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1.
BMJ Open ; 12(4): e057011, 2022 04 01.
Article in English | MEDLINE | ID: covidwho-1861631

ABSTRACT

OBJECTIVE: Ear disease in rural and remote communities is occurring at high rates, with limited access to health services and health providers contributing to the problem. Community pharmacists are well-placed to provide expanded services to improve ear health in rural communities. We aimed to evaluate the feasibility, accessibility and acceptability of a pharmacist-led intervention for ear disease in consumers presenting to community pharmacy. DESIGN: Prospective preintervention and postintervention mixed-methods study. An ethnographic lens of rural culture was applied to the descriptive qualitative component of the study. SETTING: Two rural community pharmacies in Queensland, Australia. PARTICIPANTS: People aged 6 months or older, who present with an ear complaint to a participating community pharmacy. INTERVENTION: LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Programme) is a community pharmacy-based intervention to improve the management of ear health. Trained pharmacists conducted ear examinations using otoscopy and tympanometry on consumers following a LISTEN UP protocol. They made recommendations including no treatment, pharmacy only products or general practitioner (GP) referral. Consumers were contacted 7 days later for follow-up. RESULTS: 55 rural consumers participated in the study. The most commonly reported complaints were 'blocked ear' and 'ear pain'. Pharmacists recommended over-the-counter products to two-thirds of the participants and referred one quarter to a GP. 90% (50/55) of the consumers were highly satisfied with the service and would recommend the service. All consumers described the service positively with particular reference to convenience, improved confidence and appreciation of the knowledge gained about their ear complaint. Pharmacists were motivated to upskill and manage workflow to incorporate the service and expected both consumers and GPs to be more accepting of future expanded services as a result of LISTEN UP. However, without funding to provide the service, during the study other remunerated pharmacy tasks took priority over providing LISTEN UP. CONCLUSION: Rural community pharmacists can provide an acceptable and accessible ear health service; however, it is not feasible without a clear funding structure to provide resources including additional pharmacists, equipment and training. TRIAL REGISTRATION NUMBER: ACTRN12620001297910.


Subject(s)
Community Pharmacy Services , Pharmacies , Australia , Feasibility Studies , Humans , Infant , Pharmacists , Prospective Studies , Queensland , Rural Population
2.
J Am Pharm Assoc (2003) ; 62(3): 877-882, 2022.
Article in English | MEDLINE | ID: covidwho-1828770

ABSTRACT

PURPOSE: To evaluate inpatient and infusion pharmacist order verification productivity when working from home and to report their perceptions of a flexible workplace setting. METHODS: Order verification data were pulled from the electronic medical record from April 27, 2020, to June 30, 2020, matched to the pharmacist schedule on the basis of work setting and reported as average orders verified per day. Pharmacist perceptions were gathered via a survey to evaluate practice setting background, workplace setting preference, and perceived changes in workflow and their productivity. RESULTS: There was an overall increase in order verification productivity when working from home. Inpatient pharmacists, on average, verified 152 orders per day from home and 133 orders per day onsite. Infusion pharmacists, on average, verified 144 orders per day working from home and 117 orders per day working onsite. Fifty-nine percent of pharmacists reported preferring the mix of onsite and home workplace setting and noted little change in workflow. In addition, 57% of the pharmacists perceived themselves as being more productive, 32% as maintaining the same level of productivity, and 10% felt that they are less productive when working from home. The order verification data showed a greater increase in productivity for infusion shifts worked from home than inpatient shifts. CONCLUSION: The coronavirus 2019 pandemic prompted pharmacy departments to re-evaluate their ability to provide an option for a flexible workplace for pharmacists. Our study demonstrates that pharmacists, on average, verified more orders when working from home, and they also perceive themselves as being more productive. The results of this study support long-term applicability of a flexible work schedule for inpatient and infusion pharmacists.


