scholarly journals Pharmacist-Physician Interprofessional Collaboration to Promote Early Detection of Cognitive Impairment: Increasing Diagnosis Rate

2021 ◽  
Vol 12 ◽  
Author(s):  
Hernán Ramos ◽  
Juan Pardo ◽  
Rafael Sánchez ◽  
Esteve Puchades ◽  
Jordi Pérez-Tur ◽  
...  
Keyword(s):  
Primary Care ◽  
Cognitive Impairment ◽  
Early Detection ◽  
Clinical Diagnosis ◽  
General Practitioners ◽  
Interprofessional Collaboration ◽  
Community Pharmacists ◽  
Cognitive Test ◽  
Community Pharmacies

The increased pressure on primary care makes it important for other health care providers, such as community pharmacists, to collaborate with general practitioners in activities related to chronic disease care. Therefore, the objective of the present project was to develop a protocol of action that allows close pharmacist-physician collaboration to carry out a coordinated action for very early detection of cognitive impairment (CI).Methods: A comparative study to promote early detection of CI was conducted in 19 community pharmacies divided into two groups: one group with interprofessional collaboration (IPC) and one group without interprofessional collaboration (NonIPC). IPC was defined as an interactive procedure involving all pharmacists, general practitioners and neurologists. A total of 281 subjects with subjective memory complaints were recruited. Three tests were used in the community pharmacies to detect possible CI: Memory Impairment Screening, Short Portable Mental State Questionnaire, and Semantic Verbal Fluency. Individuals with at least one positive cognitive test compatible with CI, were referred to primary care, and when appropriate, to the neurology service. Finally, we evaluated the differences in clinical and diagnostic follow-up in both groups after six months.Results: The NonIPC study group included 38 subjects compatible with CI referred to primary care (27.54%). Ten were further referred to a neurology department (7.25%) and four of them (2.90%) obtained a confirmed clinical diagnosis of CI. In contrast, in the IPC group, 46 subjects (32.17%) showed results compatible with CI and were referred to primary care. Of these, 21 (14.68%) were subsequently referred to a neurology service, while the remaining 25 were followed up by primary care. Nineteen individuals out of those referred to a neurology service obtained a confirmed clinical diagnosis of CI (13.29%). The percentage of subjects in the NonIPC group referred to neurology and the percentage of subjects diagnosed with CI, was significantly lower in comparison to the IPC group (p-value = 0.0233; p-value = 0.0007, respectively).Conclusions: The creation of IPC teams involving community pharmacists, general practitioners, and neurologists allow for increased detection of patients with CI or undiagnosed dementia and facilitates their clinical follow-up. This opens the possibility of diagnosis in patients in the very early stages of dementia, which can have positive implications to improve the prognosis and delay the evolution of the disease.

scholarly journals Decision Tree for Early Detection of Cognitive Impairment by Community Pharmacists

2018 ◽  
Vol 9 ◽  
Author(s):  
Maria Teresa Climent ◽  
Juan Pardo ◽  
Francisco Javier Muñoz-Almaraz ◽  
Maria Dolores Guerrero ◽  
Lucrecia Moreno
Keyword(s):  
Cognitive Impairment ◽  
Early Detection ◽  
Decision Tree ◽  
Community Pharmacists

scholarly journals Positioning Each Other: A Metasynthesis of Pharmacist-Physician Collaboration

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Hilde Rakvaag ◽  
Gunn Elisabeth Søreide ◽  
Reidun Lisbet Skeide Kjome
Keyword(s):  
Health Care ◽  
General Practitioners ◽  
Patient Outcomes ◽  
Interprofessional Collaboration ◽  
Community Pharmacists ◽  
Proactive Approach ◽  
Ethnographic Approach ◽  
Successful Collaboration ◽  
Taking Responsibility

