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Research in Social & Administrative... Oct 2021Competency frameworks for education, training and development are widely used in the health professions, including pharmacy. Published studies suggest that competency... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Competency frameworks for education, training and development are widely used in the health professions, including pharmacy. Published studies suggest that competency frameworks have an impact on professional performance. Professional performance that is consistent with up-to-date knowledge and skills influences health care quality and patient safety. This review assessed the effectiveness of competency frameworks in facilitating improvement in pharmacists' performance.
METHOD
PubMed/Medline, CINAHL, Embase, ERIC, PsycINFO and Scopus electronic databases were searched to identify relevant literature. The findings of the included studies were synthesised qualitatively, and via a meta-analysis. The meta-analysis evaluated the odds of improved competency behaviour as a proxy measure of impact on pharmacists' performance. Study quality was assessed using 12 criteria adapted from the EPPI-Centre guidelines v0.9.7. The protocol for this review is registered on PROSPERO with reference number CRD42018096580.
RESULTS
In total, nine interventional studies were identified for review. The review findings showed observable and significant improvement in pharmacists' performance when competency frameworks are used to appraise performance, identify knowledge gaps, and tailor learning activities. A meta-analysis that involved a total of 348 pharmacists undergoing repeat peer assessment showed pooled odds for improved competency behaviour of 4.41 (95% CI: 1.89-10.29, I = 83%). Subgroup analyses showed pooled odds with corresponding 95% CI of 6.50 (1.77-23.97, I = 77%) vs 2.95 (0.59-14.72, I = 93%) for the studies that were conducted in countries within or outside Europe, respectively; 10.51 (3.73-29.62, I = 24%) vs 2.39 (0.96-5.95, I = 87%) for studies with reassessment conducted at ≤6 months from baseline, or more, respectively; 6.68 (1.63-27.45, I = 88%) vs 2.80 (0.86-9.07, I = 74%) for studies involving hospital or community pharmacists, respectively; and 2.80 (1.22-6.45, I = 77%) for studies with low risk of bias.
CONCLUSION
These findings suggest competency frameworks facilitate improvement in pharmacists' performance; however, further evaluative studies are needed.
Topics: Health Occupations; Humans; Pharmaceutical Services; Pharmacies; Pharmacists; Pharmacy
PubMed: 33608245
DOI: 10.1016/j.sapharm.2021.02.008 -
Pharmacy (Basel, Switzerland) Apr 2022: The patronage of online pharmacies is rapidly growing, driven by the convenience and cheaper costs of purchasing prescription drugs electronically, especially under... (Review)
Review
: The patronage of online pharmacies is rapidly growing, driven by the convenience and cheaper costs of purchasing prescription drugs electronically, especially under the lockdown situation. However, there are issues regarding the quality of the prescription drugs sold online and the legitimacy of online pharmacies. The use of prescription drugs without the supervision of a licensed health care practitioner may potentially harm consumers. : This systematic review was conducted to improve the body of knowledge on three main aspects of online pharmacies: (1) type and characteristics of the online pharmacies selling drugs; (2) the quality of pharmaceutical drugs purchased online; and (3) the characteristics of consumers of online pharmacies. : Based on a pre-defined search strategy, PubMed and Scopus were utilised to search articles written in the English language published between January 2009 and February 2020. Studies focusing on the sale of prescription drugs were included. The terms used for the literature search were "online pharmacy", "internet pharmacy", "e-pharmacy", "prescription", "quality", "medication safety", and "counterfeit medicine". These terms were used alone and in combination with Boolean operators. The institutional webpages including the World Health Organization (WHO) and the United States Food and Drug Administration (USFDA) were also examined for any additional studies. No methodological limitations in terms of study design were applied. A standardised data collection form was used to compile the data. : Based on the inclusion and exclusion criteria, a total of 46 articles were eligible and included in the final analysis. There were 27 articles on types and characteristic of online pharmacies, 13 articles on the quality of prescription drugs sold from online pharmacies, and 11 articles on consumers purchasing prescription drugs from online pharmacies. Readers should note that five articles discussed both the types and characteristics of online pharmacies, and the quality of the drugs sold from the outlets. The response rate (products received out of the number of orders) ranged from 20% to 100%, whereas the proportion of consumers buying prescription drugs online ranged from 2.3% to 13%. Reasons for online purchase of prescription drugs include the difficulty of obtaining a prescription for certain medications such as opioid analgesics, cheaper cost, since the costs associated with seeing a physician to obtain a prescription are reduced, and the need to obtain drugs such as opioid analgesics and benzodiazepine for misuse. : Almost half of the online pharmacies are not properly regulated and fraudulent issues were uncovered. To address this issue, stricter regulation by World Health Organization and implementation should be carried out together with frequent monitoring of the licensure system and pharmacy verification on every online pharmacy, this would reduce the number of illegal or illegitimate online pharmacy.
