North Carolina family practice physicians' perceptions of pharmacists as vaccinators.

OBJECTIVE: To determine whether family practice physicians are aware that pharmacists can administer vaccines and assess their support of pharmacists as vaccinators. DESIGN: Cross-sectional study. SETTING: North Carolina. PARTICIPANTS: 571 family practice physicians. INTERVENTIONS: Mail survey. MAIN OUTCOME MEASURES: Physician attitudes toward pharmacists' involvement with a variety of vaccines and patient populations. RESULTS: A total of 25% of physicians correctly reported that pharmacists could administer vaccines in North Carolina, a state that had recently passed legislation permitting this practice. Almost 50% of the physicians supported pharmacists administering the influenza vaccine. Pharmacist administration of other vaccines received less support. Physicians who were newer to family practice had more positive attitudes than physicians who were in practice for longer periods of time. CONCLUSION: While agreeing that the role of the pharmacist in patient care is becoming more important, physicians were neither very knowledgeable about nor supportive of pharmacists as vaccinators.     

Physician perceptions of clinical pharmacy encounters in a family practice clinic

The purpose of this study was to classify pharmacist-physician encounters in a family medicine center into three progressive levels of service in order to determine the physician's perception of the relative value of each level. The three levels of service were drug information, pharmacy consultation individualized to the patient, and pharmaceutical care-consultation with follow-up to monitor patient outcome. Physicians received a questionnaire with each encounter and were asked to rank questions regarding the quality of the information provided, the impact they perceived that the information had on patient care, and to assign a monetary value for each encounter. A total of 106 of 141 (75 percent) questionnaires suitable for analysis were stratified into drug information (25.5 percent), pharmacy consultation (49 percent), and pharmaceutical care (25.5 percent). Physicians' perceptions toward the quality, impact, and value of pharmacy services were favorable overall, but they perceived a significantly higher quality, impact, and value to pharmaceutical care encounters than for drug information and pharmacy consultation (p < 0.05).     

Development of innovative simulation teaching for advanced general practice clinical pharmacists

International Journal of Clinical Pharmacy - Background. Advanced General Practice Clinical Pharmacists (GPCPs) are expected to manage patients by undertaking clinical assessment then make safe,...     

Family practice physicians' perceptions of the usefulness of drug therapy recommendations from clinical pharmacists

Family practice physicians' perceptions of the usefulness and clinical outcome of drug therapy recommendations made by clinical pharmacists in a family medicine clinic were determined. For 15 weeks, pharmacists in the clinic recorded all consultations in which they made recommendations about the drug therapy of specific patients. At the time of each consultation, the pharmacists gave the physician a questionnaire designed to gauge the physician's opinion of the usefulness of the consultation. Physicians who implemented the recommendations were sent a second questionnaire and asked to indicate the extent to which the clinical pharmacist influenced their decision to implement the recommendation, the effect the recommendation had on the patient's clinical status, and the usefulness of the recommendation to the patient in ways unrelated to clinical status (such as greater patient acceptance, safety, or lower cost). Five clinical pharmacists provided 59 consultations to 33 physicians. The physicians rated 51 (88%) of the consultations as very useful, and they implemented 78 (98%) of the 80 recommended actions. Of the 56 physicians who attributed their decision to implement the recommendation to their consultation with the clinical pharmacist, 43 believed that the recommendations had improved the clinical status of the patient, and 38 believed that the recommendations were useful to patients in ways unrelated to clinical status. Physicians in a family medicine residency training program had positive perceptions of the usefulness of drug therapy recommendations made by clinical pharmacists. A majority of the physicians believed that the recommendations had a positive effect on patients' clinical status.     

药师下临床工作的实践和体会

目的:探讨药师下临床工作的主要内容和进行方式。方法:以笔者临床工作实践和经验为基础,对药师下临床的意义及本院临床药师工作特点进行阐述。结果和结论:药师必须适应医院药学工作的转型,做好临床工作。     

Physician beliefs and attitudes toward collaboration with community pharmacists

Background

Collaboration between pharmacists and physicians in ambulatory care clinics has been shown to improve patient outcomes. Although collaborative working relationships (CWRs) between community pharmacists and physicians have been studied, the beliefs and attitudes of physicians toward collaborating with pharmacists in this setting have yet to be described. The Theory of Reasoned Action provides a model for studying collaborative behavior. Beliefs were defined in terms of the value and expected outcomes associated with collaborating with community pharmacists.

Objective

The purpose of this study was to describe the beliefs, attitudes, and intentions of office-based physicians toward collaborating with community pharmacists to help patients manage their medications.

Methods

A cross-sectional study of Michigan office-based physicians was conducted. A total of 1109 internists, pulmonologists, endocrinologists, and cardiologists were surveyed. CWR measures, beliefs, attitudes, and intentions to collaborate were measured using a mailed survey. Regression analysis identified beliefs relevant to intentions to collaborate.

