scholarly journals Equipping community pharmacy workers as agents for health behaviour change: developing and testing a theory-based smoking cessation intervention

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015637 ◽  
Author(s):  
Liz Steed ◽  
Ratna Sohanpal ◽  
Wai-Yee James ◽  
Carol Rivas ◽  
Sandra Jumbe ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Pilot Study ◽  
Community Pharmacy ◽  
Behaviour Change ◽  
Controlled Trial ◽  
Realist Review ◽  
Phase Iii ◽  
Community Pharmacies ◽  
Pharmacy Staff ◽  
Smoking Cessation Services

ObjectiveTo develop a complex intervention for community pharmacy staff to promote uptake of smoking cessation services and to increase quit rates.DesignFollowing the Medical Research Council framework, we used a mixed-methods approach to develop, pilot and then refine the intervention.MethodsPhase 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.SettingEight community pharmacies in three inner east London boroughs.Participants12 Stop Smoking Advisers.InterventionTwo, 150 min, skills-based training sessions focused on communication and behaviour change skills with between session practice.ResultsThe 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.ConclusionsWe 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.Trial registration numberUKCRN ID 18446, Pilot.

scholarly journals A pilot study of the S-MAP (Solutions for Medications Adherence Problems) intervention for older adults prescribed polypharmacy in primary care: study protocol

2019 ◽  
Vol 5 (1) ◽  
Author(s):  
D. E. Patton ◽  
J. J. Francis ◽  
E. Clark ◽  
F. Smith ◽  
C. A. Cadogan ◽  
...  
Keyword(s):  
Pilot Study ◽  
Process Evaluation ◽  
Behaviour Change ◽  
Older Patients ◽  
Controlled Trial ◽  
Theoretical Domains Framework ◽  
Self Report ◽  
Community Pharmacies ◽  
Behaviour Change Techniques ◽  
Limited Effectiveness

Abstract Background Adhering to multiple medications as prescribed is challenging for older patients (aged ≥ 65 years) and a difficult behaviour to improve. Previous interventions designed to address this have been largely complex in nature but have shown limited effectiveness and have rarely used theory in their design. It has been recognised that theory (‘a systematic way of understanding events or situations’) can guide intervention development and help researchers better understand how complex adherence interventions work. This pilot study aims to test a novel community pharmacy-based intervention that has been systematically developed using the Theoretical Domains Framework (12-domain version) of behaviour change. Methods As part of a non-randomised pilot study, pharmacists in 12 community pharmacies across Northern Ireland (n = 6) and London, England (n = 6), will be trained to deliver the intervention to older patients who are prescribed ≥ 4 regular medicines and are non-adherent (self-reported). Ten patients will be recruited per pharmacy (n = 120) and offered up to four tailored one-to-one sessions, in the pharmacy or via telephone depending on their adherence, over a 3–4-month period. Guided by an electronic application (app) on iPads, the intervention content will be tailored to each patient’s underlying reasons for non-adherence and mapped to the most appropriate solutions using established behaviour change techniques. This study will assess the feasibility of collecting data on the primary outcome of medication adherence (self-report and dispensing data) and secondary outcomes (health-related quality of life and unplanned hospitalisations). An embedded process evaluation will assess training fidelity for pharmacy staff, intervention fidelity, acceptability to patients and pharmacists and the intervention’s mechanism of action. Process evaluation data will include audio-recordings of training workshops, intervention sessions, feedback interviews and patient surveys. Analysis will be largely descriptive. Discussion Using pre-defined progression criteria, the findings from this pilot study will guide the decision whether to proceed to a cluster randomised controlled trial to test the effectiveness of the S-MAP intervention in comparison to usual care in community pharmacies. The study will also explore how the intervention components may work to bring about change in older patients’ adherence behaviour and guide further refinement of the intervention and study procedures. Trial registration This study is registered at ISRCTN: 10.1186/ISRCTN73831533

Pharmacist-Delivered Smoking Cessation Program in Community Pharmacy (The FINE Program) in Japan—The Development of a Training Course and a Feasibility Study

