Objective: To assist with identifying patients who may be managed by pharmacists without additional travel medicine training, versus those who may benefit from referral, we developed and validated a clinical practice framework. This framework was then piloted in eight pharmacies in Ontario, Canada, from March to August 2019. Methods: A panel of experts, comprised of physicians and pharmacists from Ontario, Canada, holding a Certificate in Travel HealthTM from the International Society of Travel Medicine was recruited. This panel participated electronically in the development of the framework in three stages: (1) Sharing their current approach when performing information gathering and assessing risk in a traveling patient; (2) judging of items collated from all panellists on the basis of how essential they are to a risk assessment; and (3) validation of items deemed essential by the panel using the Item and Average Content Validity Index. The framework was then released to community pharmacies, where pharmacists that self-identified as beginners to travel medicine completed pre- and post-test phase surveys to determine the utility of the framework. Key Findings: A total of 64 items for consideration were deemed essential enough to proceed to content validation, organized into 5 ‘W’ domains: Who, What, Where, When, and Why. Each item was ranked by the experts according to its relevancy, resulting in an Average-Content Validity Index of 0.91. The resulting framework was titled “The 5W Approach to Travel Risk Identification.” This clinical practice framework is the first published assessment tool for travel medicine tailored for pharmacy’s scope of practice that has been content validated. Pharmacists reported that the framework is simple to use and provides structure for interactions with travelling patients. However, it may not be as beneficial for those with a higher level of travel medicine expertise than the average pharmacist. Conclusion: The 5W Approach tool allows pharmacists inexperienced in travel medicine to collect information when required to use their professional judgement when assessing traveling patients as either high-risk (requiring a referral to a travel medicine specialist) or low-risk. With the aim of supporting pharmacists to be more confident in caring for traveling patients and increasing their involvement in travel medicine, future research will test this framework for feasibility in Canadian community pharmacy practice.
{"title":"Development and Testing of a Clinical Practice Framework for Pharmacists to Assess Patients’ Travel-Related Risks: The 5W Approach to Travel Risk Identification","authors":"Heidi V J Fernandes, S. Houle","doi":"10.3390/pharmacy7040159","DOIUrl":"https://doi.org/10.3390/pharmacy7040159","url":null,"abstract":"Objective: To assist with identifying patients who may be managed by pharmacists without additional travel medicine training, versus those who may benefit from referral, we developed and validated a clinical practice framework. This framework was then piloted in eight pharmacies in Ontario, Canada, from March to August 2019. Methods: A panel of experts, comprised of physicians and pharmacists from Ontario, Canada, holding a Certificate in Travel HealthTM from the International Society of Travel Medicine was recruited. This panel participated electronically in the development of the framework in three stages: (1) Sharing their current approach when performing information gathering and assessing risk in a traveling patient; (2) judging of items collated from all panellists on the basis of how essential they are to a risk assessment; and (3) validation of items deemed essential by the panel using the Item and Average Content Validity Index. The framework was then released to community pharmacies, where pharmacists that self-identified as beginners to travel medicine completed pre- and post-test phase surveys to determine the utility of the framework. Key Findings: A total of 64 items for consideration were deemed essential enough to proceed to content validation, organized into 5 ‘W’ domains: Who, What, Where, When, and Why. Each item was ranked by the experts according to its relevancy, resulting in an Average-Content Validity Index of 0.91. The resulting framework was titled “The 5W Approach to Travel Risk Identification.” This clinical practice framework is the first published assessment tool for travel medicine tailored for pharmacy’s scope of practice that has been content validated. Pharmacists reported that the framework is simple to use and provides structure for interactions with travelling patients. However, it may not be as beneficial for those with a higher level of travel medicine expertise than the average pharmacist. Conclusion: The 5W Approach tool allows pharmacists inexperienced in travel medicine to collect information when required to use their professional judgement when assessing traveling patients as either high-risk (requiring a referral to a travel medicine specialist) or low-risk. With the aim of supporting pharmacists to be more confident in caring for traveling patients and increasing their involvement in travel medicine, future research will test this framework for feasibility in Canadian community pharmacy practice.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"57 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84097255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs using the limited demographic and health history available from the screening forms. Descriptive statistics are presented, characterizing patient demographics and health condition-based recommendations, and the percentage of patients in a pharmacy population that may have potential indications for additional vaccines. Data were collected from 8669 pharmacy vaccine screening forms. Using the patient’s date of birth on the screening form, 10% (n = 759) and 34.6% (n = 2615) of patients receiving vaccines at the pharmacy may be indicated for the zoster, or both the zoster and pneumococcal vaccines, respectively. Screening form questions that inquire about medical history are also able to identify 13.9% (n = 977) of patients with a potential need for pneumococcal vaccines. Our data indicate that pharmacists can identify potential immunization opportunities proactively by using their immunization screening form, not only to identify contraindications, but also indications.
