Academic literature on the topic 'Pharmaceutical services – Scotland'

Background: The Minor Ailment Service (MAS) in Scottish community pharmacy allows eligible people to gain improved access to care by providing free treatment for self-limiting conditions. Objective: To determine the perceptions and experiences of individuals using MAS and to quantify the potential impact on usage of other healthcare services. Methods: A cross-sectional survey was conducted of patients accessing MAS across Scotland during June and July 2018. Questionnaire items included reasons for choosing treatment through MAS, which other services they may have accessed had MAS not been available, experiences of consultation, overall satisfaction, and perceived effectiveness of treatment. Those accessing MAS were given a study pack including an information sheet, pre-piloted questionnaire, and pre-paid return envelope. Participants had the option to consent to an optional one-week follow up questionnaire that focused on perceived effectiveness of treatment after seven days and any further access to healthcare services such as general practice, emergency departments or repeat pharmacy visits. Results: There were 1,121 respondents to the initial questionnaire. Most reported ‘convenient Location’ as the main reason for their access to community pharmacy (n=748; 67.1%). If MAS had not been available, 59% (n=655) of participants reported that they would have accessed general practice for treatment of their minor ailment. Experience of consultations was also rated highly with all ten outcome measures scoring ‘Excellent’ overall. Satisfaction was reported positively with most participants reporting full satisfaction with the overall experience (n=960; 87.2%). At one-week follow up, 327 participants responded, over 85% (n=281) did not require further access to care to treat their minor ailment and 99.7% (n=326) said they would use MAS again. Conclusions: Positive perceptions and experiences of those using MAS demonstrate a highly regarded service in terms of satisfaction and experience of consultation. The capacity for MAS to impact on the use of higher-cost healthcare services is evidenced through the number of participants who reported these services as a point of access to care should community pharmacy not be available. This national evaluation demonstrates MAS to be a positively experienced service and outlines the factors determining access for treatment of minor ailments.

Background: To help alleviate the global pressure on primary care, there has been an increase in the number of clinical pharmacists within primary care. Educational resources are necessary to support this workforce and their development within this role. An educational resource package was developed in Scotland to support the General Practice Clinical Pharmacists (GPCPs), containing a hard copy Competency and Capability Framework (CCF), an online platform (TURAS) and both clinical and educational supervisors in 2016. Objective: To examine the implementation of a competency-based educational resource package through the exploration of pharmacists’ perceptions of its adoption, acceptability, appropriateness, and feasibility. Methods: Participants were GPCPs who had been part of a national training event between 2016 and 2018. The participants were given the opportunity to complete an online questionnaire or a semi-structured telephone interview. Both data collection tools were based on Proctor’s model of implementation outcomes: adoption, acceptability, appropriateness and feasibility. Areas covered included GPCPs’ perceptions and level of adoption of the educational resource package developed to support them in their role. Results: Of a potential 164 participants, 52 (31.7%) completed the questionnaire and 12 (7.3%) completed the interview. GPCPs indicated widespread adoption and were accepting of the resources; however, it was suggested that its value was undermined, as it was not associated with a qualification. The appropriateness and feasibility of the resources depended on GPCPs’ individual situation (including current role, previous job experience, time available, support received from peers and supervisors, and perceptions of resources available). Conclusions: The suitability of the CCF was evidenced by participants’ adoption and acceptance of the resource, indicating the necessity of a competence-based framework to support the GPCPs’ role. However, its suitability was hindered in terms of varied perceptions of appropriateness and feasibility. Despite the limited sample size, the results indicate that the value of these resources should be promoted across primary care; nevertheless further facilitation is required to allow GPCPs to fully engage with the resources.

