International Journal of Pharmacy Practice最新文献

Background: Following increases in deaths due to alcohol during the COVID-19 pandemic, there have been renewed calls to increase resources in alcohol screening and brief intervention (SBI). Research has shown that community pharmacy could be a promising setting for SBI. This review aimed to investigate the barriers and facilitators to SBI delivery in community pharmacy to inform its further development.

Methods: A systematic search of four databases (MEDLINE, EMBASE, CINAHL, and PsycINFO) was conducted in October 2021 to identify relevant published qualitative or mixed-method studies. Relevant qualitative data were extracted from the included studies and a framework synthesis was performed using the Capability-Opportunity-Motivation-Behaviour (COM-B) model.

Results: Two thousand two hundred and ten articles were screened and nine studies were included in the review (seven in the United Kingdom and two in Australia). Identified barriers and facilitators to delivering SBI corresponded to all components of the COM-B model. Facilitators included non-confrontational communication skills, aligning SBI with existing pharmacy services and pharmacist role legitimacy. Barriers included multiple demands on staff time, a lack of staff experience with screening tools, and staff concerns of causing offence. Using the Behaviour Change Wheel (BCW), we propose five elements of a pharmacy SBI to address identified barriers.

Conclusions: Research into SBI in community pharmacy is limited in comparison to other healthcare settings and this review provides an understanding of the barriers and facilitators to the delivery of SBI in community pharmacy from a behavioural perspective. Through the use of COM-B and BCW, our findings could inform the development of future pharmacy-based SBI.

Objective: To explore pharmacy users' perceptions of current and future provision of community pharmacy services in England.

Methods: Qualitative, reconvened focus groups were conducted with community pharmacy users. An initial focus group explored preliminary views. Participants were then given an evidence brief describing community pharmacy before a reconvened focus group two weeks later. Transcripts were analysed using inductive thematic analysis.

Key findings: Eleven individuals participated across two reconvened focus groups. Participants valued community pharmacies and staff, but lacked awareness of their services and roles: '… I don't think the general public is aware of all of this … it gives you a very different perspective'. Urgent care and long-term conditions management were identified as suitable for future development, facilitated by training, closer collaboration with general practices, shared access to health records, and premises with more space and confidentiality: 'I still think of it as a retail space more than as a health service'. Concerns were expressed about working conditions in community pharmacy and unplanned closures: 'doesn't sound like a great place to work'. Participants anticipated greater use of technology but did not want this to replace face-to-face contact with pharmacy staff: 'I am not saying it's inaccurate, it is so remote and impersonal'.

Conclusions: Pharmacy users would value a greater role for community pharmacy in addressing the challenges currently faced by the health service in England, provided that their concerns on a range of issues are addressed.

Objective: The aim of this study was to examine the impact of pharmacy automation on the workload and satisfaction of pharmacists and pharmacy assistants in an inpatient setting.

Methods: This was an observational, cross-sectional survey using a convenience sampling method conducted at the University Malaya Medical Centre (UMMC) In-Patient Pharmacy. A validated online questionnaire assessed user satisfaction and task duration.

Results: A total of 21 pharmacists and 18 pharmacy assistants participated in the survey. Most pharmacists (n = 17/21) were confident in the system, and both pharmacists and pharmacy assistants perceived it to be beneficial for patients (n = 33/39) and for reducing medication errors (n = 32/39). Pharmacy assistants spent approximately 5.34 hours on traditional work including filling medication orders (1.44 hours) after automated tablet dispensing and packaging system (ATDPS) implementation. Pharmacists spent 1.19 hours filling medication orders and 1.71 hours checking/verifying them, in contrast.

Conclusion: Pharmacists focused mainly on clinical duties with healthcare colleagues, while pharmacy assistants handled various medication orders. Nevertheless, ATDPS reduced pharmacy staff workload in medication handling, achieving user satisfaction.

Objectives: This study evaluated prescribing in children under the age of five attending paediatric outpatient clinics at three Central hospitals in Delta State, Nigeria and determined the conditions mostly associated with inappropriate prescriptions and omissions.

Methods: This was a retrospective study of prescriptions made to children from 0 to 59 months who attended the clinics. Prescriptions were evaluated using the POPI tool, occurrence of potentially inappropriate prescriptions and prescribing omissions were reported as percentages and inappropriate prescription types and prescription omissions were also reported as frequencies. Relationship between inappropriate prescriptions, omissions of prescriptions and age group and gender were determined, P < 0.05 was considered significant.

Key findings: A total of 1327 prescriptions from the three centres were analyzed. There was a preponderance of infants (>1 month-12 months of age) in the study (43.0%) and a somewhat even gender distribution. Exactly 29.8% of all the prescriptions studied had at least one occurrence of inappropriate prescription. The use of H1 antagonists with sedative or atropine-like effects accounted for the majority of inappropriate prescriptions (49.5%), while the prescription of drinkable amoxicillin or other antibiotics in doses other than mg was the most frequent omission of prescription (97.2%). There was a significant relationship between the occurrence of inappropriate prescription and age group (P > 0.001).

