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Currents in Pharmacy Teaching & Learning Aug 2023Experiential education helps to integrate knowledge into practice, develops professionalism and understanding of a pharmacist's role in practice, and is a major...
INTRODUCTION
Experiential education helps to integrate knowledge into practice, develops professionalism and understanding of a pharmacist's role in practice, and is a major component of pharmacy education. The role of the preceptor in experiential education is to model professional behaviours and provide feedback on student preceptee performance and competence. Little is known about how preceptors feel about their competency being assessed or the most appropriate way to assess competency.
METHODS
A qualitative study using focus groups was designed, and a purposive convenience sampling strategy was used to target pharmacy students, current pharmacy interns, and registered pharmacists. A semi-structured interview guide was used to probe participants' views of what makes for a good preceptorship experience, opinions about assessment of preceptor competency, and barriers to training and assessment of preceptors.
RESULTS
Thirteen focus groups and three interviews were conducted with 56 participants from rural, regional, and urban areas in New South Wales, Australia. Six main themes were generated: the purpose of preceptorship, becoming a preceptor, developing shared expectations, experiences, competing demands, and assessment of preceptor competence.
CONCLUSIONS
Preceptorship plays a vital role in the career development of pharmacy students and graduates. Preceptees expect the experience they attain will be the same as their peers regardless of site. Assessing preceptor competency has been identified as a way of standardising performance. This study highlights the need to better support preceptors with the aim of better standardising the preceptorship experience.
Topics: Humans; Preceptorship; Pharmacy; Education, Pharmacy; Pharmaceutical Services; Pharmacies
PubMed: 37500303
DOI: 10.1016/j.cptl.2023.07.003 -
Missouri Medicine 2023
Topics: Humans; United States; Pharmacy; Drug Costs; Pharmacies
PubMed: 37609464
DOI: No ID Found -
Systematic Reviews Nov 2019Pharmacy interventions are a subset of public health interventions and its research is usually performed within the scope of a trial. The economic evaluation of pharmacy... (Review)
Review
BACKGROUND
Pharmacy interventions are a subset of public health interventions and its research is usually performed within the scope of a trial. The economic evaluation of pharmacy interventions requires certain considerations which have some similarities to those of public health interventions and to economic evaluations alongside trials. The objective of this research is to perform an overview of systematic reviews of economic evaluations of pharmacy services and triangulate results with recommendations for economic evaluations of both public health interventions and alongside trials.
METHODS
(1) Exploratory review of recommendations on the economic evaluation of public health interventions, (2) exploratory review of recommendations for conducting economic evaluations alongside trials, (3) overview of systematic reviews of economic evaluations of pharmacy interventions (protocol registered with PROSPERO 2016 outlining information sources, inclusion criteria, appraisal of reviews and synthesis methods).
RESULTS
Fourteen systematic reviews containing 75 index publications were included. Reviews reported favorable economic findings for 71% of studies with full economic evaluations. The types of economic analysis are diverse. Two critical quality domains are absent from most reviews. Key findings include the following: certain types of risk of bias, wider scope of study designs, and most economic quality criteria met but some issues unresolved or unclear. Triangulation revealed additional gaps. Limitations include choice of critical quality domains and potential biases in the overview process.
CONCLUSIONS
Economic evaluations of pharmacy-based public health interventions seem to follow most economic quality criteria, but there are still some issues in certain key areas to improve. These findings may assist in improving the design of pilot trials of economic evaluations in pharmacy, leading to robust evidence for payers. Based on the findings, we propose a methodological approach for the economic evaluation of pharmacy-based public health interventions.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42016032768.
Topics: Humans; Cost-Benefit Analysis; Pharmaceutical Services; Pharmacies; Public Health Practice; Systematic Reviews as Topic
PubMed: 31711541
DOI: 10.1186/s13643-019-1177-3 -
Journal of Managed Care & Specialty... Jun 2020Improving medication adherence can reduce health care spending, and studies have demonstrated community pharmacists can positively affect adherence through the provision...
BACKGROUND
Improving medication adherence can reduce health care spending, and studies have demonstrated community pharmacists can positively affect adherence through the provision of enhanced services. The North Carolina (NC) Community Pharmacy Enhanced Services Network (CPESN) was formed in early 2014 with the goal of enhancing the care provided through its network pharmacies.
