scholarly journals Primary health care policy and vision for community pharmacy and pharmacists in Australia

2020 ◽  
Vol 18 (2) ◽  
pp. 1967 ◽  
Author(s):  
Sarah Dineen-Griffin ◽  
Shalom I. Benrimoj ◽  
Victoria Garcia-Cardenas
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Community Pharmacists ◽  
Residential Aged Care ◽  
Multidisciplinary Teams ◽  
Care Providers ◽  
Australian Government ◽  
Primary Health

There is evidence that the Australian Government is embracing a more integrated approach to health, with implementation of initiatives like primary health networks (PHNs) and the Government’s Health Care Homes program. However, integration of community pharmacy into primary health care faces challenges, including the lack of realistic integration in PHNs, and in service and remuneration models from government. Ideally, coordinated multidisciplinary teams working collaboratively in the community setting are needed, where expanding skills are embraced rather than resisted. It appears that community pharmacy is not sufficiently represented at a local level. Current service remuneration models encourage a volume approach. While more complex services and clinical roles, with associated remuneration structures (such as, accredited pharmacists, pharmacists embedded in general practice and residential aged care facilities) promote follow up, collaboration and integration into primary health care, they potentially marginalize community pharmacies. Community pharmacists’ roles have evolved and are being recognized as the medication management experts of the health care team at a less complex level with the delivery of MedChecks, clinical interventions and medication adherence services. More recently, vaccination services have greatly expanded through community pharmacy. Policy documents from professional bodies highlight the need to extend pharmacy services and enhance integration within primary care. The Pharmaceutical Society of Australia’s Pharmacists in 2023 report envisages pharmacists practising to full scope, driving greater efficiencies in the health system. The Pharmacy Guild of Australia’s future vision identifies community pharmacy as health hubs facilitating the provision of cost-effective and integrated health care services to patients. In 2019, the Australian Government announced the development of a Primary Health Care 10-Year Plan which will guide resource allocation for primary health care in Australia. At the same time, the Government has committed to conclude negotiations on the 7th Community Pharmacy Agreement (7CPA) with a focus on allowing pharmacists to practice to full scope and pledges to strengthen the role of primary care by better supporting pharmacists as primary health care providers. The 7CPA and the Government’s 10-year plan will largely shape the practice and viability of community pharmacy. It is essential that both provide a philosophical direction and prioritize integration, remuneration and resources which recognize the professional contribution and competencies of community pharmacy and community pharmacists, the financial implications of service roles and the retention of medicines-supply roles.

scholarly journals Impact of mental health and addiction NIMHANS ECHO on primary care physicians: study from a rural state of India

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S157-S157
Author(s):  
Shabinabegam A M Sheth ◽  
Bhavya Bairy ◽  
Aurobind Ganesh ◽  
Sumi Jain ◽  
Prabhat Chand ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Mental Health Problems ◽  
Health Problems ◽  
Care Providers ◽  
Primary Health ◽  
Secondary Outcomes

AimsAs per National Mental Health Survey-2015-16, 83 out of 100 people having mental health problems do not have access to care in India. Further, primary health care providers (PCPs) have not been adequately trained in the screening, diagnosis, and initial management of common mental health conditions. There is thus a need to train health care providers at the State level to incorporate mental health into primary health care. In this paper, we report the findings of a collaborative project between the National Institute of Mental Health and Neuro Sciences (NIMHANS) Bangalore India, and the state of Chhattisgarh incorporating mental health into primary care and addressing urban-rural disparities through tele-mentoring.MethodWe assessed the impact of the NIMHANS Extended Community Health Care Outcome (ECHO), an online, blended training program on participants' knowledge and competence (primary outcome) and commitment, satisfaction, and performance (Secondary outcomes) using Moore's evaluation framework. Primary and secondary outcomes were determined through a pre-post evaluation, assessment of trainee participation in the quarterly tele ECHO clinic as well as periodic assignments, respectively.ResultOver ten months of the NIMHANS ECHO program, there was a significant improvement in the participants' knowledge post-ECHO (p < 0.05, t = −3.52). Self-efficacy in diagnosis and management of mental health problems approached significance; p < 0.001. Increased engagement in tele-ECHO sessions was associated with better performance for declarative and procedural knowledge. The attrition rate was low (5 out of 30 dropped out), and satisfaction ratings of the course were high across all fields. The participants reported a 10- fold increase in the number of patients with mental health problems they had seen, following the training. A statistically significant increase in the number of psychotropic drugs prescribed post ECHO with t = −3.295, p = 0.01.ConclusionThe outcomes indicate that the NIMHANS ECHO with high participant commitment is a model with capacity building potential in mental health and addiction for remote and rural areas by leveraging technology. This model has the potential to be expanded to other states in the country in providing mental health care to persons in need of care.

