Measuring the Assessment and Counseling Provided with the Supply of Nonprescription Asthma Reliever Medication: A Simulated Patient Study

2009 ◽  
Vol 43 (9) ◽  
pp. 1512-1518 ◽  
Author(s):  
Carl R Schneider ◽  
Alan W Everett ◽  
Elizabeth Geelhoed ◽  
Peter A Kendall ◽  
Rhonda M Clifford
Keyword(s):  
Community Pharmacy ◽  
Asthma Control ◽  
Simulated Patient ◽  
Simulated Patients ◽  
Community Pharmacies ◽  
Patient Assessment ◽  
Pharmacy Staff ◽  
Medication Counseling ◽  
Reliever Medication ◽  
Pharmacy Setting

Background: Over one quarter of asthma reliever medications are provided without prescription by community pharmacies in Australia. Evidence that community pharmacies provide these medications with sufficient patient assessment and medication counseling to ensure compliance with the government's Quality Use of Medicines principles is currently tacking. Objective: To assess current practice when asthma reliever medication is provided in the community pharmacy setting and to identify factors that correlate with assessment of asthma control. Methods: Researchers posing as patients visited a sample of Perth metropolitan community pharmacies in May 2007. During the visit, the simulated patient enacted a standardized scenario of someone with moderately controlled asthma who wished to purchase a salbutamol (albuterol) inhaler without prescription. Results of the encounter were recorded immediately after the visit. Regression analysis was performed, with medication use frequency (a marker of asthma control) as the dependent variable. Results: One hundred sixty community pharmacies in the Perth metropolitan area were visited in May 2007. Pharmacists and/or pharmacy assistants provided some form of assessment in 84% of the visits. Counseling was provided to the simulated patients in 24% of the visits. Only 4 pharmacy staff members asked whether the simulated patient knew how to use the inhaler. Significant correlation was found between assessment and/or counseling of reliever use frequency and 3 independent variables: visit length (p < 0.001), number of assessment questions asked (p < 0.001), and the simulated patient who conducted the visit (p < 0.02). Conclusions: Both patient assessment and medication counseling were suboptimal compared with recommended practice when nonprescription asthma reliever medication was supplied in the community pharmacy setting. Pharmacy and pharmacist demographic variables do not appear to affect assessment of asthma control. This research indicates the need for substantial improvements in practice in order to provide reliever medication in line with Quality Use of Medication principles of ensuring safe and effective use of medication.

scholarly journals Australian Community Pharmacy Harm-Minimisation Services: Scope for Service Expansion to Improve Healthcare Access

Pharmacy ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 95
Author(s):  
Sara S. McMillan ◽  
Hidy Chan ◽  
Laetitia H. Hattingh
Keyword(s):  
Community Pharmacy ◽  
Healthcare Access ◽  
Further Education ◽  
Community Pharmacies ◽  
Structured Interviews ◽  
Pharmacy Staff ◽  
Harm Minimisation ◽  
Staff Members ◽  
Education Support

Community pharmacies are well positioned to participate in harm-minimisation services to reduce harms caused by both licit and illicit substances. Considering developments in pharmacist practices and the introduction of new professional pharmacy services, we identified a need to explore the contemporary role of community pharmacy in harm minimisation. Semi-structured interviews were undertaken to explore the opinions of stakeholders, pharmacy staff, and clients about the role of community pharmacy in harm minimisation, including provision of current services, experiences, and expectations. Participants (n = 28) included 5 stakeholders, 9 consumers, and 14 staff members from seven community pharmacies. Three over-arching themes were identified across the three participants groups: (i) scope and provision, (ii) complexity, and (iii) importance of person-centred advice and support in relation to community pharmacy harm minimisation services. Community pharmacies are valuable healthcare destinations for delivery of harm minimisation services, with scope for service expansion. Further education, support, and remuneration are needed, as well as linkage to other sector providers, in order to ensure that pharmacists and pharmacy staff are well equipped to provide a range of harm minimisation services.

ASSESSING THE BENEFITS THAT COMMUNITY PHARMACIES CAN HAVE ON CHILDHOOD ASTHMA OUTCOMES

2016 ◽  
Vol 101 (9) ◽  
pp. e2.48-e2 ◽  
Author(s):  
Andrew Lilley
Keyword(s):  
Community Pharmacy ◽  
Asthma Control ◽  
Health Care Professionals ◽  
Financial Incentive ◽  
Symptom Control ◽  
Community Pharmacies ◽  
Inhaler Technique ◽  
Control Test ◽  
Asthma Control Test ◽  
Asthmatic Children

