Scottish pharmacists’ views and attitudes towards continuing professional development

Objectives To summarise Scottish pharmacists’ views and attitudes towards Continuing Professional Development (CPD). Setting Random sample of RPSGB registered Scottish pharmacists. Method A postal questionnaire of pharmacists’ CPD activity, views and attitudes was developed, piloted and sent to 2420 pharmacists. Questions were collated to produce total scores and to rate pharmacists’ motivation and attitudes to CPD separately. The number of CPD hours reported by sector and gender were compared (‘t’ test) and differences identified between hospital, community and primary care in relation to mean motivational attitudinal scores (Mann-Whitney test). Results Five hundred and forty three pharmacists completed the questionnaire (22.4% response rate). In this study 9.8% of the pharmacists reported spending no time on CPD. Comparisons of hours showed primary care pharmacists and hospital pharmacists reported similar times spent on CPD and significantly more time than community pharmacists (68 h and 66 h vs 45 h; P < 0.05). No statistically significant differences between genders were revealed. Internal reliability on motivation and attitude scores ranged from 0.74–0.83 (Cronbach’s alpha). Although scores were similar across sectors of practice in terms of motivation and attitudinal questions, statistical differences were consistent; showing higher scores for separate motivation and attitude among pharmacists in primary care than in hospital or community practice sectors (Mann Whitney test; P < 0.001). Community pharmacists had a statistically significantly lower attitude score than pharmacists in hospital or primary care sectors (Mann Whitney test; P < 0.001). Conclusion There is a section of pharmacists still not participating in CPD. Primary care pharmacists reported most motivation and scored highest in attitude score. Community pharmacists appear to be the sector requiring most support to increase not only their motivation to CPD but also their confidence and ability in participation.     

Perceived barriers to participating in continuing education: the views of newly registered community pharmacists

Objective — The main aim of this study was to explore newly registered community pharmacists' attitudes to the current provision of continuing education (CE) and to identify key factors that act as motivators and barriers to participation in CE. Method — Eight focus groups of newly registered pharmacists were set up. All focus groups were tape‐recorded and transcribed verbatim. The results presented in this paper focus specifically on the barriers to participation in CE. Setting — Four geographical areas of England. Key findings — The main barrier identified by the pharmacists was competing demands on their time, both in and out of work. Participants felt disillusioned with further study, describing this stage of their lives as a “honeymoon period” in which they sought to make adjustments in both their professional and personal lives. They also felt disillusioned with the reality of community pharmacy and offered this as an explanation for their lack of involvement in CE. In addition, many pharmacists believed themselves to be at the peak of their pharmaceutical knowledge, thus not requiring CE. Rather, it was felt that they needed to develop their skills in other areas such as communication skills or applying pharmaceutical knowledge in practice. It was suggested that this could only be remedied through working with and learning from more experienced pharmacists, rather than undertaking formal CE activities. Conclusion — Non‐participation in CE may be seen to result from a complex web of factors which do not easily map on to policies to increase participation of newly registered pharmacists in CE activities. Nevertheless, if newly registered community pharmacists are to achieve the continuity of learning necessary for continuing professional development, education providers will need to address their specific learning needs in the period following registration.     

Community pharmacists’ views on adverse drug reactions reporting in Malaysia: a pilot study

Objectives To investigate community pharmacists’ knowledge, attitudes and views on adverse drug reaction (ADR) reporting. Setting Seven community pharmacies in Malaysia. Method Structured interviews with community pharmacists. Informed consent was obtained and interviews were audio-recorded and transcribed verbatim. Main Outcome Measures Content analysis of themes on awareness of ADR reporting, reporting activities, attitudes and views on patient reporting. Results All pharmacists claimed to have some knowledge of a reporting system but only one had submitted a report directly to the regulatory authority. Despite the low level of reporting activities, all participants agreed that it was part of their professional obligation to report an ADR. Most participants were not aware of the direct patient reporting scheme and were skeptical about its success. Lack of awareness and patients’ limited knowledge about their medications were viewed as barriers to patient reporting. Local attitudinal issues including pharmacists’ attitude towards ADR reporting were described as possible contributing factors. Conclusion Community pharmacists have an important role in reporting ADRs. Many Malaysian patients are still perceived to be ill-informed of their medications, an important determinant to the success of patient reporting. There is a need for further training about ADRs and ADR reporting for health professionals and further education for patients.     

