scholarly journals Expanded Pharmacy Practice Implementation: Lessons from Remote Practice

Pharmacy ◽  
2022 ◽  
Vol 10 (1) ◽  
pp. 15
Author(s):  
Selina Taylor ◽  
Alice Cairns ◽  
Beverley Glass

Aim: The aim of this study is to explore pharmacist perspectives of the implementation of a community pharmacy-based ear health service in rural communities. Method: A community pharmacy-based health service model was designed and developed to provide an accessible ear care service (LISTEN UP—Locally Integrated Screening and Testing Ear aNd aUral Program) and pharmacist’s perspectives of the implementation of LISTEN UP were explored. Thematic analysis was conducted and data coded according to the Consolidated Framework for Implementation Research. Results: A total of 20 interviews were conducted with 10 pharmacists, averaging 30 min. Visualistion of the ear canal was reported as the greatest advantage of the service, whilst the time required for documentation reported as a complexity. The number of pharmacists working at one time and the availability of a private consultation room were identified as the two limiting factors for execution. On reflection, the need for government funding for service viability and sustainability was highlighted. Discussion/Conclusion: Expanded pharmacy practice is emerging for the Australian pharmacy profession. Rural community pharmacists are recognised as integral members of healthcare teams, providing accessible medication supply and health advice to seven million people in Australia who call rural and remote regions home. However, there are no structured models supporting them to provide expanded services to improve health outcomes in their communities. This study provides lessons learnt to guide future design and development of expanded models of pharmacy practice.

2014 ◽  
Vol 5 (2) ◽  
Author(s):  
Donald Klepser ◽  
Allison Dering-Anderson ◽  
Jacqueline Morse ◽  
Michael Klepser ◽  
Stephanie Klepser ◽  
...  

Background: It has been shown that use of rapid diagnostic tests (RDTs) is able to reduce costs and improve the prescribing practice of antivirals (i.e. oseltamivir) among patients with influenza-like illnesses (ILIs). Using existing Clinical Laboratory Improvement Amendment (CLIA)-waived RDTs and collaborative practice agreements, similar to those used to allow pharmacists to administer vaccines, it is possible for patients to seek point-of-care treatment for influenza or flu-like symptoms at a local pharmacy. Following a review of the patient's symptoms by a trained pharmacist, the qualified patient is offered an RDT to determine if the influenza virus is the cause of the symptoms. Based on the results of the RDT, the patient is provided with the appropriate treatment as defined by an approved practice agreement. Objective: The aim of this study was to evaluate the feasibility of incorporating an RDT for influenza into community pharmacy practice. Methods: This time and motion study was conducted at three community pharmacy locations, and a total of eight simulated patient visits were completed utilizing a standardized patient. In addition to determining a total time of the encounter, each simulation was divided into nine timed sub-categories. For data analysis, the time spent in each of the nine sub-categories was assigned to the pharmacist, pharmacy technician, or patient. Time and motion methodologies were used to estimate the total time required to provide the RDT service, to determine the amount of active time required of the pharmacist and pharmacy technician, and to evaluate the ability of the staff to provide the service within its existing workflow. Results: The average total time to complete the entire patient encounter for an influenza assessment utilizing an RDT was 35.5 minutes (± 3.1 minutes). On average, the pharmacist spent 9.4 minutes (± 3 minutes) per encounter or about 26.5% of the entire encounter. When the pharmacy technician collected the vital signs, the pharmacist-required time was reduced to 4.95 minutes (± 2.7 minutes), which was about a 48% reduction. Conclusions: The results indicate that an RDT program for influenza assessment required no more than a modest amount of pharmacist time and could be successfully incorporated into regular workflow with little to no disruption of other activities. As such, this approach to influenza management may be a feasible service for community pharmacies to offer patients. This was especially true if the pharmacy had well-trained technicians on staff that could support the service with collection of patient histories and vital signs.   Type: Original Research


Author(s):  
Nazri Nordin ◽  
Mohamed Azmi Ahmad Hassali, ◽  
Azmi Sarriff

  Objective: The aims of this review were to observe extended services performed in the community pharmacy settings, perceptions among community pharmacists (CPs), general practitioners (GPs), and customers of these extended services and barriers toward its performance.Methods: A literature search was conducted, using Google Scholar as database, searching for full access texts. The inclusive texts fulfilled the inclusion criteria.Results: A total of 22 texts had been systematically reviewed, noting a wide range of extended services performed in community pharmacy settings. Medication counseling or review and promoting health educations were noted as the most extended services performed. It is also noted that CPs indicated that these extended services could establish working relationship with other health-care professionals. However, it is noted that among the barriers toward extended services were lack of knowledge, skills, and time to perform.Conclusion: As a conclusion, the community pharmacy practice is evolving, transforming into more patient-oriented even though there are some negative perceptions among the customers and GPs toward these extended services. Barriers to the performance of these extended services should be intervened.  


