The Saskatchewan Medication Assessment Program for Patients With Renal Failure: A Qualitative Study to Understand Health Care Provider Perspectives

Background: The Saskatchewan Medication Assessment Program (SMAP) compensates community pharmacists for medication reviews on eligible residents with the goal of optimizing patient care. Although medication reviews are meant to reduce risks associated with complex medication regimens, some patients may already be receiving specialized care from interdisciplinary health care teams from the renal programs in Saskatchewan. Objective: A qualitative analysis was undertaken to examine the perceptions of health care providers about the SMAP process for patients receiving renal care in Saskatchewan. The goal was to explore potential benefits, facilitators, challenges, and/or barriers of the program in this population. Design: Qualitative descriptive study. Setting: The semi-structured interviews took place in the province of Saskatchewan. Participants: Community pharmacists, renal pharmacist, and nephrologists. Methods: All nephrologists, renal pharmacists, and community pharmacies in Saskatoon and Regina were sent an invitation to participate in the study. Semi-structured interviews were completed with participants and were audio-recorded and transcribed verbatim. Coding was performed using NVIVO qualitative software, and meaning units and codes were consolidated into categories and subcategories using qualitative content analysis. Results: A total of 9 community pharmacists, 10 renal pharmacists, and 8 nephrologists were interviewed. Community pharmacists had mixed levels of comfort providing SMAP assessments for renal patients, but expressed the desire to provide the best care possible and described patient benefits. Some categories (eg, barriers and improvements) and subcategories (eg, “collaboration/communication”, “other challenges,” and “suggestions for improvement”) were consistent among all participant groups, while others (eg, “renal patients have complex care needs” and “duplication of service”) were common among both renal pharmacists and nephrologists. The nephrologists had little knowledge of the program and of the role of the community pharmacist, indicating the need for improved education and communication. Limitations: The lack of renal patient perceptions on the SMAP process should be acknowledged and studied in future. A further limitation is the small sample size per subsample group. Conclusion: Despite some negative experiences, all of the participants believed the program can be beneficial. However, several recommendations were suggested to improve the SMAP process in renal patients and other complex patient populations.

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General practitioner perceptions of clinical medication reviews undertaken by community pharmacists

Journal of Primary Health Care ◽

10.1071/hc10225 ◽

2010 ◽

Vol 2 (3) ◽

pp. 225 ◽

Cited By ~ 21

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 PractitionerPharmacists 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 pharmacists 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

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Health Care Provider Perspectives on Informal Supporters’ Involvement in HIV Care

Qualitative Health Research ◽

10.1177/1049732311413783 ◽

2011 ◽

Vol 21 (11) ◽

pp. 1554-1566 ◽

Cited By ~ 4

Author(s):

Katie E. Mosack ◽

Angela R. Wendorf

Keyword(s):

Health Care ◽

Health Care Providers ◽

Role Theory ◽

Qualitative Content Analysis ◽

Qualitative Interviews ◽

Improve Patient Care ◽

Hiv Care ◽

People Living With Hiv ◽

Care Providers ◽

Provider Perspectives

Positive social support has been associated with medication adherence and slowed disease progression among people living with HIV. The nature of support within the medical context itself has not been adequately investigated, however. The purpose of our study was to describe HIV health care providers’ perspectives on informal supporter-oriented health care and whether and how the involvement of patients’ adult informal supporters in health care and health care decision making is helpful or beneficial. We conducted in-depth qualitative interviews with 11 HIV specialists between March and September, 2005. Using directed qualitative content analysis, we first describe the frequency and course of others’ involvement and the type of support provided. We then situate these findings within the context of role theory and consider the meaning they have in terms of the negotiated relationships among and between patients, providers, and informal supporters. Finally, we provide research and clinical recommendations based on these findings that are designed to improve patient care.

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Challenges of Providing Health Care in Complex Emergencies: A Systematic Review

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.312 ◽

2021 ◽

pp. 1-5

Author(s):

Hesam Seyedin ◽

Morteza Rostamian ◽

Fahimeh Barghi Shirazi ◽

Haleh Adibi Larijani

Keyword(s):