{"title":"Using Community Pharmacy Immunization Screening Forms to Identify Potential Immunization Opportunities","authors":"Albert T Bach, Jeffery A Goad","doi":"10.3390/pharmacy7040160","DOIUrl":"https://doi.org/10.3390/pharmacy7040160","url":null,"abstract":"Immunization screening forms are completed for each patient that is to be vaccinated in the pharmacy. Screening forms contain demographic and health questions, which are used to determine if a patient is contraindicated to receive a vaccine. The objective is to determine if patient responses to questions on these forms can be used to identify potential vaccine indications. De-identified data was retrospectively collected from 11 community pharmacies in California and Michigan that included basic demographics, answers to immunization screening questions, and vaccine(s) administered during that visit. The Advisory Committee on Immunization Practices (ACIP) recommendations were used to forecast vaccine needs using the limited demographic and health history available from the screening forms. Descriptive statistics are presented, characterizing patient demographics and health condition-based recommendations, and the percentage of patients in a pharmacy population that may have potential indications for additional vaccines. Data were collected from 8669 pharmacy vaccine screening forms. Using the patient’s date of birth on the screening form, 10% (n = 759) and 34.6% (n = 2615) of patients receiving vaccines at the pharmacy may be indicated for the zoster, or both the zoster and pneumococcal vaccines, respectively. Screening form questions that inquire about medical history are also able to identify 13.9% (n = 977) of patients with a potential need for pneumococcal vaccines. Our data indicate that pharmacists can identify potential immunization opportunities proactively by using their immunization screening form, not only to identify contraindications, but also indications.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"112 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80646139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jessica M. Cole, N. Wilkins, Maeghan Moss, Danny K. Fu, P. Carson, Linda Xiong
This pilot study sought to evaluate the impact of pharmacist involvement in the preexisting telehealth transitional care management (TCM) program at Atrium Health on the quality and safety of the medication discharge process for high medication risk patients. Eligible participants were those 18 years of age or older with moderate-to-high risk for hospital readmission who were contacted by a TCM Nurse, identified as high medication risk patients, and referred to the TCM Pharmacist from September 2018 through February 2019. The TCM Pharmacist contacted patients by phone, completed a comprehensive medication review, identified medication list discrepancies (MLDs) and medication-related problems (MRPs), and made interventions or recommendations to primary care providers. Primary endpoints included the number and types of MLDs identified, number and types of MRPs identified, and the rate of unplanned 30-day hospital readmissions. Seventy-six patients were enrolled, and 78 MLDs and 108 MRPs were identified. Of the identified MRPs, 74.1% were resolved. A relative risk reduction of 36.8% was achieved for 30-day hospital readmissions for those with high medication risk contacted by the TCM Pharmacist compared to those only contacted by the TCM Nurse. Overall, TCM Pharmacists identified and resolved 80 medication-related problems, improved access to medication therapy, provided comprehensive medication counseling, and bridged gaps in care following hospital discharge.
