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Qudah B, Chewning B. Exploring the impact of a digital health tool on patients' interaction with community pharmacists: A pilot randomized controlled study. Res Social Adm Pharm 2024:S1551-7411(24)00202-X. [PMID: 38971677 DOI: 10.1016/j.sapharm.2024.06.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2024] [Revised: 06/13/2024] [Accepted: 06/28/2024] [Indexed: 07/08/2024]
Abstract
BACKGROUND The use of digital Patient- Reported Outcomes (PRO) tools has been shown to enhance the exchange of information and shared decision-making in medical encounters. However, their influence on patient-pharmacist interactions has not yet been explored. OBJECTIVES This study aimed to examine the impact of RxTalk™, a digital PRO tool, in supporting the communication between patients and pharmacists compared to usual care. METHODS Intervention: RxTalk™ was developed to collect information about medication adherence and beliefs, using a tablet computer. STUDY DESIGN A pilot randomized controlled study was conducted at a community pharmacy in Wisconsin, USA. Sixty patients were randomized to either the intervention group who used RxTalk™ during medication pick-up or the control group who did not use the tool. Patients who used RxTalk™ received paper copies of their responses which were also shared with pharmacists. The consultation was audio-recorded for both groups and coded using the Active Patient Participation Coding scale. Follow-up phone interviews were conducted with both groups within one week of enrollment. RESULTS Patient tapes were analyzed. In the unadjusted model, patients in the intervention group had a higher active participation rate (p = 0.004) and raised significantly more concerns during consultations (p < 0.001) compared to the control group. Pharmacists asked twice as many questions while counseling patients in the intervention group compared to the control group (p < 0.001). After controlling for patients' demographics and pharmacists' questions, there was a statistical difference between the two patient groups in their odds of expressing at least one concern utterance. CONCLUSION This pilot study suggests that collecting PRO from patients with chronic illnesses and providing results to pharmacists and patients can help patients express their health and medication concerns. RxTalk™ would be useful for pharmacists who wish to improve the recognition and management of medication-related problems.
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Affiliation(s)
- Bonyan Qudah
- Department of Medicine, School of Medicine and Public Health, University of Wisconsin, 1685 Highland Ave, Madison, WI, 53705, USA.
| | - Betty Chewning
- Department of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin, 777 Highland Ave., Madison, WI, 53705, USA
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Lungfiel G, Mandlmeier F, Kunow C, Langer B. Oral emergency contraception practices of community pharmacies: a mystery caller study in the capital of Germany, Berlin. J Pharm Policy Pract 2023; 16:68. [PMID: 37237301 DOI: 10.1186/s40545-023-00565-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 04/25/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND In Germany, oral emergency contraception (EC) with the active ingredients levonorgestrel (LNG) and ulipristal acetate (UPA) is available as over-the-counter (OTC) medicine only from community pharmacies (CPs). Because of the window of effect, which is limited to only a few days, CPs have a great responsibility to provide rapid and unimpeded access, while also ensuring "adequate" counseling. The aim was-for the first time in Europe and thus also in Germany for the methodology used in this study-to investigate immediate availability, pricing, and aspects of counseling. METHODS Covert mystery calls were conducted in a random sample of CPs stratified by districts in the German capital Berlin. Each of the 263 CPs included was called once at random by one of two trained female student mystery callers. They simulated a product-based scenario for the UPA original ellaOne®, citing a contraceptive failure one day ago as the reason. RESULTS Of 257 successfully called CPs, UPA preparations were immediately available in 98.4% (253/257) and LNG preparations in 86.8% (184/212) of CPs. Prices for UPA preparations varied from €15.95 to €42.95 (∆ 169%; median €35.00 [interquartile range (IQR) €5.91]) and for LNG preparations from €10.60 to €32.49 (Δ 207%; median €22.00 [IQR €5.76]). Information about the correct different window of effect of UPA and LNG preparations was provided in 69.8% (127/182) of CPs. UPA preparations were recommended in 63.1% (111/176) and LNG preparations in 17.2% (30/174) of CPs. Information was provided on how to take them as soon as possible in 30.8% (44/143) of CPs and on how to use them after vomiting in 46.0% (64/139). CONCLUSIONS Berlin CPs support access through high immediate availability, especially to UPA preparations. However, access is hampered by high absolute price ranges of both UPA and LNG preparations, which could ideally be minimized by a comparison app. It is positive that CPs promote the benefits of UPA preparations by recommending them noticeably more often than LNG preparations. However, there are deficiencies in giving advice, so there is a need to raise awareness among pharmacy staff to ensure "adequate" counseling in advance over the phone.