Abstract Interprofessional collaboration between different professions within health care is essential to optimize patient outcomes. Community-pharmacists (CPs) and general-practitioners (GPs) are two professions who are encouraged to increase their collaboration. In this metasynthesis we use a meta-ethnographic approach to examine the interpersonal aspects of this collaboration, as perceived by the professionals themselves. The metasynthesis firstly suggests that CPs and GPs have differing storylines about the cooperation between them. Secondly, CPs seem to position their profession in relation to the GPs, whereas GPs do not rely on the CPs to define their professional position. A successful collaboration between the two professions requires the CPs to reposition themselves through adopting a proactive approach towards the GPs. This proactive approach should comprise the delivery of specific clinical advice, as well as taking responsibility for this advice. In this way, they can build a more coinciding storyline of the joint agenda of improved patientcare.

scholarly journals Feasibility of cardiovascular risk screening in Portuguese community pharmacies

2021 ◽  
Vol 19 (2) ◽  
pp. 2255
Author(s):  
Anabela Fonseca ◽  
Tacio Lima ◽  
Margarida Castelo-Branco ◽  
Isabel Vitória Figueiredo
Keyword(s):  
Risk Factors ◽  
At Risk ◽  
Early Detection ◽  
Community Pharmacists ◽  
Physical Parameters ◽  
Community Pharmacies ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Risk Screening ◽  
Screening Programs

Background: Cardiovascular disease (CVD) remains the leading cause of human mortality. As highly accessible and qualified health professionals, community pharmacists can be included in the early detection of patients at risk for CVD by implementing CVD screening programs. Objective: To assess the feasibility of CVD risk screening services in Portuguese community pharmacies from the evaluation of customers acceptability. Methods: A cross-sectional study was conducted in a community pharmacy in Portugal. The purpose of entering the pharmacy was recorded for all customers. Afterwards, the customers were invited to be interviewed by the pharmacist, who registered their willingness to participate and collected the participants’ data and biochemical and physical parameters to assess their CV risk by applying the Systematic COronary Risk Evaluation (SCORE) model. For the participants who were not eligible for the SCORE-based risk assessment, the pharmacist considered the major modifiable CVD risk factors - hypertension, dyslipidemia, smoking habits, obesity, impaired fasting glucose and sedentary behavior - according to the ESC guidelines. Results: Picking up medication was the most prevalent reason 69.8% (n=1,600) for entering the pharmacy, and among the contacted customers, 56.4% (n=621) agreed to have their CVD risk assessed. Of the 588 participants, 56.6% (n=333) were already on CV pharmacotherapy and were therefore not eligible for screening. Of the 43.4% (n=255) CV pharmacotherapy-naïve participants, 94.9% (n=242) were screened with at least one CVD risk factor; 52.9% (n=135) were not eligible for the SCORE assessment, of which 92.6% (n=125) presented CVD risk factors. Of the 120 SCORE eligible participants, 80.0% (n=96) were at least at moderate risk of CVD. Conclusions: We determined the feasibility of CVD risk screening in Portuguese community pharmacies, as we found high customer acceptability, noted the reasons for nonattendance, and found a high prevalence of CVD risk factors in at-risk patients. This is an opportunity for Portuguese community pharmacists to take a leading role in the early detection of CVD.

scholarly journals Collaboration amongst general practitioners and gynaecologists working in primary health care in Germany: a cross-sectional study

2021 ◽  
Vol 22 ◽  
Author(s):  
Barbara Trusch ◽  
Christoph Heintze ◽  
Elena Petelos ◽  
Lorena Dini
Keyword(s):  
Primary Care ◽  
General Practitioners ◽  
Interprofessional Collaboration ◽  
Cross Sectional Study ◽  
Postal Survey ◽  
Sectional Study ◽  
Healthcare Provision ◽  
Cross Sectional ◽  
Federal States ◽  
Key Competencies

