scholarly journals Towards equity: a qualitative exploration of the implementation and impact of a digital educational intervention for pharmacy professionals in England

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Asam Latif ◽  
Justin Waring ◽  
Kristian Pollock ◽  
Josie Solomon ◽  
Nargis Gulzar ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Educational Intervention ◽  
Medication Review ◽  
Normalisation Process Theory ◽  
Management Service ◽  
Digital Learning ◽  
Access To Health Services ◽  
Medicines Management ◽  
Marginalised Groups ◽  
The Impact

Abstract Background Patients belonging to marginalised (medically under-served) groups experience problems with medicines (i.e. non-adherence, side effects) and poorer health outcomes largely due to inequitable access to healthcare (arising from poor governance, cultural exclusion etc.). In order to promote service equity and outcomes for patients, the focus of this paper is to explore the implementation and impact of a new co-produced digital educational intervention on one National Health Service (NHS) funded community pharmacy medicines management service. Methods Semi-structured interviews with a total of 32 participants. This included a purposive sample of 22 community pharmacy professionals, (16 pharmacists and 6 pharmacy support staff) all who offered the medicine management service. In order to obtain a fuller picture of the barriers to learning, five professionals who were unable to complete the learning were also included. Ten patients (from a marginalised group) who had received the service (as a result of the digital educational intervention) were also interviewed. Drawing on an interpretative analysis, Normalisation Process Theory (NPT) was used as a theoretical framework. Results Three themes are explored. The first is how the digital learning intervention was implemented and applied. Despite being well received, pharmacists found it challenging completing and cascading the learning due to organisational constraints (e.g. lack of time, workload). Using the four NPT constructs (coherence, cognitive participation, collective action and reflexive monitoring) the second theme exposes the impact of the learning and the organisational process of ‘normalisation’. Professional reflective accounts revealed instances where inequitable access to health services were evident. Those completing the intervention felt more aware, capable and better equipped to engage with the needs of patients who were from a marginalised group. Operationally there was minimal structural change in service delivery constraining translation of learning to practice. The impact on patients, explored in our final theme, revealed that they experience significant disadvantage and problems with their medicines. The medication review was welcomed and the discussion with the pharmacist was helpful in addressing their medicine-related concerns. Conclusions The co-produced digital educational intervention increases pharmacy professionals’ awareness and motivation to engage with marginalised groups. However structural barriers often hindered translation into practice. Patients reported significant health and medicine challenges that were going unnoticed. They welcomed the additional support the medication review offered. Policy makers and employers should better enable and facilitate ways for pharmacy professionals to better engage with marginalised groups. The impact of the educational intervention on patients’ health and medicines management could be substantial if supported and promoted effectively.

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 Supporting the provision of pharmacy medication reviews to marginalised (medically underserved) groups: a before/after questionnaire study investigating the impact of a patient–professional co-produced digital educational intervention

BMJ Open ◽  
2019 ◽  
Vol 9 (9) ◽  
pp. e031548 ◽  
Author(s):  
Asam Latif ◽  
Justin Waring ◽  
Li-chia Chen ◽  
Kristian Pollock ◽  
Josie Solomon ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Behaviour Change ◽  
Educational Intervention ◽  
Medication Review ◽  
Outcome Measure ◽  
Medically Underserved ◽  
Secondary Outcome ◽  
Secondary Outcome Measure ◽  
Short Term ◽  
Underserved Groups

ObjectivesPeople who are marginalised (medically underserved) experience significant health disparities and their voices are often ‘seldom heard’. Interventions to improve professional awareness and engagement with these groups are urgently needed. This study uses a co-production approach to develop an online digital educational intervention in order to improve pharmacy staffs’ intention to offer a community pharmacy medication review service to medically underserved groups.DesignBefore/after (3 months) self-completion online questionnaire.SettingCommunity pharmacies in the Nottinghamshire (England) geographical area.ParticipantsCommunity pharmacy staff.InterventionOnline digital educational intervention.Primary and secondary outcome measuresThe primary outcome measure was ‘behaviour change intention’ using a validated 12-item survey measure. The secondary outcome measure was pharmacist self-reported recruitment of underserved groups to the medication review service.ResultsAll pharmacies in the Nottinghamshire area (n=237) were approached in June 2017 and responses were received from 149 staff (from 122 pharmacies). At 3 months (after completing the baseline questionnaire), 96 participants (from 80 pharmacies) completed a follow-up questionnaire, of which two-thirds (n=62) reported completing the e-learning. A before/after comparison analysis found an improving trend in all the five constructs of behaviour change intention (intention, social influence, beliefs about capabilities, moral norms and beliefs about consequences), with a significant increase in mean score of participants’ ‘beliefs about capabilities’ (0.44; 95% CI 0.11 to 0.76, p=0.009). In the short-term, no significant change was detected in the number of patients being offered and the patient completing a medication review.ConclusionsAlthough increases in the numbers of patients being offered a medication review was not detected, the intervention has the potential to significantly improve pharmacy professionals’ 'beliefs about capabilities' in the short-term. Wider organisational and policy barriers to engagement with marginasied groups may need to be addressed. Future research should focus on the interplay between digital learning and practice to better identify and understand effective practice change pathways.

scholarly journals Targeting adaptability to improve Medication Therapy Management (MTM) implementation in community pharmacy

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Kenneth C. Hohmeier ◽  
James S. Wheeler ◽  
Kea Turner ◽  
Jarrod S. Vick ◽  
Merrill L. Marchetti ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Educational Intervention ◽  
Self Efficacy ◽  
Completion Rates ◽  
Post Intervention ◽  
Absolute Increase ◽  
Knowledge And Beliefs ◽  
Medication Reviews ◽  
The Impact ◽  
Pharmacy Setting