Results

There were 332 usable surveys returned (30% response rate). Overall, physicians’ beliefs and attitudes toward collaborating with community pharmacists were moderately strong. Physicians’ beliefs that collaborating with a community pharmacist would result in improved medication adherence was the strongest predictor of attitude toward collaboration. The belief that collaboration with a pharmacist would result in improved prescribing was another significant predictor. The results also found attitude toward collaboration significantly predicted intention to collaborate.

Conclusions

Physicians’ beliefs and attitudes play an important role in their intentions to collaborate with community pharmacists. The findings suggest a strategy that involves collaboration to improve medication adherence may be most effective.     

Barriers and facilitators to pharmacists integrating into the ward-based multidisciplinary team: A systematic review and meta-synthesis

BackgroundPharmacists who are integrated into the ward team are involved in initial decision making, therefore pre-empting pharmaceutical problems and optimising therapy from the outset. Identifying the barriers and facilitators (determinants) to successful pharmacist integration within a multidisciplinary ward team will facilitate design of strategies to support integration.ObjectiveThe study aimed to identify the modifiable barriers and facilitators to pharmacist integration into the ward-based multidisciplinary team.MethodSearches were conducted in May 2018 across 5 databases: MEDLINE, Embase, CINAHL, PsychINFO and ASSIA, combined with grey literature and manual searches. Qualitative and mixed-methods studies using a qualitative method of data collection and analysis were eligible if reporting at least 1 modifiable determinant. Framework synthesis using the Theoretical Domains Framework (TDF) as the a priori coding framework was undertaken. Behaviour change techniques for addressing the identified determinants were selected.ResultsTwenty studies were included indicating 9 facilitators and 5 barriers to pharmacist integration. These were grouped into 3 themes. Professional knowledge and skills of the pharmacist were a facilitator to integration; interpersonal skills and relationships when representing positive interactions with team members were a facilitator whilst hierarchy was a barrier; working patterns were a facilitator when pharmacists were co-located with team members whilst profession-specific goals and excessive workload were barriers. These mapped to the TDF domains ‘knowledge’, ‘social/professional role and identity’, ‘skills’, ‘reinforcement’, ‘social influence’, ‘goals’, and ‘environmental context and resources’ respectively.ConclusionThe identified determinants within TDF domains and their associated behaviour change techniques now enable researchers to design theory- and evidence-based interventions to facilitate pharmacist integration into the ward-based multidisciplinary team. Pharmacist integration is facilitated by their knowledge and skills being valued and through demonstrating effective interpersonal skills. Re-structuring pharmacist responsibilities and working patterns to align with those of multidisciplinary team members also promotes integration.     

Health promotion perceptions among community pharmacists in Nigeria

Objective To explore the attitudes of Nigerian community pharmacists towards health promotion, to determine the importance pharmacists attach to health promotion behaviours and their perceived involvement in promoting them among their clients. Methods We conducted a cross‐sectional survey of community pharmacists in two Nigerian cities. Attitudes toward health promotion were assessed using a 24‐item instrument. The importance pharmacists attach to healthy behaviours as well as their perceived involvement was assessed using a 23‐item standard instrument. Interval data on questionnaire items were gathered on a Likert‐type scale, and the demographic characteristics of the respondents were also profiled. Principal factor analysis employed Varimax rotation with Kaiser normalisation. Associations between demographic profile and responses were evaluated using Student's t test and one‐way ANOVA. Results About 84% of the respondents indicated a favourable attitude towards health promotion. Nearly all the respondents (98%) were interested in health promotion services, and 94% indicated willingness to devote extra time to talk to patients. A majority (93%) reported willingness to retrain on health promotion. Lack of health promotion policy for pharmacists, and negative attitude towards the utilisation of pharmacy technicians were potential barriers. Pharmacists that were studied attached very high importance to 12 of the 23 widely advocated health promotion behaviours, and felt they should be very involved in seven of them. Medication‐related counselling, use of condoms, and maintenance of blood pressure were perceived to be top priorities. Rating attitudinal scores, importance of healthy behaviours, and level of involvement were 94.07 ± 20.77, 99.22 ± 21.78, and 93.33 ± 24.01 respectively (range 23 to 115; midpoint 69). Perceived involvement had moderate correlation with the importance attached, r = 0.6488 (P = 0.0008). Conclusion There is an indication that the Nigerian community pharmacists in this survey perceived an extended role in health promotion, especially medication‐related activities. This is consistent with the philosophy of primary healthcare and pharmaceutical care.     

Development of a strategic model for integrating complementary medicines into professional pharmacy practice

Background

Traditional medicine (TM) and complementary medicine (CM) products have played an increasingly important role in the business of pharmacy for over two decades in a number of countries. With a focus on the quality use of all medicines including complementary medicines, there have been a number of initiatives to encourage the integration of TM/CM products into professional practice. Recent studies report that many of the barriers that prevent such integration remain.