Health care professionals' perceptions of a community based ‘virtual ward’ medicines management service: A qualitative study

This article describes a qualitative research study using focus groups to explore the views and experiences of a medicines management team (MMT) on the service they deliver within a ‘Virtual Ward’ (VW); and those of the wider multidisciplinary team of healthcare professionals on the service provided by the MMT. Several themes emerged from the focus groups, including impact on patients and carers, team working and issues and challenges. A dedicated MMT was seen as a positive contribution to the VW, which potentially increased the quality of patient care, and appeared to be a positive experience for both the MM and wider multidisciplinary team.     

Determinants of community pharmacists’ information gathering and counseling practices during the management of minor ailments

ObjectiveTo assess the determinants of community pharmacists’ information gathering and counseling practices during the management of minor ailments in Qatar.MethodA cross-sectional study of 305 community pharmacists was conducted with a pre-tested 27-item questionnaire. Bivariate logistic regression was used to identify the determinants of information gathering and counseling practices.ResultsThe response rate was 92.5% (282/305). A majority of the respondents (68.1%) were males, within the age range of 31–40 years (55.3%), work for chains pharmacies (77.3%), and were predominantly of foreign nationalities (94.7%). Patients’ identity (91.1%), age (92.2%), symptoms (92.6%) and duration of symptoms (89.3%) were most frequent information gathered, while dose (99%), frequency (97.8%), route of administration (95.7%), and duration of use (92.9%) were the most frequent counseling information. Median information gathering score was significantly higher in females and among community pharmacists in chain pharmacies (p < 0.05), while median counseling practice scores were significantly higher among in chain pharmacies (p < 0.05). Consultation time of 6–10 min (OR = 1.75, 95% CI: 1.02–3.0, p = 0.04) and female gender (OR = 2.10, 95% CI: 1.16–3.79, p = 0.01) were significant determinants of information gathering, while age group (31–40 years) (OR = 1.84, 95% CI: 1.05–3.22, p = 0.03) and consultation time (6–10 min) (OR = 2.24, 95% CI: 1.31–3.86, p = 0.003) were significant determinants of counseling practices.ConclusionThe significant determinants of community pharmacists’ Information gathering and counseling practices during the management of minor ailments were female gender and consultation time (6–10 min), and age group (31–40 years) and consultation time (6–10 min) respectively.     

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.     

Pharmacists’ perceptions of the pharmacists’ patient care process and performance in a simulated patient interaction

ObjectivesTo (1) evaluate the use of the pharmacists’ patient care process (PPCP) by licensed pharmacists through a simulated patient activity and (2) describe pharmacists’ awareness and perceptions of the PPCP in the state of Arizona.DesignInterviews were conducted to elicit pharmacists’ perceptions and awareness of the PPCP. A simulated patient activity involved a role-play pharmacist-patient interaction in a community pharmacy setting. The PPCP was employed as the evaluative framework to assess pharmacist behavior.Setting and participantsPharmacists licensed in the state of Arizona practicing in various pharmacy settings were recruited through e-mail list serves and snowball recruitment. Data were collected in person, by telephone, and via video chat.Outcome measuresEmergent qualitative themes from interviews were used to describe pharmacists’ awareness and perceptions of the PPCP. The presence or absence of PPCP elements were assessed during the simulations.ResultsA total of 17 pharmacists were interviewed; 16 participated in the simulated activity. Of these, 7 (41.2%) participants recalled specific details regarding the PPCP process. Participants felt that the PPCP accurately reflected their daily workflow. Accordingly, a mean of 15.8 of the 19 PPCP elements was observed in simulated pharmacist-patient interactions, still allowing room for improvement in pharmacist-led care planning. Participants indicated perceived value in a shared patient care process that facilitates collaboration with myriad health professionals and as an aid to leverage pharmacists’ role on health care teams.ConclusionIn this study, pharmacists practicing in Arizona in various settings expressed an awareness of the PPCP, felt it accurately reflected the work they do, and expressed that the tool potentially added value to their work.     