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Affiliation(s)
- Gwenda Lungfiel
- Department of Health, Nursing, Management, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany
| | - Franca Mandlmeier
- Department of Health, Nursing, Management, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany
| | - Christian Kunow
- Department of Health, Nursing, Management, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany
| | - Bernhard Langer
- Department of Health, Nursing, Management, University of Applied Sciences Neubrandenburg, Neubrandenburg, Germany.
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Abraham O, Peters J, Peterson KA. Characterizing Pharmacist Perspectives on Utilizing a Personalized Family Medication Safety Plan for Opioid Education with Adolescents and Parents. PHARMACY 2023; 11:22. [PMID: 36827660 PMCID: PMC9958921 DOI: 10.3390/pharmacy11010022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 01/18/2023] [Accepted: 01/19/2023] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Exposure to prescription opioids during adolescence is associated with an increased risk of future opioid misuse. The pervasive and growing impact of the opioid epidemic requires evidence-based, co-designed interventions targeted at adolescents. MedSMA℞T Families is an intervention tailored to educate adolescents and their families about opioid misuse prevention and consists of two parts: the MedSMA℞T: Adventures in PharmaCity videogame and the family medication safety plan (FMSP). OBJECTIVE This study sought to explore pharmacists' perceptions of using the family medication safety plan to facilitate opioid education among parents and their adolescents. The purpose of this project was to also gather information for iterative adaptations to improve implementation and dissemination of the FMSP in pharmacy settings. METHODS Pharmacists were recruited from Pharmacy Practice Enhancement and Action Research Link (PearlRx) and the Pharmacy Society of Wisconsin (PSW). Twenty-one pharmacist interviews were conducted between September 2021 and March 2022. Consenting pharmacists reviewed the FMSP. Then, semi-structured interviews were conducted, recorded, and transcribed. Inductive thematic analyses were performed using NVivo software. RESULTS Four prevalent themes emerged: (1) the purpose of FMSP as a communication tool, (2) instructions to clarify how to use FMSP, (3) barriers to using FMSP, and (4) suggestions to improve FMSP format. Most pharmacists described the FMSP as a tool to encourage interactive opioid conversations between adolescents, families, and pharmacists. Pharmacists suggested creating multiple customizable formats and incorporating instructions on how to use the FMSP. CONCLUSIONS Pharmacists noted that the FMSP was an interactive and engaging communication tool to tailor opioid consultations with adolescents and their families. Patients might use the FMSP as a visual cue to help think of what question(s) they should ask pharmacists. Pharmacists stated that the FMSP could facilitate tailored opioid safety communication and medication consultations. Insights will inform future medication misuse prevention interventions as well as adaptation.