Systematic Review ◽

Health Care ◽

Health Services ◽

Health Care Providers ◽

Health Care Delivery ◽

Qualitative Content Analysis ◽

Care Delivery ◽

Information Access ◽

Care Providers ◽

Complex Emergencies

Abstract Providing health care in times of complex emergencies (CEs) is one of the most vital needs of people. CEs are situations in which a large part of the population is affected by social unrest, wars, and food shortages. This systematic review study was conducted to identify the challenges of health-care delivery in CEs. We searched terms related to health-care delivery and CEs in PubMed, Web of Sciences, Science Direct, and Google scholar databases, as well as Persian databases SID and Magiran. The searching keywords included: “Health Care, Complex Crises, War, Humanitarian, Refugees, Displaced Persons, Health Services, and Challenges.” Of 409 records, we selected 6 articles based on the Preferred Reporting Items for Systematic Reviews (PRISMA) checklist. Studies were analyzed through qualitative content analysis. The results show that CEs affect health-care delivery in 4 primary areas: the workforce, infrastructure, information access, and organization of health services. These areas can pose potential threats for health-care providers and planners at times of emergencies. Thus, they should be informed about these challenges to strengthen the health-care system.

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The role of community pharmacists in increasing access and use of self-care interventions for sexual and reproductive health in the Eastern Mediterranean Region: examples from Egypt, Jordan, Lebanon and Somalia

Health Research Policy and Systems ◽

10.1186/s12961-021-00695-0 ◽

2021 ◽

Vol 19 (S1) ◽

Author(s):

Luna El Bizri ◽

Laila Ghazi Jarrar ◽

Wael K. Ali Ali ◽

Abdifatah H. Omar

Keyword(s):

Health Care ◽

Health Care Providers ◽

Eastern Mediterranean ◽

Self Care ◽

Eastern Mediterranean Region ◽

Community Pharmacists ◽

Health Coverage ◽

Care Providers ◽

Universal Health

Abstract Background Self-care interventions offer a solution to support the achievement of three goals of the World Health Organization (WHO): to improve universal health coverage, reach people in humanitarian situations, and improve health and well-being. In light of implementing WHO consolidated guidelines on self-care interventions to strengthen sexual and reproductive health (SRH) in the Eastern Mediterranean Region (EMR), especially during the COVID-19 pandemic, pharmacists from four different EMR countries discussed the current SRH situation, inequality gaps, barriers to SRH service access and the pharmacist’s crucial role as a first-line responder to patients before, during and after COVID-19. Case presentation Self-care interventions for SRH allow health care providers to serve a greater number of patients, improve progress toward universal health coverage, and reach people in humanitarian crises. In fact, these interventions can be significantly enhanced by utilizing community pharmacists as first-line health care providers. This review highlights the important role of community pharmacists in promoting self-care interventions and empowering individuals, families and communities. As a result, well-informed individuals will be authoritative in their health decisions. Exploring self-care interventions in the EMR was done through reviewing selected SRH services delivery through community pharmacists before and during the COVID-19 pandemic in Egypt, Jordan, Lebanon and Somalia. Before the COVID-19 pandemic, community pharmacists were found to be excluded from both governmental and nongovernmental SRH programmes. During the pandemic, community pharmacists managed to support patients with self-care interventions, whether voluntarily or through their pharmacy associations. This highlights the need for the health care decision-makers to involve and support community pharmacists in influencing policies and promoting self-care interventions. Conclusion Self-care interventions can increase individuals’ choice and autonomy over SRH. Supporting community pharmacists will definitely strengthen SRH in the EMR and may help make the health system more efficient and more targeted.

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Provider perspectives on barriers and facilitators to adjuvant endocrine therapy-related symptom management.

Journal of Clinical Oncology ◽

10.1200/jco.2016.34.3_suppl.155 ◽

2016 ◽

Vol 34 (3_suppl) ◽

pp. 155-155

Author(s):

Cleo A. Samuel ◽

Kea Turner ◽

Heidi AS Donovan ◽

G J. Van Londen

Keyword(s):