scholarly journals Comprehensiveness and programmatic vulnerability to stds/hiv/aids in primary care

2014 ◽  
Vol 48 (spe) ◽  
pp. 145-151 ◽  
Author(s):  
Luciane Ferreira do Val ◽  
Lucia Yasuko Izumi Nichiata
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Prenatal Care ◽  
Online Survey ◽  
Health Centers ◽  
Multidisciplinary Teams ◽  
Primary Health ◽  
The City ◽  
Hiv Aids




This study aimed to identify programmatic vulnerability to STDs/HIV/AIDS in primary health centers (PHCs). This is a descrip - tive and quantitative study carried out in the city of São Paulo. An online survey was applied (FormSUS platform), involving administrators from 442 PHCs in the city, with responses received from 328 of them (74.2%), of which 53.6% were nurses. At - tention was raised in relation to program - matic vulnerability in the PHCs regarding certain items of infrastructure, prevention, treatment, prenatal care and integration among services on STDs/HIV/AIDS care. It was concluded that in order to reach comprehensiveness of actions for HIV/ AIDS in primary health care, it is necessary to consider programmatic vulnerability, in addition to more investment and reor - ganization of services in a dialogue with the stakeholders (users, multidisciplinary teams, and managers, among others).




scholarly journals The status of the Primary Health Care Plus pilot project in Poland

2019 ◽  
Vol 13 (2) ◽  
pp. 1-14
Author(s):  
Katarzyna Wiktorzak
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Care Providers ◽  
Access To Health Care ◽  
Current System ◽  
Pilot Project ◽  
Care Providers ◽  
Primary Health ◽  
The Status

Background The National Health Fund (NHF) is the public payer solely accountable for securing and organizing access to health care services in Poland. The NHF is responsible for implementing a project entitled “Primary Health Care PLUS” which aims to introduce a primary care centered model, based on coordinated, proactive and preventive methods relevant to patients’ needs and furthermore, works to keep patients well-informed and active participants in health care decision-making. The implementation period of the project is July 1, 2018 through Dec. 31, 2021. Aim of the study The purpose of this study is to outline patient demographics and staff structures of providers that took part in the PHC PLUS pilot program, as well as the status of the program throughout the first year of its implementation. Materials and Methods Following an open and transparent recruitment process, 42 urban and rural primary health care providers were selected. The purpose of the providers’ geographic spread was to ensure the model was tested in all representative regions of the country. Results 42 PHC PLUS providers attending to 288,392 patients are participating in the project. Approximately 1,100 medical staff members are involved in the project. PHC PLUS medical teams consist of specialists including physicians, coordinators, nurses, dietitians, psychologists, physiotherapists and health educators. Out of 41,022 health risk assessments declared to be conducted during the project, 18,058 (43.1%) were performed from July 1, 2018 to April 30, 2019, including 4,537 basic and 13,521 extended assessments. Furthermore, 15,020 patients in total, participated in the disease management programs, which are also paid from the project. Conclusions A Polish health care pilot project that centers primary care can help shift the focus toward preventive interventions, rather than the current system, which often focuses on providing medical care to patients who have already been diagnosed with diseases, often in their more advanced stages.

scholarly journals Assessment Of Treatment For Hypertension In Primary Care

10.3823/2379 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Ana Lívia Araújo Girão ◽  
Glória Yanne Martins Oliveira ◽  
Rodrigo Jacób Moreira De Freitas ◽  
Emiliana Bezerra Gomes ◽  
Rhanna Emanuela Fontenele Lima De Carvalho ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Risk Classification ◽  
Multidisciplinary Teams ◽  
Free Access ◽  
Care Needs ◽  
Qualitative Approaches ◽  
Primary Health ◽  
Evaluative Research

