A survey of Estonian consumer expectations from the pharmacy service and a comparison with the opinions of pharmacists

Objective To assess the preferences of pharmacy customers when choosing a pharmacy and their expectations of the service, and␣comparing these with the opinions of pharmacists. Main outcome measure Opinion and satisfaction of community pharmacy clients in Estonia. Methods A written survey was carried out among pharmacy customers (n=1979) in cities (in 3 community pharmacies), towns (in 2 community pharmacies), and in small towns (in 2 community pharmacies). The survey was also carried out among community pharmacists (n=135) in different regions of Estonia. Results When choosing a pharmacy, its location was considered most important, costs and wide choice are less important. The most important expectations of customers’ included help choosing the right medicine, as well as professional consultation. Preferences and expectations of pharmacy customers depended on their age, gender and income. Parking space, quickness and pleasantness were considered important by men. Costs and wide choice were considered to be more important by women. Pharmacists wish to give patients more information, but they overestimate the importance of quick service. Customers favoured privacy, discretion and confidentiality more. These characteristics were especially important to younger well-paid people living in big cities. Conclusion In contrast to the opinions offered by pharmacists’, a rapid customer service is so not as important as the quality of service in pharmacy according to customers. They also emphasised that pharmacies should highlight the choice of products, quality of service, a professional consultation, as well as ensure privacy.     

Comparing the accuracy of medication order verification between pharmacists and a tech check tech model: A prospective randomised observational study

Background

Medication errors have the potential to cause significant harm and the final verification of dispensed medications is essential to patient safety. There is international evidence to demonstrate that trained pharmacy technicians can safely and accurately undertake the verification of medication orders in ward-based unit dose containers. There is a need for evaluation of pharmacy technician verification of medication orders in broader contexts including the hospital inpatient dispensary.

陕西省医疗机构药师在抗菌药物规范化管理中的参与度及感知障碍研究

目的 旨在明确陕西省医疗机构药师在抗菌药物规范化管理工作中的参与现状以及障碍因素。方法 于2020年6—7月采用横断面、匿名、问卷星设计的在线调查方法,对陕西省的医疗机构药师开展问卷调查。主要通过省医疗机构细菌耐药监测网、抗菌药物使用监测网、省/市药学会以及医疗机构内药师的微信群邀请药师填写问卷。结果 在423名调查对象中,超过90%认为实施抗菌药物规范化管理非常重要,可以促进抗菌药物处方更加合理,有助于控制细菌耐药,可减少抗菌药物过度使用。近一半的药师主要参与了抗菌药物处方、问题处方干预,以及对处方及医嘱的点评。主要的障碍因素包括工作的时间有限（57.92%）、药师和临床医生缺乏有效沟通（57.21%）,以及药师对抗菌药物治疗方案掌握有限（48.94%）。药师参与度得分与性别,年龄,受教育程度,职称水平以及工作年限均存在相关。结论 医疗机构药师普遍认为抗菌药物规范化管理工作非常重要,未来研究和策略制定应考虑如何克服时间有限、缺乏沟通等障碍因素,提升药师参与度。     

Effects of educational interventions on the smoking cessation service provided by community pharmacists: A systematic review

ObjectiveThis systematic review aimed to evaluate the effectiveness of educational interventions on the smoking cessation service provided by community pharmacists.MethodsA systematic literature search was performed in May–July 2021, in electronic databases, which included PubMed (MEDLINE), Embase, and Web of Science. Studies were included in this systematic review if they were original articles published in English language from 2010 to 2021 and evaluated the effect of any types of educational interventions intended to improve the ability of community pharmacists to provide smoking cessation services.ResultsIn total, 12 studies were included for this systematic review. The effectiveness of the educational interventions across the included studies was measured using a range of outcomes, which can be broadly categorized into 3 categories, namely changes in pharmacists' self-efficacy, knowledge, and attitude toward providing smoking cessation service, changes in pharmacists' smoking cessation practices, and changes in the effectiveness of community pharmacy based smoking cessation services. Included studies reported that educational interventions can improve pharmacists' self-efficacy, knowledge, and attitude toward smoking cessation, as well as pharmacists’ smoking cessation practices. Though the evidence is limited, improvement in the effectiveness of community pharmacy based smoking cessation services has also been observed.ConclusionAny form educational interventions can positively impact improve community pharmacists' self-efficacy, knowledge, and attitude toward smoking cessation, as well as pharmacists’ smoking cessation practices, but it is currently uncertain whether these outcomes are able to translate into higher effectiveness of the community pharmacy based smoking cessation services.     

