the educated, the 30-49 year old people and women are likely to buy drugs online. Every fifth respondent reported willingness to buy drugs online from abroad if lower prices were offered. Most people do not know that the quality of medicines purchased online could be different from the ones purchased from community pharmacies. We would like to draw attention of healthcare professionals to the rising popularity and potential risks of drugs available online.
Takaki, Hiroko; Abe, Takeru; Hagihara, Akihito
The provision of information is now considered a major area in pharmacist-patient interactions. However, few reports have simultaneously evaluated patient and pharmacist perceptions with regard to the pharmacist's information provision. The aims were to clarify the perceptions of pharmacists and patients regarding information provision and the level of influence of those perceptions on patient satisfaction. A cross-sectional survey with respect to information provision was conducted for patients and pharmacists in community pharmacies in Fukuoka Prefecture, Japan. In total, 407 patient-pharmacist pairs were included in a t-test and multilevel analysis. The levels of patient perception regarding information provision were significantly higher than the levels of pharmacist perception in all variables. The pharmacists' perceived level of information provision concerning medication effects had a negative and significant association with patient satisfaction, while the patients' perceived level of information provision by the pharmacist had a positive and significant association with patient satisfaction. Higher patient expectations regarding the level of information provision concerning medication side effects and older age of the pharmacist were adversely related to patient satisfaction. Both pharmacist and patient perceptions of the information provision by pharmacists personalized to the patient had positive associations with patient satisfaction. Pharmacist perceptions related to the information provision were not associated with patient satisfaction. The present study highlights accurate information provision, building good patient-pharmacist relationships, and improving pharmaceutical care in community pharmacy settings. © 2015 John Wiley & Sons, Ltd.
Severin, Anne-Elise; Petitpain, Nadine; Scala-Bertola, Julien; Latarche, Clotilde; Yelehe-Okouma, Melissa; Di Patrizio, Paolo; Gillet, Pierre
Acetaminophen (paracetamol), the highest over-the-counter (OTC) selling drug in France, is also the first cause of acute hepatic failure. We aimed to assess the good use and the knowledge of acetaminophen in a setting of urban self-medicated patients. We conducted a prospective observational study in randomly selected community pharmacies of Metz (France) agglomeration. Patients coming to buy OTC acetaminophen for themselves or their family had to answer to an anonymous autoquestionnaire. Responses were individually and concomitantly analyzed through 3 scores: good use, knowledge and overdosage. Twenty-four community pharmacies participated and 302 patients were interviewed by mean of a dedicated questionnaire. Most of patients (84.4%) could be considered as "good users" and independent factors of good use were (i) a good knowledge of acetaminophen (OR=5.3; Poverdose and liver toxicity. Package leaflets have also to be more informative. Copyright © 2016 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.
Wang, Jun; Hu, Xiamin; Liu, Juan; Li, Lei
The aim of this study was to evaluate the attitudes towards physician-pharmacist collaboration among pharmacy students in order to develop an interprofessional education (IPE) opportunity through integrating cooperative learning (CL) into a team-based student-supported community service event. The study also aimed to assess the change in students' attitudes towards interprofessional collaboration after participation in the event. A bilingual version of the Scale of Attitudes Toward Physician-Pharmacist Collaboration (SATP(2)C) in English and Chinese was completed by pharmacy students enrolled in Wuhan University of Science and Technology, China. Sixty-four students (32 pharmacy students and 32 medical students) in the third year of their degree volunteered to participate in the IPE opportunity for community-based diabetes and hypertension self-management education. We found the mean score of SATP(2)C among 235 Chinese pharmacy students was 51.44. Cronbach's alpha coefficient was 0.90. Our key finding was a significant increase in positive attitudes towards interprofessional collaboration after participation in the IPE activity. These data suggest that there is an opportunity to deliver IPE in Chinese pharmacy education. It appears that the integration of CL into an interprofessional team-based community service offers a useful approach for IPE.
Thøgersen, Marie Høgh; Morthorst, Britt; Nordentoft, Merete
Assertive community treatment (ACT) has been claimed to be paternalistic and coercive, yet little is known about how patients experience the assertive aspects of ACT. To explore views on--and perceptions of--coercion of patients in Danish assertive community teams. In-depth interviews were conducted with six purposefully selected patients and analysed using thematic analysis. Patients reported lack of influence on treatment process and a poor alliance with case-mangers, not being recognised as an autonomous person, and experiences of staff crossing the line and intruding privacy, as most central to perceptions of coercion. A collaborative and mutually trusting relationship, commitment, persistence and availability of staff, and recognition of the need for social support and help with everyday activities, were most important for counteracting such experiences. Perceptions of coercion were not emphasised in patients' account of their engagement with ACT, and generally only related to patients' initial contact with ACT staff. The study suggests that developing mental health practices that enhance the formation of a therapeutic relationship with patients will minimize circumstances that induce perceptions of coercion. ACT, with its engaged and committed staff with sufficient time, focusing on social and practical issues, is successful in facilitating such a contact, as experienced by patients.
Wilkinson, Tracey A; Rafie, Sally; Clark, Porsche D; Carroll, Aaron E; Miller, Elizabeth
Since restrictions on nonprescription sales were removed in 2013, levonorgestrel emergency contraception (EC) should be available without a prescription at pharmacies for consumers of all genders and ages. Using mystery callers, we assessed variations in availability of and access to EC. In 2015-2016, three sets of mystery callers (two female physicians, two adolescent females, and two adolescent males) each called all licensed retail pharmacies in five U.S. cities using standardized call scripts. Scripts assessed same-day availability and subsequent access to EC for 17-year-olds. Data on various characteristics of calls were collected and compared by caller type. Among the 993 pharmacies called, same-day availability for EC was approximately 80%, with no differences by caller types (p = .34). However, 10.7% of calls made by the adolescent male caller and 8.3% made by the adolescent female caller resulted in incorrectly being told they could not obtain EC based on age, compared to only 1.6% of calls made by the physician (p < .01). Pharmacy staff stated correctly that EC was available over-the-counter more often to adolescent male callers (62.0%) than adolescent females (51.6%) or female physicians (57%) (p < .01). Physicians were more likely to be placed on hold, talk to a pharmacist, or be transferred to a pharmacist (p < .01) than adolescents. Persistent barriers to accessing EC exist for adolescents despite regulatory changes to make EC available over-the-counter, especially for females. Additional work to remove these barriers is needed to assure timely access for those who require effective pregnancy prevention. Copyright © 2017 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.
