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1

Renberg, Tobias. "Patient Perspectives on Community Pharmacy Services." Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-108392.

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Community pharmacy practice is changing, putting a greater emphasis on patient involvement and empowerment than on physical drug products. Developing practice philosophies, such as pharmaceutical care, are operationalised through an ever-evolving service proliferation. There is, however, a paucity of studies addressing the patients’ subjective perceptions of pharmacy services. The few studies that measure the impact of pharmacy services on humanistic outcomes show little or no effect. This might be due to the services, or the assessment instruments used. The aim of this thesis was to enhance the understanding of how patients perceive community pharmacy services, their preferences for community pharmacy services, and how these services could be evaluated from the patient perspective. This was done by: 1.exploring patients’ perceptions of an existing pharmaceutical care service using in-depth interviews; 2. exploring patient preferences for the ideal pharmacy visit using Q methodology, and characterising those patient groups that have different preferences and; 3. testing the validity of the Swedish version of the Pharmaceutical Therapy-Related Quality of Life (PTRQoL)-instrument, using think aloud methodology. Patients had vague, and sometimes erroneous, understandings about a pharmaceutical care service that they were currently receiving. They reported that the service had increased their feeling of safety, enhanced their knowledge, provided drug treatment control, and empowered them. Seven different viewpoints of the ideal pharmacy service were identified, which could be broadly divided into two groups, those emphasising the physical drug products as central to the encounter and those seeking a relationship with the pharmacist. Some differences between the group characteristics were identified, but not specific enough to guide individualised care practice. Several problems with the validity of the PTRQoL-instrument were detected. Overall, the thesis has highlighted various aspects of patient perspectives on community pharmacy services that could be used for the development andassessment of such services.
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Adams, Edries. "Independent community pharmacy : quo vadis?" Thesis, Stellenbosch : University of Stellenbosch, 2011. http://hdl.handle.net/10019.1/14640.

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Thesis (MBA)--University of Stellenbosch, 2011.
On 16 January 2004, the Parliament of the Republic of South Africa published the Draft Regulations to the Medicines and Related Substances Act No. 101 of 1965 (Republic of South Africa, 2010a) for comments due by 16 April 2004. These regulations would change the retail pharmacy landscape that generations of pharmacists had become dependent on in supporting themselves and the communities that they served. These regulations proposed a single exit price (SEP) that manufacturers might charge pharmaceutical wholesalers, which included the distribution cost. The wholesaler in turn would sell the pharmaceutical to the pharmaceutical retailer at the listed SEP, thus prohibiting discounts and in the process creating transparency in the pharmaceutical industry. This transparency would ensure that all people would pay the same price for their medication with the aim of making it affordable and available to those in need. Preceding these draft regulations was the amendment to the Pharmacy Act No. 53 of 1974 (Republic of South Africa, 2010c) concerning pharmacy ownership, which allowed non-pharmacist and legal entities to own pharmacies as of 2003. This amendment posed the first external threat to the autonomy of pharmacists regarding independent pharmacy ownership. Pharmacists now had to compete not only amongst themselves but also with large corporate food and health shops with in-house pharmacies. The resources and capabilities inherent to independent community pharmacies given the events of the past few years proved inadequate in competing with the corporate retailers. These two amendments to acts that influenced the existing pharmacy landscape posed a real threat to the sustainability of independent pharmacy business models. This paper investigates the issues that independent community pharmacies in South Africa are facing and their strategic options in the pharmaceutical and services value chain.
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Hariri, Shapour. "Multimedia health promotion in community pharmacy." Thesis, King's College London (University of London), 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.301212.

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4

Rogers, Philip John. "Patient medication records by community pharmacy." Thesis, University of Bath, 1993. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.357290.

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5

Blignault, Suzette Martha. "Audit of community pharmacy activities." Thesis, Nelson Mandela Metropolitan University, 2010. http://hdl.handle.net/10948/1533.

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In South Africa the pharmacy profession has experienced a number of changes around the turn of the century such as the introduction of the National Drug Policy (NDP), pharmacy ownership and price regulation. With this the role and earnings of the pharmacy profession, as well as to what extent the pharmacist adds value to the profession and society, are being questioned. Community pharmacists are thus faced with the challenge to prove that the value that they add to society is meaningful. Therefore, the aim of the study was to document community pharmacy availability and activities in South Africa and based on this to quantify the perceived value that the community pharmacist adds to society through the delivery of pharmaceutical services and pharmaceutical care. In order to determine the pharmacist’s true value added two surveys were conducted in 2006; an original pharmacist survey and a general public survey. The results obtained were verified by a follow–up pharmacist survey in 2009 to confirm or reject the results obtained in the original survey. The study was representative of both the community pharmacies and the general public in South Africa and was primarily quantitative in design and analysis. More than half of the responding pharmacies (63.16%) were open seven days a week. The average hours of service per day ranged from 10 hours (Monday to Friday) through to 6.45 hours on Saturdays and 3 hours on Sundays. Pharmacists continuously upgraded their professional knowledge. More than three quarters of pharmacies had the necessary equipment available to perform the services investigated in the study. The general public was not aware of all the services provided by pharmacists and as a result, depending on the service, many people did not make use of these services. The general public that made use of services delivered by community pharmacies mainly perceived the services delivered to be of good quality. The main barrier to practicing pharmaceutical care was indicated by pharmacists as not receiving payment for the advice given followed by pharmaceutical care being time consuming, and that there was not enough time to talk to patients. The general public indicated that they found it difficult to ask questions in pharmacies because other patients could hear what was discussed, or other patients had to wait longer if they asked something, and pharmacy staff being too busy. The results of the original pharmacist and the general public survey were confirmed by the results of the follow-up survey with the exception of dispensing prescription medicine (8 minutes 28 seconds), OTC medicine (7 minutes 23 seconds), counselling of prescription medicine (8 minutes 51 seconds) and OTC medicine (8 minutes) which on average took longer to conduct than in the previous analysis. The study highlighted the value added to the wellness and quality of life of the community of South Africa through the delivery of pharmaceutical care and pharmaceutical services by community pharmacy staff, and proved that pharmacists are committed to the provision of pharmaceutical care and pharmaceutical services.
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Bond, Christine M. "Prescribing in community pharmacy : barriers and opportunities." Thesis, University of Aberdeen, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.294204.

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This thesis describes the history of community pharmacy, and the current climate which has identified an extended role, particularly for 'over-the-counter' advice in response to symptoms and the reclassification of medicines. An electric methodology has been used to define current community pharmacy practice in Scotland, and to assess the attitudes of community pharmacists and GPs to an extended community pharmacy role. Attitudes of community pharmacists to medicines reclassification have been assessed nationally, and implications quantified. Clinical pharmacy guidelines for the treatment of dyspepsia have been developed and evaluated. A range of opinion formers have been interviewed to identify the different agenda which have contributed to medicines reclassification. Most of the more innovative tasks proposed are not yet commonly practised in Scotland. However most community pharmacists favour the extended role and the reclassification of medicines. Reclassification has little financial advantage for the community pharmacist, but would benefit the patient and the NHS. GPs were generally supportive of the extended role of the community pharmacist and the reclassification of medicines with a few caveats. These could be overcome by clinical pharmacy guidelines, which we demonstrated to have utility, patient acceptability and an educational value. Representatives of the medical and pharmaceutical professions, the government, the industry and the patient, revealed three agendas which have all influenced medicines reclassification. The government wish to shift the costs from the NHS to the patient. The industry wish to find additional markets and the pharmaceutical profession need a new paradigm to replace their largely redundant technical dispensing role. It is concluded that it is an opportune time for the community pharmacists to extend their professional role.
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Wilson, Debbie Louise. "Professional expertise and pharmacy technicians." [Gainesville, Fla.] : University of Florida, 2004. http://purl.fcla.edu/fcla/etd/UFE0008401.

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Thesis (Ph.D.)--University of Florida, 2004.
Typescript. Title from title page of source document. Document formatted into pages; contains 173 pages. Includes Vita. Includes bibliographical references.
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Dooda, Nicole, Alexander Leonard, and Kim Nguyen. "Patient Satisfaction and Utilization of Pharmacy Care Services at an Independent Community Pharmacy." The University of Arizona, 2017. http://hdl.handle.net/10150/624170.

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Class of 2017 Abstract
Objectives: To determine if there is a correlation between both awareness and utilization of pharmacy care services and patient satisfaction at an independent community pharmacy in Benson, Arizona. Subjects: Patients who visited the pharmacy within a 45-day period in 2016 and who have filled at least one prescription at that location. Methods: A self-reported questionnaire was administered by pharmacy staff to assess patients’ satisfaction ratings on the pharmacy’s performance. The questionnaire also inquired about patients’ awareness and use of pharmacy services as well as demographic information including a history of specific disease states. Data were evaluated using analytic software. Results: Questionnaires were completed by 48 men (mean age = 65.8; SD = 12.57) and 69 women (mean age 60.3; SD = 15.06), with the mean number of select health conditions being 1.63 (SD = 1.16) and 1.49 (SD = 1.24), respectively. There was no correlation between the number of services for which a patient was aware, nor the number of services utilized, and overall satisfaction (p=0.466 and p=0.384, respectively). However, there was a significant positive correlation between awareness and utilization of pharmacy services (r=0.208, p=0.019). Over 74% of respondents rated satisfaction for all measures “excellent,” with professionalism of the pharmacist (92.1%) and pharmacy staff (89.9%) ranking highest. The only category that received a “poor” rating was how well the pharmacist explains medication side effects. Conclusions There was no apparent correlation between awareness of pharmacy care services and patient satisfaction at The Medicine Shoppe in Benson, nor between utilization of pharmacy services and satisfaction. However, patient satisfaction scored high in all categories surveyed.
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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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Saramunee, Kritsanee. "General public views on community pharmacy services in public health." Thesis, Liverpool John Moores University, 2013. http://researchonline.ljmu.ac.uk/6170/.

