Advice-giving in Community Pharmacies in the UK

1997 ◽  
Vol 2 (1) ◽  
pp. 38-50 ◽  
Author(s):  
Mary P. Tully ◽  
Karen Hassell ◽  
Peter R. Noyce
Keyword(s):  
Pharmacy Practice ◽  
Community Pharmacists ◽  
Subjective Assessment ◽  
Community Pharmacies ◽  
Common Definition ◽  
Advice Giving ◽  
Published Evidence ◽  
Design Consistency ◽  
The Uk ◽  
The Impact

Objectives: To review (1) the published evidence on the information provided with prescribed and purchased medicines by pharmacists and pharmacy assistants, (2) clients' expectations of advice about medicines from community pharmacies and their experience and use of it, and (3) appropriateness and rigour of study methods used. Methods: Papers, published between 1980 and 1995 inclusively, were identified based on searches of on-line databases, a published literature index, key pharmacy practice journals and cited references in the bibliographies of published papers. Those papers selected reported research findings on any aspect of medicines-related communications and the provision of advice about medicines to members of the public who visited pharmacies in the UK. The comparatively small volume of work and lack of design consistency meant that a subjective assessment, rather than a criteria-based objective review, was deemed appropriate. Results: Forty-two suitable studies were identified and are reviewed. No common definition of ‘advice’ has emerged. Most studies reported were quantitative, concentrating on the frequency of advice-giving in community pharmacies and only one study considered the impact of advice on outcome. The quality of advice given was judged highly variable, although pharmacists' referrals, where made, were considered appropriate. Given that pharmacy assistants appear to make most of the medicine sales, remarkably few studies addressed their contribution to advicegiving. The review can provide little insight into what determines when advice is provided, but it does illuminate the disparity between the advice that clients say they want and what they actually seek. Conclusions: Where there appears to be a consensus that advice-giving in community pharmacies is wanted, this review reveals a lack of shared understanding between consumer bodies and the pharmacy profession about who needs advice and when and how it should be given. The need for unsolicited advice-giving associated with the sale of medicines is particularly contentious. With the current programme of deregulation of medicines, this is an increasingly important issue to resolve. The authors suggest a need for a consensus-building forum to generate guidelines that meet shared expectations between clients, community pharmacists, government and the pharmaceutical industry.

Assessing Pharmacists’ Views and Barriers to Providing and Billing for Pharmacist-Provided Health Care Services

2021 ◽  
pp. 875512252110211
Author(s):  
Michael A. Biddle ◽  
Kailyn K. Cleveland ◽  
Shanna K. O’Connor ◽  
Hayli Hruza ◽  
Madeline Foster ◽  
...  
Keyword(s):  
Health Care ◽  
Health Care Services ◽  
Care Service ◽  
Health Care Service ◽  
Pharmacy Practice ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Power Calculation ◽  
Care Services ◽  
The Impact

Background: The role of Idaho and Alaska pharmacists in providing health care services has steadily broadened over recent years. With many new pharmacist-provided health care service possibilities, this study assessed the impact of these advancements on community pharmacies. Objective: The objective of this study was to identify current pharmacist-provided health care services and pharmacist-perceived barriers to providing and billing for these services in Idaho and Alaska community pharmacies. Methods: A questionnaire was developed focusing on 2 areas: providing services and billing for services. Pharmacy students on experiential rotations administered the questionnaires to pharmacists at their rotation sites. Pharmacists at community pharmacy practice sites in Idaho and Alaska completed the questionnaire in an interview format conducted by students. Likert-type scale data were analyzed using descriptive statistics. Because the study did not include a comparator group, no power calculation was conducted. All open-response answers were analyzed independently by 2 researchers and discrepancies in coding open-ended questions were resolved by discussion with a group of 4 researchers. Results: Most pharmacists reported that they already provide non-dispensing services, desired to implement new services, and had confidence in their team’s ability to handle new services. Time and resources were the most cited barriers to providing new services; compensation, company support, and education were the most cited barriers to billing for services. Conclusions: Community pharmacists already provide non-dispensing services and many are looking to provide more services, but barriers of time, resources, compensation, company support, and education will need to be overcome to move forward.

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.

Current innovations in otolaryngology medical education in the UK: a systematic literature review

2020 ◽  
Vol 134 (4) ◽  
pp. 284-292
Author(s):  
H M Yip ◽  
T C F Soh ◽  
Z Z Lim
Keyword(s):  
Medical Education ◽  
Objective Assessment ◽  
Final Analysis ◽  
Subjective Assessment ◽  
Junior Doctors ◽  
Synthesis Methods ◽  
Qualitative Synthesis ◽  
Educational Innovations ◽  
The Uk ◽  
The Impact

AbstractObjectiveRecent studies have indicated a lack of ENT training at the undergraduate and post-graduate levels. This study aimed to review the impact of recent educational innovations in improving ENT training for medical students and junior doctors in the UK.MethodsThree independent investigators conducted a literature search of published articles on ENT education. Included studies were analysed using qualitative synthesis methods.ResultsAn initial search yielded 2008 articles; 44 underwent full-text evaluation and 5 were included for final analysis. Most included studies demonstrated benefits for students when compared to existing teaching standards in terms of objective assessment (knowledge and skills gained) or subjective assessment (confidence and preference) following implemented educational innovations.ConclusionThis study identified educational innovations developed in the past 15 years to enhance the teaching of core ENT competencies. More research is needed to establish their impact on the state of ENT medical education in the UK.