{"title":"Impact of Pharmacist Involvement on Telehealth Transitional Care Management (TCM) for High Medication Risk Patients","authors":"Jessica M. Cole, N. Wilkins, Maeghan Moss, Danny K. Fu, P. Carson, Linda Xiong","doi":"10.3390/pharmacy7040158","DOIUrl":"https://doi.org/10.3390/pharmacy7040158","url":null,"abstract":"This pilot study sought to evaluate the impact of pharmacist involvement in the preexisting telehealth transitional care management (TCM) program at Atrium Health on the quality and safety of the medication discharge process for high medication risk patients. Eligible participants were those 18 years of age or older with moderate-to-high risk for hospital readmission who were contacted by a TCM Nurse, identified as high medication risk patients, and referred to the TCM Pharmacist from September 2018 through February 2019. The TCM Pharmacist contacted patients by phone, completed a comprehensive medication review, identified medication list discrepancies (MLDs) and medication-related problems (MRPs), and made interventions or recommendations to primary care providers. Primary endpoints included the number and types of MLDs identified, number and types of MRPs identified, and the rate of unplanned 30-day hospital readmissions. Seventy-six patients were enrolled, and 78 MLDs and 108 MRPs were identified. Of the identified MRPs, 74.1% were resolved. A relative risk reduction of 36.8% was achieved for 30-day hospital readmissions for those with high medication risk contacted by the TCM Pharmacist compared to those only contacted by the TCM Nurse. Overall, TCM Pharmacists identified and resolved 80 medication-related problems, improved access to medication therapy, provided comprehensive medication counseling, and bridged gaps in care following hospital discharge.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"55 8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80698936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Vaismoradi, Flores Vizcaya Moreno, Hege Sletvold, S. Jordan
Many medications are prescribed and administered PRN (pro re nata, as needed). However, there are few integrative reviews to inform PRN psychotropic medication use in long-term care facilities and nursing or care homes. Accordingly, this integrative systematic review aimed to improve our understanding of PRN medicines management with a focus on psychotropic medications (antipsychotics, sedatives, anxiolytics, and hypnotics) in long-term care settings. Keywords relating to PRN in English, Norwegian, and Spanish were used, and articles published between 2009 and 2019 were retrieved. Based on the inclusion criteria, eight articles were used for data analysis and synthesis. This review offers a description of PRN prescription and administration of psychotropic medications in long-term care. Variations were observed in the management of PRN psychotropic medications based on residents’ underlying health conditions and needs, duration of use, and changes between medications and doses. Neither the reasons for PRN prescription and administration nor the steps taken to identify and manage any associated adverse reactions or adverse drug events were reported. Further initiatives are needed to improve PRN medicines management to explore factors that affect PRN prescription and administration and to develop appropriate PRN guidelines to prevent harm and improve the safety of people living in long-term care facilities.
{"title":"PRN Medicines Management for Psychotropic Medicines in Long-Term Care Settings: A Systematic Review","authors":"M. Vaismoradi, Flores Vizcaya Moreno, Hege Sletvold, S. Jordan","doi":"10.3390/pharmacy7040157","DOIUrl":"https://doi.org/10.3390/pharmacy7040157","url":null,"abstract":"Many medications are prescribed and administered PRN (pro re nata, as needed). However, there are few integrative reviews to inform PRN psychotropic medication use in long-term care facilities and nursing or care homes. Accordingly, this integrative systematic review aimed to improve our understanding of PRN medicines management with a focus on psychotropic medications (antipsychotics, sedatives, anxiolytics, and hypnotics) in long-term care settings. Keywords relating to PRN in English, Norwegian, and Spanish were used, and articles published between 2009 and 2019 were retrieved. Based on the inclusion criteria, eight articles were used for data analysis and synthesis. This review offers a description of PRN prescription and administration of psychotropic medications in long-term care. Variations were observed in the management of PRN psychotropic medications based on residents’ underlying health conditions and needs, duration of use, and changes between medications and doses. Neither the reasons for PRN prescription and administration nor the steps taken to identify and manage any associated adverse reactions or adverse drug events were reported. Further initiatives are needed to improve PRN medicines management to explore factors that affect PRN prescription and administration and to develop appropriate PRN guidelines to prevent harm and improve the safety of people living in long-term care facilities.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82920581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
