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Substance Abuse Jan 2018Prescribers and community pharmacists commonly perceive prescription opioid abuse to be a problem in their practice settings and communities. Both cohorts have expressed...
BACKGROUND
Prescribers and community pharmacists commonly perceive prescription opioid abuse to be a problem in their practice settings and communities. Both cohorts have expressed support for interventions that improve interprofessional communication and reduce prescription opioid abuse. The objective of this study was to describe prescription opioid abuse-related communication among and between prescribers and community pharmacists in South Central Appalachia.
METHODS
The investigators conducted five focus groups with 35 Appalachian Research Network practice-based research network providers between February and October, 2014. Two prescriber-specific, two pharmacist-specific, and one interprofessional (prescribers and pharmacists) focus groups were conducted, recorded, and transcribed. Data collection and analysis occurred iteratively. Emerging themes were inductively derived and refined. Five member-checking interviews were conducted to validate themes.
RESULTS
Providers noted several factors that influence intraprofessional and interprofessional communication, including level of trust, role perceptions, conflict history and avoidance, personal relationships, and prescription monitoring program use. Indirect communication approaches via patients, office staff, and voicemail systems were common. Direct pharmacist to prescriber and prescriber to pharmacist communication was described as rare and often perceived to be ineffective. Prescriber to pharmacist communication was reported by prescribers to have decreased after implementation of state prescription monitoring programs. Difficult or uncomfortable conversations were often avoided by providers.
CONCLUSIONS
Interprofessional and intraprofessional prescription opioid abuse communication is situational and influenced by multiple factors. Indirect communication and communication avoidance are common. Themes identified in this study can inform development of interventions that improve providers' intra- and interprofessional communication skills.
Topics: Adult; Attitude of Health Personnel; Female; Focus Groups; Humans; Interdisciplinary Communication; Male; Middle Aged; Nurses; Opioid-Related Disorders; Pharmacists; Physicians; Qualitative Research; Substance-Related Disorders
PubMed: 28799863
DOI: 10.1080/08897077.2017.1365803 -
BMC Health Services Research Sep 2018To address challenges related to medication management in underserved settings, we developed a system for Prescription Management And General Inventory Control, or...
BACKGROUND
To address challenges related to medication management in underserved settings, we developed a system for Prescription Management And General Inventory Control, or RxMAGIC, in collaboration with the Birmingham Free Clinic in Pittsburgh, Pennsylvania. RxMAGIC is an interoperable, web-based medication management system designed to standardize and streamline the dispensing practice and improve inventory control in a free clinic setting. This manuscript describes the processes used to design, develop, and deploy RxMAGIC.
METHODS
We transformed data from previously performed mixed-methods needs assessment studies into functional user requirements using agile development methods. Requirements took the form of user stories that were prioritized to drive implementation of RxMAGIC as a web-application. A functional prototype was developed and tested to understand its perceived usefulness before developing a production system. Prior to deployment, we evaluated the usability of RxMAGIC with six users to diagnose potential interaction challenges that may be avoided through redesign. The results from this study were similarly prioritized and informed the final features of the production system.
RESULTS
We developed 45 user stories that acted as functional requirements to incrementally build RxMAGIC. Integrating with the electronic health record at the clinic was a requirement for deployment. We utilized health data standards to communicate with the existing order entry system; an outgoing electronic prescribing framework was leveraged to send prescription data to RxMAGIC. The results of the usability study were positive, with all tested features receiving a mean score of four or five (i.e. somewhat easy or easy, respectively) on a five-point Likert scale assessing ease of completion, thus demonstrating the system's simplicity and high learnability. RxMAGIC was deployed at the clinic in October 2016 over a two-week period.
CONCLUSIONS
We built RxMAGIC, an open-source, pharmacist-facing dispensary management information system that augments the pharmacist's ability to efficiently deliver medication services in a free clinic setting. RxMAGIC provides electronic dispensing and automated inventory management and alerting capabilities. We deployed RxMAGIC at the Birmingham Free Clinic and measured its usability with potential users. In future work, we plan to continue to measure the impact of RxMAGIC on pharmacist efficiency and satisfaction.
Topics: Ambulatory Care Facilities; Drug Delivery Systems; Electronic Health Records; Electronic Prescribing; Humans; Medical Informatics; Pennsylvania; Personal Satisfaction; Pharmacists; Pharmacy Service, Hospital; Prescriptions; User-Computer Interface
PubMed: 30200939
DOI: 10.1186/s12913-018-3517-8 -
Pharmacist's contribution to the promotion of access and rational use of essential medicines in SUS.Ciencia & Saude Coletiva Jan 2017to describe the pharmaceutical inclusion process in a Basic Health Unit multidisciplinary team and evaluate results related to rational use and promotion of access to...