PubMed: 35448701
DOI: 10.3390/pharmacy10020042 -
Research in Social & Administrative... Oct 2020Implementation science emerged to address the challenges associated with the incorporation of evidence-based innovations into practice. Once the challenge is overcome,... (Review)
Review
BACKGROUND
Implementation science emerged to address the challenges associated with the incorporation of evidence-based innovations into practice. Once the challenge is overcome, the ultimate goal is to achieve the sustainability of innovations to promote their continuity and long-term integration. Conceptual approaches and assessment tools have been designed to assess the sustainability of innovations in research and practice environments. However, the variability of approaches and tools available becomes a challenge for policymakers, researchers and practitioners, particularly when deciding how to evaluate the sustainability of innovations.
OBJECTIVES
To identify conceptual approaches and assessment tools for the sustainability of healthcare innovations and to develop a specific discipline-based framework for the sustainability of professional pharmacy services.
METHODS
A systematic literature review was conducted in January of 2019 using PubMed, Scopus, and Web of Science. General information regarding the conceptual approaches (based on Nilsen's classification), assessment tools and the factors affecting the sustainability of the healthcare innovations was retrieved.
RESULTS
From 3123 articles screened, 132 articles were selected from which 106 conceptual approaches and 26 assessment tools were identified. Several key factors moderating the sustainability of the innovations in healthcare were identified (e.g. funding, adaptation). A framework for the sustainability of professional pharmacy services is proposed based on these factors. It presents three performance domains influencing the service sustainability (i.e. environment, social and economic).
CONCLUSIONS
The identified approaches in different healthcare settings have allowed the adaptation and design of a specific framework for pharmacy. The core factors included in the proposed framework are moderators of the sustainability process and should be considered in sustainability studies and evaluations. This framework will guide pharmacy practice researchers and practitioners to measure and achieve the sustainability of professional pharmacy services. Furthermore, the adaptation of this framework will allow its application to other healthcare settings. (Registration number CRD42018092160).
Topics: Community Pharmacy Services; Delivery of Health Care; Humans; Motivation; Pharmacies
PubMed: 32063499
DOI: 10.1016/j.sapharm.2020.01.015 -
Journal of the American Pharmacists... 2020Patient selection of community pharmacy is based on a multitude of factors. With increasing competition and rapidly changing face of pharmacy, identification of these... (Review)
Review
OBJECTIVE
Patient selection of community pharmacy is based on a multitude of factors. With increasing competition and rapidly changing face of pharmacy, identification of these factors is critical for patient satisfaction and financial success. This systematic review summarizes patient preferences for different attributes of community pharmacy.
DATA SOURCES
Systematic review of peer-reviewed studies conducted on U.S. population, published from 2005 to 2018 in EBSCO, PubMed, and EMBASE, was conducted to identify attributes of community pharmacy that determine patient patronage.
STUDY SELECTION
Studies conducted between 2005 and 2018 on U.S. population that examined attributes in choosing a pharmacy were eligible for this systematic review.
DATA EXTRACTION
Data were independently extracted, assessed, and evaluated by 2 reviewers. Any disagreements were resolved by the third reviewer. Data obtained included year, setting, number of patients, data collection and evaluation methods, and relevant results and outcomes.
