scholarly journals Qualitative study using interviews and focus groups to explore the current and potential for antimicrobial stewardship in community pharmacy informed by the Theoretical Domains Framework

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025101 ◽  
Author(s):  
Leah Ffion Jones ◽  
Rebecca Owens ◽  
Anna Sallis ◽  
Diane Ashiru-Oredope ◽  
Tracey Thornley ◽  
...  
Keyword(s):  
Focus Groups ◽  
Community Pharmacy ◽  
Antimicrobial Stewardship ◽  
Self Care ◽  
Intervention Development ◽  
Theoretical Domains Framework ◽  
Community Pharmacists ◽  
Pharmacy Staff ◽  
Barriers And Opportunities ◽  
The Impact

ObjectivesCommunity pharmacists and their staff have the potential to contribute to antimicrobial stewardship (AMS). However, their barriers and opportunities are not well understood. The aim was to investigate the experiences and perceptions of community pharmacists and their teams around AMS to inform intervention development.DesignInterviews and focus groups were used to explore the views of pharmacists, pharmacy staff, general practitioners (GPs), members of pharmacy organisations and commissioners. The questioning schedule was developed using the Theoretical Domains Framework which helped inform recommendations to facilitate AMS in community pharmacy.Results8 GPs, 28 pharmacists, 13 pharmacy staff, 6 representatives from pharmacy organisations in England and Wales, and 2 local stakeholders participated.Knowledge and skills both facilitated or hindered provision of self-care and compliance advice by different grades of pharmacy staff. Some staff were not aware of the impact of giving self-care and compliance advice to help control antimicrobial resistance (AMR). The pharmacy environment created barriers to AMS; this included lack of time of well-qualified staff leading to misinformation from underskilled staff to patients about the need for antibiotics or the need to visit the GP, this was exacerbated by lack of space. AMS activities were limited by absent diagnoses on antibiotic prescriptions.Several pharmacy staff felt that undertaking patient examinations, questioning the rationale for antibiotic prescriptions and performing audits would allow them to provide more tailored AMS advice.ConclusionsInterventions are required to overcome a lack of qualified staff, time and space to give patients AMS advice. Staff need to understand how self-care and antibiotic compliance advice can help control AMR. A multifaceted educational intervention including information for staff with feedback about the advice given may help. Indication for a prescription would enable pharmacists to provide more targeted antibiotic advice. Commissioners should consider the pharmacists’ role in examining patients, and giving advice about antibiotic prescriptions.

scholarly journals Quality improvement in community pharmacy: a qualitative investigation of the impact of a postgraduate quality improvement educational module on pharmacists understanding and practice

2020 ◽  
Author(s):  
Asam Latif ◽  
Nargis Gulzar ◽  
Sejal Gohil ◽  
Theo Ansong
Keyword(s):  
Quality Improvement ◽  
Focus Groups ◽  
Community Pharmacy ◽  
Educational Intervention ◽  
Good Practice ◽  
Community Pharmacists ◽  
Educational Module ◽  
Practical Applications ◽  
Motivation For Learning ◽  
The Impact

Abstract Objective Quality improvement (QI) is increasingly featuring in the United Kingdom (UK) National Health Service (NHS) agenda to promote safety, effectiveness and patient experience. However, the use of QI techniques by healthcare professionals appears limited and constrained with only isolated examples of good practice. This study explores QI within the pharmacy context. Focusing on the community pharmacy ‘Healthy Living Pharmacy scheme’, this study aims to explore changes in QI understanding resulting from a postgraduate QI educational intervention. Methods Four focus groups were held involving 13 community pharmacists enrolled onto a newly developed postgraduate QI educational module. Two focus groups were held before and two after the module’s completion. Knowledge of QI and practical applications following the learning was explored. Key findings Three themes emerged: pharmacists’ motivation for learning about QI, conceptual understanding and translation into practice. Pharmacists expressed positive views about learning new skills but expressed logistical concerns about how they would accommodate the extra learning. Prior knowledge of QI was found to be lacking and its application in practice ineffectual. Following completion of the QI module, significant improvements in comprehension and application were seen. Pharmacists considered it too soon to make an assessment on patient outcomes as their improvements required time to effectively embed changes in practice. Conclusions Quality improvement forms an important part of the NHS quality and safety agenda; however, community pharmacists may not currently have adequate knowledge of QI principles. The postgraduate educational intervention showed promising results in pharmacist’s knowledge, organisational culture and application in practice.