Abstract Introduction Efforts are increasingly being made to implement pharmacists working in General Practice to support General Practitioners and alleviate pressure, mainly by providing pharmacotherapy services such as medication reviews and authorising prescribing requests (1). While there is wide interest in the contributions pharmacists can make within primary care, there is limited research exploring the competencies pharmacists need to safely and effectively provide care in this area. Aim The aim of this project was to identify competencies required for pharmacists providing pharmacotherapy services in General Practice. Methods Modified eDelphi study (2), comprising a series of online questionnaires conducted between July 2019 and January 2020. Participants were pharmacists working in General Practice in Scotland. The first questionnaire consisted of open-ended questions aimed at generating a list of competencies; competency categories and individual competency items relating to pharmacotherapy service tasks were identified based on the free text responses using content analysis. Subsequently, the second questionnaire aimed to establish consensus regarding the importance of the collected competencies, using a rating scale from 1 (“not important”) to 10 (“very important”); participants’ scores were aggregated using modes and medians, and the level of agreement among participants with regards to the importance of competencies was evaluated by calculating the percentage of scores between 8 and 10. Due to the novelty of this work and the resultant uncertainty surrounding participants’ responses, no cut-off point for agreement was pre-specified. Results Overall, 10 pharmacists completed the first questionnaire, and 11 completed the second. Building on the findings from the first questionnaire, a framework of competencies necessary to provide pharmacotherapy services in General Practice was developed, comprising eight competency categories, with a total of 31 individual competency items: General Skills (e.g. ability to record patient information); IT Skills (e.g. ability to use GP computer system to update documentation); Legal & Professional Frameworks (e.g. understanding of clinical guidelines); Procedural Skills (e.g. ability to arrange follow-up); Multidisciplinary Team Communication Skills (e.g. ability to communicate with others within the GP practice); Consultation Skills (e.g. ability to take a complete history); Clinical Knowledge (e.g. knowledge related to conditions being treated); and Clinical Skills (e.g. ability to interpret clinical information). All eight competency categories were considered important across the pharmacotherapy service, with high agreement (between 71 and 85%) among participants. Conclusion Using a bottom-up, exploratory approach, this study confirmed that practicing within the General Practice setting requires a wide set of competencies, including – but not limited to – advanced clinical and consultation skills. Nevertheless, findings should be interpreted cautiously due to the limited sample size; although results have tentatively been validated using a paper-based version of the second online questionnaire during an in-person event with General Practice pharmacists, results might not be reflective of all pharmacists working in this setting. References (1) Scottish Government. (2017). The 2018 General Medical Services Contract in Scotland. Retrieved from https://www.glasgowlmc.co.uk/download/contract%20and%20contractural%20Issues/The-2018-General-Medical-Services-Contract-in-Scotland.pdf (2) Hsu, C. C., & Sandford, B. A. (2007). The Delphi technique: Making sense of consensus. Practical Assessment, Research & Evaluation, 12, Article10. https://doi.org/10.7275/pdz9-th90

Purpose The purpose of this paper is to examine the mental health literacy (MHL) of British community pharmacists. Design/methodology/approach A survey instrument was sent by facsimile to a random sample of community pharmacists in England, Scotland and Wales. The survey instrument contained items concerning recognition of the symptoms of depression, bipolar disorder or schizophrenia, the helpfulness of a range of interventions, mental health stigma and the degree of comfort providing pharmaceutical care to people with mental health problems. Findings Among community pharmacists (n=329) symptom recognition was high for depression but lower for bipolar disorder and schizophrenia. Pharmacists showed a preference for evidence-based interventions and support for psychological therapies and physical activity for all three mental health problems. Pharmacists expressed less comfort providing pharmacy services to people with bipolar disorder, schizophrenia and depression than cardiovascular disease. Mental health stigma was higher for schizophrenia and bipolar disorder than depression, with many pharmacists holding misperceptions about schizophrenia and bipolar disorder. Practical implications The study findings indicate the need for enhanced mental health content in the undergraduate pharmacy curriculum which should challenge misperceptions of mental illness. Originality/value This is the first study to investigate the MHL of British community pharmacists.

Abstract Introduction Pharmacy teams are key in helping patients to get the most from genomic medicine.1,2 However, genomics has only recently been included in undergraduate curricula, and it has been suggested that all healthcare professionals could benefit from education in pharmacogenomics2. We surveyed pharmacy staff to gather information on previous education, current practice and future educational needs in genomics and pharmacogenomics. Aim This survey aimed to establish existing levels of education and confidence in genomics and pharmacogenomics in pharmacy staff working in any role, in any sector, across the UK, and to investigate respondents’ preferences in delivery of genomic education. Methods The survey was based on a 2021 survey of genomic knowledge among medical staff by Health Education England (HEE)3, and amended to reflect pharmacy roles and practice following discussion with pharmacy leads from the 7 NHS Genomic Medicine Service Alliances in England, and from Scotland, Wales and Northern Ireland. SmartSurvey software was used to host the survey, with data held securely. The survey was open between 1st March and 16th May 2022, and was publicised via pharmacy groups including the Royal Pharmaceutical Society, National Pharmacy Association, Local Pharmaceutical Committees, chief pharmacists networks in primary and secondary care, and social media. This work was assessed using the NHS Health Research Authority Research screening tool and judged as ‘not research’; therefore ethical approval was not required. Results 1,552 responses were received from pharmacists, pharmacy technicians, dispensers and other pharmacy staff across the UK; 68% of responses were from England, 13% from Scotland, 10% from Northern Ireland and 9% from Wales. The majority of responses (69%) were from Pharmacists, with 24% from Pharmacy Technicians and 4% from Pharmacy support workers. Only 13% of respondents had received any formal training in genomics. Most respondents felt unprepared to use genomic testing in their practice; just 8% of pharmacists (including trainees), and 1% of pharmacy technicians (including trainees) felt prepared. However, 65% of respondents thought that genomics would change their practice within the next 5 years, and over 70% of pharmacists, and 56% of pharmacy technicians, could envisage ordering, advising on, or counselling patients on genomic testing in the future after appropriate training. 29% of respondents (mainly pharmacy managers) did not currently see patients and therefore might not train personally in genomics. Discussion/Conclusion This work suggests that pharmacy teams are likely to require educational support to embrace the opportunities of genomic medicine. High survey engagement suggested that respondents were keen to make their voices heard. Pharmacists appeared more confident in their ability to advise patients on genomics than Technicians, however both groups seemed keen to receive training. One limitation is that respondents were likely interested in genomics; those with no interest may not have completed the survey. Additionally, pharmacy managers who do not see patients might not train personally in genomics, but may influence strategy for pharmacy genomics service development and delivery. National bodies should capitalise on enthusiasm across the sector to help drive pharmacy genomics services forward through education and training. References 1. Royal College of Physicians and British Pharmacological Society. Personalised prescribing: using pharmacogenomics to improve patient outcomes. Report of a working party. London: RCP and BPS, 2022. https://www.rcp.ac.uk/projects/outputs/personalised-prescribing-using-pharmacogenomics-improve-patient-outcomes last accessed 1/6/23 2. Royal Pharmaceutical Society. Collaborative Position statement for Pharmacy professionals and Genomic Medicine. London: RPS, 2023 https://www.rpharms.com/development/pharmacogenomics/genomic-statement last accessed 1/6/23 3. Health Education England. Genomics in your practice: a health and social care survey. Birmingham, Health Education England, 2023 https://www.genomicseducation.hee.nhs.uk/documents/genomics-in-your-practice-a-health-and-social-care-survey/ last accessed 1/6/23

