Using computer‐tailored smoking‐cessation advice in community pharmacy: A feasibility study

Objective Community pharmacists are in an optimal position to provide smoking‐cessation services. Computer‐based interventions that generate behavioural feedback materials designed to encourage and help smokers to quit can complement existing services and ensure that smoking‐cessation advice is reliably delivered. This study aimed to assess the feasibility of offering a system of computer‐generated individually tailored behavioural feedback for smoking cessation in community pharmacy. Method The setting was community pharmacies in North London. Pharmacists, already offering cessation advice routinely in the pharmacy, were trained to use a computer‐based system generating a feedback report containing highly tailored behavioural advice about quitting. Pharmacists' advice was structured around the report, which was printed for the participant. Pharmacists were interviewed after recruitment ended, and participants were sent a follow‐up questionnaire 4 weeks after baseline. Key findings Pharmacists felt they had benefited from taking part in the study and were more confident in their management of, and advice to, smokers. All agreed that the computer program was an acceptable and valuable tool to aid smoking‐cessation advice in pharmacies. Eleven smokers were recruited; five completed the follow‐up, four of whom reported 4‐week prolonged abstinence. Reaction to the feedback report from participants was positive. Conclusions The feedback from both pharmacists and participants demonstrates that use of this computer system to structure and standardise delivery of smoking‐cessation advice in community pharmacy is feasible and acceptable. The study suggests that the use of this system could increase pharmacists' confidence and the quality of the advice they give, leading to improved outcomes. However, a randomised controlled trial to fully evaluate the effectiveness of the system is needed.     

Considering pharmacy workflow in the context of Australian community pharmacy: A pilot time and motion study

Background

Given time pressures on primary care physicians, utilising pharmacists for chronic disease management is of great interest. However, limited data are available on the current workflow in community pharmacies to guide these discussions.

An exploration of work‐related stress in Northern Ireland community pharmacy: a qualitative study

Objectives The aim of this study was, through qualitative methodology, to explore the factors which contribute to job‐related stress in community pharmacy in Northern Ireland. Methods All community pharmacists in Northern Ireland were invited to participate in one‐to‐one semi‐structured interviews. Interview schedules explored pharmacists' attitudes to job‐related stress and the situations that may contribute to stress. All interviews took place at participants' work sites between December 2007 and April 2008, were audio‐taped, transcribed verbatim, read independently by the authors and analysed using thematic analysis. Key findings Seventeen pharmacists participated in the interviews. The main themes that emerged in relation to job‐related stress were workplace issues, issues regarding professional expansion, recognition and responsibility, and a demanding public. Although there was general support for development in community pharmacy, this was tempered by concerns as to how expectations would be met and how all services would be delivered. Conclusions The themes that emerged from this work reflect what was reported from a survey conducted in 2007 and reinforce the tension between developments in practice and the ability to deliver. Developments in professional practice can be positive; however, commissioners and policy‐makers need to consider whether community pharmacists have the infrastructure in terms of environment, personnel and multi‐professional support to deliver what is required of them.     

Educational strategies to promote evidence‐based community pharmacy practice: a cluster randomised controlled trial

□ Cluster randomised controlled trial of educational strategies in community pharmacy □ Comparison of educational outreach visits and continuing professional development as strategies for implementing guidelines for the sale of over‐the‐counter (OTC) medicines □ Outcome measures derived using simulated patients visits □ Neither educational strategy produced significant change in the sale of OTC medicines □ Further research required to identify effective and efficient educational strategies in community pharmacy.     

Teaching management in a community pharmacy

Students need strong interpersonal skills to ensure application of their clinical skills and knowledge. Pharmacy schools across the nation must assess the quantity and quality of management skills instruction within their curriculums, including experiential education. The purpose of this article is to describe the importance of the development and utilization of business and people management skills within a community pharmacy, as well as how to incorporate these skills into a student's advanced pharmacy practice experience.     

Clinical pharmacy services in a community hospital

An example is given of the implementation of clinical pharmacy service program in a community hospital. The need for establishing an efficient drug distribution system is discussed, and the feasibility of utilizing clinically motivated staff pharmacists is presented. A method of limiting the number of patients admitted to the clinical pharmacy service program is also given.     

Refinement of an osteoporosis risk‐assessment questionnaire for use in community pharmacy

Objective To explore the influence of bone mineral density (BMD) tests in osteoporosis risk categorisation in community pharmacies, and to develop a simple tool for pharmacists to use as a pre‐BMD test screen. Method A secondary data analysis was conducted on the responses of 193 participants to a risk‐assessment questionnaire, used in previous osteoporosis research that included a BMD test. To explore the impact of the BMD test on pharmacists' categorisation of risk, the researchers made an independent assessment based on responses of the questionnaire. The influence of risk factors on BMD scores/bone status was explored using multiple and logistic regression respectively. Key findings A total of responses of 193 participants were available for study, with 113 in the BMD group and 80 from the non‐BMD group. In the BMD group, both researchers and pharmacists identified a similar proportion of patients in the moderate/high‐risk category when BMD results were incorporated in the risk assessments (X² = 0.78, degrees of freedom (df) = 1, 0.3 < P < 0.5). A statistically significant difference in risk categorisation was found between the pharmacists and researchers in the non‐BMD group (X² = 23.9, df = 1, P < 0.001). Risk factors identified to be significantly affecting BMD and of use for identifying patients at high risk for osteopenia/osteoporosis were age, weight, postmenopause and absence of hormone replacement therapy (HRT). These four factors were used to construct a simple risk index to guide pharmacists' initial risk categorisation. Conclusion The findings of this study suggested that BMD testing may increase the effectiveness of risk assessments and enhance the screening procedures in the community pharmacy. The simple risk index could serve as a pre‐BMD test screen, with a BMD test recommended when necessary. A refined risk‐assessment questionnaire could serve to guide pharmacists in directing individualised counselling and advice for at‐risk patients, through identification of modifiable risk factors and conditions.