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Affiliation(s)
- Olufunmilola Abraham
- Social and Administrative Sciences Division, University of Wisconsin-Madison School of Pharmacy, Madison, WI 53705, USA
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Sokol M, Do A, Hui D, St Jacques S, Sureshbabu S, Weerakoon-Wijeratne A, Bhakta K, Humpert S, Witry M, Evoy KE. Community pharmacists' counseling regarding nicotine replacement therapy: A secret shopper study. J Am Pharm Assoc (2003) 2022; 63:574-581.e3. [PMID: 36549932 DOI: 10.1016/j.japh.2022.11.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 11/12/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND Nicotine replacement therapy (NRT) is a safe and effective non-prescription tobacco cessation treatment. While most community-based pharmacists periodically provide patient education regarding NRT, there is a gap in real-world evidence assessing the counseling provided. OBJECTIVES To assess community pharmacist counseling regarding NRT in a real-world setting. METHODS A cross-sectional secret shopper audit was conducted to collect data regarding NRT counseling from 120 community pharmacist encounters. Seventeen trained college of pharmacy students presented to community pharmacies using a standardized script asking about 1 of 3 common NRT products (patch, gum, and lozenge). Pharmacies were randomly selected from a list of all community pharmacies open to the public in Bexar County, Texas. A standardized assessment form was used to document product availability, counseling length, whether or not the 7 counseling points and 6 assessment questions that could help guide the pharmacist's counseling regarding NRT products were provided without prompting, and potential inaccuracy of any recommendations and counseling points. Descriptive statistics were calculated, and analysis of variance and Fisher's exact test were used to test for variation across site type and time of day. RESULTS NRT was available for purchase without speaking to pharmacy staff in 99 of 120 (83%) pharmacies. The mean length of counseling was 136 (standard deviation = 91) seconds. The most common points discussed were recommended strength (72%), tapering schedule (58%), and assessment of the daily number of cigarettes smoked (56%). Forty-one (34%) pharmacists provided one or more potentially inaccurate counseling points, the most common being inaccurate tapering schedule (provided during 31 (26%) encounters). Only 15% of pharmacists referred auditors for additional help or recommended a follow-up. CONCLUSION NRT was commonly accessible in community pharmacies outside of the pharmacy area. Opportunities for pharmacists to provide more complete and accurate information to better assist patients with safe and effective smoking cessation were identified.
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Huang YM, Wang YH, Chan HY, Chen LJ, Hsieh LL, Lee PI, Ho YF. Engaging consumers in wise use of over-the-counter medications in Taiwan: Development and evaluation of a structured medication counseling approach. PATIENT EDUCATION AND COUNSELING 2022; 105:942-948. [PMID: 34426037 DOI: 10.1016/j.pec.2021.08.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To evaluate the impact of a tailored Symptom Allergy Indication Direction Self-care (SAIDS) counseling by pharmacists on consumers' correct understanding of over-the-counter (OTC) medication use. METHODS This study used a time-based sampling of two independent cohorts at a single community pharmacy in Taiwan for two years beginning in December 2018. In the control cohort, participants received conventional counseling for the OTCs they selected. In the intervention cohort, participants received SAIDS counseling along with pointing out OTC package label instructions. A paper-and-pencil survey was administered face-to-face to evaluate participants' understanding for the correct use of OTCs. Descriptive statistics and chi-square tests were used to evaluate the effect of the SAIDS approach on cohorts' understanding of OTC use. RESULTS Compared with conventional OTC counseling, participants reported better understanding regarding potential side effects of OTCs that they acquired (p < 0.001) and were more aware of strategies to cope with the associated side effects (p < 0.001). CONCLUSIONS AND PRACTICE IMPLICATIONS Despite the time constraints that pharmacists often can offer to each customer, the SAIDS counseling approach may refine the structure and effectiveness of pharmacists' OTC counseling skills and thereby improve consumers' understanding of their ailments and self-care medications in Taiwan.
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Affiliation(s)
- Yen-Ming Huang
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan.
| | - Yao-Hsing Wang
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan; Profession and Quality Pharmacy, Taipei 108009, Taiwan
| | - Hsun-Yu Chan
- Department of Industrial Education, National Taiwan Normal University, Taipei 106308, Taiwan.
| | | | - Ling-Ling Hsieh
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan
| | - Ping-Ing Lee
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei 100226, Taiwan
| | - Yunn-Fang Ho
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan; School of Pharmacy, College of Medicine, National Taiwan University, Taipei 100025, Taiwan.