Managing obesity in pharmacy: the Australian experience

Objective To explore pharmacists’ opinions about the provision of weight management services in community pharmacy and their attitudes towards the establishment of an accredited training course in weight management in pharmacy. Setting Interviews were conducted with practising pharmacists on site in various community pharmacies in metropolitan Sydney, Australia. Method In-depth, semi-structured interviews with twenty practising pharmacists were conducted. Of the twenty interviewed pharmacists, sixteen were involved in the provision of one or more pharmacy based weight management programs in their pharmacies. Interviews were audio-recorded, transcribed and analysed using the grounded theory approach. Main outcome measure The data were thematically analysed to identify facilitators and perceived barriers to the provision of high quality services, and pharmacists’ willingness to undertake training and accreditation. Results Participants clearly perceived a role for pharmacy in weight management. Key facilitators to provision of service were accessibility and the perception of pharmacists as trustworthy healthcare professionals. The pharmacists proposed collaboration with other healthcare professionals in order to provide a service incorporating diet, exercise and behavioural therapy. A program that was not-product-centred, and supported by ethical marketing was favoured. Appropriate training and accreditation were considered essential to assuring the quality of such services. Barriers to the provision of high quality services identified were: remuneration, pharmacy infrastructure, client demand and the current marketing of product-centred programs. Conclusion Australian pharmacists believe there is a role for pharmacy in weight management, provided training in accredited programs is made available. A holistic, evidence-based, multi-disciplinary service model has been identified as ideal.     

Concordance-based adherence support service delivery: consumer perspectives

Objectives: To explore consumers’ attitudes towards, and expectations of, adherence support services in primary health care, specifically in community pharmacy; and to explore consumers’ attitudes towards the concept of concordance. Setting: An exploratory qualitative study conducted in Metropolitan Sydney, Australia. Method: Three focus group discussions with consumers on chronic therapy (n = 22) and two focus groups with consumer representatives (n = 15) were conducted in 2002. Consumer representatives were peer educators volunteering in an association which promotes quality use of medicines among elderly patients. All discussions were audio-taped, transcribed verbatim and thematically content analysed. Main outcome measures: Consumers’ experiences with adherence support services delivered by general practitioners and pharmacists, their expectations towards general practitioners’ and pharmacists’ role in adherence support; and attitudes towards concordance in consultations. Results: Participants expected an increased provision of medicine information and a reduction in the number of medications taken as the main strategies to promote adherence. They believed that once understandable information had been delivered, it was their responsibility to take their medications as prescribed. Yet participants frequently complained about the information received, especially from doctors. Only a subgroup of participants expected pharmacists to be involved in adherence support services. These participants generally relied on pharmacists for medicine information and were satisfied with the communication process when interacting with the pharmacists. All participants were positive about concordance, because they valued two-way communication and increased consideration of their needs and beliefs by healthcare professionals. However, they were hesitant about being involved in a shared treatment decision-making process. Many participants focused on concordance with doctors and identified barriers to the establishment of concordance: time pressures, financial constraints, the gap of competence and power between patients and doctors. Conclusions: Pharmacists should consider consumers’ needs for information and establishing concordance, as well as their expectations of the pharmacy profession, in delivering concordance based adherence support services. Given participants’ high demand for medicine information, an opportunity might exist for pharmacists to influence consumers’ expectations by offering information which is tailored towards their needs.     

Continuing education needs assessment of pharmacists in the United Arab Emirates

Objective The main objective of this study was to offer an insight on the issue of continuing education (CE) in the UAE and to determine the type and format of CE pharmacists in this country prefer to attend and consider most effective. Methods A multi-theme survey was developed to find the reasons pharmacists choose to attend different CE programs, the survey assessed continuing education needs and preferences of pharmacists. Survey items included the types of formats and topics pharmacists prefer to attend and think are most useful to enhance their knowledge and skill. Finally the survey explored some barriers pharmacists conceive as such to attending effective CE. Results One hundred thirty-two surveys were included in this study, the vast majority of the participants were bachelor’s degree holders who were 40 years and younger. The participant’s main types of employment were marketing and hospital practice. Pharmacists’ preferences as for the format and topic type for programs they would like to attend were identified and compared to other practice settings. Barriers to attending effective CE programs were also elicited. Conclusion: Interactive workshops were recognized as the most favorable format for CE in this study, computer and internet-based formats were also ranked highly by participants followed by live-in person and printed material-based programs. Topics covering innovations in pharmacy practice and disease management were at the top of priorities for pharmacists who would also like to see more certificate programs be offered to them.     

