Dissertations / Theses on the topic 'Community pharmacist'
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McKinley, Brian, Seung Oh, David Zucarelli, and Rebekah Jackowski. "Availability and Cost of Pharmacist-Provided Immunizations at Community Pharmacies in Tucson, Arizona." The University of Arizona, 2013. http://hdl.handle.net/10150/614252.
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Class of 2013 AbstractSpecific Aims: The objective of this study was to examine the availability of immunizations in community pharmacies and the out-of-pocket cost for those immunizations. Methods: Twelve community pharmacies in the Tucson area were examined and one pharmacist in each store was asked to complete a questionnaire. This questionnaire aimed to determine individual immunizations offered at each pharmacy and the out-of-pocket cost for those immunizations. Main Results: Differences in the availability and cost of immunizations were compiled for each category of community pharmacy. The categories included Supermarket/grocery store, chain, Mass merchant/big box, and independent pharmacy. Seven of the twelve (58%) pharmacies included in the analysis participated in pharmacist-based immunizations. Three out of the four (75%) supermarket based pharmacies, both chain pharmacies, and two of the four (50%) mass merchant pharmacies, provided immunizations. Neither of the independent pharmacies included in the analysis provided immunizations. The pharmacies that did not currently provide immunizations, none had plans in the future to provide immunizations. There were no other non-prescription immunizations provided at the pharmacies in the study. All seven pharmacies that provided immunization services stated they would accept insurance and only one of the chain pharmacies had a walk in clinic. Conclusion: Overall this study demonstrated that there are differences associated with cost and availability of immunization services offered between pharmacies. Further research is needed to determine what hinders community pharmacy from offering immunization services and how to develop a form of commonality between all immunizations offered.
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Grainger-Rousseau, T. "Contributions of the community pharmacist to patient care." Thesis, Queen's University Belfast, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.317506.
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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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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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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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Glynn, Caroline. "Aspects of pharmaceutical care provision by the community pharmacist." Thesis, Queen's University Belfast, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.337033.
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Ghalamkari, Hossein Hooman. "Factors affecting the extended role of the community pharmacist." Thesis, University of Bristol, 1999. http://hdl.handle.net/1983/7be8f49e-200b-40c9-ac81-9a137e0c8be7.
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In recent years health care personnel have seen changes to their roles and responsibilities. A number of reports both from within the occupation and from government have recommended changes in the roles of community pharmacists so that they become more active in the provision of health care. The new roles and services suggested have become known as "extended roles" and include health promotion, treatment of minor ailments, provision of advice on prescribed medicines to the public and to other health care personnel. The aim of this study was to investigate the factors affecting the extended roles of the community pharmacist. The investigation initially took an exploratory approach and used unstructured interviews with pharmacists to ascertain influences on every day practice which could have implications on implementation of extended roles. The findings from the initial qualitative stage were incorporated into a national survey of community pharmacists. A number of interrelated factors were found to be important including work practices, financial considerations, people's expectations, relationships with GPs and pharmacists' own definitions of their roles. These findings are explained in terms of the progressive division of labour in the market for the provision of health care. Recommendations are made for extending the role of the community pharmacist
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Capstick, Toby Gareth David. "The effectiveness of pharmacist interventions in improving asthma control and quality of life in patients with difficult asthma." Thesis, University of Bradford, 2014. http://hdl.handle.net/10454/13962.