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Huang YM, Chen LJ, Hsieh LL, Chan HY, Chen-Liu KCS, Ho YF. Evaluation of use, comprehensibility and clarity of over-the-counter medicine labels: Consumers' perspectives and needs in Taiwan. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:753-761. [PMID: 33034423 DOI: 10.1111/hsc.13190] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 05/25/2020] [Accepted: 09/17/2020] [Indexed: 06/11/2023]
Abstract
An estimate of one third of preventable medication errors occurred annually due to patients' misunderstanding of use instructions. To safeguard consumers' over-the-counter (OTC) medicine use and to develop future initiatives, this study evaluated the use, comprehensibility and clarity of the information labels on OTC packages from consumers' perspectives in Taiwan. This cross-sectional study was conducted at 29 community pharmacies; 50 pharmacy clerkship students helped participant enrolment from June to September 2017. Participants (n = 470) were 20 years old or above, Mandarin speaking, and with specific OTC purchases. A face-to-face survey was administered to investigate the degree to which participants read the package labels and their comprehension of correct medicine use. An 11-item survey was used to measure participants' specific OTC purchases (3 items), the use (2 items), comprehensibility (1 item) and clarity (2 items) of OTC package labels, in addition to the sociodemographic information (3 items). Participants were also solicited to provide opinions regarding package label redesign. Descriptive statistics and logistic regressions were applied for analyses. Findings show that most (84.0%) participants read instruction labels before use, with indications (79.4%), drug names (64.5%) and dosage and administration (59.8%) being the top reads. Only 30.0% of the participants fully understood how to take the medicines correctly. Younger (OR = 1.033, p < .001) and female participants (OR = 1.965, p = .014) with a higher level of education (OR = 1.940, p = .034) tended to read package label information prior to purchase or use. Younger participants (OR = 1.030, p < .001) and those who read OTC medicine labels before use (OR = 2.317, p = .004) were more likely to correctly understand medicine use. The findings indicate that older, male adults with a lower level of education should be targeted to ensure their correct understanding of OTC labels. Pharmacists should recite pertinent label information and, concomitantly, ensure consumers' understanding when providing medicine counselling.
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Affiliation(s)
- Yen-Ming Huang
- Department of Allied and Population Health, College of Pharmacy and Allied Health Professions, South Dakota State University, Brookings, SD, USA
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | | | - Ling-Ling Hsieh
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Hsun-Yu Chan
- Department of Psychology and Special Education, Texas A&M University-Commerce, TX, USA
| | - Karin C S Chen-Liu
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Yunn-Fang Ho
- Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
- School of Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan
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Dean S, Razavy S, Walsh S, Zaslawski C, Levett-Jones T, Cant R. Building empathy awareness in undergraduate traditional Chinese Medicine students via an undercover ‘mystery shopper’ experience. ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2021.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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A Nationwide Mystery Caller Evaluation of Oral Emergency Contraception Practices from German Community Pharmacies: An Observational Study Protocol. Healthcare (Basel) 2021; 9:healthcare9080945. [PMID: 34442082 PMCID: PMC8391881 DOI: 10.3390/healthcare9080945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 06/04/2021] [Accepted: 07/22/2021] [Indexed: 11/16/2022] Open
Abstract
To prevent unwanted pregnancies, oral emergency contraception (EC) with the active ingredients levonorgestrel (LNG) and ulipristal acetate (UPA) is recommended by the guidelines of the German Federal Chamber of Pharmacists (BAK). In this respect, community pharmacies (CPs) in Germany have a major responsibility for information gathering, selecting the appropriate medicine, availability and pricing, among other things. Therefore, it would be appropriate to conduct a study with the aim of investigating information gathering, a possible recommendation as well as availability and pricing for oral EC in German CPs. A representative nationwide observational study based on the simulated patient methodology (SPM) in the form of covert mystery calls will be conducted in a random sample of German CPs stratified according to the 16 federal states. Each selected CP will be randomly called once successfully by one of six both female and male trained mystery callers (MCs). The MCs will simulate a product-based scenario using the request for oral EC. For quality assurance of the data collection, a second observer accompanying the MC is planned. After all mystery calls have been made, each CP will receive written, pharmacy-specific performance feedback. The only national SPM study on oral EC to date has identified deficits in the provision of self-medication consultations with the help of visits in the CPs studied. International studies suggest that UPA in particular is not always available. Significant price differences could be found analogous to another German study for a different indication.
