scholarly journals Community pharmacist perceptions of clinical medication reviews

2010 ◽  
Vol 2 (3) ◽  
pp. 234 ◽  
Author(s):  
Linda Bryant ◽  
Gregor Coster ◽  
Ross McCormick
Keyword(s):  
Community Pharmacy ◽  
Community Pharmacist ◽  
Health Care Services ◽  
Community Pharmacists ◽  
Utilization Review ◽  
Routine Practice ◽  
Structured Interviews ◽  
Traditional Role ◽  
Plan Implementation ◽  
Medication Reviews

INTRODUCTION: Changes in delivery of health care services has led to pressure for community pharmacists to extend their traditional role and become more involved with patient-focussed services such as medication reviews, in collaboration with general practitioners (GPs). This has not been generally implemented into routine practice, and many barriers have been suggested that inhibit community pharmacists extending their role. These have often focussed on physical or functional barriers. This study explores possible attitudinal factors that prevent increased participation of community pharmacists in medication reviews undertaken in collaboration with GPs. METHODS: Twenty community pharmacist participants who participated in the General Practitioner– Pharmacist Collaboration (GPPC) study were interviewed. The GPPC study investigated the outcomes of community pharmacists undertaking a clinical medication review in collaboration with GPs, and the potential barriers. Semi-structured interviews were analysed using a general inductive thematic approach. FINDINGS: Emerging themes were that community pharmacists perceived that they were not mandated to undertake this role, it was not a legitimate role, particularly from the business perceptive, and pharmacists were concerned that they lacked the skills and confidence to provide this level of input. CONCLUSION: While there is concern that community pharmacists’ skills are underutilised, there are probable attitudinal barriers inhibiting pharmacists from increasing their role in clinical medication reviews. Perceived legitimacy of the service was a dominant theme, which appeared to be related to issues in the business model. Further investigation should consider the use of a clinical pharmacist working within a general practice independent of a community pharmacy. KEYWORDS: Community pharmacy services; drug utilization review; primary healthcare; health plan implementation

scholarly journals General practitioner perceptions of clinical medication reviews undertaken by community pharmacists

2010 ◽  
Vol 2 (3) ◽  
pp. 225 ◽  
Author(s):  
Linda Bryant ◽  
Gregor Coster ◽  
Ross McCormick
Keyword(s):  
Health Care ◽  
General Practitioner ◽  
Patient Outcomes ◽  
Health Care Providers ◽  
Community Pharmacists ◽  
Resource Utilisation ◽  
Utilization Review ◽  
Care Providers ◽  
Factors Influencing ◽  
Medication Reviews

INTRODUCTION: Delivery of current health care services focuses on interdisciplinary teams and greater involvement of health care providers such as nurses and pharmacists. This requires a change in role perception and acceptance, usually with some resistance to changes. There are few studies investigating the perceptions of general practitioners (GPs) towards community pharmacists increasing their participation in roles such as clinical medication reviews. There is an expectation that these roles may be perceived as crossing a clinical boundary between the work of the GP and that of a pharmacist. METHODS: Thirty-eight GPs who participated in the General Practitioner–Pharmacists Collaboration (GPPC) study in New Zealand were interviewed at the study conclusion. The GPPC study investigated outcomes of a community pharmacist undertaking a clinical medication review in collaboration with a GP, and potential barriers. The GPs were exposed to one of 20 study pharmacists. The semi-structured interviews were recorded and transcribed verbatim then analysed using a general inductive thematic approach. FINDINGS: The GP balanced two themes, patient outcomes and resource utilisation, which determined the over-arching theme, value. This concept was a continuum, depending on the balance. Factors influencing the theme of patient outcomes included the clinical versus theoretical nature of the pharmacist recommendations. Factors influencing resource utilisation for general practice were primarily time and funding. CONCLUSION: GPs attributed different values to community pharmacists undertaking clinical medication reviews, but this value usually balanced the quality and usefulness of the pharmacist’s recommendations with the efficiency of the system in terms of workload and funding. KEYWORDS: Family physicians; community pharmacy services; drug utilization review; primary healthcare; health plan implementation; qualitative research; interprofessional relations

scholarly journals “Basically you wait for an ‘in’’’: community pharmacist views on their role in weight management in New Zealand