General practitioners’ perceptions of the current status and pharmacists’ contribution to primary care in Iceland

International Journal of Clinical Pharmacy - Background For the past several years pharmacists’ responsibilities have expanded globally from traditional tasks of dispensing medications to...     

Patients’ perceptions of pharmacist-managed diabetes services in the ambulatory care and community settings within Singapore

Background Qualitative evidence on patients’ perceptions of pharmacist-managed diabetes services (PMDSs) is limited. Objective To explore patients’ perceptions of PMDSs Setting Patients being cared for in the outpatient settings in Singapore. Methods This focus group included patients who were diagnosed with type 2 diabetes, spoke either English or Mandarin, attended PMDSs for at least 6 months in the ambulatory care or community settings, and were at least 21 years of age. Patients with cognitive impairments or mobility issues were excluded. Thematic analysis of transcribed audio recordings was undertaken. Main outcomes measure Patients’ care experiences with PMDSs. Results A total of 26 patients from two outpatient ambulatory care clinics and three retail pharmacies were assembled into four focus groups based on the care setting. Four themes abstracted from focus group data illustrated patients’ perspectives on PMDSs in fulfilling their health needs, delivery and quality of service, changes attributed to the service, and suggestions for improvement of service. The patients highlighted that PMDSs fulfilled their need for information on diabetes. They also felt comfortable speaking to the pharmacists about their health, and they appreciated the role of the pharmacists as healthcare professionals. Furthermore, the patients reported better diabetes-related self-empowerment via increased medication knowledge and lifestyle modification. Some of the patients noted that medication adherence and glycemic control had improved. Suggestions to improve PMDSs were minimal. Conclusions Overall, patients with type 2 diabetes had positive perceptions of PMDSs regardless of the care settings.     

An evaluation of consumers’ knowledge, perceptions and attitudes regarding generic medicines in Auckland

Objectives The aim of this project was to evaluate the perceptions, knowledge and attitudes regarding generic medicines. Methods A cross-sectional study, with self administered questionnaires, was conducted to survey consumers visiting pharmacies in four regions of Auckland (North Shore, Waitakere, Central Auckland and South Auckland). Through stratified random sampling, approximately 10% of pharmacies from each region were selected, which turn out to be 30 pharmacies. Every alternate customer coming to the pharmacy, who was eligible to participate in the study, was asked by the researchers to complete the questionnaire. Results A total of 441 questionnaires were included in the analysis. Different response rates were obtained in different regions of Auckland. Of all respondents, 51.6% had previous knowledge of generic medicines. Pharmacists were the main source of information regarding generic medicines followed by doctors and media. A higher level of education had a direct relationship with having correct knowledge of generics (P = .002). Attitude of participants toward the use of generic medicines was determined by their knowledge of generics, whether it was recommended by a pharmacist and their type of illness. Participants were more prepared to change to a generic for a minor illness (79%) than for a major illness (58.7%). Those who had better knowledge were more likely than those with poor knowledge to say they would to use a generic in major illness (P = .001) as well as minor illness (P < .0001). Previous positive experiences with generics also determined consumers’ willingness to use generics. Conclusion Many consumers have misconceptions regarding generic medicines. Having knowledge about generics and the advice by doctors and pharmacists are key indicators to improve the quality use of generic medicines.     

Predictors of enablers and barriers to community pharmacists’ management of minor ailments in a developing setting: A theory-driven assessment