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Despite national guidelines, the management of difficult asthma remains suboptimal, and there may be opportunities for pharmacists to improve asthma outcomes. This six-month prospective, randomised, open study investigated the effects of pharmaceutical care across primary and secondary care on difficult asthma. Fifty-two patients attending a hospital difficult asthma clinic were randomised (1:1) to receive usual medical care (UC), or pharmacist interventions (PI) comprising asthma review, education, and medicines optimisation from a hospital advanced clinical pharmacist, plus follow-up targeted Medicines Use Review (t-MUR) from community pharmacists. Forty-seven patients completed the study. More interventions were performed in the PI group at baseline (total 79 vs. 34, p<0.001), but only six patients received a t-MUR. At six-months, PI were non-inferior to UC for all outcomes. The primary outcome measure was Juniper’s Asthma Control Questionnaire score and reduced (improved) from a median (IQ) score of 2.86 (2.25, 3.25) and 3.00 (1.96, 3.71) in the PI and UC groups respectively to 2.57 (1.75, 3.67) and 2.29 (1.50, 3.50). At baseline, 58.8%, 46.9% and 17.6% of patients had optimal inhaler technique using Accuhalers, Turbohalers or pMDIs; education improved technique but this was not maintained at six-months. Adherence rates < 80% were observed in 57.5% of patients at baseline, and was improved in the PI group at six-months (10/20 PI vs. 3/21 UC had adherence rates of 80-120%, p=0.020). This study demonstrates that the management of difficult asthma by specialist pharmacists is as effective as usual medical care. Future research should investigate whether pharmacist-led follow-up produces further improvements.
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Capstick, Toby G. D. "The Effectiveness of Pharmacist Interventions in Improving Asthma Control and Quality of Life in Patients with Difficult Asthma." Thesis, University of Bradford, 2014. http://hdl.handle.net/10454/13962.
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Despite national guidelines, the management of difficult asthma remains suboptimal, and there may be opportunities for pharmacists to improve asthma outcomes. This six-month prospective, randomised, open study investigated the effects of pharmaceutical care across primary and secondary care on difficult asthma.
Fifty-two patients attending a hospital difficult asthma clinic were randomised
(1:1) to receive usual medical care (UC), or pharmacist interventions (PI) comprising asthma review, education, and medicines optimisation from a hospital advanced clinical pharmacist, plus follow-up targeted Medicines Use Review (t-MUR) from community pharmacists.
Forty-seven patients completed the study. More interventions were performed in the PI group at baseline (total 79 vs. 34, p<0.001), but only six patients received a t-MUR. At six-months, PI were non-inferior to UC for all outcomes. The primary outcome measure was Juniper’s Asthma Control Questionnaire score and reduced (improved) from a median (IQ) score of 2.86 (2.25, 3.25) and 3.00 (1.96, 3.71) in the PI and UC groups respectively to 2.57 (1.75, 3.67) and 2.29 (1.50, 3.50).
At baseline, 58.8%, 46.9% and 17.6% of patients had optimal inhaler technique using Accuhalers, Turbohalers or pMDIs; education improved technique but this was not maintained at six-months. Adherence rates <80% were observed in 57.5% of patients at baseline, and was improved in the PI group at six-months (10/20 PI vs. 3/21 UC had adherence rates of 80-120%, p=0.020).
This study demonstrates that the management of difficult asthma by specialist pharmacists is as effective as usual medical care. Future research should investigate whether pharmacist-led follow-up produces further improvements.The Pharmaceutical Trust for Educational and Charitable Objects (PTECO) (now known as Pharmacy Research UK).
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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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Venter, Ignatius Johannes Erhardt. "The role of the community pharmacist in cardiovascular disease management." Thesis, Nelson Mandela Metropolitan University, 2007. http://hdl.handle.net/10948/652.