2016 ◽  
Vol 8 (4) ◽  
pp. 365 ◽  
Author(s):  
Lesley Gray ◽  
Rachel Chamberlain ◽  
Caroline Morris
Keyword(s):  
New Zealand ◽  
Weight Management ◽  
Community Pharmacist ◽  
Local Community ◽  
Treatment Options ◽  
Management Strategies ◽  
Community Pharmacists ◽  
Structured Interviews ◽  
Pharmacy Staff ◽  
Health Community

ABSTRACT INTRODUCTION Obesity is now widely regarded as the main contributor to poor health globally, overtaking tobacco as the leading potentially modifiable risk to health. Community pharmacists are delivering an increasing number of extended services and are potentially well placed to contribute to obesity management strategies. No studies to date have investigated the views of community pharmacists in New Zealand about their role in weight management. AIM To explore the views of community pharmacists in one region of New Zealand about their role in weight management, including the perceived barriers and facilitators to their involvement. METHODS Qualitative, face-to-face, semi-structured interviews were undertaken with 11 community pharmacists from the Greater Wellington region. Interviews were transcribed verbatim and analysed thematically using an inductive approach. RESULTS Four key themes were identified from data analysis. These were: (i) perceptions of obesity; (ii) perceptions of weight management treatment options; (iii) the unique position of the community pharmacist; and (iv) barriers to involvement. The main barriers described included: (i) a lack of time and remuneration; (ii) the absence of an appropriate space within the pharmacy to discuss weight-related matters; (iii) and a lack of awareness of who to contact for specialist support. DISCUSSION Community pharmacists in Greater Wellington believe that they have a distinct role in their local community and can contribute to a multidisciplinary approach to reduce levels of obesity. Further work is required to determine the most appropriate role for community pharmacy in weight management and the training needs for pharmacy staff to optimally fulfil this role.

Pharmacist’s Demand for Optimal Primary Care Service Delivery in a Community Pharmacy: The OPTiPharm Study

2017 ◽  
Vol 51 (12) ◽  
pp. 1069-1076 ◽  
Author(s):  
Mark A. Munger ◽  
Michael Walsh ◽  
Jon Godin ◽  
Michael Feehan
Keyword(s):  
Primary Care ◽  
Community Pharmacy ◽  
Health Care Services ◽  
Point Of Care ◽  
Care Service ◽  
Community Pharmacists ◽  
Care Services ◽  
Primary Health ◽  
Primary Health Care Services ◽  
Pharmacy Setting

Background: The US population continues to expand providing the need for primary health care services. Community pharmacies integrated with medicine may provide greater access while providing high quality care. Objective: To gauge pharmacists’ demand for primary health care services delivered through community pharmacies. Methods: An online survey was administered to determine community pharmacists’ preferences for varying primary care services that could be offered in the community pharmacy setting. A Discrete Choice Experiment was employed to show pharmacists competing scenarios with varied primary care service offerings in the community pharmacy setting. Attributes evaluated were operation hours, service provider, medical records, service logistics, physical examinations, point-of-care diagnostic testing, preventative care, and drug prescribing. Respondents chose the scenario most likely to induce switching employment from base pharmacy to one providing advanced services. Results: The optimal service delivery model from 291 community pharmacists comprised: inclusion of patient prescriptions and health information into the patient’s medical record; provision of point of care testing and vital sign, including blood pressure, heart rate and breathing rate, and blood sugar and cholesterol measurement; and pharmacists prescribing (under physician oversight). Pharmacists were 4 times more likely to switch employment from their current pharmacy to their choice for advanced pharmacy services. Pharmacist demand was highest among those with a PharmD, less experience, working >40 hours per week, and in rural areas. Conclusions: This study provides empirical support for the model of pharmacists playing a greater role in the provision of primary care health services through community pharmacy settings.

scholarly journals Provision of community pharmacy services during the first wave of COVID-19 pandemic in Estonia – experiences and future implications

2022 ◽  
Vol 131 ◽  
pp. 02005
Author(s):  
Kristiina Sepp ◽  
Kadi Lubi ◽  
Hedvig Rass ◽  
Daisy Volmer
Keyword(s):  
Community Pharmacy ◽  
Community Pharmacists ◽  
Emergency Situation ◽  
Community Pharmacy Services ◽  
Shared Responsibility ◽  
Pharmacy Services ◽  
Structured Interviews ◽  
Health Related ◽  
Textual Content

