scholarly journals Co-designing a Community Pharmacy Pharmacogenomics Testing Service In The UK

2021 ◽  
Author(s):  
Tim Rendell ◽  
Julie Barnett ◽  
David Wright
Keyword(s):  
Focus Groups ◽  
Community Pharmacy ◽  
Community Pharmacists ◽  
Community Pharmacies ◽  
Successful Implementation ◽  
Focus Group Study ◽  
Set Up ◽  
Implementation Resources ◽  
The Uk ◽  
Interprofessional Relationship

Abstract Introduction: Pharmacogenomics (PGx) testing services have been delivered through community pharmacies across the globe, though not yet in the UK. This paper is reporting a focus group study, the first stage of a participatory co-design process to increase the chance of a successful implementation of a PGx service through community pharmacy in the UK.Aim: To identify the barriers and enablers to implementing a community pharmacy based PGx service in the UK.Method: Three focus groups were conducted with community pharmacists (n= 10), prescribers (n= 8) and patients (n=8) in England. The focus groups were recorded, transcribed and thematically analysed using the Braun and Clarke six step reflexive thematic analysis approach.Results: The analysis identified five themes about PGx testing in community pharmacies: (1) In- principle receptiveness, (2) Appreciation of the benefits, (3) Lack of implementation resources (4) Ambiguity about implications for implementation and (5) Interprofessional relationship challenges.Conclusion: The identified enablers for implementation of a PGx service were at a macro health system strategic level; the concerns were more at a granular operational procedural level. Overall receptiveness was noted by all three participant groups, and both prescriber and pharmacist groups appreciated the potential benefits for patients and the healthcare system. Prior to implementation in the UK, there is a need to disambiguate health professional’s concerns of the guidance, resources, and knowledge required to set up and deliver the service and to resolve patient concerns about the nature of genomics.

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

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

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 Qualitative study using interviews and focus groups to explore the current and potential for antimicrobial stewardship in community pharmacy informed by the Theoretical Domains Framework

BMJ Open ◽  
2018 ◽  
Vol 8 (12) ◽  
pp. e025101 ◽  
Author(s):  
Leah Ffion Jones ◽  
Rebecca Owens ◽  
Anna Sallis ◽  
Diane Ashiru-Oredope ◽  
Tracey Thornley ◽  
...  
Keyword(s):  
Focus Groups ◽  
Community Pharmacy ◽  
Antimicrobial Stewardship ◽  
Self Care ◽  
Intervention Development ◽  
Theoretical Domains Framework ◽  
Community Pharmacists ◽  
Pharmacy Staff ◽  
Barriers And Opportunities ◽  
The Impact

ObjectivesCommunity pharmacists and their staff have the potential to contribute to antimicrobial stewardship (AMS). However, their barriers and opportunities are not well understood. The aim was to investigate the experiences and perceptions of community pharmacists and their teams around AMS to inform intervention development.DesignInterviews and focus groups were used to explore the views of pharmacists, pharmacy staff, general practitioners (GPs), members of pharmacy organisations and commissioners. The questioning schedule was developed using the Theoretical Domains Framework which helped inform recommendations to facilitate AMS in community pharmacy.Results8 GPs, 28 pharmacists, 13 pharmacy staff, 6 representatives from pharmacy organisations in England and Wales, and 2 local stakeholders participated.Knowledge and skills both facilitated or hindered provision of self-care and compliance advice by different grades of pharmacy staff. Some staff were not aware of the impact of giving self-care and compliance advice to help control antimicrobial resistance (AMR). The pharmacy environment created barriers to AMS; this included lack of time of well-qualified staff leading to misinformation from underskilled staff to patients about the need for antibiotics or the need to visit the GP, this was exacerbated by lack of space. AMS activities were limited by absent diagnoses on antibiotic prescriptions.Several pharmacy staff felt that undertaking patient examinations, questioning the rationale for antibiotic prescriptions and performing audits would allow them to provide more tailored AMS advice.ConclusionsInterventions are required to overcome a lack of qualified staff, time and space to give patients AMS advice. Staff need to understand how self-care and antibiotic compliance advice can help control AMR. A multifaceted educational intervention including information for staff with feedback about the advice given may help. Indication for a prescription would enable pharmacists to provide more targeted antibiotic advice. Commissioners should consider the pharmacists’ role in examining patients, and giving advice about antibiotic prescriptions.

