The views of pharmacists supplying emergency hormonal contraception through a patient group direction

Patient group directions (PGD) to supply emergency hormonal contraception (EHC) in community pharmacies have been operating for several years, predating the deregulation of the product to a pharmacy medicine This study explored attitudes of community pharmacists involved in PGD supply towards the scheme; a short self‐completion questionnaire was distributed to 98 community pharmacies, in Manchester, Salford and Trafford and a response rate of 63 per cent was achieved Most respondents thought a private room or area was necessary to provide an EHC service; 78 per cent of pharmacies had regular locums working in pharmacy, but only a third of all the locums were trained to supply EHC Sixty per cent of respondents admitted that there were days when their pharmacy could not supply the EHC service One cause of dissatisfaction among the pharmacists offering the scheme was the lack of personal remuneration     

The impact of the deregulation of emergency hormonal contraception on a patient group direction scheme in the north‐west of England

In the past two years, sources of supply for EHC have expanded to include community pharmacies; the drug Levonelle was deregulated a pharmacy medicine in January 2001 Prior to this, in some areas of the UK, EHC was available in pharmacies free‐of‐charge through patient group direction (PGD) schemes; Manchester, Salford and Trafford health action zone (HAZ) established the first of these schemes in December 1999 This study uses audit data from two years of this scheme to explore the impact of deregulation on numbers accessing this service Consultation rates were not affected by the deregulation of Levonelle in January 2001 Over the entire data collection period, 16 per cent of women who used the PGD scheme came from outside the HAZ area; this figure was unaffected by deregulation and interim data from November 2001 to February 2002 suggesting this figure may in fact be increasing     

Professional integration within health centre pharmacies

□ The National Health Service plan proposes 500 new one‐stop centres to include pharmacy □ Little is known about current activities in health centre pharmacies □ A self‐completion survey of a sample of identifiable health centre pharmacies has been carried out □ There is some evidence of integration of pharmacists within the practice team □ Increased integration will require proactive external input     

Use of simulated patients to assess the clinical and communication skills of community pharmacists

Objective To investigate the quality and appropriateness of Emergency Hormonal Contraception (EHC) supply from community pharmacies. Setting Community pharmacies in the southwest of England during 2007. Method Two simulated patient (‘mystery shopper’) scenarios to each participating pharmacy, one where the supply of EHC would be appropriate (scenario 1) and one where there was a drug interaction between EHC and St John’s Wort, and the supply inappropriate (scenario 2). Pharmacy consultations were rated using criteria developed from two focus groups: one with pharmacist academics and one with female university students. Feedback to pharmacists to inform their continuing professional development was provided. Main outcome measure Scores on rating scales encompassing the clinical and communication skills of the participating community pharmacists completed immediately after each mystery shopper visit. Results 40 pharmacist visits were completed: 21 for scenario 1 and 19 for scenario 2. Eighteen pharmacists were visited twice. Five pharmacists visited for scenario 2 supplied EHC against professional guidance, although other reference sources conflicted with this advice. Pharmacies which were part of the local PGD scheme scored higher overall in scenario 1 (P = 0.005) than those not part of the scheme. Overall the communication skills of pharmacists were rated highly although some pharmacists used jargon when explaining the interaction for scenario 2. Conclusion Formatively assessing communication skills in an integrative manner alongside clinical skills has been identified as an important part of the medical consultation skills training and can be incorporated into the routine assessment and feedback of pharmacy over-the-counter medicines advice.     

