Study protocol for a feasibility trial in community pharmacy of a personalised behaviour change intervention to reduce reliever reliance and overuse in individuals with asthma.

Abstract BackgroundIn patients with asthma, over-reliance and overuse of short-acting beta2 agonist (SABA) is common and associated with increased morbidity and mortality. Patient beliefs are a key driver of inappropriate reliever use. A recently developed, brief, online intervention has been shown to identify and shift patient beliefs that drive inappropriate reliever use. Whether this intervention works to shift beliefs in individuals with asthma when delivered by community pharmacists is unknown. ObjectiveTo investigate the feasibility and acceptability of a brief community pharmacist-delivered behavior change intervention, and its effect on beliefs about SABA and SABA use in patients with asthma. MethodsThis is a non-randomised, before- and after- study of 120 individuals aged 18 years and older, prescribed a SABA for their asthma symptoms, presenting to one of two enrolled community pharmacies in Auckland, New Zealand. At enrolment, all participants will complete the SABA Reliance Questionnaire (SRQ), Asthma Control Test and 5-item Medication Adherence Report Scale via an online survey platform. Control participants will receive usual asthma care from their community pharmacy. Intervention participants will receive the intervention to shift any misplaced beliefs about SABA, comprising the SRQ to identify individual beliefs about SABA, then personalized information and discussion between pharmacist and patient based on the specific responses to the questionnaires. Those on SABA monotherapy and/or are at risk of SABA overuse will be referred to the general practitioner. Effect on beliefs about SABA and actual SABA use will be assessed by the SRQ and dispensing records, respectively. Feasibility will be evaluated through participant recruitment and retention rates, intervention fidelity, appropriateness and procedures of outcome measures pre- and post-intervention, and acceptability by obtaining feedback from participants (both patients and pharmacists) on the intervention.

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Smoking Cessation Services by Community Pharmacists: Real-World Practice in Thailand

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph182211890 ◽

2021 ◽

Vol 18 (22) ◽

pp. 11890

Author(s):

Sunee Lertsinudom ◽

Pentipa Kaewketthong ◽

Tamonwan Chankaew ◽

Dujrudee Chinwong ◽

Surarong Chinwong

Keyword(s):

Smoking Cessation ◽

Community Pharmacy ◽

Real World ◽

Community Pharmacists ◽

Self Report ◽

P Value ◽

Quit Smoking ◽

Smoking Cessation Services ◽

Before And After ◽

Exhaled Carbon Monoxide

This study aimed to report the effectiveness of community pharmacy smoking cessation services in 13 health regions in Thailand using a retrospective data-collecting method from the Foundation of Community Pharmacy database. The participants were smokers aged at least 18 years. The outcomes were the abstinence of smoking at least 30 consecutive days by self-report only and self-report with exhaled CO level <7 ppm (if available), the number of cigarettes smoked daily, exhaled carbon monoxide (exhaled CO), and % peak expiratory flow rate (%PEFR); smokers measured these outcomes before and after receiving the smoking cessation services. Of 58 community pharmacies, 532 smokers (93% male, mean age of 42.4 ± 14.9 years) received smoking cessation services from community pharmacists. Of 235 smokers with complete data, 153 (28.8%, 153/532) smokers reported smoking abstinence by self-report. The mean number of cigarettes smoked daily reduced from 15.3 ± 8.7 to 1.9 ± 3.8 cigarettes, p-value < 0.001. The exhaled CO levels of smokers significantly reduced from 11.7 ± 5.9 ppm to 7.2 ± 4.4 ppm, p-value < 0.001. The %PEFR also significantly increased from 84.2 ± 19.4 to 89.5 ± 19.5, p-value < 0.001. In conclusion, Thai community pharmacy smoking cessation services could aid smokers to quit smoking. This study is the outcome of the real-world community pharmacy smoking cessation service; policymakers should consider this service to be included in the national healthcare policy.

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The coping strategies of community pharmacists and pharmaceutical services provided during COVID-19 in Malaysia

10.22541/au.160340466.61396727/v2 ◽

2021 ◽

Author(s):

Kok Pim Kua ◽

Shaun Lee

Keyword(s):