RESULTS
Of the 713 papers identified, 10 articles met the inclusion criteria and were included in this systematic review. Majority of the studies used surveys to examine key attributes that influence patients' selection of a pharmacy. Pharmacist traits like friendly, helpful, trustworthy, professional, competent, caring, knowledgeable, responsive, and approachable are critical attributes that influence a patient's selection of pharmacy. Convenience (i.e., location, hours of operation, wait time, stock availability) also influenced patients' selection of pharmacy. Cost and contract with insurance were other important factors. Availability of auto-refills appeared consistently in the studies. Medication safety (detecting drug interactions) quality metrics also appeared high among patients' preferences.
CONCLUSION
The results of this review found that a relationship with a respectful, friendly, competent pharmacist represents important pharmacist-related attributes in the process of pharmacy selection. Important pharmacy-related attributes include cost, convenience, and wait times. Availability of auto-refill service was also a frequently reported attribute in this review.
Topics: Community Pharmacy Services; Humans; Patient Preference; Pharmacies; Pharmacists; Pharmacy
PubMed: 31780193
DOI: 10.1016/j.japh.2019.10.008 -
Journal of Patient Safety Sep 2021This study aimed to review and critically appraise the published literature on 2 selected prospective risk analysis tools, Failure Mode and Effects Analysis and...
OBJECTIVES
This study aimed to review and critically appraise the published literature on 2 selected prospective risk analysis tools, Failure Mode and Effects Analysis and Socio-Technical Probabilistic Risk Assessment, as applied to the dispensing of medicines in both inpatient and outpatient pharmacy settings.
METHODS
A comprehensive search of electronic databases (PubMed and Scopus) was conducted (January 1990-March 2016), supplemented by hand search of reference lists. Eligible articles were assessed for data sources used for the risk analysis, uniformity of the risk quantification framework, and whether the analysis teams assembled were multidisciplinary.
RESULTS
Of 1011 records identified, 11 articles met our inclusion criteria. These studies were mainly focused on dispensing of high-alert medications, and most were conducted in inpatient settings. The main risks identified were transcription, preparation, and selection errors, whereas the most common corrective actions included electronic transmission of prescriptions to the pharmacy, use of barcode, and medication safety training. Significant risk reduction was demonstrated by implementing corrective measures in both inpatient and outpatient pharmacy settings. The main Failure Mode and Effects Analysis limitations were its subjectivity and the lack of common risk quantification criteria.
CONCLUSIONS
The prospective risk analysis methods included in this review revealed relevant safety issues and hold significant potential for risk reduction. They were deemed suitable for application in both inpatient and outpatient pharmacy settings and should form an integral part of any patient safety improvement strategy.
Topics: Humans; Patient Safety; Pharmacies; Pharmacy; Prospective Studies; Risk Assessment
PubMed: 28662000
DOI: 10.1097/PTS.0000000000000403 -
Journal of Pharmaceutical Policy and... Mar 2021Measuring access to medicines has often been limited to assessing availability and affordability, while little is known regarding other dimensions of access including... (Review)
Review
BACKGROUND
Measuring access to medicines has often been limited to assessing availability and affordability, while little is known regarding other dimensions of access including geographical accessibility. Our study aims to provide a systematic review of literature on the accessibility of medicines by studying the geographical distribution of pharmacies using Spatial Analytical methods.
METHODS
As systematic review of scientific peer-reviewed literature between 2000 and 2018 was carried out using PubMed, Web of Science, Google Scholar, Google and the Preferred Reporting items for Systematic Reviews and Meta-Analyses (PRISMA). Data regarding pharmacy density, distance to pharmacies in relation of pharmacy to sociodemographic factors and pharmacy characteristics were extracted from studies that meet the inclusion criteria.
FINDINGS
Twenty papers fulfilled our inclusion criteria, of which only three were from middle income countries and rest from high-income economies. Pharmacy density per population was reported in 15 studies. Although geographical information was utilized in all studies, only 14 studies reported distance to pharmacies represented as Euclidean (straight line) distance. Disparities in accessibility was reported according to population income and rural or urban location. Seven studies described additional pharmacy characteristics including opening hours, presence of a pharmacist and delivery services.