2019 ◽  
pp. 089719001988974
Author(s):  
Mitsuko Onda ◽  
Takashi Kuwanoe ◽  
Atsunori Hashimoto ◽  
Michiko Horiguchi ◽  
Masayuki Domichi ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Community Pharmacy ◽  
Feasibility Study ◽  
Smoking Status ◽  
Controlled Trial ◽  
Smoking Cessation Program ◽  
Community Pharmacies ◽  
The Family ◽  
Quitting Smoking ◽  
Continuous Abstinence

Aim: Although smoking cessation support has been recommended as a routine component of pharmacists’duties, there is limited evidence of smoking cessation being achieved successfully in community pharmacy. The aim of this study was to develop a new smoking cessation program for use in the community pharmacy setting and investigate its feasibility. Methods: A feasibility study (the Family pharmacist’s Intervention for Nicotine Elimination [FINE] program) was conducted using 8 pharmacists at 2 community pharmacies in Japan. The pharmacists recruited as subjects smokers 20 or more years of age who were taking medications such as antidiabetes drugs. The patients completed questionnaires assessing their smoking status, and the pharmacists provided them with smoking cessation support services. Participating patients met with the pharmacists or talked to them on the phone 5 times at 2- to 4-week intervals and received personalized and structured brief smoking cessation advice. The primary outcome was continuous abstinence determined by Micro Smokerlyzer carbon monoxide monitor at 3 months. Results: Of 5306 patients, 2296 patients were screened and the rate of smoking was found to be 12.7%. Five smoking patients received the FINE program from pharmacists who had received training. One of the 5 succeeded in quitting smoking after 3 months. Conclusions: This is the first study to target Japanese smoking patients in community pharmacies with a brief structured intervention. The results tentatively support the feasibility of the FINE program. Further research including a randomized controlled trial is required to confirm the effectiveness of the FINE program.

scholarly journals Effects of active referral combined with a small financial incentive on smoking cessation: study protocol for a cluster randomised controlled trial

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038351
Author(s):  
Xue Weng ◽  
Man Ping Wang ◽  
Ho Cheung William Li ◽  
Yee Tak Derek Cheung ◽  
Ching Yin Lau ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Hong Kong ◽  
Randomised Controlled Trial ◽  
Financial Incentive ◽  
Controlled Trial ◽  
Reduction Rate ◽  
Cluster Randomised Controlled Trial ◽  
Cluster Randomised ◽  
Smoking Cessation Services ◽  
Randomised Controlled

IntroductionEvidence-based smoking cessation treatments are effective but underutilised, accentuating the need for novel approaches to increase use. This trial investigates the effects of active referral combined with a financial incentive to use smoking cessation services on smoking abstinence among community smokers.Methods and analysisThis ongoing study is a two-arm, assessor-blinded, pragmatic, cluster randomised controlled trial with follow‐ups at 1, 2, 3 and 6 months after randomisation. We aim to enrol 1134 daily smokers from 70 community sites (clusters) in Hong Kong. All participants receive Ask, Warn, Advise, Refer, Do-it-again (AWARD) guided advice and a self-help booklet at baseline. Additionally, participants in the intervention group receive an offer of referral to smoking cessation services at baseline and a small financial incentive (HK$300≈US$38) contingent on using any of such services within 3 months. The primary outcomes are bioverified abstinence (exhaled carbon monoxide <4 ppm and salivary cotinine <10 ng/mL) at 3 and 6 months. Secondary outcomes include self-reported 7-day point prevalence of abstinence, smoking reduction rate, quit attempts and the use of smoking cessation services at 3 and 6 months. Intention-to-treat approach and regression models will be used in primary analyses.Ethics and disseminationThis protocol has been approved by the Institutional Review Board of the University of Hong Kong/Hospital Authority Hong Kong West Cluster (IRB reference number: UW 18-318). The results of this trial will be submitted for publication in peer-reviewed journals, and the key findings will be presented at national and international conferences.Trial registration numberClinicalTrials.gov Registry NCT03565796.

scholarly journals Australian Community Pharmacy Harm-Minimisation Services: Scope for Service Expansion to Improve Healthcare Access

Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 95
Author(s):  
Sara S. McMillan ◽  
Hidy Chan ◽  
Laetitia H. Hattingh
Keyword(s):  
Community Pharmacy ◽  
Healthcare Access ◽  
Further Education ◽  
Community Pharmacies ◽  
Structured Interviews ◽  
Pharmacy Staff ◽  
Harm Minimisation ◽  
Staff Members ◽  
Education Support

Community pharmacies are well positioned to participate in harm-minimisation services to reduce harms caused by both licit and illicit substances. Considering developments in pharmacist practices and the introduction of new professional pharmacy services, we identified a need to explore the contemporary role of community pharmacy in harm minimisation. Semi-structured interviews were undertaken to explore the opinions of stakeholders, pharmacy staff, and clients about the role of community pharmacy in harm minimisation, including provision of current services, experiences, and expectations. Participants (n = 28) included 5 stakeholders, 9 consumers, and 14 staff members from seven community pharmacies. Three over-arching themes were identified across the three participants groups: (i) scope and provision, (ii) complexity, and (iii) importance of person-centred advice and support in relation to community pharmacy harm minimisation services. Community pharmacies are valuable healthcare destinations for delivery of harm minimisation services, with scope for service expansion. Further education, support, and remuneration are needed, as well as linkage to other sector providers, in order to ensure that pharmacists and pharmacy staff are well equipped to provide a range of harm minimisation services.

scholarly journals Smoking Cessation Services by Community Pharmacists: Real-World Practice in Thailand

2021 ◽  
Vol 18 (22) ◽  
pp. 11890
Author(s):  
Sunee Lertsinudom ◽  
Pentipa Kaewketthong ◽  
Tamonwan Chankaew ◽  
Dujrudee Chinwong ◽  
Surarong Chinwong
Keyword(s):  
Smoking Cessation ◽  
Community Pharmacy ◽  
Real World ◽  
Community Pharmacists ◽  
Self Report ◽  
P Value ◽  
Quit Smoking ◽  
Smoking Cessation Services ◽  
Before And After ◽  
Exhaled Carbon Monoxide

This study aimed to report the effectiveness of community pharmacy smoking cessation services in 13 health regions in Thailand using a retrospective data-collecting method from the Foundation of Community Pharmacy database. The participants were smokers aged at least 18 years. The outcomes were the abstinence of smoking at least 30 consecutive days by self-report only and self-report with exhaled CO level <7 ppm (if available), the number of cigarettes smoked daily, exhaled carbon monoxide (exhaled CO), and % peak expiratory flow rate (%PEFR); smokers measured these outcomes before and after receiving the smoking cessation services. Of 58 community pharmacies, 532 smokers (93% male, mean age of 42.4 ± 14.9 years) received smoking cessation services from community pharmacists. Of 235 smokers with complete data, 153 (28.8%, 153/532) smokers reported smoking abstinence by self-report. The mean number of cigarettes smoked daily reduced from 15.3 ± 8.7 to 1.9 ± 3.8 cigarettes, p-value < 0.001. The exhaled CO levels of smokers significantly reduced from 11.7 ± 5.9 ppm to 7.2 ± 4.4 ppm, p-value < 0.001. The %PEFR also significantly increased from 84.2 ± 19.4 to 89.5 ± 19.5, p-value < 0.001. In conclusion, Thai community pharmacy smoking cessation services could aid smokers to quit smoking. This study is the outcome of the real-world community pharmacy smoking cessation service; policymakers should consider this service to be included in the national healthcare policy.

scholarly journals A Community Pharmacist-led Smoking Cessation Intervention Using a Smartphone App (PharmQuit): A Randomized Controlled Trial

2020 ◽  
Author(s):  
Narong Asayut ◽  
Phayom Sookaneknun Olson ◽  
Juntip Kanjanasilp ◽  
Preut Thanarat ◽  
Bhattaraporn Senkraigul ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Standard Care ◽  
Controlled Trial ◽  
Intervention Group ◽  
Community Pharmacists ◽  
Adherence Rate ◽  
Smartphone App ◽  
Control Group ◽  
Randomized Controlled ◽  
Smoking Cessation Services