Subject(s)
Coronavirus , Neoplasms , Pharmaceutical Services , Electronic Health Records , Humans , Inpatients , Pharmacists
3.
Int J Environ Res Public Health ; 19(8)2022 04 14.
Article in English | MEDLINE | ID: covidwho-1809874

ABSTRACT

The unique professional competence of pharmacists can support the safe and effective use of medicines by patients. Additionally, it is important to acknowledge and incorporate the needs of patients with various cultural and social backgrounds. The objective of this study was to assess and compare the experiences and expectations of Russian- and Estonian-speaking pharmacy customers about medicines-related services in Estonian community pharmacies. Cross-sectional study among pharmacy customers was conducted in Estonia 2018-2020. For data analysis, an Independent t-Test was used to compare experiences and expectations of respondents towards medicines-related services. The study involved 552 pharmacy customers: 58.5% (n = 323) Estonians and 41.5% (n = 229) Russians. The majority of the total sample (78.3%) considered the pharmacist competent to help. Medicines-related concerns were more common among Russians (p = 0.037), however, they sought less contact to consult a pharmacist than Estonians (p < 0.001). Furthermore, expectations about different medicines-related services in the future were higher among Estonians than among Russians (p < 0.001). Community pharmacists in Estonia should focus more on person-centered care to better meet the expectations and needs of different ethnic groups about medicines-related services. It is also important to reduce the language barrier and to increase the recognition of cultural traditions by health professionals.


Subject(s)
Community Pharmacy Services , Pharmacies , Cross-Sectional Studies , Estonia , Humans , Motivation , Pharmacists , Professional Role
4.
Am J Health Syst Pharm ; 79(12): 927-928, 2022 06 07.
Article in English | MEDLINE | ID: covidwho-1806270
6.
Int J Environ Res Public Health ; 19(7)2022 04 01.
Article in English | MEDLINE | ID: covidwho-1785650

ABSTRACT

INTRODUCTION: In this study, pharmacists conducted home visits for individuals of medically underserved populations in Taiwan (i.e., socioeconomically disadvantaged individuals, middle-aged or older adults, and individuals living alone, with dementia, or with disabilities) to understand their medication habits. We quantified medication problems among various groups and investigated whether the pharmacist home visits helped to reduce the medication problems. MATERIALS AND METHODS: From April 2016 to March 2019, pharmacists visited the homes of the aforementioned medically underserved individuals in Taipei to evaluate their drug-related problems and medication problems. Age, living alone, diagnoses of dementia or disabilities, and socioeconomic disadvantages contributed significantly to inadequate disease and medical treatment knowledge and self-care skills as well as lifestyle inappropriateness among patients. The patients who were living alone and socioeconomically disadvantaged stored their drugs in inappropriate environments. RESULTS: After the pharmacists visited the patients' homes twice, the patients improved considerably in their disease and medical treatment knowledge, self-care skills, and lifestyles (p < 0.001). Problems related to the uninstructed reduction or discontinuation of drug use (p < 0.05) and use of expired drugs (p < 0.001) were also mitigated substantially. DISCUSSION AND CONCLUSION: Through the home visits, the pharmacists came to fully understand the medicine (including Chinese medicine) and health food usage behaviors of the patients and their lifestyles, enabling them to provide thorough health education. After the pharmacists' home visits, the patients' drug-related problems were mitigated, and their knowledge of diseases, drug compliance, and drug storage methods and environments improved, reducing drug waste. Our findings can help policymakers address the medication problems of various medically underserved groups, thereby improving the utilization of limited medical resources.


Subject(s)
Dementia , Pharmacists , Aged , House Calls , Humans , Medication Errors , Middle Aged , Social Class
7.
PLoS One ; 17(4): e0265166, 2022.
Article in English | MEDLINE | ID: covidwho-1785191