OBJECTIVE
To evaluate differences in medication adherence performance scores between pharmacies that participated in the NC-CPESN and control pharmacies in NC that did not.
METHODS
Medication adherence performance data for statins, renin-angiotensin system antagonists, oral diabetes medications, and a custom multiple chronic medication measure were gathered from quarterly reports between December 2014 and September 2016. Data for these quarterly reports were derived from NC Medicaid claims. These data were combined with pharmacy demographics and service offerings data from the National Council on Prescription Drug Plans dataQ database. Descriptive statistics were used to evaluate differences in demographics and service offerings between study cohorts. Generalized estimating equations were used to evaluate the relationship between medication adherence and pharmacy cohorts, demographics, and service offerings.
RESULTS
There were 267 enhanced services pharmacies and 1,872 control pharmacies included in this analysis. Enhanced services pharmacies were much more likely to be independent pharmacies, located in rural counties, offer multidose compliance packaging, and offer delivery services, but were less likely to offer 24-hour emergency services. Persistently higher adherences scores were observed for enhanced services pharmacies, with differences across measures ranging from 3.0% to 7.2% ( < 0.001). In multivariable models, the difference between enhanced services and control pharmacies was explained by differences in offerings of multidose compliance packaging and delivery services, which were associated with 3.4%-8.2% and 3.3%-4.0% improvements in adherence, respectively ( < 0.001).
CONCLUSIONS
This study found that enhanced services pharmacies had greater adherence performance scores for the NC Medicaid population. These differences appear to be due to CPESN enhanced services pharmacies' offering of multidose compliance packaging and delivery. Future work is needed to expand this analysis to other populations, as well as to explore the relationship between delivery and adherence.
DISCLOSURES
The project described was supported by Funding Opportunity Number 1C12013003897 from the U.S Department of Health and Human Services, Centers for Medicare & Medicaid Services. The contents provided are solely the responsibility of the authors and do not necessarily represent the official views of HHS or any of its agencies. Ulrick reports consulting fees from Pharmacy Quality Solutions, unrelated to this work. Bhosle is an employee of Community Care of North Carolina, the not-for-profit company that sponsored the North Carolina enhanced services pharmacy network, and CPESN USA, a for-profit company that developed out of the original grant-funded project. Farley has nothing to disclose.
Topics: Community Networks; Community Pharmacy Services; Cross-Sectional Studies; Medicaid; Medication Adherence; Models, Statistical; Multivariate Analysis; North Carolina; Pharmacies; Prescription Drugs; Retrospective Studies; United States
PubMed: 32463769
DOI: 10.18553/jmcp.2020.26.6.718 -
PloS One 2022To assess the management of requests for information about a prescription only medicine (simvastatin for treatment of dyslipidemia) by pharmacy staff in community...
OBJECTIVES
To assess the management of requests for information about a prescription only medicine (simvastatin for treatment of dyslipidemia) by pharmacy staff in community settings and explore the factors influencing the information content.
METHODS
A cross sectional study conducted using the stimulated patient (SP) method between November 2018 and May 2019. The SP conveyed the request at the beginning of the encounter in a standardized way based on predetermined plots and was instructed to ask the pharmacy staff directly if information was not discussed spontaneously. After the visit, the SP provided written feedback including information about the scenario and a copy of individualized feedback. The study was reported according to the checklist for reporting research using simulated patient methodology (CRiSP). Factors influencing information content with or without information demand were investigated.
RESULTS
A total of 55 visits were analyzed. The average content score for the information discussed spontaneously was 16.2% with the standard deviation (SD) equal to15.6. The score improved significantly after information was demanded by the SP; the average total information content score became 34.4% (SD = 16) with p < 0.001. The score of information discussed spontaneously was higher for male pharmacy staff, older age, more experience, and a Pharm D degree. When the SP prompted or demanded for information, older pharmacy staff with more experience and with a college degree scored higher. Independent pharmacies, longer visit durations, and less distraction were associated significantly with higher information scores Pharmacy staff aged 35-39 and those with 6-10 years of experience were significant contributors to spontaneous discussion of information with p values = 0.003 and 0.013, respectively. After the SP demanded information, pharmacy staff with less than 5 years of experience and greater confidence as well as longer visits were positively predicting higher information scores with p values of 0.049, 0.04, and 0.04, respectively.