Belay, Yared Belete
Job satisfaction is a multidimensional, enduring, important, and much-researched concept in the field of organizational behavior and has been identified as recognition in one's field of work, level of salary, opportunities for promotion, and achievement of personal goals. Job satisfaction directly affects the labor market behavior and economic efficiency by means of the impact on productivity and turnover of staff. The aim of this study was to assess the satisfaction level of pharmacy professionals in Mekelle city. This institution-based cross-sectional study was conducted as a survey and only included voluntary participants. Those participants who did not volunteer to participate were excluded from the study. A structured questionnaire was used as a data collection tool; it was developed from different literature in the English language, and then the original tool was translated to the local language for the purpose of understanding. In Mekelle, ~100 pharmacy professionals work in private medicine retail outlets. From those, only 60 volunteered to participate in this study. Significant difference in job satisfaction and job stress were observed between those working full-time and part-time, with P -values of 0.031 and 0.021, respectively. From the findings of the current study, it can be concluded that around two-thirds of pharmacy professionals in Mekelle city were satisfied with their professional practice.
Jang, Soo Min; Cerulli, Jennifer; Grabe, Darren W; Fox, Chester; Vassalotti, Joseph A; Prokopienko, Alexander J; Pai, Amy Barton
Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently associated with community-acquired acute kidney injury (AKI), a strong risk factor for development and progression of chronic kidney disease. Using access to prescription medication profiles, pharmacists can identify patients at high risk for NSAID-induced AKI. The primary objective of this analysis was to evaluate the effectiveness of a community pharmacy-based patient education program on patient knowledge of NSAID-associated renal safety concerns. Patients receiving prescription medications for hypertension or diabetes mellitus were invited to participate in an educational program on the risks of NSAID use. A patient knowledge questionnaire (PKQ) consisting of 5 questions scored from 1 to 5 was completed before and after the intervention. Information was collected on age, race, sex, and frequency of NSAID use. A total of 152 participants (60% women) completed both the pre- and post-intervention questionnaire; average age was 54.6 (standard deviation [SD], 17.5). Mean pre-intervention PKQ score was 3.3 (SD, 1.4), and post-intervention score was 4.6 (SD, 0.9) (P = .002). Participants rated program usefulness (1 = not useful to 5 = extremely useful) as 4.2 (SD, 1.0). In addition, 48% reported current NSAID use and 67% reported that the program encouraged them to limit their use. NSAID use was common among patients at high risk for AKI. A brief educational intervention in a community pharmacy improved patient knowledge on NSAID-associated risks. Pharmacists practicing in the community can partner with primary care providers in the medical home model to educate patients at risk for AKI.
Lingxiao Zhai, MS
Full Text Available Objectives: 1 To determine parents’ and/or guardians’ interest in having pharmacists provide children’s liquid medications in a pre-measured, individualized dosing device 2 To assess parents’ and/or guardians’ perception of dosing liquid medications for a child. Design: Observational survey Setting: Regional chain pharmacy in North Carolina Participants: > 18 years old, parent/guardian of a child <13 who had prescription filled for liquid medication within the pharmacy chain, responsible for administering child’s liquid medication Intervention: 14 item questionnaire Main Outcome Measure: Interest in pharmacists providing children’s liquid medications in pre-measured, individualized dosing devices Results: 250 questionnaires were mailed; 42 were marked “return to sender” (16.8%, 22 were returned completed (10.6%, and 20 of the 22 met inclusion criteria (9.6%. 95% of study participants reported being interested in having pharmacists provide children’s liquid medications in the proposed dosing device, and 40% were willing to pay for such a service. 90% of respondents reported it is “not at all difficult” to understand the amount of dose a child is to receive, while 55% reported it is “not at all difficult” to measure doses. 25% of respondents reported sometimes using a kitchen spoon to measure a child’s medication. Conclusion: Community pharmacists should explore providing children’s liquid medications in an individualized dosing device, as study results determined parents are interested in and willing to pay for the theoretical device. Further large-scale studies would be beneficial in determining interest in and willingness to pay for the dosing device in various pharmacy settings nationwide.
Pharmacy study of natural health product adverse reactions (SONAR): a cross-sectional study using active surveillance in community pharmacies to detect adverse events associated with natural health products and assess causality
Necyk, Candace; Tsuyuki, Ross T; Boon, Heather; Foster, Brian C; LeGatt, Don; Cembrowski, George; Murty, Mano; Barnes, Joanne; Charrois, Theresa L; Arnason, John T; Ware, Mark A; Rosychuk, Rhonda J; Vohra, Sunita
Objectives To investigate the rates and causality of adverse event(s) (AE) associated with natural health product (NHP) use, prescription drug use and concurrent NHP-drug use through active surveillance in community pharmacies. Design Cross-sectional study of screened patients. Setting 10 community pharmacies across Alberta and British Columbia, Canada from 14 January to 30 July 2011. Participants The participating pharmacy staff screened consecutive patients, or agents of patients, who were dropping or picking up prescription medications. Primary outcome measures Patients were screened to determine the proportions of them using prescription drugs and/or NHPs, as well as their respective AE rates. All AEs reported by the screened patients who took a NHP, consented to, and were available for, a detailed telephone interview (14%) were adjudicated fully to assess for causality. Results Over a total of 105 pharmacy weeks and 1118 patients screened, 410 patients reported taking prescription drugs only (36.7%; 95% CI 33.9% to 39.5%), 37 reported taking NHPs only (3.3%; 95% CI 2.4% to 4.5%) and 657 reported taking prescription drugs and NHPs concurrently (58.8%; 95% CI 55.9% to 61.6%). In total, 54 patients reported an AE, representing 1.2% (95% CI 0.51% to 2.9%), 2.7% (95% CI 0.4% to 16.9%) and 7.3% (95% CI 5.6% to 9.6%) of each population, respectively. Compared with patients who reported using prescription drugs, the patients who reported using prescription drugs and NHPs concurrently were 6.4 times more likely to experience an AE (OR; 95% CI 2.52 to 16.17; p<0.001). Combined with data from Ontario, Canada, a national proportion was calculated, which found that 45.4% (95% CI 43.8% to 47.0%) of Canadians who visit community pharmacies take NHPs and prescription drugs concurrently, and of those, 7.4% (95% CI 6.3% to 8.8%) report an AE. Conclusions A substantial proportion of community pharmacy patients use prescription drugs and NHPs concurrently; these patients are at a
Nørgaard, Lotte Stig; Sørensen, Ellen Westh
-based study. Concepts related to AR are described; in addition, the multifaceted role of the action researcher is described, along with a set of data quality criteria for evaluating the quality of an AR-based study. Then follows a thorough description of a Danish AR-based pharmacy practice study. The chapter...
Teshima, Mugen; Nakashima, Mikiro; Hatakeyama, Susumi
The Nagasaki University School of Pharmaceutical Sciences has conducted a project concerning "development of an advanced education program for community medicine" for its students in collaboration with the University's School of Nursing Sciences, the University of Nagasaki School of Nursing Sciences, and the Nagasaki International University School of Pharmaceutical Sciences. The project was named "formation of a strategic base for the integrated education of pharmacy and nursing science specially focused on home-healthcare and welfare", that has been adopted at "Strategic University Cooperative Support Program for Improving Graduate" by the Ministry of Education, Culture, Sports, Science and Technology, Japan from the 2009 academic year to the 2011 academic year. Our project is a novel education program about team medical care in collaboration with pharmacist and nurse. In order to perform this program smoothly, we established "Nagasaki pharmacy and nursing science union consortium (Nagasaki University, The University of Nagasaki, Nagasaki International University, Nagasaki Pharmaceutical Association, Nagasaki Society of Hospital Pharmacists, Nagasaki Nursing Association, Nagasaki Medical Association, Nagasaki Prefectural Government)". In this symposium, we introduce contents about university education program and life learning program of the project.
