Dissertations / Theses on the topic 'Community pharmacist; pharmacy'
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McAree, D. P. "Women's health : community pharmacy care." Thesis, Queen's University Belfast, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.391103.
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Witry, Matthew John. "Community pharmacist medication monitoring attitudes and decision making." Diss., University of Iowa, 2013. https://ir.uiowa.edu/etd/4979.
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Medication related problems occur frequently and can be difficult to predict. Medication monitoring by health care providers allows for problems to be identified before they become severe. Medication monitoring is an an emerging role for community pharmacists. This mixed methods study examines pharmacist perspectives on medication monitoring. Study methods included 12 semi-structured interviews, a mixed methods item generation process to create a pharmacist medication motioning attitude measure, and mailed factorial survey designed to assess pharmacist decision making related to asking non-adherence, side effect, and effectiveness questions for randomly generated refill dispensing vignettes. Hierarchical linear modeling was used to identify significant vignette level and pharmacist level variables associated with likelihood to ask the three monitoring questions. The qualitative analysis showed barriers to medication monitoring including time limitations, busyness, low patient expectation, and a perceived routine nature of refills by both patients and pharmacists. Monitoring non-adherence was a challenge because workflows often do not make non-adherence apparent to the pharmacists when the patient presents to the pharmacy. Lastly, monitoring interactions often are precipitated by "gateway conversations" which begin as technical or cost issues related to the prescription but then progress to monitoring issues when the patient reflects interest. Analysis of the survey showed in general, pharmacists had positive medication monitoring attitudes and worked in pharmacies somewhat conducive to medication monitoring, although there was variation. The factorial survey showed pharmacist monitoring attitudes were significantly associated with the likelihood to ask all three monitoring question types. For the different prescriptions involved, warfarin and hydrocodone were significantly associated with asking monitoring questions whereas fluoxetine and metoprolol appeared less question-worthy. The number of days late was associated with greater question asking likelihood suggesting days late is an important activator for pharmacist medication monitoring. Number of patients waiting was a barrier. This study shows community pharmacists are oriented to monitoring, but there are significant barriers which need to be addressed when advancing this role.
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Watman, Geoffrey P. "Pharmacist monitoring of patient health in the community." Thesis, Aston University, 1996. http://publications.aston.ac.uk/10935/.
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This research has explored the potential role of the community pharmacist in health promotion in the pharmacy, and at general medical practices. The feasibility of monitoring patients' health status in the community was evaluated by intervention to assess and alter cardiovascular risk factors. 68, hypertensive patients, monitored at one surgery, had a change in mean systolic blood pressure from 158.28 to 146.55 mmHg, a reduction of 7.4%, and a change in mean diastolic bood pressure from 90.91 to 84.85 mmHg, a reduction of 6.7%. 120 patients, from a cohort of 449 at the major practice, with an initial serum total cholesterol of 6.0+mmol/L, experienced a change in mean value from 6.79 to 6.05 mmol/L, equivalent to a reduction of 10.9%. 86% of this patient cohort showed a decrease in cholesterol concentration. Patients, placed in a high risk category according to their coronary rank score, assessed at the first health screening, showed a consistent and significant improvement in coronary score throughout the study period of two years. High risk and intermediate risk patients showed improvements in coronary score of 52% and 14% respectively. Patients in the low risk group maintained their good coronary score. In some cases, a patient's improvement was effected in liaison with the GP, after a change or addition of medication and/or dosage. Pharmacist intervention consisted of advice on diet and lifestyle and adherence to medication regimes. It was concluded that a pharmacist can facilitate a health screening programme in the primary care setting, and provide enhanced continuity of care for the patient.
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Kinney, Olivia. "Impact of Community-based Pharmacist Intervention on Initial Opioid Prescribing." University of Cincinnati / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1602153052809053.
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Roberts, Pauline Isobel. "Adverse drug reaction monitoring and the community pharmacist." Thesis, University of Bradford, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.335542.
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Morley, Alison. "A study of the role of the community pharmacist in responding to symptoms." Thesis, Aston University, 1987. http://publications.aston.ac.uk/12537/.
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Factors affecting the current role of the community pharmacist in responding to symptoms are investigated. Communication and collaboration with general medical practitioners (GPs), and the competency of pharmacists and counter assistants to perform the role of responding to symptoms, are examined. A national survey of GPs, conducted by postal questionnaire, explores attitudes towards the role of the community pharmacist in the treatment of patients' symptoms, and towards future extension of such a role. A majority (over 90%) of respondents thought that the counter prescribing activities of the pharmacist should be maintained or increased. Doctors supported treatment of most minor illnesses by pharmacists, but there was relatively little support for the deregulation of selected Prescription Only Medicines. Three quarters of respondents were in favour of joint educational meetings for pharmacists and doctors. Most GPs (85%) expressed support for a formal referral route from pharmacists to doctors, using a "notification card". A pilot study of the use of a notification card was conducted . Two thirds of the patients who were advised to see their doctor by the pharmacist subsequently did so. In most cases , the GP rated the patients' symptoms " significant" and the card "helpful". Pharmacists' and counter assistants' competency in responding to symptoms was assessed by a programme of pharmacy visits, where previously-defined symptoms were presented. Some pharmacists' questioning skills were found to be inadequate, and their knowledge not sufficiently current. Counter assistants asked fewer and less appropriate questions than did pharmacists, and assistants ' knowledge base was shown to be inadequate. Recommendations are made in relation to the education and training of pharmacists and counter assistants in responding to symptoms.
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Colondres, Bárbara, and Christina DiGiacomo. "Assessment of Pharmacist-run Anticoagulation Clinic in Rural Arizona." The University of Arizona, 2011. http://hdl.handle.net/10150/623569.
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Class of 2011 AbstractOBJECTIVES: To assess the outcomes of care for patients enrolled in a pharmacist-run anticoagulation clinic. METHODS: A retrospective chart review was conducted of patients who received warfarin anticoagulation therapy management at the pharmacist-managed clinic at a community health center. To be eligible for the study patients had to be between the ages of 18-80 and have at least 6 recorded INRs during the first 6 months of treatment in the clinic. The patient data were reviewed for a time period of 24 weeks from the initial visit. The primary dependent variable was whether or not a patient’s INR is within range. Secondary outcomes included frequency of adverse events (blood in urine or stool). A data extraction form was used to collect patient demographics and initial INR values from the patient charts. An odds ratio was used to compare the proportion of INRs in range upon entry into the clinic and after 6 months of care in the clinic. In addition, outcomes were evaluated for differences by gender and age. RESULTS: Sixty-six patients were included in the study; 50% (33) were men and the average age was 55.9 years old (SD = 12.9 years). At baseline, 24 patients had INRs within the therapeutic range. Patients were 5 times more likely to have INRs in range (N = 49; OR = 5.04; p < 0.001) after 6 months of treatment in the pharmacist-managed clinic than at baseline. About 59% of men and 54% of women had INRs in range during 6 months of therapy in the clinic (p=0.326). Patients under 55 were in range about 55% of the time over 6 months, while patients over 55 were in range about 59% of the time (p=0.366). CONCLUSION: Patients enrolled in the pharmacist-run anticoagulation clinic were more likely to have therapeutic INRs after 6 months of care in the clinic compared to baseline.
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Hagemeier, Nicholas E. "Public Health Minute: Prescription Drug Abuse Prevention and the Community Pharmacist." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1486.
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Melton, Tyler C., Nicholas E. Hagemeier, Kelly N. Foster, Jesse Arnold, Billy Brooks, Arsham Alamian, and Robert P. Pack. "Primary Care Physician and Community Pharmacist Opioid-Related Communication and Screening Behaviors." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7743.
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Knoesen, Brent Claud. "Exploring the communication skills of community pharmacists in the Nelson Mandela Metropole." Thesis, Nelson Mandela Metropolitan University, 2015. http://hdl.handle.net/10948/7981.
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Pharmacy is an information-driven profession that requires effective face-to-face pharmacist-client communication. With the addition of corporate community pharmacies to traditional independent community pharmacies in South Africa (SA), new challenges may hamper pharmacist-client interactions. This study aimed to identify, adapt and improve the communication skills pharmacists require for a changing community pharmacy environment. Specific objectives were to identify basic communication skills, to evaluate the use of these skills by community pharmacists in the Nelson Mandela Metropole (NMM), to identify communication barriers, and to identify any differences in pharmacist-client communication in the two community pharmacy sectors. A mixed methods research design was implemented. The empirical activities consisted of three client focus groups (17 citizens from the NMM), a client survey (220 clients visiting seven independent and seven corporate community pharmacies in the NMM), a pseudo-client study (the same 14 community pharmacies in NMM), and a Delphi study. Twenty-one pharmacists from the 14 community pharmacies participated in Phase one of the Delphi study; nine academic pharmacists from five pharmacy departments/schools/faculties in SA participated in Phase two. Various qualitative and quantitative techniques were used to analyse and interpret the results. Results indicated that clients consult on many occasions with community pharmacists. Community and academic pharmacists listed listening and nonverbal skills as most important communication skills to ensure effective pharmacist-client communication. Counselling privacy and language barriers were listed as major problems influencing the interaction. The results obtained allowed the researcher to propose a practical communication model to assist future community pharmacists in communication skills training
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Luder, Heidi R. "TransitionRx: Impact of a Community Pharmacy Post-Discharge Medication Therapy Management Program on Hospital Readmission Rate." University of Cincinnati / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1367937238.
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Silva, Diana Rocha Lopes. "Clinical research in community pharmacies : trying to find a way." Master's thesis, Universidade de Aveiro, 2014. http://hdl.handle.net/10773/12946.
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Mestrado em Biomedicina FarmacêuticaThis project aims to promote the involvement of community pharmacists in clinical research. In the last years, the pharmaceutical profession has gone through various challenges. At the same time, pharmacists have sought to develop a more active role in the community. The skills that pharmacists have allow them a more active role in clinical research, either cooperating with health units, either as researchers. The proximity to the patient and the placing in the community, allows community pharmacies to have an important role in the disclosure of clinical research. The Portuguese reality, so far, does not seem to reflect the reality of other countries in this field. However, Portugal has the necessary conditions for this situation to change. The growing importance of real world data and the placement of pharmacies in the community leave space for its involvement in clinical research to be improved. Thus, in the near future it would be important that community pharmacies are called upon to this reality. This project suggests the application of a questionnaire to Portuguese community pharmacies in order to assess the feasibility of this project, evaluating their interest in clinical research and identifying the possible barriers to their participation.