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Thakur T, Frey M, Chewning B. Communication between patients and health care professionals about opioid medications. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2021; 2:100030. [PMID: 35481112 PMCID: PMC9030717 DOI: 10.1016/j.rcsop.2021.100030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Revised: 03/26/2021] [Accepted: 05/27/2021] [Indexed: 12/01/2022] Open
Abstract
Prescription opioids contribute to 40% of opioid overdose deaths in the United States. Healthcare professionals (HCPs) play an important role in mitigating the prescription opioid epidemic by appropriate opioid prescribing and patient education. Yet, little empirical literature addresses pharmacist (and other HCP) communication with patients related to risks of opioid use associated with dependence, misuse, and overdose. Nor is there much research on the barriers and facilitators which affect whether and how much opioid-related information is discussed. This commentary, based on an extensive literature search, seeks to inform future communication, education, and research agendas by describing (1) topics commonly discussed or excluded from opioid medication counseling, (2) patient and HCP perceptions regarding opioid medication communication, and (3) barriers and facilitators to opioid risk communication. Based on this literature, recommendations are provided for opioid counseling practices, pharmacist education, and research agendas.
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Affiliation(s)
- Tanvee Thakur
- Social and Administrative Sciences in Pharmacy Division, University of Wisconsin-Madison School of Pharmacy, United States
- Corresponding author at: 777 Highland Avenue, Madison, WI 53705, United States.
| | - Meredith Frey
- PGY2 Pharmacy Resident – Ambulatory Care Setting, University of Iowa Hospitals and Clinics, United States
| | - Betty Chewning
- Social and Administrative Sciences in Pharmacy Division, University of Wisconsin-Madison School of Pharmacy, United States
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Seiberth JM, Moritz K, Herrmann NS, Bertsche T, Schiek S. What influences the information exchange during self-medication consultations in community pharmacies? A non-participant observation study. Res Social Adm Pharm 2021; 18:2444-2456. [PMID: 33840622 DOI: 10.1016/j.sapharm.2021.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Revised: 03/21/2021] [Accepted: 03/27/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although pharmaceutical staff consider guideline-compliant information exchange during self-medication consultations as crucial, they have not fully integrated it into practice. It is unclear what prevents pharmaceutical staff from implementing their positive intentions into their actual everyday practice. To improve the information exchange during the current consultation practice, a deeper understanding of its implementation is needed. OBJECTIVES The aim was to evaluate the factors influencing information exchange during self-medication consultations in German community pharmacies. METHODS We performed a non-participant observation of real-life consultations with post-consultation interviews of pharmaceutical staff in 10 pharmacies. The information exchanged during self-medication consultations was evaluated via 7 guideline-recommended information parameters in 2 stages of information exchange: (a) 'information gathering' and (b) 'provision of information'. Directly after each observed consultation, pharmaceutical staff's opinion about the consultation, the customer's interest and their own performance was questioned. Factors associated with the observed extent of information exchange were analysed by Poisson regression analysis. RESULTS In the 379 self-medication consultations with 46 pharmaceutical staff members, 454 different customer enquiries were addressed, and 483 medications were dispensed. In median, 2 predefined information parameters (First-/Third quartile: 1/4) were fulfilled during an enquiry and 2 parameters (First-/Third quartile: 1/3) were fulfilled for a dispensed medication. Pharmaceutical staff were satisfied with 85% of their consultations and perceived 76% of them as easy to handle. In both information stages, information exchange increased when 'customers were perceived to be interested in counselling' (p < 0.001) and decreased when customers had a 'specific medication request' (p < 0.001). CONCLUSIONS Information exchange in pharmacies needs to be better integrated into daily practice. Strategies to encourage information exchange should also include pharmaceutical staffs' perception of their own counselling technique. Ongoing patient-centred trainings should facilitate strategies to engage uninterested customers or costumers with specific medication requests in consultations.
