Pharmacists' views about health promotion practices

Community pharmacy staff perceptions on preventing alcohol and medication interactions in older adults

OBJECTIVES

To examine rural and urban pharmacy staff perceptions on messaging, barriers, and motivators for preventing alcohol and medication interactions (AMI) in older adults (≥65 years of age).

METHODS

A survey was distributed through the local pharmacist association and statewide pharmacy registry in Kentucky. A total of 255 responses were received from pharmacists, pharmacy technicians, and pharmacy students.

RESULTS

Across rural and urban regions alike, among the AMI prevention messages provided, participants identified the most important messages to be: AMI can be potentially dangerous and life threatening; emergency rooms should be used when experiencing an AMI; and doctors and pharmacists should be consulted about AMI. The most common AMI prevention barriers indicated were stigma, costs, and low perceived risks. The most common AMI prevention motivators indicated were physical health improvement, promoting a healthy lifestyle, convenient setting, and financial incentives.

CONCLUSION

Regardless of geography, participants similarly rated the presented AMI prevention messages, barriers, and motivators. With the use of these findings, the development of an AMI prevention program is suggested to use messaging about AMI threat, behavioral management, and behavioral prevention.

Assessment of Communication Barriers in Community Pharmacies

This study identified previously reported facilitators and barriers to pharmacist-client communication and then evaluated their impact on the observed communication behaviors of pharmacists. Pharmacists (n = 100) completed a seven-page questionnaire collecting information on 11 variables that had been organized according to the Policy, Regulatory and Organizational Constructs in Educational and Ecological Development (PROCEDE) model as predisposing, enabling, or reinforcing of pharmacist communication with their clients. Demographic variables also were included. “Communication quality” served as the study’s dependent variable, whereas pharmacist responses served as the independent variables. Communication quality scores for each pharmacist were obtained from the analysis of 765 audio recordings of verbal exchanges occurring between the study pharmacists and their consenting clients during 4-hour, on-site observation periods. Four of the variables examined in the study were found to share a unique relationship with communication quality (pharmacists’ attitude, year of graduation, adherence expectations, and outcome expectations). Hierarchical multiple regression analysis revealed that the variables measured in the questionnaire accounted for 23% of the variance in communication quality scores. Plausible explanations for why the study was unable to capture more of the variance in its proposed relationships and future areas for research are provided.

Factors influencing Australian community pharmacists' willingness to participate in research projects - an exploratory study

Objective

To identify the factors influencing Australian community pharmacists' willingness to participate in research projects and their attitudes towards research.

Method

A mixed-method survey instrument comprising demographics, previous participation in research, and perceptions about participation in research was mailed to 267 community pharmacists in New South Wales and the Australian Capital Territory. An analysis of variance test was used to identify similarities and differences between research- and non-research-active respondents. Bivariate correlations and partial least squares (PLS) regression analyses were used to identify barriers and facilitators to research participation.

Key findings

The overall response rate to the survey was 40%. Of these, 70% were classified as previous research participants (PRP), and 30% were classified as non-previous research participants (NPRP). Both groups had mostly favourable attitudes towards research; however, the results revealed several differences between the PRP and NPRP groups. Three items were identified as key facilitators to participation in research for both PRP and NPRP groups - having an interest in the research topic; believing that the research will benefit the customer; and a belief that community pharmacy research is important. Lack of time, either real or perceived, was identified as a key barrier to participation in research for both the PRP and NPRP groups.

Conclusion

Researchers should take into account pharmacists' previous research experience when recruiting pharmacists into research projects. In the case of pharmacists with research experience, emphasis should be on promoting factors that facilitate participation. In the case of pharmacists with little research experience, emphasis should be on reducing barriers to participation.

The role of community pharmacists in health education and disease prevention: a survey of their interests and needs in relation to cardiovascular disease

BACKGROUND

Recently there has been increased interest in broadening the role of community pharmacists to include more health education and disease prevention activities such as patient counseling for risk management and interventions to improve compliance. However, to date, there is little information on interest in prevention among community pharmacists or on their current prevention practices.

METHOD

Data on current health education and disease prevention practices, as well as interest in expanding their role in prevention, were collected in a cross-sectional mail survey of a random representative sample of community pharmacists currently practicing in the province of Quebec.