Waring, Justin; Latif, Asam; Boyd, Matthew; Barber, Nick; Elliott, Rachel
Community pharmacists play a growing role in the delivery of primary healthcare. This has led many to consider the changing power of the pharmacy profession in relation to other professions and patient groups. This paper contributes to these debates through developing a Foucauldian analysis of the changing dynamics of power brought about by extended roles in medicines management and patient education. Examining the New Medicine Service, the study considers how both patient and pharmacist subjectivities are transformed as pharmacists seek to survey patient's medicine use, diagnose non-adherence to prescribed medicines, and provide education to promote behaviour change. These extended roles in medicines management and patient education expand the 'pharmacy gaze' to further aspects of patient health and lifestyle, and more significantly, established a form of 'pastoral power' as pharmacists become responsible for shaping patients' self-regulating subjectivities. In concert, pharmacists are themselves enrolled within a new governing regime where their identities are conditioned by corporate and policy rationalities for the modernisation of primary care. Copyright © 2015 Elsevier Ltd. All rights reserved.
Vaccination is one of the most cost-effective healthcare interventions. Pharmacies in South Africa provide a vaccination service where childhood immunizations, some travel vaccines and vaccines for specific populations are dispensed and administered, but little has been published on which vaccines are dispensed and at what cost. Areas covered: This retrospective drug utilization study determined the dispensing patterns of vaccines in community pharmacies during 2015 with the focus on the types and cost of vaccines dispensed in ATC group J07. Expert commentary: Of the 140 902 vaccines dispensed to 79 415 patients, viral vaccines (J07B) accounted for most of the prescriptions (82.7% of volume; 62.3% of cost), followed by bacterial vaccines (J07A) (17.1% of volume; 37.5% of cost), and bacterial and viral vaccines combined (0.2% of volume; 0.3% of cost). There was an increase in the dispensing patterns of viral vaccines (J07B) in the period just before the winter months. Half of all vaccines (50.4%) were for the influenza vaccine (J07BB01). This vaccine accounted for only 15.6% of the total cost of vaccines. The most expensive vaccines were pneumococcal polysaccharide conjugate vaccine (13-valent adsorbed, pre-filled syringe) (J07AL01), followed by human papillomavirus bivalent vaccine (J07BM02).
Phipps, Denham L; Tam, W Vanessa; Ashcroft, Darren M
To explore the combined use of a critical incident database and work domain analysis to understand patient safety issues in a health-care setting. A retrospective review was conducted of incidents reported to the UK National Reporting and Learning System (NRLS) that involved community pharmacy between April 2005 and August 2010. A work domain analysis of community pharmacy was constructed using observational data from 5 community pharmacies, technical documentation, and a focus group with 6 pharmacists. Reports from the NRLS were mapped onto the model generated by the work domain analysis. Approximately 14,709 incident reports meeting the selection criteria were retrieved from the NRLS. Descriptive statistical analysis of these reports found that almost all of the incidents involved medication and that the most frequently occurring error types were dose/strength errors, incorrect medication, and incorrect formulation. The work domain analysis identified 4 overall purposes for community pharmacy: business viability, health promotion and clinical services, provision of medication, and use of medication. These purposes were served by lower-order characteristics of the work system (such as the functions, processes and objects). The tasks most frequently implicated in the incident reports were those involving medication storage, assembly, or patient medication records. Combining the insights from different analytical methods improves understanding of patient safety problems. Incident reporting data can be used to identify general patterns, whereas the work domain analysis can generate information about the contextual factors that surround a critical task.
Madsen, Mads Lægdsgaard; Noe, Egon
The Danish Agwaplan project is a water environmental planning project trying to find new ways to change practice in terms of land use on farms. The project has its starting point in a dualistic learning theoretical perception that improving of farmers’ environmental knowledge will lead them...... to create new identities. This paper suggests to base future water environmental planning projects on the actual social context. Such projects can improve their results by considering the farms involved as communities of practice and that these communities of practice including meaning negotiations...
Brata, Cecilia; Gudka, Sajni; Schneider, Carl R; Everett, Alan; Fisher, Colleen; Clifford, Rhonda M
Currently, no review has been completed regarding the information-gathering process for the provision of medicines for self-medication in community pharmacies in developing countries. To review the rate of information gathering and the types of information gathered when patients present for self-medication requests. Six databases were searched for studies that described the rate of information gathering and/or the types of information gathered in the provision of medicines for self-medication in community pharmacies in developing countries. The types of information reported were classified as: signs and symptoms, patient identity, action taken, medications, medical history, and others. Twenty-two studies met the inclusion criteria. Variations in the study populations, types of scenarios, research methods, and data reporting were observed. The reported rate of information gathering varied from 18% to 97%, depending on the research methods used. Information on signs and symptoms and patient identity was more frequently reported to be gathered compared with information on action taken, medications, and medical history. Evidence showed that the information-gathering process for the provision of medicines for self-medication via community pharmacies in developing countries is inconsistent. There is a need to determine the barriers to appropriate information-gathering practice as well as to develop strategies to implement effective information-gathering processes. It is also recommended that international and national pharmacy organizations, including pharmacy academics and pharmacy researchers, develop a consensus on the types of information that should be reported in the original studies. This will facilitate comparison across studies so that areas that need improvement can be identified. Copyright © 2013 Elsevier Inc. All rights reserved.