OBJECTIVE:
to describe the pharmaceutical inclusion process in a Basic Health Unit multidisciplinary team and evaluate results related to rational use and promotion of access to essential medicines.
METHODS:
This is a descriptive, cross-sectional study conducted in a primary care health unit in the city of São Paulo. Pharmacist's activities were evaluated regarding the service structure and organization and prescribing quality improvement, guidance method creation, and implementation of clinical pharmacy service. Data measured before and after the interventions and between 2010 and 2011 were analyzed using Pearson´s chi-square test with a significance level of 5%, and odds ratio.
RESULTS:
Pharmacist's activities had statistically significant result in drug shortage reduction; prescribing quality improvement associated with an increased proportion of prescriptions met; decrease in the total of prescribed drugs among patients receiving pharmacotherapeutic follow-up and, comparing the years 2010 and 2011, changes in the pharmacotherapy recommendations have gained increased acceptance level.
CONCLUSIONS:
Pharmacist's activities may effectively provide rational use and promotion of access to essential medicines.
Topics: Brazil; Cross-Sectional Studies; Drugs, Essential; Health Services Accessibility; Humans; Patient Care Team; Pharmaceutical Services; Pharmacists; Practice Patterns, Physicians'; Prescription Drugs; Primary Health Care; Professional Role; Quality Improvement
PubMed: 28076546
DOI: 10.1590/1413-81232017221.16202015 -
American Journal of Pharmaceutical... Oct 2020The annual number of Doctor of Pharmacy (PharmD) graduates is projected to exceed the number of annual pharmacist job openings over the next 10 years. Loss of retail...
The annual number of Doctor of Pharmacy (PharmD) graduates is projected to exceed the number of annual pharmacist job openings over the next 10 years. Loss of retail sector jobs will be partially offset by projected gains in several other sectors; however, oversupply will persist until the number of graduates is more reflective of job market capacity. Large-scale practice transformation will not happen overnight; consequently, schools and colleges of pharmacy must immediately change their perspective from producing graduates to fill pharmacist roles, to producing graduates who are prepared with expertise and professional skills to excel in many types of well-paying positions. Students need career advice including to convince potential employers how a PharmD education has prepared them with transferable high-level skills that are applicable beyond traditional pharmacist roles. Better communicating the value of pharmacy skills to students and employers may also have a positive impact on admission numbers as prospective applicants become more aware of the breadth of pharmacy career opportunities.
Topics: Career Choice; Career Mobility; Community Pharmacy Services; Education, Pharmacy; Health Workforce; Humans; Job Description; Pharmacists; Students, Pharmacy; Time Factors
PubMed: 33149327
DOI: 10.5688/ajpe7889 -
Research in Social & Administrative... Sep 2022Community pharmacists are one of the most accessible healthcare providers during the COVID-19 pandemic. Whilst playing a vital role in medication supply and patient...
BACKGROUND
Community pharmacists are one of the most accessible healthcare providers during the COVID-19 pandemic. Whilst playing a vital role in medication supply and patient education, exposure to the pandemic demands and prolonged stressors increase their risk of burnout.
OBJECTIVES
Using the Job Demands-Resources model, this study aims to understand the factors that led to community pharmacists' burnout and to identify their coping strategies and perceived recommendations on interventions to mitigate burnout during the COVID-19 pandemic.
METHODS
A qualitative phenomenological approach was used with focus groups and interviews of community pharmacists in Qatar who were recruited using purposeful, convenience, and snowballing sampling methods. Interviews were conducted between February and April 2021, were audio-recorded and transcribed verbatim. Using thematic analysis methodology, manual inductive and deductive (based on the model) codes from the interviews were used for synthesis of themes. 11 themes emerged from six focus groups, six dyadic interviews and mini focus groups, and four individual interviews with community pharmacists.
RESULTS
The contributing factors to community pharmacists' burnout have been identified as practical job demands, and emotional demands including fear of infection. On the other hand, government and workplace-specific resources, personal characteristics such as resiliency and optimism, as well as the implementation of coping strategies, have reduced their stress and burnout.
CONCLUSIONS
The use of the Job Demands-Resources model was appropriate to identify the contributing factors to community pharmacists' burnout during the COVID-19 pandemic. Based on these factors, individual, organizational, and national strategies can be implemented to mitigate burnout in community pharmacists during the pandemic and future emergencies.