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Community pharmacists are increasingly providing public health services in response to government policies. Published literature regarding the views of the general public related to pharmacy public health services, although important in ensuring uptake of these services, was limited. This study series aim to explore the general public's perspective on how to maximise the appropriate utilisation of community pharmacy services for improving public health. A large study comprising four sequential phases was designed and conducted in Sefton borough. Initially, to gather background information, focus group discussions (FGDs) and semi-structured interviews were undertaken with the general public and key stakeholders. The second phase involved the development and testing of a questionnaire extracted from the qualitative findings and a literature review. The questionnaire focused upon seven pharmacy public health services related to cardiovascular risks as well as views on factors influencing pharmacy use and advertising/promotion techniques. Geodemographic concepts, widely recognised in public health, were also included to identify potential benefits to pharmacy practice research. Next, a large scale survey was administered among the general public using eight survey modes, to additionally evaluate the range of methods available/for gathering public views. Finally, survey findings were evaluated by representatives of survey respondents using a FGD. Results indicated that, although stakeholders considered that community pharmacy can make an extensive contribution in supporting public health, pharmacy public health services are used at a relatively low level by the general public and awareness of services is also low. Survey respondents indicated a willingness to use services in the future. Important factors influencing pharmacy use include loyalty, location and convenient accessibility. Appropriate promotional campaigns are a key facilitator to help raise the public's awareness. The findings will help the profession to increase uptake of pharmacy public health services. The variety of survey modes used proved beneficial in obtaining diverse population demographics, with street survey being the optimal technique, however, the potential for social desirability bias must be considered with this and other interviewer-assisted approaches. MOSAIC™ as a geodemographic tool is potentially useful in helping to target services for specific groups and is recommended for use in further research.
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Ibrahim, Osama Mohamed. "Evaluating cholesterol screening in a community pharmacy." Scholarly Commons, 1988. https://scholarlycommons.pacific.edu/uop_etds/2162.

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The purpose of this research project was to evaluate the role of the community pharmacist in screening, identifying, and referring ambulatory patients with high total blood cholesterol (TBC) in a community pharmacy. Fifty seven patients, out of 241 initially screened individuals, met the study inclusion criteria and were accepted into this study. Of these 57 patients, 51 patients completed the six month study period. The normal population group consisted of 164 participants with TBC < 200 mgjdL at the initial cholesterol testing (visit 1). The drop out group represented six patients who failed to continue attending the two follow up tests (visit 2 and 3). For screening purposes, a non-fasting whole blood sample was used to measure TBC using the Boehringer Mannheim Reflotron analyzer. The project was evaluated based on mean TBC levels obtained during the initial screening and the two follow up tests, pre-test and post-test scores, behavior and lifestyle changes, and the number of patients who received a physician's order for lipid analysis as a result of initial screening results. In addition, influence of age and educational background on lowering TBC in visits 2 and 3, patient acceptance of blood screening in a community pharmacy and willingness to pay for this service in the future were also determined. To assess the level of significance among the means of the tested parameters, both parametric (one-way analysis of variance, Scheffe's post hoc test and two sample t-test) and non-parametric statistics (Mann-Whitney and chi-square test) were used at a probability level of less than 0.05. There was a significant difference in mean TBC levels between visit 1 and 2, and between visit 1 and 3 (P< 0.01). However, no statistically significant difference was found between visit 2 and 3 (P= 0.48). In addition, there was no significant difference in the incidence of high blood cholesterol in terms of gender or age difference at the initial screening. Further, mean TBC levels between males and females remained statistically insignificant during the two follow up tests. However, younger patients were able to lower their mean TBC level in visit 2 and 3 compared with older patients (P=< 0.031). The one-way analysis of variance results showed that there was no statistically significant difference in TBC changes during the three visits by subjects categorized by educational background levels. Patient's attitude toward the idea of blood test measurement in community pharmacies was positive. Ninety eight percent of the study group stated that they strongly liked such an idea, 92.16% expressed a willingness to pay an average of $4.55 (range $3 or less to $10), and all agreed that it was a convenient service for them. It was concluded that cholesterol screening in this community pharmacy was effective and acceptable, and may prove to be financially feasible when effectively planned and marketed. This service provides the community pharmacist with an opportunity to offer a unique patient-oriented public service.
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EINARSON, THOMAS RAY. "EVALUATION OF A BLOOD LEVEL SERVICE IN A COMMUNITY PHARMACY PRACTICE." Diss., The University of Arizona, 1987. http://hdl.handle.net/10150/184019.

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A clinical pharmacy service that determined blood potassium levels was implemented and evaluated in a community pharmacy practice. The pharmacy service utilization model was developed to guide the research. Data were gathered by two questionnaires. The study spanned four weeks at two locations. During one week at each location, blood testing was offered for a fee of $5, and on the other week it was free. A total of 320 subjects filled out a questionnaire. Patient attitude was positive toward the provision of blood level testing service in a community pharmacy. Subjects perceived a pharmacy to be a convenient place for the service, and they stated that they would use such a service if it were available. Subjects stated that they would pay a mean of $12.46 to use the service. Tests they were most interested in having were cholesterol, potassium, and glucose. Of the 320 subjects, 159 had a blood test; 63 paid a fee and 96 received it free. All subjects expressed satisfaction with the service and all said that they would use it again. The mean amount that those tested were willing to pay was $14.49. The proposed model was partially successful in describing the relationships involved in utilization of a clinical pharmacy service. Demographics did not correlate with other variables nor did the two measures of willingness to pay. All other relationships were significant. The service was shown to be financially feasible based on projections from the data collected. It was recommended that such services be implemented.
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Lee, Amy, and Nisha Patel. "A Consumer Assessment of Pharmaceutical Care Services in a Diabetes Ambulatory Clinic." The University of Arizona, 2009. http://hdl.handle.net/10150/623965.

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Class of 2009 Abstract
OBJECTIVES: To assess patients’ satisfaction with pharmaceutical care services provided in a community health center diabetes management clinic. METHODS: Patients who received diabetes-related pharmaceutical services from the clinical pharmacist at El Rio Health Center in Tucson, Arizona from November 2008 to January 2009 were contacted during a visit to the diabetes clinic and asked to complete the consumer assessment of pharmaceutical services questionnaire. The questionnaire included 14 likert-type items with response options ranging from “Never” to “Always” or “Disagree” to “Agree.” In addition, the patient’s most recent hemoglobin A1C (HgbA1C) was obtained from the electronic medical record. The survey instrument was also translated from English to Spanish to serve the Hispanic participants who could not communicate fluently in English. A descriptive cross-sectional analysis was completed in order to assess patient satisfaction. Dependent variables extracted from the survey were analyzed by Mann-Whitney U test. Interval and ratio data were analyzed by calculating means, standard deviations, and an independent t-test. Nominal data were analyzed using the Chi-Square test. RESULTS: A total of 46 patients completed the questionnaires, including 17 men and 29 women (mean age = 56, SD = 11.3, 80% Hispanic). All patients had seen the clinical pharmacist at least 3 times. Overall, this study showed that majority of the patients were satisfied with the service provided in the clinic. There was no statistically significant difference between English and Spanish patient populations in terms of satisfaction with pharmaceutical services provided about their disease management. CONCLUSIONS: Patients in this clinic were highly satisfied with the pharmaceutical care services provided by the clinical pharmacist.
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Lopatka, Harold. "An evaluation of a community pharmacy reimbursement model for cognitive services." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 2000. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape4/PQDD_0010/NQ59990.pdf.

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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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Chua, Gin Nie. "Using a discrete choice experiment to value a community pharmacy service : how valid are the findings?" Thesis, University of Aberdeen, 2017. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=236463.