Full Text Available Abstract Background The introduction of a new method of transmitting prescriptions from general practices to community pharmacies in England (Electronic Prescription Service Release 2 (EPS2 has generated debate on how it will change work practice. As EPS2 will be a key technical element in dispensing, we reviewed the literature to find that there were no studies on how social and technical elements come together to form work practice in community pharmacies. This means the debate has little point of reference. Our aim therefore was to study the ways social and technical elements of a community pharmacy are used to achieve dispensing through the development of a conceptual model on pharmacy work practice, and to consider how a core technical element such the EPS2 could change work practice. Method We used ethnographic methods inclusive of case-study observations and interviews to collect qualitative data from 15 community pharmacies that were in the process of adopting or were soon to adopt EPS2. We analysed the case studies thematically and used rigorous multi-dimensional and multi-disciplinary interpretive validation techniques to cross analyse findings. Results In practice, dispensing procedures were not designed to take into account variations in human and technical integration, and assumed that repetitive and collective use of socio-technical elements were at a constant. Variables such as availability of social and technical resources, and technical know-how of staff were not taken into account in formalised procedures. Yet community pharmacies were found to adapt their dispensing in relation to the balance of social and technical elements available, and how much of the social and technical elements they were willing to integrate into dispensing. While some integrated as few technical elements as possible, some depended entirely on technical artefacts. This pattern also applied to the social elements of dispensing. Through the conceptual
Häcker, Franziska; Morck, Hartmut
Acid-related gastrointestinal symptoms are widely prevalent. These complaints are often self-medicated with antacids. For the community pharmacy setting little is known about how patients' perceptions of self-treating symptoms are met, e.g., via patient satisfaction. Such outcomes are difficult to determine in clinical trials, therefore, non-interventional studies (NIS) are one applicable method for gaining data under real-world conditions. This study was conducted to investigate: (1) characteristics of gastrointestinal symptoms and patients' global health status, (2) drug usage and symptom relief, and (3) patient satisfaction with the medication. This prospective, cross-sectional NIS was performed in cooperation with 137 community pharmacies in Germany. Participants were recruited from customers, after they had purchased the antacid, and were asked to complete a self-administered questionnaire. Patient satisfaction with hydrotalcite was assessed by the Treatment Satisfaction Questionnaire for Medication (TSQM) on the scales effectiveness, side effects, convenience, and global satisfaction. 548 patients answered the questionnaire. The following symptoms were reported most frequently: heartburn (65%) and acid regurgitation (37%). In comparison to the general population, more participants rated their global health in lower categories, e.g., satisfying (35% vs. 23%) or poor (12% vs. 5%). Drug usage patterns were found to be in accordance with the principles of self-medication. The majority of patients reported a noticeable symptom relief within 15 min after drug intake. TSQM mean scores were high in all four scales; an excellent score was achieved in the scale side effects. Study results also revealed that the self-perceived global health status of the patients had an impact on their global satisfaction with the medication. This NIS shows that patients (1) are often affected in their global health when suffering from acid-related symptoms, (2) observed a fast symptom
Diane Macquart de Terline
Full Text Available Oral anticoagulation therapy is increasingly used for the prevention and treatment of thromboembolic complications in various clinical situations. Nowadays, education programs for patients treated with anticoagulants constitute an integrated component of their management. However, such programs are usually based on the healthcare providers' perceptions of what patients should know, rather than on patients' preferences.To investigate patients' viewpoints on educational needs and preferred modalities of information delivery.We conducted an observational study based on a self-administered questionnaire. To explore several profiles of patients, the study was designed for enrolling patients in two settings: during outpatient consultations in a cardiology department (Saint Antoine Hospital, Paris, France and in community pharmacies throughout France.Of the 371 patients who completed the questionnaire, 187 (50.4% were recruited during an outpatient consultation and 184 (49.6% were recruited in community pharmacies. 84.1% of patients were receiving a vitamin K antagonist and 15.6% a direct oral anticoagulant. Patients ranked 16 of 21 (76.2% questionnaire items on information about their treatment as important or essential; information on adverse effects of treatment was the highest ranked domain (mean score 2.38, 95% CI 2.30-2.46. Pharmacists (1.69, 1.58-1.80, nurses (1.05, 0.95-1.16, and patient associations (0.36, 0.29-0.44, along with group sessions (0.85, 0.75-0.95, the internet (0.77, 0.67-0.88, and delivery of material at the patient's home (1.26, 1.14-1.38, were ranked poorly in terms of delivering educational material.This study revealed substantial discrepancies between patient preferences and current educational programs. These findings should be useful for tailoring future educational programs that are better adapted to patients, with a potential associated enhancement of their effectiveness.
Smith, Lorraine; Bosnic-Anticevich, Sinthia Z; Mitchell, Bernadette; Saini, Bandana; Krass, Ines; Armour, Carol
Asthma affects a considerable proportion of the population worldwide and presents a significant health problem in Australia. Given its chronic nature, effective asthma self-management approaches are important. However, despite research and interventions targeting its treatment, the management of asthma remains problematic. This study aimed to develop, from a theoretical basis, an asthma self-management model and implement it in an Australian community pharmacy setting in metropolitan Sydney, using a controlled, parallel-groups repeated-measures design. Trained pharmacists delivered a structured, step-wise, patient-focused asthma self-management program to adult participants over a 9-month period focusing on identification of asthma problems, goal setting and strategy development. Data on process- clinical- and psychosocial-outcome measures were gathered. Results showed that participants set an average of four new goals and six repeated goals over the course of the intervention. Most common goal-related themes included asthma triggers, asthma control and medications. An average of nine strategies per participant was developed to achieve the set goals. Common strategies involved visiting a medical practitioner for review of medications, improving adherence to medications and using medications before exercise. Clinical and psychosocial outcomes indicated significant improvements over time in asthma symptom control, asthma-related self-efficacy and quality of life, and negative affect. These results suggest that an asthma self-management model of illness behaviour has the potential to provide patients with a range of process skills for self-management, and deliver improvements in clinical and psychosocial indicators of asthma control. The results also indicate the capacity for the effective delivery of such an intervention by pharmacists in Australian community pharmacy settings.
Bush, J; Langley, C; Mills, S; Hindle, L
This study aimed to assess the effectiveness of a novel, community-based weight management programme delivered through general practitioner (GP) practices and community pharmacies in one city in the United Kingdom. This study used a non-randomized, retrospective, observational comparison of clinical data collected by participating GP practices and community pharmacies. Subjects were 451 overweight or obese men and women resident in areas of high socioeconomic deprivation (82% from black and minority ethnic groups, 86% women, mean age: 41.1 years, mean body mass index [BMI]: 34.5 kg m(-2)). Weight, waist circumference and BMI at baseline, after 12 weeks and after 9 months were measured. Costs of delivery were also analysed. Sixty-four per cent of participants lost weight after the first 12 weeks of the My Choice Weight Management Programme. There was considerable dropout. Mean percentage weight loss (last observation carried forward) was 1.9% at 12 weeks and 1.9% at final follow-up (9 months). There was no significant difference in weight loss between participants attending GP practices and those attending pharmacies at both 12 weeks and at final follow-up. Costs per participant were higher via community pharmacy which was attributable to better attendance at sessions among community pharmacy participants than among GP participants. The My Choice Weight Management Programme produced modest reductions in weight at 12 weeks and 9 months. Such programmes may not be sufficient to tackle the obesity epidemic. © 2014 The Authors. Clinical Obesity © 2014 International Association for the Study of Obesity.