Abstract Objectives (1) To develop an adaptation framework for MTM delivery for pharmacists (the MTM Adaptability Framework), (2) to examine the impact of an educational intervention informed by the MTM Adaptability Framework on MTM completion rates over a 2-year period, and (3) to explore pharmacists’ perceptions regarding knowledge and beliefs about MTM and MTM implementation self-efficacy pre- and post-intervention. Methods This study is a prospective, mixed-methods research study including a quasi-experimental, one-group pretest-posttest quantitative study with a sequential explanatory qualitative study arm featuring semi-structured key informant interviews. US supermarket pharmacy chain setting included 93 community pharmacy sites located in Tennessee, Kentucky, and Alabama. MTM completion rates are reported as percentage of completed comprehensive medication reviews (CMRs) and targeted medication reviews (TMRs) and pharmacist perceptions. Results An 11.4% absolute increase in MTM completion rates was seen after the educational intervention targeting adaptation of MTM in the community pharmacy setting. This was found to be significant (46.92% vs. 58.3%; p < 0.001). Responses to the semi-structured interviews were mapped against CFIR and included themes: “knowledge and beliefs about MTM (pre-intervention),” “self-efficacy for MTM implementation (pre-intervention),” “knowledge and beliefs about MTM (post-intervention),” and “self-efficacy for MTM implementation (post-intervention).” Data convergence was found across these methodologies and suggested that targeting adaptability of MTM delivery increases MTM completion rates (quantitative data) and positively changes perceptions of MTM feasibility and self-efficacy (interviews). Conclusion The use of an educational intervention about adaptation of MTM to influence adaptation of MTM to a chain community pharmacy setting part of an implementation strategy improved MTM completion rates significantly. Future research should investigate combined implementation strategies and their impact on MTM implementation success.

Patients’ experiences of a community pharmacy-led medicines management service

2008 ◽  
Vol 16 (4) ◽  
pp. 363-369 ◽  
Author(s):  
Paul Bissell ◽  
Alison Blenkinsopp ◽  
Duncan Short ◽  
Linda Mason
Keyword(s):  
Community Pharmacy ◽  
Management Service ◽  
Medicines Management

scholarly journals An Effectiveness Trial of STEADI in an Outpatient, Primary Care Practice

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 774-774
Author(s):  
David Rein ◽  
Madeleine Hackney ◽  
Michele Dougherty ◽  
Camille Vaughan ◽  
Laurie Imhof ◽  
...  
Keyword(s):  
Primary Care ◽  
Medication Review ◽  
Primary Care Practice ◽  
Controlled Trial ◽  
Care Practice ◽  
Strength Assessment ◽  
Randomized Controlled ◽  
Study Team ◽  
One Year ◽  
The Impact

Abstract The STEADI Options trial uses a randomized, controlled-trial design to assess the effectiveness and cost-effectiveness of the STEADI Initiative . Beginning March, 2020, we will randomize 3,000 adults ≥ 65 years of age at risk for falls seen in an Emory Clinic primary care practice to: (1) full STEADI; (2) a STEADI-derived gait, balance, and strength assessment with physical therapy referrals; (3) a STEADI-derived medication review and management; or (4) usual care. This presentation will discuss decisions made by the study team to facilitate implementation of STEADI including electronically conducting screening prior to the date of encounter, the use of dedicated nursing staff to conduct assessments, implementation of strength, balance, orthostatic hypotension, and vision testing, methods to facilitate medication review, and communication of assessment information to providers. The results from this study will be used to estimate the impact of STEADI on falls, service utilization, and costs over one year.

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 Medical Studies during the COVID-19 Pandemic: The Impact of Digital Learning on Medical Students’ Burnout and Mental Health

2021 ◽  
Vol 18 (1) ◽  
pp. 349
Author(s):  
Panagiotis Zis ◽  
Artemios Artemiadis ◽  
Panagiotis Bargiotas ◽  
Antonios Nteveros ◽  
Georgios M. Hadjigeorgiou
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Emotional Exhaustion ◽  
Short Form ◽  
Maslach Burnout Inventory ◽  
Junior Doctors ◽  
Digital Learning ◽  
Student Survey ◽  
Medical Studies ◽  
The Impact

Objectives: The aim of this ecological study was to investigate what the impact of digital learning due to the COVID-19 pandemic was on the burnout and overall mental health (MH) of medical students. Background: During the unprecedented era of the COVID-19 pandemic, the majority of countries worldwide adopted very strong measures. Universities closed their doors, and education continued through digital learning lectures. Methods: An anonymous questionnaire was administered to all 189 eligible candidates before and during the COVID-19 pandemic. Mental health was assessed via the MH domain of the 36-item Short Form Health Survey (SF-36) and burnout with the Maslach Burnout Inventory—Student Survey (MBI-SS). Results: The overall response rate was 81.5%. The overall burnout prevalence did not differ significantly between the two periods (pre-COVID-19 18.1% vs. COVID-19 18.2%). However, the burnout prevalence dropped significantly in year 4 (pre-COVID-19 40.7% vs. COVID-19 16.7%, p = 0.011), whereas it increased significantly in year 6 (pre-COVID-19 27.6% vs. COVID-19 50%, p = 0.01). When looking at each MBI-SS dimension separately, we found that emotional exhaustion decreased significantly in year 4 but increased in year 6, and cynicism increased in all years. The overall MH deteriorated significantly between the two periods (pre-COVID-19 58.8 ± 21.6 vs. COVID-19 48.3 ± 23, p < 0.001). Conclusions: Digital learning in medical studies carries significant risks. Not only does the MH deteriorate, but cynicism levels also increase. Emotional exhaustion was found to increase particularly in final year students, who struggle with the lack of clinical experience just before they start working as qualified junior doctors.

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