I. Arnet, Jean-Pierre Rothen, V. Albert, K. Hersberger
Several methods exist for measuring medication adherence. The Time4MedTM device (Adherence Innovations, Hong Kong) is a small, electronic card to affix on medication packaging that records date and time of intakes when a button is pushed. We aimed to validate the device with an emphasis on polypharmacy. Twenty volunteers used Time4MedTM devices with a virtual thrice daily intake over 14 days. Diary-recorded date and time were compared to electronically-stored events. Functionality, reliability and recovery for different stress conditions were calculated. User‘s acceptability was assessed with the System Usability Scale (SUS). Eleven elderly outpatients (mean age 80.2 ± 8.1 years) taking >3 medications daily used the device over 4 weeks. Volunteers logged 847 events. Functionality (100%), sensitivity (94.9%), specificity (99.4%) and recovery (100%) were high. Dropping the smart card and storing it in a refrigerator caused either the recording of false events or no recording at all. The mean SUS score was 82.6 (SD 14.8), demonstrating excellent acceptability. Satisfaction was very high for volunteers and patients, except for pushing the button. Time4MedTM devices are highly accurate in recording, retaining and delivering electronic data of multiple medication intake. They are well accepted by elderly patients. They can be recommended in clinical studies and for practitioners who desire to elucidate adherence patterns of ambulatory patients.
{"title":"Validation of a Novel Electronic Device for Medication Adherence Monitoring of Ambulatory Patients","authors":"I. Arnet, Jean-Pierre Rothen, V. Albert, K. Hersberger","doi":"10.3390/pharmacy7040155","DOIUrl":"https://doi.org/10.3390/pharmacy7040155","url":null,"abstract":"Several methods exist for measuring medication adherence. The Time4MedTM device (Adherence Innovations, Hong Kong) is a small, electronic card to affix on medication packaging that records date and time of intakes when a button is pushed. We aimed to validate the device with an emphasis on polypharmacy. Twenty volunteers used Time4MedTM devices with a virtual thrice daily intake over 14 days. Diary-recorded date and time were compared to electronically-stored events. Functionality, reliability and recovery for different stress conditions were calculated. User‘s acceptability was assessed with the System Usability Scale (SUS). Eleven elderly outpatients (mean age 80.2 ± 8.1 years) taking >3 medications daily used the device over 4 weeks. Volunteers logged 847 events. Functionality (100%), sensitivity (94.9%), specificity (99.4%) and recovery (100%) were high. Dropping the smart card and storing it in a refrigerator caused either the recording of false events or no recording at all. The mean SUS score was 82.6 (SD 14.8), demonstrating excellent acceptability. Satisfaction was very high for volunteers and patients, except for pushing the button. Time4MedTM devices are highly accurate in recording, retaining and delivering electronic data of multiple medication intake. They are well accepted by elderly patients. They can be recommended in clinical studies and for practitioners who desire to elucidate adherence patterns of ambulatory patients.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"10 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77732993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Continuing Education (CE) or Continuing Professional Development (CPD) are used by pharmacists globally to maintain up-to-date knowledge and skills throughout their careers. The primary aim of this study was to identify the formats or models used by pharmacists for CE and CPD globally. The secondary aim was to identify preferences of pharmacists, in relation to the variety of formats or models used to fulfil mandatory requirements, in order to support future planning of lifelong learning events. A systematic review was performed using PubMed, Science Direct, and Web of Science covering a time period from 1995 until March 2018. Searches were conducted in English, with studies on undergraduate studies being excluded. Eighteen papers from an initial search of 4561 were included from 2004 to 2014. All studies focused on pharmacists. Three studies identified face-to-face learning as a preference, with six studies identifying a positive impact of interactive learning. All four identified studies focusing on online provision were linked to CE. One study highlighted the benefits of blended learning. Two studies identified concluded that no one size fits all. A clear structure of event was highlighted in three studies. Three studies highlighted the relevance of topics to practice, and two studies showed the need for opportunities to apply knowledge. Due to the variety of formats and no consistent model, no perfect model or activity has been identified. However, CPD showed increased practice outcomes versus CE. Although an increasing amount of technology is being utilized, face-to-face learning is still preferred. Interactive, multiple-format learning should be used where possible, to reflect preferences of different learners. There is a need for a structured approach to the planning and learning event itself to support CE and CPD.