CONCLUSIONS
Information provided by community pharmacists responding to information requests about prescription only medications was found to be suboptimal. Patient requests for information were found to be a positive driver for better information content. Further research of mixed methodologies is required to clarify the factors and motivators enabling information exchange in community settings and to outline true training needs.
Topics: Computer Simulation; Humans; Patient Satisfaction; Pharmacies
PubMed: 35180273
DOI: 10.1371/journal.pone.0264224 -
International Journal of Environmental... Feb 2023There is an increasing motivation to implement pharmacist-led screening services in community pharmacies. This study aims to develop tools to support the pharmacist in...
There is an increasing motivation to implement pharmacist-led screening services in community pharmacies. This study aims to develop tools to support the pharmacist in the context of a diabetes and cardiovascular disease risk assessment service. Our development involved a multistep process using a user-centred approach, including a need assessment phase (14 patients, 17 pharmacists) and a creative design phase, followed by the evaluation of the materials (10 patients, 16 pharmacists). Three following themes covering educational needs emerged from stakeholders' discussions: "content", "layout", and "form", with three additional themes regarding the practical organisation: "software", "awareness", and "referral". Based on the need assessment, tools for patient education purposes and awareness campaigns were created. During the development, special attention was paid to the writing style and structure with less text and more graphical colourful elements to suit patients with different health literacy and educational levels. The evaluation phase allowed researchers to observe participants engaging with the materials. Overall, participants were satisfied with the tools. The contents were considered valuable and relevant. However, adaptations were necessary to ensure their understanding and long-term usability. Finally, future research is required to evaluate the materials' impact on patients' behaviour towards their identified risk factors and ensure their effectiveness.
Topics: Humans; Pharmacies; Community Pharmacy Services; Cardiovascular Diseases; Diabetes Mellitus; Pharmacists; Professional Role
PubMed: 36833517
DOI: 10.3390/ijerph20042819 -
American Journal of Pharmaceutical... Oct 2014To address the academic gap (or lack of adequate training and programs) between 4- and 6-year pharmacy programs and suggest methods for reducing this gap and to evaluate... (Review)
Review
OBJECTIVE
To address the academic gap (or lack of adequate training and programs) between 4- and 6-year pharmacy programs and suggest methods for reducing this gap and to evaluate pharmacists' perceptions of preceptorship.
METHODS
We surveyed a convenience sample of 200 community pharmacists who graduated from a 4-year program who were participating in a continuing education program for clinical pharmacy as organized by the Daejeon branch of the Korea Pharmaceutical Association in 2011. Twenty-one questions were asked about the academic gap, needs for an education program, preceptorship, and medication therapy management services. International precedents were examined through a literature review to glean ideas of how to bridge the academic gap between the 4- and 6-year programs.
RESULTS
In total, 132 pharmacists answered the survey (return rate=66.0%). The survey findings included problems caused by the academic gap, high need for an adequate education program, low acceptability of preceptorship, and the possibility of medication therapy management services. US-based, non-traditional PharmD programs and new curriculum-support training in Japan provided examples of how the academic gap has been successfully bridged.
CONCLUSION
Nationwide efforts and government support are urgently required to close the academic gap, and experiential education should be included in transitional programs for 4-year pharmacy program pharmacists.
Topics: Adult; Aged; Data Collection; Education, Pharmacy; Educational Measurement; Humans; Male; Middle Aged; Pharmacies; Republic of Korea; Schools, Pharmacy; Young Adult
PubMed: 25386014
DOI: 10.5688/ajpe788149 -
Health Promotion International Feb 2022Health promotion programmes are complex and need to engage all health care specialists, including pharmacists. Pharmacies are considered as a potentially ideal place for...
