Evaluation of community pharmacy service mix: evidence from the 2004 National Pharmacist Workforce Study.

OBJECTIVES: To describe the mix of pharmacy services being offered in different types of community pharmacy practices and to identify factors associated with a community pharmacy offering pharmacy services. DESIGN: Cross-sectional study. SETTING: Community pharmacies (independent, chain, mass merchandiser, and supermarket pharmacies). PARTICIPANTS: Pharmacists practicing full-time or part-time who worked in community pharmacies and responded to the 2004 National Pharmacist Workforce Survey. INTERVENTION: Mailed survey from the 2004 National Pharmacist Workforce Survey, which included core content questions for all sampled pharmacists and supplemental surveys that included workplace questions for a selected subsample of pharmacists. MAIN OUTCOME MEASURES: Type and frequency of pharmacy services being offered in a community pharmacy, including dispensing and product-related services (e.g., specialty compounding), and pharmacist care services (e.g., immunizations, smoking cessation, health screening, medication therapy management, wellness screening, nutritional support, and disease management services). RESULTS: Four pharmacist care services were reported as being offered at more than 10% of community pharmacy practices: immunizations, smoking cessation, health screening, and diabetes management. The number of pharmacist care services offered at a community pharmacy was positively associated with having at least three pharmacists on duty, innovativeness of the pharmacy, status as an independent pharmacy, and status as a supermarket pharmacy. More than one half of the community pharmacy practices did not offer any of the eight pharmacist care services included in a pharmacy service index. CONCLUSION: Pharmacy services were reported at relatively few community pharmacies, and were associated with pharmacy innovativeness, pharmacist staffing levels, and pharmacy setting. Some community pharmacies are offering pharmacy services as part of their business strategy, while others are dedicated to dispensing services. Continued study of pharmacy service availability in community pharmacies is needed to improve our understanding of our capacity to deliver such services, including medication therapy management services.     

Opportunities and responsibilities for pharmacists on short-term medical mission teams

BackgroundAmerican medical mission teams commonly travel to developing countries for short-term provision of clinical services. Although medications play an important role in the work of these teams, how to plan and organize a mission field pharmacy has been seldom described in the literature.ObjectiveTo describe pharmacist participation in medical mission work.SummaryGlobal standards and policies, as well as traditional best practices, should be applied to the selection, acquisition, use, and disposition of medications taken into a host country. This report describes the roles and responsibilities of pharmacists in planning and organizing a mission pharmacy and in delivering quality pharmacy services in the field.ConclusionPharmacists have an important contribution to make to medical mission teams. Pharmacist knowledge of drug products, regulatory issues, medication storage, dispensing, patient consultation, therapeutic substitution, and pharmacy organization and workflow is ideally suited for mission field work.     

Effectiveness and acceptability of community pharmacy‐based interventions in type 2 diabetes: a critical review of intervention design,pharmacist and patient perspectives

Objective It is generally accepted that greater use could be made of community pharmacy‐based interventions. Diabetes care has been proposed as an area for enhanced community pharmacy involvement. However there is no published structured review of available evidence of either effectiveness or acceptability. This review aims to identify and assess such evidence and to synthesise findings to inform the design and delivery of future community pharmacy‐based interventions in diabetes care. Method A systematic search of published literature was conducted using a defined search strategy, electronic databases and targeted hand searching of non Index Medicus journals. The search dates were 1990–2003. The scope was international and we included only articles in the English language. Key findings Seven experimental studies which tested community pharmacy‐based interventions were reviewed. Four different primary outcomes were studied: diabetes control (three studies), adherence (two studies), medication problems (one study) and patient knowledge (one study). Six studies showed positive outcomes, and the findings were statistically significant in two. The theoretical basis of the interventions was unclear. Only one study included a cost‐effectiveness analysis, and the interventions were provided free of charge to patients in all seven studies. Nine attitudinal studies were included, five involving pharmacists and four with patients. Members of the public do not currently expect community pharmacists to become involved in discussions about diabetes treatment and its monitoring, but when such services are offered they are well used by patients. Pharmacists were positive about the provision of services for people with diabetes. Patients' experiences indicated that community pharmacists overestimate their current provision of information and advice to people with diabetes. Conclusions There is limited evidence of effectiveness of community pharmacy‐based interventions in diabetes care. Components of pharmacy‐based intervention which appear to contribute to effectiveness include: elicitation and discussion of patient beliefs about their diabetes and its treatment; discussion of how patients are using their medicines; review of haemoglobin A_1c (HbA_1c) levels; and assessing and supporting necessary lifestyle changes. Further research is needed and future interventions need to incorporate evidence from the literature on patient and pharmacist perspectives on diabetes. The findings of this review will be useful to researchers and service planners involved in developing community pharmacy‐based diabetes care.     

糖尿病患者的社区药学服务效果评价

目的对社区糖尿病患者实施药学服务并进行效果评价。方法以农民健康体检中发现的糖尿病患者为开展社区药学服务的对象,成立社区糖尿病协会,联村社区责任医生及药学专业技术人员对糖尿病患者进行定期集中或上门药学咨询服务。结果经过1年社区药学服务,367例糖尿病患者的服药率、规律服药率、血糖知晓率和控制率得到了较大提高,其中规律服药率由干预前的51.23%上升到干预一年后的90.19%,血糖知晓率由74.11%上升为97.55%,血糖控制率由47.14%上升到89.65%。药品不良反应的发生率明显降低,群众的用药知识显著增加,群众对社区卫生服务的信任、满意度提高。结论实施糖尿病患者社区药学服务是控制糖尿病的有效措施。