scholarly journals Patient and public perception and experience of community pharmacy services post-discharge in the UK: a rapid review and qualitative study

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043344
Author(s):  
Sarah Khayyat ◽  
Philippa Walters ◽  
Cate Whittlesea ◽  
Hamde Nazar
Keyword(s):  
Primary Care ◽  
Qualitative Study ◽  
Community Pharmacy ◽  
Healthcare Providers ◽  
Pharmacy Practice ◽  
Rapid Review ◽  
Post Discharge ◽  
Care Services ◽  
Primary Care Services ◽  
The Uk

ObjectivesTo investigate the perception and experience of patients and the public (PP) about community pharmacy (CP) services and other primary care services after hospital discharge back home.Design and settingA rapid review and qualitative study exploring PP perceptions of primary care, focusing on CP services in the UK.MethodsA mixed-methods approach was adopted including a rapid review undertaken between 24 April and 8 May 2019 across four databases (MEDLINE, EMBASE, PsycINFO and CINAHL). Semistructured interviews were then conducted investigating for shifts in current PP perception, but also nuanced opinion pertaining to CP services. A convenience sampling technique was used through two online PP groups for recruitment. Thematic framework analysis was applied to interview transcripts.ParticipantsAny consenting adults ≥18 years old were invited regardless of their medical condition, and whether they had used post-discharge services or not.ResultsTwenty-five studies met the inclusion criteria. Patients were generally supportive and satisfied with primary care services. However, some barriers to the use of these services included: resource limitations; poor communication between healthcare providers or between patient and healthcare providers; and patients’ lack of awareness of available services. From the 11 interviewees, there was a lack of awareness of CP post-discharge services. Nevertheless, there was general appreciation of the benefit of CP services to patients, professionals and wider healthcare system. Potential barriers to uptake and use included: accessibility, resource availability, lack of awareness, and privacy and confidentiality issues related to information-sharing. Several participants felt the uptake of such services should be improved.ConclusionThere was alignment between the review and qualitative study about high patient acceptance, appreciation and satisfaction with primary care services post-discharge. Barriers to the use of CP post-discharge services identified from interviews resonated with the existing literature; this is despite developments in pharmacy practice in recent times towards clinical and public health services.

scholarly journals A Qualitative Study of Patients’ Perceptions of Dental Care in Primary Health Care

2020 ◽  
Author(s):  
Heriberto F. Sanchez ◽  
Andrea Maria D. Vargas ◽  
Marcos Azeredo F. Werneck ◽  
Efigênia F. Ferreira
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Qualitative Study ◽  
Health Services ◽  
Citizen Participation ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Belo Horizonte ◽  
The City

Knowledge of patients' views can contribute to the strengthening of health services. The aim of this study is to describe the patients' perception of a public oral health service, contributing to evaluations in health services. This is a qualitative study in which a focus group was conducted, with the participation of six patients of the oral health system in the city of Belo Horizonte, MG, Brazil, all with a minimum experience of three years of using the service. A theoretical model with dimensions aimed at assessing integrality and primary care services was used. In conducting the research, a semi-structured script was used. The data were analyzed by content analysis. The most representative categories for evaluating oral health actions in primary care are the health unit; the welcoming and its relation with the creation of the bond; service with a strong emphasis on the humanized relationship between professional and patient and on teamwork and; as a highlight, citizen participation, based on the recognition of a “system” that prevents the proper functioning of services and that must be fought with citizenship. Patients’ perceptions can be used to assess oral health in primary care from the perspective of those who actually use health services, seeking ultimately to constantly improve them. Knowledge of patients' perceptions may enable organizations to know their performance, through assessment methodologies based on the established perceptions.

scholarly journals Scaling Community Pharmacy Transformation with the ‘Flip the Pharmacy’ Implementation Model: Program Origins

2020 ◽  
Vol 11 (3) ◽  
pp. 22
Author(s):  
Anne Marie Kondic ◽  
Troy Trygstad ◽  
Randy McDonough ◽  
Matt Osterhaus
Keyword(s):  
Community Pharmacy ◽  
Patient Care ◽  
Healthcare Providers ◽  
Pharmacy Practice ◽  
Community Based ◽  
Care Community ◽  
Implementation Model ◽  
Care Services ◽  
Community Pharmacy Practice ◽  
Payment Models