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Affiliation(s)
- Jasmin Mina Seiberth
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Katharina Moritz
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Nia Sophie Herrmann
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
| | - Thilo Bertsche
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany.
| | - Susanne Schiek
- Department of Clinical Pharmacy, Institute of Pharmacy, Faculty of Medicine, Leipzig University, Leipzig, Germany; Drug Safety Center, University Hospital Leipzig and Leipzig University, Leipzig, Germany
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Qudah B, Thakur T, Chewning B. Factors influencing patient participation in medication counseling at the community pharmacy: A systematic review. Res Social Adm Pharm 2021; 17:1863-1876. [PMID: 33766505 DOI: 10.1016/j.sapharm.2021.03.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/07/2021] [Accepted: 03/08/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Findings document that patient participation in pharmacy encounters is associated with favorable outcomes. However, there is a need to understand factors that may enhance or hinder patient engagement and pharmacist counseling behaviors during their medication discussions. This review aims to: (1) identify barriers and facilitators for patient engagement in pharmacy consultations, (2) explore the relationship between patient factors (such as demographics and communication behavior) and subsequent pharmacist counseling behavior. METHODS A systematic review of literature using PRISMA guidelines examined studies published in English addressing influences on patient participation and the relationship between patient factors and pharmacist counseling behavior. Four databases were used - PubMed, CINAHL, PsycINFO, and Scopus. Findings were framed thematically within the constructs of Street's Linguistic Model of Patient Participation in Care (LM). FINDINGS Fifty studies from 1983 to 2019, including 37 using self-reported data, were identified. Patient involvement in patient-pharmacist communication was influenced by enabling factors such as patient knowledge, communication skills, and pharmacy environment. Predisposing factors for participation ranged from patients' beliefs and past experiences to demographic characteristics such as gender and age. Pharmacists' participative behavior with patients was positively associated with patients' engagement and perceived patient cues in the conversation. CONCLUSION This systematic review identified predictors of patients' engagement in pharmacy encounters drawing on LM framework. Various predisposing factors, enabling factors, and pharmacist' responses impacted patients' willingness to actively participate in medication counseling at community pharmacies. Equally important, studies documented considerable impact by patients on pharmacists' counseling behavior. Pharmacy encounters should no longer be viewed as controlled simply by pharmacists' expertise and agendas. Patient characteristics and factors such as patient question-asking and expectations also appear to be associated with and influence patient-pharmacist interpersonal communication. Additional research needs to address the identified facilitators and barriers to enhance patient participation and pharmacist counseling behavior.
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Affiliation(s)
- Bonyan Qudah
- Department of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin, Madison, 777 Highland Ave., Madison, WI, 53705, USA.