An audit of the supply of emergency hormonal contraception through patient group direction

This abstract reports on an innovative semi‐covert audit of community pharmacists' supply of emergency hormonal contraception (EHC) via patient group directions Two women researchers were trained to request EHC in 10 community pharmacies; they were told to tell the pharmacist that this was a result of unprotected sexual intercourse and they recorded their experiences of the consultation on a structured form following supply of EHC In 100 per cent of cases, pharmacists asked about the date of the last menstrual cycle, whether the last menstrual cycle was normal, whether they were taking any other medication, whether experiencing any other conditions and whether they had taken EHC before, and explained how EHC worked In 70 per cent of cases, pharmacists provided information about STIs, and long term contraception; in 80 per cent of cases, they provided condoms and in 100 per cent of cases supplied EHC; neither women experienced judgmental of negative attitudes Although we should be cautious about generalising from this small sample, on the evidence of this evaluation it appears that the service is being provided appropriately     

Preliminary investigation of the problems associated with supply of palliative care medicines in primary care

□ Fax‐back was a cost effective method for administration of a self‐completion questionnaire which produced a high (76 per cent) response rate □ Problems with supply of palliative care medicines were reported by 58.5 per cent of health authorities responding to the survey □ Supply of medicines out of hours was the most common problem reported (93 per cent), with stock levels held in pharmacies and problems with specialist medicines also causing problems in over 50 per cent of respondents □ Some health authorities reported that protocols for supply of palliative medicines, or the existence of designated community pharmacies for their provision, reduced the problems reported □ Further research into effectiveness of protocols and designated palliative care pharmacies is indicated, and our study has identified those health authorities where such research could be targeted     

Scottish community pharmacists' current involvement in and attitudes towards ‘extended service’ provision: a national survey

Objective To determine Scottish community pharmacists' present involvement with ‘extended’ service provision, as outlined in ‘The right medicine’ policy document, as well as an insight into the attitudes of pharmacists in delivering such services. Setting All community pharmacists working in Scotland. Method A questionnaire was developed, piloted and refined before mailing to all community pharmacists working in Scotland (n = 1621). Two reminders were sent to non‐responders. Data on current service provision was analysed using SPSS version 11 for windows. Key findings An overall response rate of 56.4% (914/1621) was achieved for pharmacists. The survey revealed that the majority of respondents either agreed or strongly agreed with the ‘key service areas’ being provided from community pharmacies. Some services were obviously agreed with more than others. In particular repeat dispensing and emergency hormonal contraception (EHC) were rated highly. Least agreement was provided for needle exchange and schemes for supporting carers. Conclusion There appears to be wide variation in current service provision in the ‘key service areas’ considered. The highest involvement included EHC and methadone supervision. The lowest involvement was for needle exchange and schemes for supporting carers. Community pharmacist's attitudinal ratings were generally positive towards the ‘key service areas’ suggested.     

The sale of emergency hormonal contraception in community pharmacies in the UK: the views of users

Sales of emergency hormonal contraception (EHC) in community pharmacies began in 2001 This study set out to explore the views of a small group of women purchasing EHC in community pharmacies, using qualitative techniques Users were broadly positive about pharmacy sales of EHC, citing access, convenience and confidentiality as key benefits Four out of 12 respondents made a decision to engage in unprotected intercourse because they were aware that EHC was available from the pharmacy More research is required to explore the impact of pharmacy sales of EHC on unprotected intercourse and sexually transmitted infections     

Attitudes of community pharmacists towards medication error reporting

□ Community pharmacists' attitudes towards a centralised error reporting scheme are presented □ The majority of pharmacists were in favour of such a scheme and would participate in the scheme □ Ease of use, anonymity, review and feedback were considered important success factors for an error reporting scheme □ Information from the questionnaire has been incorporated into the design of a scheme for error reporting by community pharmacists     

Planning for health information exchange: Perspectives of community pharmacists in the Community Pharmacy Enhanced Services Network of Indiana