scholarly journals Qualitative assessment of patients’ perspectives and needs from community pharmacists in substance use disorder management

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sarah Fatani ◽  
Daniel Bakke ◽  
Marcel D’Eon ◽  
Anas El-Aneed
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Focus Groups ◽  
Community Pharmacy ◽  
Treatment Outcomes ◽  
Community Pharmacists ◽  
Health Concern ◽  
Care Providers ◽  
Opioid Agonist ◽  
The Impact

Abstract Background Non-medical use of psychoactive substances is a common harmful behavior that leads to the development of Substance Use Disorders (SUDs). SUD is a significant health concern that causes adverse health consequences and elevates the economic burden on the health care system. SUD treatment plans that utilize a patient-centered approach have demonstrated improved treatment outcomes. It is essential for health care providers, including community pharmacists, to understand patients’ needs and prioritize them. Therefore, this study was conducted to explore the perspective of patients living with SUDs or who used substances non-medically regarding community pharmacist services and the delivery of services in a community pharmacy setting. The study took place in Saskatoon, a small urban center of Saskatchewan, Canada. Methods Qualitative methodology was used for this research inquiry. Four focus groups were conducted, with a total of 20 individuals who had experienced substance use and accessed community pharmacy services. The discussion of the four focus groups was transcribed verbatim and analyzed independently by two researchers. Agreement on the emergent themes was reached through discussion between the two researchers. Results Data analysis resulted in four themes that described participants’ perspectives about community pharmacists. The four emergent themes are: 1) conflicted experiences with community pharmacists, 2) lack of knowledge concerning community pharmacists’ extended services, 3) negative experiences in Opioid Agonist Therapy (OAT) program, and 4) needs from community pharmacists. Conclusion There is significant potential for the patient-pharmacist relationship to address the varying needs of patients who use substances and improve their overall health care experience. Patients who use substances are receptive to pharmacists’ services beyond dispensary; however, respectful communication, provision of drug-related information, and counseling are among the primary demands. Future research should focus on studying the impact of meeting the needs of patients on their treatment outcomes.

scholarly journals Feasibility of a community pharmacy antimicrobial stewardship intervention (PAMSI): an innovative approach to improve patients’ understanding of their antibiotics

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Rosalie Allison ◽  
Sarah Chapman ◽  
Philip Howard ◽  
Tracey Thornley ◽  
Diane Ashiru-Oredope ◽  
...  
Keyword(s):  
Side Effects ◽  
Community Pharmacy ◽  
Antimicrobial Stewardship ◽  
Self Care ◽  
Community Pharmacies ◽  
Symptom Duration ◽  
Intention To Use ◽  
Pharmacy Staff ◽  
Digital Format ◽  
Consumption Advice

Abstract Background Community pharmacy staff have an opportunity to play a pivotal role in antimicrobial stewardship (AMS) due to their expertise in medicines and accessibility to patients. Objectives To develop and test the feasibility of a pharmacy AMS intervention (PAMSI) to increase community pharmacy staff’s capability, opportunity and motivation to check antibiotic appropriateness and provide self-care and adherence advice when dispensing antibiotics. Methods The PAMSI was centred around an Antibiotic Checklist, completed by patients and pharmacy staff, to facilitate personalized advice to the patient, based on their reported knowledge. An educational webinar for staff and patient-facing materials were also developed. Staff and patients completing Antibiotic Checklists were invited to provide feedback via questionnaires. Results In February 2019, 12 community pharmacies in England trialled the intervention. Forty-three pharmacy staff evaluated the educational webinar and reported increases in their understanding, confidence, commitment and intention to use the tools provided to give adherence and self-care advice. Over 4 weeks, 931 Antibiotic Checklists were completed. Staff reported being more focused on giving advice and able to address patients’ knowledge gaps (mainly: likely symptom duration; alcohol and food consumption advice; possible side effects from antibiotics; returning unused antibiotics to the pharmacy), resulting in increased self-reported effective and meaningful conversations. Conclusions Implementation of a PAMSI is feasible and effectively promotes AMS. Pharmacy staff and commissioners should consider this within their AMS plans. An optional digital format of the Antibiotic Checklist should be explored, for patients who are not collecting their antibiotic prescriptions themselves, and to save printing costs.