scholarly journals Quality improvement in community pharmacy: a qualitative investigation of the impact of a postgraduate quality improvement educational module on pharmacists understanding and practice

2020 ◽  
Author(s):  
Asam Latif ◽  
Nargis Gulzar ◽  
Sejal Gohil ◽  
Theo Ansong
Keyword(s):  
Quality Improvement ◽  
Focus Groups ◽  
Community Pharmacy ◽  
Educational Intervention ◽  
Good Practice ◽  
Community Pharmacists ◽  
Educational Module ◽  
Practical Applications ◽  
Motivation For Learning ◽  
The Impact

Abstract Objective Quality improvement (QI) is increasingly featuring in the United Kingdom (UK) National Health Service (NHS) agenda to promote safety, effectiveness and patient experience. However, the use of QI techniques by healthcare professionals appears limited and constrained with only isolated examples of good practice. This study explores QI within the pharmacy context. Focusing on the community pharmacy ‘Healthy Living Pharmacy scheme’, this study aims to explore changes in QI understanding resulting from a postgraduate QI educational intervention. Methods Four focus groups were held involving 13 community pharmacists enrolled onto a newly developed postgraduate QI educational module. Two focus groups were held before and two after the module’s completion. Knowledge of QI and practical applications following the learning was explored. Key findings Three themes emerged: pharmacists’ motivation for learning about QI, conceptual understanding and translation into practice. Pharmacists expressed positive views about learning new skills but expressed logistical concerns about how they would accommodate the extra learning. Prior knowledge of QI was found to be lacking and its application in practice ineffectual. Following completion of the QI module, significant improvements in comprehension and application were seen. Pharmacists considered it too soon to make an assessment on patient outcomes as their improvements required time to effectively embed changes in practice. Conclusions Quality improvement forms an important part of the NHS quality and safety agenda; however, community pharmacists may not currently have adequate knowledge of QI principles. The postgraduate educational intervention showed promising results in pharmacist’s knowledge, organisational culture and application in practice.

Advice-giving in Community Pharmacies in the UK

1997 ◽  
Vol 2 (1) ◽  
pp. 38-50 ◽  
Author(s):  
Mary P. Tully ◽  
Karen Hassell ◽  
Peter R. Noyce
Keyword(s):  
Pharmacy Practice ◽  
Community Pharmacists ◽  
Subjective Assessment ◽  
Community Pharmacies ◽  
Common Definition ◽  
Advice Giving ◽  
Published Evidence ◽  
Design Consistency ◽  
The Uk ◽  
The Impact