Abstract Background: WHO supports the harnessing of mobile technologies to improve access to smoking cessation services. PharmQuit, a smartphone app, was developed to support smoking cessation efforts by pharmacists taking into consideration the design of the app according to the needs of smokers. This study evaluated the effectiveness of smoking cessation services conducted by community pharmacists using PharmQuit compared with standard care.Methods: An open-label prospective, randomized, controlled trial was conducted. Stratified random sampling by sex, age, and nicotine addiction was used to allocate participants to either the intervention group or control group. Eligible participants were smokers 18 years old or older who smoked at least one cigarette daily for a month, were ready to quit, willing to participate, and had a smartphone. The study was performed at seven community pharmacies situated in three provinces in Thailand. In the intervention group, participants received smoking cessation services by community pharmacists using PharmQuit. The control group received standard care delivered by community pharmacists. Both groups were scheduled follow-ups at day 7, 14, 30, 60, 120, and 180. The primary outcomes were quit rate and number of cigarettes smoked per day. Secondary outcomes were exhaled carbon monoxide levels, adherence rate to the program, and satisfaction with PharmQuit. Analysis using the intent-to-treat principle was carried out. Results: A total of 156 smokers were randomly assigned to either the intervention (n=78) or control (n=78) group. Smoking cessation rates and the number of cigarettes smoked per day were significantly better over the follow-up visits in both groups (p<0.05). However, there were no statistically significant differences between the two groups. Adherence rate to the smoking cessation program was higher in the intervention group than the control group (74 days vs 60 days, p>0.05). Relapse rate was found to be lower in the intervention group as compared to the control group (28.6% vs 71.4%). Conclusions: The results showed obvious benefits of the community pharmacist’s contribution in helping smokers quit smoking. PharmQuit was not better than just pharmacist’s counselling but it might help to obtain better adherence to smoking cessation programs, and have less likelihood of relapse. Trial registration: Thai Clinical Trials Registry: TCTR20200925004. Registration date September 25, 2020 – Retrospectively registered, http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=6841

scholarly journals The smoking cessation in pregnancy incentives trial (CPIT): study protocol for a phase III randomised controlled trial

Trials ◽  
2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Lesley Sinclair ◽  
◽  
Margaret McFadden ◽  
Helen Tilbrook ◽  
Alex Mitchell ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Randomised Controlled Trial ◽  
Study Protocol ◽  
Controlled Trial ◽  
Phase Iii ◽  
Randomised Controlled ◽  
In Pregnancy

scholarly journals Over-The-Counter Codeine: Can Community Pharmacy Staff Nudge Customers into Its Safe and Appropriate Use?

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 185
Author(s):  
Sapana Mody ◽  
Charlotte L. Kirkdale ◽  
Tracey Thornley ◽  
Aimi Dickinson ◽  
Anthony J. Avery ◽  
...  
Keyword(s):  
Patient Safety ◽  
Pain Relief ◽  
Community Pharmacy ◽  
Health Concern ◽  
Community Pharmacies ◽  
Public Health Concern ◽  
Appropriate Use ◽  
Pharmacy Staff ◽  
Over The Counter ◽  
Web Based

The misuse of opioids, including codeine which is sold over-the-counter (OTC) in United Kingdom (UK) community pharmacies, is a growing public health concern. An educational Patient Safety Card was developed and piloted to see if it nudged customers into the safe and appropriate use of OTC codeine. Exploratory analysis was conducted by (i) recording quantitative interactions for people requesting OTC codeine in community pharmacies; and (ii) a web-based pharmacy staff survey. Twenty-four pharmacies submitted data on 3993 interactions using the Patient Safety Card. Staff found the majority of interactions (91.3%) to be very or quite easy. Following an interaction using the card, customers known to pharmacy staff as frequent purchasers of OTC codeine were more likely not to purchase a pain relief medicine compared to customers not known to staff (5.5% of known customers did not purchase any pain relief product versus 1.1% for unknown customers (χ2 = 41.73, df = 1, p < 0.001)). These results support both the use of a visual educational intervention to encourage appropriate use of OTC codeine in community pharmacy and the principles behind better self-care.

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