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PloS One 2018This is the first exploration of service providers' attitudes and beliefs of quality and quality improvement in the community pharmacy setting in the UK.
INTRODUCTION
This is the first exploration of service providers' attitudes and beliefs of quality and quality improvement in the community pharmacy setting in the UK.
MATERIALS AND METHODS
A series of interviews and focus groups was conducted with stakeholders from the pharmacy profession in the UK. Interviews were semi-structured and conducted face-to-face or by telephone. Focus groups were conducted with naturally-occurring groups i.e. at pharmacy conferences. Interviews and focus groups were audio-recorded, transcribed and analysed systematically using an interpretive approach.
RESULTS
Forty-two individuals participated across four focus groups and four interviews. A maximum variation sample was achieved in terms of pharmacist and pharmacy characteristics. Participants were generally positive about the need for quality and quality improvement and provided multifaceted and interlinked interpretations of quality and acknowledged its dynamic nature "quality moves forward". The challenge of standardising practice whilst providing person-centred care emerged: "you don't want to lose the personal touch, but you can't have people having a variable experience and one day it's fantastic and the next day it isn't". A variety of quality measurement methods were identified including direct observation (by internal and external agents) and feedback (mystery shoppers, colleagues, regulatory inspectors, service users), suggesting that standardisation was also needed in terms of future quality measurement. There was a tendency to report negative events as triggers for improvement. Future initiatives could adopt more positive approaches including positive deviants "There's nothing more powerful than people who've come up with something really good sharing it with their other colleagues".
DISCUSSION
The results are being used to develop and evaluate future quality improvement initiatives in this sector. These are likely to be targeted at organisational, team and individual levels.
Topics: Attitude of Health Personnel; Community Pharmacy Services; Female; Focus Groups; Humans; Male; Pharmacies; Pharmacists; Quality Improvement; United Kingdom
PubMed: 30036368
DOI: 10.1371/journal.pone.0200610 -
The International Journal of Pharmacy... Apr 2018The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary... (Review)
Review
OBJECTIVE
The widespread sale of complementary medicines in community pharmacy raises important questions regarding the responsibilities of pharmacists when selling complementary medicines. This study reviews the academic literature that explores a pharmacist's responsibilities when selling complementary medicines.
METHODS
International Pharmaceutical Abstracts, Embase, PubMed, Cinahl, PsycINFO and Philosopher's index databases were searched for articles written in English and published between 1995 and 2017. Empirical studies discussing pharmacists' practices or perceptions, consumers' expectations and normative studies discussing ethical perspectives or proposing ethical frameworks related to pharmacists' responsibilities in selling complementary medicines were included in the review.
KEY FINDINGS
Fifty-eight studies met the inclusion criteria. The majority of the studies discussing the responsibilities of pharmacists selling complementary medicines had an empirical focus. Pharmacists and consumers identified counselling and ensuring safe use of complementary medicines as the primary responsibilities of pharmacists. No formal ethical framework is explicitly employed to describe the responsibilities of pharmacists selling complementary medicines. To the degree any ethical framework is employed, a number of papers implicitly rely on principlism. The studies discussing the ethical perspectives of selling complementary medicines mainly describe the ethical conflict between a pharmacist's business and health professional role. No attempt is made to provide guidance on appropriate ways to resolve the conflict.
CONCLUSION
There is a lack of explicit normative advice in the existing literature regarding the responsibilities of pharmacists selling complementary medicines. This review identifies the need to develop a detailed practice-specific ethical framework to guide pharmacists regarding their responsibilities when selling complementary medicines.
Topics: Attitude of Health Personnel; Commerce; Community Pharmacy Services; Complementary Therapies; Humans; Pharmacies; Pharmacists; Practice Guidelines as Topic; Professional Role; Professional-Patient Relations
PubMed: 29315916
DOI: 10.1111/ijpp.12425 -
The Annals of Pharmacotherapy Sep 2020To review specific literature that aimed to predict the future of US pharmacy, beginning in the late 1980s. Articles were identified from searching MEDLINE, CINAHL,...
