Physicians' and patients' valuation of pharmaceutical care implementation in Poznan (Poland) community pharmacies

Public Perception of Pharmacists in Poland

Background. Pharmacists constitute one of the largest groups of medical professionals and play a significant role in public health. Pharmaceutical care in community pharmacies is one of the key elements that impact the clinical outcomes of patients. The main objective of this study was to evaluate the public perception of pharmacists in Poland, as well as the knowledge of and willingness of Polish people to use pharmaceutical care services. Methods. This study was carried out in 2017 on 1435 people. The research tool was an anonymous online questionnaire. Results. Of the participants, 61% considered pharmacists to have a position of public trust, and 25% trusted pharmacists to a lesser extent than representatives of other medical professions. The participants stated that pharmacists were kind (74%) and helpful (69%). For 52% of the participants, pharmacists were fully competent to provide information on medications. Twenty-eight percent of the participants ask pharmacists for advice related to medicinal products. Poles’ knowledge on pharmaceutical care was low (44% of the respondents knew this notion). Sixty-six percent of the participants were willing to use pharmaceutical consultations (43% free of charge, and 23% for a nominal fee). Conclusions. Although the overall perception of patients towards pharmacists was positive in Poland, it is essential to educate patients on the possibilities of using pharmaceutical services, and to promote the role of pharmacists in healthcare systems.

How to effectively promote interprofessional collaboration? - a qualitative study on physicians' and pharmacists' perspectives driven by the theory of planned behavior

BACKGROUND

Ajzen's theory of planned behavior (TPB) postulates that individuals' behavioral intention is influenced by their attitudes, subjective norms, and perceived behavioral control. Therefore, it can be used to broaden the understanding of particular behaviors, including healthcare workers' professional activities.

METHODS

In this study, we used TPB as a theoretical framework to evaluate semi-structured interviews with pharmacists and physicians to build an understanding of the interprofessional collaboration between them. Sixteen semi-structured interviews were conducted with pharmacists and eleven with physicians. The sample of participants comprised a diverse group with varying work experience and workplaces. Data were analyzed independently by two researchers following the thematic analysis method using ATLAS.ti software. Data saturation was set in the absence of new issues arising during the interviews.

RESULTS

The content analysis allowed for the determination of six main themes: the relationship between previous experiences and attitudes towards collaboration, pharmacist's role in collaboration, mutual reluctance toward collaboration, the role of decision- and policy-makers, knowledge and qualifications gaps regarding collaboration, and lack of organizational paths.

CONCLUSIONS

Despite both physicians and pharmacists displaying positive attitudes towards collaboration may foster their intention to establish a professional partnership, subjective norms (e.g., the lack of appropriate legal regulations) and perceived behavioral control (physicians' lack of awareness about pharmacists' qualifications and the low level of interpersonal skills) might impede the process.

A survey of pharmacists' knowledge, attitudes and barriers in pharmaceutical care concept in Poland

BACKGROUND

The major goals of pharmaceutical care (PC) are to improve the patient's quality of life and ensure safety of pharmacotherapy. Inclusion of a pharmacist in the multidisciplinary team caring for the patient and integration of state-of-the-art pharmaceutical services with medical care and nursing are some of the most important challenges that the health care system in Poland is facing.

OBJECTIVES

To evaluate the pharmacists attitudes towards practice in, and knowledge of PC in Poland and to identify the barriers in PC provision.

METHODS

The study was designed as a multicenter study, conducted among Polish pharmacists. Random sampling technique was employed to select the study group. Face-to-face questionnaire method was used to interview the pharmacists, upon obtaining their prior verbal consent to participate in the study. The study was conducted between January 2017 and September 2019.

RESULTS

Only 15% of the pharmacists have ever attended a training on PC. 72% believed PC provision was necessary to ensure pharmacotherapy safety. Only 63% of the pharmacists believed that preventing and solving health-related and drug therapy problems for patients were their responsibilities. The main reason for non-provision of PC by the pharmacists was the lack of time for such activities, lack of legal regulations, lack of organizational facilities.

CONCLUSION

This study indicates that implementation of PC is expected in Poland. Educational programs in this respect are urgently needed. PC provision should be included in the curricula of academic pharmaceutical courses.

