Consumer attitudes towards community pharmacy services in Saudi Arabia

Objective The purpose of this study was to determine consumer attitudes towards community pharmacy and their preferences for the introduction of new services. Methods A self‐completion questionnaire was developed and 1,144 consumers in 55 community pharmacies were invited to complete it. The questionnaire covered consumers' choice of pharmacy; their perceptions of, and actual interactions with, community pharmacists; advice from pharmacists about general health and prescribed medicines; and privacy in the pharmacy. Respondents were asked for their views about five possible new services. Setting The study was based in community pharmacies in Riyadh City, Saudi Arabia. Key findings The response rate was 79.6%. Fifty‐nine per cent of respondents often or sometimes visited a particular pharmacy. One‐quarter of respondents perceived community pharmacists as having a good balance between health and business matters, while 56.1% thought pharmacists were more concerned with the business. The majority of respondents (69.7%) said they felt comfortable asking the pharmacist for advice. Just under half (44.8%) felt that pharmacists allowed them enough time to discuss their problem fully and listened well. In addition, 58.5% of respondents indicated that their pharmacists showed sensitivity to privacy by speaking more quietly across the counter. In 14.4% of situations pharmacists were reported to use a private area within the pharmacy when discussing personal or private matters. Most respondents (65.2%) indicated that their pharmacist was willing to discuss their health problems and tried to understand their feelings. Consumers' priorities for new services were: monitoring blood pressure; measuring weight, height and temperature; monitoring blood sugar; and monitoring cholesterol. Conclusion This study showed that most pharmacy customers feel comfortable seeking advice from their pharmacist. Although many pharmacists were reported to show sensitivity to a possible lack of privacy in the pharmacy, few respondents reported that their pharmacy had a private area for discussion. Customers' views on possible new services were generally positive, with the exception of patient medication records.     

Food for thought: Can community pharmacists help patients living in food deserts?

BackgroundCommunity pharmacists can play an important role in helping patients who live in food deserts through screening, adjusting therapeutic recommendations and counseling practices, and making referrals to community resources. However, literature regarding community pharmacists’ knowledge, practices, and attitudes regarding food deserts is scant.ObjectivesThe primary objective of this study was to assess Ohio community pharmacists’ knowledge regarding food deserts. Secondary objectives included determining their attitudes, practices, and perceived barriers related to this topic.MethodsAn anonymous 26-question survey was created and distributed to a random sample of 500 licensed community pharmacists in Ohio. Participants were granted 3 weeks to complete the survey and were offered a link to free Accreditation Council for Pharmacy Education–approved continuing pharmacy education as an incentive. The survey was deemed exempt by the Institutional Review Board.ResultsThe survey was successfully delivered to 491 pharmacists; 72 participated (14.7% response rate). About 43% of respondents were familiar with the term “food desert,” and less than one-third (31.9%) reported being aware of community resources. Of those who thought that some of their patients lived in food deserts, the majority indicated that they did not consider it in patient interactions (65.1%) and “never” adjusted their counseling practices (65.1%). Barriers that prevented them from referring patients included lack of knowledge and confidence as well as workflow constraints. About 68% of respondents somewhat or strongly agreed that pharmacists could help patients living in food deserts, and 65.3% were interested in learning more information about food deserts.ConclusionDeficiencies in knowledge regarding food deserts and available resources were found among Ohio community pharmacists, but they showed interest in learning more information. Efforts should be made to educate community pharmacists about food deserts and to determine how to optimize their ability to assist patients as needed.     

Pharmacists solving problems in asthma management — experiences from a one‐year intervention programme in Finland

Objective — To study the effect of an intervention provided by community pharmacists on detection and resolution of problems in asthma patients' self‐management and to study patients' opinions about the perceived usefulness of the pharmacists' input. Method — A one‐year intervention study was conducted with scheduled visits and follow‐ups at baseline, four, eight and 12 months. Study patients (n=28) acted as their own controls. Setting — Four communities and community pharmacies in different parts of Finland. Key findings — At study baseline, all patients had at least one documented problem, the most commonly reported being problems with medication, side effects, problems with inhalation devices and not using asthma medicines according to the physician's instructions. On average, patients had five “intervention” consultations with the pharmacist during the one‐year study. After the intervention, half of the patients reported that their problems had been resolved. The most useful areas of advice were considered by the patients to be instructions about changing asthma medication according to asthma symptoms and management of asthma symptoms. Twenty‐five of the 28 patients reported that they were satisfied with the education and counselling provided by pharmacists, a higher number than for physicians or nurses. Conclusion — The findings from this small longitudinal study indicate that community pharmacists can improve asthma patients' treatment by consultations during which they identify and address problems in self‐management of asthma.     