CONCLUSIONS
Geographical accessibility is a key dimension of access to medicines. Pharmacy density per population is a relevant indicator to assess geographical accessibility which should be complemented by an equity analysis using socio-demographic information and population perception of accessibility.
PubMed: 33663583
DOI: 10.1186/s40545-020-00291-7 -
Health Expectations : An International... Sep 2004To systematically review feedback from pharmacy users on their perceptions and experiences of health-related advice and services provided from community pharmacies. (Review)
Review
Feedback from community pharmacy users on the contribution of community pharmacy to improving the public's health: a systematic review of the peer reviewed and non-peer reviewed literature 1990-2002.
OBJECTIVE
To systematically review feedback from pharmacy users on their perceptions and experiences of health-related advice and services provided from community pharmacies.
METHODS
The focus of the review was community pharmacy activities in relation to promoting health and well-being, preventing ill-health and maintaining health. Searches were conducted for peer-reviewed (international) and non-peer-reviewed (UK) research. Electronic databases searched included MEDLINE, EMBASE, Cochrane Library and International Pharmaceutical Abstracts; hand searches of key journals and conference abstracts, key informants. Key informants in the UK were contacted to identify unpublished studies. The inclusion period was 1990 onwards. Data extraction and synthesis Data were abstracted into a matrix by one author with a sample checked by a second. The Health Development Agency's Evidence Base 2000 standards and the evidence categories used by the Department of Health in the National Service Frameworks were applied to each item.
MAIN RESULTS
Seven peer reviewed papers and 13 non-peer reviewed reports were identified for inclusion in the review. Consumer usage of pharmacies is almost universal with prescription supplies and purchase of over the counter medicines predominating. Evidence shows that not only is usage low for general health advice, but that pharmacists are perceived as 'drugs experts' rather than experts on health and illness. Emergency hormonal contraception and head lice management schemes have been well received. There is a need to consider privacy and confidentiality surrounding advice giving.
CONCLUSIONS
Users of community pharmacy-based health development initiatives express a high level of satisfaction. If community pharmacies are to be used to their full extent, then actions to extending the public's awareness and acceptance of the pharmacist's role in giving advice will be crucial. Further research will be needed to measure any change in premises development on the public's perception of the level of privacy in pharmacies.
Topics: Confidentiality; Feedback; Humans; Patient Satisfaction; Peer Review, Health Care; Pharmacies; Quality Assurance, Health Care
PubMed: 15327458
DOI: 10.1111/j.1369-7625.2004.00274.x -
Health & Social Care in the Community Jan 2022Relational continuity of care (COC) is becoming an important concept related to improving healthcare quality, reducing medical costs and increasing patient satisfaction... (Review)
Review
Relational continuity of care (COC) is becoming an important concept related to improving healthcare quality, reducing medical costs and increasing patient satisfaction with primary care. While community pharmacy (CP) has a considerable role in primary care, there are few reports dedicated to the role of relational COC in CP. This study reviewed the existing evidence of relational COC in CP and its effect on patients. PubMed, Embase, CINAHL, Cochrane Library CENTRAL and Google Scholar were used to search for relevant studies from the date of database inception through to January 2021, which were appraised according to eligibility criteria. There were no limitations on the primary outcome or language. Case reports and studies without control groups were excluded. The Newcastle-Ottawa quality assessment scale was used to assess the quality of the studies. Database searches identified 13 records. Relational COC measures in the included studies were grouped in three kinds; pharmacy-visiting pattern, Continuity of Care Index and loyalty. The assessed outcomes were medication adherence behaviour (e.g., the proportion of days covered, medication possession ratio), adverse drug reactions, potentially inappropriate drug prescribing and clinical outcomes. The odds of patients adhering to their medication regimen were about 1.1~2.5 times higher among those who consistently visited a single pharmacy compared to patients visiting multiple pharmacies. Additionally, the care provision with a high level of relational continuity could lower inappropriate drug use by 21~32 per cent and the use of other costly services by 12~29 per cent. This study suggests that a high degree of relational COC in CP could improve safe use of medications among patients. Future research is needed to employ more rigorous methods to reduce heterogeneity and to measure effects on clinical outcomes.