The changing roles of pharmacists in community pharmacies: perception of reality in India

Aim of the review To summarise the state of community pharmacy in India including: the provision of patient care, pharmacy education, the pharmaceutical market, healthcare delivery, community pharmacy services, the professional role of community pharmacists, and future developments. Method Medline, Scirus, and Google Scholar databases and the journals “Indian Journal of Pharmaceutical Sciences” and “Indian Journal of Hospital Pharmacy” were searched up to the end of December 2008. In addition to these, other available sources were used to identify relevant articles. Results India has a fast growing pharmaceutical industry sector and a need for well educated pharmacists. Domestic sale of medicines is estimated to be $5 billion during 2006 and increasing. The supply of medicines to the population is undertaken by privately owned community pharmacies and sometimes also by hospital pharmacies. Community pharmacists are involved only in dispensing medicines. Community pharmacists have an opportunity to improve healthcare of the population, particularly of the disadvantaged section of the society that does not have the resources to visit clinics (both the poor and rural population). However, important barriers to the provision of pharmaceutical care exists, including lack of proper education and training of pharmacists, weak implementation of existing laws, and lack of recognition of the pharmacy as a profession by the other healthcare professionals. Conclusion The healthcare services in community pharmacies, currently insignificant, must undergo reforms to meet the changing needs of modern medicines users. The pharmacist’s role in patient care is expected to grow as professional and educational standards develop. Although pharmacists’ contributions to health care are not yet recognized, there is every reason to be optimistic toward making patient care in community pharmacy setting a success. For this, the educational system for pharmacists has to be adapted.     

Community pharmacists’ perceptions of medicines use reviews and quality assurance by peer review

Objectives To explore existing mechanism to ensure quality assurance of medicine use reviews (MURs), and to identify those parameters of an MUR that community pharmacists consider as indicators of quality. Setting Community pharmacists undertaking MURs in Cornwall, United Kingdom. Method A questionnaire was developed to investigate pharmacists’ attitudes towards MURs and towards quality assurance of MURs. Questionnaires were distributed during December 2008 to a sample of pharmacists in Cornwall accredited to provide the service. Main outcome measures Community pharmacists’ attitudes towards quality assurance of MURs. Results Fifty completed questionnaires were returned, a third of which were from locum pharmacists. The most frequently reported determinant for undertaking an MUR was the pharmacist’s judgement. Company policy to deliver MURs was acknowledged as a potential indicator of a sub-optimal MUR. Pharmacists shared a common sense of what constitutes a “poor” MUR but not what defines a quality one. Conclusion For peer review to operate as an effective mechanism to assure quality of MURs, pharmacists need to develop an effective forum to share their practice experiences.     

The effect of pharmacist education on asthma treatment plans for simulated patients

Objective To determine if an educational program designed for community pharmacists to help patients self manage their asthma could improve pharmacists abilities to facilitate asthma treatment plans. Setting Hamilton and Toronto, Ontario, Canada. Method A randomized controlled trial involving volunteer community pharmacists who received either an asthma education program (AEP; intervention group) or a delayed AEP (control group). The AEP consisted of a one-day workshop and two follow-up telephone calls. Teaching methods progressed from a didactic approach to self-directed learning and role playing with simulated patients (SPs). The primary outcome was measured by SPs who conducted unannounced pharmacy visits. Main Outcomes Measures The number of appropriate (defined a priori) action plans facilitated by the pharmacist was the primary outcome. Facilitated was defined as the pharmacist recommending a specific plan, taking responsibility for telephoning the physician, or ensuring the patient would take responsibility for contacting the physician. Results Thirty-three pharmacists were randomized to the intervention group and 31 pharmacists were randomized to the control group. Pharmacists in the intervention group facilitated an appropriate plan in 44.8% of situations (117 out of a possible 261) compared with 29.3% (79 out of a possible 270) in the control group, (mean difference 15.5% (95% CI: 7.4–23.8%; P = 0.0004)). Intervention group pharmacists were better able to facilitate plans for the ‘under use of inhaled corticosteroids,’ ‘exposure to pet dander as an asthma trigger,’ and ‘overuse of short-acting beta-agonist’ problems. Intervention group pharmacists exhibited better overall communication skills (including empathy, coherence, verbal skills, and nonverbal skills). Conclusion This AEP produced improvements in pharmacists’ abilities to facilitate plans for SPs in a community pharmacy setting.