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Introduction: Expanding the role of community pharmacists within primary care has become an important policy agenda in the UK. To ensure that pharmacy services are delivered to their full potential, services need to be better tailored to consumers' needs and preferences. The discrete choice experiment (DCE), a technique rooted in economic theory, has been used extensively to elicit consumers' preferences and values in healthcare. However, despite its popularity, there is limited empirical evidence on the external validity of DCEs. Aims: The aim of this thesis was to assess consumers' preferences for a community pharmacyled health check using a DCE with a methodological focus to investigate the external validity of DCE. Method: This thesis employed a four-phased mixed methods study design. In Phase I, a convenience sample of participants was recruited from within a community pharmacy, a colocated dental practice and nearby public spaces and invited to complete a DCE questionnaire to assess preferences for a community pharmacy-led health-check. The DCE comprised twelve choices examining preferences for six attributes of the health check. Additionally, the questionnaire included post-choice certainty questions and attitudinal measures developed from the Theory of Planned Behaviour (TPB). Four weeks later, these participants were offered a real choice between two actual health-checks (Phase II). Their actual choices were compared with DCE-predicted choices; if these differed, participants were invited to an in-depth, face-toface interview (Phase III). In Phase IV, leaflets promoting the service were handed out to the local population and uptake was compared with that predicted by the DCE. Results: The DCE was completed by 423 individuals; 133 (31.4%) were contactable in Phase II and 10 were interviewed in Phase III. The DCE suggested that consumers preferred a healthcheck that was: cheaper; delivered by experienced personnel; with follow-up; available by appointment; lasted 30-minutes; with weekend availability. The estimated value of the health check was £49. The DCE correctly predicted 42.1% of participants' actual choices in Phase II. Calibration of the DCE with certainty questions and incorporation of the TPB into DCE improved DCE-prediction. From the interviews in Phase III, reasons for discrepancies in stated choice and actual behaviour included differences in decision-making processes in DCE and real life, attitudinal and other contextual factors (e.g. timing, location). Discussion & Conclusion: Consumers valued the role of community pharmacists in providing public health services targeted at disease prevention. This finding supports government policies to increase community pharmacists' contribution to public health. Whilst the results raised questions about the external validity of DCE in this study context, different choice modelling approaches (i.e. incorporation of TPB and certainty calibration) improved external validity of DCE. Qualitative findings provided deeper insights into why participants did not do as they said and do not necessarily invalidate DCE findings. The findings from this study should not act as a deterrent to future use of DCEs but more to raise awareness of the need to take into account how choices are made in real life. Ideally the development of DCE and the modelling of choice responses should mimic as closely as possible the decision-making process individuals face in reality.
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Wong, Peter Kim-Hung. "QUANTIFYING THE PERCEIVED VALUE OF PHARMACY SERVICES AS MEASURED BY THE CONTINGENT VALUATION METHOD: FOCUS ON COMMUNITY PHARMACY." University of Cincinnati / OhioLINK, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=ucin980272432.

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Matheson, Catriona I. "Community pharmacy services for drug misusers : a study of the perspectives of service users and providers." Thesis, University of Aberdeen, 1998. http://digitool.abdn.ac.uk/R?func=search-advanced-go&find_code1=WSN&request1=AAIU105510.

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The aim of this research project was to investigate, in detail, all aspects of the apparently increasing role of the community pharmacist in Scotland in providing services to drug misusers. The research focused on two areas: firstly, the effect of pharmacists' attitudes on their actual behaviour (i.e. whether services are provided), the type of services provided and how these services are delivered in practice as perceived by the pharmacist and the drug misusing client; secondly, the nature of the interaction between the pharmacist and drug misuser. Drug misusers valued a good relationship with their pharmacist and this encouraged service usage. Negative attitudes from pharmacist about drug misusers were a barrier to service provision both in terms of whether services were provided and the process of service delivery to drug misusers. This could be relieved by encouragement and endorsement of the pharmacist's role. Negative attitudes are counterproductive as they promote the sense of stigmatisation of drug misusers and may precipitate negative behaviour. To some extent negative attitudes are caused by personal conflict regarding the appropriate professional role of the community pharmacists in drug misuse. Greater local networking, joint training with other service providers and active support from local health boards would encourage more pharmacists to provide the services desired by drug misusers such as greater availability of injecting equipment and methadone dispensing. This would enable the principles of the harm reduction strategy to be widely practised.
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Andersson, Karolina. "Swedish pharmaceutical benefit reforms : analyses of implementation, pharmaceutical sales patterns and expenditures /." Göteborg : Department of Public Health and Community Medicine, The Sahlgrenska Academy at Göteborg University, 2006. http://hdl.handle.net/2077/724.

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Schiraldi, Katherine. "Qualitative Needs Assessment of Pharmacy Services in an Arizona-Mexico Border Community Clinic." The University of Arizona, 2011. http://hdl.handle.net/10150/623530.

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Class of 2011 Abstract
OBJECTIVES: To identify the pharmacy service needs of providers and staff at the San Luis Walk-In Clinic, and to evaluate whether the addition of a dispensing pharmacy to the clinic will benefit the community of San Luis. METHODS: Two focus groups were conducted with employees of the clinic: one with providers and another with supportive staff. Subjects discussed included major health issues at the clinic, where patients received health care products and information, barriers to receiving health care, beneficial pharmacy services and products, and the role of pharmacists in health care. Data was collected regarding whether participants were providers or staff members and whether they lived within or outside of San Luis. These sessions were audio-recorded, transcribed, and analyzed for recurrent themes and patterns. RESULTS: The first focus group consisted of three providers, one of whom was living within San Luis, and the second group was comprised of six supportive staff members, five of whom were from the community. In regards to pharmacy service needs, providers cited medication management, patient education, and treatment recommendations as beneficial resources. Both groups identified the top four major health problems seen in their clinic as hypertension, diabetes, allergies, and dyslipidemia, and barriers to adequate healthcare included financial issues, time constraints, transportation, and lack of education. CONCLUSION: There is a need for pharmacy services, including medication therapy management and disease state education, at the San Luis Walk-In Clinic. This need likely extends to many rural communities throughout the nation.
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Byrt, Sarah. "Social, medical and geographical aspects of the provision of community pharmacy services in rural West Wales." Thesis, University of Wales Trinity Saint David, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.683168.

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Tan, Grace T. H. U. "An interpretive approach to power, professionalism and control : with special reference to the functions of hospital pharmacy departments." Thesis, University of Oxford, 1992. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.334805.

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Hunt, John Anthony. "The development of pharmaceutical services in the British welfare state." Thesis, University of Portsmouth, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.266923.

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24

Montgomery, Anna. "Counselling in Swedish Community Pharmacies : Understanding the Process of a Pharmaceutical Care Service." Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-108973.

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Community pharmacy practice is moving towards patient care and away from the mere dispensing of medicines. In this movement, which is guided by the philosophy of Pharmaceutical care (PC), new counselling services emerge. The purpose of the thesis was to add knowledge about the real-world provision of PC services by studying a defined PC service in Swedish pharmacies. Specific aims of this thesis were to investigate the experiences of professionals working with or close to the service and to describe the content of consultations, counselling behaviour and patterns of follow-up. Further aims were to characterise patients receiving the service and describe their perceived outcomes, in relation to standard service. Data were collected via focus groups, telephone interviews, observations, a patient medication record database and a cross-sectional survey. The practitioners reported greater use of their pharmaceutical knowledge and provision of more thorough patient support. Perceived barriers in delivering the service included difficulties in documenting and getting commitment from colleagues, managers and prescribers. Doctors working close to PC pharmacies held varying opinions about the service. Consultations dealt with issues potentially improving the outcomes of medical treatment, but the level of patient centredness varied and was limited by the practitioners’ focus on the computer screen. The rate of follow-up evaluations was modest, but was higher at pharmacies with a high volume of patients receiving the service. PC patients were mostly elderly and female, using about 10 prescription drugs. In comparison to patients receiving standard service, they were more worried, vulnerable and information-seeking. At the same time, their feelings of safety following the pharmacy visit were more pronounced than those of patients receiving standard service. They also felt better prepared for doctor visits. In order for community pharmacy to better meet patients’ needs and optimise PC services, increased attention should be given to implementation strategies, interprofessional collaboration and educational efforts focusing on patient centredness.
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Fuller, Heather. "A Quality Improvement Analysis and Assessment of Counseling Services Provided at a Community Pharmacy." The University of Arizona, 2005. http://hdl.handle.net/10150/624731.

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Class of 2005 Abstract
Objectives: To determine the level of patient satisfaction regarding counseling services provided at a local community pharmacy. Methods: 100 questionnaires were handed out randomly to pharmacy customers who received counseling services on new prescription medication(s). The questionnaires contained multiple criteria/statements regarding the provision of counseling services. Customers were also asked to select from a list of potential additional categories of information that they would like to receive during counseling. Results: 48 of 100 questionnaires were received at the time this report was written. Customers strongly agreed that the criteria regarding the content of the counseling services were met: (name/strength/dose, and with all of the statements regarding the pharmacist's professional attributes and the counseling environment except one regarding privacy involved with counseling). Suprisingly, only 20% of customers would feel more comfortable being counseled in a more private area such as a separate room or walled off area. Implications: This study provided important feedback to the community pharmacy as well as the pharmacists working there in regards to the evaluation of counseling services provided to their valued customers. Customers have the opportunity to provide their input in regard to their satisfaction level of the quality of counseling services they receive at this community pharmacy (in the form of a questionnaire). Customers, through the completion of the questionnaire, may realize the value of this questionnaire and its use as a tool to improve the areas of the counseling services that customers agree need improvement as well as the opportunity to realize that this community pharmacy does care and value it’s customers and their level of satisfaction in the counseling services provided. This questionnaire may be used as a tool by the community pharmacy in the future to re-assess these criteria of counseling services in the overall purpose of improving the quality of counseling services provided by this community pharmacy.
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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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27

Hunter, Carole. "Evaluation of syringe markers distributed through community pharmacy needle exchanges." Thesis, University of Stirling, 2012. http://hdl.handle.net/1893/11096.