The spread of COVID-19 outbreak in 2020 had significant impact on the functioning of the existing healthcare system and required fast adaption to new circumstances for continuing with daily practices. Community pharmacists shared responsibility of ensuring supply of medicines and medical devices, educating people on health related issues, providing pharmaceutical care etc. The aim of this study was to understand how the provision of community pharmacy services changed during the first wave of COVID-19 pandemic in spring of 2020 in Estonia. Qualitative in-depth semi-structured interviews were conducted. Recorded interviews with community pharmacists (n = 21) and experts (n =10) were transcribed verbatim and a systematic text condensation method for textual content analysis was performed. The findings indicated that a number of changes took place in provision of community pharmacy services to assure continuity in providing high-quality pharmacy services in crisis, including addressing difficulties in the supply of medicines; at the same time, to acquire new knowledge for counselling health related topics and personal protective equipment, and to provide psychological support to people in stress. Pandemic had an impact on the content and structure of traditional community pharmacy services in Estonia. The need for expanded professional role of pharmacists was clearly expressed in an emergency situation.

scholarly journals Development and Implementation of Charitable Pharmacy Services within a Federally-Qualified Health Center (FQHC)

2015 ◽  
Vol 6 (3) ◽  
Author(s):  
Cortney M. Mospan ◽  
Katelyn M. Alexander
Keyword(s):  
Health Care ◽  
Community Pharmacy ◽  
Access To Health Care ◽  
Health Care Services ◽  
Quality Care ◽  
Community Pharmacists ◽  
Health Care Team ◽  
Pharmacy Services ◽  
Care Services ◽  
Access To Health

Underserved patient populations often have limited access to health care services, especially medications, leading to lower quality care due to their transitional status and lack of access. To ensure access to medications for underserved patients in the Johnson City, Tennessee area, the Colleges of Nursing and Pharmacy at ETSU developed a charitable pharmacy to serve those of greatest need in hopes of improving quality of care. By establishing a community pharmacy within a FQHC, clinical community pharmacists were able to establish enhanced community pharmacy services as a part of the health-care team. This manuscript describes the development, implementation, and benefits of the community pharmacy integration within a FQHC   Type: Clinical Experience

Community Pharmacist Preferences in Transition of Care Communications

2018 ◽  
Vol 32 (5) ◽  
pp. 524-528 ◽  
Author(s):  
Mackenzie A. Dolan ◽  
Chelsea P. Renfro ◽  
Stefanie P. Ferreri ◽  
Betsy B. Shilliday ◽  
Timothy J. Ives ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Health Care Providers ◽  
Community Pharmacist ◽  
Community Pharmacists ◽  
Cross Sectional Study ◽  
Study Data ◽  
Future Research ◽  
Transition Of Care ◽  
Care Providers ◽  
Cross Sectional

Objective: To determine community pharmacist preferences in transition of care (TOC) communications. Methods: In this cross-sectional study, data were gathered via electronic survey of community pharmacists regarding their preferences for TOC communications. The survey was distributed via email by the North Carolina Board of Pharmacy. Results were analyzed using descriptive statistics. Results: Survey responses were received from 343 community pharmacists (response rate = 6.1%). Responders most commonly worked in an independent, single store (29.2%, n = 100) or national chain (29.2%, n = 100) pharmacy setting. Preferred method for a TOC communication was via electronic health record (63.0%, n = 184). Preferred TOC communication content are mentioned as follows: active (93.2%, n = 274) and discontinued (86.4%, n = 254) medications and reason for hospitalization (85.0%, n = 250). The top 3 self-identified barriers to utilizing a TOC communication: lack of care coordination with community pharmacy (35.0%, n = 14), lack of support from other health-care providers (22.5%, n = 9), and absence of compensation for providing the service (17.5%, n = 7). When asked if TOC communications were available, 97.5% (n = 278) indicated it would be useful. Conclusion: Community pharmacists acknowledged a need for TOC communications and shared their preferences in the content and method of communication. Future research is warranted to implement TOC communications between a health system and community pharmacy.

scholarly journals Exploring the perspectives and strategies of Ontario community pharmacists to improve routine follow-up for patients with diabetes: A qualitative study

2021 ◽  
pp. 171516352110184
Author(s):  
Natali Surkic ◽  
Annalise Mathers ◽  
Jamie Kellar ◽  
Lori MacCallum ◽  
Lisa Dolovich
Keyword(s):  
Community Pharmacy ◽  
Diabetes Education ◽  
Community Pharmacists ◽  
Future Research ◽  
Convenience Sample ◽  
Routine Monitoring ◽  
Semistructured Interviews ◽  
Patients With Diabetes ◽  
Medication Reviews