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Cardiovascular disease contributes to mortality and morbidity statistics worldwide and in South Africa. The current focus in health care revolves around activities aimed at preventing the development of cardiovascular disease, rather than the treatment of disease. The identification of risk factors that can predispose a patient to the development of cardiovascular disease is an essential component of any cardiovascular disease management programme. It is necessary that in the management of these risk factors, they are not considered to be isolated, but inter-related. Through the provision of point-of-care cardiovascular risk screening and monitoring services as well as disease-related counselling, the community pharmacist, as a readily accessible source of healthcare, can play an essential role in the cardiovascular disease management process. The aim of this study was to describe the nature of the services provided by community pharmacists with respect to cardiovascular risk and disease management in the Nelson Mandela Metropole. The research design was a non-experimental, descriptive study using a crosssectional survey method. Data was obtained through the utilisation of a questionnaire. The questionnaire consisted of three sections and was administered to community pharmacies in the Nelson Mandela Metropole, that provided cardiovascular point-of-care screening services. The community pharmacists correctly identified cardiovascular risk factors such as obesity (76.6 percent; 36, n=47) and smoking (27.7 percent; 13, n=47). Other cardiovascular risk factors such as abdominal obesity (4.2 percent; 2, n=47), gender (2.1 percent; 1, n=47) and family history (4.2 percent; 2, n=47) were largely ignored by the pharmacists. Point-of-care testing services were readily available in the pharmacies, with all of the pharmacies providing blood glucose and blood pressure measurements. Blood cholesterol measurements were only provided in 87.8 percent (36, n=41) of the pharmacies. The services were generally provided in a clinic facility, with 90.2 percent (37, n=41) of the pharmacies having a clinic facility available. Pharmacists were involved in the provision of point-of-care services, with 85.4 percent (35, n=41) of the pharmacies indicating that the pharmacists participated. Pharmacists readily provided counselling prior (70.7 percent; 29, n=41) to and after (80.5 percent; 33, n=41) the conduction of the screening services on areas such as lifestyle modification and treatment options. Only 15 percent (7, n=47) of the pharmacists indicated that they were aware of Cardiovascular Risk Calculator Tools and none of the pharmacists indicated that they had utilised such a tool. Pharmacists recommended frequent monitoring (60.5 percent; 26, n=43) and lifestyle modification (67.4 percent; 29, n=43) to patients, if the result of their screening service was within normal limits. However, the majority of the pharmacists indicated that they would refer patients, if the results obtained were out of the normal range. Conclusions based on the findings indicated that the pharmacists are readily providing cardiovascular risk screening services. The pharmacists were also able to identify the presence of any risk factors that can lead to the development of cardiovascular disease in the patients. However, active pharmaceutical involvement in further cardiovascular disease monitoring seemed to be lacking. Recommendations were made on areas such as reimbursement for pharmaceutical care services, increased utilisation of support staff and Continuing Professional Development events that could assist in improving the role of the community pharmacist in cardiovascular disease management.
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Hunt, Adrian John. "Continuing education and the developing role of the community pharmacist." Thesis, University of Portsmouth, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.297016.
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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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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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Brewster, S., Fred Tudiver, E. Hagy, Angela Hagaman, Robert E. Pack, and Nicholas E. Hagemeier. "Prescriber and Pharmacist Prescription Drug Abuse Communication Perceptions." Digital Commons @ East Tennessee State University, 2016. https://dc.etsu.edu/etsu-works/1358.
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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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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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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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Lindqvist, Elias. "Målbild för receptarien - uppfattningar bland apoteksaktörer, myndigheter, organisationer och utbildningar." Thesis, Malmö universitet, Fakulteten för hälsa och samhälle (HS), 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-26451.