Evaluating the impact of pharmaceutical care services on the clinical outcomes of epilepsy: a randomised controlled trial

BACKGROUND

The involvement of pharmacists in the provision of specialised care to patients with epilepsy is poor.

OBJECTIVE

To evaluate the impact of pharmaceutical care services on the clinical outcomes of epilepsy.

SETTING

Two selected major referral epilepsy treatment centres in southern Nigeria were used for the study. Patients were recruited from the Neurology and Medical out-patient clinics of the hospitals.

METHOD

An open randomised controlled study was carried out on epilepsy patients receiving clinical care at the selected hospitals. Patients in the intervention group were offered pharmaceutical care services. The impact of the pharmaceutical care services on the clinical outcomes of epilepsy (seizure frequency and severity) was evaluated.

MAIN OUTCOME MEASURE

The effect of pharmaceutical care services on seizure frequency and severity in patients with epilepsy.

RESULTS

There was a statistically significant difference between the usual care (UC) and the pharmaceutical care (PC) group on the clinical outcomes of epilepsy post-PC intervention. Comparison between the groups (UC versus PC) revealed that patients in the PC group had a significantly lower seizure frequency score than those in the UC group at 3 months and 6 months-(pre-intervention: 3.09 versus 3.34; t = -1.685; p = 0.094) (3 months 2.45 versus 1.68; t = 4.494; p = 0.001), (6 months: 1.97 versus 0.92; t = -3.137; p = 0.001). Also, comparisons between the groups (UC versus PC) showed that patients in the PC group had a significantly lower seizure severity score than those in the UC group at 3 months and 6 months-(pre-intervention 18.46 versus 20.38; t = -3.102; p = 0.01) (3 months: 17.51 versus 14.79; t = 4.202; p = 0.001) (6 months 16.41 versus 11.66; t = 8.930; p = 0.001).

CONCLUSION

Pharmaceutical care interventions may significantly reduce seizure frequency and severity in patients with epilepsy.

IMPACT OF FINDINGS ON PRACTICE

These findings provide justification for the integration of pharmaceutical care services with other elements of health care for epilepsy patients.

Pharmacists' Preparedness to Patients Education at the Time of Pandemic-A Cross-Sectional Study with an Example of SARS-CoV-2 Outbreak in Poland

Although pharmacy employees’ involvement in patient education has great potential, the extent to which they actually provide cognitive services seems inadequate. Given the overburdening of the healthcare system and limited access to medical services due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic outbreak, this study aimed to evaluate the preparedness of Polish pharmacy employees for patient education on the new threat. The study was conducted using the mystery shopper method. Two interviewers phoned 90 randomly chosen community pharmacies throughout Poland and presented some inquiries on the SARS-CoV-2. Pharmacists devoted more time to patients than pharmacy technicians (2:22 vs. 1:54), and the information they provided was significantly more comprehensive (p = 0.006). The majority of respondents provided an evidence-based recommendation on prevention, symptoms, and management of SARS-CoV-2; however, the scope of advice significantly varied. Community pharmacy staff often expressed their concern about the lack of time to address patients’ questions adequately. No statistically significant differences were found in recommendations provided by chain and non-chain pharmacy staff. Obtained results seem to confirm the possibility of involving pharmacists in public health activities during a pandemic. Nevertheless, providing proper working conditions and adequate just-in-time learning solutions is crucial.

As the twig is bent, so is the tree inclined: a survey of student attitudes toward interprofessional collaboration supported with the curricula analysis

Pharmaceutical care was legally introduced as an interprofessional service in Poland in 2009. However, a collaboration between physicians and pharmacists remains incidental. Proper education at the undergraduate level is necessary to shape the attitudes of students toward establishing interprofessional relations. The aim of the study was to assess the perception of physician-pharmacist collaboration among final-year medical and pharmacy students through questionnaires with both closed-ended and open-ended questions. The study also includes an analysis of medicine and pharmacy curricula in terms of promoting interprofessional collaboration between the two fields. The statistical analysis of data obtained from 502 respondents revealed significant differences between the perceived areas for such collaboration. Moreover, the division of roles and responsibilities during the pharmacotherapy process between both professions seems to be unclear. Importantly, only 10.14% of the respondents evaluated these professional relations as 'good' or 'very good'. Also, 66.87% of the students emphasized the importance of educational interventions to improve interprofessional collaboration between pharmacists and physicians. Although 70% of medical and 87% of pharmacy students wish to establish such collaboration in the future, only 15% and 35%, respectively feel adequately prepared for the task. Understanding similarities and differences in this field appears to be the key to designing effective educational solutions for promoting interprofessional attitudes among healthcare undergraduates.