Abstract Introduction Community pharmacies are well-placed to provide public health interventions, yet they are underutilised for services of this nature (1), which are needed to achieve public health policy goals. Previous qualitative studies have explored public perceptions of the role of community pharmacy in delivering public health services (2). However, to date, these views have not been captured quantitatively, which means it is not clear if the general public shares these views. Aim The aim was to design a questionnaire to obtain public perceptions of the role of community pharmacy in public health interventions and to establish any barriers and facilitators that exist regarding community pharmacy utilisation. Methods A questionnaire was developed based on published literature and semi-structured interviews. Following initial piloting of a paper-based then online format (by ten individuals) a 42-item questionnaire was completed digitally via Qualtrics by a self-selecting sample of the general public recruited through social media (i.e., Twitter, Instagram and Facebook) in May and June 2021. Principal component analysis with Varimax rotation was used to identify the underlying factors (scales) of the questionnaire. Cronbach’s alpha analysis was undertaken to ensure good internal consistency. Information on frequency of community pharmacy use and for what reason was collected. Content and thematic analysis were conducted on the free text qualitative comments. Content analysis was conducted first to observe which aspects of the questionnaire were mentioned the most. Further to this, thematic analysis was conducted as there were responses which did not fit into the content analysis. Results There were 306 valid questionnaire responses, where 235 (76.8%) were females. The mean age was 34.5 years (SD=15.09). Factor analysis identified four scales with a total of 18-items, all demonstrating good internal consistency. Scales were labelled as (n=number of items; ἀ =Cronbach’s alpha value): Expertise (n=3, ἀ =0.815); Role (n=4, ἀ =0.745); Privacy (n=3, ἀ =0.770) and Relationship (n=8, ἀ =0.862). Scale scores indicated that a lack of awareness of their role and expertise was a barrier and adequate privacy was an important facilitator in delivering public health services. In support of the quantitative findings, content analysis identified lack of privacy as a dominant theme, and further thematic analysis uncovered lack of knowledge of community pharmacy’s role in public health as an important barrier to uptake of services. Thematic analysis uncovered the themes ‘lack of knowledge of services’ and ‘accessibility’. Conclusion The outcome of this study was the development of a four scale, 18-item questionnaire to capture public perceptions of the community pharmacy’s role in public health. This can, therefore, be used in future studies aiming to explore public perceptions of community pharmacy. Strengths include being the first questionnaire to explore perceptions of community pharmacy. Weaknesses include the possibility of bias using social media in recruitment. This could be tackled using paper versions of the questionnaire in different settings. Further research is needed to continue testing the psychometric properties of the questionnaire with consideration given to the addition of a fifth scale to measure perceptions of Accessibility. References (1) Kember, J., Hodson, K., & James, D. H. (2018). The public’s perception of the role of community pharmacists in Wales. International Journal of Pharmacy Practice (26), 120-128. (2) Gidman, W., & Cowley, J. (2013). A qualitative exploration of opinions on the community pharmacists’ role amongst the general public in Scotland, International Journal of Pharmacy Practice, (21), 288-296.