IntroductionThe local Clinical Commissioning Group has funded an innovative one-year pilot project to assess the value of providing specialist paediatric pharmacist and physiotherapist support direct to families and health care professionals (GP's, community pharmacists, practice nurses etc.) regarding asthma in the primary care setting. Community pharmacies are the one service that asthmatic children come in contact with in order to pick up their medications it was decided to encourage staff to provide interventions at the point of collection.Methods22 large chain, small chain and independent community pharmacy branches were included in the pilot (out of 152 within CCG area) with a total of 31 pharmacists and 67 assistants trained to provide the service. The plan was to provide ‘back to basics’ leaflets on collection of prescription to help improve education on the medications being used; provide inhaler technique counselling on the collection of all prescriptions for children; encourage pharmacist's to perform medicines use reviews and the new medicines service in asthmatic children of high school age (for which they could collect the standard NHS fee). In order to assess the benefits of this, the pharmacist or assistant would first perform the standard asthma control test, marked out of 25 with the parent/patient completing an online version one month later to assess any improvement in symptom management. In order to trace the number of MURs, NMS, inhaler counselling sessions and leaflets given out a tally chart was completed each month by the branches involved.ResultsUnfortunately of the 22 branches that signed up to the pilot only 15 returned tally charts to the team. Over a six month period 23 MUR's, 3 NMS and 32 inhaler technique sessions were performed with 67 leaflets distributed. Of a possible 55 asthma control tests (MURs and inhaler technique counselling sessions) only 23 patients completed the four week post intervention online form. Of those completed the average asthma control test score increased by 7 points (30% increase). In particular feedback from the pharmacists involved was that the inhaler counselling sessions were of particular benefit to parents/patients.Feedback from the pharmacy teams in general was positive with many stating it was good to be more involved in the care of children's conditions; however many stated in order for the service to roll out to a wider audience the scheme would have to provide a financial incentive for the large chains to take part.ConclusionsIt is clear that interventions performed by the community pharmacy teams can help improve symptom control in asthmatic children. In particular ensuring patients are using their medications correctly appears to be key to symptom control. Encouraging pharmacists to provide child friendly MURs should be investigated further to prove the benefit of this service further. It should be noted that ensuring patients are using their medications correctly is already part of the essential service contract for pharmacies.

scholarly journals Evaluation of Allergic Rhinitis and Asthma Control in a Portuguese Community Pharmacy Setting

2014 ◽  
Vol 20 (5) ◽  
pp. 513-522 ◽  
Author(s):  
Olga Lourenço ◽  
Sofia Calado ◽  
Ana Sá-Sousa ◽  
João Fonseca
Keyword(s):  
Allergic Rhinitis ◽  
Community Pharmacy ◽  
Asthma Control ◽  
Pharmacy Setting

scholarly journals Over-The-Counter Codeine: Can Community Pharmacy Staff Nudge Customers into Its Safe and Appropriate Use?

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 185
Author(s):  
Sapana Mody ◽  
Charlotte L. Kirkdale ◽  
Tracey Thornley ◽  
Aimi Dickinson ◽  
Anthony J. Avery ◽  
...  
Keyword(s):  
Patient Safety ◽  
Pain Relief ◽  
Community Pharmacy ◽  
Health Concern ◽  
Community Pharmacies ◽  
Public Health Concern ◽  
Appropriate Use ◽  
Pharmacy Staff ◽  
Over The Counter ◽  
Web Based

The misuse of opioids, including codeine which is sold over-the-counter (OTC) in United Kingdom (UK) community pharmacies, is a growing public health concern. An educational Patient Safety Card was developed and piloted to see if it nudged customers into the safe and appropriate use of OTC codeine. Exploratory analysis was conducted by (i) recording quantitative interactions for people requesting OTC codeine in community pharmacies; and (ii) a web-based pharmacy staff survey. Twenty-four pharmacies submitted data on 3993 interactions using the Patient Safety Card. Staff found the majority of interactions (91.3%) to be very or quite easy. Following an interaction using the card, customers known to pharmacy staff as frequent purchasers of OTC codeine were more likely not to purchase a pain relief medicine compared to customers not known to staff (5.5% of known customers did not purchase any pain relief product versus 1.1% for unknown customers (χ2 = 41.73, df = 1, p < 0.001)). These results support both the use of a visual educational intervention to encourage appropriate use of OTC codeine in community pharmacy and the principles behind better self-care.