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The aim of this study is to evaluate the supply of markers for the identification of syringes distributed by pharmacy needle exchanges and to determine if this product and service delivery offers a feasible method of marking syringes to promote the reduction of accidental sharing of syringes and needles amongst injecting drug users (IDU) and thereby reduce the risk of transmission of blood borne viruses (BBVs) and other related infections. This study involves the assessment, implementation and evaluation of syringe markers as a pilot study within three community pharmacy sites in Glasgow. The secondary aims of the study were to identify whether the supply of syringe markers from community pharmacy needle exchanges was acceptable to IDU and if it enabled them to mark their syringes. The literature review demonstrates that providing a means of identification of personal injecting equipment has been proposed as a viable option that should be promoted to prevent the inadvertent accidental sharing of syringes within a group setting. Needle exchanges (NEX) are important component parts of the harm reduction responses designed to reduce the physical health harms caused to individuals through injecting drug use. The literature is reviewed on BBV transmission and the historical, legal and policy context associated with the development of NEXs. Community pharmacies act as a source of health advice and can help to facilitate access to treatment services for those attending the NEX. However the specific aim of this study is not to investigate the totality of the benefits of a NEX but to examine the supply of a potential means of reducing accidental and unintentional sharing of all injecting equipment and thereby contribute to minimising some of the health harms linked to injecting drug use. Three established community pharmacies were identified as suitable sites to pilot the supply of syringe markers. A number of criteria were used to select the sites. These included an assessment of the geographic locations, staffing arrangements, NEX attendances and transactional activity and the availability of private consultation facilities. The health board central database which holds records on a range of factors including, the characteristics of those who attend NEX and detailed information on all transactions, was used to identify the most suitable sites to pilot the new intervention. This indicated that the characteristics of those who attended the three chosen sites were broadly similar to the wider NEX attending population. The evaluation was conducted in two separate periods. The first 4 week period was the supply phase where markers were distributed over this period to all patients receiving NEX packs from the 3 pharmacies. The second data collection phase was undertaken in the following 4 week period. Data was collected by means of a structured questionnaire. In order to reduce the potential interviewer bias it was decided to incorporate the use of peer researchers in the administration of the questionnaire. The Scottish Drugs Forum (SDF) was approached and agreement was reached to use members of the Service User Involvement Group (SUIG) to assist with the design and administration of the questionnaire. A submission was made to the health board Research Ethics Committee (REC) and approval was given to enable the study and the research evaluation to proceed. Before the start of the study, joint briefing and training sessions were held for pharmacy staff from the 3 sites and the 6 participating SUIG members. A total of 177 questionnaires were completed during the second data collection phase of the evaluation. Information was collected on personal details and injecting behaviours (including deliberate and accidental sharing), any current means of syringe identification, use of the markers and on the usefulness of the instruction card. Most individuals (75%, n=132) had been supplied with the markers to trial during the first supply phase of the study with 63% of the 132 (n=83) of those individuals reporting use of the markers. The results of the evaluation and subsequent analysis of the findings indicated that the syringe marker supply could be successfully implemented using pharmacy NEXs. The product and the supply method were acceptable to both staff and service users. Initial bivariate analysis was conducted using a number of dependent and independent variables identified within the questionnaire. These findings highlighted a number of areas worthy of further exploration, including emerging differences between male and female respondents, and indicated specific target groups for future developments in syringe identification. The contribution of the peer researchers was found to be a significant factor in successfully completing the evaluation. However it is not possible to make any definitive statements on how effective the intervention is in terms of reducing the transmission of BBVs and other related infections. The findings of the evaluation indicated a number of potential areas of work that could be usefully explored to investigate the effectiveness of the markers in reducing the transmission of infections. The limitations of the evaluation became apparent during the course of the study and the implications of these limitations are discussed.
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Södergård, Björn. "Adherence and Readiness to Antiretroviral Treatment." Doctoral thesis, Uppsala University, Department of Pharmacy, 2006. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-7282.

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Antiretroviral therapy places extraordinarily high demands on adherence, since non-adherence affects both individuals and society due to the spread of resistant viral strains. The aims of the thesis were to investigate the prevalence of adherence in Swedish HIV-infected patients, changes in adherence over time, and factors associated with adherence, including patients’ readiness to adhere. Further, to investigate the collaboration between nurses, doctors and pharmacists after the introduction of a HIV-clinic satellite pharmacy. Data were collected via two cross-sectional patient surveys in 1998 and 2002, qualitative interviews with health care personnel at a major HIV clinic, and a nation-wide, cross-sectional patient survey in 2003-2004.

The level of adherence improved from 28% in 1998 to 57% in 2002, possibly due to simplified treatment and a new multi-professional treatment model at the clinic. The proportion of adherent patients was 63% in the nationwide survey. Factors associated with adherence were high age, high quality patient-provider relationships, no drug or alcohol problems and shorter time on treatment.

A hypothesized structural equational model, using readiness and adherence as separate latent concepts, was tested and found to support readiness as a distinct factor influencing adherence.

The health care personnel believed that conventional pharmacies had several disadvantages in serving the HIV infected population. They found the HIV-clinic satellite pharmacy valuable, since it contributed to increased communication and trust between the health care professions, and improved teamwork in medication management.

In conclusion, the level of adherence increased over time, and several factors associated with adherence were identified. Improved collaboration between health care professionals may enhance treatment support, and increased attention should be given to interventions that focus on the individual’s readiness for behavioural change in order to optimize treatment outcomes.

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Allan, Lucie. "Competing interests and change within the pharmacy education system in South Africa." Thesis, Rhodes University, 2006. http://hdl.handle.net/10962/d1003219.

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This thesis provides a historical account of the emergence of the pharmacy education system in South Africa, and an analysis of the influence of competing interest groups over the pharmacy education curriculum. It provides a critical evaluation of structural-consensus and micro-interpretive approaches to medical and pharmacy education, and sets out a macrointerpretive account of pharmacy education in South Africa. Following Margaret Archer (1979) it analyzes three forms of negotiation between competing interest groups in their efforts to change the pharmacy curriculum; these are political manipulation, external transaction and internal initiation. The thesis argues that whilst the private sector interest group (comprising of retail, wholesale and manufacturing pharmacy) dominated the pharmacy education system until 1994, since then a newly emerged government interest group has begun to compete for educational control. The priorities pursued by this interest group have consistently reflected the objectives set out in the ANC National Health Plan of 1994. The thesis maintains that given its frustration over the non-implementation of the ANC’s health policy objectives, the government interest group is likely to resort to direct political manipulation by passing legislation to alter the content of the current pharmacy curriculum. Such changes would seek to ensure that the syllabus more accurately reflects the ANC Plan’s community health and primary health care objectives. The thesis asserts that such an outcome (of direct political manipulation of the curriculum) is not inevitable, and can be avoided through a process of internally initiated change. It presents the findings of an interpretive case study into how the Rhodes University Community Experience Programme (CEP) influenced final year pharmacy students’ perceptions of the role of the pharmacist. The students’ comments were collected by means of focus group interviews, participant observation and documentary analysis. Whilst the CEP did not successfully transform their concept of the pharmacist’s role, it did succeed in influencing students’ understanding of the notions of community pharmacy and primary health care in line with the government interest group’s health objectives. This thesis concludes that internally initiated change within the pharmacy education system, would be preferable to that imposed through external political manipulation, as such change would be more likely to preserve the independent professional interests of pharmacy academics.
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Hattingh, Hendrika Laetitia. "An Investigation of Community Pharmacy Risk Management Regulation and Practices in the Context of an Expanding Role." Thesis, Griffith University, 2008. http://hdl.handle.net/10072/366632.

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The practice of pharmacy has changed over recent years with a greater emphasis on the patient and the provision of patient care services. This expanded role of pharmacists as medication managers impacts on their responsibility and potential legal liability. However, there is a dearth of information about the effectiveness of the regulation of community pharmacy practice and it is not known to what extent regulatory requirements support the changed role. Additionally, limited information is available with regard to risk management practices in community pharmacy in the context of this expanding role. This exploratory study hence examined risk management regulation and practices in community pharmacy. The type and extent of potential liability was informed by officially recognised and endorsed professional practice standards and national and international case law. However, case law regarding the professional liability in civil actions of pharmacists is limited. Therefore, judicial decisions and legal principles generated through litigation involving other health professions provided the basis for extrapolating common principles that could be used to determine pharmacists’ potential liability. Qualitative methodology was used and various methods of data gathering were employed to provide in-depth information about pharmacy regulation and risk management. The methods chosen provided information about the extent to which endorsed practice standards were applied in disciplinary proceedings by the Pharmacists Board of Queensland in cases of professional misconduct; the utilisation of practice standards by community pharmacists and the risk management procedures implemented by them; and the diversity of pharmacy practice regulatory requirements throughout Australian jurisdictions. The analysis performed as part of the study provided information about the types of errors that lead to disciplinary action and insight into the factors underpinning the decisions of the Pharmacists Board of Queensland in making determinations and formulating outcomes. The findings of interviews with community pharmacists demonstrated a need for them to increase their knowledge of the essential processes involved in practice services to improve risk management and ensure the provision of safe patient care services. Legislative inconsistencies between states and territories that directly impact on risk management in pharmacy practice were also highlighted, indicating a need for the harmonisation of regulation. The study highlighted the need to improve risk management regulation and practices in community pharmacy in the context of expanding services. The initial base of evidence suggests implications for regulatory authorities, pharmacy professional organisations and individual practitioners, which are outlined in the final chapter.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Pharmacy
Griffith Health
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31

Serhal, Sarah. "Building A Sustainable Future For Asthma Health Services In Community Pharmacy Practice - An Implementation Science Approach." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29939.

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Innovative ways to engage patients in their asthma care are warranted to alleviate the burden of disease, as approximately 50% of people with asthma remain poorly controlled within the community. There is opportunity for pharmacists to add value to the care of asthma patients offered by general practitioners (GPs) and help mitigate current and future predicted asthma risk. Building on lessons learnt from evidence-based community pharmacy asthma management models, a streamlined and technology supported Pharmacy Asthma Service was developed to promote the integration of the service into routine practice, which up until now has not been achieved in Australia. Grounded in implementation science theory, this body of research used The Conceptual Model of Implementation Research to guide an exploration of the design, implementation and evaluation of the pharmacist-led novel health service in Australian community pharmacy practice. The investigation used both quantitative and qualitative research methods to discuss the efficacy and suitability of the service and discusses challenges and facilitators to the routine implementation of the service in community pharmacy practice.
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Chuc, Nguyen Thi Kim. "Towards good pharmacy practice in Hanoi : a multi-intervention study in private sector /." Stockholm, 2002. http://diss.kib.ki.se/2002/91-7349-316-3.