Este projeto propõe-se promover o envolvimento dos farmacêuticos de farmácia comunitária em investigação clínica. Nos últimos anos, a profissão farmacêutica tem passado por vários desafios. Ao mesmo tempo, os farmacêuticos têm procurado desenvolver um papel mais interventivo na comunidade. As competências que os farmacêuticos têm permitem-lhes um papel mais interventivo em investigação clínica, quer cooperando com as unidades de saúde, quer como investigadores. A proximidade ao utente e a inserção na comunidade, permite às farmácias comunitárias terem um papel importante em investigação clínica. A realidade portuguesa, até ao momento, não parece acompanhar a realidade doutros países neste âmbito. No entanto, Portugal reúne as condições necessárias para que essa realidade se altere. A crescente importância dos dados de vida real e o posicionamento das farmácias na comunidade deixam espaço para que a sua intervenção em investigação clínica possa ser melhorada. Assim, num futuro próximo será importante que as farmácias comunitárias sejam chamadas para esta realidade. Este projeto sugere a aplicação futura de um questionário de modo a avaliar a sua exequibilidade, avaliando o interesse das farmácias comunitárias portuguesas em investigação clínica e as possíveis barreiras à sua participação.
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Hagemeier, Nicholas E., Daniel Ventricelli, and Rajkumar J. Sevak. "Situational Communication Self-Confidence Among Community Pharmacists: A Descriptive Analysis." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1481.
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Objective: To compare community pharmacists' self-perceived communication confidence in prescription drug abuse and addiction (PDAA)-related scenarios to their self-confidence in other scenarios.
Methods: An 18-item survey instrument adapted from the Self-Perceived Communication Competence instrument was administered to 2000 licensed Tennessee community pharmacists. Items elicited communication confidence across common community pharmacy scenarios. Analysis of communication self-confidence scores across context, receiver, audience, and demographic variables was conducted.
Results: Mean self-confidence ratings ranged from 54.2 to 92.6 (0-100 scale). Self-perceived communication confidence varied across context, receiver, audience, personal and practice setting characteristics. Scenarios that involved PDAA communication with patients were scored significantly lower than non-PDAA patient scenarios (mean = 84.2 vs. 90.4, p
Conclusion: Community pharmacists are less confident in their ability to communicate with patients about PDAA as compared to non-PDAA scenarios. Practice Implications: Engaging patients and prescribers in PDAA conversations is a critical component of preventing and treating PDAA. Research is warranted to further explore measures of situational communication self-confidence and interventions to optimize self-confidence beliefs across PDAA scenarios.
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Tatari, Wisam. "Using Pharmacist-Led Tele-Consultation to Review Patients with Chronic Obstructive Pulmonary Disease." Thesis, University of Bradford, 2018. http://hdl.handle.net/10454/17311.
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Shah, Richa S., Sarah Blevins, Emily L. Sorah, Kelly M. Ferris, Kyle S. Hagen, and Nicholas E. Hagemeier. "Community Pharmacists' Willingness to Participate in a Rural Appalachian Practice-Based Research Network." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1454.
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Practice-based research networks (PBRNs) are groups of health care practitioners who engage in translational research and quality improvement activities, with the overarching goal of improving patient care in primary care settings. The Appalachian Research Network (AppNET), a rural primary care PBRN, was created in 2009 and comprises 17 clinics in 16 rural communities in South Central Appalachia. Nationally, only 4 of 152 PBRNs registered with the Agency for Healthcare Research and Quality (AHRQ) place particular emphasis on community pharmacies and pharmacists in research efforts. Researchers at ETSU seek to integrate community pharmacies into AppNET, thereby establishing a novel interprofessional rural PBRN. The objective of this study was to assess pharmacist perceptions regarding practice-based research and interest in participating in AppNET. Barriers to participation in a PBRN, perceived benefits of participation, and practice-specific characteristics were also assessed. Contact information was obtained via telephone calls made to individual pharmacies in AppNET communities. Thereafter, paper-based surveys were mailed to 69 pharmacist contacts, along with a personalized cover letter and a stamped return envelope. A total of two mailings were used to recruit pharmacists to participate in the study. A response rate of 42% was obtained. Respondents were on average 44 years of age and had been licensed as a pharmacist for an average of 19 years. A large majority of respondents (86%) were very or somewhat interested in participating in AppNET. The majority of respondents felt that time constraints and workflow interruptions were the greatest barriers to participation. One hundred percent of respondents indicated that research on prescription drug abuse, medication adherence, and medication safety are very or somewhat applicable to their practice settings. Ninety-two percent felt that research on value-added services (e.g., immunizations, diabetes education) and medication therapy management was somewhat or very applicable to their practice. Overall, pharmacist respondents in AppNET communities indicated interest in research that benefits the care of their patients and interest in AppNET. Researchers are presently conducting a third recruitment attempt and will thereafter develop AppNET enrollment mechanisms that minimize barriers to participation of community pharmacies in practice-based research.
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Salwan, Aaron J., Nicholas E. Hagemeier, Kelly N. Foster, Jesse Arnold, Billy Brooks, Arsham Alamian, and Robert P. Pack. "Pharmacist and Physician Engagement in Tertiary Prevention of Opioid Use Disorder." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/7742.
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Tan, Rachel. "The Management of Allergic Rhinitis in the Community Pharmacy: A Real-Life Study of Current Practice in Australia." Thesis, The University of Sydney, 2019. https://hdl.handle.net/2123/21222.
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Allergic rhinitis (AR) is a highly prevalent, chronic respiratory condition which results in significant personal and socioeconomic burdens on communities, that are of concern globally. These burdens are pronounced because people with AR often trivialise their condition and do not optimally manage their symptoms. This is of particular concern in people with co-morbid asthma, as asthma exacerbations are more pronounced particularly when AR control is poor. Considering AR is a manageable condition, it is imperative that we optimise management strategies to minimise the widespread burden caused by AR. This thesis aims to investigate the current AR management practices in the Australian community pharmacy setting in real time, in order to fully understand why AR is suboptimally managed and how it can be improved. Several research strategies were employed in this thesis. A researcher administered survey was carried out to explore pharmacy customer’s management of AR within the community pharmacy. This thesis showed the majority of the pharmacy customers are making suboptimal over the counter (OTC) medicines selections without consulting a pharmacist for recommendations or a general practitioner (GP) for a diagnosis. This is concerning as the majority experience moderate-severe symptoms yet only 15% of them selected the appropriate medication for the symptoms reported individually. This thesis also investigated the use of mobile health applications (mHealth apps) in the Australian Apple app store and Android Google Play Store, to address the specific tools used for patient’s AR self-management. Amongst the many apps evaluated in this thesis, Allergy Diary by MASK was identified to be effective in assisting patients in covering the multifaced AR self-management. It allowed patients to keep track of their symptoms daily, measure the severity of their symptoms, enhance their medication adherence and communication with their HCPs to manage their condition optimally. The findings in this thesis formed the basis for the development of an evidence-based clinical pathway, specific for the Australian community health care environment. It helps the AR health care community realise the problems associated with AR management and for best practice guidelines to be implemented in the community pharmacy.
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Kubashe, Nomachina Theopatra. "The influence of corporatization on the professional identity of community pharmacists." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/18189.
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As a potential main player in the primary health care sector and the impending National Health Insurance (NHI), community pharmacists could make a significant contribution to easing the health care burden in South Africa. Recent legislative and organizational changes related to the corporatization of pharmacy in South Africa have impacted significantly on the profession and stand to weaken the already ‘tenuous’ professional identity of pharmacists in the country. Since community pharmacists are viewed as potential main players in the primary health care sector, the influence of corporatization on pharmacists’ identities and their concomitant ability to contribute to easing the health care burden in South Africa need to be considered. In this regard, this study examined the influence that corporatization has had on the professional identity of community pharmacists practicing in the Nelson Mandela Bay area of South Africa. That is, in an effort to understand the influence that corporatization has had on changing professional identities and practices the attitudes, beliefs, and behaviours of community pharmacists regarding the philosophy and practice of pharmacy were explored. This included ascertaining community pharmacists’ self-perception of their professional identity and the perception of users of these community pharmacies. The study was conducted from an interpretative epistemological paradigm, based on a philosophy of pragmatism. Data collection was conducted in two phases and a qualitative approach, which included in-depth and semi-structured interviews, was adopted as a design. Phase one investigated the self-perceptions of sixteen community pharmacists, equally distributed between independent and corporate pharmacies in the Nelson Mandela Bay (NMB). Phase two examined the perceptions of thirty-two end-users of the pharmacies included in the study. Data from both phases were then analysed and interpreted. Following the identification of seven core professional identities, namely pharmacists as custodian or keeper of medicines; primary health care givers; confidante and carer; jaded; astute and credible; corporate; and independent, it was determined that corporatization has, to various degrees, had an effect on the undermining of Nelson Mandela Bay community pharmacists’ view of themselves as skilled professionals in the health care sector. In short, it was found that corporatization is believed to have blurred the boundaries related to what it means to be a pharmacist and what role pharmacists should play in the provision of public health care. Corporatization does not appear to have influenced the patients’ or pharmacy end-users’ perceptions of the pharmacist, and furthermore does not play a major role in their choice of pharmacy. It is the perception of pharmacists in this study that with the introduction of legislative changes, more so corporatization, they experienced an undermining of their professional skill and disregard for costs involved in becoming a pharmacist. The perceived undermining of the professional skill of pharmacists threatens the valuable contribution that community pharmacists can make to balancing the country’s socio-economic status by appropriately and efficiently assisting in preventing, managing and/or reducing the disease burden in South Africa. Corporatization of the community pharmacy sector seems to have realized the government’s intention of making medication affordable to its citizens, however, the certainty of whether corporatization benefits patients that are in need of access remains to be seen. Community pharmacists could in fact, capitalize on the identification and enactment of their clinical skill (pharmaceutical and social caregiving) as this skill appears to be a tool that will allow pharmacists meaningful transition to being real contributors of primary health care in the imminent introduction of the NHI. At the same time, recognition of the role a pharmacist plays in primary health care will be supporting the government in its endeavours to making medicine accessible and affordable to all South African citizens without compromising their health needs. Ultimately, pharmacists can assist in the balancing and/or improvement of the socio-economic status of our society and the country.