Consumer willingness to pay for pharmacy services: An updated review of the literature

BACKGROUND

Quantifying the value of pharmacy services is imperative for the profession as it works to establish an expanded role within evolving health care systems. The literature documents the work that many have contributed toward meeting this goal. To date, however, the preponderance of evidence evaluates the value of pharmacist services to third-party payers; few published studies address the value that consumers place on these services.

OBJECTIVES

In 1999, a review of studies that used the contingent valuation method to value pharmacy services was published. The objective of this manuscript is to provide an update of that review.

METHODS

Relevant studies published in the English language were identified searching MEDLINE, ECONLIT and International Pharmaceutical Abstracts databases from January 1999 to November 2017. Only studies that specifically elicited willingness to pay for a community pharmacist provided service from actual or potential consumers were included.

RESULTS

Thirty-one studies using the contingent valuation method to value pharmacy services were identified using the search strategy outlined. These studies included surveys in different demographic and geographic populations and valuing various pharmacy services.

CONCLUSIONS

Improving the quality of studies using contingent valuation to value pharmacy services will aid the profession in marketing pharmacy services to consumers, and may assist practitioners who wish to implement various pharmacy services in their practice settings. A limited number of studies have been conducted, but the quality of contingent valuation studies valuing pharmacist services is improving. Understanding the pharmacy services that consumers value, and understanding the level of their monetary willingness to pay for those services will be crucial as the profession continues to work toward establishing a sustainable and economically viable role within the evolving health care systems.

Patients' willingness to pay for cognitive pharmacist services in community pharmacies

AIM

To determine the general population willingness to pay for cognitive pharmacist service in community pharmacy, describe the behavior of participants regarding health care issues, and evaluate correlation between participants' sociodemographic characteristics or attitudes and their willingness to pay.

METHODS

A questionnaire-based survey was conducted among general population visiting community pharmacies. The participants were asked about receiving cognitive pharmacist services to identify and resolve potential medication therapy problems after the initiation of a new medicine to optimize health outcomes of the patients. A univariate and multivariate analysis were used to analyze associations between different variables and willingness to pay for pharmacy service.

RESULTS

Of 444 respondents, 167 (38%) reported that they were willing to pay for a medication management service provided in the community pharmacy. Univariate analysis showed significant association between the willingness to pay for pharmacist-provided service and respondents' socio-demographic factors, health-related characteristics, and behavior, dilemmas, or need for certain pharmacist-provided service. The logistic regression model was statistically significant (χ2=4.599, P<0.001).

CONCLUSIONS

The respondents expressed their willingness to pay for cognitive pharmacist services, which has not been fully recognized within the health care system. In future, pharmacists should focus on practical implementation of the service and models of funding.

The paradigm model of distorted doctor-patient relationship in Southern Iran: a grounded theory study

The doctor-patient relationship (DPR) is one of the most important subjects in medical sociology and health policy. Due to mutual understanding, undistorted DPRs not only result in satisfaction of both doctors and patients, but also help to reduce financial burdens for patients and the health care system. The purpose of this research was to identify a DPR based on the qualitative paradigm model which is called the grounded theory (GT) methodology. The data were collected from 3 focus groups, the participants of which consisted of 21 faculty members of Shiraz University of Medical Sciences, Shiraz, Iran. The content of the interviews, following the transcription stage, was organized based on open, axial, and selective coding. Results showed that DPR was distorted which was the consequence of an inefficient structure in the healthcare system which is related to several cultural barriers. In this situation, agency is determinant so the doctor's personality determines the direction of DPR. Consequences of such scenarios are the patient's distrust, patient's dissatisfaction, lack of mutual understanding, patient suppression, and patient deception. Therefore, the health care system should emphasize on reforming its inefficient infrastructures, so that, besides being controlled and surveyed, physicians are socialized ethically.