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Perspectives in Public Health Mar 2022This systematic review aimed to provide new insights into how pharmacy spaces, or the , are experienced by pharmacy service users and staff. The review sought to...
AIM
This systematic review aimed to provide new insights into how pharmacy spaces, or the , are experienced by pharmacy service users and staff. The review sought to identify environmental factors which may influence service users' and staff participation in community-based pharmacy health services.
METHOD
Ten databases were searched for English language publications, using a combination of search terms relating to pharmacy service users and staff; pharmacy spaces; and health and social care outcomes. Data from the final selected studies were extracted, thematically analysed using a narrative approach and the quality of each study assessed using the Integrated quality Criteria for the Review of Multiple Study designs (ICROMS).
RESULTS
80 articles reporting 80 studies published between 1994 and 2020 were identified; they were from 28 countries, involving around 3234 community pharmacies, 13,615 pharmacy service users, 5056 pharmacists and 78 pharmacy health staff. Most studies (94%) met the ICROMS minimum score, and half did not meet the mandatory quality criteria. Four themes likely to influence service users' and staff experiences of pharmacy health services were identified: (1) privacy; (2) experience of the physical environment; (3) professional image; and (4) risk of error.
CONCLUSION
To optimise the delivery and experience of pharmacy health services, these spaces should be made more engaging. Future applied research could focus on optimising inclusive pharmacy design features.
Topics: Community Pharmacy Services; Humans; Pharmacies; Pharmacists
PubMed: 35274562
DOI: 10.1177/17579139221080608 -
Research in Social & Administrative... Nov 2019Stakeholder engagement is an important component of the research process for improving the use and uptake of patient-centered health care innovations. Participatory...
BACKGROUND
Stakeholder engagement is an important component of the research process for improving the use and uptake of patient-centered health care innovations. Participatory design (PD), a method that utilizes the involvement of patients and other stakeholders, is well-suited for the design of multifaceted interventions in complex work systems, such as community pharmacies, that have diverse and dynamic end-users.
OBJECTIVE
The objective is to describe a blueprint for how to use PD when designing a community pharmacy intervention. This paper outlines the steps of PD and highlights the advantages and disadvantages of this method.
METHODS
PD is explained step-wise to underscore the considerations required of researchers unfamiliar with PD. This includes the development of a tailored PD approach, PD session preparatory work, data collection, and intervention development and evaluation. The stakeholders recruited for the community pharmacy intervention were pharmacy staff and older adult patients who received prescriptions at the pharmacy corporation in which the intervention was being implemented. The PD process was a series of six adaptive sessions: (1) problem identification, (2) solution generation, (3) convergence, (4) prototyping, (5) initial evaluation, and (6) formative evaluation.
RESULTS
A description of the PD process to design a community pharmacy intervention is provided. The process led to the development of a patient-centered prototype. The advantages of using PD included the opportunity to clarify problems faced by stakeholders, generation of novel solutions to incorporate into the intervention, and the ability to vet and fine-tune stakeholder design ideas in an iterative fashion. The insight gained was unprecedented and invaluable to the researchers. The biggest challenge of employing PD was the time-sensitive and time-intensive nature of developing each session, collecting data, and reflecting on the results in order to design subsequent sessions.
CONCLUSIONS
The PD process led to the development of a patient-centered prototype. PD enabled stakeholders to generate creative solutions and provide unique insight on addressing issues faced in healthcare redesign research and specifically in community pharmacies.
Topics: Humans; Patient Participation; Patient-Centered Care; Pharmacies; Stakeholder Participation
PubMed: 30509852
DOI: 10.1016/j.sapharm.2018.11.012 -
Yakugaku Zasshi : Journal of the... 2023This review introduces two sets of research results, one regarding patients' and consumers' perceptions of the pharmacist profession and pharmacy function, and the other... (Review)
Review
This review introduces two sets of research results, one regarding patients' and consumers' perceptions of the pharmacist profession and pharmacy function, and the other regarding factors that influence patients' medication-taking behavior. First, as an example of what was examined from patients' perspectives regarding the pharmacist profession and pharmacy function, an analysis of patient response data before the introduction of the family pharmacist/pharmacy system is presented. The results clarified that the quality of medication instruction influences patients' evaluations of pharmacists and further affects their evaluation of pharmacies, and that the main factor influencing patients' evaluation of pharmacies is their evaluation of the pharmacists. In particular, patients who continuously used the same pharmacist and the same pharmacy were highly statistically related, demonstrating the significance of recommending a family pharmacist/pharmacy. Next, regarding patients' medication-taking behavior, an empirical study of Japanese patients regarding the two-dimensional influencing factors was conducted. These factors, which have been the focus of recent overseas studies, included intentional nonadherence, such as skipping a dose, and unintentional nonadherence, such as forgetting to take a dose. The main influences were found to be from unintentional nonadherence and intentional non-adherence, with excessive information seeking and motivation to acquire knowledge potentially exacerbating intentional nonadherence in particular, as well as differences across diseases. These findings may contribute to supporting medication adherence in patients. In collaboration with graduate and postgraduate research students, future studies will continue to examine patients' and consumers' perspectives on medication adherence.