RESULTS

Among 597 eligible subjects, 455 (76.2%) completed the questionnaire. Few pharmacists practice prevention routinely. Independent correlates of engaging in prevention included working in a smaller pharmacy (odds ratio (OR) 3. 2 (95% confidence interval 2.0-5.3)), owning the pharmacy (OR 1.9 (1. 2-3.0)), moderate/high job satisfaction (OR 2.1 (1.4-4.3)), and history of prevention activities in the pharmacy (OR 2.2 (1.4-3.6)). Over 90% of respondents reported that integrating prevention into their practices was important. Independent correlates of high perceived importance included working as a salaried pharmacist (OR 2. 3 (1.4-3.8)), high job satisfaction (OR 4.1 (1.7-9.7)), and currently practicing prevention (OR 2.0 (1.2-3.2)). The most important perceived barriers to integrating prevention included lack of time and lack of skills/instrumentation for practicing prevention.

CONCLUSIONS

There is considerable interest among community pharmacists in expanding their role to include more prevention, but there are many barriers to actualizing this role. Further work should focus on ways to overcome these barriers because pharmacists are particularly well-situated to make an important contribution to prevention.

Pharmacists' concerns and suggestions related to the sale of tobacco and alcohol in pharmacies

A random sample of Pharmacists in Indiana was selected and surveyed regarding their thoughts and comments on the sale of tobacco and alcoholic products by pharmacies. A total of 212 pharmacists provided written responses to an open-ended question. The replies were then synthesized into major themes. The majority of comments categorized revealed strong opposition to pharmacies selling tobacco and alcohol products. The most frequently occurring message regarding the sale of these products by pharmacies was that it goes against the pharmacist's role as a professional health care provider and may harm their image. For some pharmacists, this issue posed a moral dilemma between caring for patient safety and the economic incentives provided by the sale of tobacco and alcohol. Based on these findings, a follow-up phone survey was conducted to solicit suggestions from pharmacists on how to advocate against the sale of tobacco and alcohol by pharmacies. The majority of pharmacists strongly recommended that they need to do more among themselves and within their store environment, rather than have regulations imposed on pharmacies when it comes to limiting the sale of these products.

Pharmacists' opinions and practices related to the sale of cigarettes and alcohol--a follow-up study

Opinions that pharmacists hold and their practices concerning sale of cigarettes and alcohol are of interest to health experts. As a follow-up to a 1990 statewide survey of pharmacists opinions and practices related to the sale of cigarettes and alcohol, this study was designed (1) to determine current opinions and practices of pharmacists' related to the sale of cigarettes and alcohol; (2) compare these findings with results from the 1990 study; and (3) to gather new information on pharmacists' practice of health promotion activities. A structured survey questionnaire was designed and reviewed by a jury of experts and subsequently administered to half of the 1340 pharmacies in Indiana. Collected data were analyzed by using descriptive and inferential statistical methods. Findings reveal that 64 percent of responding pharmacists sell cigarettes in their stores even though 82 percent think that their stores should not sell cigarettes. Approximately 42 percent of the pharmacies sell alcoholic beverages while more than two-thirds of the pharmacists (68%) think pharmacies should not sell alcoholic beverages. These findings represent a decline of 7.2 percent in pharmacies that sell cigarettes and a 6.8 percent increase in pharmacies selling alcoholic beverages compared to the 1990 study. Study results also revealed that most pharmacists agree the use of cigarettes and alcohol were important causes of morbidity and mortality and that pharmacists should play a role in health promotion and disease prevention to the public. However, the majority do not ask their patients about their smoking and alcohol habits and do not participate in health education/promotion programs for the general community.

Student nurse opinions about the importance of health promotion practices

Senior nursing students (N = 505) attending 13 schools in the NY metropolitan area were administered a questionnaire to assess their beliefs about the importance of health promotion behaviors to the average person. Respondents rated 23 health promotion practices on a Likert scale. The five most important items concerned: knowledge of drug contents and their side effects; the elimination of cigarette and cigar smoking; eating a balanced diet; and using a seat belt. The least important item concerned having an annual exercise test. These results were similar to those found for other health care providers, including physicians, dietitians, and pharmacists. Further, the results were similar to those found in an earlier survey of student nurses. Nurses' attitudes and beliefs seem supportive of health promotion and disease prevention. These attitudes also seem associated with the nurse's role as health promoter. Positive nurse attitudes/beliefs toward health promotion are posited as precursors to the alteration of patient behaviors, although further exploration in this area is needed.

Dietitians' beliefs about the importance of health promotion practices

Registered dietitians throughout the state of Delaware (N = 146) were surveyed by mail to assess their beliefs about the importance of health promoting behaviors to the health of the average person. Respondents were instructed to rate each of 25 health promotion practices on a Likert scale. Results were compared with investigations of other health care providers. "Eating a balanced diet" was rated among the top five items. "Taking vitamin supplements" received the lowest mean rating. Results of the present study compared well with the beliefs of pharmacists and physicians. Ratings by other registered dietitians from an earlier study tended to be more conservative. Dietitians are supportive of health promotion and disease prevention. Their current role in health promotion activities needs further investigation.