BackgroundCommunity pharmacists are one of the most accessible health professionals and provide many different services. However, lack of access to complete patient information is a barrier to making meaningful patient interventions.ObjectivesTo determine (1) current and desired health information access among community pharmacists in the Community Pharmacy Enhanced Services Network (CPESN) of Indiana and (2) design considerations for a health information exchange tool for use by community pharmacists.MethodsThis voluntary study was conducted over an 8-day survey period in which 40 pharmacies within the CPESN Indiana network were contacted during regular business hours and asked to take part in a 15-minute telephone survey. Questions asked were informed by the following Consolidated Framework for Implementation Research intervention characteristics domain constructs: relative advantage, evidence strength and quality, adaptability, trialability, complexity, costs, and design quality and packaging.ResultsOf the 40 contacted pharmacies, 32 (80%) completed the survey. Most pharmacies reported access to immunization registry data; no other routine access was reported by any pharmacy. In questions assessing the relative advantage of Health Information Exchange (HIE) access compared with their current information access, at least 84.4% said that they agreed or strongly agreed with all statements. When choosing the data element most desirable to have access to via HIE in a community pharmacy, the most frequently selected choices were updated medication orders (n = 18, 56.3%), progress notes (n = 5, 15.6%), and laboratory tests (n = 4, 12.5%). Suggestions to improve ease of implementation included integration within dispensing software and clinical decision-making support features, such as alerts for pertinent lab values.ConclusionIntegrating HIE data into community pharmacies would provide community pharmacists with access to important patient data, and pharmacists believed that this would improve their practice. Future research should explore whether implementation of this type of tool leads to better patient outcomes and improved pharmacist job satisfaction.     

Supplying emergency hormonal contraception through patient group direction: a qualitative study of the views of pharmacists

□ Pharmacists have been supplying emergency hormonal contraception via patient group direction in two health action zone areas since late 1999 and early 2000 □ This paper presents qualitative interview data on participating pharmacists' views of the service □ Pharmacists were in general extremely positive about supplying EHC via patient group direction in the pharmacy, citing the chief benefits to users as including greatly improved access at no financial cost □ Participants also noted that the scheme also enhanced the professional standing of community pharmacy and demonstrated its worth as a sexual health resource □ There were concerns about use of EHC as a “regular” form of contraception and that widened availability might increase the number of episodes of unprotected sexual intercourse and consequently, sexually transmitted infections     

Community pharmacists' attitudes to their advice-giving role and to the deregulation of medicines

The attitudes of pharmacists towards their advisory role and to the further deregulation of medicines have been surveyed using a postal questionnaire distributed to a randomly selected 20 per cent (227) of all community pharmacies in Scotland (response rate 90 per cent). Half the pharmacists thought that their role had changed since the publication of the Nuffield report in 1987, 81 per cent that their role was restricted by the range of drugs available for over-the-counter sale, and 93 per cent that they would like to see their role extended by the further deregulation of medicines; fifty eight per cent agreed that there should be a nursing formulary and 74 per cent that a corresponding pharmacists' formulary should be established. Pharmacists were also asked to suggest target preparations for deregulation: ninety per cent suggested at least one preparation, with chloramphenicol eye ointment and drops being the most frequently cited.     

Community pharmacist perceptions of delivering post-hospital discharge Medicines Use Reviews for elderly patients

Background The UK’s Department of Health has recommended that formal communication channels between hospital and community pharmacy should be established so that post discharge Medicines Use Reviews (dMUR) become an integral part of the medicines pathway. Objective To investigate the perspective of community pharmacists on the usefulness of dMUR referrals from hospital, the suitability of patients referred and overall views on the service. Method Self-completed survey distributed to 21 community pharmacists who had received referrals from the hospital during a 9-month randomized controlled feasibility study. Results Nineteen pharmacists (90.4%) returned the survey. Seven (36.8%) felt that it was hard to engage patients with dMURs. Failure or inability of patients to attend the pharmacy were the most common barriers. Reasons for medication changes (n = 5) and indications for new medicines (n = 4) were the most common examples of extra information that would be useful on referral. Community pharmacists held positive opinions on the dMUR service and could see the benefit to patients. Pharmacists wanted more referrals but reported performing few dMURs outside this study. Conclusion This study highlights the need to improve communication between hospital and community pharmacies and to overcome barriers to performing dMURs outside the pharmacy premises in this patient group.     