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Faya, Sultan. "Pharmaceutical care for elderly patients in community pharmacy : analysis and evaluation of community pharmacist interventions in the Randomised Evaluation of Shared Prescribing for Elderly People in the Community over Time (RESPECT) Study." Thesis, University of Bradford, 2009. http://hdl.handle.net/10454/3345.
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The impact of the pharmacist in elderly patient healthcare management is developing. In our study, the interventions made by community pharmacists in the RESPECT study (Randomised Evaluation of Shared Prescribing for Elderly people in the Community over Time) were analysed and evaluated. In our study, the study sample was chosen according to specific criteria. The outcomes of these pharmacist interventions were measured by a clinical panel which scored and categorised each intervention into one of five categories. The study also investigated the percentage of interventions implemented or not implemented by GPs. In our study, initially 398 patients and of these 52 were excluded because their files did not contain the entry criteria information, leaving 346 patients who were identified with a mean (SD) of 8.9 (3.3) pharmaceutical care plans which contained mean (SD) 8.2(7.2) pharmaceutical care issues. Of these 43% were males and 57% were females with a mean (SD) age of 81(3.7) years. There were many missing data about drugs prescribed due to poor documentation by community pharmacists in the RESPECT study particularly at post study period (T5). The mean (SD) for all drugs prescribed was 35.9 (12.38) for each patient and for the whole study period including the post period (T5). In our study a total of 2879 individual pharmaceutical care issues were identified. A clinical panel judged that 43% of the interventions prevented harm, 31% improved the efficacy of management, 3% were detrimental to the patient's management plan, 12% only provided information and there was insufficient information to make a decision on the remaining 11%. For the classifications prevented harm to the patient and improve efficacy of management, the panel gave a score of 7 or more to 264 and 103 respectively which were classed as potential prevented hospital admissions. The outcome of 1628 could not be determined from the data and the pharmacist did not intervene on 361 occasions. Of the remaining 890 (30.9%) GPs accepted 715 and did not accept 175. The cost effectiveness of providing pharmaceutical care to older people by community pharmacists could be estimated (£620,000) by calculating reduction in expenditure of hospital admissions. In addition, there would be the possibility of reduced pressure on other NHS resources such as availability of hospital beds. The involvement of a clinical pharmacist in elderly patient health care, within the setting of a community pharmacy, provided positive healthcare outcomes and therefore should be encouraged in line with the new white paper for England "Building on strengths-delivering the future" (2008). The study emphasises the importance of revising the nature and period of postgraduate training for community pharmacists who are going to provide pharmaceutical care for elderly patients. This raises the possibility of specialised competency based postgraduate training for community pharmacists with a special interest in the care of older people (PhwSI). This would enable community pharmacists practising as generalists to become advanced practitioners in the specialist clinical area of older people and ensure a consistent level of service for elderly patients in line with government expectations.
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Kritikos, Vicky. "INNOVATIVE ASTHMA MANAGEMENT BY COMMUNITY PHARMACISTS IN AUSTRALIA." Thesis, The University of Sydney, 2007. http://hdl.handle.net/2123/2064.
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Excerpt Chapter 2 - A review of the literature has revealed that asthma management practices in the Australian community are currently suboptimal resulting in significant morbidity and mortality. In adolescent asthma there are added challenges, with problems of self-image, denial and non-adherence to therapy where self-management skills assume a greater importance (Forero et al 1996, Price 1996, Brook and Tepper 1997, Buston and Wood 2000, Kyngäs et al 2000). In rural and remote areas in Australia, asthma management practices have been shown to be poorer and mortality rates from asthma are considerably higher compared to metropolitan areas (AIHW ACAM 2005, AIHW 2006). Limited access and chronic shortages of specialist services in rural areas are shifting the burden more and more towards the primary sector (AIHW 2006). It becomes paramount that people with asthma in rural settings become involved in self-management of their asthma and that community based health care providers be more proactive in facilitating these self-management behaviours by appropriate education and counselling. Health promotion activities, which are a broad range of activities including health education, have been acknowledged as having the potential to improve the health status of rural populations (National Rural Health Alliance 2002). Community pharmacy settings have been shown to be effective sites for the delivery of health promotion, screening and education programs (Anderson 2000, Elliott et al 2002, Cote et al 2003, Hourihan et al 2003, Watson et al 2003, Boyle et al 2004, Goode et al 2004, Paluck et al 2004, Sunderland et al 2004, Chambers et al 2005, Saini et al 2006). In the case of asthma, outreach programs have been shown to have beneficial effects in terms of reducing hospital admissions and emergency visits and improved asthma outcomes (Greineder et al 1995, Stout et al 1998, Kelly et al 2000, Legorreta et al 2000, Lin et al 2004). We proposed to extend the role of the community pharmacist beyond the traditional realm of the “pharmacy” into the community in rural Australia with the first asthma outreach programs designed for community pharmacy. The outreach programs were designed to include two health promotion strategies, the first targeting adolescents in high schools and the second targeting the general community. The project aimed firstly, to assess the feasibility of using community pharmacists to deliver two asthma outreach programs, one targeting adolescents and one for the wider community in a rural area and secondly, to assess the programs’ impact on adolescent asthma knowledge and requests for information at the community pharmacy. Excerpt Chapter 3 - Patient education is one of the six critical elements to successful long-term asthma management included in international and national asthma management guidelines, which have emphasised education as a process underpinning the understanding associated with appropriate medication use, the need for regular review, and self-management on the part of the person with asthma (Boulet et al 1999, National Asthma Council 2002, National Asthma Education and Prevention Program 2002, British Thoracic Society 2003, NHLBI/WHO 2005). The ongoing process of asthma education is considered necessary for helping people with asthma gain the knowledge, skills, confidence and motivation to control their own asthma. Since most health care professionals are key providers of asthma education, their knowledge of asthma and asthma management practices often needs to be updated through continuing education. This is to ensure that the education provided to the patient conforms to best practice guidelines. Moreover, health care professionals need to tailor this education to the patients’ needs and determine if the education provided results in an improvement in asthma knowledge. A review of the literature has revealed that a number of questionnaires have been developed that assess the asthma knowledge of parents of children with asthma (Parcel et al 1980, Fitzclarence and Henry 1990, Brook et al 1993, Moosa and Henley 1997, Ho et al 2003), adults with asthma (Wigal et al 1993, Allen and Jones 1998, Allen et al 2000, Bertolotti et al 2001), children with asthma (Parcel et al 1980, Wade et al 1997), or the general public (Grant et al 1999). However, the existing asthma knowledge questionnaires have several limitations. The only validated asthma knowledge questionnaire was developed in 1990 and hence, out of date with current asthma management guidelines (Fitzclarence and Henry 1990). The shortcomings of the other knowledge questionnaires relate to the lack of evidence of the validity (Wade et al 1997, Grant et al 1999, Bertolotti et al 2001), being outdated 81 with current concepts of asthma (Parcel et al 1980) or having been tested on small or inadequately characterised subject samples e.g. subject samples consisting of mainly middle class and well educated parents (Brook et al 1993, Wigal et al 1993, Moosa and Henley 1997, Allen and Jones 1998, Allen et al 2000, Ho et al 2003). Furthermore, most of the published asthma knowledge questionnaires have been designed to assess the asthma knowledge of the consumer (i.e. a lay person with asthma or a parent/carer of a person with asthma). There is no questionnaire specifically developed to assess the asthma knowledge of health care professionals, who are key providers of asthma education. It is hence important to have a reliable and validated instrument to be able to assess education needs and to measure the impact of training programs on asthma knowledge of health care professionals as well. An asthma knowledge questionnaire for health care professionals might also be used to gauge how successful dissemination and implementation of guidelines have been. Excerpt Chapter 4 - Asthma self-management education for adults that includes information about asthma and self-management, self-monitoring, a written action plan and regular medical review has been shown to be effective in improving asthma outcomes (Gibson et al 1999). These interventions have been delivered mostly in a hospital setting and have utilised individual and/or group formats. Fewer interventions have been delivered in a primary care setting, usually by qualified practice nurses and/or general practitioners or asthma educators and, to date, their success has not been established (Fay et al 2002, Gibson et al 2003). Community pharmacy provides a strategic venue for the provision of patient education about asthma. Traditionally, patient education provided by community pharmacists has been individualised. However, group education has been shown to be as effective as individualised education with the added benefits of being simpler, more cost effective and better received by patients and educators (Wilson et al 1993, Wilson 1997). While small group education has been shown to improve asthma outcomes (Snyder et al 1987, Bailey et al 1990, Wilson et al 1993, Yoon et al 1993, Allen et al 1995, Kotses et al 1995, Berg et al 1997, de Oliveira et al 1999, Marabini et al 2002), to date, no small-group asthma education provided by pharmacists in the community pharmacy setting has been implemented and evaluated.
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Kritikos, Vicky. "INNOVATIVE ASTHMA MANAGEMENT BY COMMUNITY PHARMACISTS IN AUSTRALIA." University of Sydney, 2007. http://hdl.handle.net/2123/2064.