Background: Because hypertension is a multifactorial clinical condition, primary care in this  context consists in strategies for detecting and controlling the disease. Programs emphasizing  this level of care incentive evaluative research as fundamental to generate mechanisms for quality assessment and control, as well as to provide information on the functioning and effectiveness of the health system. The present study aimed to evaluate the quality of health  care provided for hypertensive users in primary health care.  Methods and findings: This is an evaluative research conducted by triangulation of methods  in which the quantitative and qualitative approaches were simultaneously used through  observation, application of questionnaires, interviews and focus group data including  managers, workers and users of a primary health care unit. The study showed that the health  service has fulfilled its role of welcoming users through multidisciplinary teams as a gateway  to the public system. However, the link between the health team and the community has been  gradually undermined by the implementation of spontaneous demand with risk classification,  compromising the continuity of treatment for hypertension.   Conclusions: Multidisciplinary team and empowerment of individuals are fundamental for  the qualification of care. However, the care provided for hypertensive users in primary care  has in most cases been fragmented after the implementation of the system of free access with  risk classification. This fact points to the need to adapt the care needs of hypertensive users to  the new health care model.  

Primary Health Care in the 21st century: primary care providers and people’s empowerment

2010 ◽  
Author(s):  
Josefien van Olmen ◽  
Bart Criel ◽  
Narayanan Devadasan ◽  
George Pariyo ◽  
Pol De Vos ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
21St Century ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Health

scholarly journals Provision of mental health care within primary care in Peru: A qualitative study exploring the perspectives of psychologists, primary health care providers, and patients

2018 ◽  
Vol 3 ◽  
pp. 9 ◽  
Author(s):  
Victoria Cavero ◽  
Francisco Diez-Canseco ◽  
Mauricio Toyama ◽  
Gustavo Flórez Salcedo ◽  
Alessandra Ipince ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Mental Health Care ◽  
Health Care Providers ◽  
Care Providers ◽  
Perceived Need ◽  
Primary Health ◽  
Primary Health Care Providers

Background: This study aimed to understand the offer of mental health care at the primary care level, collecting the views of psychologists, primary health care providers (PHCPs), and patients, with a focus on health services in which patients attend regularly and who present a higher prevalence of mental disorders. Methods: A qualitative study was conducted in antenatal care, tuberculosis, HIV/AIDS, and chronic diseases services from six primary health care centers. Semi-structured interviews were conducted with psychologists, PHCPs, and patients working in or attending the selected facilities.  Results: A total of 4 psychologists, 22 PHCPs, and 37 patients were interviewed. A high perceived need for mental health care was noted. PHCPs acknowledged the emotional impact physical health conditions have on their patients and mentioned that referral to psychologists was reserved only for serious problems. Their approach to emotional problems was providing emotional support (includes listening, talk about their patients’ feelings, provide advice). PHCPs identified system-level barriers about the specialized mental health care, including a shortage of psychologists and an overwhelming demand, which results in brief consultations and lack in continuity of care. Psychologists focus their work on individual consultations; however, consultations were brief, did not follow a standardized model of care, and most patients attend only once. Psychologists also mentioned the lack of collaborative work among other healthcare providers. Despite these limitations, interviewed patients declared that they were willing to seek specialized care if advised and considered the psychologist's care provided as helpful; however, they recognized the stigmatization related to seeking mental health care. Conclusions: There is a perceived need of mental health care for primary care patients. To attend these needs, PHCPs provide emotional support and refer to psychology the most severe cases, while psychologists provide one-to-one consultations. Significant limitations in the care provided are discussed.

scholarly journals PRIMARY HEALTH CARE ACTIONS IN NATURAL DISASTERS

2020 ◽  
Vol 29 ◽  
Author(s):  
Gisele Cristina Manfrini ◽  
Raiza Santos Treich ◽  
Pamela Camila Fernandes Rumor ◽  
Adriana Bitencourt Magagnin ◽  
María Arcaya Moncada ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Literature Review ◽  
Qualitative Analysis ◽  
Natural Disasters ◽  
Disaster Recovery ◽  
Multidisciplinary Teams ◽  
International Literature ◽  
Primary Health

ABSTRACT Objective: to identify in the national and international literature Primary Health Care actions in natural disasters. Method: an integrative literature review, which included 24 original surveys between 2006 and 2018 on natural disasters. Results: a qualitative analysis of the studies included primary care actions in the prevention and mitigation, preparation, response, and disaster recovery phases. Conclusion: Primary Health Care actions involve multidisciplinary teams, the community and families in the territory in which the teams operate, articulation in a network of intersectoral services, in managerial and educational dimensions to implement effective plans for disaster situations.