Objectives: To review (1) the published evidence on the information provided with prescribed and purchased medicines by pharmacists and pharmacy assistants, (2) clients' expectations of advice about medicines from community pharmacies and their experience and use of it, and (3) appropriateness and rigour of study methods used. Methods: Papers, published between 1980 and 1995 inclusively, were identified based on searches of on-line databases, a published literature index, key pharmacy practice journals and cited references in the bibliographies of published papers. Those papers selected reported research findings on any aspect of medicines-related communications and the provision of advice about medicines to members of the public who visited pharmacies in the UK. The comparatively small volume of work and lack of design consistency meant that a subjective assessment, rather than a criteria-based objective review, was deemed appropriate. Results: Forty-two suitable studies were identified and are reviewed. No common definition of ‘advice’ has emerged. Most studies reported were quantitative, concentrating on the frequency of advice-giving in community pharmacies and only one study considered the impact of advice on outcome. The quality of advice given was judged highly variable, although pharmacists' referrals, where made, were considered appropriate. Given that pharmacy assistants appear to make most of the medicine sales, remarkably few studies addressed their contribution to advicegiving. The review can provide little insight into what determines when advice is provided, but it does illuminate the disparity between the advice that clients say they want and what they actually seek. Conclusions: Where there appears to be a consensus that advice-giving in community pharmacies is wanted, this review reveals a lack of shared understanding between consumer bodies and the pharmacy profession about who needs advice and when and how it should be given. The need for unsolicited advice-giving associated with the sale of medicines is particularly contentious. With the current programme of deregulation of medicines, this is an increasingly important issue to resolve. The authors suggest a need for a consensus-building forum to generate guidelines that meet shared expectations between clients, community pharmacists, government and the pharmaceutical industry.

scholarly journals Accessing Mole-Scanning through Community Pharmacy: A Pilot Service in Collaboration with Dermatology Specialists

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 231
Author(s):  
Charlotte L. Kirkdale ◽  
Zoe Archer ◽  
Tracey Thornley ◽  
David Wright ◽  
Mette Valeur ◽  
...  
Keyword(s):  
Malignant Melanoma ◽  
Community Pharmacy ◽  
Skin Lesions ◽  
Service Evaluation ◽  
Outcome Data ◽  
Medical Attention ◽  
Community Pharmacies ◽  
Service Outcomes ◽  
The Uk ◽  
Care Costs

Early identification and treatment of malignant melanoma is crucial to prevent mortality. The aim of this work was to describe the uptake, profile of users and service outcomes of a mole scanning service in the community pharmacy setting in the UK. In addition, health care costs saved from the perspective of general practice were estimated. The service allowed patients to have concerning skin lesions scanned with a dermatoscopy device which were analyzed remotely by clinical dermatology specialists in order to provide recommendations for the patient. Patients were followed up to ascertain the clinical outcome. Data were analyzed for 6355 patients and 9881 scans across 50 community pharmacies. The majority of the scans required no further follow-up (n = 8763, 88.7%). Diagnosis was confirmed for 70.4% (n = 757/1118) of scans where patients were recommended to seek further medical attention. Of these, 44.3% were ultimately defined as normal (n = 335) and 6.2% as malignant melanoma (n = 47/757). An estimated 0.7% of scans taken as part of the service led to a confirmed diagnosis of malignant melanoma. This service evaluation has shown that a mole scanning service available within community pharmacies is effective at triaging patients and ultimately playing a part in identifying diagnoses of malignant melanoma.

scholarly journals AB1203 INVESTIGATING THE VIEWS OF COMMUNITY PHARMACISTS ON THEIR ROLE IN THE MANAGEMENT OF RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1892.2-1893
Author(s):  
S. Wood ◽  
K. Hyrich ◽  
S. Verstappen ◽  
D. Steinke
Keyword(s):  
Rheumatoid Arthritis ◽  
Community Pharmacy ◽  
Potential Role ◽  
Community Pharmacists ◽  
Access To Information ◽  
Research Support ◽  
Current Role ◽  
The Uk