Abstract Aim: This cross-sectional study is the first one to explore the collaboration of the influencing factors thereof amongst general practitioners (GPs) and gynaecologists (Gyns) working in primary care in urban and rural settings in Germany. Background: The number of women aged ≥ 50 years is predicted to increase in the next years in Germany. This coincides with the ageing of primary care specialists providing outpatient care. Whereas delegation of tasks to nurses as a form of interprofessional collaboration has been the target of recent studies, there is no data regarding collaboration amongst physicians in different specialisations working in primary care. We explored collaboration amongst GPs and Gyn regarding the healthcare provision to women aged ≥ 50 years. Methods: A quantitative postal survey was administered to GPs and Gyns in three federal states in Germany, focusing on care provision to women aged ≥ 50 years. A total of 4545 physicians, comprising 3514 GPs (67% of the total GP population) randomly selected, and all 1031 Gyns practicing in these states received the postal survey in March 2018. A single reminder was sent in April 2018 with data collection ending in June 2018. Multiple logistic regressions were performed for collaboration, adjusted by age and sex, alongside descriptive methods. Findings: The overall response rate was 31% (1389 respondents): 861 GPs (25%) and 528 Gyns (51%), with the mean respondent age being 54.4 years. Seventy-two per cent were female. Key competencies of collaboration are associated with working in rural federal states and with network participation. Physicians from rural states [odds ratio (OR) = 1.5, 95% confidence interval (CI) = 1.2, 1.9] and physicians in networks (OR = 3.0, CI = 2.3, 3.9) were more satisfied with collaboration. Collaboration to deliver services for women aged ≥ 50 years is more systematic amongst GPs and Gyns who are members of a network; increased networking could improve collaboration, and ultimately, outcomes too.

The role of primary care in early detection and follow-up of cancer

2013 ◽  
Vol 11 (1) ◽  
pp. 38-48 ◽  
Author(s):  
Jon D. Emery ◽  
Katie Shaw ◽  
Briony Williams ◽  
Danielle Mazza ◽  
Julia Fallon-Ferguson ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Detection

scholarly journals Complementing or conflicting? How pharmacists and physicians position the community pharmacist

2020 ◽  
Vol 18 (3) ◽  
pp. 2078
Author(s):  
Hilde Rakvaag ◽  
Gunn E. Søreide ◽  
Eivind Meland ◽  
Reidun L. Kjome
Keyword(s):  
Focus Group ◽  
General Practitioners ◽  
Interprofessional Collaboration ◽  
Community Pharmacists ◽  
Active Role ◽  
Structured Interview ◽  
Study Data ◽  
Positioning Theory ◽  
Focus Group Interviews ◽  
Group Interviews

Background: Interprofessional collaboration between pharmacists and physicians in primary care has been linked to improved patient outcomes. How professionals position themselves and each other can shed light upon their relationship, and positioning theory can be used as a tool to better understand intergroup relations. Objectives: 1) To identify how community pharmacists position themselves, and how they are positioned by general practitioners. 2) To assess how well these positions correspond, how the positions align with a proactive position for the pharmacists, and discuss how the positions could potentially impact collaboration. Methods: In this qualitative study, data were collected through six focus group interviews held between June and October 2019, three with pharmacists and three with physicians. The focus group interviews were conducted using a semi-structured interview guide. Data were audio recorded, transcribed verbatim, and analyzed using the Systematic text condensation method. Positioning theory was used as a theoretical framework to identify the positions assigned to community pharmacists by the pharmacists themselves and by the physicians. Results: Twelve pharmacists and ten physicians participated. The pharmacists positioned themselves as the “last line of defense”, “bridge-builders”, “outsiders” – with responsibility, but with a lack of information and authority – and “practical problem solvers”. The physicians positioned pharmacists as “a useful checkpoint”, “non-clinicians” and “unknown”. Conclusions: The study revealed both commonalities and disagreements in how community pharmacists position themselves and are positioned by general practitioners. Few of the positions assigned to pharmacists by the physicians support an active role for the pharmacists, while the pharmacists´ positioning of themselves is more diverse. The physicians´ positioning of pharmacists as an unknown group represents a major challenge for collaboration. Increasing the two professions´ knowledge of each other may help produce new positions that are more coordinated, and thus more supportive towards collaboration.

scholarly journals Electronic transmission of prescriptions in primary care: transformation, timing and teamwork

2021 ◽  
Vol 13 (4) ◽  
pp. 340
Author(s):  
Chloë Campbell ◽  
Caroline Morris ◽  
Lynn McBain
Keyword(s):  
Primary Care ◽  
New Zealand ◽  
General Practitioners ◽  
Community Pharmacists ◽  
Unintended Consequences ◽  
Structured Interviews ◽  
Interprofessional Communication ◽  
Potential Benefits ◽  
Handwritten Signature ◽  
Purposive Sample