Topics: Burnout, Psychological; COVID-19; Community Pharmacy Services; Humans; Pandemics; Pharmacists
PubMed: 35418325
DOI: 10.1016/j.sapharm.2022.03.011 -
European Journal of Hospital Pharmacy :... Mar 2022The inappropriate use of antimicrobial agents is contributing to an increasing phenomenon of bacterial resistance. For this reason, there is a growing interest in...
UNLABELLED
The inappropriate use of antimicrobial agents is contributing to an increasing phenomenon of bacterial resistance. For this reason, there is a growing interest in 'antimicrobial stewardship', a series of coordinated and multidisciplinary interventions aimed to promote the safe and appropriate use of antimicrobials in which the pharmacist's contribution is necessary for the optimal choice of drug, dose, duration of therapy and the implementation of cost containment strategies.
AIM OF THE STUDY
We wanted to create a reference model and a specific training manual on antibiotic stewardship to introduce the role of the department pharmacist with specific infection disease skills in the Italian health system hospitals.
METHODS
This study was conducted in six Italian hospitals for 24 months. It was divided into three phases: definition of indicators (as defined daily doses/100 days of hospitalisation, switches from intravenous (IV) to oral and from empirical to targeted therapies, etc) elaboration of research protocol; sharing, application and detection of the indicators and selection of centres involved; analysis and sharing of results and subsequent drafting and distribution of the training manual.Statistical analysis focused on possible differences between the frequencies of the aforementioned switches. Differences were analysed comparing the values recorded in the first quarter with those of the third quarter trough a χ² test. Statistical significance was set at p<0.05.
RESULTS
The pharmacist's work showed a statistically significant increase in the conversion from IV to oral antibiotic therapy (χ² (1.496)=9112 ; p=0.0025; df=1). It was also detected a 5% improvement in appropriate dosing, 34% reduction in drug stocks, 4% increase in allergy reports and 275% increase in the number of adverse drug reactions reported.
CONCLUSIONS
In this study, the interventions of the antibiotic stewardship pharmacist led to an improvement in quality of care, resource efficiency and healthcare professional awareness.
Topics: Anti-Infective Agents; Antimicrobial Stewardship; Communicable Diseases; Hospitals; Humans; Pharmacists
PubMed: 32900820
DOI: 10.1136/ejhpharm-2020-002242 -
BMC Health Services Research Oct 2023Building interprofessional working relationships between general practitioners (GPs) and pharmacists is essential to ensure high-quality patient care. However, there is...
BACKGROUND
Building interprofessional working relationships between general practitioners (GPs) and pharmacists is essential to ensure high-quality patient care. However, there is limited Chinese literature on GP-pharmacist collaboration, and few studies have explored GPs' experiences with pharmacist integration into general practices. This study aimed to investigate GPs' attitudes towards and frequency of collaboration with pharmacists in China.
METHODS
This cross-sectional study used an online self-administered questionnaire integrating two scales, ATCI-GP and FICI-GP, which had been translated and validated to investigate 3,248 GPs from February 15 to March 15, 2023 across Zhejiang Province, China. Descriptive analyses were used, and the factors associated with GPs' frequency of collaboration with pharmacists were explored using logistic regression analysis.
RESULTS
A total of 2,487 GPs (76.6%) responded and consented to participate in the survey; 52.3% were male and the mean age was 35.4 years. Most GPs agreed that they shared common goals and objectives with pharmacists when caring for patients (90.0%), and pharmacists were open to working with them on patients' medication management (80.8%). However, half of the GPs did not change or seldom changed the patient's medication on the pharmacist's advice (51.4%). Logistic regression analysis showed that GPs who were older and had more years of practice were more likely to agree that pharmacists were willing to collaborate, had common goals for treatment and that they would change the patient's medication on the advice of the pharmacist. GPs who had regular communication protocols (adjusted odds ratio [aOR] = 1.88, 95% CI 1.45-2.45; aOR = 3.33, 95% CI 2.76-4.02), participated in joint continuing education (aOR = 1.87, 95% CI 1.44-2.43; aOR = 2.27, 95% CI 1.91-2.70), provided recommendations for medication review (aOR = 3.01, 95% CI 2.07-4.38; aOR = 3.50, 95% CI 2.51-4.86), and communicated with pharmacists during resident training (aOR = 2.15, 95% CI 1.78-2.60; aOR = 1.38, 95% CI 1.18-1.62) were associated with a more positive attitude towards and higher frequency of cooperation.