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Lakhani, Neena. "An exploration of factors affecting the use of community pharmacy services by South Asians in Leicester." Thesis, De Montfort University, 2012. http://hdl.handle.net/2086/9880.

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Understanding the philosophy of a different culture and integrating this understanding into the provision of pharmaceutical care is challenging and complex. This thesis argues the importance for community pharmacists to acknowledge that culture, religion, family and community dynamics can impact on patients' health, health seeking behaviour and medicines adherence. The perceptions of members of the South Asian population, general practitioners, and community pharmacists about how these factors are viewed in relation to community pharmacy services were explored in this study. It was conducted in Leicester City, which has a South Asian minority ethnic population of more than 25%. Participants' views of the role of extended community pharmacy services in the wider government agenda were explored. South Asians attitudes to healthcare, self care and the management of minor ailments were discussed. A qualitative methodology approach was adopted, which used constructivist and interpretive principles. Data collection for the study was conducted in two phases. In Phase 1, one to one semi-structured interviews were conducted separately with six local GPs and five community pharmacists from both 'white' (European) and South Asian backgrounds. In Phase 2, six gender specific focus groups were convened comprising of fifty five participants in total from the Sikh, Moslem and Hindu communities. Bi-lingual community workers were used in this study which allowed a more 'sensitive' exploration of the sociological aspects of health seeking behaviour and the impact of 'cultural' influences on medicines adherence. The need for 'cultural competence' of community pharmacists is discussed as one of the major contributions to the evidence base for pharmacy practice. Such initiatives would require pharmacists to acquire more effective consultation skills in the first instance. South Asians expressed views that community pharmacists need to be more knowledgeable, responsive and flexible in their professional practice by assessing their pharmaceutical needs and being aware of particular cultural sensitivities when planning their services in line with the new pharmaceutical contract. More specifically, South Asian participants illustrated the need for community pharmacists and their staff to be more 'culturally knowledgeable' about the communities in which they practice. It is argued that the provision of a more culturally sensitive and pro-active service is needed to develop a better patient-practitioner professional relationship that promotes trust. South Asians illustrated how certain behavioural, religious and cultural beliefs impact on medicines adherence, such as compliance issues whilst on holiday to their homeland, the impact of religious pilgrimage and fasts. Many South Asian participants had limited understanding about 'generic' medicines and considered these to be 'inferior' or 'less effective' than 'branded' medication. Participants' views of 'sharing' of medicines and medicines waste were also illustrated. Factors such as 'stress', 'fate' and 'karma' and their impact on health of the participants were discussed. Many of these factors could not be solely attributable to a South Asian 'culture'. However, the findings illustrate a need for a Medicines Use Review (MUR) service to include more 'targeted' exploration of medicines adherence and medicines optimisation for this population. The findings also highlighted why South Asians rarely consult the community pharmacist about sensitive or stigmatised issues such as depression, and how some conditions and symptoms were perceived to have negative impact on the 'social acceptance' of South Asian individuals within their own communities. South Asians suggested that community pharmacists needed to be more pro-active and 'responsive' to their pharmaceutical needs and respect confidentiality through use of private consultation areas for routine counselling, health promotion and medicines information. All participants endorsed a need for more 'professional' recognition of the pharmacist not only as an autonomous health care professional, but as one integral to providing NHS services relating to medicines and public health. The findings illustrated a lack of professional collaboration between community pharmacists and GPs, confounded by community pharmacists being 'subordinate' to GPs and portraying more of a 'shopkeeper' image. South Asians were well informed about the lack of shared medical records and relied heavily on a doctor's definitive 'diagnosis' for somatic symptoms related common ailments. South Asians pro-actively engaged with 'community action' based approaches in health education and health promotion, and an opportunity for community pharmacists to become more involved with social initiatives was inferred from the findings. Candid and animated discussions explored their understanding of exercise as part of weight management and their interpretation of effects of the use of herbal products, alternative practitioners and the importance of collaboration with religious and community leaders in promoting medicines adherence. Participants desired alternative communication methods other than leaflets (translated or otherwise), including the use of audio-visual means and use of media. Communication difficulties were still prevalent, and trained interpreters were rarely used. By embracing some of these challenges, community pharmacists could enhance the value of their services and provide a more meaningful, 'culturally' competent and responsive services based on the needs of their local populations and nurture a better trusting and professional relationship with their service users and healthcare colleagues.
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Wibowo, Yosi Irawati. "A model of community pharmacy-based services for type 2 diabetes patients in the Indonesian setting." Thesis, Curtin University, 2014. http://hdl.handle.net/20.500.11937/878.

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This study analysed pharmacy-based services for type 2 diabetes patients in Surabaya, Indonesia, including: current practice, views on pharmacists’ roles, and factors influencing the practice development. Currently basic pharmacy services are provided but hampered by lack of pharmacist availability, remuneration, and other supporting resources (such as IT systems, appropriate training and standards/procedures). An Indonesian model of diabetes care in community pharmacies was developed for testing in the context of the new Indonesian health system.
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Clayton-Smith, Bevan, and n/a. "He ratonga hauora Maori me nga ratonga rarau rongoa o Aotearoa e tirohanga, he tataritanga i nga mohio o tenei wa, i nga tumanako me etahi huarahi atu = Maori health providers and pharmacy services in New Zealand : a survey and analysis of current awareness, expectations and options." University of Otago. School of Pharmacy, 2005. http://adt.otago.ac.nz./public/adt-NZDU20070501.142338.

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This research aims to assess the existing relationship and characteristics between Maori health providers (MHPs) and pharmacy services in New Zealand and to provide future direction, pathways and strategies for collaboration, planning and improving health outcomes for Maori within the primary health care environment. The characteristics of the relationship were identified and discussed before exploring strategies to strengthen the relationship and to improve Māori health outcomes. The assessment and analysis of the characteristics required an exploration of MHPs current knowledge of pharmacy services, the expectations of MHPs of pharmacy services and the current knowledge of pharmacists of MHP services and Maori health. Themes identified that characterised the relationship were related to knowledge, health philosophies, interaction, service and capacity issues. Knowledge issues incorporated themes of group dynamics, historical context, participant knowledge, pharmacy participant knowledge, MHP participant knowledge, solutions/ outcome knowledge, consideration of Maori. Health philosophies related to themes of paradigms/worldviews, kaupapa Maori, capacity, culture and delivery of services, Treaty of Waitangi, knowledge of culture, communication and te reo, rongoa Maori, environmental culture, access, tino rangatiratanga. Interaction issues discussed the themes of collaboration and communication, extent of collaboration, contact with Maori, community relationships, cost, benefits and opportunities. The pharmacy environment, cost and health service delivery were identified as themes relating to service issues. Capacity issues included themes of mana, direct workforce development (education, employment, promotion), indirect workforce development (education, environment, relationship building, funding), and the Maori Pharmacists Association. This research attempted to follow kaupapa Maori qualitative research methodology, methods and the epistemology of kaupapa Maori throughout the research and design process. One to one semi-structured interviews were conducted with participants from each group. The sample size was established based on the purposeful sampling strategy of maximum variation sampling (7 MHP participants, 8 pharmacy participants. Responses were directly related to differences in world-views and the historical context of the two health provider groups with respect to their roles in health. Variations within each group were related to knowledge, location and previous experience working with their counterparts. Recommendations were associated with themes/issues of environment, knowledge, communication, cultural awareness, collaboration, services and the increased awareness of the roles and responsibilities with respect to each health provider group. This dissertation also highlighted a number of key components that formed a collaborative, empowerment model of health created between organisations with different world-views, which can be adapted to a number of environments where there are different or opposing world-views within the overall same patient population. It is anticipated that the results and outcomes from this research will help develop Maori responsive pharmacy services based on health promotion and wellness to Maori locally, regionally, nationally and have a positive impact on Maori health in collaboration with MHPs. Areas of pharmaceutical care are highlighted which may encourage projects or initiatives in collaboration with MHPs to enhance health gains for Maori, while increasing professional practice roles and scope for pharmacy.
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Hagemeier, Nicholas E., Sarah Blevins, Kyle Hagen, Emily Sorah, Richa Shah, and Kelly Ferris. "Integration of Rural Community Pharmacies into a Rural Family Medicine Practice-Based Research Network: A Descriptive Analysis." Digital Commons @ East Tennessee State University, 2015. https://dc.etsu.edu/etsu-works/1476.

