A postal survey to assess the views of community pharmacists on the deregulation of emergency hormonal contraception

□ This was a postal survey undertaken before EHC was available nationally in UK community pharmacies □ The survey aimed to assess attitudes of UK community pharmacists towards the deregulation of EHC □ A response rate of 66 per cent was attained and the consensus was that community pharmacists broadly agreed with the deregulation of EHC □ Pharmacists believed that the supply of EHC through pharmacies would increase their professional status, and there would be need for GP collaboration □ Although pharmacists welcomed EHC deregulation, they had reservations about legal implications     

Supply of over‐the‐counter weight‐loss products from community pharmacies

Objectives The aim was to ascertain the availability of over‐the‐counter (OTC) weight‐loss products from community pharmacies and other retail outlets in a large conurbation, and to determine the knowledge and practices of pharmacy staff in the supply of OTC weight‐loss products. Method The setting was one primary care trust in England. We used a cross‐sectional survey of 123 community pharmacies, 12 health stores and 64 supermarkets, plus telephone interview of the pharmacists. Key findings Over two‐thirds of community pharmacies (69%) and health stores (67%) but few supermarkets (8%) stocked one or more OTC weight‐loss products. In total, 73 different products were available from pharmacies, most of which (50) were claimed by manufacturers to be appetite suppressants. Seventy‐eight pharmacists were interviewed, of whom 57 stocked OTC weight‐loss products. Of these 57, only two claimed to undertake any measurements before supplying the products and 33 had no supporting materials/information about the products, although 38 claimed to provide advice. None of the 57 pharmacists had undertaken any specific training in relation to weight loss. Only 44% of all those interviewed considered OTC weight‐loss products to be useful, with even fewer (35%) considering them to be safe. Conclusions Community pharmacies are a major distributor of OTC weight‐loss products, despite the lack of evidence of their efficacy and concerns about their safety. Many pharmacists had limited knowledge of the products, placed few restrictions on their supply and viewed training in weight loss as unnecessary. Pharmacists should consider the appropriateness of supplying these products and utilize the opportunities presented to support weight reduction by more effective means.     

Educational strategies to promote evidence‐based community pharmacy practice: a cluster randomised controlled trial

□ Cluster randomised controlled trial of educational strategies in community pharmacy □ Comparison of educational outreach visits and continuing professional development as strategies for implementing guidelines for the sale of over‐the‐counter (OTC) medicines □ Outcome measures derived using simulated patients visits □ Neither educational strategy produced significant change in the sale of OTC medicines □ Further research required to identify effective and efficient educational strategies in community pharmacy.     

Evaluation of the impact of pharmacist's advice giving on the outcomes of self-medication in patients suffering from dyspepsia

The aim of this study was to investigate the outcomes of self‐medication in patients suffering from dyspepsia by comparing changes in the Health related Quality of Life before and after self‐medication of dyspeptic disorders. Another study objective was the quantitative and qualitative analysis of the pharmacist's advice‐giving to patients with dyspepsia. Therefore the impact of the counselling by the pharmacist on the patient's health outcomes was surveyed and compared between study and control pharmacies. Moreover, the study analysed the influence of a special training on the services provided by the pharmacies with regard to self‐medication.A beneficial effect of self‐medication on the HRQoL of patients with dyspepsia on a weekly basis has been detected in the study. There is evidence that advice‐giving and counselling by the pharmacists in self‐medication have a measurable impact on self‐medication outcomes. Moreover, the study reveals that patients value the information provided by the pharmacist. Pharmacists gathered the relevant and comprehensive information from the patients having dyspeptic symptoms and provided advice concerning OTC‐drugs. Moreover, pharmacists frequently discussed the relevance of factors aggravating dyspeptic disorders such as lifestyle, drinking, smoking, and manner of nutrition with the patient. Training programs and treatment guidelines for the pharmacist seem to obtain a positive effect on his performance. The findings of the study substantiate the value of a pharmacist‐controlled self‐medication. The study results suggest that the quality of primary health care in self‐medication would improve if pharmacists' involvement were even more intense.     