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Doctor of PhilosophyExcerpt Chapter 2 - A review of the literature has revealed that asthma management practices in the Australian community are currently suboptimal resulting in significant morbidity and mortality. In adolescent asthma there are added challenges, with problems of self-image, denial and non-adherence to therapy where self-management skills assume a greater importance (Forero et al 1996, Price 1996, Brook and Tepper 1997, Buston and Wood 2000, Kyngäs et al 2000). In rural and remote areas in Australia, asthma management practices have been shown to be poorer and mortality rates from asthma are considerably higher compared to metropolitan areas (AIHW ACAM 2005, AIHW 2006). Limited access and chronic shortages of specialist services in rural areas are shifting the burden more and more towards the primary sector (AIHW 2006). It becomes paramount that people with asthma in rural settings become involved in self-management of their asthma and that community based health care providers be more proactive in facilitating these self-management behaviours by appropriate education and counselling. Health promotion activities, which are a broad range of activities including health education, have been acknowledged as having the potential to improve the health status of rural populations (National Rural Health Alliance 2002). Community pharmacy settings have been shown to be effective sites for the delivery of health promotion, screening and education programs (Anderson 2000, Elliott et al 2002, Cote et al 2003, Hourihan et al 2003, Watson et al 2003, Boyle et al 2004, Goode et al 2004, Paluck et al 2004, Sunderland et al 2004, Chambers et al 2005, Saini et al 2006). In the case of asthma, outreach programs have been shown to have beneficial effects in terms of reducing hospital admissions and emergency visits and improved asthma outcomes (Greineder et al 1995, Stout et al 1998, Kelly et al 2000, Legorreta et al 2000, Lin et al 2004). We proposed to extend the role of the community pharmacist beyond the traditional realm of the “pharmacy” into the community in rural Australia with the first asthma outreach programs designed for community pharmacy. The outreach programs were designed to include two health promotion strategies, the first targeting adolescents in high schools and the second targeting the general community. The project aimed firstly, to assess the feasibility of using community pharmacists to deliver two asthma outreach programs, one targeting adolescents and one for the wider community in a rural area and secondly, to assess the programs’ impact on adolescent asthma knowledge and requests for information at the community pharmacy. Excerpt Chapter 3 - Patient education is one of the six critical elements to successful long-term asthma management included in international and national asthma management guidelines, which have emphasised education as a process underpinning the understanding associated with appropriate medication use, the need for regular review, and self-management on the part of the person with asthma (Boulet et al 1999, National Asthma Council 2002, National Asthma Education and Prevention Program 2002, British Thoracic Society 2003, NHLBI/WHO 2005). The ongoing process of asthma education is considered necessary for helping people with asthma gain the knowledge, skills, confidence and motivation to control their own asthma. Since most health care professionals are key providers of asthma education, their knowledge of asthma and asthma management practices often needs to be updated through continuing education. This is to ensure that the education provided to the patient conforms to best practice guidelines. Moreover, health care professionals need to tailor this education to the patients’ needs and determine if the education provided results in an improvement in asthma knowledge. A review of the literature has revealed that a number of questionnaires have been developed that assess the asthma knowledge of parents of children with asthma (Parcel et al 1980, Fitzclarence and Henry 1990, Brook et al 1993, Moosa and Henley 1997, Ho et al 2003), adults with asthma (Wigal et al 1993, Allen and Jones 1998, Allen et al 2000, Bertolotti et al 2001), children with asthma (Parcel et al 1980, Wade et al 1997), or the general public (Grant et al 1999). However, the existing asthma knowledge questionnaires have several limitations. The only validated asthma knowledge questionnaire was developed in 1990 and hence, out of date with current asthma management guidelines (Fitzclarence and Henry 1990). The shortcomings of the other knowledge questionnaires relate to the lack of evidence of the validity (Wade et al 1997, Grant et al 1999, Bertolotti et al 2001), being outdated 81 with current concepts of asthma (Parcel et al 1980) or having been tested on small or inadequately characterised subject samples e.g. subject samples consisting of mainly middle class and well educated parents (Brook et al 1993, Wigal et al 1993, Moosa and Henley 1997, Allen and Jones 1998, Allen et al 2000, Ho et al 2003). Furthermore, most of the published asthma knowledge questionnaires have been designed to assess the asthma knowledge of the consumer (i.e. a lay person with asthma or a parent/carer of a person with asthma). There is no questionnaire specifically developed to assess the asthma knowledge of health care professionals, who are key providers of asthma education. It is hence important to have a reliable and validated instrument to be able to assess education needs and to measure the impact of training programs on asthma knowledge of health care professionals as well. An asthma knowledge questionnaire for health care professionals might also be used to gauge how successful dissemination and implementation of guidelines have been. Excerpt Chapter 4 - Asthma self-management education for adults that includes information about asthma and self-management, self-monitoring, a written action plan and regular medical review has been shown to be effective in improving asthma outcomes (Gibson et al 1999). These interventions have been delivered mostly in a hospital setting and have utilised individual and/or group formats. Fewer interventions have been delivered in a primary care setting, usually by qualified practice nurses and/or general practitioners or asthma educators and, to date, their success has not been established (Fay et al 2002, Gibson et al 2003). Community pharmacy provides a strategic venue for the provision of patient education about asthma. Traditionally, patient education provided by community pharmacists has been individualised. However, group education has been shown to be as effective as individualised education with the added benefits of being simpler, more cost effective and better received by patients and educators (Wilson et al 1993, Wilson 1997). While small group education has been shown to improve asthma outcomes (Snyder et al 1987, Bailey et al 1990, Wilson et al 1993, Yoon et al 1993, Allen et al 1995, Kotses et al 1995, Berg et al 1997, de Oliveira et al 1999, Marabini et al 2002), to date, no small-group asthma education provided by pharmacists in the community pharmacy setting has been implemented and evaluated.
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Hawksworth, Gillian Mary. "Pharmaceutical care - clinical community pharmacy services in primary care : an evaluation of drug monitoring, clinical interventions, domiciliary visiting and other unremunerated clinical pharmacy services which could be provided by a community pharmacist." Thesis, University of Bradford, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.559095.
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Phillips, Chelsea E., Alea S. Moore, Caralyn I. Snyder, Whitney P. Varney, and Nicholas E. Hagemeier. "Pharmacy-Related Ambulatory Care Sensitive Conditions: An Analysis of Tennessee’s County-Level Characteristics." Digital Commons @ East Tennessee State University, 2014. https://dc.etsu.edu/etsu-works/1459.
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Objectives: 1) To determine 2010 pharmacy-related ambulatory care sensitive condition (ACSC) hospital discharges by Tennessee (TN) county; 2) To explore pharmacy-related ACSC hospital discharges across county characteristics for Tennessee counties, including community pharmacies per county, age, and county rurality; 3) To explore pharmacy-related ACSC hospital discharges across age for northeastern Tennessee counties. Methods: Data were obtained from the TN Department of Health Statistics (hospital discharge data), TN Board of Pharmacy (licensed community pharmacies), the United States (US) Census Bureau (county-level populations), the Office of Rural Health Policy (rural designations), and the US Health Resources and Services Administration (health professional shortage area designations). ACSC discharges were determined using the Agency for Healthcare Research & Quality's (AHRQ's) Prevention Quality Indictors (PQIs) for asthma, bacterial pneumonia, congestive heart failure, chronic obstructive pulmonary disease, hypertension, uncontrolled diabetes, and short-term and long-term diabetes complications. County-level analyses were population adjusted and analyzed across age. Analyses were conducted using SPSS and ArcGIS software. Results: In 2010, 79,683 hospital discharges were noted for pharmacy-related ACSCs, 55% of which were for residents 65 and over. For northeast Tennessee counties, 8,538 were documented accounting for 11% of Tennessee pharmacy-related ACSCs discharges. Bacterial pneumonia, heart failure, and COPD accounted for nearly 65% of discharges in northeastern Tennessee counties. The number of community pharmacies per Tennessee county was statistically significantly negatively correlated with county-level bacterial pneumonia (r=-0.339; p=0.001), CHF (r=-0.215; p=0.036), and COPD (r=-0.403; p<0.001) hospital discharges. Implications/Conclusions: Community pharmacies have the potential to positively impact the health needs of Tennesseans by targeting services (e.g., MTM, immunizations, adherence assistance) based on ambulatory care sensitive conditions. Future research is warranted to quantify current services and determine the capacity to provide such services.
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Salwan, A., Nicholas E. Hagemeier, Karilynn Dowling, Kelly N. Foster, J. Arnold, Arsham Alamian, and Robert P. Pack. "Community Pharmacist Engagement in Co-Dispensing Naloxone to Patients at Risk for Opioid Overdose." Digital Commons @ East Tennessee State University, 2019. https://dc.etsu.edu/etsu-works/5427.
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Hagemeier, Nicholas E., Jeffrey A. Gray, and Robert P. Pack. "Prescription Drug Abuse: A Comparison of Prescriber and Pharmacist Perspectives." Digital Commons @ East Tennessee State University, 2013. https://dc.etsu.edu/etsu-works/1326.
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This study compared perceptions of prescribers and pharmacists (N = 89) regarding multiple aspects of prescription drug abuse. Questionnaires were developed to assess perceptions regarding the prevalence of prescription drug abuse, self-perceived communication competence, and additional communication and prescription drug abuse domains. Pharmacists perceived a larger percentage of patients (41%) to be abusing opioid pain relievers as compared with their prescriber colleagues (17%). Both prescribers and pharmacists indicated improvements in prescriber–pharmacist communication would serve to deter prescription drug abuse. Self-efficacy beliefs for detecting and discussing prescription drug abuse with patients were low for both cohorts. Implications and limitations are noted.
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Al-Saeed, Eman. "A mixed methods study of the feasibility and acceptability of an opportunistic community pharmacy based CVD risk assessment service in Alexandria, Egypt." Thesis, University of Cambridge, 2015. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.709157.
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Hagemeier, Nicholas E., Fred Tudiver, Scott Brewster, Elizabeth J. Hagy, Angela Hagaman, and Robert P. Pack. "Prescription Drug Abuse Communication: A Qualitative Analysis of Prescriber and Pharmacist Perceptions and Behaviors." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1320.
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Background: Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited. Objectives This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists. Methods: Five focus groups (N = 35) were conducted within the Appalachian Research Network (AppNET), a rural primary care practice-based research network (PBRN) in South Central Appalachia between February and October, 2014. Focus groups were structured around the administration of three previously validated trait-level communication survey instruments, and one instrument developed by the investigators to gauge HCP prescription drug abuse communication engagement and perceived communication importance. Using a grounded theory approach, focus group themes were inductively derived and coded independently by study investigators. Member-checking interviews were conducted to validate derived themes. Results: Respondents' trait-level communication self-perceptions indicated low communication apprehension, high self-perceived communication competence, and average willingness to communicate as compared to instrument specific criteria and norms. Significant variation in HCP communication behavior engagement was noted specific to PDA. Two overarching themes were noted for HCP-patient communication: 1) influencers of HCP communication and prescribing/dispensing behaviors, and 2) communication behaviors. Multiple sub-themes were identified within each theme. Similarities were noted in perceptions and behaviors across both prescribers and pharmacists. Conclusions: Despite the perceived importance of engaging in PDA communication, HCPs reported that prescription drug abuse communication is uncomfortable, variable, multifactorial, and often avoided. The themes that emerged from this analysis support the utility of communication science and health behavior theories to better understand and improve PDA communication behaviors of both prescribers and pharmacists, and thereby improve engagement in PDA prevention and treatment.
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Sevak, Rajkumar J., Ivy Click, Jeri Ann Basden, and Nicholas E. Hagemeier. "Community Pharmacists’ Perceptions of Neonatal Abstinence Syndrome and Opioid-Based Medication-Assisted Treatment in Northeast Tennessee." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1447.