CONCLUSIONS
GPs in China displayed a positive attitude towards cooperating with pharmacists, but they did not demonstrate a similar level of practice. As environmental determinants impact interdisciplinary collaboration, healthcare managers and policy-makers need to implement measures that foster a supportive environment conducive to interdisciplinary collaboration.
Topics: Humans; Male; Adult; Female; General Practitioners; Pharmacists; Cross-Sectional Studies; Attitude of Health Personnel; Cooperative Behavior; Surveys and Questionnaires; China
PubMed: 37891601
DOI: 10.1186/s12913-023-10151-0 -
The American Journal of Managed Care May 2020To implement a project of linked pharmacist-provider new patient visits and then evaluate the impact on the productivity of the provider and pharmacist.
OBJECTIVES
To implement a project of linked pharmacist-provider new patient visits and then evaluate the impact on the productivity of the provider and pharmacist.
STUDY DESIGN
A clinical pharmacist was integrated into the workflow at 2 sites (sites A and B) of Henry J. Austin Health Center, a federally qualified health center, so that new patients were scheduled to see the pharmacist in a 15-minute encounter immediately before a 15-minute encounter with the primary care provider.
METHODS
Reports generated in the electronic health record were downloaded into Microsoft Excel for statistical analysis. Two-sample 2-tailed t tests assuming unequal variances were used to evaluate changes in the mean number of appointments checked in and canceled before and after the project's implementation to study provider productivity, the primary study outcome. Descriptive statistics were used to report the pharmacist's productivity.
RESULTS
Statistically significant increases in the number of checked-in new patient visits and in all visits of any type were observed at site A; however, these changes were not observed at site B.
CONCLUSIONS
The linked visits between the pharmacist and provider allowed for increased provider productivity at 1 of the sites. Based on these results and provider feedback from both sites, this project was viewed as a positive initiative. Scheduling challenges were a barrier to project success at site B.
Topics: Appointments and Schedules; Efficiency, Organizational; Electronic Health Records; Humans; Pharmacists; Primary Health Care; Professional Role; Safety-net Providers
PubMed: 32436685
DOI: 10.37765/ajmc.2020.43159 -
BMC Health Services Research Jan 2018In many countries, clinical pharmacists are part of health care teams that work to optimize drug therapy and ensure patient safety. However, in Sweden, clinical pharmacy...
BACKGROUND
In many countries, clinical pharmacists are part of health care teams that work to optimize drug therapy and ensure patient safety. However, in Sweden, clinical pharmacy services (CPSs) in hospital settings have not been widely implemented and regional differences exist in the uptake of these services. Physicians' attitudes toward CPSs and collaborating with clinical pharmacists may facilitate or hinder the implementation and expansion of the CPSs and the role of the clinical pharmacist in hospital wards. The aim of this study was to explore physicians' perceptions regarding CPSs performed at hospital wards in Northern Sweden.
METHODS
Face-to-face semi-structured interviews were conducted with a purposive sample of nine physicians who had previously worked with clinical pharmacists between November 2014 and January 2015. Interviews were digitally recorded, transcribed and analysed using a constant comparison method.
RESULTS
Different themes emerged regarding physicians' views of clinical pharmacy; two main interlinked themes were service factors and pharmacist factors. The service was valued and described in a positive way by all physicians. It was seen as an opportunity for them to learn more about pharmacological treatment and also an opportunity to discuss patient medication treatment in detail. Physicians considered that CPSs could improve patient outcomes and they valued continuity and the ability to build a trusting relationship with the pharmacists over time. However, there was a lack of awareness of the CPSs. All physicians knew that one of the pharmacist's roles is to conduct medication reviews, but most of them were only able to describe a few elements of what this service encompasses. Pharmacists were described as "drug experts" and their recommendations were perceived as clinically relevant. Physicians wanted CPSs to continue and to be implemented in other wards.
CONCLUSIONS
All physicians were positive regarding CPSs and were satisfied with the collaboration with the clinical pharmacists. These findings are important for further implementation and expansion of CPSs, particularly in Northern Sweden.
Topics: Adult; Attitude of Health Personnel; Female; Health Services Needs and Demand; Hospitals; Humans; Interprofessional Relations; Intersectoral Collaboration; Interviews as Topic; Male; Patient Safety; Pharmacists; Pharmacy Service, Hospital; Physicians; Professional Role; Qualitative Research; Sweden
PubMed: 29361941
DOI: 10.1186/s12913-018-2841-3 -
American Journal of Health-system... Dec 2016
Review
Topics: Humans; Pharmacists; Pharmacogenetics; Professional Role; Randomized Controlled Trials as Topic
PubMed: 27864209
DOI: 10.2146/ajhp160046