继续教育(CE)或持续专业发展(CPD)是全球药剂师在其职业生涯中保持最新知识和技能的方法。本研究的主要目的是确定全球药剂师用于CE和CPD的格式或模型。第二个目的是确定药剂师在满足强制性要求的各种形式或模式方面的偏好，以便支持终身学习活动的未来规划。使用PubMed、Science Direct和Web of Science对1995年至2018年3月的时间段进行了系统评价。检索以英语进行，排除了本科生研究。从2004年到2014年，最初的4561篇论文中有18篇被纳入。所有的研究都集中在药剂师身上。三项研究发现面对面学习是一种偏好，六项研究发现互动学习的积极影响。所有四项关注在线提供的研究都与CE有关。一项研究强调了混合式学习的好处。两项研究得出结论，没有一种方法适合所有人。三个研究突出了清晰的事件结构。三项研究强调了主题与实践的相关性，两项研究表明需要有机会应用知识。由于形式多样，没有一致的模型，因此没有确定出完美的模型或活动。然而，与CE相比，CPD显示出更高的实践结果。虽然越来越多的技术正在被利用，面对面的学习仍然是首选。在可能的情况下，应采用互动式、多种形式的学习，以反映不同学习者的偏好。需要一种结构化的方法来规划和学习活动本身，以支持CE和CPD。
{"title":"A Systematic Review of Models Used and Preferences for Continuing Education and Continuing Professional Development of Pharmacists","authors":"R. Micallef, R. Kayyali","doi":"10.3390/pharmacy7040154","DOIUrl":"https://doi.org/10.3390/pharmacy7040154","url":null,"abstract":"Continuing Education (CE) or Continuing Professional Development (CPD) are used by pharmacists globally to maintain up-to-date knowledge and skills throughout their careers. The primary aim of this study was to identify the formats or models used by pharmacists for CE and CPD globally. The secondary aim was to identify preferences of pharmacists, in relation to the variety of formats or models used to fulfil mandatory requirements, in order to support future planning of lifelong learning events. A systematic review was performed using PubMed, Science Direct, and Web of Science covering a time period from 1995 until March 2018. Searches were conducted in English, with studies on undergraduate studies being excluded. Eighteen papers from an initial search of 4561 were included from 2004 to 2014. All studies focused on pharmacists. Three studies identified face-to-face learning as a preference, with six studies identifying a positive impact of interactive learning. All four identified studies focusing on online provision were linked to CE. One study highlighted the benefits of blended learning. Two studies identified concluded that no one size fits all. A clear structure of event was highlighted in three studies. Three studies highlighted the relevance of topics to practice, and two studies showed the need for opportunities to apply knowledge. Due to the variety of formats and no consistent model, no perfect model or activity has been identified. However, CPD showed increased practice outcomes versus CE. Although an increasing amount of technology is being utilized, face-to-face learning is still preferred. Interactive, multiple-format learning should be used where possible, to reflect preferences of different learners. There is a need for a structured approach to the planning and learning event itself to support CE and CPD.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82891626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Parbir Jagpal, Nigel Barnes, R. Lowrie, A. Banerjee, V. Paudyal
Persons experiencing homelessness have a high prevalence of severe mental health problems, alcohol dependence, substance misuse and infectious hepatitis C, and face up to twelve times higher mortality rates compared to the general population. They also face barriers to accessing healthcare. However, clinical pharmacy services are currently not available to homeless populations in England. The aim of this study was to conduct public involvement sessions with persons experiencing homelessness with a view to inform the design of patient-centred clinical pharmacy healthcare services. Qualitative methodology was used, using a focus group with homeless persons from emergency shelters and one to one engagement with those sleeping rough, using a topic guide. A total of nine homeless persons took part—seven males and two females. The participants of the sessions said that patient-centred clinical pharmacy services delivered for homeless persons would address many of their unmet needs around access to medicines, their understanding of prescribed medicines and holistic management of their health. The service would be able to make a positive impact on their health outcomes by screening for health conditions, facilitating better integration across services, referral and liaison with other services, and minimising misuse of prescribed medicines. The findings of this study will be used to inform the development, implementation and evaluation of a patient-centred clinical pharmacy service tailored to meet the specific needs of the homeless population.
