Australian community pharmacists' practice in complementary medicines: a structural equation modeling approach

Objective

This survey tested a model of factors influencing pharmacists’ practice in relation to complementary medicines (CMs).

Methods

Self-administered questionnaires were used to collect data from 212 community pharmacists in New South Wales. Structural equation modeling with AMOS version 6.0, was used to model two practices in relation to CMs: an evaluation of appropriateness of CM use and the decision to sell.

Results

Pharmacists’ perceptions of their responsibilities in ensuring the safe use of CMs predicted the comprehensiveness of an evaluation for appropriateness of CM use (P = 0.002). When level of comprehensiveness of evaluation increased, pharmacists were less likely to sell CMs in situations where the use of the products was not considered appropriate (P = 0.021). Pharmacists’ confidence in their CM knowledge, attitudes towards CMs, concern about pharmacy income and pharmacists’ characteristics did not significantly affect their practice.

Conclusion

Pharmacists’ acceptance of their counseling responsibility with respect to CMs was the strongest predictor of both comprehensiveness of an evaluation and the decision to sell a CM.

Practice implications

Pharmacists must be encouraged to recognise and accept their responsibility in ensuring the safe and effective use of CMs.     

Different development of general beliefs about medicines during undergraduate studies in medicine,nursing and pharmacy

Objective

To analyze differences in general beliefs about medicines between healthcare students and to see if health education was of importance to general beliefs about medicines.

Method

The participants were students of medicine, pharmacy, pharmaceutical bioscience, dispensing pharmacy, nursing and economics (comparison group) at the University of Gothenburg. Data were collected twice in 2003 and 2005. A questionnaire was used comprising background questions and the general part of Beliefs about Medicines Questionnaire.

Results

The questionnaire was completed by 460 of 642 (71.7%) first-year and 293 of 398 (73.6%) third-year students. Over 70% were women and two-thirds were under 25 years of age. Medical and pharmacy students saw medicines as less harmful than nursing students did. Stage of education was also important: third-year medical and pharmacy students saw medicines as more beneficial and less harmful than first-year students did. Experience of medicine use was relevant to general beliefs about medicines.

Conclusion

Different beliefs exist between healthcare professions owing to different types and stages of education, which could result in different messages being given to the patient.

Practice implications

It is important to educate future healthcare professionals about the potential effect of beliefs on communication.     

Low perceived service quality in community pharmacy is associated with poor medication adherence

ObjectiveCommunity pharmacists are highly accessible healthcare professionals, whose regular contact with patients provides ongoing opportunities to improve medication safety and promote medication adherence. This study investigates whether patients who experience low service quality in community pharmacies are less adherent to their regular medications.MethodsEight Australian pharmacies were recruited, 5 self-identified as having a price promotion business strategy and 3 with a service-focused business strategy. Patients taking regular prescribed medicines who had previously attended the pharmacy completed e-surveys in-store with measures of perceived service quality (pSQ) and self-reported adherence. Multivariate regression using multilevel modelling with bootstrapping was used to explore the relationships between variables.ResultsSurveys were completed by 319 respondents. Attending pharmacies with a price promotion business strategy was predictive of lower pSQ and poor medication adherence. The between-pharmacy slope of the relationship between pSQ and adherence was 2.25 (with 95 % confidence intervals = 1.50, 2.86) and was highest in pharmacies with lowest pSQ.ConclusionThis study highlights that when patients experience low service quality, in community pharmacies they are more likely to report poor adherence to their regular prescribed medicines.Practice implicationsCommunity pharmacies need to be designed and managed to allow pharmacists to provide high levels of patient-centred care.     

Communication with patients who are dispensed a first prescription of chronic medication in the community pharmacy

Objective

To analyze information and communication in the community pharmacy when patients collect a first dispensing for chronic medication.

Methods

In 3 pharmacies in the South-West of the Netherlands, counter-based communication with patients receiving a first dispensing for chronic medication was observed and audiotaped. Each contact was analyzed by two observers using an observation checklist. An 11-item questionnaire was given to the patients.

Results

72 Patients were included. Only pharmacy technicians provided information. Average contact lasted approximately 2 min. A computer checklist to support information giving was closely followed. Interactions were structured with introduction and closure. Mostly, information was given without exploring needs of the patient. Questioning showed open-ended questions (26%); check-questions and questions asking feedback (57%). A mean general score given was 5.8 (range 1-9). Of 46 responders who filled in a questionnaire, the majority felt that information was useful, clear and understandable.

Conclusion

Our results show a concise and efficient way of information giving, closely related to a computer checklist. Technicians dominate the interaction. They ask few questions. Patients are satisfied about provided information and the contact.

Practice implications

We suggest a more patient-centered way of communication to increase patients’ participation and to meet patients’ needs for information.