A pilot project on the impact of a community pharmacy programme providing advice to women initiating HRT therapy

□ The pilot study evaluated the outcome of a pharmacy‐based initiative for women starting or having recently started HRT □ At the end of the study over twice as many women in the control group had stopped taking HRT than in the intervention group □ Kupperman menopausal index scores used to indicate control of menopausal symptoms had improved significantly more in the intervention group compared with the control group □ Intervention group patients were more knowledgeable of the benefits of HRT, and of osteoporosis risk factors and preventive measures □ The control group expressed significantly more concerns about HRT at the end of the study compared with the intervention group     

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.

Integrating community pharmacy with NHS Direct: evaluation of a pilot scheme

□ The National Health Service plan promised referral to pharmacy by NHS Direct by 2002 □ Evaluation of a pilot scheme showed that the initial referral rate to pharmacists fell markedly over a few months □ Pharmacists were positive about both NHS Direct and the pilot scheme but we found no evidence of added benefit in terms of callers' views of the service □ NHS Direct nurses supported the scheme in principle, but in practice had concerns about referring to pharmacists in the absence of a clear rationale     

Exploratory planning and implementation of a pilot pharmacogenetic program in a community pharmacy

AIM: To describe the exploratory planning and implementation of a pilot pharmacogenetic program in a community pharmacy. An institutional review board-approved protocol for a clopidogrel pharmacogenetic program in a community pharmacy was developed to address feasibility and evaluate the pilot program. STUDY CONCEPT: Subjects taking clopidogrel are asked to participate at the point of medication dispensing. A pharmacist schedules an appointment with subjects to discuss the study and collects a buccal swab sample for CYP2C19 testing. When the results are available, the pharmacist consults with the subject's prescriber regarding test result interpretation and associated recommendations, and schedules a second appointment with the participant to discuss results and review any physician-approved therapeutic changes. The intervention-associated consultation is then billed to the subject's insurance. Results: Subject enrollment has begun. CONCLUSION: Community pharmacists may be valuable partners in pharmacogenetics.     

Consumer perceptions of and willingness-to-pay for point-of-care testing services in the community pharmacy

Background

Point-of-care testing (POCT) is a specialty of laboratory medicine that occurs at the bedside or near the patient when receiving health services. Despite its clinical utility, POCT implementation in the community pharmacy setting is slow due to uncertainty about the market for this novel service and remuneration for services rendered.

Cardiovascular drug use prior to diagnosis of diabetes: A pilot study in community pharmacy

Objectives The literature indicates that cardiovascular drug use is higher during the years prior to diagnosis of type 2 diabetes mellitus. As there are pharmaco‐epidemiological and economic consequences of enhanced medication use prior to diagnosis of diabetes, there is a need for a comparative analysis of the drug‐use pattern by patients with a subsequent diagnosis of diabetes and control patients. This pilot study aimed to investigate cardiovascular drug use in patients with a subsequent diagnosis of diabetes using data extracted from 200 community pharmacies in the Belgian township of Hasselt. Methods Based on community pharmacy data, a retrospective case‐control study compared the drug use of patients with a subsequent diagnosis of type 2 diabetes (cases) with patients without a subsequent diagnosis (controls). Cases were identified if patients started taking metformin (and possibly other drugs used in diabetes) during the 2004–2006 study period. Drug use was expressed as a binary variable, reflecting whether or not a patient took drugs belonging to a specific cardiovascular subclass. Key findings Our dataset consisted of 158 cases with a subsequent diagnosis of type 2 diabetes and 632 control patients. Patients with a subsequent diagnosis of type 2 diabetes had a higher propensity to take cardiovascular drugs prior to diagnosis than control patients. This trend was observed across all cardiovascular drug classes, except for calcium‐channel blockers, and was statistically significant for β‐blocking agents and agents acting on the renin‐angiotensin system. Conclusions A positive association was observed between cardiovascular drug use and subsequent diagnosis of type 2 diabetes. This study emphasizes the potential role for community pharmacy in early identification of diabetes using more targeted screening based on cardiovascular drug use as derived from pharmacy databases.     

Pharmacists experience of and perspectives about recruiting patients into a community pharmacy asthma service trial

BackgroundResearch trials testing the impact of community pharmacy services require adequate and appropriate recruitment of patients by participating pharmacists, however, this step presents an ongoing challenge.ObjectiveTo identify factors affecting recruitment of patients in community pharmacies participating in a multi-center trial of a pharmacy asthma service in Australia (Pharmacy Trial Program – Asthma and Rhinitis Control (PTP-ARC).MethodsThe PTP-ARC protocol required identification and recruitment of seven eligible asthma patients per pharmacy. Pharmacists responsible for sites that failed to recruit or retain any patients into the PTP-ARC trial participated in a semi-structured telephone interview about their experiences with these elements of the trial. The interviews were recorded, transcribed and coded using QSR International's NVivo 11 software. The analysis was conducted with reference to the COM-B framework (Capability, Opportunity, Motivation).ResultsPharmacists from 47 of 50 eligible pharmacies were interviewed. Seventeen factors were isolated and mapped to the COM-B framework. Psychological capability (recruitment hesitancy, research literacy and health literacy), physical capability (technological barriers, staffing issues and pharmacy busyness), physical opportunity (patient busyness, trial timing, study protocol, support and location), social opportunity (health literacy and supportive milieu), reflective motivation (incentive for participation, simplification) and automatic motivation (patient attitudes and pharmacist-felt experience) were factors affecting pharmacists' participation. Challenges identified included: issues with the software, unfamiliarity with research procedures generally (and specifically with the PTP-ARC protocols), the patients' lack of interest and pharmacists’ lack of time.ConclusionsTo the best of our knowledge, this is the first study to focus on issues affecting patient recruitment into a pharmacy health services (asthma) trial in real time. To propel evidence-based trials towards practice implementation, user-friendly software, pharmacists’ training on research and patient-engagement and adequate remuneration to address pharmacist time issues need to be key foci for health services design and implementation research.     

Utilization of influenza and streptococcal pharyngitis point-of-care testing in the community pharmacy practice setting

Background

One way to reduce the complications and costs of influenza like illness and pharyngitis is to improve access to testing and treatment in early stages of infection. Pharmacy-based screening and treatment of group A streptococcus (GAS) infection and influenza has the potential to improve patient care and population health.

A satellite pharmacy program in a community hospital

A satellite (decentralized) pharmacy program in a medium-size community hospital is described. The hospital is a private institution consisting of three divisions: an acute-care division, a psychiatric division, and a long-term care division. Pharmacy services are provided on an around-the-clock basis, and the satellites are operational 16 hours daily. Pharmacy services include unit dose distribution, I.V. admixture services, and clinical pharmacy programs. Structurally, the department is divided into four satellite units and a central pharmacy unit to provide care to all areas of the health center. The professional staff is divided into several categories as a means to overcome the difficulties and take full advantage of all of the benefits of the satellite system. The Associate Director and the Assistant Director perform primarily administrative functions in order to maintain overall control, coordination, and quality assurance of the department. The Education Coordinator helps maintain the level of basic competence of the staff and coordinates the development and implementation of new departmental programs. Staff Pharmacists II provide both administrative and professional functions in their roles as team leaders of individual satellite units. Staff Pharmacists I serve the traditional staff functions in a satellite unit or in the central pharmacy.