Qualitative Assessment of Patients’ Perspectives and Needs from Community Pharmacists in Substance Use Disorder Management

2020 ◽  
Author(s):  
Sarah Fatani ◽  
Daniel Bakke ◽  
Marcel D’Eon ◽  
Anas El-Aneed
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Focus Groups ◽  
Community Pharmacy ◽  
Treatment Outcomes ◽  
Substance Use Disorder ◽  
Community Pharmacists ◽  
Health Concern ◽  
Care Providers ◽  
The Impact

Abstract Background: Substance use disorder (SUD) is a major health concern affecting Canadians and their health care system. SUD treatment plans addressing patients’ needs and choices have demonstrated improved treatment outcomes. It is essential for health care providers, including community pharmacists, to understand patients' needs and prioritize them. Therefore, this study explores the perspective of patients living with SUD regarding community pharmacist services and the delivery of care in a community pharmacy setting located in the small urban center of, Saskatoon, Saskatchewan, Canada.Methods: A qualitative methodology was used for this research inquiry. Four focus groups were conducted in Saskatoon, with a total of 20 individuals who had experienced substance use and accessed community pharmacy services. The discussion of the four focus groups was transcribed verbatim and analyzed independently by two researchers. Agreement on the emergent themes was reached through discussion between the two researchers. Results: Data analysis resulted in four themes that described participants' perspectives about community pharmacists. The four emergent themes are: 1) experience of people living with SUD in a community pharmacy, 2) services provided by community pharmacists, 3) the methadone maintenance program, and 4) needs from community pharmacists. Conclusion: There is significant potential for the patient-pharmacist relationship to address the varying needs of patients living with SUD and improve their overall health care experience. Patients who use substances are receptive to pharmacists' services beyond dispensary; however, respectful communication, provision of drug-related information, and counseling are among the primary demands. Future research should focus on studying the impact of meeting the needs of patients on their treatment outcomes.

scholarly journals Exploring the independent prescribing role of the community pharmacists in Wales

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i35-i35
Author(s):  
S S Alghamdi ◽  
R Deslandes ◽  
S White ◽  
K Hodson ◽  
A Mackridge ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Committee Report ◽  
Independent Prescribing ◽  
General Practices ◽  
The Government ◽  
Clinical Records ◽  
The Impact