2020 ◽  
Vol 153 (2) ◽  
pp. 101-107 ◽  
Author(s):  
John Papastergiou ◽  
Michelle Donnelly ◽  
Terence Yuen ◽  
Wilson Li ◽  
Bart van den Bemt

Background: Helicobacter pylori is identified by the World Health Organization as a major risk factor of gastritis, peptic ulcer disease and gastric carcinomas. As point-of-care screening technology becomes more widely available, pharmacists are ideally suited to use this tool to screen patients with H. pylori infection. Purpose: The objective of this study was to evaluate the feasibility of implementing point-of-care screening technology for H. pylori into community pharmacy practice and to assess the number of patients who are positively identified as a result of testing. Methods: Three pharmacies in Toronto, Ontario, offered H. pylori screening as part of their clinical programs. Pharmacists enrolled patients with symptoms of dyspepsia and/or receiving acid suppressant therapy for >6 weeks. Decision to screen was based on the Canadian Helicobacter Study Group Consensus (CHSG). Patients were screened using the Rapid Response H. pylori test. Results: Seventy-one patients were recruited, with a mean age of 46.3 years. Patients were ethnically diverse, with a significant proportion (59.2%) identified as being born outside of North America, including Asia (26.8%), Africa (9.9%), the Middle East (7%), Europe (9.9%) and South and Central America (5.6%). Overall, the detection rate of H. pylori infection was 21%. North Americans had the lowest incidence of an undiagnosed H. pylori infection (6.9%). Europeans (28.6%), Middle Easterners (20%) and Asians (21.1%) had a moderate incidence, followed by the highest prevalence in those of African descent (71.4%). Conclusion: These results highlight the readiness of community pharmacists to adopt H. pylori screening into practice and to leverage this novel technology to positively identify and treat undiagnosed H. pylori infection. Can Pharm J (Ott) 2020;153:xx-xx.


2017 ◽  
Vol 51 (12) ◽  
pp. 1069-1076 ◽  
Author(s):  
Mark A. Munger ◽  
Michael Walsh ◽  
Jon Godin ◽  
Michael Feehan

Background: The US population continues to expand providing the need for primary health care services. Community pharmacies integrated with medicine may provide greater access while providing high quality care. Objective: To gauge pharmacists’ demand for primary health care services delivered through community pharmacies. Methods: An online survey was administered to determine community pharmacists’ preferences for varying primary care services that could be offered in the community pharmacy setting. A Discrete Choice Experiment was employed to show pharmacists competing scenarios with varied primary care service offerings in the community pharmacy setting. Attributes evaluated were operation hours, service provider, medical records, service logistics, physical examinations, point-of-care diagnostic testing, preventative care, and drug prescribing. Respondents chose the scenario most likely to induce switching employment from base pharmacy to one providing advanced services. Results: The optimal service delivery model from 291 community pharmacists comprised: inclusion of patient prescriptions and health information into the patient’s medical record; provision of point of care testing and vital sign, including blood pressure, heart rate and breathing rate, and blood sugar and cholesterol measurement; and pharmacists prescribing (under physician oversight). Pharmacists were 4 times more likely to switch employment from their current pharmacy to their choice for advanced pharmacy services. Pharmacist demand was highest among those with a PharmD, less experience, working >40 hours per week, and in rural areas. Conclusions: This study provides empirical support for the model of pharmacists playing a greater role in the provision of primary care health services through community pharmacy settings.


