General practitioners’ experiences with, views of, and attitudes towards, general practice-based pharmacists: a cross-sectional survey

Background There is limited United Kingdom (UK) literature on general practice-based pharmacists’ (PBPs’) role evolution and few studies have explored general practitioners’ (GPs’) experiences on pharmacist integration into general practice. Therefore, this study aimed to investigate GPs’ experiences with, views of, and attitudes towards PBPs in Northern Ireland (NI). Methods A paper-based self-administered questionnaire comprising four sections was mailed in 2019 to 329 general practices across NI and was completed by one GP in every practice who had most contact with the PBP. Descriptive analyses were used and responses to open-ended questions were analysed thematically. Results The response rate was 61.7% (203/329). There was at least one PBP per general practice. All GPs had face-to-face meetings with PBPs, with three-quarters (78.7%, n = 159) meeting with the PBP more than once a week. Approximately two-thirds of GPs (62.4%, n = 126) reported that PBPs were qualified as independent prescribers, and 76.2% of these (n = 96/126) indicated that prescribers were currently prescribing for patients. The majority of GPs reported that PBPs always/very often had the required clinical skills (83.6%, n = 162) and knowledge (87.0%, n = 167) to provide safe and effective care for patients. However, 31.1% (n = 61) stated that PBPs only sometimes had the confidence to make clinical decisions. The majority of GPs (> 85%) displayed largely positive attitudes towards collaboration with PBPs. Most GPs agreed/strongly agreed that PBPs will have a positive impact on patient outcomes (95.0%, n = 192) and can provide a better link between general practices and community pharmacists (96.1%, n = 194). However, 24.8% of GPs (n = 50) were unclear if the PBP role moved community pharmacists to the periphery of the primary care team. An evaluation of the free-text comments indicated that GPs were in favour of more PBP sessions and full-time posts. Conclusion Most GPs had positive views of, and attitudes towards, PBPs. The findings may have implications for future developments in order to extend integration of PBPs within general practice, including the enhancement of training in clinical skills and decision-making. Exploring PBPs’, community pharmacists’ and patients’ views of this role in general practice is required to corroborate study findings.

Living with COVID-19 and Sustaining a Tourism Recovery—Adopting a Front-Line Collaborative Response between the Tourism Industry and Community Pharmacists

While the COVID-19 pandemic evolves and new variants emerge, destinations and cities look to tourism recovery, cautiously rebooting and re-opening borders. Since the start of the pandemic, dramatic lockdowns have been employed, resulting in dire economic and social consequences to the tourism and hospitality industry and creating the need for a more feasible and sustainable response in the post-pandemic era. Pandemic vigilance and resilience at the societal level have become key in pandemic preparedness. However, due to the complexity of managing COVID-19, no clear cross-disciplinary collaborative framework for tourism recovery has been developed. Cross-sector collaboration to collectively integrate resources, capabilities, and experiences should be prioritised to spearhead tourism recovery plans. With insight on public health, pandemic preparedness, and community access, we hypothesised that cross-industry collaboration between the tourism industry and the pharmacist profession is relevant to the measures adopted for recovery from the COVID-19 pandemic. To examine this hypothesis, this study aimed to explore perceptions from key stakeholders in the tourism and the pharmacist sectors on cross-industry collaboration towards COVID-19 management and the “know-how” in developing, adopting, and advancing such a partnership. This exploratory study adopts and advances the ‘Four Cs’ conceptual framework of communication, cooperation, coordination, and collaboration. In terms of our hypothesis, interview responses with tourism executives and CPs confirm the framework’s suitability and the importance of an interdisciplinary collaborative approach between CPs and the tourism sector to craft a sustainable pathway to recovery from COVID-19 and future pandemic measures as borders re-open and international mobility increases. A tourism recovery strategy from this pandemic can occur more judiciously through a collaborative partnership with an extensive network of pharmacists within communities and popular tourism sites, as CPs have valuable healthcare resources and the ability to track and communicate healthcare alerts to tourism destination recovery efforts.

Sleep Medication in Older Adults: Identifying the Need for Support by a Community Pharmacist