To review specific literature that aimed to predict the future of US pharmacy, beginning in the late 1980s. Articles were identified from searching MEDLINE, CINAHL, Google Scholar, and references of relevant articles. The following combinations of search terms were used: , , , and . The following inclusion criteria were applied: (1) full-text commentary, review, or original research and (2) focused predominantly on the pharmacy in the United States. Data on predictions for the future of pharmacy were extracted. We selected 3 articles published between 1988 and 2006, with each aiming to project the future for the following decade. We examined each prediction in light of the current knowledge. Educators, practitioners, and other stakeholders should consider reflecting on the changes in pharmacy for the past 3 decades and applying both historical and emerging trends to improve patient care and sustain practice in the third decade of the 21st century and beyond. Most of the predictions for the future of pharmacy from the past 3 decades materialized, with some still in progress (reimbursement for pharmacy services), whereas others manifested in unexpected ways (transition from shortage to excess of pharmacists). Current forces shaping pharmacy include, but are not limited to, growing spending and use of specialty drugs, automation of pharmacy operations, growth of pharmacy in the digital health enterprise, and growing consumer interest in the use of analytical pharmacy that tests drugs before dispensing.
Topics: History, 20th Century; History, 21st Century; Humans; Patient Care; Pharmaceutical Services; Pharmacies; Pharmacists; Pharmacy; United States
PubMed: 32115996
DOI: 10.1177/1060028020911085 -
Die Pharmazie Oct 2019The aim of this study was to clarify the community pharmacy-level factors related to experiences of and attitudes toward collaboration with medical and nursing home care...
The aim of this study was to clarify the community pharmacy-level factors related to experiences of and attitudes toward collaboration with medical and nursing home care facilities. We conducted a postal questionnaire survey of all pharmacies in Gifu, Japan, assessing the experiences and attitudes of supervising pharmacists regarding the following activities related to collaboration between medical facilities and nursing home care facilities: regional care meetings/service adjustment meetings, case discussion conferences, joint workshops/continuing education conferences, community service, information sharing through medical cooperation networks, and pharmacists accompanying physicians on home care visits. The factors significantly related to inter-professional collaboration were the family pharmacist guidance fee and the number of patients offered pharmaceutical care through cooperation with other medical facilities. Items on attitudes toward collaborating with other medical facilities showed similar results. Overall, policies that support inter-professional collaboration to create a foundation, establish mechanisms to facilitate collaboration, and identify collaborative activities that can be carried out at each pharmacy should be developed.
Topics: Community Pharmacy Services; Female; Home Care Services; Humans; Japan; Male; Nursing Homes; Pharmacies; Pharmacists; Surveys and Questionnaires
PubMed: 31685091
DOI: 10.1691/ph.2019.9489 -
The International Journal of Pharmacy... Feb 2018Effective strategies are needed to translate knowledge (evidence) into practice to improve the quality of community pharmacy services. We report the first step of a...
OBJECTIVES
Effective strategies are needed to translate knowledge (evidence) into practice to improve the quality of community pharmacy services. We report the first step of a novel knowledge translation process which involved the systematic identification and prioritisation of community pharmacy services in Scotland which were perceived to require improvement and/or guideline development.
METHODS
This process involved three stages and a stakeholder group comprising community pharmacists, policy makers, lay and pharmacy organisation representatives. A modified nominal group technique (NGT) was used for topic generation (August 2013) followed by an electronic Delphi survey (eDelphi), October-December 2013) and topic rationalisation (December 2013) based on feasibility, acceptability, and potential impact for practice improvement.
KEY FINDINGS
In total, 63 items were identified during the modified NGT which were categorised into 20 topics to form the starting point of the eDelphi. In total, 74 individuals (mostly community pharmacists) indicated an interest in the eDelphi, which achieved response rates of 63.5%, 67.6%, and 70.3%, respectively in Rounds 1, 2, and 3. Consensus was achieved with six topics: promoting the appropriate sale and supply of over-the-counter medicines; patient counselling for prescribed medication; pharmaceutical care to promote medication adherence; promotion and delivery of a Minor Ailment Scheme; pharmaceutical care of vulnerable patients; and effective use of community pharmacy workforce. Of these, the priority topic selected for the next stage of the programme was promoting the appropriate sale and supply of over-the-counter medicines.
CONCLUSIONS
This study adopted a systematic, inclusive, and rapid approach to identify priorities for community pharmacy practice improvement in Scotland.