Community Pharmacy ◽

Coping Strategies ◽

Organizational Support ◽

Online Survey ◽

Community Setting ◽

Community Pharmacists ◽

Pharmaceutical Services ◽

Snowball Sampling ◽

Cross Sectional ◽

Number Of Customers

Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in profound health challenges across the globe. Pharmacists’ readiness to cope with the pandemic is critical in supporting and sustaining the healthcare workforce to meet the challenges. Objective This study aims to examine community pharmacists’ views on their work environment, policies, and preparedness for safe retail patronage to prevent the transmission of COVID-19 and assess the variables influencing coping strategies during the pandemic. Setting An online survey of pharmacists practicing in community pharmacy setting in Malaysia. Method A questionnaire-based, cross-sectional study was conducted in Malaysia to evaluate coping strategies of community pharmacists and pharmaceutical services provided during COVID-19 pandemic. Between May 1 and July 31, 2020, the questionnaire was distributed to pharmacists working in community setting nationwide utilizing a snowball sampling method. Main outcome measure Community pharmacists’ perceptions on safety, resilience, organizational support, and pharmaceutical services offered during COVID-19 pandemic. Results A total of 217 pharmacists participated in the study. The vast majority of community pharmacists reported a positive outlook and were able to balance working with self-care during this period. Most reported to have access to personal protective equipment such as gloves and hand sanitizers. A large proportion of community pharmacies also installed physical barriers in doorways or in front of the counter, put markings on the ground to section areas to ensure physical distancing, and controlled the number of customers who could access the pharmacy during this period. Innovations reported to be implemented included teleconsultations and providing curb-side or drive-through delivery and pickup services. Conclusion The findings suggest the frontline and essential roles of community pharmacists in delivering pandemic responses, creating the opportunity to determine areas where community pharmacy services can be incorporated to strengthen the public health system and improve patient health outcomes.

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Changing Patient and Public Beliefs About Antimicrobials and Antimicrobial Resistance (AMR) Using a Brief Digital Intervention

Frontiers in Pharmacology ◽

10.3389/fphar.2021.608971 ◽

2021 ◽

Vol 12 ◽

Author(s):

Amy Hai Yan Chan ◽

Rob Horne ◽

Helen Lycett ◽

Eva Raebel ◽

Jordi Guitart ◽

...

Keyword(s):

Antimicrobial Resistance ◽

Online Survey ◽

Online Intervention ◽

Post Intervention ◽

Intervention Effect ◽

Patient Beliefs ◽

Paired Samples ◽

The United Kingdom ◽

Key Driver ◽

Change Beliefs

Background: A key driver of antimicrobial resistance (AMR) is patient demand for unnecessary antibiotics, which is driven by patients’ beliefs about antibiotics and AMR. Few interventions have targeted beliefs to reduce inappropriate demand.Objective: To examine whether a brief, online algorithm-based intervention can change beliefs that may lead to inappropriate antibiotic demand (i.e. perceptions of antibiotic necessity and lack of concern about antibiotic harm).Design: Pre- and post-intervention study.Participants: Participants were 18 years or older, and residing in the United Kingdom, who self-selected to participate via Amazon mTurk, an online survey plaform, and via research networks.Intervention: Participants were presented with a hypothetical situation of cold and flu symptoms, then exposed to the intervention. The online intervention comprised: 1) a profiling tool identifying individual beliefs (antibiotic necessity, concerns, and knowledge) driving inappropriate antibiotic demand; 2) messages designed to change beliefs and knowledge (i.e. reduce antibiotic necessity, and increase antibiotic concerns and knowledge), and 3) an algorithm linking specific messages to specific beliefs and knowledge.Main measures: The profiling tool was repeated immediately after the intervention and compared with baseline scores to assess change in beliefs. A paired samples t-test was used to determine intervention effect.Key Results: A total of 100 respondents completed the study. A significant change in beliefs relating to inappropriate demand was observed after the intervention, with a reduction in beliefs about antibiotic necessity (t = 7.254; p < 0.0001), an increase in antibiotic concerns (t = −7.214; p < 0.0001), and increases in antibiotic and AMR knowledge (t = −4.651; p < 0.0001).Conclusion: This study is the first to demonstrate that patient beliefs about antibiotics and AMR associated with inappropriate demand can be changed by a brief, tailored online intervention. This has implications for the design of future interventions to reduce unnecessary antimicrobial use.

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Mental well-being promotion by Australian community pharmacists: what’s happening and what needs to be done?

Journal of Pharmaceutical Health Services Research ◽

10.1093/jphsr/rmab051 ◽

2021 ◽

Author(s):

Vijayaprakash Suppiah ◽

Fiona Kelly ◽

Oliver Watt ◽

Amanda J Wheeler ◽

Elizabeth Hotham ◽

...