Vu Phan Hoang Nguyen
Full Text Available Medication adherence is one of the major factors that determine an outcome of a treatment. Despite the effort of healthcare providers to improve the adherence rate, it still remains a serious issue in our health care system today. Many patients do not take their medications as directed or just simply do not want to fill or refill their prescriptions. A small survey performed by pharmacy students at Temple School of Pharmacy showed that there is a significant number of patients did not pick up their medications. Cardiovascular medications are the most common non-picked up drugs. There are various reasons that patients use to justify for this non-adherence behavior. However, they are unaware that their actions create a tremendous negative effect not only on the treatment itself but also on the entire health care system. The consequences include expensive therapies, inaccurate research data, and poor treatment outcomes. Many solutions have been utilized to solve this problem, but it is still the major problem for healthcare providers to keep in mind when planning a drug regimen. Although many people believed that pharmacists are responsible for solving this problem, it should be a multidisciplinary effort of all healthcare providers to improve the medication adherence. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including grants (pending or received, employment, gifts, stock holdings or options, honoraria, consultancies, expert testimony, patents and royalties. Type: Student Project
Krass, Ines; Carter, Rob; Mitchell, Bernadette; Mohebbi, Mohammadreza; Shih, Sophy T F; Trinder, Peta; Versace, Vincent L; Wilson, Frances; Namara, Kevin Mc
Introduction With the rising prevalence of type 2 diabetes in Australia, screening and earlier diagnosis is needed to provide opportunities to intervene with evidence-based lifestyle and treatment options to reduce the individual, social and economic impact of the disease. The objectives of the Pharmacy Diabetes Screening Trial are to compare the clinical effectiveness and cost-effectiveness of three screening models for type 2 diabetes in a previously undiagnosed population. Methods and anal...
Assessing the effects of pharmacists' perceived organizational support, organizational commitment and turnover intention on provision of medication information at community pharmacies in Lithuania: a structural equation modeling approach.
Urbonas, Gvidas; Kubilienė, Loreta; Kubilius, Raimondas; Urbonienė, Aušra
As a member of a pharmacy organization, a pharmacist is not only bound to fulfill his/her professional obligations but is also affected by different personal and organizational factors that may influence his/her behavior and, consequently, the quality of the services he/she provides to patients. The main purpose of the research was to test a hypothesized model of the relationships among several organizational variables, and to investigate whether any of these variables affects the service of provision of medication information at community pharmacies. During the survey, pharmacists working at community pharmacies in Lithuania were asked to express their opinions on the community pharmacies at which they worked and to reflect on their actions when providing information on medicines to their patients. The statistical data were analyzed by applying a structural equation modeling technique to test the hypothesized model of the relationships among the variables of Perceived Organizational Support, Organizational Commitment, Turnover Intention, and Provision of Medication Information. The final model revealed that Organizational Commitment had a positive direct effect on Provision of Medication Information (standardized estimate = 0.27) and a negative direct effect (standardized estimate = -0.66) on Turnover Intention. Organizational Commitment mediated the indirect effects of Perceived Organizational Support on Turnover Intention (standardized estimate = -0.48) and on Provision of Medication Information (standardized estimate = 0.20). Pharmacists' Turnover Intention had no significant effect on Provision of Medication Information. Community pharmacies may be viewed as encouraging, to some extent, the service of provision of medication information. Pharmacists who felt higher levels of support from their organizations also expressed, to a certain extent, higher commitment to their organizations by providing more consistent medication information to patients. However, the
Pharmacy study of natural health product adverse reactions (SONAR): a cross-sectional study using active surveillance in community pharmacies to detect adverse events associated with natural health products and assess causality.
Necyk, Candace; Tsuyuki, Ross T; Boon, Heather; Foster, Brian C; Legatt, Don; Cembrowski, George; Murty, Mano; Barnes, Joanne; Charrois, Theresa L; Arnason, John T; Ware, Mark A; Rosychuk, Rhonda J; Vohra, Sunita
To investigate the rates and causality of adverse event(s) (AE) associated with natural health product (NHP) use, prescription drug use and concurrent NHP-drug use through active surveillance in community pharmacies. Cross-sectional study of screened patients. 10 community pharmacies across Alberta and British Columbia, Canada from 14 January to 30 July 2011. The participating pharmacy staff screened consecutive patients, or agents of patients, who were dropping or picking up prescription medications. Patients were screened to determine the proportions of them using prescription drugs and/or NHPs, as well as their respective AE rates. All AEs reported by the screened patients who took a NHP, consented to, and were available for, a detailed telephone interview (14%) were adjudicated fully to assess for causality. Over a total of 105 pharmacy weeks and 1118 patients screened, 410 patients reported taking prescription drugs only (36.7%; 95% CI 33.9% to 39.5%), 37 reported taking NHPs only (3.3%; 95% CI 2.4% to 4.5%) and 657 reported taking prescription drugs and NHPs concurrently (58.8%; 95% CI 55.9% to 61.6%). In total, 54 patients reported an AE, representing 1.2% (95% CI 0.51% to 2.9%), 2.7% (95% CI 0.4% to 16.9%) and 7.3% (95% CI 5.6% to 9.6%) of each population, respectively. Compared with patients who reported using prescription drugs, the patients who reported using prescription drugs and NHPs concurrently were 6.4 times more likely to experience an AE (OR; 95% CI 2.52 to 16.17; ppharmacies take NHPs and prescription drugs concurrently, and of those, 7.4% (95% CI 6.3% to 8.8%) report an AE. A substantial proportion of community pharmacy patients use prescription drugs and NHPs concurrently; these patients are at a greater risk of experiencing an AE. Active surveillance provides a means of detecting such AEs and collecting high-quality data on which causality assessment can be based.