Topics: Humans; Community Pharmacy Services; Pharmacists; Education, Pharmacy; Pharmacies; Medication Adherence
PubMed: 36596533
DOI: 10.1248/yakushi.22-00126 -
Farmacia Hospitalaria : Organo Oficial... 2023Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as "the scientific discipline that studies the...
Pharmacy and pharmaceutical sciences embrace a series of different disciplines. Pharmacy practice has been defined as "the scientific discipline that studies the different aspects of the practice of pharmacy and its impact on health care systems, medicine use, and patient care". Thus, pharmacy practice studies embrace both clinical pharmacy and social pharmacy elements. Like any other scientific discipline, clinical and social pharmacy practice disseminates research findings using scientific journals. Clinical pharmacy and social pharmacy journal editors have a role in promoting the discipline by enhancing the quality of the articles published. As has occurred in other health care areas (i.e., medicine and nursing), a group of clinical and social pharmacy practice journal editors gathered in Granada, Spain to discuss how journals could contribute to strengthening pharmacy practice as a discipline. The result of that meeting was compiled in these Granada Statements, which comprise 18 recommendations gathered into six topics: the appropriate use of terminology, impactful abstracts, the required peer reviews, journal scattering, more effective and wiser use of journal and article performance metrics, and authors' selection of the most appropriate pharmacy practice journal to submit their work.
Topics: Humans; Pharmacy; Pharmacies; Spain; Pharmacy Service, Hospital
PubMed: 36963994
DOI: 10.1016/j.farma.2023.01.006 -
International Journal of Clinical... Jun 2022Pharmacy professionals are increasingly moving into advanced roles, including in primary care. In England, the publicly funded Pharmacy Integration Fund (PhIF) enabled...
Pharmacy professionals are increasingly moving into advanced roles, including in primary care. In England, the publicly funded Pharmacy Integration Fund (PhIF) enabled employment and training of pharmacy professionals in new patient-facing roles, including general practice and care homes. In recognition of the need for support and supervision during work-based learning and building on established support structures in medicine and nursing, one of the providers of PhIF funded learning developed a supervision structure which mirrors arrangements for postgraduate medical specialty training. This paper describes what informed this supervision model, with a particular focus on educational supervision, its delivery, and the training which was developed to support supervisors. This supervision enabled pharmacy professionals moving into primary care to practise safely, manage workplace challenges, extend their roles and make progress with their education. This model illustrates the benefits of supervision in supporting post-registration learning to facilitate the development of advanced patient-facing clinical roles.
Topics: England; Humans; Pharmaceutical Services; Pharmacies; Pharmacy; Workplace
PubMed: 35575956
DOI: 10.1007/s11096-022-01421-8 -
The American Journal of Managed Care Apr 2023The share of Medicare stand-alone prescription drug plans with a preferred pharmacy network has grown from less than 9% in 2011 to 98% in 2021. This article assesses the...
OBJECTIVES
The share of Medicare stand-alone prescription drug plans with a preferred pharmacy network has grown from less than 9% in 2011 to 98% in 2021. This article assesses the financial incentives that such networks created for unsubsidized and subsidized beneficiaries and their pharmacy switching.
STUDY DESIGN
We analyzed prescription drug claims data for a nationally representative 20% sample of Medicare beneficiaries from 2010 through 2016.
METHODS
We evaluated the financial incentives for using preferred pharmacies by simulating unsubsidized and subsidized beneficiaries' annual out-of-pocket spending differentials between using nonpreferred and preferred pharmacies for all their prescriptions. We then compared beneficiaries' use of pharmacies before and after their plans adopted preferred networks. We also examined the amount of money that beneficiaries left on the table under such networks, based on their pharmacy use.
RESULTS
Unsubsidized beneficiaries faced substantial incentives-on average, $147 annually in out-of-pocket spending-and moderately switched toward preferred pharmacies, whereas subsidized beneficiaries were insulated from the incentives and demonstrated little switching. Among those who continued to mainly use nonpreferred pharmacies (half of the unsubsidized and about two-thirds of the subsidized), on average, the unsubsidized paid more out of pocket ($94) relative to if they had used preferred pharmacies, whereas Medicare bore the extra spending ($170) for the subsidized through cost-sharing subsidies.