1992 ◽  
Vol 8 (3) ◽  
pp. 119-124
Author(s):  
Edward D. Sumner ◽  
Ronald P. Durand ◽  
Carol J. Lancaster ◽  
George E. Dickinson

Objective: To determine pharmacists' perceptions of the influence of older patients on community pharmacy practice. Data Sources: A mailing list obtained from the South Carolina Board of Pharmacy provided names of community pharmacists by practice setting and gender. Design: A questionnaire was mailed in July 1990 to a random sample of community pharmacists in South Carolina. The questionnaire contained 41 Likert-type opinion statements. Demographic questions relating to practice type and location, pharmacists' educational experiences, and position were included. Data Synthesis: The opinion statements were examined by grouping respondents on the basis of demographic information. Analysis of variance or Student's t-test was used to look for differences among survey responses among various groups of pharmacists. Scheffe's test was used to compare means when the groups were significantly different. The a priori level of significance was 0.05. Critical values were adjusted by the number of statements considered to preserve the error rate at five percent (Bonferroni procedure). Conclusions: The strongest indicator of the impact of the elderly population on community pharmacy is pharmacists' perceived need for more continuing education in geriatrics and gerontology. Economic problems, physician overprescribing, and patient compliance were ranked as the three most difficult aspects of geriatric pharmacy. This study reinforces the need to incorporate geriatric/gerontology education into every pharmacy curriculum.


2021 ◽  
pp. 875512252110211
Author(s):  
Michael A. Biddle ◽  
Kailyn K. Cleveland ◽  
Shanna K. O’Connor ◽  
Hayli Hruza ◽  
Madeline Foster ◽  
...  

Background: The role of Idaho and Alaska pharmacists in providing health care services has steadily broadened over recent years. With many new pharmacist-provided health care service possibilities, this study assessed the impact of these advancements on community pharmacies. Objective: The objective of this study was to identify current pharmacist-provided health care services and pharmacist-perceived barriers to providing and billing for these services in Idaho and Alaska community pharmacies. Methods: A questionnaire was developed focusing on 2 areas: providing services and billing for services. Pharmacy students on experiential rotations administered the questionnaires to pharmacists at their rotation sites. Pharmacists at community pharmacy practice sites in Idaho and Alaska completed the questionnaire in an interview format conducted by students. Likert-type scale data were analyzed using descriptive statistics. Because the study did not include a comparator group, no power calculation was conducted. All open-response answers were analyzed independently by 2 researchers and discrepancies in coding open-ended questions were resolved by discussion with a group of 4 researchers. Results: Most pharmacists reported that they already provide non-dispensing services, desired to implement new services, and had confidence in their team’s ability to handle new services. Time and resources were the most cited barriers to providing new services; compensation, company support, and education were the most cited barriers to billing for services. Conclusions: Community pharmacists already provide non-dispensing services and many are looking to provide more services, but barriers of time, resources, compensation, company support, and education will need to be overcome to move forward.


2011 ◽  
Vol 2 (2) ◽  
Author(s):  
Timothy McPherson ◽  
Patrick Fontane

Leaders in the profession of pharmacy have articulated a vision of pharmacists as providers of patient-centered care (PCC) services and the Doctor of Pharmacy was established as the required practice degree to achieve this vision. Pharmacist-provided PCC services have been shown to reduce medication costs and improve patient compliance with therapies. While community pharmacists are capable of, and are ideally placed for, providing PCC services, in fact they devote most of their time to prescription dispensing rather than direct patient care. As professionals, community pharmacists are charged with protecting society by providing expert services to help consumers manage risks associated with drug therapies. Historically pharmacists fulfilled this responsibility by accurately dispensing prescription medications, verifying doses, and allergy checking. This limited view of pharmacy practice is insufficient in light of the modern view of pharmacists as providers of PCC. The consumers' view of community pharmacy as a profession represents a barrier to transforming the basis of community pharmacy from product distribution to providing PCC services. Community pharmacists are conferred with social authority to dictate the manner in which their professional services are provided. Pharmacists can therefore facilitate the transition to PCC as the primary function of community pharmacy by exercising their social authority to engage consumers in their roles in the new patient-pharmacist relationship. Each pharmacist must decide to provide PCC services. Suggestions for initiating PCC services in community pharmacy are offered.   Type: Idea Paper


2017 ◽  
Vol 31 (6) ◽  
pp. 629-635 ◽  
Author(s):  
Emily A. Steltenpohl ◽  
Brandon K. Barry ◽  
Kim C. Coley ◽  
Melissa S. McGivney ◽  
Julie L. Olenak ◽  
...  