Hirsch, Jan D; Rosenquist, Ashley; Best, Brookie M; Miller, Teresa Ann; Gilmer, Todd P
The advent of combined antiretroviral therapy (ART) has increased treatment effectiveness but created new challenges for patients infected with human immunodeficiency virus (HIV) and for community pharmacists managing patients' drug therapy. The ability of pharmacist-provided medication therapy management (MTM) services to increase medication adherence, improve health outcomes, and reduce overall medical costs has been demonstrated in community pharmacies for chronic diseases such as diabetes and hypertension. However, the effectiveness of pharmacist-provided MTM services in HIV/acquired immune deficiency syndrome (AIDS) has not been well studied. In January 2005, a pilot program to evaluate MTM services for patients with HIV/AIDS began in California, allowing 10 HIV/AIDS specialty pharmacies to receive compensation for the MTM services that they provided to HIV/AIDS patients. To examine the first year of the HIV/AIDS pharmacy MTM compensation pilot program, which described and compared pilot and nonpilot pharmacies with respect to (a) patient characteristics; (b) intermediate outcomes including type and number of ART medication regimens used, rates of adherence and excess medication fills for ART, use of contraindicated ART regimens, and occurrence of opportunistic infections; and (c) pharmacy and medical costs. This was a cohort study examining 2005 Medi-Cal pharmacy and medical claims data for patients with HIV/AIDS who were served by pilot pharmacies versus other pharmacies. The HIV/AIDS patients were Medi-Cal beneficiaries aged 18 years or older as of January 1, 2005, who were continuously enrolled from January 1, 2004, through December 31, 2005, and diagnosed with HIV/AIDS, identified by receipt of at least 1 ART prescription and at least 1 medical claim with a diagnosis (primary or secondary) of HIV/AIDS (ICD-9-CM code 042.0) during both the index period (the year before pilot program implementation, 2004) and the intervention period (the study year, 2005
Full Text Available Objectives: 1 To determine parents' and/or guardians' interest in having pharmacists provide children's liquid medications in a pre-measured, individualized dosing device 2 To assess parents' and/or guardians' perception of dosing liquid medications for a child. Design: Observational survey Setting: Regional chain pharmacy in North Carolina Participants: > 18 years old, parent/guardian of a childchain, responsible for administering child's liquid medication Intervention: 14 item questionnaire Main Outcome Measure: Interest in pharmacists providing children's liquid medications in pre-measured, individualized dosing devices Results: 250 questionnaires were mailed; 42 were marked "return to sender" (16.8%, 22 were returned completed (10.6%, and 20 of the 22 met inclusion criteria (9.6%. 95% of study participants reported being interested in having pharmacists provide children's liquid medications in the proposed dosing device, and 40% were willing to pay for such a service. 90% of respondents reported it is "not at all difficult" to understand the amount of dose a child is to receive, while 55% reported it is "not at all difficult" to measure doses. 25% of respondents reported sometimes using a kitchen spoon to measure a child's medication. Conclusion: Community pharmacists should explore providing children's liquid medications in an individualized dosing device, as study results determined parents are interested in and willing to pay for the theoretical device. Further large-scale studies would be beneficial in determining interest in and willingness to pay for the dosing device in various pharmacy settings nationwide. Type: Original Research
Andreasen, Karen Egedal; Ydesen, Christian
International forums and organizations, as well as non-governmental organizations, have played a considerable role in societal developments since the end of World War II. Many changes in post-war Danish public schools like standardized educational testing were formed in dialogue with or initiated...... in such forums or organizations. This contribution explores the importance of these connections by focussing on the period from 1945 to around 1990, i.e., from the end of World War II when Danish education was characterized by a high degree of national unity as a contrast to the strife of the inter-war years......, and up to the end of the Cold War. Exploring the transnational angle is a highly relevant and interesting research topic because it contributes to a deeper understanding of the origin, development and design of Danish school policy and school practice, and the influence from transnational spaces....
Full Text Available Piotr Merks,1,2,* Damian Świeczkowski,3,* Marcin Balcerzak,4 Ewelina Drelich,4 Katarzyna Białoszewska,5 Natalia Cwalina,3 Jerzy Krysinski,1 Miłosz Jaguszewski,3 Annie Pouliot,6 Regis Vaillancourt6 1Department of Pharmaceutical Technology, Collegium Medicum in Bydgoszcz, Nicolaus University in Torun, Bydgoszcz-Torun, Poland; 2Piktorex Sp. z.o.o., Warsaw, Poland; 3First Department of Cardiology, Medical University of Gdansk, Gdansk, Poland; 4Farenta Polska, Warsaw, Poland; 5Department of Medical Psychology, Medical University of Warsaw, Warsaw, Poland; 6Children’s Hospital of Eastern Ontario, Ottawa, ON, Canada *These authors contributed equally to this work Introduction: The search for new ways to optimize the use of medications by patients has led the pharmaceutical community to promote the idea of introducing pictograms into routine practice. The main intention of pictograms is to ease patient adherence and to reduce potential risks or errors associated with the use of medications. Purpose: To evaluate a series of pharmaceutical pictograms for patient comprehension. Patients and methods: The study was conducted in community pharmacies within a European Union country that belongs to the professional research network. Structured interviews were used to evaluate the pictograms for patient comprehension. This consisted of an assessment of the following: the transparency and translucency of the pictograms, health literacy, and pictogram recall. Participants were also given the opportunity to provide feedback on how to improve the pictograms. The primary endpoint was pictogram comprehension. Secondary outcomes included recall of the pictograms and pictogram translucency. Results: The study included 68 patients with whom face-to-face interviews were performed. Low transparency results (≤25% and extensive patient feedback in initial interviews led to the withdrawal of certain pictograms (n=15 from the evaluation. Among the pictograms included in
Michael Melczak, PhD
Full Text Available Purpose: This qualitative study was concerned with investigating community pharmacists’ thoughts on the use of two brief scales to measure patient outcomes and therapeutic alliance in the context of their Medication Therapy Management (MTM services. The scales were originally developed for use in behavioral healthcare, but were used in a novel (community pharmacy setting as part of a previous parent study. We describe this practice (using these scales in a novel setting as an innovative practice, report on the pharmacists’ experiences with the practice, and discuss relative advantages and disadvantages for integrating the use of the scales as part of routine practice.Methods: Six community pharmacy practitioners participated in a semi-structured interview pertaining to the use of the scales in their MTM services. Pharmacist interviews were transcribed, analyzed according to qualitative content analysis methodology, and presented in relation to the guiding interview questions.Results: Pharmacists had varying opinions on the use of the scales as part of their practice. Initial concerns included patient (misunderstanding about the purpose and proper completion of the scales, as well as apprehension about the use of the information. These concerns were largely resolved through education, repeated use, and routinization. Pharmacists, in general, saw a value to using these scales in clinical practice, for clinical and professional reasons, although there was variability on the degree to which pharmacists integrated the scales into practice after the study completion. Pharmacists had varied opinions as well as on the degree to which the use of the scales would impact medication adherence. Pharmacists were most surprised by how much participation in this study prompted them to reflect on their interactions with patients.Conclusions: Pharmacists, in general, were receptive to participating in the parent study and using two brief scales to measure
Full Text Available Purpose: This qualitative study was concerned with investigating community pharmacists' thoughts on the use of two brief scales to measure patient outcomes and therapeutic alliance in the context of their Medication Therapy Management (MTM services. The scales were originally developed for use in behavioral healthcare, but were used in a novel (community pharmacy setting as part of a previous parent study. We describe this practice (using these scales in a novel setting as an innovative practice, report on the pharmacists' experiences with the practice, and discuss relative advantages and disadvantages for integrating the use of the scales as part of routine practice. Methods: Six community pharmacy practitioners participated in a semi-structured interview pertaining to the use of the scales in their MTM services. Pharmacist interviews were transcribed, analyzed according to qualitative content analysis methodology, and presented in relation to the guiding interview questions. Results: Pharmacists had varying opinions on the use of the scales as part of their practice. Initial concerns included patient (misunderstanding about the purpose and proper completion of the scales, as well as apprehension about the use of the information. These concerns were largely resolved through education, repeated use, and routinization. Pharmacists, in general, saw a value to using these scales in clinical practice, for clinical and professional reasons, although there was variability on the degree to which pharmacists integrated the scales into practice after the study completion. Pharmacists had varied opinions as well as on the degree to which the use of the scales would impact medication adherence. Pharmacists were most surprised by how much participation in this study prompted them to reflect on their interactions with patients. Conclusions: Pharmacists, in general, were receptive to participating in the parent study and using two brief scales to measure
Cates, Marshall E.; Hogue, Michael D.