scholarly journals Views of Community Pharmacists on Antimicrobial Resistance and Antimicrobial Stewardship in Jordan: A Qualitative Study

2021 ◽  
Author(s):  
Doaa Saleh ◽  
Rana Abu Farha ◽  
Tareq Mukattash ◽  
Muna Barakat ◽  
Eman Alefishat
Keyword(s):  
Antimicrobial Resistance ◽  
Qualitative Study ◽  
Antimicrobial Stewardship ◽  
Action Plan ◽  
Pharmacy Practice ◽  
Community Pharmacists ◽  
Academic Disciplines ◽  
World Health ◽  
Community Pharmacies ◽  
Stewardship Program

The Center for Disease Control and Prevention and the World Health Organization issued a practical approach and Global Action Plan to control the threatening emerging antibacterial resistance. One of the main basis of this plan is the Antimicrobial Stewardship Program (ASPs). This study aimed to evaluate community pharmacists’ awareness and perception towards antimicrobial resistance and ASPs in Jordan. Thus, a qualitative study was conducted through in-depth interviews with twenty community pharmacists. Convienience sampling was used in the study. Qualitative analysis of the data yielded four themes and eleven sub-themes. All the respondents showed good understanding about the causes of antimicrobial resistance. The most important causes reported by them was the non-restricted prescription of antimicrobials. Most of the pharmacists believed that they are competent to provide ASPs, however, they believed that there are several barriers against the implementation of ASPs in community pharmacies in Jordan. Barriers demonstrated by the pharmacists, including organizational obstacles, resources obstacles, and personal obstacles. As a conclusion, this study revealed several barriers against the implementation of ASPs in community pharmacies in Jordan. Incorporating ASPs in the community pharmacy settings requires proper pharmacist training, several academic disciplines team efforts, and good pharmacy practice of antimicrobial guidelines.

scholarly journals Pharmacists' Roles and Factors Affecting Patient Care in Korea

2015 ◽  
Vol 6 (1) ◽  
Author(s):  
Monica J. Hwang ◽  
Henry N. Young
Keyword(s):  
Patient Care ◽  
Pharmacy Practice ◽  
Community Pharmacists ◽  
Sampling Technique ◽  
Future Research ◽  
Original Research ◽  
Primary Role ◽  
Snowball Sampling ◽  
Factors Affecting ◽  
The Impact

Objectives: This study was conducted to explore Korean community pharmacists' perceptions of their roles in providing care to patients after the implementation of the Separation of Prescribing and Dispensing Act (SPD Act) and to investigate pharmacists' perceptions about factors that impact their patient care. Methods: Eight community pharmacists participated in semi-structured, face-to-face, in-depth interviews in Korea. A snowball sampling technique was used to obtain participants. Interviews were audio-recorded and transcribed. Interviews were analyzed using a summative content analysis procedure. Key findings: Participants' perceptions of their roles centered on dispensing prescriptions, educating and counseling patients, and helping patients with OTC products. Participants perceived time constraints due to prescription volume and patient expectations as factors influencing their provision of patient care. Conclusion: This study suggests that the SPD Act was successful in changing pharmacists' roles in the Korean health care system. None of the participants perceived their role to include prescribing, while all of the participants indicated that their primary role was to dispense medications. Future research should examine the pervasiveness of the themes identified in this study across Korean community pharmacy practice in order to generalize the impact of the SPD Act.   Type: Original Research

scholarly journals The Need for an Evidence-Based Encyclopaedia in Health Services Research in Pharmacy

2020 ◽  
Vol 17 (7) ◽  
pp. 2549 ◽  
Author(s):  
Zaheer-Ud-Din Babar
Keyword(s):  
Health Services Research ◽  
Health Services ◽  
Pharmacy Practice ◽  
Practice Research ◽  
Evidence Based ◽  
Global Level ◽  
Services Research ◽  
The Uk ◽  
The Impact

Pharmacy practice research (PPR) is a specialty field within the wider area of health services research and it focuses on studies of how and why people access pharmacy services. This stream of research is also referred to as more universally recognized term such as health services research in pharmacy. The health services research in pharmacy has increased manifold; however, the impact of this research is not visible at the global level. The editorial explains several issues on quality and quantity of evidence produced including how evidence produced could contribute to improve quality of care and patients’ health outcomes. It also narrates examples from the UK and Australia showing how health services research in pharmacy has made an impact on healthcare service delivery. The editorial argues that building an encyclopaedia in health services research in pharmacy is vital to enhance the visibility and impact of this research.

