scholarly journals Integration of and visions for community pharmacy in primary health care in Denmark

2021 ◽  
Vol 19 (1) ◽  
pp. 2212
Author(s):  
Rikke N. Hansen ◽  
Lotte S. Nørgaard ◽  
Ulla Hedegaard ◽  
Lone Søndergaard ◽  
Kerly Servilieri ◽  
...  
Keyword(s):  
Public Health ◽  
Health Care ◽  
Community Pharmacy ◽  
Health Care Professionals ◽  
Central Government ◽  
National Level ◽  
Community Pharmacies ◽  
Pharmacy Services ◽  
Health And Social Care ◽  
The Government

In 2014, the Danish government launched a plan for health entitled: “Healthier lives for everyone – national goals for the health of Danes within the next 10 years”. The overall objective is to prolong healthy years of life and to reduce inequality in health. In Denmark, the responsibility for health and social care is shared between the central government, the regions and the municipalities. National and local strategies seek to enhance public health through national and local initiatives initiated by different stakeholders. The Danish community pharmacies also contribute to promoting public health through distribution of and counselling on medication in the entire country and through offering several pharmacy services, six of which are fully or partly remunerated on a national level. Because of greater demands from patients, health care professionals and society and a lack of general practitioners, the Danish community pharmacies now have the opportunity to suggest several new functions and services or to extend existing services. The Danish pharmacy law changed in 2015 with the objective to maintain and develop community pharmacies and to achieve increased patient accessibility. The change in the law made it possible for every community pharmacy owner to open a maximum of seven pharmacy branches (apart from the main pharmacy) in a range of 75 km. This change also increased the competition between community pharmacies and consequently the pharmacies are now under financial pressure. On the other hand, each pharmacy may have been given an incentive to develop their specific pharmacy and become the best pharmacy for the patients. Community pharmacies are working to be seen as partners in the health care system. This role is in Denmark increasingly being supported by the government through the remunerated pharmacy services and through contract with municipalities. Concurrent with the extended tasks for the Danish community pharmacies and utilisation of their excellent competencies in medication the community pharmacies need to focus on their main tasks of supplying medicines and implementing services. This requires efficient management, an increased use of technology for distribution and communication and continuing education and training.

scholarly journals Integrating Palliative Care in Cancer Care in Kenya

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 164s-164s
Author(s):  
Z. Ali
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Pain Relief ◽  
Health Care Professionals ◽  
Medical Training ◽  
Cultural Beliefs ◽  
National Level ◽  
Public Hospitals ◽  
Essential Medicines ◽  
The Government

Background and context: Most Africa countries now recognize the pain and suffering of many patients and families who have no access to cure (where cure is possible), cannot afford treatment of cancer or other progressive chronic illnesses, are stigmatized or discriminated against because of their illness among many other dehumanizing issues. This project aims to ensure that all those in need of palliative care and pain relief have access close to their homes. Aim: This project aims to ensure that all those in need of palliative care and pain relief have access close to their homes. Strategy/Tactics: In the recent past Kenya Hospices and Palliative Care Association has extensively advocated for the integration of palliative care into the Kenya health services; thus, resulting in many health care professionals being trained in palliative care; integration of palliative care in public, private and mission health institutions and integration of palliative care in undergraduate medical and nursing curricula, as well as policy documents. Program/Policy process: The process of integrating palliative care in public hospitals involved advocacy at the national level as well as at the institutional level, training of health care professionals and setting up services within the hospitals that we worked with. Technical support was provided to each individual institution as needed. Outcomes: Palliative care units have been set up in over 25 government hospitals across the country. National Palliative Care Guidelines have been developed. A Diploma in Palliative Care for nurses has been initiated at the Kenya Medical Training College since 2012. Palliative care has been included in all the relevant health policies/strategies. Kenya Essential Medicines List includes Opioids. The Ministry of Health is supplying morphine powder for the country. More patients are now able to access quality palliative care. What was learned: National associations are challenged by an enormous need for services, education and training of health care professionals as well as educating the public and policy makers. The government has no budget for palliative care and most of the work is donor funded. Cultural beliefs are a big barrier to accessing PC. Only a small fraction of patients in need of opioids for pain medication are receiving opioids due to lack of awareness; reluctance of HPCs to prescribe. For many years PC in Kenya has been provided by a few hospices, thus making access very limited to many who are in need. Regional and national associations in Africa should work together with African Ministries of Health and other relevant stakeholders to ensure that there is greater access to palliative care for cancer patients. This encompasses addressing issues of accessibility, affordability, quality palliative care (PC) and a human's right approach to PC.