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Purpose: Practice-based research networks (PBRN) seek to shorten the gap between research and application in primary patient care settings. Inclusion of community pharmacies in primary care PBRNs is relatively unexplored. Such a PBRN model could improve care coordination and community-based research, especially in rural and underserved areas. The objectives of this study were to: 1) evaluate rural Appalachian community pharmacy key informants’ perceptions of PBRNs and practice-based research; 2) explore key informants’ perceptions of perceived applicability of practice-based research domains; and 3) explore pharmacy key informant interest in PBRN participation. Methods: The sample consisted of community pharmacies within city limits of all Appalachian Research Network (AppNET) PBRN communities in South Central Appalachia. A descriptive, cross-sectional, questionnaire-based study was conducted from November 2013 to February 2014. Bivariate and multivariate analyses were conducted to examine associations between key informant and practice characteristics, and PBRN interest and perceptions. Findings: A 47.8% response rate was obtained. Most key informants (88%) were very or somewhat interested in participating in AppNET. Enrichment of patient care (82.8%), improved relationships with providers in the community (75.9%), and professional development opportunities (69.0%) were perceived by more than two-thirds of respondents to be very beneficial outcomes of PBRN participation. Respondents ranked time constraints (63%) and workflow disruptions (20%) as the biggest barriers to PBRN participation. Conclusion: Key informants in rural Appalachian community pharmacies indicated interest in PBRN participation. Integration of community pharmacies into existing rural PBRNs could advance community level care coordination and promote improved health outcomes in rural and underserved areas. Type: Original Research
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Hanes, Carissa Ann. "The provision of obstructive sleep apnea services in community pharmacies and development of professional practice guidelines." Thesis, The University of Sydney, 2015. http://hdl.handle.net/2123/13870.

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Obstructive sleep apnea (OSA) is a prevalent disorder that poses a substantial public health burden. The supply of the mainstay treatment, continuous positive airway pressure (CPAP), is unregulated in Australia and a variety of publicly accessible provider venues exist. Certain pharmacies have undertaken a role in providing CPAP and related services, but there is scarce evidence describing their scope and a lack of pharmacy-specific professional guidelines to direct practice. Studies were conducted to examine and describe OSA service provision in pharmacies. Findings revealed non-uniformity in service range and quality, and highlighted areas for practice improvement. Pharmacist roles in this novel service area were also characterised and practitioner needs assessed. Based on preliminary study findings, a project to develop professional practice guidelines in an effort to standardise care and define best practice was undertaken. A 3-phase project involving broad stakeholder consultation culminated in the formation of 51 consensus-defined criteria that formed the basis for a comprehensive model of care. This model of care was presented to pharmacy and sleep medicine peak bodies and subsequently translated into practice guidelines for dissemination to the pharmacy profession. This research highlights the contribution that pharmacists can make to the management of OSA as part of a multidisciplinary team. Consensus-defined best practice guidelines may promote medically and ethically appropriate, patient-centred care.
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Notman, Frances. "Investigating patients' experience and self-management of early cancer symptoms prior to their cancer diagnosis in order to identify the role of community pharmacy in earlier diagnosis." Thesis, University of Aberdeen, 2016. http://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=231748.

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Wallman, Andy. "Pharmacy Internship : Students’ Learning in a Professional Practice Setting." Doctoral thesis, Uppsala universitet, Institutionen för farmaci, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-112771.

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The aim of this thesis was to explore Swedish pharmacist students’ learning during pharmacy internship. Internships are meant to introduce students to professional practice. Education programs have to reflect changes in the professional role, and take into account that learning in a professional practice setting differs from organized formal education. This thesis includes both quantitative and qualitative research approaches and applies workplace learning theories. A scheme for measuring pharmacy students’ reflective ability was developed and shown to be feasible and reliable. Factors important for reflection were found to be primarily social and contextual, especially trained tutor and small pharmacy size. Notably, learning style or critical thinking did not correlate to students’ reflective ability. Tutors and students perceived that students used a wide variety of activities supporting learning of a broad repertoire of knowledge and skills, preparing them for coming professional working life. Tutors are most important to support learning. However, the current curriculum and formal activities do not address all these outcomes and learning activities used, e.g. workplace learning. The first overall conclusion is that internship plays an essential part in the pharmacist education program. The integration of formal and informal learning activities during internship, including raising awareness of incidental learning, is important to support students in learning the professional practice of pharmacy. This integration could possibly be strengthened by introducing further tutor training, different assignments, and by using portfolios. The second conclusion is that the community of practice is essential for students’ learning during internship, especially the student-tutor interaction. Hence, the entire social context has to be considered and it is important to ensure a good learning environment at pharmacies during internship. In summary, this thesis contributes to the understanding of students’ learning during pharmacy internship and introduces educational research on the Swedish undergraduate pharmacy education programs.
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Chinthammit, Chanadda. "A Single-Blind, Randomized, Controlled study of Efficacy and Effectiveness of Pharmacy Quality Improvement." Thesis, The University of Arizona, 2014. http://hdl.handle.net/10150/323441.

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Background: The Alliance for Patient Medication Safety (APMS) helps community pharmacies comply with continuous quality improvement requirements of many states and third party payment contracts through use of their Pharmacy Quality Commitment (PQC) program. Aims: To assess changes in the incidence of prescription Quality Related Events (QREs) and adoption of patient safety culture attitudes after guided PQC implementation. Methods: Twenty-one pharmacies were randomized to standard PQC practices (control) or guided PQC implementation (treatment). Pharmacy staff completed retrospective pre and post safety culture questionnaires. Negative binomial mixed and linear regression analyses were employed to examine changes in QREs rates and attitudes, respectively. Rasch analysis was used to assess questionnaire validity and reliability. Results: During the 2-month study period 3,343 QREs were reported to the online PQC system. At baseline, no difference in the average QRE reporting rate was identified between groups. Treatment group QRE reporting rates differed in one category post treatment (more incorrect safety caps QREs reported in treatment group, p<0.034). Seventy-one employees completed the questionnaire (70% response). Attitude improvement in the treatment group was 36% greater than in control (p<0.0001). The questionnaire demonstrated acceptable reliability and validity evidence. Conclusions: Guided PQC implementation increased reporting of certain QREs and increased the adoption of patient safety culture attitudes among staff pharmacy.
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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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42

Krigsman, Kristin. "Refill Adherence to Long-Term Drug Treatment with a Focus on Asthma/COPD Medication." Doctoral thesis, Uppsala University, Department of Pharmacy, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8094.

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Most patients are non-adherent with their medication sometimes, i.e. that they do not always use their medicines as prescribed. This might result in both under- and overuse and can lead to therapy failure, resulting in both unnecessary suffering and high costs. Therefore, medication adherence should be as high as possible.

The aims of this thesis were to investigate the refill adherence to long-term drug treatment, especially for patients with asthma and chronic obstructive pulmonary disease (COPD), and to study treatment gaps for patients with undersupply and drug costs for patients with oversupply. Further aims were to compare different methods for assessing refill adherence and analyse whether the same patient has the same refill adherence pattern to two different chronic drug treatments, i.e. diabetes and asthma/COPD.

The thesis shows that satisfactory refill adherence (80-120% of the prescribed dose) was 57% for repeat prescriptions with long-term drug treatment; undersupply was 21% and oversupply 22%. Patients with undersupply were without drugs more than half of the prescribed treatment time and the median oversupply for 90-100 days dispensation interval was 28 days. Patients who were exempt from charges had significantly higher oversupply than non-exempt patients and that leads to unnecessary cost for society. The level of satisfactory refill adherence for repeat prescriptions dispensed for asthma/COPD was on average 30%. The same low level was displayed for the elderly, where undersupply was more common than oversupply.

Assessments of refill adherence during a one-year period gave the same results irrespective of whether the repeat prescriptions were from an individual pharmacy record database or were manually collected at a pharmacy.

Patients with concomitant use of diabetes and asthma/COPD drugs do not have the same dispensation pattern for both drug types.

The introduction of patient profiles as a new approach to complement the calculated refill adherence needs to be further studied in larger and more divergent populations. In the future, the new national pharmacy record database in Sweden has opened up for larger studies and will be valuable when studying patterns of drug utilization.

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43

Ching, Diana K. "Factors that Explain and Predict Community Pharmacists' Provision of Smoking Cessation Services: An Application of the Integrated Behavioral Model." University of Toledo Health Science Campus / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=mco155681784242428.

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44

Smith, Robert Mark Houston. "South African community pharmacists’ self-perception of their professional identity and job satisfaction." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/20637.

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The role of the community pharmacist has changed over the past two decades. The traditional specialist roles of pharmacists, such as compounding and preparation of medications, are now infrequent activities and the profession has moved to a more patient-centred focus. Furthermore, pharmaceutical care has been developed and adopted as a practice philosophy to add value and bring care for patients back into the profession. However, there is still much debate in academic and policy literature concerning the reluctance of community pharmacists to adopt and implement pharmaceutical care in practice environments. Empirical evidence has suggested that the professional identity of pharmacists is both ambiguous and multifaceted. However, the practice of pharmaceutical care has been demonstrated to increase organisational identity of pharmacists, as well as their job satisfaction. In addition, pharmacists in a clinical role have been shown to have higher levels of job satisfaction than their counterparts in nonclinical roles. This study has identified, described and analysed the self-perceived professional identities of community pharmacists within a South African context. Furthermore, it sought to determine their current levels of job satisfaction. The relationships between professional identity, job satisfaction and role were analysed in an attempt to understand the influence of professional identity on job satisfaction and behaviour of pharmacists. This study made use of a mixed method of inquiry, online questionnaire, administered to a large sample, which allowed the researcher to take a broad view of the research foci at a specific moment in time. This study found the existence of six professional identities amongst South African Community Pharmacists; namely the practitioner, the jaded pharmacist, the social carer, the professional, the medicine supplier and the entrepreneur. South African community pharmacists were, generally, satisfied with their jobs, professed to practice pharmaceutical care and adopted it as a practice philosophy. South African Community pharmacists were, in general, committed to their profession. Correlation between a pharmacist’s professional identity and their job title, job satisfaction and their commitment were found to be statistically significant. A pharmacist’s level of job satisfaction was statistically correlated to their practice of pharmaceutical care. No statistically significant relationship was found to exist between a pharmacist’s identity and their work load or tasks performed. Characterising South African community pharmacists’ identities is of great significance in an effort to better understand the forces that drive our profession of pharmacy. In doing so, have found that identity affects many elements of work life such as job satisfaction, professional commitment and the practice of patient care.
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45

Paudyal, Vibhu. "An exploration of Scottish community pharmacists' adoption of innovative services and products relating to minor ailment management." Thesis, Robert Gordon University, 2011. http://hdl.handle.net/10059/664.