Community pharmacist's perspective regarding patient-centred communication in conjunction with pharmaceutical practice: A cross-sectional survey

Effective communication between pharmacists and patients is essential for therapeutic success. The pharmacist's perspective may differ from that of the patient in terms of effective communication. Our study aimed to assess the communication efficiency in the pharmacist-patient relationship from the pharmacists’ perspective. We hypothesize that the community pharmacist's perspective can lead to relevant aspects of patient-centred communication and their profession. A cross-sectional study was conducted through an online questionnaire addressed to pharmacists. A number of 506 questionnaires were collected, evaluated, analyzed and interpreted. The questionnaire focused on the following main issues: degree of job satisfaction, essential skills of a pharmacist working in a community pharmacy, different aspects of pharmacist-patient communication, shared decision-making, patient monitoring plan and other elements related to a patient under treatment (healthy lifestyle, receptivity to counselling, loyalty and appreciation of pharmaceutical services). The pharmacist's efficiency in communication with the patient and professional education were also targeted in the study. There are no significant differences between job satisfaction in women compared to men. However, the job satisfaction increases with the average age. Caregiver, communicator and life-long learner were identified as essential skills of a pharmacist. Pharmacists participating in the study generally perceive themselves as good communicators with the patient. Nevertheless, many particular aspects of communication with patients can be greatly improved. The lack of training in the spirit of the ?patient-centred communication” concept has been identified. Still, more than a third of the respondents are missing the need for professional training. A periodic evaluation of the efficiency of pharmacist-patient communication in the community pharmacy is necessary. The degree of subjectivity of the pharmacist from this perspective and self-sufficiency would be significantly diminished if the pharmacists had access to the results of the periodic evaluations.     

Mental health training programs for community pharmacists,pharmacy staff and students: A systematic review

BackgroundPrimary care is often the first point of contact for people living with mental disorders. Community pharmacists, pharmacy staff and students are increasingly being trained to deliver mental health care. However, there is still a gap in the literature exploring the characteristics of all available mental health training programs and their components and their influence on pharmacists, pharmacy staff and students’ outcomes.ObjectivesTo summarize the evidence evaluating mental health training programs completed by community pharmacists, pharmacy staff and students. More specifically, to explore the components of mental health training programs and identify those that facilitate significant improvements in outcomes.MethodsA systematic review was conducted following the Cochrane handbook and reported according to PRISMA guidelines. A search for published literature was conducted in three databases (PubMed, Scopus, and Web of Science) in July 2021. Eligible studies were included if they described and evaluated the impact of mental health training programs delivered to community pharmacists, pharmacy staff and pharmacy students regardless of design or comparator. The methodological quality of included studies was appraised using both the NIH quality assessment, to evaluate studies with an uncontrolled pre-post design, and the Cochrane EPOC risk of bias assessment, to evaluate studies with a controlled (randomized and non-randomized) study design.ResultsThirty-three studies were included. Most of the identified mental health training programs contained knowledge-based components and active learning activities. Changes in participants' attitudes, stigma, knowledge, confidence and skills were frequently assessed. An extensive range of self-assessment and observational instruments used to evaluate the impact of the training programs were identified. Positive improvements in participants’ attitudes, knowledge and stigma were frequently identified following participation in training programs.ConclusionsThis systematic review highlights the importance of mental health training programs in increasing pharmacists', pharmacy staff and pharmacy students’ skills and confidence to deliver mental health care in community pharmacy. Future research should build upon this basis and further focus on finding the most efficient measures to evaluate these training programs and assess their long-term effectiveness, allowing comparison between programs.     

我院门诊药房窗口处方审核的分析与思考

目的 探索窗口处方审核的模式.方法 对我院2011年门诊药房窗口审核登记的1026例不合理处方进行统计分析.结果 处方不规范563例,占不合格处方总数的54.87%,用药不适宜376例,主要体现在用法用量不合理、诊断与用药不符以及重复用药等.结论 开展处方审核体现了药师的价值,我们的工作重点应该逐步转向对用药合理性的审核,如何提高药学服务水平,不断改进模式是我们努力的方向.     