CONCLUSIONS
Preferred networks have important implications for beneficiaries' out-of-pocket spending and the low-income subsidy program. Further research is needed about the impact on the quality of beneficiaries' decision-making and cost savings to fully evaluate preferred networks.
Topics: Aged; Humans; United States; Medicare Part D; Prescription Drugs; Pharmacies; Motivation; Pharmacy
PubMed: 37104832
DOI: 10.37765/ajmc.2023.89346 -
BMC Infectious Diseases Aug 2023Point-of-care testing (POCT) using rapid diagnostic tests for infectious disease can potentially guide appropriate use of antimicrobials, reduce antimicrobial... (Review)
Review
BACKGROUND
Point-of-care testing (POCT) using rapid diagnostic tests for infectious disease can potentially guide appropriate use of antimicrobials, reduce antimicrobial resistance, and economise use of healthcare resources. POCT implementation in private retail settings such as pharmacies and drug shops could lessen the burden on public healthcare. We performed a narrative review on studies of POCTs in low- and middle-income countries (LMICs), and explored uptake, impact on treatment, and feasibility of implementation.
METHODS
We searched MEDLINE/PubMed for interventional studies on the implementation of POCT for infectious diseases performed by personnel in private retail settings. Data were extracted and analysed by two independent reviewers.
RESULTS
Of the 848 studies retrieved, 23 were included in the review. Studies were on malaria (19/23), malaria and pneumonia (3/23) or respiratory tract infection (1/23). Nine randomised controlled studies, four controlled, non-randomised studies, five uncontrolled interventions, one interventional pre-post study, one cross-over interventional study and three retrospective analyses of RCTs were included. Study quality was poor. Overall, studies showed that POCT can be implemented successfully, leading to improvements in appropriate treatment as measured by outcomes like adherence to treatment guidelines. Despite some concerns by health workers, customers and shop providers were welcoming of POCT implementation in private retail settings. Main themes that arose from the review included the need for well-structured training with post-training certification covering guidelines for test-negative patients, integrated waste management, community sensitization and demand generation activities, financial remuneration and pricing schemes for providers, and formal linkage to healthcare and support.
CONCLUSION
Our review found evidence that POCT can be implemented successfully in private retail settings in LMICs, but comprehensive protocols are needed. High-quality randomised studies are needed to understand POCTs for infectious diseases other than malaria.
Topics: Humans; Health Facilities; Pharmacies; Pharmacy; Point-of-Care Testing; Retrospective Studies
PubMed: 37612636
DOI: 10.1186/s12879-023-08480-w -
Health Services Research Oct 2022To evaluate the effects of preferred pharmacy networks-a tool that Medicare Part D plans have recently adopted to steer patients to lower cost pharmacies-on the use of...
OBJECTIVE
To evaluate the effects of preferred pharmacy networks-a tool that Medicare Part D plans have recently adopted to steer patients to lower cost pharmacies-on the use of preferred pharmacies and factors underlying beneficiaries' decisions on whether to switch to preferred pharmacies.
DATA SOURCES
Medicare claims data were collected for a nationally representative 20% sample of beneficiaries during 2010-2016 and merged with annual Part D pharmacy network files.
STUDY DESIGN
We examined preferred networks' impact on pharmacy choice by estimating a difference-in-differences model comparing preferred pharmacies' claim share before and after implementation among unsubsidized and subsidized beneficiaries. Additionally, we evaluated the factors affecting whether a beneficiary switched from mainly using nonpreferred to preferred pharmacies.
DATA COLLECTION/EXTRACTION METHODS
We examined stand-alone drug plans that adopted a preferred network during 2011-2016. Our main sample included beneficiaries 65 years and older who stayed in their plan in both the first year of implementation and the year before and whose cost-sharing subsidy status and ZIP code remained unchanged during the 2-year period.
PRINCIPAL FINDINGS
Unsubsidized Part D beneficiaries faced an average difference of $129 per year in out-of-pocket spending between using nonpreferred and preferred pharmacies, while subsidized beneficiaries were insulated from these cost differences. The implementation of preferred networks resulted in a 3.7-percentage point (95% CI: 3.3, 4.2) increase in preferred pharmacies' claim share in the first year among the unsubsidized. Existing relationships with preferred pharmacies, the size of financial incentives, proximity to preferred pharmacies, and urban residence were positively associated with beneficiaries' decisions to switch to these pharmacies.