Health promotion programmes are complex and need to engage all health care specialists, including pharmacists. Pharmacies are considered as a potentially ideal place for health promotion and education. To evaluate own qualifications, competences, relevance, motivation and effectiveness of Polish pharmacy staff with regard to health-related information provided to patients, which contributes to health promotion. 308 pharmacy staff from Lublin (Poland) were surveyed with a questionnaire prepared by the researchers and piloted previously. It consisted of 5 domains: qualifications, competences, relevance, motivation, and effectiveness of health promotion. Items in each domain were scored by respondents in 1 - 10 scale where 1 is 'very low' and 10 is 'very high'. Pharmacy staff rated the relevance of health promotion the highest, while the lowest-own competences and effectiveness in health promotion. Female pharmacy staff assessed the relevance of health promotion significantly higher than males (7.1 vs. 6.1, p = 0.005). Higher self-assessments of qualifications, competences, relevance, motivation and effectiveness in health promotion were provided by: the youngest pharmacy staff, those with a short period of employment, and pharmacy staff working in pharmacies employing up to 3 persons. Qualification and competences in health promotion were assessed higher by pharmacy technicians and masters of pharmacy with post-graduate studies or professional specialization, or Ph.D. than by masters of pharmacy. Relevance and effectiveness in health promotion were evaluated higher by pharmacy staff in pharmacies serving more than 100 customers daily. There is a need to improve qualifications, competences, relevance, motivation and effectiveness in health promotion conducted by Polish pharmacy staff.
Topics: Community Pharmacy Services; Female; Health Promotion; Humans; Male; Motivation; Pharmacies; Pharmacy; Poland
PubMed: 34165539
DOI: 10.1093/heapro/daab043 -
PloS One 2021Interprofessional Education (IPE) is one approach to improving communication and collaborative practice between professions, which are essential for the optimal delivery...
Interprofessional Education (IPE) is one approach to improving communication and collaborative practice between professions, which are essential for the optimal delivery of healthcare. Common barriers include negative attitudes, professional stereotypes, professional cultures and power differentials between professional groups. The aim of this qualitative study was to explore how professional hierarchies and power differentials shape interprofessional interactions between preregistration pharmacy and medicine students. Data were gathered via semi-structured interviews and subject to thematic analysis. Four main themes were identified: Reproducing traditional hierarchies; Social norms around respect; Hierarchies in care values and goals; and Challenging the narrative is possible. Students' interactions with and views of the other profession largely reflected traditional stereotypes and power differentials. Hierarchy was evident in how respect was accorded and in how care values and goals were managed. Despite this, students overwhelmingly perceived and reported a sense of agency in changing the status quo. Emerging professional identity and conceptualisation of future roles is heavily influenced by the hierarchical relationship between the professions and can pose a significant barrier to collaborative practice. Greater support for collaborative interprofessional practice is needed at the level of policy and accreditation in health education and healthcare to ensure greater commitment to change.
Topics: Adult; Attitude of Health Personnel; Cooperative Behavior; Education, Pharmacy; Female; Humans; Interprofessional Relations; Male; Patient Care Team; Pharmaceutical Services; Pharmacies; Pharmacists; Pharmacy; Students, Medical; Students, Pharmacy; Young Adult
PubMed: 34437641
DOI: 10.1371/journal.pone.0256776 -
Research in Social & Administrative... Nov 2022The Senior Section is a continuation of a previous intervention that aims to address a gap in medication safety, specifically related to older adult selection and use of... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
The Senior Section is a continuation of a previous intervention that aims to address a gap in medication safety, specifically related to older adult selection and use of over-the-counter medications. The purpose of this paper is to describe the protocol of this study.
METHODS
This study will occur in three phases: an adaptation phase, an effectiveness phase using a randomized controlled trial, and a sustainment phase. This study will take place in conjunction with administrative leadership and pharmacy sites of a regional Midwest integrated health system. Eye tracking technology will inform the adaptation of the intervention and demonstrate effectiveness in the randomized controlled trial. Following the randomized controlled trial, the health system will implement the intervention without research team support. Fidelity and long-term effectiveness outcomes will be collected to demonstrate sustainment.
DISCUSSION
The potential implications of this study are a complete and sustained redesign of the pharmacy setting to include educational and directional materials on medication safety, leading to a decrease in over-the-counter medication misuse in older adults. This project could provide a road map for pharmacy organizations to tailor and adopt the Senior Section, to ultimately reduce inappropriate over-the-counter medication use in older adults.
Topics: Aged; Humans; Nonprescription Drugs; Pharmacies
PubMed: 35753964
DOI: 10.1016/j.sapharm.2022.06.008