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Miller, Elizabeth J. "A Mixed Methods Study Investigating the Community Pharmacist’s Role in Palliative Care." Thesis, University of Bradford, 2017. http://hdl.handle.net/10454/17392.
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There is little research investigating factors that facilitate or inhibit timely access to palliative care medicines from community pharmacies. Though palliative care is recognised within the UK government’s strategy and community pharmacists are considered to have a role it is uncertain to what extent this aim is incorporated into local practice.
This thesis uses mixed methods to investigate the time taken to access palliative care medication from five community pharmacies in one area of England. The effect of prescription errors, stock availability and other factors is examined. Furthermore, semi-structured interviews with five community pharmacists and eleven other healthcare professionals explore medication access and the community pharmacist’s role in palliative care using the Framework method.
Stock availability led to delays with one in five customers going to more than one pharmacy to get urgently required palliative care medications. Legal prescription errors were more common on computer generated prescriptions but did not lead to delays. Three subthemes were identified in accessing palliative care medicines: environment and resources; communication and collaboration; skills and knowledge.
The community pharmacist’s role in palliative care was limited due to reluctance from other healthcare professionals to share information, poor access to patient records and lack of integration into the primary healthcare team.
This study highlights implications for professionals, commissioners and providers to improve services for those trying to access palliative medication. Community pharmacies remain a largely untapped resource for supporting patients, relatives and carers towards the end of life in both cancer and other advanced life-limiting diseases.
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Hagemeier, Nicholas E., Arsham Alamian, Matthew M. Murawski, Heather Flippin, Elizabeth J. Hagy, and Robert P. Pack. "Correlates of Prescription Opioid Legitimacy Judgments Among Community Pharmacists." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1321.
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Background: Community pharmacists are legally required to evaluate and confirm the legitimacy of prescription opioids (POs) prior to dispensing. Yet, previous research has indicated community pharmacists perceive nearly 50% of dispensed POs to be issued lacking a legitimate medical purpose. Objective: To analyze correlates of PO legitimacy judgments across pharmacist and pharmacy setting characteristics. Methods: A cross-sectional study of 2000 Tennessee pharmacists was conducted during October and November of 2012. Community pharmacists' self-reported attitudes, beliefs, and behaviors specific to PO legitimacy were elicited. Step-wise multinomial logistic regression techniques were used to model correlates of PO legitimacy across low, moderate and high PO legitimacy estimations. Results: Being female, practicing in a chain or independent practice setting, fear of employer disciplinary action if PO legitimacy is questioned, and self-confidence in one's ability to detect PO abuse increased the odds of low (vs. high) PO legitimacy estimation (p < 0.05). Employment in chain and independent pharmacies, having POs as a greater percent of total prescriptions filled, and having the perception of PO abuse as a problem in the practice setting were significant positive correlates of moderate (vs high) PO legitimacy estimation (p < 0.05). Conclusions: Both modifiable and non-modifiable correlates were statistically significantly associated with PO legitimacy judgments. Distinct correlates were noted across low and moderate as compared to high estimations of PO legitimacy. Legitimacy judgments can inform theoretical exploration of PO dispensing behaviors and inform intervention development targeted at reducing and preventing prescription drug abuse.
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Grincevičiūtė, Nora. "Ekstemporalių vaistų gamyba visuomenės gamybinėse vaistinėse: situacijos analizė ir perspektyvos." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2010. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2010~D_20100621_093031-55914.
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Lietuvai tapus Europos Sąjungos nare, farmacijos specialistai susidūrė su naujais iššūkiais: VVKT duomenimis per laikotarpį nuo 2007 01 09 iki 2009 09 09 Lietuvoje gamybinių vaistinių skaičius sumažėjo nuo 118 iki 95 t.y. 19.5 proc. Problema – gamybinių vaistinių bei vaistinėse gaminamų vaistų kiekio mažėjimas. Tai skatina giliau pažvelgti į šio reiškinio priežastį kitu aspektu: kaip besiklostanti tendencija lemia farmacinės paslaugos kokybę, ar nenukenčia pacientas nebegalėdamas gauti jo individualius poreikius tenkinančius ekstemporalios gamybos vaistus. Aktualumas- poreikis išsiaiškinti ar ekstemporalūs vaistai reikalingi visuomenei, ar yra poreikis iš pacientų, bei gydytojų pusės. Tokia tema darbai nepublikuoti. Tyrimo tikslas- išanalizuoti ekstemporalių vaistų gamybos ypatumus visuomenės gamybinėse vaistinėse ir pateikti rekomendacijas sveikatos politikos formuotojams, gydytojus rengiančioms institucijoms ir gamybinėms vaistinėms. Magistro studijų baigiamajame darbe apžvelgta gamybinių vaistinių raida skirtingais Lietuvos vystymosi laikotarpiais; pateikta norminių aktų, reglamentuojančių ekstemporalių vaistų gamybą, apžvalgą; įvertintos ir nusakytos sąlygos, kurios užtikrina individualios gamybos vaistų išlikimą bei plėtojimą; atskleistos pagrindinės priežastys, lėmusios gamybinių vaistinių skaičiaus mažėjimą. Tyrimas atliktas dviem etapais: pilotinis 2007 metais, pagrindinis 2010 metais. Tyrimo metodai: teoriniai (profesinės literatūros šaltinių analizė pasirinktu... [toliau žr. visą tekstą]After Lithuania joined European Union (EU) our pharmacists faced with new challenges. According to data of State Medicines Control Agency (SMCA) at the period from 2007-01-09 till 2009-09-09 the total number of community pharmacies which produce extemporaneous preparations have decreased by 19.5 % (from 118 till 95). The problem. The total number of community pharmacies which are able to produce extemporaneous preparations and the quantities of produced medicines are decreasing. Such situation encourages for further analysis in order to evaluate the reasons of such situation – does it make any influence on the quality of pharmaceutical services or does it affect the personal needs of patients who cannot get extemporaneous preparations for individual needs. The topicality. There is a need to determine whether extemporaneous preparations are still required by community, patients and physicians. There is insufficient data which would be published on such topic. The aim of this survey was to analyze the features of extemporaneous manufacturing in community pharmacies in order to provide recommendations for health policy makers, Medical faculties and community pharmacies. In this overview I present the development of extemporaneous manufacturing processes in Lithuanian pharmacies in different periods. Also the overview of legal acts on extemporaneous manufacturing, designated conditions which would help to ensure that extemporaneous preparations remain on the market and the main... [to full text]
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Valaika, Gytis. "Visuomenės vaistinėje dirbančių farmacijos specialistų nuomonė apie farmakologinį budrumą ir patirtis teikiant informaciją gyventojams apie nepageidaujamas reakcijas į vaistą." Master's thesis, Lithuanian Academic Libraries Network (LABT), 2014. http://vddb.library.lt/obj/LT-eLABa-0001:E.02~2014~D_20140630_134304-53222.
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Tikslas: Išanalizuoti Lietuvos visuomenės vaistinėse dirbančių farmacijos specialistų požiūrį į pacientams suteikiamą informaciją apie galimus vaistų nepageidaujamus poveikius.
Darbo metodika: Tyrimui atlikti buvo taikomas analizės metodas – anketavimas. Apklausta 230 farmacijos specialistų dirbančių visuomenės vaistinėse. Tyrimo duomenys apdoroti naudojant SPSS 17.0 versiją. Darbe pateikiami grafikai ir lentelės sudaryti MS Excel 2007 programa.
Rezultatai: Daugumos farmacijos specialistų (98,2%) nuomone, teikti informaciją apie NRV yra būtina. Pagrindiniai veiksmai, pacientui pasireiškus NRV, yra paciento nukreipimas pas gydytoją (93,8%) arba konsultavimas (73,0%). Tik 4 proc. respondentų nesusiduria su problemomis teikiant informaciją susijusią su NRV. Pagrindiniai barjerai iš farmacijos specialisto pusės yra laiko (83,7%) bei žinių (57,2%) trūkumas, o iš paciento pusės – nenoras išklausyti suteikiamos informacijos (63,9%), nedrąsa klausti (44,6%), konfidencialumo (42,1%) bei išsilavinimo (41,6%) trūkumas. Nustatyta, kad ne visos vaistų grupės yra vienodai svarbios suteikiant informaciją apie NRV (p<0,05). Pagrindinės vaistų grupės yra antidepresantai (82,4%), krešumo sistemą veikiantys vaistai (82,4%), antibiotikai (79,4%), antipsichoziniai vaistai (73,5%) bei NVNU (67,6%).
Išvados:
1. Farmacijos specialistų nuomone, informacijos apie NRV teikimas pacientams yra būtinas, tačiau ne visi sutinka, kad jis yra pagrindinis asmuo, galintis suteikti šią informaciją. Daugiau nei... [toliau žr. visą tekstą]Objective: To analyze the attitude of pharmaceutical professionals working in Lithuanian community pharmacies towards providing information about adverse drug reactions. Methods: A questionnaire method was aplied during this research. 230 of 264 pharmacists working in community pharmacies participated in the survey (response rate 87,1%). Results: The majority of pharmaceutical professionals (98,2%) believed that the provision of information about adverse drug reactions (ADRs) is necessary. 97,8% of respondents said that they spoke to patients about reported adverse effects to drugs.The main pharmacists actions after receiving information that patients experienced ADRs were consulting (93,8%) or reffering the patient to a doctor (73,0%). Almost all (96%) respondents told that they have problems when providing information about ADRs. 3 out of 4 specialists point out that the main problem is the lack of time. Approximately half of them think that they lack of knowledge to provide such information. Problems encountered from the patient‘s side is their unwillingness to listen to the information provided (63,9%), timidity to ask for such information (44,6%), lack of privacy (42,1%) and education (41,6%).It was found that not all drug groups are equally important in providing information about ADRs (p<0,05). The main groups of medicines are antidepressants (82.4%), coagulation system drugs (82.4%), antibiotics (79.4%), antipsychotics (73.5%) and NSAIDs (67.6%). Conclusion: According... [to full text]
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Hagemeier, Nicholas E., Arsham Alamian, Matthew M. Murawski, and Robert P. Pack. "Factors Associated With Provision of Addiction Treatment Information by Community Pharmacists." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1324.