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This research utilised mixed methodology to gain insight into community pharmacists’ adoption of medicines and services related to two key innovative policy interventions aimed at enhanced minor ailment management; namely the ongoing legal status reclassification of medicines; and the introduction of the Scottish Minor Ailment Service. Prompted by the lack of qualitative and large scale quantitative evaluation from the pharmacists’ perspective, the aim was to investigate pharmacists’ adoption of these innovations. Data were generated to evaluate the process related aspects of innovation adoption from community pharmacists’ perspectives; and to identify and quantify key factors associated with the adoption of these innovations, thereby considering the wider relevance to new community pharmacy services. A range of methods was used including: formal systematic review of peer reviewed published literature on factors associated with innovation adoption following methods recommended by the Centre for Reviews and Dissemination at the University of York; extensive review of policy documents of all the devolved UK Governments; qualitative focus groups and interviews with 20 community pharmacists from four Scottish Health Boards; and lastly a cross sectional survey of the pharmacists responsible for nonprescription medicines from all Scottish community pharmacies (N=1138). The theoretical framework of diffusion of innovations was adopted to design the quantitative research instrument and interpret the data. Rigour was enhanced by consideration of aspects of validity and reliability at all stages. The highest standards of research governance and ethics were applied throughout the study. Qualitative interviews provided insight into the process related aspects of innovation adoption. Where current changes were embraced reluctantly by many who deemed the pace as fast and furious, others were keen to contribute to developments taking place within pharmacy and were eager to play a more proactive role in leading and introducing change to the public. Regardless of practice setting and ownership model, the merits of each innovation appeared to be considered at the individual practitioner level. Hence an organisational level decision to implement an innovation did not necessarily translate to adoption at the individual practitioner level. Using descriptive, bivariate and multivariate quantitative models informed by the results of the qualitative interviews and systematic review of the literature, the quantitative study showed pharmacists’ perceived attributes of innovations (such as benefits to their professional role development and patients); and patient demand and use of services had the highest association with whether or how far innovations were adopted. Issues such as differences in availability of resources were less able to explain differing level of innovation adoption by the pharmacist respondents. These findings suggest that as innovations around minor ailment management have not yet required reorientation of existing services, the issue of how pharmacists’ perceive the characteristics of the innovations such as: potential for financial benefits to pharmacy, professional role development and patients; is key to predicting whether future innovations of a similar nature will be successfully adopted by pharmacists.
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46

Ward, Kim Lana. "Expanding presumptive male partner management of sexually transmitted infections (STIs) to Western Cape, South African community retail pharmacies." Thesis, University of the Western Cape, 2007. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_2411_1257329598.

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The effect of industrialisation has thrust the pharmaceutical profession into a clinical paradigm where the approcah to pharmaceutical decisions is more disease and patient orientated. Consequently, South African community pharmacies are inundated with requests from the public for advice and treatment on a wide range of medical conditions, including sexually transmitted infections (STI's). Although community pharmacies are often the first port of call for undiagnosed STI, limited diagnostic skills and legally-imposed prescribing restrictions preclude pharmacists from providing the necessary clinical management. The overarching goal of this dissertation was to present objective arguments and evidences (new and existing) around an expanded role for pharmacists in STI partner management.

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47

Brito, Giselle de Carvalho. "Serviços clínicos farmacêuticos em unidades do programa Farmácia Popular do Brasil do estado de Sergipe: implantação, implementação e consolidação." Universidade Federal de Sergipe, 2015. https://ri.ufs.br/handle/riufs/3592.

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Objective: To establishing, implement and consolidate clinical pharmacy services in units of Farmácia Popular do Brasil program in state of Sergipe. Methods: Initially, systematic review was performed in the databases PubMed, Scopus, EMBASE using the key words "community pharmacy services", "quality assurance health care", "outcome assessment". A longitudinal study of three units of the Farmácia Popular do Brasil in the state of Sergipe on the establishment was carried out (2012), implementation (2013) and consolidation of clinical pharmacy services (2014). The structure of pharmacies was evaluated for physical structure, through the RDC 44/2009, and human resources, the technique of simulated patient. Then three focus groups were conducted (2012, 2013 and 2014) for the perceptions of pharmacists. Finally, we used the coaching technique for establishment, implementation and consolidation of services: dispensing, measurement of blood pressure and blood capillary glucose, medication review and medication therapy management. Results: In the systematic review 42 articles met the inclusion criteria. It was observed that the most valued results were glycosylated hemoglobin (clinical), quality of life (humanistic) and analysis of the cost-effectiveness of the service relationship (economic). In assessing the structure, interventions enabled improvements on all items that were considered non-compliant. However, the overall impression of the pharmaceutical skills for clinical services was considered regular (3) on a scale from 1 to 5. Regarding the focus groups, pharmacists reported expectations in technical support to develop skills, gain knowledge and have a constant monitoring of the researchers, also identified 13 types of barriers. Finally, was designed 520 hours of coaching in place to implement flows and processes, development of standard operating procedures and preparation of strategic plans. In the education training, pharmacists underwent 176 hours of theoretical and practical training and employees to 24h. After the coaching interventions the numbers of services were expanded: there was 767 dispensations in 2012, 1444 in 2013 and 2537 in 2014; 714 measurements of blood pressure and blood capillary glucose in 2012, 2375 in 2013 and 5039 to 2014; 49 consultations of medication review in 2012, 87 in 2013 and 355 in 2014; 15 consultations of medication therapy management in 2012, 33 in 2013 and 271 in 2014. Conclusion: From the good situational diagnosis, the coaching can be considered a technique that assists in establishment, implementation and consolidation of clinical pharmacy services. Combined with a professional training, it allows the individual follow-up in steps as: definition of services and processes, selection of indicators for the assessment and development of strategic plans. In this perspective, this results may support the construction of a differentiated and replicable model of clinical services in community pharmacies.
Objetivo: Implantar, implementar e consolidar serviços clínicos farmacêuticos em unidades do programa Farmácia Popular do Brasil do Estado de Sergipe. Métodos: Inicialmente, foi realizada revisão sistemática da literatura nas bases de dados PubMed, SCOPUS, EMBASE utilizando os descritores community pharmacy services , quality assurance health care , outcome assessment . Foi realizado um estudo longitudinal em três unidades da Farmácia Popular do Brasil do estado de Sergipe sobre a implantação (2012), implementação (2013) e consolidação dos serviços clínicos farmacêuticos (2014). Foi avaliada a estrutura das farmácias quanto à estrutura física, por meio da RDC 44/2009, e aos recursos humanos, pela técnica do paciente simulado. Em seguida, foram realizados três grupos focais (2012, 2013 e 2014) para obter as percepções dos farmacêuticos. Por fim, foi utilizada a técnica de coaching para a implantação, implementação e consolidação dos serviços de: dispensação, aferição da pressão arterial e glicemia capilar, revisão da farmacoterapia e seguimento da farmacoterapia. Resultados: Na revisão sistemática 42 artigos preencheram os critérios de inclusão. Observou-se que os resultados mais avaliados foram hemoglobina glicosilada (clínico), qualidade de vida (humanístico) e análise da relação custo-eficácia do serviço (econômico). Na avaliação da estrutura, as intervenções possibilitaram melhorias em todos os itens que foram considerados inconformes. No entanto, a impressão geral sobre as competências farmacêuticas para serviços clínicos foi considerada regular (3) numa escala de 1 a 5. Com relação aos grupos focais, os farmacêuticos relataram expectativas quanto ter suporte técnico para desenvolver habilidades, adquirir conhecimentos e ter um acompanhamento constante dos pesquisadores, além disso, identificaram 13 tipos de barreiras. Por fim, foram destinadas 520 horas de coaching in loco para implantação de fluxos e processos, elaboração de procedimentos operacionais padrão e elaboração de planos estratégicos situacionais. Na etapa de treinamento, os farmacêuticos foram submetidos a 176h de treinamento teórico-prático e os colaboradores a 24h. Após as intervenções do coaching os números dos serviços foram ampliados: obteve-se 767 atendimentos de dispensação em 2012, 1444 em 2013 e 2537 em 2014; 714 aferições da pressão arterial e glicemia capilar em 2012, 2375 em 2013 e 5039 em 2014; 49 consultas da revisão da farmacoterapia em 2012, 87 em 2013 e 355 em 2014; 15 consultas de seguimento da farmacoterapia em 2012, 33 em 2013 e 271 em 2014. Conclusão:. A partir de um bom diagnóstico situacional o coaching pode ser considerado uma técnica que auxilia nas etapas de implantação, implementação e consolidação de serviços clínicos farmacêuticos. Aliado a um treinanamento profissional, ele permite o acompanhamento individualizado em etapas como: definição dos serviços e processos, seleção de indicadores para a avaliação e elaboração de planos estratégicos situacionais. Nesta perspectiva, os resultados observados poderão embasar a construção de um modelo diferenciado e replicável de serviços clínicos farmacêuticos em farmácias comunitárias.
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48

Stöger, Ulrika. "Kommunala sjuksköterskors kontakt med apoteken : en tids- och enkätstudie bland Kalmar kommuns sjuksköterskor." Thesis, University of Kalmar, School of Pure and Applied Natural Sciences, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:hik:diva-1473.