Topics: Commerce; Community Pharmacy Services; Counseling; Humans; Medication Adherence; Nonprescription Drugs; Pharmacies; Pharmacists; Practice Guidelines as Topic; Prescription Drugs; Professional Role; Quality Improvement; Scotland
PubMed: 28349646
DOI: 10.1111/ijpp.12354 -
BMC Health Services Research Mar 2019Worldwide community pharmacies are shifting their role in the healthcare system from simple medication dispensers to health care providers. High levels of satisfaction...
BACKGROUND
Worldwide community pharmacies are shifting their role in the healthcare system from simple medication dispensers to health care providers. High levels of satisfaction with pharmacy services were found in previous studies. This study has two main goals. The primary goal is to describe the levels of satisfaction and knowledge regarding pharmacy services in Portugal. The secondary goal is to explore the perceptions and the utilisation of pharmacy services by the Portuguese. This statement includes exploring the impact of a set of variables on both perceptions and uses of pharmacies in regard to services that are currently offered as well as to new services that may be provided in the future.
METHODS
A face-to-face survey of closed-ended questions was applied to a nationwide representative sample of the Portuguese population in September 2015. The sample was weighted based on population distribution across regions, habitat, age and gender. Data analysis comprises descriptive statistics and Multiple Correspondence Analysis to explore different typologies of respondent's orientation toward community pharmacy.
RESULTS
A total of 1114 interviews comprised the study. Of the respondents, 36% used the pharmacy as a first resource when seeking to treat a minor ailment, and 54% reported that they use the pharmacy as a first resource when seeking answers about medicines. Of those who visited their pharmacy at least once in the previous year, 94% were either globally satisfied or very satisfied. The level of acknowledgement of pharmacy services' was also high among the Portuguese. Of the participants, 29% considered there could be more services available in pharmacies that are currently provided by other health care facilities. The construction of a typology of orientations towards community pharmacy practice resulted in three outcome groups: "Motivated" (63%), those with a connection to a pharmacy; "Settled" (23%), mainly those who had a pharmacy nearby; and "Demobilised" (14%), those who are weakly tied to a pharmacy.
CONCLUSIONS
The vast majority of the Portuguese population has a strong positive attitude towards their community pharmacy, as expressed by the high levels of satisfaction with, and positive evaluation of, the pharmacy's services.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Community Pharmacy Services; Delivery of Health Care; Facilities and Services Utilization; Female; Humans; Male; Middle Aged; Patient Satisfaction; Perception; Pharmacies; Portugal; Public Opinion; Surveys and Questionnaires; Young Adult
PubMed: 30898124
DOI: 10.1186/s12913-019-3987-3 -
BMJ Sexual & Reproductive Health Jan 2021Over-the-counter provision of emergency contraception pills (ECP) has increased since deregulation of progestogen-only formulations and is now the most common public...
INTRODUCTION
Over-the-counter provision of emergency contraception pills (ECP) has increased since deregulation of progestogen-only formulations and is now the most common public health service provided by UK pharmacists. Important questions relate to women's perceptions of their experience of receiving ECPs from pharmacists.
METHODS
Qualitative study: in-depth interviews with young women reporting ECP use, recruited from clinic (10); pharmacy (6) and community settings (5) in London.
RESULTS
Key advantages of pharmacy provision were ease and speed of access and convenience. Disadvantages included a less personal service, inadequate attention to information needs and to prevention of recurrence of ECP need, and unsupportive attitudes of pharmacy staff. Suggested service improvements included increasing privacy, providing more contraceptive advice, adopting a more empathetic approach and signposting follow-up services.
CONCLUSION
Pharmacies are important in the choice of settings from which ECPs can be obtained and many aspects of pharmacy provision are appreciated by young women. There is scope to further enhance pharmacists' role.
Topics: Adolescent; Adult; Contraception, Postcoital; Female; Health Services Accessibility; Humans; Interviews as Topic; London; Pharmacies; Qualitative Research; Surveys and Questionnaires
PubMed: 32576555
DOI: 10.1136/bmjsrh-2019-200339 -
American Journal of Pharmaceutical... Sep 2018The first tenet of the Code of Ethics for Pharmacists of the American Pharmacists Association describes the relationship between the pharmacist and the patient as a...