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Community pharmacists in the United States have significant opportunity to engage in community-level prescription substance abuse prevention and treatment efforts, including dissemination of information specific to available addiction treatment options. Our cross-sectional study of Tennessee community pharmacists noted that 26% had previously provided addiction treatment facility information to one or more patients in the past. The purpose of this study was to employ multivariate modeling techniques to investigate associations between community pharmacist and community pharmacy factors and past provision of addiction treatment information to pharmacy patients. Multivariate logistic regression indicated having addiction treatment facility information in a pharmacy setting (aOR=8.19; 95% CI=4.36–15.37), having high confidence in ability to discuss treatment facility options (aOR=4.16; 95% CI=2.65–6.52), having participated in prescription opioid abuse-specific continuing education (aOR=2.90; 95% CI=1.70–4.97), being male (aOR=2.23; 95% CI=1.38–3.59), and increased hours per week in the practice setting (aOR=1.02; 95% CI=1.004–1.05) were all significantly associated with provision of information about addiction treatment. Dissemination of addiction treatment information, improvements in communicative self-efficacy beliefs, and dissemination of prescription opioid abuse-specific continuing education are modifiable factors significantly associated with increased provision of addiction treatment information by community pharmacists.
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Davies, J. E. "Community pharmacy businesses and community pharmacists." Thesis, University College London (University of London), 2013. http://discovery.ucl.ac.uk/1384825/.
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The change in community pharmacists’ practice from compounding and effectively unregulated medicines supply through to the highly regulated and largely automated high-volume dispensing process of today has been challenging. The economic and social standing of community pharmacy was transformed creating a need for further adaptation. This thesis explores ‘how business and professional practice models for community pharmacy in England in ten to twenty years are likely to be structured?’. It has six sections, plus an overarching discussion. A work sampling study of ten community pharmacies found that pharmacists continue to spend two-thirds of their time on dispensing related activities, compared to one tenth on counselling. The accompanying analysis links this to an increase in prescription volumes and payments that have incentivised pharmacy contractors to focus on medicines supply. A significant decrease in the average prescription duration for eight chronic disease medications over the past decade is revealed, and its desirability questioned. Using the Kingdon model of the policy process as an evaluative framework, 16 interviews with ‘policy leaders’ provided insight into how seven factors (identified from a structured thematic review of the implementation of Medicines Use Reviews) have influenced the implementation of the New Medicines Service. In addition, role theory-based thematic analysis involving 17 stakeholders in pharmacy policy highlighted the tensions between community pharmacists’ roles as shopkeepers, clinicians and businessmen, and the effects that new technologies will have on them. The analysis identifies a need for pharmacy to embrace a new strategic direction that enhances pharmacy’s contributions to health outcomes. In conclusion, community pharmacy in England should offer timelier and economically efficient ways of solving contemporary health problems. The evidence presented here suggests that without stronger internal leadership and robust external stakeholder support medicines supply will split from the provision of clinical pharmacy in the community setting, leaving community pharmacies as ‘commodity cost’, low return medicines suppliers.
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Boaventura, Thays Carneiro. "Processo de trabalho da dispensação farmacêutica : revisões sistemáticas." Universidade Federal de Sergipe, 2016. https://ri.ufs.br/handle/riufs/3792.
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Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPESObjective: To describe the studies on the working process during the practice of pharmacist dispensing. Methods: Three systematic reviews the following steps were performed accordingly: (1) identification of studies in the following databases: PubMed / Medline, Web of Science, Scopus, and Lilacs, using the descriptors ''counseling'', ''dispensing'', ''community pharmacy services'',' ''pharmacies'' and ''pharmacists'' and its synonyms with different combinations; (2) evaluation studies, in which the title and summary were eligible, according to the following inclusion criteria: studies were conducted in community pharmacies, studies on the working process in the practice of pharmaceutical dispensing and articles published in English, Portuguese or Spanish. (3) Full Text evaluation according to the following inclusion criteria: - 1st Systematic Review: The aim of this review was to understand the process of work and the quality indicators used in the Dispensation. Thus, we had the following inclusion criteria: studies with quality indicators in the dispensing work process; - 2nd Systematic Review: this review aimed to identify the questions and instructions given by the pharmacist and propose a model of practice for dispensing. Therefore, he presented as specific inclusion criteria: studies that have questions and/ or guidelines in the work process in the practice of pharmaceutical dispensing; - 3rd Systematic Review: whose objective was to evaluate the studies documenting the work process in the practice of pharmaceutical dispensing. Therefore, we had the specific inclusion criteria: studies that addressed the documentation of the work process in the practice of pharmaceutical dispensing. When there were differences between the two evaluators, a third evaluator examined and judged discrepancies in each systematic review. The databases were reviewed until September 02, 2015. Results: - In the first systematic review included 60 articles. The studies showed high heterogeneity indicating the lack of standardization of the practice of pharmaceutical dispensing work process. It was found that the quality of the tools used to evaluate the dispensing work process was not often assessed. Nine quality indicators in practice dispensing work process were found. - In the second systematic review articles 65 were included, with most studies used the method of Simulated patient, with most patients showing a passive behavior. by were listed and quantified the most common questions and instructions given pharmacists as: identification and clinical condition of the patient, indication, dose and effect of the drug, allergy, duration of treatment, adverse effects, drug interactions, non-pharmacological treatments and referral to the doctor. - In the third systematic review were included 26 articles. Few studies have addressed the documentation as part of the dispensing work process and most documented by non-computerized instruments. Conclusion: Studies on pharmaceutical dispensing should be standardized, which will facilitate the comparison of results and measure the working process of this service. Protocols, algorithms and practical documentation are needed to guide, standardize the work process of dispensing and measuring the impact of interventions by community pharmacists in patient care.
Objetivo: descrever os estudos publicados sobre o processo de trabalho durante a prática da dispensação farmacêutica. Métodos: Três revisões sistemáticas foram realizadas de acordo as seguintes etapas: (1) identificação de estudos nas seguintes bases de dados: PubMed/ Medline, Web of Science, Scopus e Lilacs, usando os descritores ‘‘counseling”, ‘‘dispensing”, ‘‘community pharmacy services’’, ‘‘pharmacies’’ and ‘‘pharmacists’’ e seus sinônimos com diferentes combinações; (2) avaliação de estudos, no qual o título e resumo foram elegíveis, de acordo com as seguintes critérios de inclusão: estudos serem conduzidos em farmácias comunitárias, estudos sobre o processo de trabalho na prática da dispensação farmacêutica e artigos publicados em inglês, português ou espanhol. (3) avaliação do texto completo de acordo com os critérios de inclusão a seguir: - 1ª Revisão Sistemática: o objetivo desta revisão foi conhecer o processo de trabalho e os indicadores de qualidade utilizados na Dispensação. Assim, teve-se como critérios de inclusão: estudos com indicadores de qualidade no processo de trabalho da Dispensação; - 2ª Revisão Sistemática: esta revisão visou Identificar as perguntas e orientações realizadas pelo farmacêutico e propor um modelo de prática para a dispensação. Logo, apresentou-se como critérios de inclusão específicos: estudos que tiveram perguntas e/ou orientações no processo de trabalho na prática da dispensação farmacêutica; - 3ª Revisão Sistemática: cujo objetivo foi avaliar os estudos que documentaram o processo de trabalho na prática da dispensação farmacêutica. Portanto, teve-se como critério de inclusão específico: estudos que abordaram a documentação no processo de trabalho na prática da dispensação farmacêutica. Quando ocorreram divergências entre os dois avaliadores, um terceiro avaliador analisou e julgou as discrepâncias em cada revisão sistemática. As bases de dados foram revisadas até 02 de setembro de 2015. Resultados: - Na primeira revisão sistemática foram incluídos 60 artigos. Os estudos apresentaram alta heterogeneidade indicando a falta de padronização do processo de trabalho da prática da dispensação farmacêutica. Foi detectado que a qualidade dos instrumentos utilizados para avaliar o processo de trabalho da dispensação não foi, muitas vezes, avaliada. Nove indicadores de qualidade no processo de trabalho da dispensação prática foram encontrados. – Na segunda revisão sistemática foram incluídos 65 artigos, sendo que a maior parte dos estudos utilizou o método do Paciente Simulado, com a maioria dos pacientes apresentando comportamento passivo. Foram listadas e quantificadas as perguntas e orientações mais comuns realizadas pelos farmacêuticos como: identificação e condição clínica do paciente, indicação, dose e ação do medicamento, alergia, duração do tratamento, efeitos adversos, interações medicamentosas, tratamentos não farmacológicos e encaminhamento ao médico. – Na terceira revisão sistemática foram incluídos 26 artigos. Poucos estudos abordaram a documentação como parte do processo de trabalho da dispensação e a maioria documentou por meio de instrumentos não informatizados. Conclusão: Estudos e a prática da dispensação farmacêutica devem ser padronizados, o que irá facilitar a comparação dos resultados e medir o processo de trabalho desse serviço. Protocolos, algoritmos e documentação da prática são necessários para guiar, padronizar o processo de trabalho da dispensação e medir o impacto das intervenções dos farmacêuticos comunitários no cuidado ao paciente.
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Hagemeier, Nicholas E., Fred Tudiver, Scott Brewster, Elizabeth J. Hagy, Brittany Ratliff, Angela Hagaman, and Robert P. Pack. "Interprofessional Prescription Opioid Abuse Communication Among Prescribers and Pharmacists: A Qualitative Analysis." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/etsu-works/1323.
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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.
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Amirthalingam, Amirthan Rajakumaran Selliah. "An evaluation of a community pharmacy based, pharmacist-led intervention package targeted to the patients' adherence status, to achieve and maintain target blood pressure (BP) control by optimising antihypertensive medicine adherence." Thesis, University of Birmingham, 2017. http://etheses.bham.ac.uk//id/eprint/7834/.
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Antihypertensive pharmacotherapy is associated with poor adherence. No validated method exists to establish patients’ likely adherence level. A systematic review and a single, Swedish community pharmacy practice-based pilot study were undertaken investigating blood pressure (BP) optimization from pharmacist-led, community pharmacy based antihypertensive adherence interventions titrated to individual patients. The systematic review showed generic interventions are often used for optimizing BP. Different intervention outcomes vary: positive, negative and no effect has been demonstrated. Pilot study participants (n=153) were categorised into adherence subgroups (A=Adherent, IR=Intentionally non adherent rational, II=Intentionally non-adherent irrational, U=Unintentionally non-adherent) based on responses to questionnaire format adherence screens. Interventions were designed intuitively to optimize adherence for each subgroup: changes in blood pressure and adherence attitudes were assessed. A significant reduction in mean systolic BP (SBP) (3 mmHg, P < 0.05), with no change in mean diastolic BP (DBP) was seen overall. However, outcomes varied with subgroup: adherence was enhanced in the U subgroup (decreased SBP: 3 mmHg; DBP: no change), but indications of a detrimental effect were observed in the II subgroup (SBP: no change; increased DBP: 3 mmHg). It is feasible to assign patients to different adherence subgroups in community pharmacy, which may optimize medicines adherence through personalization of interventions.