Background:Medicines optimisation is essential in the long-term management of rheumatoid arthritis (RA), particularly when considering combinations of conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs). Community pharmacists are ideally placed to optimise medicines use including monitoring side effects, counselling on dose and frequency and improving medicines adherence; however, in some countries, such as the UK, there are currently no community pharmacy services that address csDMARD use and little is known about the role community pharmacists play in managing RA as a long-term condition.Objectives:The objectives of this qualitative study were to understand community pharmacists’ views of their training, knowledge and current role in the management of RA.Methods:We conducted 9 semi-structured, face-to-face or telephone interviews with community pharmacists based in the UK; all were transcribed verbatim. A topic guide, used to inform the interviews, covered four key areas: 1) knowledge and training, 2) pharmacological management 3) patients and services, 4) potential role. The transcriptions were then imported into NVivo for thematic analysis. A coding framework was developed from continual emerging themes and applied to the transcripts.Results:Five male/4 female participants, the median age was 39 years (range 27 to 42) with a median number of years qualified as a pharmacist of 12 years (range 5 to 20) were included. The participants covered a range of roles including: pharmacist non-manager, pharmacist manager, locum pharmacist, superintendent pharmacist and relief pharmacist.In assessing the current role of community pharmacists, 4 main themes were identified: (1) access to information about the patient’s condition as a barrier, (2) their lack of knowledge in the management of RA, (3) providing practical advice about taking csDMARDs, and (4) exploring the reasons for non-adherence before taking further action. In assessing the potential role of community pharmacists, a further 2 themes were identified: improving access to information about the patient’s condition before the current role can be increased and other barriers to an additional role, including time and funding.In the theme ‘access to information as a barrier’ the most common point made was about the lack of information available to pharmacists on the individual indication for medicines. Pharmacists said this posed a barrier both to current practice and their potential role. No participants suggested the potential for an additional service specifically for RA, but some suggested that current services could be expanded to include RA as a target group. Participants discussed side effect counselling and ensuring access to medicines in detail with patients, but only 2 briefly mentioned discussing the benefits of csDMARDs.Conclusion:This is the first in-depth exploration of the perspectives of community pharmacists on the management of RA in community pharmacy. This study has highlighted several important barriers both environmental and personal including time, education and resources that, if addressed, could allow community pharmacists to play a greater role in the management of RA.Disclosure of Interests:Sarah Wood: None declared, Kimme Hyrich Grant/research support from: Pfizer, UCB, BMS, Speakers bureau: Abbvie, Suzanne Verstappen Grant/research support from: BMS, Consultant of: Celltrion, Speakers bureau: Pfizer, Douglas Steinke: None declared

scholarly journals Qualitative assessment of patients’ perspectives and needs from community pharmacists in substance use disorder management

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Sarah Fatani ◽  
Daniel Bakke ◽  
Marcel D’Eon ◽  
Anas El-Aneed
Keyword(s):  
Health Care ◽  
Substance Use ◽  
Focus Groups ◽  
Community Pharmacy ◽  
Treatment Outcomes ◽  
Community Pharmacists ◽  
Health Concern ◽  
Care Providers ◽  
Opioid Agonist ◽  
The Impact

Abstract Background Non-medical use of psychoactive substances is a common harmful behavior that leads to the development of Substance Use Disorders (SUDs). SUD is a significant health concern that causes adverse health consequences and elevates the economic burden on the health care system. SUD treatment plans that utilize a patient-centered approach have demonstrated improved treatment outcomes. It is essential for health care providers, including community pharmacists, to understand patients’ needs and prioritize them. Therefore, this study was conducted to explore the perspective of patients living with SUDs or who used substances non-medically regarding community pharmacist services and the delivery of services in a community pharmacy setting. The study took place in Saskatoon, a small urban center of Saskatchewan, Canada. Methods Qualitative methodology was used for this research inquiry. Four focus groups were conducted, with a total of 20 individuals who had experienced substance use and accessed community pharmacy services. The discussion of the four focus groups was transcribed verbatim and analyzed independently by two researchers. Agreement on the emergent themes was reached through discussion between the two researchers. Results Data analysis resulted in four themes that described participants’ perspectives about community pharmacists. The four emergent themes are: 1) conflicted experiences with community pharmacists, 2) lack of knowledge concerning community pharmacists’ extended services, 3) negative experiences in Opioid Agonist Therapy (OAT) program, and 4) needs from community pharmacists. Conclusion There is significant potential for the patient-pharmacist relationship to address the varying needs of patients who use substances and improve their overall health care experience. Patients who use substances are receptive to pharmacists’ services beyond dispensary; however, respectful communication, provision of drug-related information, and counseling are among the primary demands. Future research should focus on studying the impact of meeting the needs of patients on their treatment outcomes.