Many older adults take benzodiazepines and sedative-hypnotics for the treatment of sleep disorders. With a view to considering the possible discontinuation of hypnotics, the objectives of the present study were to describe bedtime habits and sleep patterns in older adults and to identify the sleep medications taken. An expert group developed a structured interview guide for assessing the patients’ bedtime habits, sleep patterns, and medications. During an internship in a community pharmacy, 103 sixth-year pharmacy students conducted around 10 interviews each with older adults (aged 65 or over) complaining of sleep disorders and taking at least one of the following medications: benzodiazepines, benzodiazepine derivatives (“Z-drugs”), antihistamines, and melatonin. A prospective, observational study was carried out from 4 January to 30 June 2016. The pharmacy students performed 960 interviews (with 330 men and 630 women; mean ± standard deviation age: 75.1 ± 8.8). The most commonly taken hypnotics were the Z-drugs zolpidem (n = 465, 48%) and zopiclone (n = 259, 27%). The vast majority of patients (n = 768, 80%) had only ever taken a single hypnotic medication. The median [interquartile range] prescription duration was 120 (48–180) months. About 75% (n = 696) of the patients had at least 1 poor sleep habit, and over 41% (n = 374) had 2 or more poor sleep habits. A total of 742 of the patients (77%) reported getting up at night—mainly due to nycturia (n = 481, 51%). Further, 330 of the patients (35%) stated that they were keen to discontinue their medication, of which 96 (29%) authorized the pharmacist to contact their family physician and discuss discontinuation. In France, pharmacy students and supervising community pharmacists can identify problems related to sleep disorders by asking simple questions about the patient’s sleep patterns. Together with family physicians, community pharmacists can encourage patients to discuss their hypnotic medications.

Evaluation of Community Pharmacists Knowledge, Attitude and Practice towards Modified Release Dosage Forms

Purpose:To evaluate knowledge, practice and attitude of community pharmacists in Basra regarding modified release dosage forms which are widely used for many therapeutic purposes in pharmacy practice. Methods:The current study was conducted among certified pharmacists in Basra governorate- south of Iraq. Data collection was carried out by a questionnaire. Results:A total number of 175 community pharmacists responded to the questionnaire. The majority worked in OTC based dispensing pharmacies located in the center of the city. Most respondents missed K1 and were unable to state the difference between different types of modified products. There was a major positive agreement towards medical representatives' rule in promoting the prescribing of modified release products by physicians. Avoiding crushing and breaking of solid oral modified release drugs were identified by the majority of participants. Correlation analysis showed a 22.8 correlation coefficient between knowledge and attitude which was statistically significant. Males showed statistically significant higher knowledge and practice scores than females. Conclusions:The conduction of a brief educational program would be very beneficial in bringing basic theoretical knowledge with practicing points of interest and promote a more positive attitude toward this unique class of novel drug delivery system.

Community Pharmacists’ Knowledge on Cancer and Screening Methods

Background and Objective The aim of the study is to evaluate the knowledge of community pharmacists on cancer and screening methods. Setting and Method This study was a descriptive cross-sectional study and was conducted between January-June 2020 in Istanbul/Turkey. a structured questionnaire was applied to pharmacists as online. The questionnaire was prepared by the researchers and consisted of 49 questions; basic information about cancer (15 items), signs and symptoms (11 items), causes and risk factors (14 items), cancer screening methods (9 items). Results It was determined that the majority (>90%) of the pharmacists did not receive any education on cancer and/or cancer screening methods after graduation. The sufficient knowledge level of the pharmacists about cancer basics, signs and symptoms, and risk factors were found to be as 80%, 77%, and 67%, respectively. The internal consistency level of the questionnaire was calculated (Cronbach's alpha = 0.814). The item “Every woman should perform breast self-examination and notify a health professional when there is a change in breast appearance or feeling,” was answered correctly by 98% of the pharmacists. It was determined that 71% of the pharmacists gave the correct answer to the item “Women aged 21–30 years should have a PAP smear every 3 years”. Conclusion According to the results of the study, while the rate of sufficient knowledge level on cancer was found to be low, knowledge on cancer screening was found to be sufficient. We think that pharmacists should receive training on cancer and screening methods and to follow the guidelines closely.

Expanded Pharmacy Practice Implementation: Lessons from Remote Practice

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.

Provision of community pharmacy services during the first wave of COVID-19 pandemic in Estonia – experiences and future implications

The spread of COVID-19 outbreak in 2020 had significant impact on the functioning of the existing healthcare system and required fast adaption to new circumstances for continuing with daily practices. Community pharmacists shared responsibility of ensuring supply of medicines and medical devices, educating people on health related issues, providing pharmaceutical care etc. The aim of this study was to understand how the provision of community pharmacy services changed during the first wave of COVID-19 pandemic in spring of 2020 in Estonia. Qualitative in-depth semi-structured interviews were conducted. Recorded interviews with community pharmacists (n = 21) and experts (n =10) were transcribed verbatim and a systematic text condensation method for textual content analysis was performed. The findings indicated that a number of changes took place in provision of community pharmacy services to assure continuity in providing high-quality pharmacy services in crisis, including addressing difficulties in the supply of medicines; at the same time, to acquire new knowledge for counselling health related topics and personal protective equipment, and to provide psychological support to people in stress. Pandemic had an impact on the content and structure of traditional community pharmacy services in Estonia. The need for expanded professional role of pharmacists was clearly expressed in an emergency situation.