Community chain pharmacists’ perceptions of increased technicians’ involvement in the immunization process

BackgroundOver the past 2 decades, pharmacists have positioned immunization services as an important aspect of their expanding role in patient care.ObjectivesTo examine how community chain pharmacists view time spent on immunization, available in-store resources and barriers, and pharmacy technician involvement in the context of their views about the achievement of key National Vaccine Advisory Committee (NVAC) Standards of Adult Immunization Practice in their workplace.MethodsA representative, nationwide survey was administered electronically to chain community pharmacists over a 4-week period. Community pharmacists offering year-round immunization in retail chain, supermarket, and mass-merchant settings, randomly sampled from a database maintained by the American Pharmacists Association. We examined several sets of interrelated relationships regarding pharmacists’ perceived achievement of 3 key NVAC standards (assessment, recommendation and administration), time spent on the overall immunization process, the effectiveness of available in-store resources, immunization impediments, and the endorsement of increased technician involvement in community pharmacy-based immunization service (PBIS) delivery.ResultsA sample of 590 survey responses was obtained from 9717 e-mails delivered, with 489 deemed eligible (5% response rate). Sizeable numbers of pharmacists acknowledged that several activities integral to achieving optimal immunization levels were not being addressed. Although pharmacists accepted that appropriately trained pharmacy technicians should be able to ask (77%) and assess (66%) patients, only 24% agreed that technicians should be able to administer vaccine doses. Pharmacists satisfied with in-store immunization resources and technicians’ involvement were more likely to report achieving the 3 key NVAC standards. Paradoxically, how pharmacists viewed their immunization time expenditures was unrelated to whether they agreed that pharmacy technicians should have an expanded role in asking, assessing, or administering vaccines to their patients.ConclusionOverall, community pharmacies would likely better meet national immunization goals by achieving all 3 key NVAC standards and incorporating expanded roles for appropriately trained and supervised technicians in PBIS.     

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.     

Community pharmacists’ knowledge of diabetes management during Ramadan in Egypt

Background Although Muslim diabetic patients may be aware of their religious exemption from fasting, many still fast and adjust their medication regimens accordingly. Pharmacists have a significant potential to identify and prevent harm from medication misuse in Ramadan. Objectives This study examines Egyptian pharmacists’ knowledge regarding management of diabetes during Ramadan. It also explores pharmacists’ willingness to attend a 1 day workshop on medication regimen adjustment during Ramadan. Setting Community pharmacies throughout Alexandria, Egypt. Methods A cross-sectional study using a pretested self-administered survey was conducted among a random sample of community pharmacists. The survey included three knowledge questions relevant to counseling diabetic patients during Ramadan. Questions covered the recommended timing and dosing for metformin and insulin as well as the safe blood glucose range required for diabetic patients to safely continue their fast. Using logistic regression, a model was estimated to predict pharmacists’ willingness to attend a workshop on the adjustment of medication regimens during Ramadan. Content analysis was used to analyze pharmacists’ answers to the question concerning what they would like the workshop to cover. Main outcome measure Pharmacists’ aggregate scores for all three diabetes management knowledge questions and pharmacists’ willingness to attend a workshop on the adjustment of medication regimens during Ramadan. Results Ninety three percent of the 298 approached pharmacists agreed to participate. Forty three pharmacists (15.9 %) did not know the correct answer to any question, 118(43.7 %) 24 answered one correctly, 86 (31.9 %) answered two correctly and only 23 (8.5 %) answered all 25 three correctly. Confidence in therapeutic knowledge regarding medication regimen 26 adjustment during Ramadan was not associated with the pharmacists’ knowledge of diabetes management during Ramadan. One hundred seventy five (63.6 %) pharmacists wanted to attend a workshop on adjusting medication regimens during Ramadan. This was significantly associated with pharmacists being Muslim (OR 3.52, CI 1.70–7.27) and of younger age (OR 30 = 0.98, CI 0.96–0.99978). Pharmacists offered specific content and communication process 31 suggestions for the workshop content. Conclusion This study identifies variability among community pharmacists’ knowledge of diabetes management during Ramadan. It also shows willingness among the majority of pharmacists to learn more about the topic     

Community pharmacists’ perspectives on implementation of Medicines Use Review in Slovenia

International Journal of Clinical Pharmacy - Background In December 2014 Slovene Chamber of Pharmacies defined procedures for Medicines Use Review (MUR) in Slovenia, together with an educational...     