Substance use and abuse among pharmacy students is a concern of pharmacy schools, boards of pharmacy, and training sites alike. Pharmacy students must complete approximately 30% of their academic coursework in experiential settings such as community pharmacies, hospitals, and other health systems as part of any accredited pharmacy school's…
Objective This study compares reconviction rates for Danish offenders sentenced to community service and imprisonment. A large general sample of offenders (n = 1602) is examined. Methods The study relies on a quasi-experimental design and uses propensity score matching as well as logistic...... service eligibility assessments and registry databases, provide powerful controls over potential selection mechanisms in the multivariate analyses. Furthermore, contrary to previous studies, the current study limits itself to subjects officially assessed and deemed eligible for community service sentences....... Results Imprisonment is associated with a higher rate of recidivism and the result is statistically significant at conventional statistical levels. Conclusions Community service (CS) compared to imprisonment appears to cause a lower reconviction rate in general. Additional research is needed to shed light...
Hassali, Mohamed Azmi; Shafie, Asrul Akmal; Al-Qazaz, Harith; Tambyappa, Jayabalan; Palaian, Subish; Hariraj, Vidhya
To assess the prevalence of self-medication among adults in an urban setting and to identify any factors contributing to self-medication in relation to consumer characteristics. The study was carried out in Kuala Lumpur, the capital of Malaysia. A cross-sectional study using a self administered questionnaire including adults above 21 years old as an exit survey was conducted in Kuala Lumpur. Number of medications taken in a day by participants, source of medication for the treatment of minor illnesses among participants, common illnesses chosen for self-medication by participants, and the sources of information of participants. Of 314 participants, 62.7% had taken at least one medication in the past week without prescription and 62.7% believed that over the counter medicines were just as effective as those prescribed by doctors. 69.4% would seek a healthcare professional's advice before purchasing any medication and 86.9% would consult a pharmacist prior to buying medication from the pharmacy. Only 86% checked the expiry dates on medications and 54.5% reported keeping leftover medication. Self-medication practice is prevalent in Kuala Lumpur but some practice might be harmful. Education on appropriate use of self-medication need to be emphasized in order to ensure quality use of medicines.
Full Text Available Background. Metoclopramide is a pharmacological agent frequently used in therapy against nausea and vomiting that can occur in indigestion, motion sickness, gastric ulcer, pyloric spasm and after surgery as a side effect of some anesthetics. Knowing the frequency and intensity of metoclopramide neurological side effects is essential for an efficient management of the dysfunctions it addresses. Material and method. Based on a standard questionnaire containing questions regarding metoclopramide therapy, we analyzed the answers given by 1000 patients or patient tutors in 20 open circuit pharmacies situated all over Bucharest. All subjects freely consented to participate in this study that was coordinated only by pharmacists. Results. Our study highlights the fact that in certain situations having to do with the age of patients, with the use of multiple drugs or with the tendency to self medicate, the neurological side effects of metoclopramide can reach dangerous levels. In some cases it might even be necessary to immediately interrupt metoclopramide therapy, despite its positive benefit/ risk ratio. Conclusions. Respecting the physician’s recommendations, avoiding self medication and reporting side effects as quickly as possible, are essential elements for minimizing the consequences of metoclopramide side effects.
Crawford, Natalie D.; Amesty, Silvia; Rivera, Alexis V.; Harripersaud, Katherine; Turner, Alezandria; Fuller, Crystal M.
Objectives: In an effort to reduce HIV transmission among injection drug users (IDUs), New York State deregulated pharmacy syringe sales in 2001 through the Expanded Syringe Access Program by removing the requirement of a prescription. With evidence suggesting pharmacists' ability to expand their public health role, a structural, pharmacy-based…
utilization between the plans. This supports the findings in a 2001 study by Gaither, Kirking, Ascione , and Welage which indicated consumers would...pharmacy.html Gaither, C. A., Kirking, D. M., Ascione , F. J., & Welage, L. S. Retail Pharmacy Intervention 35 (2001). Consumers’ views on
Simpson, Scot H; Lin, Mu; Eurich, Dean T
Inducement programs can promote customer loyalty; however, the clinical effects of these programs are unknown. To examine relationships among inducement program use, medication adherence, and health outcomes. Alberta residents with ≥ 1 physician visit for diabetes or hypertension between April 2008 and March 2014 were eligible for this study and included if they were new statin users and alive at least 455 days after the first statin dispensation. Group assignment was based on whether all statin dispensations in the first year were obtained from pharmacies with or without inducement programs. Discontinuation was defined as no statin dispensations between 275 and 455 days after the first statin dispensation. Acute coronary syndrome (ACS) hospitalizations or deaths were identified between 456 days and 3 years after the first statin dispensation. Multivariable regression analyses were conducted to examine relationships among inducement program use, discontinuation, and ACS events. Among the 159 998 new statin users, mean age was 60.2 (±13.7) years and 67 534 (42%) were women. Statin discontinuation occurred in 22 455 (28.9%) of 77 803 inducement group participants and 25 816 (31.4%) of 82 195 noninducement group participants (adjusted odds ratio = 0.88; 95% CI = 0.86-0.90). Risk of an ACS event was similar between groups (adjusted hazard ratio = 1.00; 95% CI 0.92-1.08); however, discontinuing statin therapy was associated with a higher risk of an ACS event (adjusted hazard ratio = 1.27; 95% CI = 1.16-1.39). Inducement programs are associated with better adherence and not directly associated with risk of health outcomes.
hospitals are not benefiting from the training of pharmacy graduates just like community pharmacies ... A proper regulatory framework that ensures quality training of ... quality assurance . In order to ensure socio- economic development, many countries that provide Pharmacy Education do so by having different types of ...
Marcieli Maria Navarini; Viviane Cecilia Kessler Nunes Deuschle; Regis Augusto Norbert Deuschle
Obesity is defined as the excess adipose tissue in the body. Drugs responsible for inhibiting the appetite are called anorectics or appetite suppressants. Sibutramine, fenproporex and amfepramone belongs to this class, and are capable of causing physical or psychological dependence. The aim of this study was to evaluate the frequency of prescriptions for appetite suppressants in community pharmacies at Cruz Alta, State of Rio Grande do Sul, Brazil. The sales of fenproporex, amfepramone and si...
Todd, Adam; Copeland, Alison; Husband, Andy; Kasim, Adetayo; Bambra, Clare
(1) To determine the percentage of the population in England that has access to a general practitioner (GP) premises within a 20 min walk (the accessibility); (2) explore the relationship between the walking distance to a GP premises and urbanity and social deprivation and (3) compare accessibility of a GP premises to that of a community pharmacy--and how this may vary by urbanity and social deprivation. This area-level analysis spatial study used postcodes for all GP premises and community pharmacies in England. Each postcode was assigned to a population lookup table and Lower Super Output Area (LSOA). The LSOA was then matched to urbanity (urban, town and fringe, or village, hamlet and isolated dwellings) and deprivation decile (using the Index of Multiple Deprivation score 2010). Living within a 20 min walk of a GP premises. Overall, 84.8% of the population is estimated to live within a 20 min walk of a GP premises: 81.2% in the most affluent areas, 98.2% in the most deprived areas, 94.2% in urban and 19.4% in rural areas. This is consistently lower when compared with the population living within a 20 min walk of a community pharmacy. Our study shows that the vast majority of the population live within a 20 min walk of a GP premises, with higher proportions in the most deprived areas--a positive primary care law. However, more people live within a 20 min walk of a community pharmacy compared with a GP premises, and this potentially has implications for the commissioning of future services from these healthcare providers in England. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
[Pharmaceutical counseling of non-conventional dosage forms concerning the health-literacy and the patient adherence in public medication dispensing -Questionnaire surveys in Hungarian community pharmacies.