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 Treatment of methicillin-resistant Staphylococcus aureus (MRSA): updated guidelines from the UK

2021 ◽  
Author(s):  
Nicholas M Brown ◽  
Erwin M Brown ◽  
Nicholas M Brown ◽  
Anna L Goodman ◽  
Carolyne Horner ◽  
...  
Keyword(s):  
Bacterial Infections ◽  
Antimicrobial Agents ◽  
Methicillin Resistant Staphylococcus Aureus ◽  
Superior Efficacy ◽  
Published Evidence ◽  
Impact On Treatment ◽  
The Uk ◽  
The Impact ◽  
New Evidence ◽  
Current Guidelines

Abstract The UK guidelines for the treatment of infections caused by MRSA have been updated and are published in JAC-Antimicrobial Resistance. The update reviews new evidence published since the previous UK guidelines were published over 10 years ago. It includes evidence relating to antimicrobial agents that have been licensed since then for the treatment of Gram-positive bacterial infections including MRSA. It also considers the impact on treatment of the changing epidemiology of MRSA in the UK, especially relating to circulating community strains. A striking finding from the current literature review was the paucity of good quality evidence. The current guidelines therefore represent a hybrid of varying degrees of evidence and expert opinion. Where there was no new published evidence, we have retained some of the existing recommendations. We were unable to find strong evidence of the superior efficacy of newer agents compared with that of vancomycin.

Tailored intervention to implement the management of hypertensive and type 2 diabetes mellitus patients in community pharmacies – a pilot study

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i47-i48
Author(s):  
A Ogunbeku ◽  
S J Showande ◽  
R Adisa ◽  
T O Fakeye
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Community Pharmacists ◽  
Joint National Committee ◽  
National Committee ◽  
Community Pharmacies ◽  
Tailored Intervention ◽  
The Impact

Abstract Introduction Uncontrolled blood pressure and poor glycaemic control may lead to increased morbidity and mortality (1). A systematic review of 40 studies reported beneficial effects of interventions conducted in community pharmacies in the management of diabetes and cardiovascular diseases (2). Aim To evaluate the impact of a tailored intervention on clinical outcomes in the management of hypertensive and/or type 2 diabetes mellitus (T2DM) patients in community pharmacies in a pilot implementation study. Methods The study (April to July 2019) utilized a mixed-method design. This included a cross-sectional survey among 133 consented community pharmacists and 390 T2DM and/or hypertensive patients at the pharmacies. Thirty-one item (pharmacists) and 29-item (patients) semi-structured questionnaires were used to gather information on their perception of pharmacists’ roles in the management of T2DM and/or hypertension. Barriers to implement identified roles by the pharmacists were documented. Thereafter, a prospective before- and after-intervention study was conducted in four consented pharmacies to address the barriers. Two pharmacists per pharmacy and 34 consented T2DM and/or hypertensive adult patients who had been on medications for ≥3 months participated. Pharmacists were provided with 2-hr one-on-one training on the management of T2DM and hypertension based on standard guidelines pre-intervention and at 4 weeks. Components of the pharmacist’s intervention included patient’s education, medication counselling , lifestyle modifications and self-care use of point of care devices. Systolic and diastolic blood pressure (SBP and DBP), fasting blood glucose (FBG) and body mass index (BMI) of all patients were measured at baseline, 4- and 8-week post-intervention. Weekly patient follow-up visits to the pharmacies were mandatory. Telephone calls and referral were incorporated, when necessary. Failure to show up for two consecutive visits disqualified patients from completing the study. Descriptive statistics (to summarise data), and paired t-test to compare mean differences in the measured parameters at α=0.05. Results Hypertensive and/or T2DM patients (374) and 71 pharmacists participated in the survey. The patients expected pharmacists to provide medication counselling (81;27.1%), education (47;12.6%), follow-up (18;4.8%), health outcomes monitoring (17;4.5%), and collaboration with physicians (12;3.2%). Sixty-nine (97.2%) pharmacists agreed that patients’ follow-up, patient counselling (71;100.0%), therapeutic plan design to achieve goals (67;94.4%) and collaboration with physicians (61;85.9%) were important. Barriers to providing adequate counsel to these patients were time constraints (23;32.4%), unconducive environment (7;9.9%) and patient’s impatience (33;46.5%). For the intervention component, 16 of the 34 patients enrolled were lost to follow-up (one hospitalized, seven failed two consecutive visits, and eight lost to referral). Effects of the tailored intervention on the parameters are in Table 1. Conclusion The patients’ and pharmacists’ perceived roles of the pharmacist in the management of hypertension and T2DM were in tandem. The 8-week tailored pharmacists’ intervention resulted in better control of blood pressure but increased FBG. This pilot study is limited by the small sample size of patients and pharmacists, as well as the lack of appropriate comparator. Future large-scale multi-site study with relevant comparator is required for a far-reaching conclusion on the impact of the tailored pharmacist intervention in the management of diabetes and hypertension. References 1. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure; National High Blood Pressure Education Program Coordinating Committee. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: The JNC 7 report. JAMA. 2003;289:2560–72. 2. Evans CD, Watson E, Eurich DT, Taylor JG, Yakiwchuk EM, Shevchuk YM, et al. Diabetes and cardiovascular disease interventions by community pharmacists: a systematic review. Ann Pharmacother. 2011;45(5):615–28.

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.

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