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Syftet med denna studie är dels att undersöka hur stor andel av arbetstiden som sjuksköterskor, inom kommunala hälso- och sjukvården i Kalmar kommun, använder för kontakt med apoteken, dels att belysa hur sjuksköterskorna ser på kontakten med apoteken med avseende på dess omfattning och innehåll.

Kalmars kommunala sjuksköterskor förde under en vecka i februari 2009 tidsdagbok över sin apotekskontakt. I anslutning till detta utfördes även en enkätundersökning bland dessa sjuksköterskor.

Svarsfrekvensen var låg; 43 % av sjuksköterskorna deltog i enkätstudien och endast 19 % deltog i tidsstudien. Den genomsnittliga andelen arbetstid som ägnades åt apotekskontakt fastställdes till 4,6 ± 3,9 %. Enkätstudien visade på en del önskemål om förändring i såväl kontakten med apoteken som i de kommunala rutinerna. Förslag som lades fram av sjuksköterskorna för en minskning av kontakttiden med apoteken var bland annat att annan personal inom hälso- och sjukvården eller anhöriga till patienten gör apoteksärenden i stället för sjuksköterskorna, samt att apoteken ska införa en särskild kö för vårdpersonal och därmed minska kötiden.

Den låga svarsfrekvensen gör att inga statistiskt signifikanta slutsatser kan dras av studien och då i synnerhet inte av tidsstudien. Studien visar dock på stora variationer sjuksköterskorna emellan, i andel arbetstid som ägnas åt apotekskontakt. Validiteten och precisionen för denna variation är ej hög, delvis på grund av det låga deltagandet. Enkätundersökningen visade på problem som kan härröras till brist i kommunikationen mellan såväl sjuksköterskor och övrig hälso- och sjukvårdspersonal, som mellan sjuksköterskor och apotekspersonal. En förbättrad interprofessionell kommunikation skulle eventuellt kunna lösa denna problematik.

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49

Bardet, Jean-Didier. "Les pratiques pharmaceutiques collaboratives en soins de premier recours dans le contexte de l'émergence des TIC." Thesis, Université Grenoble Alpes (ComUE), 2016. http://www.theses.fr/2016GREAS027/document.

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Suite à l’analyse des causes d’iatrogénie médicamenteuse en soins ambulatoires en France, la collaboration entre professionnels de santé en soins de premiers recours, soutenue par les technologies de l’information et de communication, apparait comme un enjeu de première importance pour la sécurisation de la prise en charge des patients. L’objectif de ce travail de thèse était d’identifier les aspects de la pratique pharmaceutique officinale sur lesquels s’appuyer pour développer la collaboration entre médecins et pharmaciens d’officine en soins de premier recours et d’explorer les formes organisées d’exercice pharmaceutique collaboratif, dans le contexte du déploiement du Dossier Pharmaceutique (DP).Nous nous sommes tout d’abord intéressés au processus de développement de la collaboration entre médecins et pharmaciens d’officine. Une revue de la littérature a été conduite afin d’identifier les modèles spécifiques à cette collaboration. Aussi, 16 articles ont été inclus et ont permis d’identifier 4 modèles distincts. Leur analyse a mis en évidence que la collaboration repose sur un processus individuel sous-tendu par 2 catégories déterminants : (1) les attentes professionnelles vis-à-vis de l’autre – et par là même envers la collaboration - et l’intérêt personnel pour la pratique collaborative ; (2) la perception que le professionnel a de l’autre et l’évaluation de ses compétences.La collaboration reposant sur la reconnaissance des compétences du professionnel, la deuxième partie de ce travail a consisté à valoriser les rôles du pharmacien d’officine et du DP dans la sécurisation de la prise en charge médicamenteuse. L’étude DOPI-OFFI ainsi menée est une étude observationnelle, transversale et multicentrique portant sur les Interventions Pharmaceutiques (IP) réalisées en officine et l’apport du DP dans la sécurisation de la dispensation médicamenteuse. Un total de 243 pharmacies d’officine ont documenté 7231 IP. Le DP apparait comme un bon substitut lorsque le dossier local du patient est vierge ou incomplet et comme un outil efficace pour prévenir les divergences par rapport à l’historique médicamenteux. L’étude a également permis d’identifier le contexte associé à la formulation des IP en officine. Ainsi, il sera désormais possible de proposer des actions adéquates pour aider à l’amélioration des pratiques pharmaceutiques officinales. Enfin, l’étude a mis en évidence la communication soutenue entre pharmaciens et médecins généralistes quant aux problèmes liés aux thérapeutiques.La dynamique de collaboration repose également sur les attentes spécifiques de chaque professionnel de santé. L’objectif de la troisième partie de ce travail était de déterminer des préférences de la population générale, des médecins et des pharmaciens d’officine quant à l’offre de services pharmaceutiques et leur organisation. Pour se faire, nous avons développé un outil d’analyse de type Best-Worst Scaling. Nous avons identifié les caractéristiques clefs des services pharmaceutiques à tester à partir de 6 entretiens de recherche en groupe conduits auprès de patients, des médecins généralistes et des pharmaciens d’officine. Trois questionnaires de 20 attributs chacun ont ensuite été développés.Le développement des missions du pharmacien d’officine doit s’appuyer sur la pratique actuelle mais également sur des services pharmaceutiques ayant fait la preuve de leur efficacité et sur la légitimité du pharmacien à les proposer. Les résultats du BWS compléteront les résultats déjà établis par ce travail
With the analysis of the causes of drug-induced diseases in the French primary care, the collaboration between healthcare professionals, supported by information and communication technology, appears to be a major challenge to secure the patient’s care. The objective of this thesis was to identify the aspects of pharmacy practice on which to develop the physician – community pharmacist collaboration and to explore the organized forms of collaborative pharmacy practice in the context of the deployment of the Pharmaceutical Record (DP).First, we explored the process of the physician – community pharmacist collaboration. A literature review was conducted to identify the specific models of collaboration. A total of 16 articles were included and four different models were identified. Their analysis showed that collaboration is based on an individual process underpinned by two categories of drivers: (1) towards the other professional and the personal interest for collaborative practice; (2) the perception of the other professional and the evaluation of his skills.As the collaboration is based on the recognition of professional skills, the second part of this work was to analyze the pharmacists’ role and the impact of the DP in the safety of the dispensing. The DOPI-OFFI study is an observational, cross-sectional and multicenter study on pharmacists’ interventions (PIs) performed in the primary care and on the evaluation of the DP in the dispensing process. A total of 243 community pharmacies have documented 7231 PIs. The DP appears to be a valuable complement when the patient's local pharmacy record is blank or incomplete and as an effective tool to prevent discrepancies with the medication history. The study also identified the context associated with the PIs. Thus appropriate actions would be proposed to enhance the quality of pharmacy practices. Finally, the study demonstrated the sustained communication between general practitioners and community pharmacists about the drug-related problems.The collaborative dynamics is also based on the specific healthcare professionals’ and patients’ needs. The objective of the third part of this work was to determine the preferences of the general population, the physicians and the community pharmacists on pharmacy services and their organization. We developed a Best-Worst Scaling experiment. We identified the key characteristics of pharmacy services from 6 focus groups that were conducted with patients, general practitioners and community pharmacists. Three questionnaires, each consisting of 20 attributes, were developed.The development of the community pharmacists’ role must be based on the current practice, on pharmacy services that have demonstrated their effectiveness and on the legitimacy of the pharmacist to propose them. The results of the BWS will complement the results that were already established by this work
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50

Elhatab, Nesrin M. "The community pharmacist's role enhancing medicines management for type II diabetes in Tripoli, Libya : a randomised controlled trial in community pharmacy to investigate knowledge and practice in relation to type II diabetes and glycaemic control." Thesis, University of Bradford, 2016. http://hdl.handle.net/10454/15903.

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Aim/Objectives: There were two aims; improving type II diabetes glycaemic control; and enhancing the role of community pharmacists by engaging them in type II diabetes medicine management. Methods: This quantitative study collected data from both community pharmacists and patients. In a premises survey, 426 self-administered questionnaires were distributed to community pharmacies. In a knowledge survey, 125 questionnaires were distributed to community pharmacists. In a clinical trial, 40 community pharmacies were randomly assigned to be control (18) and intervention (22) premises. Each pharmacy recruited 4 or 5 patients with type II diabetes. 225 patients were recruited and assigned to receive usual pharmacist care (n=100) or a pre-defined pharmacist intervention (n=125). Results: Community pharmacists had good knowledge of diabetes with average scores 21/29 (±3.18). The differences between control and intervention groups in patients' HbA1c and FPG changes were not significant. In the intervention group patients' diabetes knowledge was significantly improved (p=0.031). In the intervention group HbA1c and FPG improved significantly and in the control group FPG improved significantly and HbA1c did not. Patients' self-reported self-management activities improved significantly around blood glucose measurements (p < 0.001) and physical exercising (p=0.001). Attitudes around the value of tight control of diabetes improved (p < 0.001). Conclusion: The findings suggest that community pharmacists in Libya may have the ability to improve type II diabetes care. The primary outcomes were not improved in intervention versus control. The before/after analysis showed significant improvement in primary outcomes in the intervention group and also in one of the primary outcomes in the control group. Patients' self-reported self-care activities and attitudes improved significantly in the intervention group.
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