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Mathis, Taylor. "Beating Diabetes: The Use of a Novel Nutrition and Medication Adherence Measure to Improve the Outcomes of Patients with Diabetes." University of Cincinnati / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=ucin153570253467365.
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Rashid, Amir. "Characterising and understanding the professional and organisational commitment of community pharmacists." Thesis, University of Manchester, 2013. https://www.research.manchester.ac.uk/portal/en/theses/characterising-and-understanding-the-professional-and-organisational-commitment-of-community-pharmacists(40992b1d-4e95-42ed-9c31-a2f1a57a1a9d).html.
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Community-pharmacy is in a state of flux with a series of significant recent changes including the Community-pharmacy Contract, the reconstitution of the RPSGB and the General Pharmaceutical Council. There are also socio-cultural changes such as greater numbers of women in the profession, and an increase in pharmacists reducing their hours of work. The latter comes at a time when workload/roles are expanding and diversifying, leading to potential scenarios in which there are shortfalls between the hours worked and workload demands. This will have an impact on community pharmacists, but its magnitude may be dependent on how they are professionally and organisationally committed. Whilst there has been some promising commitment research in the USA, little research has been published in GB. However, multidimensional models of commitment have been researched extensively in other professions.A programme of research was developed and conducted to characterise and understand the role of professional and organisational commitment in community-pharmacy in GB using the Three-Component Model of commitment (TCM). Various methods were used to answer the research questions including focus-groups to assess qualitatively the contextual appropriateness of the constructs (stage 1.1), and cognitive-interviews to assess construct validity (stage 1.2). Stage 2 consisted of a large survey study, which examined the psychometric validity of the measurement scales as well as salient a-priori theoretical relationships found in both community pharmacy in GB and other professional contexts. A total of 32 participants were recruited for stage one and 713 community-pharmacists participated in stage two. Ethical approval was attained from the University of Manchester Ethics Committee for both stages one and two.The research found that beyond the affective facets of professional and organisational commitment both normative and continuance facets made significant, unique and yet varied contributions to the influence of both withdrawal-behaviours and work-performance behaviours in the community pharmacy population in GB. However, the levels and strengths of the different facets of professional and organisational commitment also appeared to differ amongst the different subgroups in community pharmacists in GB. For example, independent/small-chain pharmacists exhibited significantly higher levels of affective and normative organisational commitment and significantly lower levels of organisational withdrawal behaviours compared to large-multiple pharmacists. The implications of these and other differences were highlighted and recommendations made salient to the profession and community pharmacy organisations about how the levels of the different facets of commitment may be managed to foster greater work-performance behaviours and mitigate the different withdrawal behaviours.
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Okumoto, Kaci, and Harumi Sanagawa. "Assessment of Japanese Pharmacists’ Perceptions towards Community Pharmacy." The University of Arizona, 2005. http://hdl.handle.net/10150/624766.
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Class of 2005 AbstractObjectives: The objectives of this study were to 1) describe Japanese pharmacists’ perceptions about community pharmacy on a variety of issues and 2) compare the perceptions between different groups. Methods: A questionnaire was administered to a convenience sample of community pharmacists in the Tokyo metropolitan area and Hiroshima prefecture. Pharmacists were surveyed on various issues such as job satisfaction, the separation of prescribing and dispensing, their relationship with patients and physicians, and pharmacy education. A five-point Likert scale was used to measure responses. Results: One hundred forty-four questionnaires were completed. Eighty-four percent of respondents were female, 37.5% had more than ten years of practice experience, and 81.9% worked in Tokyo. Japanese community pharmacists are neutral or satisfied with their jobs. However, respondents were not satisfied with the current state of community pharmacy in Japan (2.81 + 0.83), did not feel respected by patients (2.74 + 0.99) and physicians (1.99 + 0.95), felt that four years of education was not enough to provide adequate patient care (1.96 + 1.01), and would like to do more clinical oriented activities (3.77 + 0.84). Significant differences were found in some responses between groups such as males versus females and pharmacists with more versus less than ten years of practice experience. Conclusions: Respondents were not satisfied with the current state of community pharmacy in Japan. Areas that could use improvement are respect from patients and physicians, involvement in clinical activities, and assistance at work. Significant differences were found in the perceptions of the groups studied.
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Astles, Alison Margaret. "Professional engagement of locum community pharmacists." Thesis, University of Central Lancashire, 2017. http://clok.uclan.ac.uk/17672/.
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Locum community pharmacists (‘locums’) constitute a significant proportion of the community pharmacy workforce in the UK, and have been identified as isolated practitioners who work outside existing quality assurance processes. This study examines professional engagement of locums in terms of their networking with pharmacist colleagues and their professional identity as pharmacists. With a constructivist, inductive approach, the study consisted of a series of five focus groups with a total of 25 participants in 2013, which were thematically analysed to yield a series of themes around professional engagement. The focus groups confirmed the isolation felt by locums and the effort undertaken by them to develop and maintain networks with colleagues. Locums used their networks for obtaining information, benchmarking their practice, decreasing personal stress, problem solving, sharing opinion on moral and ethical issues and promoting professional growth Next, the LocumVoice online forum for locum pharmacists was observed for a two month period in 2014, with the data being examined using an adaptation of Bales’ interaction process analysis, integrated with thematic analysis of the content. The interactions and content of the forum support it being considered a pharmacy community of practice, with locums’ interactions developing professional identity concepts via storytelling, sharing opinions and information. In particular, views on the nature of the role of the pharmacist were prominent in the discussions. The study contributes to knowledge of UK locum community pharmacists in that it describes the purpose and value of networking as perceived by locums and examines in detail the interactions occurring on an online community of practice that contribute to locum professional engagement and identity development.
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Lelubre, Melanie. "Implementation Study of Professional Pharmacy Services in Community Pharmacies." Doctoral thesis, Universite Libre de Bruxelles, 2018. http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/268974.
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Introduction: In recent year, the role of the pharmacist has evolved from product-focused to patient-focused activities. Following this evolution, new professional pharmacy services were simultaneously developed by researchers and started to be legally implemented and remunerated for community pharmacists around the world. Implementation, essential to ensure a good programme delivery and therefore its effectiveness, was seen as a passive process for which diffusion and dissemination were sufficient to translate research into practice. However, the transition from theory to practice is often difficult as different factors hinder or facilitate the implementation of such services. In consequence of that, implementation research started to be developed in the community pharmacy field to understand and fil the gap between theory and practice.Objectives of the thesis: Three projects were conducted in Belgium and Switzerland; (1) to understand the implementation of an existing programme in Belgium; the isotretinoin pregnancy prevention programme (PPP) (Chapter IV, point 4.1), and (2) to study the implementation of two new developed pharmaceutical services, which include an interview between the pharmacist and the patient and require interprofessional collaboration; the medication adherence program in Switzerland and the medication review in Belgium (Chapter IV, point 4.2). Methods: To understand the implementation of the isotretinoin PPP, two studies were conducted. The first study was a survey sent to health care professionals (pharmacists, general practitioners and dermatologists) and patients. The outcomes of the survey were the PPP awareness and compliance to safety recommendations related to the teratogenic risk of isotretinoin. The second study was cross-sectional and analysed the reimbursed prescription data of the Belgian population taking isotretinoin between January 2012 and August 2015. The outcomes were medication adherence to isotretinoin and to contraception, and the concomitant use of contraception and isotretinoin. Medication adherence was measured using the medication possession ratio (MPR), dividing the total days of medication supplied within the refill interval by the number of days in the refill interval. The concomitant use of isotretinoin and contraception was realised in combining prescription database of both isotretinoin and contraception of women between 12 and 21 years old, who received at least one prescription of isotretinoin during the study period.To study the implementation of the medication adherence program in Switzerland and the medication review service in Belgium, two prospective and observational studies were conducted with a mixed method approach (quantitative and qualitative outcomes). The defined outcomes, based on the RE-AIM model, were; reach of the target patients, adoption of the service by health care professionals providing the service, implementation (facilitators, barriers and fidelity or the extent to which the intervention is delivered as intended), and maintenance (the extent to which the intervention become institutionalized or part of the routine activity). Outcomes were collected through web platforms for quantitative data, and interviews and focus groups for qualitative data.Results and discussion: The study of the isotretinoin PPP implementation showed that two safety recommendations related to the teratogenic risk were particularly poorly applied by interviewed health care professionals. These two recommendations were the use of a second contraceptive method (like condoms) and the monthly pregnancy test. They considered these two recommendations as unnecessary for women taking an effective contraceptive method. Through the prescription refill data analysis, we observed that 46.1% of patients were adherent to isotretinoin (MPR ≥ 0.8) and 74.0% of women taking isotretinoin to their prescribed contraception (oral contraceptive, rings and patches). Lastly, 83.4% of women between 12 and 21 years taking isotretinoin did not receive an effective contraceptive method one month before, during and one month after isotretinoin treatment. However, the proportion of women receiving at least one prescription of contraception during (74.1%) and after (72.1%) isotretinoin treatment was higher than one month before isotretinoin treatment (35.7%). Regarding these results, less adopted recommendations should be reviewed by an expert committee and interventions focused on the improvement of the use of contraception during isotretinoin treatment could be developed.The two studies related to two new developed pharmaceutical services showed that their implementation was feasible in community pharmacy practice. Most of pharmacists participating in both projects had positive attitude regarding the implementation of these services in their daily practice. They considered it as professionally satisfying and important for patients and perceived the benefits of the programs. However, similar barriers were observed; difficulties to include patients and lack of interprofessional collaboration, and lack of time (related to lack of staff, administrative burden and lack of team adoption). According to participating health care professionals, the development of new strategies to overcome these barriers is necessary to anticipate the future implementation and the maintenance of these services at the national level. Following these results, the proposed strategies are for example the development of broad based media campaigns (for health care professionals and patients), or the development of specific trainings focusing on interprofessional collaboration, service-process, practice change management and leadership. Conclusion: The legal evolution of the pharmacists’ role is a positive progress but insufficient to ensure a full implementation in practice. Implementation strategies should be considered at different implementation stages (exploration, preparation, testing, operation and maintenance) and levels (individual, pharmacy, local setting, and system). The use of implementation science would allow a quicker and more effective implementation of these new professional pharmacy services. The anticipation of change and the selection of appropriate strategies would allow a higher fidelity level to the different components of the service by health care professionals and therefore a higher effectiveness, e.g. clinical and economic outcomes. Health care professionals, professional associations, academics and policy makers should be aware of implementation science and integrate it in the development of the new pharmacists’ role. As shown in our results, it should also be considered for existing programmes such as the isotretinoin PPP.Doctorat en Sciences biomédicales et pharmaceutiques (Pharmacie)
info:eu-repo/semantics/nonPublished
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Brinkerhoff, Andrew J. "Patient Perceptions of Medication Counseling Provided by Community Pharmacists." University of Toledo Health Science Campus / OhioLINK, 2016. http://rave.ohiolink.edu/etdc/view?acc_num=mco1470423191.