我院门诊药房药师服务模式转变的探讨

为探讨门诊药房药师服务模式转变的效果,本院加强创新药师管理理念,提高服务态度,同时狠抓药品质量管理,对药师实行弹性工作制,设立门诊用药咨询服务窗口,旨在提高药师自身素质,创建一支优秀的药师队伍,实现药师服务专业化与标准化,提高药师服务质量,从而为患者提供优质、高效、人性化的药师服务,大大提高了药师的工作效率和患者及家属的满意度,充分保障了患者的用药安全。     

Pharmacist,the pharmaceutical industry and pharmacy education in Saudi Arabia: A questionnaire-based study

Background: In Saudi Arabia there is an estimated need of more than 100,000 pharmacy graduates to cover all present sectors. The shortage of pharmacists has affected many of these sectors especially the pharmaceutical industry. The contribution of Saudi pharmacists to local pharmaceuticals industry would be extremely beneficial and important for shaping the future of the drug industry within the Kingdom. It is not clear whether future Saudi pharmacists are willing to contribute to local pharmaco-industrial fields. Methods: A cross-sectional, questionnaire-based survey was conducted on all final-year pharmacy students in King Saud University (KSU), Riyadh, Kingdom of Saudi Arabia (KSA). Results: Out of a total of 130 students registered in the final-year of the pharmacy program in KSU, 122 (93.8%) were able to complete the questionnaire. The results showed that the majority (83%) of Saudi pharmacy students indicated that they had not received practical training in the pharmaceutical companies, while only 17.2% of the students felt that they had the knowledge and the skills to work in the pharmaceutical industry after graduation. The majority of the students (66.7%) chose clinical pharmacy as their future career field while only 10.9% indicated willingness to work in a pharmaceutical industry career. Only 8.2% selected working in the pharmaceutical industry. The significant predictor of possibly choosing a career in the local drug industry is a student with a bachelor’s degree (compared to Pharm D degree) in pharmacy (OR = 2.7 [95% CI 1.1–6.3]). Conclusion: Pharmacy students who are enrolled in the capital city of Riyadh are not properly trained to play an influential role in local drug companies. As a result, their level of willingness to have a career in such important business is not promising (more among Pharm D program). Future research in other pharmacy colleges within Saudi Arabia is needed to confirm such results.     

Utilization of drug information resources among community pharmacists in Jordan: A cross-sectional study

BackgroundPharmacists are considered to be important sources of drug information (DI) for patients and other healthcare providers. This study aims to examine the characteristics of DI utilization for practicing pharmacists in Jordan and identify the main barriers that impede their ability to utilize them.MethodA cross-sectional study using an online survey was conducted in Jordan between the 27th of November 2020 and 18th of January 2021. Our questionnaire was constructed to explore pharmacists’ utilization patterns of DI resources, the types of DI resources they use and barriers impeding them.ResultsA total of 1875 pharmacists participated in this study. Only one-fifth of the participating pharmacists reported that they referred to DI databases. The most commonly reported databases/websites were Drugs.com, Jordan FDA, and Medscape. The most commonly reported paper-based resources were Drugs in Jordan, Step up pharmacy, and British Pharmacopeia. The most commonly used mobile applications were Drugs.com, Medscape and Lexicomp. 44% of the pharmacists reported that they use DI resources fewer than five times per week and more than half of them (60.7%, n = 1138) reported that the day-shift was the shift that allowed them more time to use DI resources. Lack of time was the most common barrier (53.2%) that restricted the ability of pharmacists to use DI resources.ConclusionUsing electronic resources is still deficient and far from optimum and interventions to improve the pharmacists’ utilization of electronic drug databases are required. Universities and various pharmaceutical bodies are advised to train pharmacists on using DI databases.     

Evaluation of pharmacy intern-led transition of care service at an academic hospital in Saudi Arabia: A prospective pilot study

ObjectivesThe transition of patients from one setting to another increases the risk of medication errors (MEs). This study aims to assess the implementation of pharmacy intern-led transition of care (TOC) service and to demonstrate its impact on the quality of patient care.MethodA prospective interventional pilot study was carried out from August 2020 to April 2021 at an academic hospital in Saudi Arabia. The TOC team consisted of three pharmacy interns and one pharmacist-in-charge. Daily activities included medication reconciliation, discharge counseling, and follow-up call after 3 days of discharge. The identified discrepancies were categorized according to the National Coordinating Council for Medication Error Reporting Program.Key findingsA total of 182 patients were included in the analysis. During medication reconciliation, 102 discrepancies were detected, with an average of 0.7 discrepancy per patient. The most common discrepancy at admission and discharge was omission (41.7% and 70%, respectively). Category B was the most frequent and accounted for 46% at admission and 93% at discharge. Around 39% of TOC beneficiaries received a follow-up call, and all reported a high level of satisfaction with the service.ConclusionInvolving the pharmacy team in TOC activities was effective in identifying discrepancies and resolving MEs.     