ABSTRACT

JUSTIFICATION: The WHO 95-95-95 targets for 2030 do not imply that people living with HIV (PLHIV) achieve a good quality of life. The current 30-day dispensing interval for antiretroviral (ART) burdens the healthcare system. Lengthening dispensing intervals could alleviate this burden as well as enhance patient well-being. OBJECTIVES: To capture perceptions on 90-day dispensing interval (90D) for ART from the perspective of PLHIV, people on pre-exposure prophylaxis (PrEP), doctors, and pharmacists. METHODS: Multi-centre observational survey led in France from 16 to 20 October 2020, among doctors agreeing to participate via regional coordinated care organisations for HIV, all PLHIV or people on PrEP consulting these outpatient-clinic doctors, and pharmacists doing ART dispensing. RESULTS: The survey was completed by 220 doctors who saw 1087 people (999 PLHIV; 88 on PrEP) and 176 pharmacists from 55 centres. Among the PLHIV, 855 (85.6%, 95% CI: 83.2%-87.7%) and among the patients on PrEP, 70 (79.5%, 95% CI: 69.6%-87.4%) stated they would be interested in 90D. All in all, patients who were more likely to endorse 90D are those who opt exclusively for hospital dispensing (OR 3.22 [1.57-6.58]) and who rotate between hospital and community pharmacy dispensing (OR 3.29 [1.15-9.32]). Patients who were less likely to endorse 90-D were those who consult in a city located outside the 3 French high HIV prevalence regions (OR 0.66 [0.44-0.99]), receive 2 vs 1 pill QD regimens (OR 0.53 [0.31-0.91]), and anticipate at least one vs no limitation to 90D (OR 0.27 [0.17-0.42]). 90D was perceived as possible by 152 pharmacists (86.4%), including 8 (5%) without restriction, and 219 doctors (99.6%), including 42 (19.2%) regardless of PLHIV's immunovirologic status or social conditions (health insurance coverage, access to housing or accommodation, access to rights, resources). Comparison of the benefits and limitations of a 90-day ART dispensing interval as perceived by PLHIV and people on PrEP, doctors and pharmacists shows that doctors anticipate a higher number of benefits than people on ART and/or pharmacists, chiefly that 90D would be more convenient and create less risk of drug shortages and that patients would gain autonomy and a better quality of life. Pharmacists were found to clearly perceive the economic benefits (90D would be less expensive) but anticipate more drawbacks than doctors and the people on ART themselves: more administrative burdens, more non-dispensing if doses get lost, harder to track adherence and more drug-drug interaction issues, and more work as they shall have to warn the patient of potential risks of shortages due to the cost of the stock. CONCLUSION: A clear majority of PLHIV, people on PrEP, doctors, and pharmacists endorsed 90D of ART. Most patients thought that 90D would be a good option, whereas most pharmacists and doctors thought that eligibility for 90D dispensing should depend on immunovirologic factors and social condition criteria. Moreover, pharmacists thought it would be necessary to commit regulatory resources and a better follow-up on adherence and drug-drug interactions.


Subject(s)
Anti-HIV Agents , HIV Infections , Pre-Exposure Prophylaxis , Anti-HIV Agents/therapeutic use , Anti-Retroviral Agents/therapeutic use , HIV Infections/epidemiology , Humans , Pharmacists , Quality of Life
8.
BMJ Open Qual ; 11(2)2022 04.
Article in English | MEDLINE | ID: covidwho-1784846

ABSTRACT

Discharge summaries are important medical documents that summarise a patient's hospital admission. The Royal College of Physicians provides standardised guidance on the content of discharge summaries, given their important role as a handover document to general practitioners (GPs). Our project started in June 2020 on an acute medical ward, where significant variation had been noted in the quality and content of discharge summaries. A multidisciplinary team (MDT) was formed including doctors, nurses and hospital/community pharmacists, as well as a patient representative, to ensure active patient co-design. The problem was scoped by asking GPs to provide feedback via surveys and process mapping. Our aim was to increase the compliance of discharge summaries with 10 core criteria from a baseline of 55% to 95% by June 2021. Change ideas were developed by the MDT and were tested using plan-do-study-act (PDSA) cycles that included additional pharmacy support, a discharge summary template and individualised feedback. The project reached its goal of 95% compliance in January 2021, 5 months ahead of the target date, and this improvement has been sustained since. The project expanded to a second acute medical unit ward in May 2021. The expanded project reached its goal of 90% compliance within 6 weeks and maintained sustained improvement with further PDSA cycles. A standard operating procedure has been created to help embed the changes on these wards. Our future aims are to redesign and improve the current electronic system and to help spread positive changes throughout the Trust.