{"title":"Clinical Pharmacy Intervention for Persons Experiencing Homelessness: Evaluation of Patient Perspectives in Service Design and Development","authors":"Parbir Jagpal, Nigel Barnes, R. Lowrie, A. Banerjee, V. Paudyal","doi":"10.3390/pharmacy7040153","DOIUrl":"https://doi.org/10.3390/pharmacy7040153","url":null,"abstract":"Persons experiencing homelessness have a high prevalence of severe mental health problems, alcohol dependence, substance misuse and infectious hepatitis C, and face up to twelve times higher mortality rates compared to the general population. They also face barriers to accessing healthcare. However, clinical pharmacy services are currently not available to homeless populations in England. The aim of this study was to conduct public involvement sessions with persons experiencing homelessness with a view to inform the design of patient-centred clinical pharmacy healthcare services. Qualitative methodology was used, using a focus group with homeless persons from emergency shelters and one to one engagement with those sleeping rough, using a topic guide. A total of nine homeless persons took part—seven males and two females. The participants of the sessions said that patient-centred clinical pharmacy services delivered for homeless persons would address many of their unmet needs around access to medicines, their understanding of prescribed medicines and holistic management of their health. The service would be able to make a positive impact on their health outcomes by screening for health conditions, facilitating better integration across services, referral and liaison with other services, and minimising misuse of prescribed medicines. The findings of this study will be used to inform the development, implementation and evaluation of a patient-centred clinical pharmacy service tailored to meet the specific needs of the homeless population.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"16 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89687215","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Erini Abdelmessih, M. Simpson, J. Cox, Yann Guisard
The Arabic-speaking immigrant group, which makes up the fourth largest language group in Australia, has a high prevalence of cardiovascular disease. The objective of this study was to explore the health care challenges and needs of Arabic-speaking immigrants with cardiovascular disease (CVD), using a comparative approach with English-speaking patients with CVD as the comparable group. Methods: Participants were recruited from community settings in Melbourne, Australia. Face-to-face semi-structured individual interviews were conducted at the recruitment sites. All interviews were audio-taped, transcribed, and coded thematically. Results: 29 participants with CVD were recruited; 15 Arabic-speaking and 14 English-speaking. Arabic-speaking immigrants, and to a lesser extent English-speaking patients with CVD may have specific health care challenges and needs. Arabic-speaking immigrants’ health care needs include: effective health care provider (HCP)-patient communication, accessible care, participation in decision-making, and empowerment. English-speaking participants viewed these needs as important for CVD management. However, only a few English-speaking participants cited these needs as unmet health care needs. Conclusion: This study suggests that Arabic-speaking immigrants with CVD may have unique needs including the need for privacy, effective HCP-patient communication that takes into account patients’ limited English proficiency, and pharmacist-physician collaboration. Therefore, there may be a need to identify a health care model that can address these patients’ health care challenges and needs. This, in turn, may improve their disease management and health outcomes.