scholarly journals The Development and Proof of Principle Test of TRIAGE: A Practical Question Set to Identify and Discuss Medication-Related Problems in Community Pharmacy

Pharmacy ◽  
2020 ◽  
Vol 8 (4) ◽  
pp. 178
Author(s):  
Marcia Vervloet ◽  
Hanneke E. Zwikker ◽  
Annemiek J. Linn ◽  
Ellen S. Koster ◽  
Suzan G. H. Gipmans ◽  
...  
Keyword(s):  
Side Effects ◽  
Focus Groups ◽  
Community Pharmacy ◽  
Medication Use ◽  
Community Pharmacies ◽  
Communication Tools ◽  
Pharmacy Technicians ◽  
Practical Question ◽  
Proof Of Principle

The pharmacy counter is a good place to identify and discuss medication-related problems. However, there is a lack of practical communication tools to support pharmacy technicians (PTs) in initiating a conversation with patients. This study aimed to develop and test a practical set of questions for PTs, called TRIAGE, to identify problems during encounters. TRIAGE was developed based on insight from the literature, focus groups with PTs and pharmacists, and input from patients and experts. In 10 community pharmacies, 17 PTs used TRIAGE during encounters with patients who collected their cardiovascular medication. For each encounter, PTs registered the identified problems and suggested solutions. A total of 105 TRIAGE conversations were held, 66 for first refill and 39 for follow-up refill prescriptions. In 15 (23%) first refill prescription encounters, a problem was identified. These problems concerned forgetting to take the medication, a complex medication regime or (fear of) side effects. In three (8%) follow-up refill prescription encounters, a problem was identified. Most of the problems were solved on the spot. Pharmacy technicians indicated that they identified medication-related problems with TRIAGE that otherwise would be left unnoticed. They appreciated TRIAGE as a useful instrument for starting the conversation with patients about medication use.

scholarly journals Exploring public attitudes towards the new Faster Diagnosis Standard for cancer: a focus group study with the UK public

2019 ◽  
Vol 69 (683) ◽  
pp. e413-e421 ◽  
Author(s):  
Marianne Piano ◽  
Georgia Black ◽  
Dorothee Amelung ◽  
Emily Power ◽  
Katriina L Whitaker
Keyword(s):  
Focus Group ◽  
Focus Groups ◽  
Cancer Diagnosis ◽  
Diagnostic Tests ◽  
Public Attitudes ◽  
Referral Process ◽  
Test Results ◽  
Focus Group Study ◽  
The Uk ◽  
A Current

BackgroundThe Faster Diagnosis Standard (FDS) is to be introduced in England in 2020. This standard is a new policy in which patients should have cancer ruled out or diagnosed within 28 days of referral.AimTo explore public attitudes towards the FDS within the context of their recent referral experiences.Design and settingFour 90-minute focus groups (two in Guildford, two in Bradford).MethodParticipants aged >50 years without a current cancer diagnosis (N = 29), who had completed certain diagnostic tests, for example, ultrasound, and received results within the last 6 months were recruited. Age, education, and sex were evenly distributed across groups through purposive sampling.ResultsThe largest cause of concern was the waiting process for obtaining test results. Most had experienced swift referral, and it was difficult for participants to understand how the new standard could impact upon time progressing through the system. Responsibility for meeting the standard was also a concern: participants did not see their own behaviours as a form of involvement. The GP’s role was conceptualised by patients as communicating about their referral, establishing patients’ preferences for information, and continued involvement at each stage of the referral process. The standard legitimised chasing for test results, but 28 days was considered too long.ConclusionPatients should be asked what they would like to know about their referral. GPs should be more transparent about the referral process and the potential for a lack of clarity around next steps.

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