Background Clinical Laboratory Improvement Amendments (CLIA)-waived tests allow for quick, accurate, and noninvasive laboratory testing. Community pharmacists utilize CLIA-waived tests to provide clinical services such as point-of-care (POC) testing to help manage chronic disease and acute illness. Objective To identify key themes in the successful delivery of POC testing services by community pharmacists in Pennsylvania. Results An initial search identified 51 Pennsylvania pharmacies with a CLIA waiver. Of these, five independent pharmacies met inclusion criteria, three of which completed interviews. The remaining 38 chain pharmacies were represented by three interviews. In total, five key themes were identified as essential to POC testing services: (1) utilize state resources and professional connections to navigate federal and state regulations, (2) establish relationships with physician partners (3) offer tests that are meaningful to patients and their physicians, (4) evaluate financial impact, workflow adaptations, and marketing approaches when implementing POC testing services, and (5) focus on individualized attention and convenience of community pharmacy-based POC testing to improve patient satisfaction. Conclusion Successful POC testing services in community pharmacy practice rely on utilizing resources, partnering with known physicians, selecting meaningful tests for patients, and analyzing finances, workflow, and marketing to provide individualized attention and convenient care.


2021 ◽  
Vol 11 (2) ◽  
pp. 113-122
Author(s):  
T.T. Muhammed Anwar ◽  
G.R. Rajalakshmi

Drugs are the prime member of any disease prevention plans and ailment treatment programmes. Pharmacists are the health professionals appointed by relevant authorities for safe and efficacious use of drugs, since they are the specially upskilled and trained personnel for controlling, organizing and distribution of medicines. Medicine alone does not provide desired treatment output. In order to achieve the optimal treatment goals pharmacist must provide enhanced drug related needs and ensure the services are of proper quality. This study aims to assess the Good Pharmacy Practice among community pharmacist, determine the frequency of ethical dilemma at community pharmacy settings and to assess the reasons why community pharmacists may compromise ethical values.It was a descriptive cross - sectional study carried out in different community pharmacies in Kozhikode district of Kerala. The study was executed in 6 months time period. The sample size was 115 community pharmacists working in Kozhikode district. Total of 120 subjects were enrolled and data were collected using a validated self-administered questionnaire. The result shows that most of the pharmacists were providing quality services to the patients and they are facing various ethical dilemma situations in their day today life. They were facing ethical dilemma situation at least once in three months. Community pharmacists compromise on ethical values and ethical issues mainly for protecting their job. The physicians request and employer’s invasion into their activities has a great role in ethical dilemma situations and thus violating the rules. Keywords: GPP, community pharmacy, ethical dilemma, pharmacy services.


2020 ◽  
Vol 18 (4) ◽  
pp. 2224
Author(s):  
Martin C. Henman

Ireland is small country with a population of 4.8M which spent 6.9% of its gross domestic product on healthcare in 2018. Health services are provided through a twin track approach – all public services are largely free to those eligible (32.44% in 2019) and private patients pay for most services. Most of the expenditure on medicines is paid by the government while visits to General Practitioners (GPs) are an out-of-pocket expense for private patients under 70 years of age, and private health insurance provides cover for most hospital services. Healthcare professionals in the primary care sector contract to provide public services with the Health Services Executive (HSE) which is responsible for the day-to-day running of the service. Primary care teams began to be formed in 2001 to try to link and integrate the provision of care but since these are led by GPs neither community pharmacists nor dentists joined these teams. The focus of policy remained the primary care team until a proposal to create a public health service to provide universal health coverage called Sláintecare was agreed in 2017. However, implementation of Sláintecare has been slow and piecemeal. The government regularly devises policies to control prescribing and the HSE, together with other regulators has implemented generic substitution and preferred drugs and limited access to expensive drugs through schemes for particular patient groups. A programme called Healthy Ireland has taken on the health promotion policies but pharmacists have been excluded from most programmes although some campaigns have included them. Community pharmacy organisations have tried to develop pharmacy services and while a few which are targeted at specified patient groups, such as opioid substitution, emergency administration of certain drugs, emergency hormonal contraception and seasonal influenza vaccination have been remunerated for public patients by the HSE, other services have not. GP organisations defend their members’ scope of practice and seek to influence policy makers to channel schemes and services through general practice. There is no professional body to represent pharmacists that is independent of any trade union responsibilities and this has weakened the profession’s advocacy. Pharmacists are one of the most trusted group of professionals in Ireland and have maintained their practices throughout periods of recession and declining income from government. Whether pharmacists can argue that the optimisation of a patient’s medicines depends upon their contribution and will benefit the health service remains an open question.


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