{"title":"Exploring the Health Care Challenges and Health Care Needs of Arabic-Speaking Immigrants with Cardiovascular Disease in Australia","authors":"Erini Abdelmessih, M. Simpson, J. Cox, Yann Guisard","doi":"10.3390/pharmacy7040151","DOIUrl":"https://doi.org/10.3390/pharmacy7040151","url":null,"abstract":"The Arabic-speaking immigrant group, which makes up the fourth largest language group in Australia, has a high prevalence of cardiovascular disease. The objective of this study was to explore the health care challenges and needs of Arabic-speaking immigrants with cardiovascular disease (CVD), using a comparative approach with English-speaking patients with CVD as the comparable group. Methods: Participants were recruited from community settings in Melbourne, Australia. Face-to-face semi-structured individual interviews were conducted at the recruitment sites. All interviews were audio-taped, transcribed, and coded thematically. Results: 29 participants with CVD were recruited; 15 Arabic-speaking and 14 English-speaking. Arabic-speaking immigrants, and to a lesser extent English-speaking patients with CVD may have specific health care challenges and needs. Arabic-speaking immigrants’ health care needs include: effective health care provider (HCP)-patient communication, accessible care, participation in decision-making, and empowerment. English-speaking participants viewed these needs as important for CVD management. However, only a few English-speaking participants cited these needs as unmet health care needs. Conclusion: This study suggests that Arabic-speaking immigrants with CVD may have unique needs including the need for privacy, effective HCP-patient communication that takes into account patients’ limited English proficiency, and pharmacist-physician collaboration. Therefore, there may be a need to identify a health care model that can address these patients’ health care challenges and needs. This, in turn, may improve their disease management and health outcomes.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83379354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Pharmacy technicians are legally allowed to administer immunizations in specific U.S. states, provided they meet certain criteria, including the completion of an accredited immunization training course. Immunizing pharmacy technicians were incorporated into an Indian Health Services federal facility, Whiteriver Service Unit (WRSU), in 2018. The objective of this research was to gather information about implementing immunizing pharmacy technicians in a federal facility serving a large rural and medically underserved population. Methods: WRSU launched a Pharmacy Technician Immunization Program in June 2018 after seven federally employed pharmacy technicians participated in the Washington State University accredited technician immunization training. The types of vaccinations administered, and the ages of patients immunized by pharmacy technicians, were tracked from July 1, 2018 to June 30, 2019. Results: Seven immunization-trained pharmacy technicians administered 4394 injections for a total of 4852 vaccinations in one year. Vaccinations were administered to patients ranging in age from 2 months old to 85 years old and included protection against diphtheria, tetanus, polio, hepatitis A and B, H. influenza, human papillomavirus, seasonal influenza, meningococcal, measles, mumps, rubella, varicella, pneumonia, and rotavirus. Conclusion: In one year, seven pharmacy technicians administered more than 4800 vaccinations to underserved patients. Pharmacy technicians trained and certified to administer immunizations increase access to vaccination care and have the potential to drastically increase the number of immunizations given and reduce the number of deaths from vaccine-preventable diseases.
{"title":"Implementing Immunizing Pharmacy Technicians in a Federal Healthcare Facility","authors":"K. McKeirnan, Gregory Sarchet","doi":"10.3390/pharmacy7040152","DOIUrl":"https://doi.org/10.3390/pharmacy7040152","url":null,"abstract":"Background: Pharmacy technicians are legally allowed to administer immunizations in specific U.S. states, provided they meet certain criteria, including the completion of an accredited immunization training course. Immunizing pharmacy technicians were incorporated into an Indian Health Services federal facility, Whiteriver Service Unit (WRSU), in 2018. The objective of this research was to gather information about implementing immunizing pharmacy technicians in a federal facility serving a large rural and medically underserved population. Methods: WRSU launched a Pharmacy Technician Immunization Program in June 2018 after seven federally employed pharmacy technicians participated in the Washington State University accredited technician immunization training. The types of vaccinations administered, and the ages of patients immunized by pharmacy technicians, were tracked from July 1, 2018 to June 30, 2019. Results: Seven immunization-trained pharmacy technicians administered 4394 injections for a total of 4852 vaccinations in one year. Vaccinations were administered to patients ranging in age from 2 months old to 85 years old and included protection against diphtheria, tetanus, polio, hepatitis A and B, H. influenza, human papillomavirus, seasonal influenza, meningococcal, measles, mumps, rubella, varicella, pneumonia, and rotavirus. Conclusion: In one year, seven pharmacy technicians administered more than 4800 vaccinations to underserved patients. Pharmacy technicians trained and certified to administer immunizations increase access to vaccination care and have the potential to drastically increase the number of immunizations given and reduce the number of deaths from vaccine-preventable diseases.