The implementation of a harm‐minimisation model for the identification and treatment of over‐the‐counter drug misuse and abuse in community pharmacies

This ongoing research study seeks to test a harm‐minimisation model in the community pharmacy setting for clients suspected of abusing or misusing OTC medicines Pharmacists are identifying suspected clients through record keeping of sales of OTC products containing opioids, antihistamines and laxatives A preliminary evaluation (after seven weeks of data collection) showed that most suspected OTC misusers were female and regular customers while most OTC abusers were strangers Pharmacists are now recruiting patients into the treatment (harm‐minimisation) phase of the study     

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.     

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     

Using computer‐tailored smoking‐cessation advice in community pharmacy: A feasibility study

Objective Community pharmacists are in an optimal position to provide smoking‐cessation services. Computer‐based interventions that generate behavioural feedback materials designed to encourage and help smokers to quit can complement existing services and ensure that smoking‐cessation advice is reliably delivered. This study aimed to assess the feasibility of offering a system of computer‐generated individually tailored behavioural feedback for smoking cessation in community pharmacy. Method The setting was community pharmacies in North London. Pharmacists, already offering cessation advice routinely in the pharmacy, were trained to use a computer‐based system generating a feedback report containing highly tailored behavioural advice about quitting. Pharmacists' advice was structured around the report, which was printed for the participant. Pharmacists were interviewed after recruitment ended, and participants were sent a follow‐up questionnaire 4 weeks after baseline. Key findings Pharmacists felt they had benefited from taking part in the study and were more confident in their management of, and advice to, smokers. All agreed that the computer program was an acceptable and valuable tool to aid smoking‐cessation advice in pharmacies. Eleven smokers were recruited; five completed the follow‐up, four of whom reported 4‐week prolonged abstinence. Reaction to the feedback report from participants was positive. Conclusions The feedback from both pharmacists and participants demonstrates that use of this computer system to structure and standardise delivery of smoking‐cessation advice in community pharmacy is feasible and acceptable. The study suggests that the use of this system could increase pharmacists' confidence and the quality of the advice they give, leading to improved outcomes. However, a randomised controlled trial to fully evaluate the effectiveness of the system is needed.     

A patient‐held medication record and a patient medication profile to support the continuity of acute cancer care

□ The sharing of care of patients receiving medical oncology care is vulnerable to errors in their documented drug history □ A patient‐held medication record identified over 90 per cent of patients' medications but was ‘forgotten’ by the patient in a third of contacts with a pharmacist □ Discrepancies between the medication records of GPs, community pharmacists and the medical oncology clinic were highly prevalent □ A posted patient medication profile issued by the hospital pharmacist to both the patient's GP and their community pharmacist was associated with a significant convergence in their records (discrepancies reduced from 17 to 6 % P<0.001) □ The patient‐held record had little impact on the accuracy of practitioners' records and its value lies more in facilitating patient education than rectifying errors in documentation     

Identification of medication error through community pharmacies

Objective The objective of this study was to record medication error against specific categories identified through community pharmacies in Southern Derbyshire. Method A piloted diary‐based reporting instrument was used with defined medication error incident type related to who identified the error and the stage in the process when the error was discovered. Setting Community pharmacies in Southern Derbyshire (UK) between October 2002 and October 2003. Key findings Seventeen pharmacies over 104 months supplied 485 940 prescribed items and provided data on 987 medication errors. A large variation in error reporting between pharmacies was noted. Pharmacists identified 72% of reported errors. This has implications for system change, clinical governance and the evolving role of the pharmacy technician. Critically, 23% of reported errors were identified after medicines were issued to patients or carers. This begs a question as to the effectiveness of current practice in identifying error early in the process. Of 968 recorded errors for which full data were available, 70% were classed as dispensing errors. This compared with 24.1% of recorded errors being prescribing and 6.0% as ‘other’ types of error. While 25.2% of identified errors concerned the wrong strength or form of medication, more worryingly, 11.0% of identified errors involved the wrong drug being potentially or actually dispensed. Conclusions We conclude that medication error will occur in current practice. There are identifiable deficiencies in practice that leave patients potentially exposed. This study provides benchmark figures on reported error and concludes that there are specific areas of concern for future research.     