Documentation of patient care services in a community pharmacy setting.

OBJECTIVE: To assess the types of patient care documentation systems currently being used by community pharmacists and determine the preferred characteristics of an ideal patient care documentation system. DESIGN: Mailed survey. SETTING: United States. PARTICIPANTS: One pharmacist from each of 125 targeted community pharmacies. INTERVENTION: Survey mailed in February 2003, followed by a second mailing to nonrespondents in March 2003. MAIN OUTCOME MEASURES: Responses to survey items about (1) patient care services provided at the pharmacy, (2) characteristics of the current documentation system, and (3) characteristics of an ideal documentation system. RESULTS: A total of 48 usable responses were received from 106 pharmacies to which surveys were delivered (45.3%). Independent pharmacies accounted for 50% of survey respondents. More than 80% of respondents were providing patient screening or management services associated with a chronic disease such as diabetes, hypertension, or dyslipidemia. Approximately 54% of the pharmacists were using a paper documentation system. However, challenges identified with a paper system included documentation time, retrieval of patient data, tracking patient outcomes, and storage. Respondents indicated that an ideal documentation system would be comprehensive, easy and efficient to use, and affordable. CONCLUSION: Pharmacists recognize the importance of documenting patient care services. While the majority of respondents are using paper charts to document patient care services, computerized systems appear to offer advantages over paper charts. This information offers community pharmacists a summary of previous experiences and a starting point when trying to identify or modify a documentation system that would better meet the pharmacies' needs.     

Survey of the clinical orientation of retail pharmacists in Zimbabwe

A previous report suggests the popularity of the idea of installing consulting rooms in Zimbabwe pharmacies. A survey sent randomly to 30 retail pharmacies got 24 replies. Only 13% of pharmacists considered themselves to be pure professionals, 83% being aware of a professionel/business conflict, with 71% claming deviation from their primary role of selling medicines. 2/3 of pharmacies keep patient profiles, showing concern with medication control. Results showed that most pharmacists would be willing to extend clinical services, although it would be helpful to promote them by stressing business advantages. 74% of pharmacists would be prepared to conduct routine medical tests such as blood pressure monitoring, a program likely to enjoy public approval.     

The knowledge and attitude of the Turkish community pharmacists toward pharmacovigilance in the Kadikoy district of Istanbul

Objective We investigated the knowledge and attitudes of community pharmacists towards pharmacovigilance and adverse drug reactions (ADRs) in Kadık?y district of Istanbul (Turkey). Setting The community pharmacies in Kadikoy. Kadikoy is one of the biggest districts of Istanbul and has the largest number of pharmacies. Kadikoy district was divided into two regions, the central and the peripheral. Method Between December 2005 and June 2006 we conducted a survey about the knowledge and attitude of community pharmacists (n = 219) using a face-to-face questionnaire. The questionnaire consisted of questions about the sociodemographic characteristics of the pharmacists, their knowledge of pharmacovigilance and their attitudes towards ADR reporting. Main outcomes measured The knowledge of pharmacovigilance practice, ADR reporting compliance rates, reasons for not reporting ADR and perceptions of the Turkish community pharmacists on pharmacovigilance practice were evaluated. Results Although all 411 pharmacies in the Kadikoy district were visited, only 53% of the community pharmacists (n = 219) consented to participate in the study. Of those that did respond, only 17.2% of the pharmacists had any knowledge about ‘pharmacovigilance’. Sixty-five percent of the pharmacists stated that patients reported an ADR to them during the previous 12 months, and 21% of pharmacists reported to the concerned organizations. Our survey showed that only 7% actually reported an ADR to the national pharmacovigilance center. On the other hand, 89% of the pharmacists believed that the role of the pharmacist in ADR reporting was essential. Conclusion The results show that Turkish community pharmacists have poor knowledge about pharmacovigilance. There is an urgent need for educational programs to train them about pharmacovigilance and ADR reporting.