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Bakgrund: Denna rapporten undersökte målbilden av en receptarie, en treårig farmaciutbildning i Sverige. Idag, är inte mycket arbete gjort för att utveckla och definiera målbilden av en receptarie. Olika verksamheter kan ha olika uppfattningar om vad en receptarie är menad att göra i sitt arbete. Mål: Att studera hur den nya nationella målbilden för receptarier uppfattas i grundutbildningarna, i ansvar och arbetsuppgifter på apotek samt vilka förändringar som behöver genomföras enligt de som har möjlighet att påverka. Metod: En enkätstudie skickades ut till receptarieutbildningar, apoteksaktörer och relevanta myndigheter och organisationer, som frågade om deras uppfattning av en receptaries målbild jämfört med Apotekarsocietetens målbild. Resultat: Över lag instämde enkätdeltagarna med Apotekarsocietetens målbild, och många deltagare uttryckte en vilja att vidare bidra för att uppnå målen. Åsikterna om de andra verksamheternas bidrag till målsättningarna var negativa. Apoteksaktörerna var den gruppen som ansågs bidra sämst till att uppfylla målsättningarna. Diskussion: Synen på apoteksaktörernas bidrag var mycket olika beroende på vem som frågades, där apoteken själva ansåg att de bidrog mycket väl, medan andra verksamheter tyckte de bidrog mycket lite. Många framförde även önskemålet att öka fokus på rådgivning och patientkommunikation. Slutsats: Apotekarsocietetens målbild stämde bra överens med deltagarnas uppfattningar. Deltagarna hade överlag en positiv inställning och uttryckte en vilja att arbeta vidare med många förslag på förbättringar. Huvudresultatet av rapporten var skillnaden i syn på apoteksaktörernas bidrag.Background: This report explored the vision of a “receptarie”, a three-year long pharmacist bachelor’s degree in Sweden. Today, not much work is done to develop and define the profession of a “receptarie”. Different actors might have different understandings on what a “receptarie” should do in their work. Aim: To study how the new target set by Apotekarsocieteten is perceived by the relevant educations and in responsibilities and work tasks in pharmacies, aswell as what changes is needed to be performed according to the ones in a position to influence. Method: The study involved four “receptarie”-educations, located in Göteborg, Malmö. Umeå and Uppsala. A survey was performed, questioning the different educations, apothecary's and relevant organisations about their view of what a “receptarie”s goal is compared to a target published by Apotekarsocieteten. Result: In broad, the participants in the survey agreed with the publishing from Apotekarsocieteten and many participants expressed a will to further contribute to reaching the set goals. The opinions of other actors’ contributions were negative. The apothecaries were seen as the least contributing actors. Discussion: The biggest deviance, was the perception of the contribution of apothecaries, where they themselves belived they contributed well, but other occupations did not. Many participants expressed the desire to increase the focus of counseling and patient communication. Conclusion: Apotekarsocietetens target harmonized well with the participants. The participants had a positive view and had many suggestions for improvements. The main result was the perceived difference in contribution from the apothecaries.
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Bell, Heather M. "Pharmaceutical care provision in N. Ireland - a focus on asthma." Thesis, Queen's University Belfast, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.268179.
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Hill, Peter William. "The South African community pharmacist and Type 2 Diabetes Mellitus a pharmaceutical care intervention." Thesis, Rhodes University, 2009. http://hdl.handle.net/10962/d1003238.
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Type 2 diabetes mellitus is a chronic disease of pandemic magnitude, increasingly contributing to the disease burden of countries in the developing world, largely because of the effects of unhealthy lifestyles fuelled by unbridled urbanisation. In certain settings, patients with diabetes are more likely to have a healthcare encounter with a pharmacist than with any other healthcare provider. The overall aim of the study was to investigate the potential of South African community pharmacists to positively influence patient adherence and metabolic control in Type 2 diabetes. The designated primary endpoint was glycated haemoglobin, with the intermediate health outcomes of blood lipids, serum creatinine, blood pressure and body mass index serving as secondary endpoints. Community pharmacists and their associated Type 2 diabetes patients were recruited from areas throughout South Africa using the communication media of various nonstatutory pharmacy organisations. Although 156 pharmacists initially indicated interest in participating in the study, only 28 pharmacists and 153 patients were enrolled prior to baseline data collection. Of these, 16 pharmacists and 57 patients participated in the study for the full twelve months. Baseline clinical and psychosocial data were collected, after which pharmacists and their patients were randomised, nine pharmacists and 34 patients to the intervention group and 8 pharmacists and 27 patients to the control group. The sample size calculation revealed that each group required the participation of a minimum of 35 patients. Control pharmacists were requested to offer standard pharmaceutical care, while the intervention pharmacists were provided with a scope of practice diabetes care plan to guide the diabetes care they were to provide. Data were again collected 12-months postbaseline. At baseline, proportionally more intervention patients (82.4%) than control patients (59.3%) were using only oral anti-diabetes agents (i.e. not in combination with insulin), while insulin usage, either alone or in combination with oral agents was conversely greater in the control group (40.7%) than in the intervention group (17.6%) (Chi-squared test, p=0.013). Approximately half of the patients (53.8% control and 47.1% intervention) reported having their HbA1c levels measured in terms of accepted guidelines. There was no significant difference in HbA1c between the groups at the end of the study (Independent t-test, p=0.514). In the control group, the mean HbA1c increased from 7.3±1.2% to 7.6±1.5%, while for the intervention patients the variable remained almost constant (8.2±2.0% at baseline and 8.2±1.8% at post-baseline). Similarly, there were no significant differences between the groups with regard to any of the designated secondary clinical endpoints. Adherence to medication and self-management recommendations was similarly good for both groups. There were no significant differences between the two groups for any of the other psychosocial variables measured. In conclusion, intervention pharmacists were not able to significantly influence glycaemic control or therapeutic adherence compared to the control pharmacists.