Recommendations and guidance for providing pharmaceutical care services during COVID-19 pandemic: A China perspective

BackgroundThe novel coronavirus pneumonia (COVID-19), which was first detected in Wuhan City, has now became a pandemic that affecting patients around the world. Particularly, the community patient population are at high risk of infection and are facing potential failure of proper medication use during the pandemic.ObjectiveTo discuss community pharmacists’ role and the content of pharmaceutical care (PC) during the novel coronavirus pandemic to promote effective prevention and control and safe drug use of the community patient population.MethodCollect and summarize the experience Chinese community pharmacies gained from providing pharmacy services during the COVID-19 outbreak, and taking patients' PC needs into consideration, analyze and discuss the methods and strategies that community pharmacies and pharmacists shall use to provide PC during the pandemic.ResultsCommunity pharmacy management teams shall support PC services by providing adequate supply of COVID-19 related medications and preventative products, following environment regulations, and providing sufficient staff trainings. Pharmacists shall use various approaches to provide PC services in drug dispensing, consulting and referrals, chronic disease management, safe use of infusions, patient education, home care guidance and psychological support to promote the COVID-19 pandemic control and ensure safe medication use of community patients during the pandemic.ConclusionPC services in communities during the COVID-19 shall possess different properties due to disease characteristics and related change in patients' need. Community pharmacies shall work as a strong supporter of patient's medication and protective equipment supply. Community pharmacists shall be prepared to provide skilled and effective PC services for community patient population to ensure medication safety and promote the overall COVID-19 pandemic control.     

Working alongside nursing staff to review medication in nursing homes

□ Pharmacists performed medication reviews in nursing homes using the nursing staff as a source of information □ Lack of access to medical records did hamper the review but was not the main reason for non‐implementation □ The recommendations were more likely to be implemented if further clinical information was supplied to the general practitioner □ All of the pharmacists, all of the nursing staff responding and a majority of the GPs who responded wished to see the project continue □ Future training of community pharmacists should focus on “how to review”.     

Children's over‐the‐counter medicines pharmacoepidemiological (COPE) study

Objective To quantify the extent and types of minor ailments in children that were presented at community pharmacies and the types of over‐the‐counter (OTC) medicines purchased in response to these ailments. Method Data on all requests and sales of OTC medicines for children (aged 16 years and under) and consultations for minor ailments in children were recorded in eight community pharmacies for one week every month over a 12‐month period. Participants were members of the public who consulted the pharmacists or other pharmacy staff in the community pharmacies. Key findings A total of 976 consultations was recorded with 61.5% requesting an OTC medicine by name and 38.5% by symptom presentation. An average of 10.2 consultations was made per pharmacy per week. Requests for treatment were usually made within five days of symptom occurrence (86%). Most of the consultations were made by mothers (75%), although 17% were by fathers. The most commonly purchased OTC medicine was paracetamol. There were five requests for aspirin and one was for a 2‐year old child. A total of 62 cases (6%) was referred back to the child's primary care physician (general practitioner). Conclusions Symptoms related to cough and cold were the most common problems in children presenting to community pharmacies for treatment. Paracetamol was the most widely used OTC medicine in children. Pharmacy staff do question the request for OTC medicines such as aspirin, to ensure its safe use. Community pharmacies play an important role as the first port of call for advice on minor ailments in children and have an opportunity to provide health promotion to carers of children.