Subject(s)
General Practitioners , Quality Improvement , Hospitals , Humans , Patient Discharge , Pharmacists
9.
BMC Health Serv Res ; 22(1): 467, 2022 Apr 09.
Article in English | MEDLINE | ID: covidwho-1779646

ABSTRACT

BACKGROUND: In the wake of COVID-19, community pharmacists (CP) were called upon to free up healthcare providers to treat more serious conditions and alleviate overcrowded healthcare centers. CPs were placed under tremendous pressure, where many patients primarily sought their health advice. This situation raised concerns about the preparedness of CPs in facing these challenges. Therefore, this study aimed to assess the appropriateness of pharmaceutical care provided by CPs to patients with suspected COVID-19 and to investigate their communication skills. METHODS: A simulated patient (SP) study was conducted among randomly selected community pharmacies in Beirut, Lebanon. Each pharmacy was visited by the SP who complained of fever and loss of smell sensation. Interactions between the attending pharmacist and the suspected COVID-19 patient were documented directly after each visit in a standardized data collection form. RESULTS: More than half of the CPs (56%) did not retrieve any relevant information to assess the patient's condition. While pharmacists' responses were limited to one to two recommendations, with the majority recommending the patient to perform the PCR test (90%). Inappropriate recommendations made by the CPs included mainly the confirmation that the patient had COVID-19 without prior testing (9%), and prescribing either an antimicrobial drug (5%) or dietary supplements (20%), claiming that the latter are essential to boost the patient's immunity. As for the pharmacist-patient communication skills, the mean total score was 2.25 ± 0.79 (out of 4), displaying nonoptimal and ineffective communication. CONCLUSION: An unsatisfactory and suboptimal provision of pharmaceutical care to a suspected COVID-19 case was evident. This may be a public health threat, particularly for developing countries that lack an efficient and unified healthcare system. The findings should alert health authorities to support and guide community pharmacists in assisting suspected COVID-19 patients.


Subject(s)
COVID-19 , Community Pharmacy Services , Pharmacies , Pharmacy , COVID-19/drug therapy , Humans , Pharmacists , Professional Role
10.
Am J Health Syst Pharm ; 79(13): 1023-1024, 2022 06 23.
Article in English | MEDLINE | ID: covidwho-1774341
11.
Int J Clin Pharm ; 44(3): 775-780, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1772977

ABSTRACT

Pharmacists now face the biggest challenges in the history of the profession: the use of digital technologies in pharmacy practice and education and the outbreak of coronavirus disease 2019. Worldwide, pharmaceutical care and pharmacy education via digital technologies have significantly increased and will be incorporated into patient care and the teaching-learning process, respectively. Thus, in this new era of pharmacy practice and education, curricula should promote the development of specific competencies for the cognitive, conscious, and effective use of digital tools. This requires the training of "disruptive" educators, who are capable of using teaching-learning methods adapted to the digital environment and educational processes suitable for stimulating the use of effective disruptive technologies. This commentary argues that the pharmacy profession can no longer wait for the slow integration of digital technologies into pharmacy practice and education.


Subject(s)
COVID-19 , Education, Pharmacy , Pharmaceutical Services , Pharmacy , COVID-19/epidemiology , Humans , Pharmacists/psychology
12.
Int J Pharm Pract ; 30(3): 226-234, 2022 Jun 25.
Article in English | MEDLINE | ID: covidwho-1769291