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

2021 ◽  
Vol 19 (2) ◽  
pp. 2404
Author(s):  
Kristiina Sepp ◽  
Anita Tuula ◽  
Veera Bobrova ◽  
Daisy Volmer
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Community Pharmacy ◽  
Health Care System ◽  
Professional Staff ◽  
Community Pharmacies ◽  
Primary Health Care System ◽  
Pharmacy Services ◽  
Primary Health ◽  
Care System

Estonia, with a population of 1.3 million, is the smallest country in the three Baltic States. As a post-soviet country, Estonia over the past 30 years has built up a new health care system, including the pharmaceutical sector. The GDP allocated to cover health care costs is significantly lower in Estonia compared to the EU average. Despite this, Estonia has excelled in the development of digital e-services in healthcare at both the domestic and international levels. The development and integration of the Estonian community pharmacy sector into primary health care has been influenced and affected by the liberalization within pharmaceutical policy and the lack of cooperation with the rest of the health care sector. Community pharmacy ownership and location matters have been prevalent. The promotion of the pharmacy services has mostly taken place on the basis of a professional initiative, as cooperation with the state has not been active. Possibly the professional fragmentation of the pharmacy sector may have played a negative role. The community pharmacy network in Estonia, especially in cities, enables fast and convenient access to the pharmacy services. Community Pharmacy Service Quality Guidelines support the harmonization of the provided services and patient-centered concept to enhance the patient role and involvement in their care. In recent years, community pharmacies in Estonia have also offered various extended services that are more or less integrated with the primary health care system. New developments may be affected by frequent changes in legislation and a shortage of professional staff in community pharmacies. The ownership reform of pharmacies in 2020 has so far not had a significant impact on the operation of pharmacies or the quality of services provided.

Still Burning: An Exploration of the Impacts of the 2018/2019 Tasmanian Summer Bushfires on Community Pharmacy Operations in Affected Communities

2020 ◽  
Vol 35 (6) ◽  
pp. 612-618
Author(s):  
Judith A. Singleton ◽  
Sherley Khng ◽  
Elizabeth M. McCourt ◽  
Kaitlyn E. Watson ◽  
Esther T.L. Lau
Keyword(s):  
Health Care ◽  
Community Pharmacy ◽  
Community Pharmacists ◽  
Public Hospitals ◽  
Community Pharmacies ◽  
Negative Consequences ◽  
Study Objective ◽  
Local Council ◽  
Multiple Challenges ◽  
The Government

AbstractIntroduction:Human-induced climate change is increasing the likelihood and severity of wildfires across the globe. This has negative consequences for the health of affected communities through the loss of health systems’ infrastructure and disrupted health services. Community pharmacies are a central hub between patients and the health care system and can provide continuity of care during wildfires. However, there is little in peer-reviewed literature about the impacts of wildfires on community pharmacy operations.Study Objective:The aim of this study was therefore to explore the impacts of the 2018/2019 summer bushfires in Tasmania, Australia on community pharmacy operations in affected areas.Methods:Semi-structured telephone interviews were conducted with four community pharmacists who were working in the affected region during the bushfires. Interviews were audio recorded and transcribed verbatim. Qualitative data were analyzed using two methods– manual coding utilizing NVivo software and Leximancer analysis. Inter-rater reliability was ensured by two researchers analyzing the data independently. Differences in coding were discussed and agreement reached through negotiation amongst the research team.Results:From the manual coding analysis, five key themes emerged – communication and collaboration; support; patient health challenges; pharmacist experiences in delivering health care; and future planning. These aligned with the five themes that emerged from the Leximancer analysis – community; local; town; patients; and work. Participants described working during the wildfires as difficult, with multiple challenges reported including communication difficulties, operational barriers such as power cuts, legislative barriers, logistical issues with obtaining and storing medication supplies, and lack of preparation, support, and funding. They highlighted a lack of operational and financial support from the government and received most assistance from local council bodies and local branches of professional pharmacy organizations.Conclusion:During disasters, community pharmacies help reduce the burden on public hospitals by maintaining medication supplies and treating patients with minor ailments. However, increased support and inclusion in disaster management planning is needed to continue this role.

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

2020 ◽  
Vol 18 (2) ◽  
pp. 1999 ◽  
Author(s):  
Miguel A. Gastelurrutia ◽  
Maria J. Faus ◽  
Fernando Martinez-Martinez
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Health Care ◽  
Health Services ◽  
Community Pharmacy ◽  
The State ◽  
Community Pharmacies ◽  
State Health ◽  
Primary Health

From a political and governance perspective Spain is a decentralized country with 17 states [comunidades autónomas] resulting in a governmental structure similar to a federal state. The various state regional health services organizational and management structures are focused on caring for acute illnesses and are dominated by hospitals and technology. In a review by the Interstate Council, a body for intercommunication and cooperation between the state health care services and national government, there is a move to improve health care through an integrative approach between specialized care and primary care at the state level. Community pharmacy does not appear to have a major role in this review. Primary health care is becoming more important and leading the change to improve the roles of the health care teams. Primary care pharmacists as the rest of public health professionals are employed by the respective states and are considered public servants. Total health care expenditure is 9.0% of its GDP with the public health sector accounting for the 71% and the private sector 29% of this expenditure. Community pharmacy contracts with each state health administration for the supply and dispensing of medicines and a very limited number of services. There are approximately 22,000 community pharmacies and 52,000 community pharmacists for a population of 47 million people. All community pharmacies are privately owned with only pharmacists owning a single pharmacy. Pharmacy chain stores are not legally permitted. Community pharmacy practice is based on dispensing of medications and dealing with consumer minor symptoms and requests for nonprescription medications although extensive philosophical deep debates on the conceptual and practical development of new clinical services have resulted in national consensually agreed classifications, definitions and protocolized services. There are a few remunerated services in Spain and these are funded at state, provincial or municipal level. There are no health services approved or funded at a national level. Although the profession promulgates a patient orientated community pharmacy it appears to be reluctant to advocate for a change in the remuneration model. The profession as a whole should reflect on the role of community pharmacy and advocate for a change to practice that is patient orientated alongside the maintenance of its stance on being a medication supplier. The future strategic position of community pharmacy in Spain as a primary health care partner with government would then be enhanced.