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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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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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Maddox, Clare. "Influences on non-medical prescribing : nurse and pharmacist prescribers in primary and community care." Thesis, University of Manchester, 2011. https://www.research.manchester.ac.uk/portal/en/theses/influences-on-nonmedical-prescribing-nurse-and-pharmacist-prescribers-in-primary-and-community-care(d15ec348-3783-4364-afe7-726581ebbcfa).html.
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Since 1994 there have been considerable additions to the range of health care professionals (HCPs) that can prescribe in the United Kingdom (UK). These HCPs include nurses, pharmacists, radiographers, physiotherapists, podiatrists, chiropodists and optometrists. After a period of specific prescribing training these HCPs are often referred to as non-medical prescribers (NMPs). There has been a limited amount of research that has investigated the influences on the prescribing behaviour of NMPs. Additional research with NMPs would be beneficial to contribute to the currently limited understanding of the prescribing behaviour of NMPs. Knowledge about the influences on NMPs' decisions will also provide further insight into the training and support requirements of these HCPs. A programme of research was conducted to explore the influences on the prescribing behaviour of nurse and pharmacist independent and/or supplementary prescribers working in primary and community care. The research utilised a range of qualitative data collection techniques including interviews, semi-structured interviews, focus groups and the critical incident technique. The Q-method was also used. This allowed perspectives amongst NMPs about prescribing influences to be identified. In total, 104 NMPs took part in this research. This included 31 pharmacist prescribers and 73 nurse prescribers. NMPs were mainly recruited via their primary care trust prescribing lead but pharmacist prescribers were also contacted using the details they provided to their professional body. NMPs in this research occupied a wide range of roles and had diverse demographic characteristics. Relevant ethical approval was obtained before conducting this research. NMPs were motivated by their desire to feel safe, keep it simple and fit in with prescribing culture when prescribing. They also had a code of practice which underlined their rejection of some influences, such as patient pressure and logistical influences, and their acceptance of others, such as guidelines and formularies. The research found that the influences on NMPs' prescribing decisions can be best understood through identifying how and in what circumstances NMPs take responsibility for issuing prescriptions and making prescribing decisions. As well as providing insights into the training and support requirements of NMPs the findings of this research are important to others that may want to research the prescribing influences on NMPs in the future.
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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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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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Cotter, Siobhan Maire. "The clinical role of the hospital pharmacist in the United Kingdom National Health Service." Thesis, London School of Hygiene and Tropical Medicine (University of London), 1995. http://researchonline.lshtm.ac.uk/682295/.