Keyword(s):

Mental Health ◽

Community Pharmacy ◽

Online Survey ◽

Health Workers ◽

Full Range ◽

Community Pharmacists ◽

Well Being ◽

Face Validity ◽

Pharmacy Staff ◽

Mental Well Being

Abstract Objectives This study aimed to explore the range of activities provided by community pharmacists for promoting mental well-being in Australia. Methods An online survey was developed and piloted by 2 community pharmacists, 1 representative from the Pharmaceutical Society of Australia and 11 pharmacy students for content and face validity. Community pharmacists were recruited via direct emails to pharmacy groups and social media between November 2019 and January 2020. Descriptive statistics and chi-squared analyses were conducted. Key findings Data were analysed from 85 pharmacists (of 115 total pharmacy staff respondents). Although 40% reported working in a pharmacy that promoted mental well-being, most (88.2%) were not involved in such activities. However, most respondents (88.0%) identified community pharmacy as a suitable setting to promote mental well-being. Barriers to mental well-being promotion included busy pharmacy environment with competing priorities, a lack of staff training and confidence in discussing mental well-being and stigma associated with mental illness. Conclusions Community pharmacy presents a suitable setting to promote mental well-being. However, pharmacists may not be utilizing their full range of skills and knowledge in promoting a national health priority. This study identified opportunities for increased pharmacist-led promotion of mental well-being, particularly given the emerging mental health impacts of the COVID-19 pandemic. The pandemic has highlighted the growing urgency for mental health-friendly health workers across the sector including the community pharmacy workforce to engage consumers about their mental well-being.

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A pilot project to assess community pharmacists' knowledge and caring behaviors for recurrent headache sufferers after a migraine-focused educational intervention

INNOVATIONS in pharmacy ◽

10.24926/iip.v5i4.363 ◽

2014 ◽

Vol 5 (4) ◽

Author(s):

Kelly A. Murray ◽

Monica L. Skomo ◽

Sandra M. Carter

Keyword(s):

Educational Intervention ◽

Intervention Group ◽

Community Pharmacists ◽

Pilot Project ◽

Current Treatment ◽

Control Group ◽

Original Research ◽

Community Pharmacies ◽

Post Intervention ◽

Before And After

Objectives: (1) Compare pharmacists' self-assessed knowledge of migraine before and after an educational intervention; (2) Compare pharmacists' self-reported care behaviors following an educational intervention with a control group of pharmacists; (3) Identify interactions between the educational intervention results and individual independent variables. Design: Quasi-experimental, parallel design. Setting: Twenty community pharmacies in northeastern Oklahoma from March to May 2010. Participants: 49 pharmacists at one of twenty community pharmacies, with active and in-good-standing Oklahoma pharmacy licenses. Intervention: Two-hour educational session on migraine identification and current treatment. Main outcome measures: Compare pharmacists' self-assessed knowledge of migraine before and after an educational intervention and compare self-reported care behaviors of these same pharmacists with a control group of pharmacists. Results: Pharmacists' self-assessed knowledge mean scores were significantly higher post-intervention compared to pre-intervention (p<0.0001). Self-assessed knowledge was higher in the intervention group post-questionnaire scores compared to the control group of pharmacists (p=0.004). Intervention group pharmacists were more confident in their ability to maintain knowledge of migraine (p=0.04). No difference was seen regarding difficulty in providing care for a migraineur (p=0.16) or in how the pharmacists perceived employer culture (p=0.79). No significant interactions were found between the educational intervention and demographic variables collected. Conclusion: Attending an educational program on migraine improved pharmacists' knowledge and confidence when providing care to migraineurs. Type: Original Research

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Assessing the feasibility of a classroom-based visual attention training program targeting academics for students with extremely low IQ

Pilot and Feasibility Studies ◽

10.1186/s40814-021-00879-z ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Catherine Archambault ◽

Domenico Tullo ◽

Emma Clark ◽

Jocelyn Faubert ◽

Armando Bertone

Keyword(s):

Training Program ◽

Reading Performance ◽

Retention Rates ◽

Attention Training ◽

Inclusion Criteria ◽

Control Task ◽

Post Intervention ◽

Before And After ◽

Low Iq ◽

Academic Measures

Abstract Background This feasibility study investigated the viability of implementing a cognitive-based training program (NeuroTracker) and assessing its potential effects on academic performance for adolescents with extremely low IQ. Methods Twenty-six adolescents aged between 11 and 16 years with a Wechsler-based IQs in the extremely low range (MIQ = 56.00, SDIQ = 13.89) completed 15 training sessions on either the NeuroTracker or an active control task; math and reading performance were assessed using clinically validated instruments before and after training. Recruitment and retention rates, adherence, and properties of the academic measures were assessed. Results All recruited participants completed 15 training sessions within a 6-week period. Eighty-three percent of participants meeting initial inclusion criteria completed all stages of the study from baseline to post-intervention assessments. Some limitations of the academic measures were identified. Conclusions Results suggest that implementing NeuroTracker as a classroom-based intervention and using clinically validated outcome measures is feasible with this population.