Background: Medication reviews are a fundamental activity carried out as part of comprehensive care delivered by pharmacists. Varying programs that reimburse pharmacists for conduct of medication reviews are in place in different jurisdictions in Canada and other countries around the world. The MedsCheck Diabetes (MCD) program is a publicly funded service in Ontario, Canada, offered to patients with type 1 or type 2 diabetes. Through this service, pharmacists can complete a focused medication review with advice, training, monitoring and follow-up diabetes education. Although pharmacists can be reimbursed for patient follow-up activities, a low number of follow-up medication reviews are billed through this program. Methods: The study explores the barriers and facilitators that community pharmacists in Ontario experience in conducting routine monitoring and follow-up of patients with diabetes. Using a descriptive content analysis approach study, semistructured interviews were conducted with a convenience sample of 8 community pharmacists working in Ontario. Results: Three main themes emerged: the design of the MCD program, the state of community pharmacy and collaboration and relationships. These themes demonstrate challenges and potential strategies recognized by community pharmacists to conduct routine diabetes follow-up through the MCD program. Conclusion: Future research should more closely examine and implement strategies to optimize routine follow-up in community pharmacy for patients with diabetes, taking into consideration the themes and examples identified in this study. Can Pharm J (Ott) 2021;154:xx-xx.

scholarly journals 147. Pharmacist Attitudes Towards Using Clinical Decision Support in Community Pharmacies to Promote Antibiotic Stewardship in the Treatment of Uncomplicated UTI

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S84-S84
Author(s):  
Sena Sayood ◽  
Katie Suda ◽  
Michael Durkin
Keyword(s):  
Decision Support ◽  
Community Pharmacy ◽  
Clinical Decision Support ◽  
Community Pharmacists ◽  
Clinical Decision ◽  
Community Pharmacies ◽  
Uncomplicated Urinary Tract Infection ◽  
Prescribing Practices ◽  
Structured Interviews ◽  
Pharmacist Attitudes

Abstract Background Prior studies of prescribing practices have shown that providers frequently choose non-guideline concordant treatment regimens to treat uncomplicated urinary tract infection (UTI). It has also been shown that uncomplicated UTI can be treated safely, and in a guideline concordant manner, by non-physician providers using an algorithm over the phone. The purpose of this study was to assess pharmacist attitudes towards using a clinical decision support (CDS) tool that would be used to evaluate and manage patients presenting with complaints of UTI in the community pharmacy setting. Methods We conducted semi-structured interviews of community pharmacists (n = 21) from 2019 to 2020 until thematic saturation was reached. Pharmacists were questioned about their attitudes towards stewardship, workflow, interactions with patients and providers, and interest in using a computerized CDS tool. Interviews were recorded, transcribed, and de-identified. Coding and analysis of the interviews was performed using NVivo version 12. Results Pharmacists were interviewed with practice experience ranging from 2 to 54 years (median 13, IQR 6, 27). All pharmacists expressed interest in using CDS to assist with patient evaluations and stewardship. They reported that patients routinely use the community pharmacy as a first stop for medical advice and that they have several interactions per day with patients in which they counsel them on a variety of issues, including UTI. Their assessment and management decisions of UTIs were based on personal knowledge and not on any standard of care. Communication difficulties with primary care offices often delayed management of these patients and lack of information sharing made it difficult for pharmacists to engage in stewardship practices. Conclusion Community pharmacies are an important point of contact for patients and represent a significant opportunity to implement outpatient stewardship interventions. Pharmacists had an overwhelmingly favorable response to the prospect of using a CDS tool, both to help in patient evaluation and to promote antimicrobial stewardship. Based on these results we can conclude that it would be feasible to pilot a CDS tool in community pharmacies to further evaluate its safety and efficacy in the treatment of UTI. Disclosures All Authors: No reported disclosures

Community pharmacy led atrial fibrillation detection and referral service – the Capture AF study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Z Khanbhai ◽  
S Manning ◽  
R Fordham ◽  
G Xydopoulos ◽  
C Grossi-Sampedro ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Community Pharmacy ◽  
Community Pharmacist ◽  
Symptom Burden ◽  
Community Pharmacists ◽  
Health Impact ◽  
Funding Source ◽  
Intensive Training ◽  
Pulse Palpation ◽  
Health And Social Care