Community pharmacists at the heart of public health: A longitudinal evaluation of the community pharmacy influenza vaccination service

BackgroundInfluenza (“flu”) is a contagious viral infection causing approximately 600 deaths/year in the United Kingdom. Annual vaccination is the most effective prevention strategy with a target of 75% uptake in ‘at-risk’ patient groups. Before 2012, immunisation was conducted in General Practice (GP), but uptake was below target. NHS Wales therefore introduced a programme allowing community pharmacists to administer the vaccine to certain patient groups^.ObjectivesThis study aimed to evaluate the community pharmacy (CP) flu Vaccination Programme in Wales.MethodsA longitudinal study was undertaken by secondary data analysis on data related to all NHS funded flu vaccinations administered in CP between 2012 and 2018 (n = 103941). Data were analysed using IBM SPSS® and Excel®. Pearson's correlation and independent sample t-test were conducted to compare the number of vaccines administered in CP vs overall numbers and those under 65 years and in the ‘at risk’ category in CP and GP respectively. Ethical approval was not required.ResultsIn total, pharmacists administered 103941 vaccinations. Vaccination numbers increased each season from 1568 in 2012/13 to 36238 in 2017/18. The main risk group was those aged 65 and over (59.9% of vaccinations). The proportion of those vaccinated who were aged <65 years and in an ‘at risk’ category was significantly higher in CP than GP (p < 0.01). There was a shift in balance between vaccinations administered by GPs and CPs in which CPs increased their share of all vaccinations in the flu programme from 0.3% in 2012–13 to 5.7% in 2017–18. A strong positive correlation was observed between increasing CP vaccinations and total vaccination numbers (R = 0.9316, p < 0.01).ConclusionsCommunity pharmacists are providing increasing numbers of flu vaccinations in Wales, benefitting patients in all at-risk groups and reinforcing the valuable role of pharmacists at the heart of their communities, in terms of public choice and accessibility.     

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.

The role of pharmacists in opioid stewardship: A scoping review

BackgroundThe opioid epidemic is an international public health concern. Pharmacists are in a strategic position to promote and implement effective opioid stewardship due to both their central role on health care teams and frequent interaction with patients. Despite this integral role, pharmacists do not have harmonized scopes of practice in opioid stewardship.ObjectivesThis scoping review was conducted to identify and critically review the role of pharmacists in opioid stewardship and identify future areas of study.MethodsThe scoping review was conducted according to the methodological framework proposed by Arksey and O'Malley, which was further modified by the Joanna Briggs Institute. Six databases were searched for original, peer-reviewed research; PubMed (MEDLINE), Ovid Embase, Ovid International Pharmaceutical Abstracts, Scopus, Cochrane Library, and APA PsycInfo.ResultsIn 92% of the included studies (n = 77), opioid stewardship interventions led by either a pharmacist or in an interdisciplinary team resulted in improvements in at least one outcome measure, with education and medication therapy adjustments being the most predominant activities. Other areas supported by evidence include community stakeholder education, policy and guideline setting, and risk assessment.ConclusionThis scoping review provides valuable insight into the various roles pharmacists can have in opioid stewardship. The findings from this review identified opioid stewardship activities that can make significant contributions towards reducing the impact of the opioid crisis. This review informs future research and has the potential to influence pharmacy practice on a national and international scale.     

The effectiveness of hospital pharmacy in the UK: methodology for finding the evidence

OBJECTIVE: To describe the methodology used to identify United Kingdom (UK) hospital pharmacy practice research work from the last two decades. METHOD: A comprehensive search for citations that appeared to contribute to the overall evidence or in some way measure, demonstrate or evaluate the effectiveness of UK hospital pharmacy practice. This involved a search of thirteen electronic databases covering a wide variety of UK, European and international publications, hand searching of selected UK journals and conference proceedings, a written request for details sent to all UK Chief Pharmacists and Directors of Pharmacy and a bibliography search of each reference identified. All appropriate references were then added to a single computer database. MAIN OUTCOME MEASURE: Number of references identified by each strand of the search strategy. RESULTS: The search initially highlighted a total of 10,099 articles from the thirteen reference databases, but only 281 were considered suitable for inclusion in the final review. Hand searching of the selected journals and conference proceedings yielded another 173 references and the written requests to hospital chief pharmacists resulted in another 128 references being identified. Finally, bibliography searches of the articles identified by the above three methods resulted in another 242 references, bringing the total number of references to 824. CONCLUSION: This paper describes a strategy to identify a comprehensive collection of citations supporting the evidence for the effectiveness of hospital pharmaceutical services in the UK. The large number of references identified demonstrate that hospital pharmacists in the UK make significant contributions to both the research literature and to patient care. However, database searches alone highlighted just 34% of the total references finally included in this study, demonstrating that pharmacy practice research work may be difficult to access by conducting database searches alone. The results from this project provide a resource for the profession and can be utilised as a foundation for future developments in both the delivery and research of hospital pharmacy practice.