Community pharmacists’ attitudes and opinions towards supplying clozapine

International Journal of Clinical Pharmacy - Background Clozapine is very effective for treatment-resistant schizophrenia, but its use has been limited due to the risk of agranulocytosis. From July...     

Physicians’ perceptions,expectations, and experiences of clinical pharmacists in Jordan-2017

International Journal of Clinical Pharmacy - Background A decade ago, clinical pharmacy was a new concept in hospital settings in Jordan, as evidenced in our 2006/2007 study. Changes in the...     

Renal pharmacists’ perceptions and current practices of assessing medication adherence in dialysis patients

Background Medication nonadherence is a major problem in chronic kidney failure patients undergoing dialysis. Pharmacists play a vital role in improving medication-related patient outcomes, reducing drug-related problems, and improving medication adherence. However, little is known about how pharmacists assess medication adherence in dialysis patients. Objective To measure pharmacists’ perceptions, current practices, and barriers to assessing adherence in dialysis patients. Setting Australian renal-specialised pharmacists. Method An online survey was conducted between March and May 2016. Survey included five psychometric scales measuring perceived prevalence, contributors, effective methods, barriers, and confidence to assess adherence on a 10-point Likert scale (1 = strongly disagree; 10 = strongly agree). Current practices were identified using a 4-point graded response (1 = do not practice; 4 = practice for all). Main outcome measure: Perception scores, scale reliability, and responses to current practices questionnaire. Results 41 pharmacists completed the survey (response rate, 91.1%). The majority (91.9%, n = 34; median = 8.0) agreed patients were nonadherent to medication. Time constraints (43.8%, n = 14) and hospital support (31.3%, n = 10) were perceived as barriers to assessment. Objective blood monitoring was frequently used to determine nonadherence (57.1%, n = 16), whereas subjective interviews were rarely conducted (27.6%, n = 8). Though all pharmacists support the presence of dedicated pharmacist for assessing adherence (100.0%, n = 33), only 24.2% were actually performing this function. Conclusion Pharmacists were rarely assigned for adherence assessment in dialysis settings. Established self-report methods were under-utilised compared to objective methods. Future research should investigate the effectiveness of pharmacists’ involvement in facilitating adherence promotion and early identification of medication-related issues in dialysis patients.

     

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...     

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.     

Community pharmacists’ perspectives about the sustainability of professional pharmacy services: A qualitative study

ObjectivePharmacists have been increasing patient-focused care through the implementation and provision of professional services. However, there is a lack of evidence on how to achieve long-term sustainability of the service once it is implemented. A framework identifying the factors affecting the sustainability of professional pharmacy services was developed. The objectives of this study were to explore the experiences of community pharmacists providing professional services to contextualize and assess the applicability in practice of the sustainability framework.MethodsA qualitative study was undertaken across Australia. Community pharmacists were identified using snowball sampling. Data were collected through semistructured interviews. Eighteen interviews were conducted and analyzed using framework methodology in NVivo 12 (QSR International).ResultsA range of major sustainability factors was identified and organized in social, economic, and environmental domains. In the social domain, most of the interviewees stated the importance of motivating staff to increase service promotion and patients’ demand. Most of the participants emphasized that having an adequate number of trained staff is required to enhance and maintain services over time. The perceived reluctance of some patients to spend more time than usual at the community pharmacy was another factor highlighted as affecting service sustainability. In the economic domain, the concern about lack of remuneration for service provision was highlighted by most of the interviewees. Having economic support was seen as essential for achieving sustainable services. In the environmental domain, the necessity of government recognition of the pharmacists’ role and value to the health care system was identified as a new key sustainability driver.ConclusionThe applicability of the framework for the sustainability of professional services was evaluated in practice. The identified factors will guide pharmacists to maintain implemented services and achieve their sustainability. Future research should focus on designing a tool to measure the sustainability of pharmacy services.