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This thesis examines the roles adopted by clinical pharmacists in the United Kingdom (UK), the evidence for the effectiveness of the interventions arising from these roles, and the challenges to and opportunities for future developments in clinical pharmacy. The research was undertaken in four phases: problem definition; national survey of services currently provided; in-depth interviews on roles; and a review of literature on effectiveness. A literature search provided background information on the evolution of pharmacy and of clinical pharmacy, particularly in the UK. These developments in have been set in the context of changes in health care provision and in the roles of the other health care professions and occupational groups. Preliminary interviews, meetings and group work were carried out to facilitate clarification of the research questions and to assist in the choice of methods. Two nationwide postal questionnaire surveys were conducted. One inquired about the provision of clinical pharmacy services to the primary care sector and the other about service provision within secondary care facilities in the National Health Service (NHS). The response rates were 91% and 90% respectively. The results show some diversity in the provision of clinical pharmacy services and provide possible explanations for this variation. Subsequently, semi-structured interviews were conducted with pharmacists, pharmacy technicians, doctors, nurses and managers at eight sites selected to represent different characteristics of hospitals. These qualitative data were analyzed by constant comparison. The results provide a picture of the clinical roles that hospital pharmacists are, and should be, providing. In addition, they indicate the potential barriers to, and opportunities for, future role development. An assessment of the evaluative literature on clinical pharmacy services was undertaken. Most literature is descriptive and much of the evaluative literature has shortcomings. The results present the evidence for the effectiveness of clinical pharmacy services in improving patient care and financial outcomes in the UK NHS. Finally, quantitative information gathered in the questionnaire survey, qualitative information from the interviews and the literature evidence were combined to create models of the future role of the hospital clinical pharmacist in the UK.
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Aggarwal, Anjana Mohini. "An examination of the role of the community pharmacist in the pharmacovigilance of herbal medicines." Thesis, University College London (University of London), 2008. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.502451.
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Twigg, Michael. "Is there a role for the community pharmacist in the management of long-term conditions?" Thesis, University of East Anglia, 2013. https://ueaeprints.uea.ac.uk/47916/.
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The Government agenda is to move pharmacists away from dispensing medicines from a prescription to the provision of clinical services aimed at managing patients with long-term conditions. This thesis uses the approach defined by the MRC framework for developing complex interventions to ascertain whether there is a pharmacist role in this area. An initial study was conducted to determine the feasibility of a community pharmacist eczema management support service (PLEEZ). It demonstrated encouraging results, however failed to recruit the required number of participants. A pharmacist focus group indicated that the study had failed because of an insufficient population, overly complex study design and insufficient intervention preparation and training. Type 2 diabetes was subsequently chosen for the intervention as these patients have an anticipated greater pharmaceutical need and there is a larger available patient population. In line with the MRC framework, appropriate developmental work was then undertaken in the form of a literature review, an audit and a series of focus groups to determine the composition of a novel intervention focused on this condition. These results came together to form the diabetes community pharmacy drop-in clinic comprising the following elements: Targeting poorly controlled patients A system of referral from the medical practice A suitable training programme No appointment system Additional pharmacist to support A focus on adherence and dose optimisation as well as diet and lifestyle advice The clinics, in five pharmacies, recruited 33 participants providing positive results from the outcomes measured, excellent patient feedback and pharmacist comments that can be used to inform future studies. The thesis demonstrates that there is a potential role for the community pharmacist in the care of patients with type 2 diabetes, however further, large scale research is needed to confirm whether this is the case.
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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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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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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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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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Ewan, Marilyn Adunke. "The potential contribution of the community pharmacist to the care of the long term mentally ill." Thesis, King's College London (University of London), 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.392416.
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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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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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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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Lau, Ming-wai, and 劉明偉. "Effectiveness of pharmacist interventions in the self management of asthma in the community setting : a systematic review." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2013. http://hdl.handle.net/10722/193784.
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Background: Asthma is a global health problem affecting people of all ages. Despite huge progress on the management of asthma in recent decades, suboptimal health outcomes associated with under-management is still commonly encountered. Self management was shown to be a both clinically and cost effective approach to improve asthma outcomes in some studies. The role of pharmacists in promoting self management of asthma was explored in individual studies but limited review was conducted to assess its effectiveness.
Objective: To investigate the effectiveness of pharmacist interventions on the self management of asthma patients in the community setting and to examine if the benefits, if any, could be realized by implementing such interventions in Hong Kong.