ABSTRACT

BACKGROUND: Community pharmacies provide an important healthcare service. Their significant value has been further highlighted during the COVID-19 pandemic crisis. OBJECTIVES: To identify and categorize potential barriers and facilitators to the role of community pharmacists during the pandemic and their association with demographic factors. METHODS: A cross-sectional survey of community pharmacists was conducted using a self-administered questionnaire during April 2020 across all regions of Egypt. KEY FINDINGS: Respondents (n = 1018; 98.4% response rate) revealed practical and psychological barriers, including inadequate levels of pandemic preparedness (mean 61.43%; ±SD 0.47), inadequate working environments (mean 56.23%; ±SD 0.49) and uncooperative behaviour from stakeholders (mean 65.3%; ±SD 0.47).The majority of respondents emphasized the universal, region-independent necessity for facilitators, including the availability of timely (94.9%) guidance (97.4%) published by the Egyptian healthcare authority (94.6%), in electronic format (82.1%), through smartphone application (80.0%) and the provision of a dedicated telephone hotline (89.5%). Furthermore, authorities must use the media to manage public perceptions (97.2%) and increase public trust (94.8%) towards the pharmacist. CONCLUSIONS: The barriers and facilitators identified herein could improve service provision in an integrated manner by overcoming the reported inadequate level of preparedness (barrier) through the provision of electronic guidance (facilitator), and the use of the media in managing public perceptions and trust (facilitators) to reduce the panic that negatively affects the working environment (barrier) for pharmacy staff. The varied level of healthcare authority cooperation reported in many regions requires further investigation.


Subject(s)
COVID-19 , Community Pharmacy Services , Pharmacies , Pharmacy , Cross-Sectional Studies , Humans , Pandemics , Pharmacists/psychology , Professional Role
14.
CMAJ ; 194(11): E424-E425, 2022 03 21.
Article in English | MEDLINE | ID: covidwho-1759981
15.
16.
Geriatr Nurs ; 44: 266-271, 2022.
Article in English | MEDLINE | ID: covidwho-1739747

ABSTRACT

The Medication Management Guide (MMG) provides guidance on strategies to optimize medication management in PA-LTC and simplify administration to reduce the transmission risk of COVID-19. The objectives of this study were to evaluate the utility of the MMG, determine the barriers and facilitators of the MMG implementation in PALTC sites to help inform future research and initiatives. Individuals who accessed MMG during the pandemic (April 2020-March 2021) were contacted to elicit feedback on this tool via an online survey. The survey response rate was 7.7% (156/2,018) after three rounds of emails. Respondents consisted of 31% (n=49) pharmacists, 27% (n=42) physicians, 11% (n=18) nurses, and 12% (n=19) nurse practitioners. The "Other" respondents (11%, n=17) included dieticians (n=4), physician assistants (n=3), pharmacy technicians (n=3), students (n=1), consultants (n=1), and educators (n=2). From these respondents, 77% (n=122) took tactics to optimize medications at their facilities during COVID-19.


Subject(s)
COVID-19 , Long-Term Care , Humans , Medication Therapy Management , Pharmaceutical Preparations , Pharmacists
17.
Am J Health Syst Pharm ; 79(13): 1110-1114, 2022 06 23.
Article in English | MEDLINE | ID: covidwho-1740800

ABSTRACT

PURPOSE: To explore the perceptions of pharmacists and administrators who had an integral role in designing and operationalizing an integrated community pharmacist hypertension management program with collaboration between an academic medical center and a regional chain community pharmacy. SUMMARY: Community pharmacists (n = 3), ambulatory care pharmacists (n = 2), medical directors (n = 2), and health-system (n = 1) and pharmacy (n = 1) administrators reported positive experiences engaging with the hypertension management program. Strengths of the program included comprehensive training by the ambulatory care pharmacists, community pharmacist access to the electronic health record (EHR), and primary care providers who were receptive to referring patients and accepting recommendations from the community pharmacists. All participants felt that the program had a positive outlook and saw opportunity for expansion, such as extended hours of operation, new locations, and additional pharmacists. CONCLUSION: Pharmacists are well positioned to extend hypertension management programs from primary care clinics into local pharmacies if they have appropriate training, access to the EHR, and ongoing support from collaborating primary care offices. Additional research using implementation science methods is needed to further test the scalability and replicability of the program among different patient populations, community pharmacies, and health systems.


Subject(s)
Community Pharmacy Services , Hypertension , Pharmaceutical Services , Pharmacies , Academic Medical Centers , Humans , Hypertension/drug therapy , Pharmacists , Professional Role
18.
BMJ Sex Reprod Health ; 48(1): 66-67, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1736083
19.
Am J Health Syst Pharm ; 78(23): 2103-2104, 2021 11 23.
Article in English | MEDLINE | ID: covidwho-1730634

Subject(s)
COVID-19 , Pharmacists , Humans
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