The first tenet of the Code of Ethics for Pharmacists of the American Pharmacists Association describes the relationship between the pharmacist and the patient as a covenant. The central argument of this commentary is that the symbolic language of covenant, the metaphor used to describe the pharmacist-patient relationship, should be formally acknowledged as an ideal theory or concept. However, before committing to this ideal, there should be resonance with the realities of pharmacy practice. This commentary argues that the intimate nature of a covenantal relationship is not a good fit with most contexts in which pharmacists practice. The disconnection between the ideal of the covenantal relationship and context is important because codes of ethics apply regardless of context. By acknowledging the ideal of a covenantal relationship, transitional structures could then be developed to move the pharmacy profession toward this ideal.
Topics: Education, Pharmacy; Humans; Pharmaceutical Services; Pharmacies; Pharmacists; Professional Role; Professional-Patient Relations; United States
PubMed: 30323395
DOI: 10.5688/ajpe6806 -
Journal of the American Pharmacists... 20181) To describe reported medication diversion within the practice of pharmacy; and 2) to compare diversion by employee type.
OBJECTIVES
1) To describe reported medication diversion within the practice of pharmacy; and 2) to compare diversion by employee type.
DESIGN
Retrospective study.
SETTING
A sample of state board of pharmacy records was examined from 9 states. Disciplinary actions were obtained from the records for the time period of May 2008 to May 2013.
PARTICIPANTS
Pharmacy employees (pharmacist, technician, interns).
INTERVENTION
Not applicable.
MAIN OUTCOME MEASURES
When a diversion case was identified, the following items were obtained for each case of medication diversion: 1) category of pharmacy employee (pharmacist, technician, intern); 2) type of substance (control, noncontrol, both); 3) use of diverted substance (sale, personal use, both, undetermined); and 4) action taken by the board.
RESULTS
A total of 811 medication diversion cases in 9 states were identified. Most cases involved a pharmacy technician (71.4%), controlled substances only (94.2%), and diversion for personal use (46.6%) and resulted in license or registration revocation or surrender (62.5%). When examining medication diversion use by purpose for diversion, there were significant differences by pharmacy employee type (sale use: P = 0.003; personal use: P = 0.032; unknown use: P < 0.001).
CONCLUSION
Medication diversion is a pressing problem. There were 811 cases examined by 9 state boards, and many cases may be unreported. Technicians represent nearly three-fourths of diversions. It is essential that the practice of pharmacy identifies and assesses strategies to reduce medication diversion.
Topics: Health Personnel; Humans; Internship and Residency; Pharmaceutical Services; Pharmacies; Pharmacists; Pharmacy Technicians; Professional Role; Retrospective Studies
PubMed: 29602744
DOI: 10.1016/j.japh.2018.02.009 -
Journal of the American Pharmacists... 2018To determine the awareness, collaboration, and perceived values and barriers of enhanced pharmacy services from care managers and primary care practice responders.
OBJECTIVES
To determine the awareness, collaboration, and perceived values and barriers of enhanced pharmacy services from care managers and primary care practice responders.
METHODS
An electronic questionnaire was sent to 1648 primary care practices and 600 care managers that work in 76 North Carolina counties containing an enhanced-service community pharmacy. Questionnaires were distributed in January 2017 and responses collected for 7 weeks. The questionnaire collected data on the awareness and perceived value of enhanced pharmacy services, preferred method and level of communication for referral, and barriers to using enhanced services. Data were gathered with the use of Likert-type, rank-order, dichotomous, and multiple-choice questions. Data were analyzed with the use of descriptive statistics, and group mean responses were compared by means of t tests.
RESULTS
Data analysis was performed in March 2017. Response rates were 5.4% (n = 89) from practice responders and 45% (n = 270) from care managers. In the responses received, 35% of practice responders and 88% of care managers were familiar with enhanced services offered by community pharmacies. A majority of respondents thought that enhanced pharmacy services are valuable, with more than 85% of practice responders agreeing that partnering with an enhanced-service pharmacy can help to improve patient health outcomes. Lack of knowledge of enhanced-service pharmacies, services offered, and the referral process were identified as significant barriers for practice responders.
CONCLUSION
Community-based pharmacies have an opportunity to collaborate with patient-centered medical home teams to provide enhanced pharmacy services, but provider outreach and education on enhanced services offered and the referral process are necessary to maximize this collaboration.
Topics: Community Pharmacy Services; Humans; Pharmacies; Pharmacists; Primary Health Care; Professional Role; Surveys and Questionnaires
PubMed: 30006190
DOI: 10.1016/j.japh.2018.05.009