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 Community pharmacy as a setting for public health nutrition action: Australian nutritionists’ perspectives

2014 ◽  
Vol 18 (10) ◽  
pp. 1864-1872 ◽  
Author(s):  
Judith H Maher ◽  
John Lowe ◽  
Roger Hughes
Keyword(s):  
Public Health ◽  
Health Care ◽  
Community Pharmacy ◽  
Qualitative Data ◽  
Infant Nutrition ◽  
Public Health Nutrition ◽  
Structured Interviews ◽  
Nutrient Supplementation ◽  
Practice Experience ◽  
In Pregnancy

AbstractObjectiveTo explore public health nutritionists’ perceptions of nutrition and its place in community pharmacy (CP) presently and into the future; and to explore perceived opportunities, feasibility and scope of public health nutrition (PHN) interventions in CP, with a focus on maternal and infant nutrition.DesignQualitative data were gathered through semi-structured interviews and drew on hermeneutics as the theoretical framework for analysis and interpretation.SettingQueensland, Australia.SubjectsPublic health nutritionists, identified through purposive, criterion sampling, were chosen due to (i) their role as potential stakeholders, (ii) their knowledge and emphasis on nutrition and (iii) their practice experience.ResultsOpportunities for PHN action focused primarily on actions relating to early nutrient supplementation in pregnancy and breast-feeding protection and promotion. Opportunities in CP were constrained by practitioners’ perception of (i) conflict between health care and commercial interests in CP, (ii) problematic practices in CP and (iii) values and motivations of practitioners and other stakeholders in the CP sector. Strategies were suggested to improve practices and enhance the setting from a PHN perspective. Participants suggested both collaborative and regulatory approaches to achieve settings-based changes, identifying the need for these to coexist for effective outcomes.ConclusionsPublic health nutritionists suggest that opportunities for PHN action are constrained by perceived conflicted interests and that consumers need to be adequately protected from the influence of commercial interests. PHN action in this setting needs adequate reflection on evidence as well as ethics ensuring that practices are ‘for the good’ of mothers and infants.

Advancing Public Health Through Continuing Education of Health Care Professionals

2011 ◽  
Vol 31 ◽  
pp. S60-S66 ◽  
Author(s):  
Karen Suchanek Hudmon ◽  
Robert L. Addleton ◽  
Frank M. Vitale ◽  
Bruce A. Christiansen ◽  
George C. Mejicano
Keyword(s):  
Public Health ◽  
Health Care ◽  
Continuing Education ◽  
Health Care Professionals

scholarly journals Does Fiscal Transfer Improve the Equalization of Regional Public Health Service Evidence from a Spatial Panel-Data Analysis in China

2021 ◽  
Vol 235 ◽  
pp. 03001
Author(s):  
Youwen Jin ◽  
Guoping Nong
Keyword(s):  
Public Health ◽  
Health Service ◽  
Central Government ◽  
Public Health Service ◽  
Panel Data Analysis ◽  
Service Development ◽  
Spatial Panel ◽  
Fiscal Transfer ◽  
Spatial Panel Data ◽  
The Government

Public health service is regarded a key social resource contributing to the national health and sustainable development. Its development gap, however, exists among regions in China due to the unbalanced regional economy, and is also affected by financial distribution. With the effect of tax reform, central fiscal transfer has become a strategic approach to narrow the regional gap of public health service and improve the regional development. This paper aims to evaluate provincial public health service levels in China by applying entropy method and shows that obvious spatial imbalance of public health service level exists in Chinese provinces and such imbalance is also consistent with that of average fiscal transfer from the central government to the regional ones. The current research also looks at, by adopting spatial panel model, a model developed from economic convergence model, whether central fiscal transfer effectively helps to lower the level of public health service difference in regions and the outcome depicts that central fiscal transfer, particularly fiscal transfer for specific purposes, accelerates Chinese public health service development especially in eastern, middle and western regions. From the perspective of spatial effect, neighborhood imitation effect exists to allow completion among neighboring regional governments and therefore more investment to public health service. Compared with the pace of economic development, central fiscal transfer’s limited effect is still seen in less developed regions particularly some midland and western areas, due to the inadequate investment rooted in government’s structured expenditure plan. The implication of this research is that, apart from the attention to economic growth, the government should, with the effort of fiscal transfer, financially focus more on the area of public health service.

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