CONCLUSIONS
Preferred pharmacy networks caused a moderate shift on average towards preferred pharmacies among unsubsidized beneficiaries, although stronger financial incentives correlated with more switching. Researchers and policymakers should better understand plans' cost-sharing strategies and assess whether communities have equitable access to preferred pharmacies.
Topics: Aged; Cost Sharing; Humans; Medicare Part D; Pharmaceutical Services; Pharmacies; Pharmacy; United States
PubMed: 35297507
DOI: 10.1111/1475-6773.13973 -
BMC Medical Informatics and Decision... Aug 2020In recent years, online pharmacies have been accepted by increasingly more consumers, and the prospects for online pharmacies are optimistic. This article explores the...
BACKGROUND
In recent years, online pharmacies have been accepted by increasingly more consumers, and the prospects for online pharmacies are optimistic. This article explores the consumers' satisfaction factors addressed in Business to Customer (B2C) online pharmacy reviews and analyzes the sentiments expressed in the reviews. The goal of this work is to help B2C online pharmacy enterprises identify consumers' concerns, continuously improve the health services level.
METHODS
This article was based on the Latent Dirichlet Allocation (LDA) topic model. From a third-party platform-based B2C online pharmacy and a proprietary B2C online pharmacy (JD Pharmacy and J1.COM, respectively), 136,630 pieces of over-the-counter (OTC) drug review data posted from January 1, 2015 to December 31, 2018 were selected as samples and used to explore the satisfaction factors of B2C online pharmacy consumers regarding the entire drug purchasing process. Then, the sentiments expressed in the drug reviews were analyzed with SnowNLP.
RESULT
Categorization of the 12 factors identified by LDA showed that 5 factors were related to logistics; these 5 factors, which also included the most drug reviews, made up 38.5% of the reviews. The number of factors related to drug prices was second, with 3 factors, and reviews of drug prices made up 25.5% of the reviews. Customer service and drug effects each had two related factors, and a smaller percentage of these reviews (13.95%) were related to drug effects. Consumers still maintain positive opinions of JD Pharmacy and J1.COM. However, some opinions on logistics and drug prices are expressed.
CONCLUSION
The most important task for online pharmacies is to improve logistics. It is better to develop self-built logistics. Both types of B2C online pharmacies can improve consumer viscosity by implementing marketing strategies. With regard to customer service, focusing on improving employees' service attitudes is necessary.
Topics: Commerce; Consumer Behavior; Humans; Personal Satisfaction; Pharmaceutical Services, Online; Pharmacies
PubMed: 32807175
DOI: 10.1186/s12911-020-01214-x -
BMC Medical Informatics and Decision... Feb 2022Prescription opioid misuse is a serious national crisis; in 2018 the top drugs involved in prescription overdose deaths included pain medications (opioids),...
BACKGROUND
Prescription opioid misuse is a serious national crisis; in 2018 the top drugs involved in prescription overdose deaths included pain medications (opioids), benzodiazepines, and stimulants. Health information technology (health IT) provides a means to address this crisis through technologies that streamline the prescribing and discontinuation process. CancelRx is a health IT function that communicates when medications, such as controlled substances, are discontinued at the clinic and therefore should not be filled at the pharmacy. Prior to CancelRx, the communication of discontinued medications was a manual process, requiring the patient or a clinic staff member to personally contact the pharmacy to inform them of the change. The objective of this study was to assess how controlled substance medication discontinuations were communicated over time, before and after the implementation of CancelRx.
METHODS
Secondary data from a midwestern academic health system electronic health record and pharmacy platform were collected 12-months prior to CancelRx implementation and for 12-months post implementation. The study utilized an interrupted time series analysis (ITSA) to capture the percentage of controlled substance medications that were discontinued in the clinic's electronic health record and discontinued in the pharmacy's dispensing software. The ITSA plotted the percentage of successful discontinuation messages over time, particularly after the health system's implementation of CancelRx, a novel technology.
RESULTS
After CancelRx implementation there was an immediate (change = 77.7 percentage point) and significant (p < 0.001) increase in the number of controlled substance medications that were successfully discontinued at the pharmacy after being discontinued in the clinic. This change was sustained in the year following CancelRx (slope = 0.03 pp, 95% CI - 0.050 to 0.110) and did not revert to pre-CancelRx levels. The health IT functionality was able to effectively complete discontinuation tasks and potentially reduce workload for clinic staff.
CONCLUSIONS
Overall, this study demonstrates the role that technology can play in promoting communication between clinics and pharmacies, especially when medications such as controlled substances are discontinued.
Topics: Controlled Substances; Humans; Interrupted Time Series Analysis; Medical Informatics; Pharmacies; Prescriptions
PubMed: 35216591
DOI: 10.1186/s12911-022-01779-9