Current models of support from community pharmacies for patients on oral anticancer medicines

2017 ◽  
Vol 25 (1) ◽  
pp. 140-147 ◽  
Author(s):  
Melanie Dalby
Keyword(s):  
Community Pharmacy ◽  
Side Effect ◽  
Community Pharmacies ◽  
Evidence Based ◽  
Pharmacy Staff ◽  
New Model ◽  
Oral Medications ◽  
Key Aspects ◽  
Oral Anticancer Medication

Administration of chemotherapy is moving into the community as more and more therapies to treat cancer are being developed as oral medications. Patients taking these oral medications still require support, as many of these agents can be toxic. This support could be simple side effect management, compliance issues or even reassurance with regards to their diagnosis as examples. Community pharmacies are ideally placed within the community to help these patients. The purpose of this review is to determine what support community pharmacies are currently providing for patients taking oral anticancer medication and if there is a model that can be adopted or adapted to be used elsewhere. Searches were undertaken using two databases, Medline and Embase. Other evidence-based articles were discovered from other sources. The different services currently available from community pharmacies were largely varied. There are some key aspects to each which could be used in the development of a new model. Further research is required to determine the views of the patients, carers and community pharmacy staff.

Providing Patient Care in Community Pharmacies: Practice and Research in Finland

2007 ◽  
Vol 41 (6) ◽  
pp. 1039-1046 ◽  
Author(s):  
J Simon Bell ◽  
Minna Väänänen ◽  
Harri Ovaskainen ◽  
Ulla Närhi ◽  
Marja S Airaksinen
Keyword(s):  
Community Pharmacy ◽  
Patient Care ◽  
Pharmacy Practice ◽  
Professional Associations ◽  
World Health ◽  
Electronic Prescribing ◽  
Community Pharmacies ◽  
University Departments ◽  
Medication Counseling

OBJECTIVE: To describe the provision of patient care in community pharmacies in Finland. FINDINGS: The network of 799 community pharmacies across Finland dispensed 42.1 million prescriptions in 2005. Medication counseling has been mandated by law since 1983 and only pharmacists are permitted to provide therapeutic advice in pharmacies. Measurable improvements in the rates of pharmacists' medication counseling have been observed since 2000. Long-term national pharmacy practice initiatives commenced with the World Health Organization EuroPharm Forum's Questions to Ask About Your Medicines campaign from 1993 to 1996. This was followed by the larger Customized Information for the Benefit of Community Pharmacy Patients project. Since the late 1990s, Finnish pharmacies have actively participated in ongoing national public health programs, initially in the areas of asthma and diabetes, and more recently in the treatment and prevention of heart disease. Automated dose dispensing and electronic prescribing are in the process of wider uptake and implementation. A nationwide multidisciplinary project to improve the use of drugs in older people has recently been announced and research in this area is underway. DISCUSSION: Research has focused on improving the quality of patient care as a strategic priority in community pharmacies. The development of community pharmacy services in Finland has been characterized by strong collaboration among the professional associations, university departments of social pharmacy, continuing education centers, and practicing pharmacists. CONCLUSIONS: Implementation of new patient care services has required long-term, systematic, and well coordinated actions at the local and national levels. Future services will seek to promote the quality use of medications and to ensure that rising costs do not limit uniform access to drugs by all Finnish residents.

scholarly journals Training and standardization of simulated patients for multicentre studies in clinical pharmacy education

2020 ◽  
Vol 18 (4) ◽  
pp. 2038
Author(s):  
Karina A. Resende ◽  
Afonso M. Cavaco ◽  
Márcia A. Luna-Leite ◽  
Bianca R. Acacio ◽  
Núbia N. Pinto ◽  
...  
Keyword(s):  
Role Play ◽  
Training Session ◽  
Simulated Patient ◽  
Pharmacy Education ◽  
Simulated Patients ◽  
Complete Agreement ◽  
Patient Assessment ◽  
Cronbach’S Alpha ◽  
Cronbach's Alpha ◽  
Standardization Process

Objective: To evaluate the training and standardization methods of multiple simulated patients (SPs) performing a single scenario in a multicenter study. Methods: A prospective quasi-experimental study, using a multicenter approach, evaluated the performance of five different individuals with the same biotype during a simulation session in a high-fidelity environment. The SPs training and standardization process consisted of four steps and six web or face-to-face mediated: Step 1: simulation scenario design and pilot test. Step 2: SPs selection, recruitment and beginning training (Session 1: performance instructions and memorization request.) Session 2: check the SPs’ performances and adjustments). Step 3 and session 3: training role-play and performance’s evaluation. Step 4: SPs' standardization and performances’ evaluation (Sessions 4 and 5: first and second rounds of SPs' standardization assessment. Session 6: Global training and standardization evaluation. SPs performance consistency was estimated using Cronbach's alpha and ICC. Results: In the evaluation of training results, the Maastricht Simulated Patient Assessment dimensions of SPs performances "It seems authentic", "Can be a real patient" and "Answered questions naturally", presented “moderate or complete agreement” of all evaluators. The dimensions "Seems to retain information unnecessarily", "Remains in his/her role all the time", "Challenges/tests the student", and "Simulates physical complaints in an unrealistic way" presented “moderate or complete disagreement” in all evaluations. The SPs "Appearance fits the role" showed “moderate or complete agreement” in most evaluations. In the second round of evaluations, the SPs had better performance than the first ones. This could indicate the training process’s had good influence on SPs performances. The Cronbach's alpha in the second assessment was better than the first (varied from 0.699 to 0.978). The same improvement occurred in the second round of intraclass correlation coefficient that was between 0.424 and 0.978. The SPs were satisfied with the training method and standardization process. They could perceive improvement on their role-play authenticity. Conclusions: The SPs training and standardization process revealed good SPs reliability and simulation reproducibility, demonstrating to be a feasible method for SPs standardization in multicenter studies. The Maastricht Simulated Patient Assessment was regarded as missing the assessment of the information consistency between the simulation script and the SPs provision.