BackgroundThe clinical and financial burdens associated with minor ailments are well documented, but published evidence suggests that minor ailment services led by community pharmacists have a remarkable positive impact, mainly in developed settings. There is a paucity of evidence on community pharmacists’ self-perceived enablers and barriers to the effective management of minor ailments.ObjectivesThe objective of the study was to identify community pharmacists’ self-perceived enablers and barriers to the effective management of minor ailments as well as their significant predictors.MethodsA Kurt Lewin’s theory-driven cross-sectional survey of 305 community pharmacists was conducted in Qatar using a pretested 25-item structured questionnaire developed with an adapted conceptual framework focused on 4 key areas: education, regulation, practice, and research. Bivariate logistic regression was used to identify significant predictors of community pharmacists’ self-perceived enablers and barriers.ResultsThe response rate was 92.5% (282/305). Most of the respondents (68.1%) were males, who were 31-40 years of age (55.3%) and worked for pharmacy chains (77.3%). Community pharmacists identified a higher proportion of enablers (positive force) (82.4%) relative to only 3 barriers (negative force) (17.6%). The barriers identified included insufficient private or semiprivate space for patient counseling, the paucity of invitations to participate in practice-based research, and lack of feedback regarding the results and recommendations of previous research in which they were participants. The significant predictors of self-perceived enablers and barriers were female gender (odds ratio [OR], 2.21; 95% CI, 1.25-3.91; P = 0.007) and age group of ≤40 years (OR, 4.74; 95% CI, 3.50-7.16; P = 0.006).ConclusionCommunity pharmacists’ perceptions of the factors that enhance their effective management of minor ailments were overwhelmingly positive, as 14 enablers were identified relative to only 3 barriers. Female and young community pharmacists were significantly more likely to perceive enablers than barriers. The insights provided are potentially useful in developing pharmacy-based schemes to improve the effective management of minor ailments.     

Effects of economic recession on elderly patients’ perceptions of access to health care and medicines in Portugal

Background In view of the current financial and demographic situation in Portugal, accessibility to health care may be affected, including the ability to adhere to medication. Objective To evaluate the perceived effects of the crisis on elderly patient’s access to medicines and medical care, and its implications on medicine-taking behaviour. Setting Community pharmacy. Method A cross-sectional study was undertaken during April 2013, where elderly patients answered a self-administered questionnaire based on their health-related experiences in the current and previous year. Binary logistic regression was used to ascertain the effects of potential predictors on the likelihood of adherence. Main outcome measures self-reported adherence. Results A total of 1231 questionnaires were collected. 27.3% of patients had stopped using treatments or health services in the previous year for financial motives; mostly private medical appointments, followed by dentist appointments. Almost 30% of patients stopped purchasing prescribed medicines. Over 20% of patients reduced their use of public services. Out-of-pocket expenses with medicines were considered higher in the current year by 40.1% of patients. The most common strategy developed to cope with increasing costs of medicines was generic substitution, but around 15% of patients also stopped taking their medication or started saving by increasing the interdose interval. Conclusion Reports of decreasing costs with medicines was associated with a decreased likelihood of adherence (OR 0.42; 95% CI 0.27–0.65). Lower perceived health status and having 3 or more co-morbidities were associated with lower odds of adhering, whilst less frequent medical appointments was associated with a higher likelihood of exhibiting adherence.     

Knowledge and pharmacological management of Alzheimer’s disease by managing community pharmacists: a nationwide study

Background Managing community pharmacists can play a leading role in supporting community dwelling individuals with Alzheimer’s disease and their caregivers. Objective The main purpose of this study was to assess knowledge of managing community pharmacists towards Alzheimer’s disease and its pharmacological management. Setting Community pharmacies in the Maltese islands. Method A nationwide survey was conducted with full-time managing community pharmacists in possession of a tertiary education degree in pharmacy studies. The level of knowledge was investigated using the Alzheimer’s Disease Knowledge Scale and the Alzheimer’s Disease Pharmacotherapy Measure. Participants were also asked to rate a number of statements related to disease management. Results Maltese managing community pharmacists (57 % response rate) had inadequate knowledge on risk factors, caregiving issues and pharmacological management of Alzheimer’s disease. Age and number of years working in a community pharmacy setting were found to be negatively correlated with increased knowledge. Conclusion The findings highlight the need of providing training and continued educational support to managing community pharmacists in order to provide quality advice to individuals with dementia and their caregivers in the community.     

Turkish community pharmacists’ behavioral determinants in provision of pharmaceutical care to elderly patients

International Journal of Clinical Pharmacy - Background It is crucial to develop and implement community pharmacist-led pharmaceutical care services in primary care that could prevent and detect...