Abstract Introduction Since 2019, the role of independent pharmacist prescribers (IPPs) in primary care has extended to community pharmacies in Wales [1]. This was in response to a Welsh Pharmaceutical Committee report in 2019 that outlined a plan to include an IPP in each community pharmacy in Wales by 2030. This aimed to relieve pressure on general practices, enhance patient care and reduce referral and admission rates to secondary care [2]. As funding was provided by the Government, the number of community pharmacists completing the independent prescribing course increased and many have implemented their prescribing role. Aim To explore the views of community IPPs regarding their prescribing role within community pharmacies in Wales. Methods Semi-structured face-to-face and telephone interviews were conducted with community IPPs from all seven health boards (HBs) in Wales. Ethical approval was obtained from the School of Pharmacy and Pharmaceutical Sciences at Cardiff University and the School of Pharmacy and Bioengineering at Keele University. Purposive sampling was used to identify potential participants. Gatekeepers (HB community pharmacy leads and directors of IPP courses in Wales) sent invitation emails, participant information sheet and consent form to potential participants. Written consent was obtained. Interviews were audio-recorded and transcribed ad verbatim. Thematic analysis was used to analyse the data. Results Thirteen community IPPs across Wales participated. Six themes were identified, including the utilisation of their role as community IPPs, their experiences with their independent prescribing training, motivation to obtain their prescribing qualification and utilise it, the impact, barriers and facilitators to implement and utilise their role. Participants practised as IPPs in the management of minor ailments and some other conditions, such as respiratory and sexual health. The course and training for community IPPs was helpful, but there was a need to focus more on therapeutic and clinical examination skills. The main impact of the role was that it helped to improve communication between community pharmacies and general practices and relieved some pressure on general practices. The main barriers were the lack of appropriate funding by the Government to develop the role, lack of access to patients’ medical records, lack of support and high workload. “One of the areas identified as high risk is for pharmacy prescribers is the lack of access to clinical records. How can you [as community IPPs] make any sensible decisions with half the information?” IPP6 Facilitators included that some services were already in place and the drive from the 2030 vision. Conclusion This is the first study that explored the views of community IPPs regarding their prescribing role in community pharmacies in Wales. It provided an insight into this new role that can be considered by the Welsh Government to achieve the 2030 vision for this role. A limitation to this study was that the role is still new in community pharmacies, which may affect the views of the community IPPs. Many of them have obtained their prescribing qualification but have not started to utilise it yet. Further work is needed to explore a wider population of community IPPs’ experiences as the role develops. References 1. Wickware, C. 2019. All community pharmacies in Wales to have an independent prescriber as part of long-term plan for Welsh pharmacy. Available at: https://www.pharmaceutical-journal.com/news-and-analysis/news/all-community-pharmacies. 2. Welsh Pharmaceutical Committee. 2019. Pharmacy: Delivering a Healthier Wales. Available at: https://www.rpharms.com/Portals/0/RPS%2.

scholarly journals Engaging community pharmacists in quality improvement (QI): a qualitative case study of a partnership between a Higher Education Institute and Local Pharmaceutical Committees

2021 ◽  
Vol 10 (1) ◽  
pp. e001047
Author(s):  
Asam Latif ◽  
Nargis Gulzar ◽  
Fiona Lowe ◽  
Theo Ansong ◽  
Sejal Gohil
Keyword(s):  
Quality Improvement ◽  
Focus Groups ◽  
Qualitative Methodology ◽  
Positive Impact ◽  
Community Pharmacists ◽  
Educational Institute ◽  
Collaboration And Communication ◽  
Improve Service Quality ◽  
The Impact

BackgroundQuality improvement (QI) involves the use of systematic tools and methods to improve the quality of care and outcomes for patients. However, awareness and application of QI among healthcare professionals is poor and new strategies are needed to engage them in this area.ObjectivesThis study describes an innovative collaboration between one Higher Educational Institute (HEI) and Local Pharmaceutical Committees (LPCs) to develop a postgraduate QI module aimed to upskill community pharmacists in QI methods. The study explores pharmacist engagement with the learning and investigates the impact on their practice.MethodsDetails of the HEI–LPCs collaboration and communication with pharmacist were recorded. Focus groups were held with community pharmacists who enrolled onto the module to explore their motivation for undertaking the learning, how their knowledge of QI had changed and how they applied this learning in practice. A constructivist qualitative methodology was used to analyse the data.ResultsThe study found that a HEI–LPC partnership was feasible in developing and delivering the QI module. Fifteen pharmacists enrolled and following its completion, eight took part in one of two focus groups. Pharmacists reported a desire to extend and acquire new skills. The HEI–LPC partnership signalled a vote of confidence that gave pharmacists reassurance to sign up for the training. Some found returning to academia challenging and reported a lack of time and organisational support. Despite this, pharmacists demonstrated an enhanced understanding of QI, were more analytical in their day-to-day problem-solving and viewed the learning as having a positive impact on their team’s organisational culture with potential to improve service quality for patients.ConclusionsWith the increased adoption of new pharmacist’s roles and recent changes to governance associated with the COVID-19 pandemic, a HEI–LPC collaborative approach could upskill pharmacists and help them acquire skills to accommodate new working practices.