Health Care ◽

Endocrine Therapy ◽

Health Care Providers ◽

Symptom Management ◽

Adjuvant Endocrine Therapy ◽

Barriers And Facilitators ◽

System Level ◽

Care Providers ◽

Provider Perspectives ◽

Related Symptom

155 Background: Adjuvant endocrine therapy (AET)-related symptom management (SM) among breast cancer survivors (BCS) typically involves a multidisciplinary team of health care providers; yet few studies have examined provider perspectives on AET-related SM. The purpose of this study was to examine provider perspectives on the barriers and facilitators to AET-related SM among BCS and opportunities for improvement. Methods: We conducted 3 focus groups (FGs) with a multidisciplinary group of health care providers (n = [6] physician; n = [7] non-physician) experienced in caring for BCS undergoing AET. We utilized semi-structured discussion guides to elicit provider perspectives on AET-related SM and its barriers and facilitators as well as recommendations for improvement. All FGs were held at the University of Pittsburgh, audiotaped, and transcribed. We analyzed FG transcripts using qualitative software to identify key themes. Results: Providers described patient-, provider-, and system- level facilitators and barriers to AET-related SM. At the patient-level, facilitators included social support and provider communication about symptoms while cancer-related distress, misinformation and misinterpretation of online information were identified as barriers. Provider-level facilitators included strong relationships with other providers and ongoing communication with patients; however, lack of time, insufficient resources, and challenges distinguishing AET-related symptoms from other conditions were key provider-level barriers. Finally, at the system-level, electronic health records were described as both a facilitator and barrier to SM. Moreover, poor care coordination among different providers and lack of clear guidelines on which provider “owns” AET-related SM emerged as key system-level barriers. Conclusions: Findings suggest that efforts to improve AET-related SM should span multiple levels, in order to address patient-, provider-, and system-level barriers to SM. Recommendations include increased education for patients, greater access to clinical decision support tools for providers, and improved coordination of survivorship resources within hospitals.

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‘He should feel your pain’: Patient insights on patient–provider communication in Rwanda

African Journal of Primary Health Care & Family Medicine ◽

10.4102/phcfm.v10i1.1514 ◽

2018 ◽

Vol 10 (1) ◽

Cited By ~ 5

Author(s):

Vincent K. Cubaka ◽

Michael Schriver ◽

Janvier B. Kayitare ◽

Phil Cotton ◽

Helle T. Maindal ◽

...

Keyword(s):

Health Care ◽

Health Care Providers ◽

Pain Patient ◽

Provider Communication ◽

Care Providers ◽

Structured Interviews ◽

Communication Preferences ◽

Limited Literacy ◽

Patient Provider Communication ◽

Sub Saharan

Background: Patient–provider communication is an interpersonal interaction between a patient and a health care provider.Objective: This study explored patients’ communication preferences and perceptions on what factors influence the patient–provider communication in primary health care settings in Rwanda.Methods: In-depth semi-structured interviews with 15 individuals including 8 with limited literacy. A thematic inductive analysis was used.Results: Patients valued communication with providers and expressed the need for interacting with caring, empathic providers who can share all the information they want and involve them in their own care. Health literacy and power issues were factors that may influence patient–provider communication. Patients with limited literacy appeared to rely highly on health care providers for making decisions about and managing their health care.Conclusion: The expressed preferences, including those of patients with limited literacy, aligned well with the patient-centred care model. There were indications of a power imbalance weighing on the provider’s side. Although patients with limited literacy were reliant on providers for decision-making, they were ready to be more involved in the care, suggesting a potential for improved patient involvement even for patients with paternalistic care preferences. These patients’ insights can impact policies and curricula to optimise clinical practice. Generated knowledge will contribute to the indispensable yet underdeveloped field of health communication in sub-Saharan Africa.Practice implications: Findings call for more inclusion of patient perspectives in the patient–provider encounter. This could require more training of professionals and research on the topic, both in Rwanda and in other regions.

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The determination of data collection tools that can measure and document the cooperation of local health care providers

10.21203/rs.3.rs-21309/v1 ◽

2020 ◽

Author(s):

Beáta Erika Nagy ◽

Róza Oláh ◽

Erika Zombor ◽

Péter Boris ◽

Anna Szabina Szele

Keyword(s):

Mental Health ◽

Health Care ◽

Health Care Providers ◽

Health Improvement ◽

Local Health ◽

Care Providers ◽

Structured Interviews ◽

Daily Work ◽

Local Health Care ◽

Institutional Relations

Abstract Background The overall objective of the study is to improve the mental health of the age group below 18 years through the investigation of the intra-and inter-sectoral cooperation between local suppliers and to make the intensity and quality of collaborations measurable. In this paper, based on Hungarian and international literature, we aim at describing the current and future optimal cooperation between the members of the mental health care system and examine the possibilities for documenting and measuring cooperation. Methods Semi-structured interviews were recorded with the leaders or representatives of 12 public educational institutions, six social and six health institutions involvement of the relevant experts (N = 24). Results The function of the institutions belonging to these systems, as well as the daily work of the professionals working there, have a significant impact on the mental health of children in either positive or negative directions. After exploring the current situation, the cooperation of local suppliers and inter-institutional relations can highly increase the mental health improvement of the youth. Conclusion According to the results, the developing progress can be more effective through organising the different forms of care, sectors and professionals together to achieve a common goal.