| | - Tanvee Thakur
- Research Triangle Institute, 3005 Boardwalk Drive, Suite 105, Ann Arbor, MI, 48108, USA
| | - Betty Chewning
- Department of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin, Madison, 777 Highland Ave., Madison, WI, 53705, USA
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Hasan S, Al Oum L, Hassan NA. A simulated patient study to evaluate community pharmacist assessment, management and advice giving to patients with asthma. J Pharm Policy Pract 2021; 14:8. [PMID: 33436091 PMCID: PMC7805111 DOI: 10.1186/s40545-020-00294-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 12/28/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research has shown that there is an increase in the global prevalence of asthma. Pharmacists are well positioned to screen and refer patients for better management of asthma. This study aimed to evaluate community pharmacists' ability to assess the 3 C's (Control, Compliance, Complications) and offer Management and Advice for patients with asthma in the UAE. METHODS Three fifth year pharmacy students role played a mystery shopper visiting community pharmacies and requesting symptom relief from uncontrolled asthma. Incidence of cough syrup and reliever inhaler supply, physician referral rate, correction of inhaler technique, and counseling on the medications, adherence to the medications and adverse drug reactions were calculated. RESULTS One hundred, ninety five pharmacies were visited, 27% of pharmacists asked about the need for cough syrup and 60% asked about the need for albuterol inhaler. Only 26% asked about other medications. Less than 20% assessed inhaler technique, only one pharmacist asked about regular use of preventer medications and if the patient was adhering to them and only 16% asked about side effects from medications. Most pharmacists (67%) supplied at least one of the medications, while 65% referred the patient to a physician. Only 21% gave information about correct inhaler technique, the majority (> 60%) being incomplete, only 16 pharmacists gave information about asthma and its triggers; the majority (63%) being incomplete. One third of the pharmacists counselled the patient on the medications with one giving complete information. CONCLUSIONS The study highlighted suboptimal assessment of control, compliance to preventer medications and complications of asthma and the medications that treat it. It also highlighted suboptimal Management and Advice giving and counseling on medication use by pharmacists. Training pharmacists in all aspects of asthma handling is clearly indicated. Despite the high rate of correct patient referral to a physician noted in this study, there is risk to it, as patients might not actually go to see their physician and continue to depend on symptom relief for the management of their asthma. This study highlighted the importance of improving patient education and information seeking attitude.
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Affiliation(s)
- Sanah Hasan
- Department of Clinical Sciences, College of Pharmacy and Health Sciences, Ajman University, Ajman, United Arab Emirates.
| | - Lujain Al Oum
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Nageeb AbdulGalil Hassan
- Department of Pharmaceutical Sciences, College of Pharmacy and Health Sciences, Ajman, United Arab Emirates
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Thakur T, Chewning B. Using role theory to explore pharmacist role conflict in opioid risks communication. Res Social Adm Pharm 2020; 16:1121-1126. [DOI: 10.1016/j.sapharm.2019.11.012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 11/20/2019] [Accepted: 11/20/2019] [Indexed: 02/04/2023]
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Gernant SA, Adeoye-Olatunde OA, Murawski MM, Jaynes H, Chewning B, Knox LM, Martinez III M, Schommer JC, Snyder ME. Experiences Applying Technology to Overcome Common Challenges in Pharmacy Practice-Based Research in the United States. PHARMACY 2020; 8:E93. [PMID: 32486241 PMCID: PMC7356027 DOI: 10.3390/pharmacy8020093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/06/2020] [Accepted: 05/14/2020] [Indexed: 11/17/2022] Open
Abstract
Despite the importance of pharmacy practice-based research in generating knowledge that results in better outcomes for patients, health systems and society alike, common challenges to PPBR persist. Herein, we authors describe PPBR challenges our research teams have encountered, and our experiences using technology-driven solutions to overcome such challenges. Notably, limited financial resources reduce the time available for clinicians and researchers to participate in study activities; therefore, resource allocation must be optimized. We authors have also encountered primary data collection challenges due to unique data needs and data access/ownership issues. Moreover, we have experienced a wide geographic dispersion of study practices and collaborating researchers; a lack of trained, on-site research personnel; and the identification and enrollment of participants meeting study eligibility criteria. To address these PPBR challenges, we authors have begun to turn to technology-driven solutions, as described here.
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Affiliation(s)
- Stephanie A Gernant
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, 69 North Eagleville Rd., Storrs, CT 06226, USA
| | - Omolola A. Adeoye-Olatunde
- Department of Pharmacy Practice, Purdue University College of Pharmacy, 640 Eskenazi Avenue, Indianapolis, IN 46202, USA; (O.A.A.-O.); (H.J.); (M.E.S.)
| | - Matthew M. Murawski
- Department of Pharmacy Practice, Purdue University College of Pharmacy, 575 Stadium Mall Drive, West Lafayette, IN 47907, USA; (M.M.M.); (M.M.III)
| | - Heather Jaynes
- Department of Pharmacy Practice, Purdue University College of Pharmacy, 640 Eskenazi Avenue, Indianapolis, IN 46202, USA; (O.A.A.-O.); (H.J.); (M.E.S.)