Abstract Background Atrial fibrillation (AF) is the most common sustained atrial arrhythmia. AF significantly affects patients' quality of life and increase morbidity and mortality. Patients with AF need to be appropriately anticoagulated to reduce the risk of stroke. Approximately every fifth stroke is due to AF and average costs for both health and social care is £44,000 over the first five years. Recent updated guidelines on the management of AF have recommended that all patients over the age of 65 be offered screening in the community using either short term ECG or manual pulse palpation. Purpose To determine the feasibility of an innovative community pharmacy led AF detection service incorporating referral for review and treatment to a specialist arrhythmia centre. Method Community pharmacists received intensive training on AF, how to record an ECG using a Kardia monitor and documenting the consultation on a referral form hosted on a national pharmacy database called PharmOutcomes. Targeted opportunistic detection was undertaken by the pharmacists for anyone over the age of 65 years with risk factors for AF. Patients were referred by the pharmacist to the specialist team via PharmOutcomes if they had possible new AF, previous AF and not anticoagulated, anticoagulated but experiencing side effects or adherence issues or a high AF symptom burden. Patients initated on anticoagulation by the specialist team were referred back to the community pharmacist via the New Medicines Service (NMS) for adherence monitoring. Results During a proof of concept phase (May to October 2016) and an upscale phase (May 2018-May 2019) 28 pharmacies were recruited and 1737 participants were enrolled in the study. 891 (51.3%) were male, 851 (41%) were aged over 75 years. 299 patients were referred by the pharmacists and 99 of these were seen by the specialist team in clinic. 28 patients (1.6%) were diagnosed with AF. 20 out of 28 (71.0%) were initiated on anticoagulation. 29 out of 146 patients (19.9%) had previous AF with either a high symptom burden (11) or a heart rate below 50 or above 100 beats per minutes (18). 7 patients (4.3%) with previous AF were started on anticoagulation. 48 out of 99 patients (48.4%) had their medication optimised. This included rate control titration and adjustment of anticoagulation doses. 31 out of 99 patients (31.3%) required further interventions such as holter monitors, echocardiograms or referral to other specialists. Conclusions The results demonstrate that the this service is a robust multidisciplinary process for the detection, protection and perfection of AF. The direct referral pathway ensures that patients are reviewed by a specialist team and receive optimal treatment and management. Referral back to the community pharmacist via the NMS enhances concordance with anticoagulation. Further analysis is being undertaken to assess the cost-effectiveness and health impact of this service. Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): The Health Foundation; ASHN in collaboration with BMS Pfizer

scholarly journals Assessment of Good Pharmacy Practice among Community Pharmacist and their Perceptions on Ethical Dilemmas

2021 ◽  
Vol 11 (2) ◽  
pp. 113-122
Author(s):  
T.T. Muhammed Anwar ◽  
G.R. Rajalakshmi
Keyword(s):  
Community Pharmacy ◽  
Community Pharmacist ◽  
Ethical Dilemma ◽  
Ethical Issues ◽  
Pharmacy Practice ◽  
Community Pharmacists ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Time Period ◽  
Self Administered Questionnaire

Drugs are the prime member of any disease prevention plans and ailment treatment programmes. Pharmacists are the health professionals appointed by relevant authorities for safe and efficacious use of drugs, since they are the specially upskilled and trained personnel for controlling, organizing and distribution of medicines. Medicine alone does not provide desired treatment output. In order to achieve the optimal treatment goals pharmacist must provide enhanced drug related needs and ensure the services are of proper quality. This study aims to assess the Good Pharmacy Practice among community pharmacist, determine the frequency of ethical dilemma at community pharmacy settings and to assess the reasons why community pharmacists may compromise ethical values.It was a descriptive cross - sectional study carried out in different community pharmacies in Kozhikode district of Kerala. The study was executed in 6 months time period. The sample size was 115 community pharmacists working in Kozhikode district. Total of 120 subjects were enrolled and data were collected using a validated self-administered questionnaire. The result shows that most of the pharmacists were providing quality services to the patients and they are facing various ethical dilemma situations in their day today life. They were facing ethical dilemma situation at least once in three months. Community pharmacists compromise on ethical values and ethical issues mainly for protecting their job. The physicians request and employer’s invasion into their activities has a great role in ethical dilemma situations and thus violating the rules. Keywords: GPP, community pharmacy, ethical dilemma, pharmacy services.

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