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Patient and Health Care Provider Perspectives on Long Acting Injectable Antipsychotics in Schizophrenia and the Introduction of Olanzapine Long-Acting Injection

Journal of Central Nervous System Disease ◽

10.4137/jcnsd.s4091 ◽

2011 ◽

Vol 3 ◽

pp. JCNSD.S4091 ◽

Cited By ~ 3

Author(s):

Heidi J. Wehring ◽

Sheryl Thedford ◽

Maju Koola ◽

Deanna L. Kelly

Keyword(s):

Health Care ◽

Health Care Provider ◽

Health Care Providers ◽

Care Provider ◽

Treatment Options ◽

Care Providers ◽

Provider Attitudes ◽

Provider Perspectives ◽

Long Acting ◽

Acting Agent

Olanzapine long acting injection has joined risperidone and paliperidone as the second generation long acting antipsychotic injection options for treatment of patients with schizophrenia. Long acting injections are important alternatives to oral medications for patients who have difficulty adhering to daily or multiple daily medication administrations, yet may be underutilized or not well understood. Patient perceptions, adherence, and preferences are important issues for health care providers to address when discussing treatment options with their patients. Reviewed here are overall patient and health care provider attitudes and perceptions regarding long acting injections and the details of olanzapine long acting injectable, the newest agent, and how it will fit in the marketplace. In addition, efficacy, safety, dosing and use data regarding this newest long acting agent are reviewed and compared to other available long acting agents.

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The psychosocial effects of being quarantined following exposure to COVID-19: A qualitative study of Lebanese health care workers

International Journal of Social Psychiatry ◽

10.1177/0020764020932202 ◽

2020 ◽

Vol 66 (6) ◽

pp. 560-565 ◽

Cited By ~ 4

Author(s):

Mirna Fawaz ◽

Ali Samaha

Keyword(s):

Health Care ◽

Health Care Providers ◽

Health Care Workers ◽

Health Care Professionals ◽

Control Measures ◽

Mental Wellbeing ◽

Care Providers ◽

Structured Interviews ◽

Psychosocial Effects ◽

Care Workers

Background: Since the outbreak of the novel Coronavirus (COVID-19), health care professionals in Lebanon have been diligently serving as the frontline of defense. In the light of challenging economic and political circumstances, putting their community wellbeing as a priority, and abiding by quarantine and strict infection control measures, health care professionals risk both their physical and mental wellbeing. Objective: The aim of this study is to explore the psychosocial effects of being quarantined following exposure to COVID-19 among Lebanese health care professionals. Method: An exploratory qualitative research design was employed, where semi-structured interviews were carried out involving a sample of 13 Lebanese health care providers working at various COVID-19 units. Results: The qualitative analysis has revealed four themes namely ‘Fears of contracting and spreading the virus’, ‘Conflict between professional duty and family obligation’, ‘Stigma of being infected’, and ‘Inadequate or inaccurate information’. Conclusion: COVID-19 quarantine has been posing intense psychological challenges among Lebanese health care workers which are worsened at times by the economic instability; thus, health care policymakers are urged to take proper action nationwide to alleviate longlisting implications and support the health care providers in fulfilling their mission.

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“Beyond Personal Beliefs”

SAGE Open ◽

10.1177/2158244016672714 ◽

2016 ◽

Vol 6 (4) ◽

pp. 215824401667271 ◽

Cited By ~ 3

Author(s):

Maria Giulia Olivari ◽

Gaia Cuccì ◽

Emanuela Confalonieri

Keyword(s):

Health Care ◽

Health Care Providers ◽

Family Health ◽

Job Attitudes ◽

Main Theme ◽

Care Providers ◽

Personal Beliefs ◽

Structured Interviews ◽

Adolescent Patients

Using a qualitative method, our study aims to explore, identify, and describe Italian health care providers’ reflections on the contraceptive behaviors of adolescents attending family health centers, and health care providers’ self-perception of their own job attitudes toward these adolescent patients. Semi-structured interviews with 46 Italian health care providers were conducted and analyzed using thematic analysis. Two main themes emerged from the thematic data analysis regarding Italian health care providers’ self-perceptions and reflections. The first main theme was labeled “adolescents’ contraceptive behavior” and included two subthemes: “adolescents are confused and unprepared” and “contraception is a girls’ responsibility.” The second theme was labeled “job attitudes with adolescents,” and included three subthemes: “to inform and to educate,” “to build trustful relationships,” and “to go beyond personal beliefs.” The findings of this study showed that Italian health care providers perceive themselves as nonjudgmental and they interpret their own behavior as an attempt to answer adolescents’ sexual and reproductive health (SRH) needs in an open-minded way. Their work with adolescent patients with relation to contraceptive behaviors is led by the desire to educate through building a significant and long-term relationship that could sustain these patients.

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