Simulated patients in the community pharmacy setting – Using simulated patients to measure practice in the community pharmacy setting

2004 ◽  
Vol 26 (1) ◽  
pp. 32-37 ◽  
Author(s):  
Margaret C. Watson ◽  
John R. Skelton ◽  
Christine M. Bond ◽  
Phil Croft ◽  
Connie M. Wiskin ◽  
...  
Keyword(s):  
Community Pharmacy ◽  
Simulated Patients ◽  
Pharmacy Setting

scholarly journals Pharmacist-Provided Pharmacogenetic Point-of-Care Testing Consultation Service: A Time and Motion Study

2018 ◽  
Vol 34 (4) ◽  
pp. 139-143 ◽  
Author(s):  
David R. Bright ◽  
Michael E. Klepser ◽  
Logan Murry ◽  
Donald G. Klepser
Keyword(s):  
Community Pharmacy ◽  
Point Of Care ◽  
Pharmacy Practice ◽  
Point Of Care Testing ◽  
Pharmacy Staff ◽  
Pharmacy Technician ◽  
Time And Motion Study ◽  
Time And Motion ◽  
Motion Study ◽  
Pharmacy Setting

Background: With recent advances in pharmacogenomics (PGx) comes the potential to customize medication use based on genetic data. Support for PGx has found practical limitations in terms of workflow and turnaround time of a test. However, with the expansion of point-of-care testing (POCT) in pharmacy practice models comes opportunity for PGx testing in the pharmacy setting. Objective: The purpose of this study is to quantify the amount of time spent during each step of a PGx POCT encounter in a community pharmacy setting. Methods: A time and motion study was conducted using a mock community pharmacy space for a simulated PGx-focused encounter to manage antiplatelet therapy following hospital discharge. PGx POCT was conducted using the Spartan RX instrument. Simulated patient encounters were divided into 7 categories. Time spent in each step, as well as total time spent, was tracked. Results: A total of 54 simulated PGx POCT encounters took place with an average time of 9.49 minutes (SD ± 1.38 minutes). Instrument run time adds 60 minutes to the total time required to obtain a result. Duties that could be performed by an appropriately trained pharmacy technician totaled 6.86 minutes. Conclusions: PGx POCT would require 9.49 minutes of pharmacy staff hands-on time for the encounter, which could be reduced to 2.64 minutes of pharmacist time with appropriate pharmacy technician involvement. Time requirements for PGx POCT are similar to that of community pharmacy–based immunizations. Future studies could explore how practice could change if PGx testing were routinely performed in the pharmacy.

DIRECT OBSERVATION OF COUNSELING ACTIVITIES OF OTC DRUGS IN COMMUNITY PHARMACIES AT HUE CITY&NBSP

2018 ◽  
Vol 8 (4) ◽  
pp. 58-64
Author(s):  
Ha Vo Thi ◽  
Quynh Le Thi
Keyword(s):  
Drug Use ◽  
Community Pharmacy ◽  
Key Words ◽  
Direct Observation ◽  
Community Pharmacies ◽  
Pharmacy Staff ◽  
Disease Symptoms ◽  
Otc Drugs ◽  
Drug Counseling

Background: This study aimed to characterize counseling activities of drug use at community pharmacies at Hue City. Methods: researchers observed directly customers buying OTC drugs during 63 hours in 21 pharmacies. Results: Of 269 interactions between pharmacy staff and customers, 61.0% of cases received counseling. Pharmacists asked question about whom the drugs were bought for (52.4%), disease symptoms (63.4%). Pharmacists counseled on drug indications (51.2%), dosage and duration of drug use (61.0%). In about one-fifth of cases, pharmacists asked questions to confirm patients’ comprehension. About 37.2% cases were counseled by pharmacists with a-2-year degree and 42.1% were advised by college pharmacists with a-3-year degree. Only 0.6% lasted more than 5 minutes. Conclusions: Drug counseling activities in community pharmacies were still limited in term of quantity and quality of interactions between pharmacists and patients. Key words: pharmacists; community pharmacy; counseling; OTC drugs; Hue city

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