Methods: A systematic search was conducted on Medline, Embase, Pubmed and Cochrane Library without time limit to identify studies assessing the clinical, humanistic and economic outcomes of pharmacist-led self management interventions towards adolescent or adult patients with asthma compared to usual care. Risk of bias of studies was appraised using a tool adapted from the Effective Practice of Organization of Care version of the Cochrane Risk of Bias Tool.
Results: The search yielded 504 studies of which eight studies were eligible for inclusion. The included studies involved 1674 patients, were published between 2001 and 2008 and were originated from seven countries. Discrepancies of findings were noted in the majority of outcome measures reviewed. Significant benefits of pharmacist interventions included improvement of inhalation technique and reduction of rescue medication use although no significant effect was observed with regard to forced expiratory volume in one second and days lost from work or school.
Conclusions: The evidence of pharmacist interventions on the self management of asthma remains inconsistent, probably attributable to variable quality of studies and heterogeneous assessment methods and outcome measures. Future research should aim to produce randomized, controlled studies incorporating allocation concealment with a follow-up period of over one year. Nevertheless, pharmacist-led asthma self management initiatives could be implemented at the general outpatient clinic setting in Hong Kong to further improve the quality of primary care.published_or_final_version
Public Health
Master
Master of Public Health
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Lahrman, Rebecca M. "Improving Bidirectional Communication: The Effect of a Warm-Handoff Transfer Between Ambulatory Pharmacists and Community Pharmacists for High-Risk Patients." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1562923386274222.
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Bradley, Fay. "Exploring interactions between General Practitioners and Community Pharmacists : a novel application of social network analysis." Thesis, University of Manchester, 2012. https://www.research.manchester.ac.uk/portal/en/theses/exploring-interactions-between-general-practitioners-and-community-pharmacists-a-novel-application-of-social-network-analysis(d55b4c02-1c23-4f57-a0f8-4afed6406c64).html.
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Increasing collaborative working between GPs and community pharmacists has recently become a high priority for the NHS. Previous research suggests that interaction is limited and problematic between the two professions, forming a barrier to service provision. This PhD aimed to explore the level, nature and process of interaction between GPs and community pharmacists, using a social network analysis approach.The study focused on four geographically different case study areas and 90 GPs and community pharmacists participated in total. A two-stage design was adopted. Firstly data were collected through a network questionnaire and analysed using social network analysis. Secondly, qualitative interviews were conducted to provide narrative to the network findings and analysed using the framework approach.The nature of contact was characterised as mostly indirect through brokers, de-personalised and non-reciprocal and seemingly at odds with collaborative behaviour. A misalignment in responses pointed to asymmetry in the relationship, representing little commonality, knowing and understanding of each other. Through social network analysis, individuals and dyads in possession of strong ties were identified. Strong ties were not the norm and were characterised by more personalised forms of reciprocal contact. Qualitative interviews provided insight into the processes of interaction between the two professional groups. An approach to the interaction, which involved pharmacists tactically managing the potential conflict in the interaction through use of deferential and sometimes subservient behaviour, was conceptualised as the ‘pharmacist-GP game’. Those pharmacists with strong ties to GPs also, at times, adopted aspects of this approach but also attempted to set themselves apart from other pharmacists in order to develop and maintain their strong ties with GPs. However, possession of strong ties did not always lead to capitalisation, and the benefits of possessing these were often viewed as efficiency and convenience gains rather than anything more wide-reaching. Often, more isolated GPs and pharmacists did not view strong ties as a necessity, with the benefits of these not considered rewarding enough for the time and effort required to achieve them. This effort-reward conflict was identified as an important constraint faced by GPs and pharmacists in relation to transforming these loose connections into more integrated networks. Other micro and macro level constraints were also identified and a series of accompanying recommendations made for future practice and research.
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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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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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Stavchansky, Liza E. "An exploratory study of consumer, community pharmacist, and physician attitudes and comprehension of direct-to-consumer prescription drug advertising /." Digital version accessible at:, 2000. http://wwwlib.umi.com/cr/utexas/main.
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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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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.
Full textAbstract:
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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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.
Full textAbstract:
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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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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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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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.
Full textAbstract:
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.