Somogyi, O; Zelko, R
Although the non-conventional dosage forms (e.g. modified release per oral systems or transdermal patches) have more significant advantages than other conventional dosage forms, the pa- tients have to apply them correctly in their home medicine using to reach the effective and safe therapy. A guideline of relevant application instructions contribute to development of an effective pharmaceutical counseling in community pharmacies. The counseling and advices can improve the patients' knowledge concerning application rules of different new dosage forms (health- literacy) with patient adherence. Finally it will result more effective and safer therapies. The aim of our Hungarian questionnaire surveys was to explore the patients' drug application habits or application errors and improve special verbal counseling of mentioned non-conventional dosage forms in community pharmacies. Understandable patient information leaflets were developed about application rules and besides the levels of patients' reading comprehension was evaluated in case of the leaflet of medicinal patches. The results show that a properly developed text is useful for the majority of patients but they need the verbal explanation as well, moreover there is a demand for the verbal counseling in community pharmacies. The most common application errors were explored and the most effective instructions or application rules were collected for the pharmacists and patients concerning the modified release tablets or capsules and transdermal patches.
Full Text Available This paper presents five consultation workshops with 29 community pharmacists, stakeholders and patients that examined "patient-centred professionalism" in terms of pharmacists' working day and environment. The concept is ill-defined in both medical and pharmacy literature and the study aimed to clarify the situated nature of the term for patients and health professionals across settings. Workshops were supported by bio-photographic datasets of "in-situ" practice and Nominal Group Work. The thematic content analyses led to the following aspects: building caring relationships; managing external forces; the effects of space and environment, and different roles and expectations. The study reveals how patient-centred professionalism cannot be defined in any singular or stationary sense, but should be seen as a "moveable feast", best understood through everyday examples of practice and interaction, in relation to whose experience is being expressed, and whose needs considered. The phrase is being mobilised by a whole set of interests and stakeholders to reshape practice, the effect of which remains both uncertain and contested. Whilst patients prioritise a quick and efficient dispensing service from knowledgeable pharmacists, pharmacists rail against increasing public demands and overtly formalised consultations that take them away from the dispensary where the defining aspects of their professionalism lie. URN: urn:nbn:de:0114-fqs100177
Um, Irene S.; Armour, Carol; Krass, Ines; Gill, Timothy; Chaar, Betty B.
Background Obesity is a public health challenge faced worldwide. Community pharmacists may be well placed to manage Australia’s obesity problem owing to their training, accessibility and trustworthiness. However, determining consumers’ needs is vital to the development of any new services or the evaluation of existing services.
McNamara, K. P.; O'Reilly, S. L.; George, J.; Peterson, G. M.; Jackson, S. L.; Duncan, G.; Howarth, H.; Dunbar, J. A.
Background: Delivery of cardiovascular disease (CVD) prevention programs by community pharmacists appears effective and enhances health service access. However, their capacity to implement complex behavioural change processes during patient counselling remains largely unexplored. This study aims to determine intervention fidelity by pharmacists…
Full Text Available Objective: to apply the Rogers’ diffusion of innovation model to the implementation of pharmacotherapy follow-up in community pharmacies at Badajoz (Spain. Methods: A telephonic survey to 120 randomly chosen pharmacy owners from Badajoz was done. A questionnaire and an algorithm that allow to objectively assign each pharmacists to an stage in the diffusion of innovation model were used. Results: Badajoz pharmacy owners scatter into different the model stages as follows: lower than knowledge27,9%; knowledge 9,6%; persuasion 32,7%; adopting decision 20,2%; implementation 6,7%; y confirmation 2,9%. Conclusions: Near 30% of Badajoz pharmacy owners do not know pharmacotherapy follow-up yet. After their opinions, pharmacotherapy follow-up can be considered as implemented in 10% of Badajoz Pharmacies.
Aabenhus, Rune; Siersma, Volkert; Hansen, Malene Plejdrup
OBJECTIVES: Antibiotic consumption in the primary care sector is often perceived as synonymous with consumption in general practice despite the fact that few countries stratify the primary care sector by providers' medical specialty. We aimed to characterize and quantify antibiotic use in Danish...... general practice relative to the entire primary care sector. METHODS: This was a registry-based study including all patients who redeemed an antibiotic prescription between July 2004 and June 2013 at a Danish community pharmacy. Antibiotic use was expressed as DDDs and treatments/1000 inhabitants....../day (DIDs and TIDs, respectively) and assessed according to antibiotic spectrum (narrow versus broad) and their anatomical therapeutic classification codes in total as well as in six age groups. RESULTS: The contribution of general practice to the entire antibiotic use in the primary care sector declined...
Kjome, Reidun Lisbet Skeide
Diabetes is a growing concern worldwide. Ideal management of the disease requires extensive self-care and broad follow-up by health care professionals. Considerable research has been done on involving the pharmacist in the healthcare of patients with diabetes, arguing that community pharmacists’ high availability to patients and specialized medication-focused education makes them a valuable asset to the diabetes team. This thesis consists of four papers. The work for these pape...
Elaro, Amanda; Bosnic-Anticevich, Sinthia; Kraus, Kathleen; Farris, Karen B; Shah, Smita; Armour, Carol; Patel, Minal R
Objective To explore community pharmacists' continuing education, counseling and communication practices, attitudes and barriers in relation to pediatric asthma management. Setting Community pharmacies in Michigan, United States. Methods Between July and September 2015 a convenience sample of community pharmacists was recruited from southeastern Michigan and asked to complete a structured, self-reported questionnaire. The questionnaire elucidated information on 4 general domains relating to pharmacists' pediatric asthma management including: (1) guidelines and continuing education (CE); (2) counseling and medicines; (3) communication and self-management practices; (4) attitudes and barriers to practice. Regression analyses were conducted to determine predictors towards pharmacists' confidence/frequency of use of communication/counseling strategies. Main outcome measure Confidence in counseling skills around asthma. Results 105 pharmacists completed the study questionnaire. Fifty-four percent of pharmacists reported participating in asthma related CE in the past year. Over 70% of pharmacists reported confidence in general communication skills, while a lower portion reported confidence in engaging in higher order self-management activities that involved tailoring the regimen (58%), decision-making (50%) and setting short-term (47%) and long-term goals (47%) with the patient and caregiver for managing asthma at home. Pharmacists who reported