Professional practices and experiences with complementary medicines: a cross‐sectional study involving community pharmacists in England

Objective As retailers of complementary medicines (CMs), pharmacists are well placed to advise consumers on the safe and effective use of these products; where CMs are available in pharmacies, pharmacists should be well informed about such products. This study explored the extent to which CMs are available in community pharmacies in England, and examined pharmacists' experiences, professional practices and training with regard to these products. Method A cross‐sectional study was conducted, involving a structured questionnaire posted to community pharmacists. Coded follow‐up mailings were sent to non‐responders after 2 and 4 months, and a reminder telephone call made after 3 months. Setting All community pharmacists in six areas (Devon, Cornwall, Bradford, Leeds, Manchester, Stockport) of England (total n = 1337). Key findings The response rate was 66.5%. Overall, 92% of respondents reported that CMs (excluding vitamins/minerals) are sold in the pharmacy in which they practise, 81% had received requests from patients/consumers for specific CMs in the previous year, and 58% had recommended CMs. Around 70% of respondents rarely/never asks about CMs use when counter‐prescribing conventional medicines or when receiving reports of suspected adverse drug reactions (ADRs) associated with conventional medicines. In total, 40% of respondents had undertaken training in complementary/alternative medicine (CAM). Pharmacists who had undertaken training were more likely to ask patients/consumers specifically about use of CMs when counter‐prescribing conventional over‐the‐counter (OTC) medicines (37.0% versus 23.4%, respectively; χ² = 17.4; P = 0.0003) and when receiving reports from patients/customers of suspected ADRs associated with conventional (prescribed or OTC) medicines (35.6% versus 23.8%, respectively; χ² = 13.0; P = 0.0003). Conclusion CMs are widely available in pharmacies in England, and pharmacists interact with users of these products. An opportunity exists for pharmacists to embrace a professional role as expert advisors on CMs. However, pharmacists' training, professional practices and competence with respect to CMs first need to improve.     

Community pharmacists' attitudes to adverse drug reaction reporting

Objective — A “demonstration” scheme for adverse drug reaction (ADR) reporting by United Kingdom community pharmacists began in April, 1997. The objective of this study was to investigate community pharmacists' attitudes to and knowledge of ADR reporting and the “yellow card” scheme. Method — Structured face-to-face interview with community pharmacists, using a prepiloted questionnaire. Setting — Randomly selected community pharmacies within one demonstration scheme area. Key findings — Almost all of the pharmacists (28, 93 per cent) were aware that they were able to report ADRs but only one had done so. Just under half recalled receiving the official information pack and half of these had read it. Reasons given for not submitting reports were lack of information or time, and that most reactions seen were already well-recognised. Although most pharmacists knew that serious reactions to established drugs should be reported, fewer recognised the need to report unusual reactions to established drugs and reactions to herbal medicines. Few participants knew the reporting criteria for “black triangle” drugs. Reporting on over-the-counter (OTC) products was an area specifically identified where it was expected that community pharmacists could “add value” to the previous, yellow card, scheme. It was thus of some concern that 21 pharmacists (70 per cent) agreed that they would be unlikely to report an ADR to a product they had counter-prescribed for a patient. Few respondents had negative attitudes to the scheme. Most agreed that ADR reporting is important, and a professional role in which pharmacists should be involved. Conclusion — Community pharmacists are supportive of their involvement in ADR reporting. Their concerns about reporting need to be addressed and further publicity given to the scheme if reporting is to increase. Our findings suggest that more research is needed to identify the factors which encourage and inhibit reporting, and that further efforts may be needed to promote ADR reporting.     

The status of the performance of medication reviews in German community pharmacies and assessment of the practical performance

Background Pharmacist-led medication reviews have shown to prevent drug-related problems (DRPs). So far, data is rare about the implementation in routine care, the conditions for intensifying this service and the practical skills of community pharmacists to perform medication reviews. Objective To assess the current status of medication review implementation in German community pharmacies and the performance of identifying DRPs in a ficticious patient example. Setting German community pharmacies. Method An online survey was conducted from July to September 2015 including questions about medication reviews currently performed in routine care of community pharmacies and hidden DRPs in a ficticious patient example. Pharmacists were invited via newsletters from three local chambers of pharmacists. Main outcome measure (i) Frequency, conditions for implementation, and criteria of medication reviews currently being performed in routine care, (ii) requested further information to perform medication reviews, and (iii) proportion of pharmacists who identify DRPs in the patient example. Results A total of 143 community pharmacists completed the questionnaire. (i) One hundred and twenty-seven respondents (89 %) reported reviewing the medication regularly in routine care, whereas 56 (39 %) stated that they performed medication reviews between one and five times monthly. For 124 pharmacists (87 %), remuneration would be a necessary condition for performing medication reviews more frequently. When reviewing the medication, 112 (78 %) of the pharmacists considered the criterion ‘drug–drug interactions’ and 107 (75 %) reviewed the criterion ‘correct dosage’. One of the least reviewed criteria was ‘effectiveness of medication’ [22 (16 %)]. (ii) According to the participants, laboratory values should be available in the community pharmacy, since 87/143 (61 %) would appreciate the GFR and the HbA1c level. Twenty-two of 54 respondents (41 %) would appreciate further administration instructions and 5 of 54 (15 %) think they would benefit from information about the recommended duration of drug use. (iii) Depending on the category, 4 (3 %) to 49 (34 %) of all 143 pharmacists identified the hidden DRP in the patient example. Conclusion German community pharmacists reported reviewing the medication of their patients regularly; however, most of the respondents review the medication very rarely in routine care. Consequently, their practical performance needs to be improved.     