Community Pharmacy Practice and an Aging Population

1992 ◽  
Vol 8 (3) ◽  
pp. 119-124
Author(s):  
Edward D. Sumner ◽  
Ronald P. Durand ◽  
Carol J. Lancaster ◽  
George E. Dickinson
Keyword(s):  
South Carolina ◽  
Community Pharmacy ◽  
A Priori ◽  
Pharmacy Practice ◽  
Community Pharmacists ◽  
The Elderly ◽  
Community Pharmacy Practice ◽  
Pharmacy Curriculum ◽  
Survey Responses ◽  
The Impact

Objective: To determine pharmacists' perceptions of the influence of older patients on community pharmacy practice. Data Sources: A mailing list obtained from the South Carolina Board of Pharmacy provided names of community pharmacists by practice setting and gender. Design: A questionnaire was mailed in July 1990 to a random sample of community pharmacists in South Carolina. The questionnaire contained 41 Likert-type opinion statements. Demographic questions relating to practice type and location, pharmacists' educational experiences, and position were included. Data Synthesis: The opinion statements were examined by grouping respondents on the basis of demographic information. Analysis of variance or Student's t-test was used to look for differences among survey responses among various groups of pharmacists. Scheffe's test was used to compare means when the groups were significantly different. The a priori level of significance was 0.05. Critical values were adjusted by the number of statements considered to preserve the error rate at five percent (Bonferroni procedure). Conclusions: The strongest indicator of the impact of the elderly population on community pharmacy is pharmacists' perceived need for more continuing education in geriatrics and gerontology. Economic problems, physician overprescribing, and patient compliance were ranked as the three most difficult aspects of geriatric pharmacy. This study reinforces the need to incorporate geriatric/gerontology education into every pharmacy curriculum.

scholarly journals Impact of Pharmacists’ Interventions and Patients’ Decision on Health Outcomes in Terms of Medication Adherence and Quality Use of Medicines among Patients Attending Community Pharmacies: A Systematic Review

2021 ◽  
Vol 18 (9) ◽  
pp. 4392
Author(s):  
Kingston Rajiah ◽  
Shreeta Sivarasa ◽  
Mari Kannan Maharajan
Keyword(s):  
Medication Adherence ◽  
Health Outcomes ◽  
Systematic Reviews ◽  
Effective Interaction ◽  
Self Care ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Quality Use Of Medicines ◽  
The Impact ◽  
Decision Choice

Community pharmacists are responsible for providing the appropriate information on the use of medications to patients, which may enhance their medication adherence. The extent of control that patients have on their health care preferences creates many challenges for community pharmacists. This study aimed to determine the impact of pharmacist interventions and patient decisions on health outcomes concerning medication adherence and the quality use of medicines among patients attending community pharmacies. Appropriate studies were identified in a systematic search using the databases of Medline, Scopus, Google Scholar, and PubMed. The search included literature published between 2004 and 2019. The database searches yielded 683 titles, of which 19 studies were included after the full-text analysis with a total of 9313 participants. Metaprop command in Stata software version 14 was used for the analysis. This study was undertaken based on the general principles of the Cochrane Handbook for Systematic Reviews of Interventions and subsequently reported according to the Preferred Reporting Items for Systematic Reviews (PRISMA) extension. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach was directly used to rate the quality of evidence (high, moderate, low, or very low). The results revealed the effective interaction between patients and community pharmacists, the importance of pharmacist intervention on medication adherence and quality use of medicine, and the role of community pharmacists in counselling patients. Decision/choice of patients in self-care and self-medication is a factor contributing to health outcomes. Effective interaction of community pharmacists with patients in terms of medication adherence and quality use of medicines provided a better health outcome among patients. The community pharmacists influenced the decision/choice of patients in self-care and self-medications.

scholarly journals Digital interventions for parents of acutely ill children and their treatment-seeking behaviour: a systematic review