Conclusions: Inappropriate prescriptions and omissions of prescriptions were high and effectively detected by the POPI tool.

Background: Many transgender and gender diverse (TGD) people access care through community pharmacy in Australia. However, there is limited information available about the role of Australian pharmacists in providing care for TGD people.

Objective: To explore the attitudes, practices, and training needs of pharmacists in the provision of care for TGD people in Australia.

Method: Pharmacists Australia-wide were invited to participate in an online survey through Facebook, e-newsletters of pharmacy organizations and a professional pharmacy journal. Quantitative data were analysed for descriptive and inferential statistics. A Fisher exact test was used to investigate associations between two variables. Results with P value <0.05 were considered statistically significant. Content analysis was used to analyse data from free-text responses.

Result: Of the 169 respondents, the majority were female (75.1%), aged below 40 years (74%) and with less than 10 years of working experience as a pharmacist (58%). Although 95% of the sample agreed that they had an important role in the provision of care for TGD people, only 29.6% were confident about their knowledge of pharmacotherapeutic treatments for gender affirmation. Only 2.4% had received education about TGD care at university, and only 5.3% received any TGD healthcare training over the past 5 years.

Conclusion: Although pharmacists had a positive attitude and recognized their role in TGD care, they expressed a lack of confidence in their knowledge to be a barrier to providing quality care. Most recommended the need for more education about TGD healthcare in pharmacy curricula and continuous professional education activities.

Background: Burnout of health professionals is of concern internationally and the pharmacy profession is no exception. The period of transition from University to autonomous practitioner is recognized to be challenging and these Early Career Pharmacists (ECPs), may be at increased risk of stress and burnout.

Objectives: This study aimed to collect data on the current extent of self-identified stress and burnout, of ECPs, and to (i) identify contributing factors and (ii) identify strategies used to manage this stress.

Methods: This study was conducted in Aotearoa New Zealand and was based on a survey used previously in Australia. A national database was used to identify all pharmacists who had been registered for <10 years. The survey was emailed to each pharmacist, and was further advertised through social media platforms.

Results: A total of 1418 ECPs were identified and invited to participate, and responses were received by 416 of these. The majority of respondents were female (73%) and community pharmacy based (79%). A vast majority (89%) indicated that a normal working day was at least moderately stressful with 79% indicating a level of burnout. These reflect a combination of "external" stressors, i.e. negative patient interactions, staff shortages, and "internal" stressors, i.e. fear of making a mistake, adjustment from University to working life.

Conclusions: Stress and burnout appear to be widespread in the ECPs, this study highlights areas of concern and potential support where efforts can be focussed to create a more sustainable working environment.

Objectives: Investment in the development of the pharmacy workforce has been recognized as crucial for achieving universal health coverage. The 21 International Pharmaceutical Federation (FIP) Development Goals (DGs) have been used when conducting national needs assessments in several countries to provide evidence-based policy on workforce development. This study aimed to explore factors contributing to education and training in a FIP sample of mainly low- to middle-income countries (LMICs), and current national policy initiatives and priorities, mapped against the FIP DGs.

Methods: The study employed a mixed-methods approach, including an online survey questionnaire and interviews with representatives from 26 national professional organizations from 21 countries. A Multiple Correspondence Analysis (MCA), descriptive analysis, and thematic analysis were carried out to analyse the data.

Key findings: A total of 26 national professional organizations from 21 countries participated in this study. The quantitative MCA results indicated categorical correlations with variables related to the maintenance of licensed pharmacy practice and mechanisms for personal career development and advancement, such as the availability of competency development frameworks. Six themes emerged from the qualitative analysis of ongoing national programmes in the sampled countries: strengthening initial education and training, competency and career development programmes, initiatives related to pharmacists' role in patient safety, communicable diseases, and antimicrobial stewardship, pharmaceutical care and medicines access, strengthening research to improve pharmacists' impact, and outcomes and policy review and development.

Conclusion: This study provided an evidence-based needs assessment exploring factors contributing to workforce development and identifying pharmaceutical development priorities mapped to the FIP DGs across a cohort of nations.

Objectives: To describe and assess a dosing calculations course presented to first-year college honors students who are not healthcare majors. The primary objective is, can first year undergraduate college honors students, who have not enrolled in a professional healthcare program, be successful in a calculations dosing course? The secondary objective is, what are the students' perceptions of the course?

Methods: The instructor facilitated an in-person dosage calculations course, 1 h per week over 14 weeks. Small teams of students were created to facilitate learning throughout the semester.

Key findings: All 15 students passed the course, and overall, the student perceptions were positive.

Conclusion: First-year college students, who were not healthcare majors, were able to be successful in a math and medications course. Overall, students had a positive perception of the course. Some students did have a concern about the relevance of the course to their future careers. This may be improved with the selection of healthcare students in the course for future offerings.