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79730843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This research aims to identify the most prevalent and impactful sales promotion tools used by pharmaceutical companies on consumers’ purchasing decisions at community pharmacies. A cross-sectional study design was carried out using the non-repeated random sampling technique. Standardized questionnaires were administered by means of face-to-face interviews or via emails. The relative importance of prevalence (RIP) and the mean evaluation of effectiveness (MEE) were determined for all studied marketing tools for the different groups of respondents (pharmaceutical sales representatives (PSRs), community pharmacists, consumers, and the entire sample). Inter-individual differences in RIP and MEE were assessed by computing the coefficient of variation, whereas inter-group differences were determined by one-way analysis of variance (ANOVA) with the Scheffé test as a post-hoc test. Research findings showed that, according to all respondents, the consumer promotion technique had the strongest impact on consumers’ purchasing decisions while merchandising was the most common sales promotion technique at community pharmacies. PSRs and pharmacists identified trade promotion as the most effective and prevalent technique. Furthermore, research findings showed that, according to all respondents, the following sales promotion tools had the strongest impact on consumers’ purchasing decisions: arrangement and design of showcases among the studied tools for merchandising; buy 1 and get 2 among the studied tools for consumer promotion; and gifts among the trade promotion studied tools. The same tools were identified as the most prevalent by all respondents. Free samples of promoted products appeared to be the most prevalent tool, but at the same time was the least effective. In conclusion, the results of the present research enable an understanding of which sales promotion tools are commonly used at community pharmacies and which ones have the strongest impact on consumers’ purchasing decisions.
{"title":"Influence of Sales Promotion Techniques on Consumers’ Purchasing Decisions at Community Pharmacies","authors":"Y. Ben Said, N. Bragazzi, N. Pyatigorskaya","doi":"10.3390/pharmacy7040150","DOIUrl":"https://doi.org/10.3390/pharmacy7040150","url":null,"abstract":"This research aims to identify the most prevalent and impactful sales promotion tools used by pharmaceutical companies on consumers’ purchasing decisions at community pharmacies. A cross-sectional study design was carried out using the non-repeated random sampling technique. Standardized questionnaires were administered by means of face-to-face interviews or via emails. The relative importance of prevalence (RIP) and the mean evaluation of effectiveness (MEE) were determined for all studied marketing tools for the different groups of respondents (pharmaceutical sales representatives (PSRs), community pharmacists, consumers, and the entire sample). Inter-individual differences in RIP and MEE were assessed by computing the coefficient of variation, whereas inter-group differences were determined by one-way analysis of variance (ANOVA) with the Scheffé test as a post-hoc test. Research findings showed that, according to all respondents, the consumer promotion technique had the strongest impact on consumers’ purchasing decisions while merchandising was the most common sales promotion technique at community pharmacies. PSRs and pharmacists identified trade promotion as the most effective and prevalent technique. Furthermore, research findings showed that, according to all respondents, the following sales promotion tools had the strongest impact on consumers’ purchasing decisions: arrangement and design of showcases among the studied tools for merchandising; buy 1 and get 2 among the studied tools for consumer promotion; and gifts among the trade promotion studied tools. The same tools were identified as the most prevalent by all respondents. Free samples of promoted products appeared to be the most prevalent tool, but at the same time was the least effective. In conclusion, the results of the present research enable an understanding of which sales promotion tools are commonly used at community pharmacies and which ones have the strongest impact on consumers’ purchasing decisions.","PeriodicalId":19920,"journal":{"name":"Pharmacy: Journal of Pharmacy Education and Practice","volume":"122 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81386616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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