Communicating medication changes to community pharmacy post-discharge: the good, the bad, and the improvements

Background Communication between hospital and community pharmacists when a patient is discharged from hospital can improve the accuracy of medication reconciliation, thus preventing unintentional changes and ensuring continuity of supply. It allows problems to be resolved before a patient requires a further supply of medication post-discharge. Despite evidence demonstrating the benefits of sharing information, community pharmacists’ willingness to receive information and advances in information technology (particularly electronic discharge medication summaries), there is little published evidence to indicate whether communication has improved over the last 15 years. This study aimed to explore community pharmacists’ experience of information sharing by and with their local hospital and GP practices. Objectives (1) To establish the extent to which community pharmacies currently receive discharge medication information, and for which patients.(2)To determine community pharmacy staff opinion on where and how current communication practice could be improved. Setting Community Pharmacies in one Primary Care Organisation (PCO) in England. Method Semi-structured interviews conducted during visits to community pharmacies. Main outcome measure Reported receipt of discharge medication information from hospitals and general practices. Results A total of 14 community pharmacies participated. Current provision of information to community pharmacies from hospitals regarding medication changes at discharge was reported to be inconsistent and lacking in quality. Where information was received it was predominantly for patients who receive their medicines in monitored dosage systems (MDS) rather than for the general population of patients. Some examples of “notable practice” were reported. Conclusion Community pharmacists received post-discharge information rarely and mainly for patients where the hospital perceived the patient’s medication issues as “complex”. Practice was inconsistent overall. These findings suggest that the potential of community pharmacists to improve patient safety after discharge from hospital is not being utilised.     

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.     

Diabetes care in Qatar: a survey of pharmacists’ activities,attitudes and knowledge

Background Diabetes mellitus is recognized as a major public health issue and is one of the top ten causes of death in Qatar. Objective To describe the activities, and attitudes of Qatar pharmacists toward diabetes, to measure their diabetes knowledge and to assess their perceived barriers for diabetes care. Setting Community and ambulatory pharmacies in Qatar. Method Study objectives were addressed in a cross sectional survey of community and ambulatory pharmacists in Qatar. A phone call explaining the study was made to all community and ambulatory pharmacists in Qatar. Consenting pharmacists anonymously completed the survey either online or as paper. Main outcome measure Diabetes related activities, knowledge, attitudes and perceived barriers. Results Over 7 months, 126 surveys were collected (28% response rate). The majority of pharmacists always or often counselled patients on the appropriate time to take each medication and on medication side effects (90%, n = 100/111 and 73%, n = 81/111 respectively). Yet around 50% always or often provided education on the importance of screening for nephropathy (n = 59/112) and retinopathy (n = 58/109). In addition, 41% always or often provided education about the importance of immunization (n = 45/111) and 45% always or often provided therapy recommendations to physicians (n = 49/111). Using Diabetes Attitude Scale-3, most respondents had positive attitudes toward the need for special training, psychosocial impact of diabetes, and patient autonomy. Around 25% (n = 32/126) scored less than 6 out of 10 on the diabetes related knowledge test. The top three barriers for providing diabetes services were lack of time (53%, n = 67/126) shortage of personnel (42%, n = 53/126) and lack of private counseling area (42%, n = 53/126). Conclusion Qatar pharmacists mainly provide basic services for diabetic patients. They have an average diabetes related knowledge. Yet overall, they have positive attitudes toward diabetes, which is a vital component of any successful diabetes care service.

     

Workcoping and homecoping: achieving a balance in part‐time community pharmacy

Objectives — (1) To explore different concepts of part‐time work by means of a study of part‐time work in community pharmacy; (2) to ascertain the complexity and diversity of part‐time work patterns; (3) to consider the strategies employed by part‐time pharmacists to make their part‐time working possible. Methods — Records of part‐time work in community pharmacy were examined. A quantitative survey was conducted by sending a postal self‐completion questionnaire to 975 pharmacists. There were 727 valid responses. Qualitative semi‐structured interviews were conducted with 33 community pharmacists, identified from the survey as working part time. The emphasis was on data representing the part‐timers' own perceptions of their work and careers. Setting — The total membership of two Midlands branches of the Royal Pharmaceutical Society of Great Britain. Key findings — Of the 230 pharmacists (31 per cent of all respondents) who worked part time, 200 (140 women; 60 men) worked in community pharmacy. There was a considerable range and variability of working patterns, the clearest division being between employed (70) and self‐employed (122) part‐timers. The strategies used to cope with work and family responsibilities by both men and women of different ages and under different circumstances were sometimes very complex. The terms “workcoping” and “homecoping” were devised to describe these strategies. Conclusions — Existing concepts of part‐time work do not fully explain the complexities revealed in this study. Many part‐time pharmacists believed they had achieved a balance which was both professionally satisfying and socially responsible. They employed strategies which enabled them to maintain this balance and keep control over their lives.