Community pharmacists on the frontline in the chronic disease management: The need for primary healthcare policy reforms in low and middle income countries

Background: An integrated chronic disease management model has been implemented across primary healthcare clinics in order to transform the delivery of services for patients with chronic diseases. The sustainability and rapid scale-up of the model is dependent on positive staff perceptions and experiences.Objectives: The aim of the study was to determine the perceptions and experiences of professional nurses with the integrated chronic care model that has been implemented.Method: A cross-sectional descriptive survey utilising a self-administered questionnaire was conducted amongst all professional nurses who were involved in delivering primary healthcare services at the 42 implementing facilities in September 2014. Each facility has between four and eight professional nurses providing a service daily at the facilitiesResults: A total of 264 professional nurses participated in the survey. Prior to the implementation, 34% (91) of the staff perceived the model to be an added programme, whilst 36% (96) of the staff experienced an increased workload. Staff noted an improved process of care, better level of interaction with patients, improved level of knowledge and better teamwork coupled with an improved level of satisfaction with the work environment at the clinic after implementation of the integrated chronic disease model.Conclusion: Professional nurses have a positive experience with the implementation of the integrated chronic disease management model.

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Empowering patients, empowering clinicians: How the lessons of HIV can inform chronic disease management across the primary healthcare system

Southern African Journal of HIV Medicine ◽

10.4102/sajhivmed.v18i1.692 ◽

2017 ◽

Vol 18 (1) ◽

Author(s):

Andrea S. Mendelsohn

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Healthcare System ◽

Primary Healthcare ◽

Chronic Disease Management

No abstract available.

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2031. Impact of Education and Antibiotic Guidelines on Dispensing Antibiotics with Community Pharmacists in a Low- and Middle-Income Country

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1711 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S682-S682

Author(s):

Smitha Gudipati ◽

Deepak Bajracharya ◽

Lenjana Jimee ◽

Gina Maki ◽

Marcus Zervos ◽

...

Keyword(s):

Community Pharmacists ◽

Antibiotic Use ◽

Educational Assessment ◽

The Body ◽

Control Groups ◽

Post Intervention ◽

Middle Income ◽

Middle Income Countries ◽

And Control ◽

Low And Middle Income

Abstract Background Non-prescription use of antibiotics in low- and middle-income countries has contributed to significant antimicrobial resistance (AMR). Henry Ford Health System has partnered with multinational organizations in Nepal to address the need for increasing awareness of AMR and implementation of effective antimicrobial stewardship. This partnership confirmed the importance of increasing knowledge and awareness regarding AMR and antibiotic use to community pharmacists. The present pilot study assessed if outpatient antibiotic dispensing guidelines given to community pharmacists could result in a reduction of unneeded antibiotic use. Methods Nine community pharmacies from Kathmandu were selected of which two were used as controls. Seven pharmacists were educated on the appropriate use of antibiotics, and outpatient dispensing before and after guidelines at all pharmacies were evaluated. The pharmacists were given guidelines on antibiotic use and duration needed for common bacterial infections encountered. Controls were not given guidelines. At baseline and post-intervention (1 week), pill counts were performed of the top six antibiotics that were dispensed by the pharmacist. Pharmacists were requested to keep a log of how many antibiotics were dispensed for one week. The pharmacists also were requested to fill out a post-intervention educational assessment to evaluate retention. Results Pill count pre-intervention was 15,856 and 1512 and post-intervention was 11,168 and 1,440 in the intervention and control groups respectively (Table 1). A post-intervention educational assessment revealed that both the intervention and control groups believed antibiotics can treat viruses (57% vs. 50%) and that antibiotics do not kill good bacteria that protect the body from infection (57% vs. 50%) (Table 2). Conclusion There was no difference in the dispensing of antibiotics between pre- and post-intervention. The findings of this study show significant room for improvement in continuing education about antibiotic use in outpatient pharmacies. Further studies are needed to target outpatient antibiotic dispensing with education and identifying economic or other incentives in hopes of reducing the burden of AMR in low- and middle-income countries. Disclosures All authors: No reported disclosures.