ABSTRACTINTRODUCTIONDuring the coronavirus disease 2019 (COVID-19) pandemic lockdown in New Zealand in March 2020, there was a rapid shift to virtual consultations in primary care. This change was supported by system adjustments to enable electronic transmission of prescriptions without a handwritten signature if they met certain security criteria. International research suggests potential for unintended consequences with such changes, so it is important to understand the effect on professional practice in New Zealand general practice and community pharmacy.AIMThe purpose of this study was to undertake a preliminary exploration of the experiences of New Zealand general practitioners and community pharmacists when prescriptions are transmitted electronically directly from prescriber to pharmacy.METHODSSemi-structured interviews with a purposive sample of four pharmacists and four general practitioners gathered qualitative data about their experiences of the shift to electronic transmission of prescriptions. Participants’ perceptions of effect on professional workflow, interprofessional interactions between general practitioners and pharmacists, and interactions with patients were explored. Interviews were audio-recorded, and the data analysed thematically using an inductive approach.RESULTSFour themes were identified: workflow transformation; mixed impact on interactions with patients; juggling timing and expectations; and new avenues for interprofessional communication (with some cul-de-sacs).DISCUSSIONBoth general practitioners and pharmacists experienced transformational changes to workflow. This was positive for general practitioners due to saved time and increased work flexibility. Pharmacists noted potential benefits but also some challenges. To fully reap teamwork benefits, more work is needed on managing the timing issues and patient expectations, and to refine the new modes of communication between health-care practitioners.

scholarly journals Optimising retention success: a research team’s experience of following-up participants recruited to a pilot trial through community pharmacies in England

F1000Research ◽  
2021 ◽  
Vol 9 ◽  
pp. 1042
Author(s):  
Michelle Watson ◽  
Anne van Dongen ◽  
Catherine Hewitt ◽  
Laura Mandefield ◽  
Duncan Stewart ◽  
...  
Keyword(s):  
Data Collection ◽  
Pilot Trial ◽  
Community Pharmacists ◽  
Optimal Strategies ◽  
Community Pharmacies ◽  
Medicine Service ◽  
Data Completion ◽  
Sensitive Issues ◽  
Patient Retention

Background: The CHAMP-1 (Community pharmacy: Highlighting Alcohol use in Medication aPpointments) pilot trial aimed to explore an intervention discussing alcohol during medication consultations with community pharmacists. It presented various challenges regarding patient retention, as participants were recruited by their pharmacist and followed-up remotely by a trained researcher, who they had not met, two months later.  We discuss our actions and experiences of completing follow-up activities. Methods: Community pharmacists recruited patients aged 18 and over, attending a Medicine Use Review (MUR) or New Medicine Service (NMS) consultation, and drinking alcohol at least twice per week. Pharmacies were randomised to conduct their consultations as usual (control), or to incorporate the Medicines and Alcohol Consultation (MAC) intervention. All participants were followed-up by a researcher after two months to complete data collection via telephone or post. We employed standard follow-up strategies, including a plan to text participants with a reminder in advance of their follow-up. Results: Forty-seven of 51 participants (92%) completed the two month follow-up. Thirty-eight (81%) responses were provided by telephone and nine (19%) by post. Of the 38 follow-up calls completed by telephone, 17 (45%) participants were reached at first attempt; 16 (42%) at second attempt; and five (13%) at the third attempt. We observed a high percentage of data completion across telephone and postal collection methods.  Participants were willing to discuss potentially sensitive issues, such as alcohol consumption, anxiety, and depression, with a researcher who was external to the pharmacy team.  Conclusions: The results suggest that patients recruited to a trial by community pharmacists are willing to take part in data collection activities, and remote follow-up can be successfully conducted by researchers. The techniques employed to encourage high levels of retention should be investigated further in a larger study, alongside consideration of optimal strategies to collect data within community pharmacies.

Sign in / Sign up

Export Citation Format

Share Document