The rising costs of healthcare, increased chronic illnesses, and healthcare provider burnout has led to an environment desperate for scalable solutions to ease practice burdens. With a projected shortage in the number of primary healthcare providers available to provide team-based care, community-based pharmacy practitioners are accessible and eager to assist. In order to provide enhanced patient care services to aid their clinician colleagues, community-based pharmacists will have to transform their practices to support the provision of enhanced services and medication optimization in value-based payment models. The purpose of this article is to define how multiple factors in pharmacy, healthcare, technology and payment models aligned to create an opportunity for the Community Pharmacy Foundation and CPESN® USA to implement a nationwide community pharmacy practice model called ‘Flip the Pharmacy’.  This new model aims to scale community pharmacy practice transformation and move beyond filling prescriptions at a moment-in-time to caring for patients over time through a 24-month step-wise program paired with in-person pharmacist coaching. Preliminary observations from the first six months of the program highlight community pharmacy as a site of care with community-based pharmacist practitioners providing and documenting targeted patient care interventions.    Article Type: Commentary

scholarly journals A Qualitative Study of Patients’ Perceptions of Dental Care in Primary Health Care

2020 ◽  
Vol 3 (4) ◽  
Author(s):  
Heriberto F. Sanchez ◽  
◽  
Andrea Maria D. Vargas ◽  
Marcos Azeredo F. Werneck ◽  
Efigênia F. Ferreira
Keyword(s):  
Primary Care ◽  
Oral Health ◽  
Qualitative Study ◽  
Health Services ◽  
Citizen Participation ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Belo Horizonte ◽  
The City

Knowledge of patients' views can contribute to the strengthening of health services. The aim of this study is to describe the patients' perception of a public oral health service, contributing to evaluations in health services. This is a qualitative study in which a focus group was conducted, with the participation of six patients of the oral health system in the city of Belo Horizonte, MG, Brazil, all with a minimum experience of three years of using the service. A theoretical model with dimensions aimed at assessing integrality and primary care services was used. In conducting the research, a semi-structured script was used. The data were analyzed by content analysis. The most representative categories for evaluating oral health actions in primary care are the health unit; the welcoming and its relation with the creation of the bond; service with a strong emphasis on the humanized relationship between professional and patient and on teamwork and; as a highlight, citizen participation, based on the recognition of a “system” that prevents the proper functioning of services and that must be fought with citizenship. Patients’ perceptions can be used to assess oral health in primary care from the perspective of those who actually use health services, seeking ultimately to constantly improve them. Knowledge of patients' perceptions may enable organizations to know their performance, through assessment methodologies based on the established perceptions.

scholarly journals 736. Delays in Malaria Recognition and Door to Anti-malarial Time in a South London Hospital

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S466-S466
Author(s):  
Nisha Patel ◽  
Tomasz Materski ◽  
Elisa Gonzalez ◽  
Solomon Russom ◽  
Gurjinder Sandhu
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Care Physician ◽  
African Countries ◽  
College Hospital ◽  
Travel History ◽  
Care Services ◽  
Primary Care Services ◽  
Sub Saharan ◽  
The Uk

Abstract Background The prompt recognition and treatment of Plasmodium falciparum is necessary to prevent death. We reviewed data from a cohort of patients presenting with malaria to Kings College Hospital NHS Trust, London. Methods Retrospective review of electronic records and drug charts of patients diagnosed with malaria from Jan 2019- March 2021. Results 109 cases of malaria were identified representing travellers from 11 Sub-Saharan African countries: Nigeria(38%), Sierra Leone(33%), Ivory Coast(10%). The age range varied from 4 to 76 years with a mean of 44, 66% of the cohort was male. 22 cases occurred during the COVID-19 Pandemic. The commonest symptoms were Fever (97%), Headache (92%) and malaise (72%). P. falciparum was present in 99% cases. A travel history was taken in 94% of cases. Malaria was considered by the first clinician in 82% of cases with the second highest differential being a viral illness. In 6 cases, it took 4 to 11 medical reviews before malaria was considered. 29 patients met the UK criteria for severe malaria. Door to antimalarial time varied from 1 to 128 hours, with a median of 7.4 hours. 46% of the cohort received intravenous Artesunate as their first antimalarial. Extreme delays occurred were clinicians did not consider malaria, patients had negative films or a patient did not declare a travel history when asked. 1 patient died of cerebral malaria with a door to needle time of 2hr 3min. Where a reason for delay is documented, drug availability represented the highest cause with mean delay from prescribing antimalarial to giving antimalarial of 2.7 hours. There was no difference in door to antimalarial administration during the COVID-19 Pandemic, but patients did have a delay in presentation to hospital from onset of symptoms, mean 6.2 days pre-pandemic, 10.5 days during pandemic, this was not statistically significant (P= 0.198). 3 patients presenting during the Pandemic had covid-19 swabs prior to admission and 10 had attended primary care services. Number of days between onset of malaria symptoms and presentation to the Emergency Department Box plot demonstrating that patients were waiting longer post symptom onset to access care in the Emergency Department. 3 patients had covid swabs in the community and 10 accessed care through their primary care physician. Conclusion Our data show that malaria is being considered early in the emergency department however there remain significant delays in administration of treatment. In 6 cases where malaria was not considered early there were delays in diagnosis of up to 5 days. An audit cycle will be completed with the aim of reducing door to antimalarial time. Disclosures All Authors: No reported disclosures

scholarly journals Community pharmacy and primary health care in Sweden - at a crossroads