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A Prescription for Improved Chronic Disease Management: Have Community Pharmacists Function at the Top of Their Training

Archives of Internal Medicine ◽

10.1001/archinternmed.2010.343 ◽

2010 ◽

Vol 170 (18) ◽

Cited By ~ 5

Author(s):

B. Joseph Guglielmo

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Chronic Disease Management ◽

Community Pharmacists

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Primary healthcare providers' attitudes and beliefs about the menopause-related care needs of women who have migrated from low- and middle-income countries to Australia

Australian Journal of Primary Health ◽

10.1071/py19132 ◽

2020 ◽

Vol 26 (1) ◽

pp. 88

Author(s):

Karin A. Stanzel ◽

Karin Hammarberg ◽

Jane Fisher

Keyword(s):

Primary Healthcare ◽

Online Survey ◽

Healthcare Providers ◽

Migrant Women ◽

Care Needs ◽

Middle Income ◽

Structural Support ◽

Middle Income Countries ◽

Primary Healthcare Providers ◽

Low And Middle Income

Health behaviour during midlife is linked to health outcomes in older age. Primary healthcare providers (PHCPs) are ideally placed to provide health-promoting information opportunistically to women in midlife. The aim of this study was to explore PHCPs views about the menopause-related care needs of migrant women from low- and middle-income countries and what they perceive as barriers and enablers for providing this. Of the 139 PHCPs who responded to an anonymous online survey, less than one-third (29.9%) routinely offered menopause-related information during consultations with migrant women. Most agreed that short appointments times (70.8%), lack of culturally and linguistically appropriate menopause information (82.5%) and lack of confidence in providing menopause-related care (32.5%) are barriers for providing comprehensive menopause-related care to migrant women. To overcome these, a menopause-specific Medicare item number and a one-stop website with health information in community languages were suggested. These findings suggest that menopause-related care is not routinely offered by PHCPs to migrant women from low- and middle- income countries and that their capacity to do this may be improved with adequate educational and structural support.

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Study of Understanding Pharmacists' Perspectives on Remuneration and Transition toward Chronic Disease Management (SUPPORT-CDM): Results of an Alberta-Wide Survey of Community Pharmacists

Canadian Pharmacists Journal / Revue des Pharmaciens du Canada ◽

10.3821/1913-701x-142.3.136 ◽

2009 ◽

Vol 142 (3) ◽

pp. 136-143.e1 ◽

Cited By ~ 5

Author(s):

Ellen Mah ◽

Meagen Rosenthal ◽

Ross T. Tsuyuki

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Current Practice ◽

Chronic Disease Management ◽

Resistance To Change ◽

Clinical Care ◽

Community Pharmacists ◽

Pharmacist Intervention ◽

Fee For Service ◽

Management Support

Background: Strong evidence supports the benefits of pharmacist intervention and chronic disease management (CDM) for patients, yet most pharmacists are not providing such services. The purpose of this study was to better understand pharmacists' perceptions of CDM and potential remuneration models. Methods: We developed and tested a web-based survey based on the issues identified in a series of focus groups involving pharmacists: current practice setting, education, remuneration models, current practice environment and implementation. An invitation to complete the survey was e-mailed to registered pharmacists and was included in a weekly newsletter to Alberta pharmacists in January 2008, with 3 subsequent reminders to complete the survey. Results: Responses from 140 pharmacists were included. Pharmacists were most interested in providing CDM for diabetes (79%), although only 49% were presently comfortable with managing diabetes. The top enablers for provision of CDM included pharmacists' desire to change their scope of practice, a supportive work environment and patient demand. The top barriers included a lack of time to engage in CDM, lack of remuneration and staffing issues. Interestingly, relatively few identified pharmacists' resistance to change and difficulty finding eligible patients (38% and 25%, respectively) as important barriers. The majority of pharmacists agreed that payment should be shared between the pharmacy and the pharmacist as a fee-for-service. The average amount pharmacists expected for this model was $44.23/service. Conclusions: Pharmacists showed interest but may lack the confidence to provide CDM services to patients. Many of the facilitators and barriers point toward the need for a sustainable remuneration model for pharmacists' clinical care. We plan to use these results to help develop such a model.

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Community pharmacists’ attitudes toward the chronic disease management in R.N. Macedonia – part II

Macedonian Pharmaceutical Bulletin ◽

10.33320/maced.pharm.bull.2020.66.03.114 ◽

2020 ◽

Vol 66 (03) ◽

pp. 229-230

Author(s):

Donka Pankov ◽

Nikola Geskovski ◽

Maja Simonoska Crcarevska ◽

Marija Glavas Dodov

Keyword(s):

Chronic Disease ◽

Disease Management ◽

Chronic Disease Management ◽

Community Pharmacists

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