scholarly journals Innovation in primary health care responses to COVID-19 in Sub-Saharan Africa

2021 ◽  
Vol 22 ◽  
Author(s):  
Sunanda Ray ◽  
Robert Mash
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Family Medicine ◽  
Health Services ◽  
Primary Care Providers ◽  
Sub Saharan Africa ◽  
Care Providers ◽  
Primary Health ◽  
Lessons Learnt

Abstract Background: In May 2020, the African Journal of Primary Health Care and Family Medicine invited submissions on lessons learnt from responses to the COVID-19 pandemic from primary care providers in Africa. This included descriptions of innovations and good practices, the management of COVID-19 in district health services and responses of communities to the outbreak. Aim: To synthesise the lessons learnt from the COVID-19 pandemic in the Africa region. Methods: A thematic document analysis was conducted on twenty-seven short report publications from Botswana, Ghana, Nigeria, South Africa, Uganda and Zimbabwe. Findings: Eight major themes were derived from the data: community-based activities; screening and testing; reorganisation of health services; emergency care for COVID-19; maintenance of essential non-COVID-19 health services; caring for the vulnerable; use of information technology; and reframing training opportunities. Community health workers were a vital community resource, delivering medications and other supplies to homes, as well as following up on patients with chronic conditions. More investment in community partnerships and social mobilisation was proposed. Difficulties with procurement of test kits and turn-around times were constraints for most countries. Authors described how services were reorganised for focused COVID-19 activities, sometimes to the detriment of essential services and training of junior doctors. Innovations in use of internet technology for communication and remote consultations were explored. The contribution of family medicine principles in upholding the humanity of patients and their families, clear leadership and planning, multidisciplinary teamwork and continuity of care was emphasised even in the context of providing critical care. Conclusions: The community-orientated primary care approach was emphasised as well as long-term benefits of technological innovations. The pandemic exposed the need to deliver on governmental commitments to strengthening primary health care and universal health coverage.

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.

scholarly journals Primary health care policy and vision for community pharmacy and pharmacists in Lebanon

2020 ◽  
Vol 18 (2) ◽  
pp. 2003 ◽  
Author(s):  
Souheil Hallit ◽  
Carla Abou Selwan ◽  
Pascale Salameh
Keyword(s):  
Public Health ◽  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Strategic Plan ◽  
Pharmacy Education ◽  
World Health ◽  
Care Providers ◽  
Primary Health ◽  
Pharmacy Profession

Within a crippling economic context and a rapidly evolving healthcare system, pharmacists in Lebanon are striving to promote their role in primary care. Community pharmacists, although held in high esteem by the population, are not recognised as primary health care providers by concerned authorities. They are perceived as medication sellers. The role of the pharmacist in primary health care networks, established by the Ministry of Public Health (MOPH) to serve most vulnerable populations, is limited to medication delivery. The practice of the pharmacy profession in Lebanon has been regulated in 1950 by the Lebanese Pharmacists Association [Order of Pharmacists of Lebanon] (OPL). In 2016, the OPL published its mission, vision, and objectives, aiming to protect the pharmacists’ rights by enforcing rules and procedures, raise the profession’s level through continuous education, and ensure patients’ appropriate access to medications and pharmacist’s counseling for safe medication use. Since then, based on the identified challenges, the OPL has suggested several programs, inspired by the World Health Organization and the International Pharmaceutical Federation guidelines, as part of a strategic plan to develop the pharmacy profession and support patient safety. These programs included the application of principles of good governance, the provision of paid services, developing pharmacists’ core and advanced competencies, generation of accreditation standards for both community pharmacy and pharmacy education, suggesting new laws and decrees, continuing education consolidation and professional development. There was an emphasis on all decisions to be evidence assessment-based. However, OPL faces a major internal political challenge: its governing body, which is reelected every three years, holds absolute powers in changing strategies for the three-year mandate, without program continuation beyond each mandate. Within this context, we recommend the implementation of a strategic plan to integrate pharmacy in primary health centers, promoting the public health aspect of the profession and taking into account of critical health issues and the changing demographics and epidemiological transition of the Lebanese population. Unless the proposed blueprint in this paper is adopted, the profession is unfortunately condemned to disappear in the current political, economic and health-related Lebanese context.

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