2020 ◽  
Vol 18 (2) ◽  
pp. 1927 ◽  
Author(s):  
Tommy Westerlund ◽  
Bertil Marklund
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Significant Risk ◽  
Small Scale ◽  
Care Services ◽  
Primary Health ◽  
Primary Care Services ◽  
Physical Care

The overall goal of Swedish health care is good health and equitable care for the whole population. The responsibility for health is shared by the central government, the regions, and the municipalities. Primary care accounts for approximately 20 percent of all expenditures on health care. About 16% of all physicians work in primary health. The regions have also employed a large number of clinical pharmacists, usually hospital-based, but many perform a variety of different primary care services, the most common of which is patient medication reviews. Swedish primary health care is at a crossroads facing extensive challenges, due to changes in demography and demanding financial conditions. These changes necessitate large transformations in health services and delivery. Current Government inquiries have primarily focused on two ways to meet the challenges; a shift towards more local care requiring a transfer of resources from hospital care, and a further development of structured digi-physical care, that is both digital (“online doctors”) and physical accessibility of care. While primary care at present is undergoing processes of change, community pharmacy has done so during the past decade since the re-regulation of the Swedish pharmacy market. A monopoly was replaced by a competitive system, where five pharmacy chains now share most of the market, a competition that has made community pharmacy very commercialized. A number of different, promising primary care services are being offered, but they are usually delivered on a small scale due to a lack of remuneration and philosophy of providers. Priority is given to sales and fast dispensing of prescriptions, often with a minimum of counseling. Reflecting primary health care, community pharmacy in Sweden is at a crossroads but currently has a golden opportunity to choose a route of collaboration with primary health care in its current transformation into more local and digi-physical care. A major challenge is that primary health care inquires, strategic plans, and national policy documents usually do not include community pharmacy as a partner. Hence, community pharmacy have to be proactive and seize this chance of changes in primary health policy and organization in order to become an important link in the chain of health care delivery, or there is a significant risk that it will predominantly remain a retail business.

Physicians' attitudes towards provision of primary care services in community pharmacy in the United Arab Emirates

2014 ◽  
Vol 23 (4) ◽  
pp. 274-282 ◽  
Author(s):  
Sanah Hasan ◽  
Kay Stewart ◽  
Colin B. Chapman ◽  
Mohammed Yousif Hasan ◽  
David C.M. Kong
Keyword(s):  
Primary Care ◽  
Community Pharmacy ◽  
United Arab Emirates ◽  
Care Services ◽  
Primary Care Services

scholarly journals Adapting primary care for new migrants: a formative assessment

BJGP Open ◽  
2017 ◽  
Vol 1 (1) ◽  
pp. bjgpopen17X100701 ◽  
Author(s):  
Elizabeth Such ◽  
Elizabeth Walton ◽  
Brigitte Delaney ◽  
Janet Harris ◽  
Sarah Salway
Keyword(s):  
Primary Care ◽  
Case Studies ◽  
Online Survey ◽  
Resource Constraints ◽  
Sample Survey ◽  
Service Development ◽  
Care Provision ◽  
Care Services ◽  
Primary Care Services ◽  
The Uk

BackgroundImmigration rates have increased recently in the UK. Migrant patients may have particular needs that are inadequately met by existing primary care provision. In the absence of national guidance, local adaptations are emerging in response to these new demands.AimTo formatively assess the primary care services offered to new migrants and the ways in which practitioners and practices are adapting to meet need.Design & settingOnline survey and case studies of current practice across primary care in the UK. Case studies were selected from mainstream and specialist general practice as well as primary care provision in the third sector.MethodNon-probability sample survey of primary care practitioners (n = 70) with descriptive statistical analysis. Qualitative case studies (n = 8) selected purposively; in-depth exploration of organisational and practitioner adaptations to services. Analysis is structured around the principles of equitable care.ResultsSurvey results indicated that practitioners focused on working with communities and external agencies and adapting processes of, for example, screening, vaccination, and health checks. Lack of funding was cited most frequently as a barrier to service development (n = 51; 73%). Case studies highlighted the prominence partnership working and of an organisational and practitioner focus on equitable care. Adaptations centred on addressing wider social determinants, trauma, and violence, and additional individual needs; and on delivering culturally-competent care.ConclusionDespite significant resource constraints, some primary care services are adapting to the needs of new migrants. Many adapted approaches can be characterised as equity-oriented.

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