Topics: Continuity of Patient Care; Databases, Factual; Drug Prescriptions; Humans; Medication Adherence; Pharmacies
PubMed: 34060170
DOI: 10.1111/hsc.13428 -
Journal of the American Medical... Sep 2022To summarize current evidence regarding facility and prescriber characteristics associated with potentially harmful medication (PHM) use by residents in nursing homes... (Review)
Review
OBJECTIVES
To summarize current evidence regarding facility and prescriber characteristics associated with potentially harmful medication (PHM) use by residents in nursing homes (NHs), which could inform the development of interventions to reduce this potentially harmful practice.
DESIGN
Scoping review.
SETTING AND PARTICIPANTS
Studies conducted in the United States that described facility and prescriber factors associated with PHM use in NHs.
METHODS
Electronic searches of PubMed/MEDLINE were conducted for articles published in English between April 2011 and November 2021. PHMs were defined based on the Beers List criteria. Studies testing focused interventions targeting PHM prescribing or deprescribing were excluded. Studies were characterized by the strengths and weaknesses of the analytic approach and generalizability.
RESULTS
Systematic search yielded 1253 articles. Of these, 29 were assessed in full text and 20 met inclusion criteria. Sixteen examined antipsychotic medication (APM) use, 2 anticholinergic medications, 1 sedative-hypnotics, and 2 overall PHM use. APM use was most commonly associated with facilities with a higher proportion of male patients, younger patients, and patients with severe cognitive impairment, anxiety, depression, and aggressive behavior. The use of APM and anticholinergic medications was associated with low registered nurse staffing ratios and for-profit facility status. No studies evaluated prescriber characteristics.
CONCLUSIONS AND IMPLICATIONS
Included studies primarily examined APM use. The most commonly reported facility characteristics were consistent with previously reported indicators of poor NH quality and NHs with patient case mix more likely to use PHMs.
Topics: Antipsychotic Agents; Cholinergic Antagonists; Drug Prescriptions; Female; Humans; Inappropriate Prescribing; Male; Nursing Homes; United States
PubMed: 35868350
DOI: 10.1016/j.jamda.2022.06.008 -
The American Journal of Managed Care Mar 2016The burden of visiting pharmacies to fill medications is a central contributor to nonadherence to maintenance medications. Recently, pharmacies have begun offering... (Review)
Review
OBJECTIVES
The burden of visiting pharmacies to fill medications is a central contributor to nonadherence to maintenance medications. Recently, pharmacies have begun offering services that align prescription fill dates to allow patients to pick up all medications on a single visit. We evaluated the prevalence and structure of synchronization programs and evidence of their impact on adherence and clinical outcomes.
STUDY DESIGN
Mixed-methods approach consisting of semi-structured interviews, data from surveillance activities, and a systematic literature review.
METHODS
We conducted interviews with opinion leaders from nonprofit advocacy organizations and exemplary synchronization programs. Program prevalence was determined using data from regular surveillance efforts. A literature review included Medline, EMBASE, Google Scholar, and general Internet searches.
RESULTS
Synchronization programs exist in approximately 10% of independent, 6% of stand-alone chain, and 11% of retail store pharmacies. The majority of programs include a monthly pharmacist appointment and reminder communication. Programs reported the importance of pharmacist buy-in, technology to track and recruit patients, links to other healthcare services, and flexible solutions for managing costs and communication preferences. Although existing peer-reviewed literature suggests that synchronization improves adherence, more evidence is needed to evaluate its impact on patient-centered outcomes.
CONCLUSIONS
As medication synchronization programs shift directions and compete for patients and payer resources, it will be more important than ever to rigorously evaluate their ability to improve clinical outcomes while also providing the growing number of patients managing multiple chronic conditions with the highest level of patient engagement and consumer choice.
Topics: Adult; Aged; Chronic Disease; Community Pharmacy Services; Female; Humans; Male; Medication Adherence; Middle Aged; Organizational Innovation; Patient Compliance; Prescription Drug Overuse; Prescription Drugs; Prevalence; Program Development; Program Evaluation; Risk Assessment; United States
PubMed: 27023023
DOI: No ID Found