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Smith, Kristin M., and Jessica J. Collins. "Patient Perceptions of Pharmacists as Influenza Vaccine Administrators in the Community Pharmacy Setting." The University of Arizona, 2009. http://hdl.handle.net/10150/623997.
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Class of 2009 AbstractOBJECTIVES: To evaluate patients’ perceptions of receiving a pharmacist-administered influenza vaccine in the community pharmacy setting. METHODS: All patients receiving a pharmacist-administered influenza vaccine at a Safeway Pharmacy in Tucson, Arizona were invited to participate in the survey. Participants completed the survey in a waiting area outside the pharmacy. At the completion of the study time frame, surveys were collected, and each response was entered into an Excel spreadsheet for data analysis. RESULTS: Seventy-five patients completed the Flu Shot Survey. One hundred percent of patients reported that getting the influenza vaccine at a grocery store pharmacy is convenient. Respondents reported being either very confident (97.3%) or somewhat confident (2.7%) in pharmacists as immunizers. Only 18.7% reported having never received an influenza vaccine from a pharmacist, and 13.3% reported having no prior knowledge that Arizona pharmacists could administer the influenza vaccine. CONCLUSIONS: All patients responded that receiving the influenza vaccine from a community pharmacist was convenient. Patients wanted to receive the vaccine next year from a pharmacist, and the majority of respondents were confident in the pharmacist as an immunizer. Few patients reported never receiving the influenza vaccine from a community pharmacist, and even fewer patients were unaware that pharmacists in Arizona can immunize.
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Lopes, Joana Sofia Neves de Assunção. "Polifarmacologia e promoção da adesão à terapêutica na farmácia comunitária." Master's thesis, [s.n.], 2012. http://hdl.handle.net/10284/3562.
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Trabalho apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Mestre em Ciências FarmacêuticasA Adesão à Terapêutica constitui uma fonte de preocupação transversal a todos os profissionais de saúde. A taxa de incumprimento terapêutico é particularmente elevada no Doente Polimedicado, pela complexidade do regime terapêutico a que estão sujeitos e pelo elevado número de medicamentos que lhes são prescritos. O aparecimento de efeitos clínicos indesejáveis é prevalente neste grupo de Doentes, representado essencialmente por Idosos e Doentes Crónicos. O Farmacêutico, pela proximidade que mantém com o Doente no contexto de uma Farmácia Comunitária, deve esclarecer o Doente sobre o tratamento que lhe foi instituído e criar estratégias que garantam a sua efetividade. A adoção por parte do Farmacêutico de intervenções múltiplas e multidisciplinares, que respeitem a singularidade do Doente, permite um maior controlo de distintos problemas de saúde. Têm sido desenvolvidos vários projetos em Farmácias Comunitárias da União Europeia em que o Farmacêutico tem um contributo fundamental na redução significativa do insucesso terapêutico. O incumprimento terapêutico constitui um dos principais desafios para o Farmacêutico Comunitário como corresponsável pela terapia medicamentosa e promotor do uso racional dos medicamentos. The Adherence to Therapeutics is one of the transversal worries of every health professional. The rate of non Adherence to Therapeutics is greatly high in Polymedicated Patients on account of the complex therapeutical system they are dependent on and also because of the great number of medicines they are prescribed. Undesirable clinical effects are likely to happen in this type of Patients, essentially formed by Old People and Chronic Patients. The Pharmacist by the close relation he has with the Patient in the context of a Community Pharmacy should explain the Patient about the prescription he is going to be addicted to and create strategies able to become efficient. Different actions, adopted by the Pharmacist respecting the individuality of the Patient, makes easier a better and more efficient control of different health disturbs. Several projects have been achieved in Community Pharmacies of the European Union where the Pharmacist has a vital role to reduce the risk of the therapeutical failure. The non Adherence to Therapeutics is one of the main challenges for the community Pharmacist once he is corresponsable for the drug therapy and the promoter in the rational use of medicines.
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Hagemeier, Nicholas E., and Karilynn Dowling. "Community Pharmacists and Harm Reduction: Evidence and Opportunities." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/5421.
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Harm reduction is a concept that has gained momentum as it relates to prevention of negative consequences of drug use. Some harm reduction approaches, such as naloxone provision, have garnered significant support, whereas others, such as providing access to clean syringes, are the exception as opposed the rule. Evidence suggests there is significant variation in harm reduction behaviors among providers, including community pharmacists. Community pharmacies are one of the most accessible points for healthcare; approximately 90% of U.S. residents live within five miles of a pharmacy. Therefore, pharmacies have a great opportunity to promote and engage their communities in harm reduction approaches. This session will examine evidence-based harm reduction approaches that can be employed in community pharmacies. The presenters will use their syringe dispensing research conducted across three states to describe the current harm reduction climate in community pharmacies. During this interactive session, participants will discuss scenarios in which they are encouraged to evaluate their own attitudes and beliefs toward non-Rx syringe sales, naloxone dispensing and other harm reduction strategies while taking a look at the impact of state level policies on these approaches. The session will be targeted to practicing pharmacists, coalition leaders and harm reduction stakeholders.
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Fuller, Joanne. "Identifying and developing the role of community pharmacists in sleep health." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/12613.
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Sleep disorders are a highly prevalent health problem and impose significant levels of morbidity and serious economic and health consequences. As an alternative pathway, community pharmacists are well placed to identify individuals at risk for sleep disorders and deliver education and counselling to improve sleep health. Separate studies were conducted to develop, implement and evaluate firstly a sleep health awareness and sleep disorder screening program to be delivered in community pharmacy; and secondly, a pharmacy brief behavioural treatment for insomnia (BBTi) program to be delivered by specially trained community pharmacists. In a RCT across 23 pharmacies, 325 patients were recruited and screened for OSA, insomnia and RLS (Risk Assessment Only (RAO) =152, Risk Assessment Plus the addition of an OSA objective marker (RA+) =173). The proportion at risk for any sleep disorder and being referred to their primary physician per group were significantly higher in the RA+ group (RAO (54%, 82/152), RA+ (79%, 136/173), OR 3.2, 95% CI 1.7-6.3, p=0.0001). A 12-month follow-up found that the proportion of participants who reported a confirmed diagnosis was higher in the RA+ group (RAO=6 and RA+=17 diagnoses (OR 2.7, 95% CI 1.1-7.5, p=0.03)). In 12 pharmacies, a RCT tested a pharmacy BBTi program. Patients were similar at baseline (control n=19, BBTi n=17) with 67% completing follow-up (control=86% 19/22, BBTi=50% 17/34). BBTi patients experienced clinically and statistically significant improvement in insomnia from baseline to follow-up as compared to the control patients and also reported a greater increase in satisfaction and subjective increase in sleep quality as compared to control patients. This research demonstrates roles in which community pharmacists can deliver models-of-care for common sleep disorders using pragmatic and practice friendly protocols.
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Brown, Malcolm Ernest. "The sociology of pharmacy : an ethnography of community pharmacists, their medicines and other artefacts." Thesis, University of East Anglia, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.302147.
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Rutter, Paul Michael. "Application of work study techniques to quantify the work of community pharmacists." Thesis, University of Portsmouth, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.323287.
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The way in which British community pharmacists work has been much talked about but, until now, not quantified. A review of work study techniques within the field of pharmacy revealed that community pharmacy had been largely neglected. In the light of recommendations to extend the community pharmacists' role to provide non-traditional services it was necessary to examine community pharmacy practice to investigate the feasibility of diversifying pharmacy roles. Utilising the technique of subjective evaluation, pharmacy managers from a national multiple chain were asked to estimate how much time they spent on each of sixteen activity categories that had been devised by the author to represent their work. Three hundred and twenty three managers replied to the study generating 1,084 usable responses. The findings showed that seven categories accounted for almost 80% of their time, of which dispensing [as defined in this thesis] occupied proportionally the greatest amount of time of any category [37%]. However, subjective evaluation relies on estimation and has been previously criticised as being imprecise. A further work study technique, work sampling, was chosen as the most appropriate validation tool to determine the accuracy of the subjective evaluation findings. Five pre-registration pharmacists recorded the work of five pharmacy managers, generating 2,682 observations. The results from the observed data set were compared with those from subjective evaluation. Only two categories were found to be significantly different, lending weight to the assumption that the results obtained from the subjective evaluation study were an accurate record of how community pharmacists spent their time. These results demonstrated that the work patterns of community pharmacists mainly centre on the supply of medicines. The final stage of the research programme attempted to alter pharmacist work patterns via a skill mix programme in an attempt to limit pharmacist involvement in technical tasks such as dispensing. A `pre-test post-test' design was employed to determine the success of the study on three outcome measuresthe change in work patterns after skill mix implementation; non-pharmacist acceptance of altering their way of working; the perceptions held by the pharmacists also on the new way of working. The results showed that pharmacists' work patterns were altered, although changes could not be directly attributable to the intervention. In addition, the principal aim of substantially reducing the time they spent dispensing was not achieved. Non-pharmacist staff, on the whole, accepted or preferred the change to work practice as too did pharmacists. However, barriers to change were identified which needed to be rectified before skill mixing can have a significant impact on freeing pharmacist time away from dispensing
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Gilliam, Holly, Ivy Click, J. A. Basden, R. Carico, H. Flippin, C. Murray, and Nicholas E. Hagemeier. "Community Pharmacists’ Engagement in Neonatal Abstinence Syndrome Prevention." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1445.
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