2020 ◽  
Vol 70 (692) ◽  
pp. e172-e178 ◽  
Author(s):  
Emily Donovan ◽  
Christopher R Wilcox ◽  
Sanjay Patel ◽  
Alastair D Hay ◽  
Paul Little ◽  
...  
Keyword(s):  
Systematic Review ◽  
Self Care ◽  
Intervention Development ◽  
Acute Illness ◽  
Urgent Care ◽  
Treatment Seeking ◽  
Future Research ◽  
Care Services ◽  
Digital Interventions ◽  
The Impact

BackgroundConsultations for self-limiting infections in children are increasing. It has been proposed that digital technology could be used to enable parents’ decision making in terms of self-care and treatment seeking.AimTo evaluate the evidence that digital interventions facilitate parents deciding whether to self-care or seek treatment for acute illnesses in children.Design and settingSystematic review of studies undertaken worldwide.MethodSearches of MEDLINE and EMBASE were made to identify studies (of any design) published between database inception and January 2019 that assessed digital interventions for parents of children (from any healthcare setting) with acute illnesses. The primary outcome of interest was whether the use of digital interventions reduced the use of urgent care services.ResultsThree studies were included in the review. They assessed two apps and one website: Children’s On-Call — a US advice-only app; Should I See a Doctor? — a Dutch self-triage app for any acute illness; and Strategy for Off-Site Rapid Triage (SORT) for Kids — a US self-triage website for influenza-like illness. None of the studies involved parents during intervention development and it was shown that many parents did not find the two apps easy to use. The sensitivity of self-triage interventions was 84% for Should I See a Doctor? compared with nurse triage, and 93.3% for SORT for Kids compared with the need for emergency-department intervention; however, both had lower specificity (74% and 13%, respectively). None of the interventions demonstrated reduced use of urgent-care services.ConclusionThere is little evidence to support the use of digital interventions to help parent and/or carers looking after children with acute illness. Future research should involve parents during intervention development, and adequately powered trials are needed to assess the impact of such interventions on health services and the identification of children who are seriously ill.

scholarly journals The Impact of a Digital Vaccine Consent Form in a Large Community Pharmacy Chain

2021 ◽  
Vol 12 (3) ◽  
pp. 14
Author(s):  
Aylin Unal ◽  
Amy Spakrman ◽  
Pramit Nadpara ◽  
Jean-Venable R. Goode
Keyword(s):  
Community Pharmacy ◽  
Digital Technologies ◽  
Consent Form ◽  
Pharmacy Services ◽  
Pharmacy Staff ◽  
Large Community ◽  
The Impact ◽  
To Receive ◽  
Patient Confidence ◽  
Pharmacy Chain

Background: A large community pharmacy chain implemented a new digital platform to eliminate the need for patients to fill out a traditional vaccine consent form in the pharmacy. The new digital vaccine consent form allowed patients to complete the form online, where it was transmitted directly to the pharmacy’s network. Objectives: To identify the characteristics of patients who used an online digital vaccine consent form to receive vaccinations and to evaluate patient satisfaction and confidence in utilizing the digital vaccine consent form to receive pharmacy services. Methods: This three-month prospective study was conducted in the Mid-Atlantic division of a large community pharmacy chain. A 16-question survey was developed using information from the literature to collect demographic information and patient confidence and satisfaction with the digital vaccine consent form. An email was sent to pharmacy staff containing instructions on the procedure for posting a recruitment flyer, distributing the survey post-vaccination, and how to return completed surveys. Univariate and bi-variate analysis were conducted. Results: Thirty-six participants responded to the survey, majority of participants were female (56%). Two patients used the digital vaccine consent form; both used because it was more convenient and were likely to use the form again. For those who did not use the digital vaccine consent form, 32% feel somewhat unconfident in using digital technologies for pharmacy services. A majority of patients prefer to be notified about new online services by email (39%) or advertisements in the pharmacy (31%). When asked the likelihood of using the digital vaccine consent form in the future, majority stated unlikely (34%) or neutral (25%). Conclusions: Most participants did not utilize the new digital vaccine form. This provides an opportunity to further engage patients on the availability and use of the digital vaccine consent form in order to advance digital technologies for pharmacy services.

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