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The coping strategies of community pharmacists and pharmaceutical services provided during COVID-19 in Malaysia

10.22541/au.160340466.61396727/v3 ◽

2021 ◽

Author(s):

Kok Pim Kua ◽

Shaun Lee

Keyword(s):

Community Pharmacy ◽

Coping Strategies ◽

Organizational Support ◽

Online Survey ◽

Community Setting ◽

Community Pharmacists ◽

Pharmaceutical Services ◽

Snowball Sampling ◽

Cross Sectional ◽

Number Of Customers

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COUNSELLING ACTIVITIES OF DRUG USE IN 58 COMMUNITY PHARMACIES AT HUE CITY

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2017.3.11 ◽

2017 ◽

pp. 75-80

Author(s):

Quoc Duong Doan ◽

Thi Ha Vo

Keyword(s):

Blood Pressure ◽

Drug Use ◽

Community Pharmacy ◽

Key Words ◽

Community Pharmacists ◽

Community Pharmacies ◽

Cough Headache ◽

Rational Drug ◽

Question Survey

Background: Community pharmacists play an important role in counseling of rational drug use for population. The study aimed to characterize counselling activities of drug use and demand of counselling tools at some community pharmacies at Hue City. Materials and method: A 17-question survey were asked to fill pharmacy staffs of a convenient sample of 100 community pharmacies at Hue City from 2/2017 to 7/2017. Results: There were 58 pharmacies (58.0%) answered this survey. Cough, headache, fever, high blood pressure and diabetes were the most popular symptoms/diseases presented in pharmacies. Patients often need counselling about dose (82.8%) and when to take medicine (79.3%). The main bariers for counselling were a lack of time (53.4%), and of skills/medthods for counseling (31.7%). About 96.6% pharmacies demanded counselling tools and favorite formats were book (32.9%) or pocket handbook (29.3%). Conclusion: Most pharmacies demanded counselling tools. Other studies should be conducted to develop supporting tools for counseling and to assess the quality of counseling in pharmacies. Key words: community pharmacy, counseling of drug use, pharmacist, Hue

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Exploring the independent prescribing role of the community pharmacists in Wales

International Journal of Pharmacy Practice ◽

10.1093/ijpp/riab015.042 ◽

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.

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Treating sleep problems in young people at ultra-high-risk of psychosis: study protocol for a single-blind parallel group randomised controlled feasibility trial (SleepWell)

BMJ Open ◽

10.1136/bmjopen-2020-045235 ◽

2020 ◽

Vol 10 (11) ◽

pp. e045235

Author(s):

Felicity Waite ◽

Thomas Kabir ◽

Louise Johns ◽

Jill Mollison ◽

Apostolos Tsiachristas ◽

...

Keyword(s):

Mental Health ◽

High Risk ◽

Young People ◽

Sleep Problems ◽

Qualitative Interviews ◽

Feasibility Trial ◽

Psychotic Experiences ◽

Post Intervention ◽

Ultra High Risk ◽

Randomised Controlled

BackgroundEffective interventions, targeting key contributory causal factors, are needed to prevent the emergence of severe mental health problems in young people. Insomnia is a common clinical issue that is problematic in its own right but that also leads to the development and persistence of psychotic experiences. The implication is that treating sleep problems may prevent the onset of psychosis. We collected initial case series data with 12 young people at ultra-high-risk of psychosis. Post-intervention, there were improvements in sleep, depression and psychotic experiences. Now we test the feasibility of a randomised controlled trial, with a clinical aim to treat sleep problems and hence reduce depression, psychotic experiences, and prevent transition to psychosis.Methods and analysisA randomised controlled feasibility trial will be conducted. Forty patients aged 14 to 25 years who are at ultra-high-risk of psychosis and have sleep disturbance will be recruited from National Health Service (NHS) mental health services. Participants will be randomised to receive either a novel, targeted, youth-focussed sleep intervention in addition to usual care or usual care alone. Assessor-blinded assessments will be conducted at baseline, 3 months (post-intervention) and 9 months (follow-up). The eight-session psychological intervention will target the key mechanisms which disrupt sleep: circadian rhythm irregularities, low sleep pressure, and hyperarousal. To gain an in-depth understanding of participants’ views on the acceptability of the intervention and study procedures, 16 participants (n=10 intervention, n=6 control) will take part in qualitative interviews. Analyses will focus on feasibility outcomes (recruitment, retention, and treatment uptake rates) and provide initial CI estimates of intervention effects. Thematic analysis of the qualitative interviews will assess the acceptability of the intervention and trial procedures.Ethics and disseminationThe trial has received ethical approval from the NHS Health Research Authority. Findings will be disseminated through peer-reviewed publications, conference presentations, and lay networks.Trial registration numberISRCTN85601537.

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