| | - Betty Chewning
- Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Ave., Madison, WI 53705, USA;
| | - Lyndee M. Knox
- LA Net Community Health Resource Network Collaboratory, 800 East Ocean Blvd, Suite 104, Long Beach, CA 90802, USA;
| | - Moises Martinez III
- Department of Pharmacy Practice, Purdue University College of Pharmacy, 575 Stadium Mall Drive, West Lafayette, IN 47907, USA; (M.M.M.); (M.M.III)
| | - Jon C. Schommer
- College of Pharmacy, University of Minnesota, 308 Harvard St. SE, Minneapolis, MN 55455, USA;
| | - Margie E. Snyder
- Department of Pharmacy Practice, Purdue University College of Pharmacy, 640 Eskenazi Avenue, Indianapolis, IN 46202, USA; (O.A.A.-O.); (H.J.); (M.E.S.)
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Thakur T, Frey M, Chewning B. Pharmacy Student Opioid Consultations with Standardized Limited English Proficiency Patients. CURRENTS IN PHARMACY TEACHING & LEARNING 2020; 12:418-422. [PMID: 32334757 DOI: 10.1016/j.cptl.2019.12.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 09/27/2019] [Accepted: 12/07/2019] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Limited healthcare studies have analyzed communication practices with limited English proficiency (LEP) patients. Empirical literature lacks evidence about LEP patient-pharmacist communication about opioid risks. This study aimed to (1) explore topics discussed in opioid medication consults, (2) assess if students inform patients about dependency and overdose risks associated with opioid use and the manner in which those risks were introduced and discussed, and (3) assess LEP specific communication practices. METHODS Third-year pharmacy students in a required communications course consulted LEP standardized patients (SPs) who spoke 30% English and 70% non-English language. The SP followed a script simulating an encounter between a pharmacist and patient picking up a new, month long prescription of oxycodone. All consultations were video recorded and quantitatively coded for verbal and non-verbal communication skills. RESULTS Twenty-three pharmacy students conducted consultations with LEP SPs. The majority of students discussed common side effects, but only a few discussed severe side effects. Four of 23 students named the medication as an "opioid" or "narcotic" and described dependency, overdose, or other opioid specific risks. Students used several filler words, long sentences, and a fast pace. A majority of students used teach back methods to identify patient understanding. Students expressed the need for more structured education and training in providing patient counseling for opioids and communicating with LEP patients. CONCLUSIONS Pharmacy students lack confidence and skills in communicating with LEP patients regarding opioid-specific risks, suggesting structured training is needed.
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Affiliation(s)
- Tanvee Thakur
- University of Wisconsin-Madison School of Pharmacy, United States.
| | - Meredith Frey
- University of Iowa Hospitals and Clinics, United States.
| | - Betty Chewning
- University of Wisconsin-Madison School of Pharmacy, United States.
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Exploring how pharmacists engage with patients about over-the-counter medications. J Am Pharm Assoc (2003) 2019; 59:852-856. [PMID: 31501006 DOI: 10.1016/j.japh.2019.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVE This study used an innovative information-gathering approach to provide insight into the nature and structure of pharmacy staff encounters with patients seeking over-the-counter (OTC) medications and revealed specific activities of pharmacy staff around these encounters. METHODS A multistep process was used to develop and standardize an 8-item OTC Encounter Form to document the characteristics of pharmacy staff-patient encounters. The OTC Form contained several domains, including topics discussed and the problems or symptoms identified during the encounter, staff functions during the encounter, and approximate time spent with the patient. Nine pharmacists and 8 technicians used the OTC Form to document patient encounters over 7 consecutive days. Frequency distributions for each OTC Form item are reported. RESULTS One hundred eleven OTC Forms were completed. Adults aged 65 years or older were involved in 46% of all encounters. Pharmacists provided the only assistance in 41% of encounters and worked in partnership with other pharmacy staff for another 25% of encounters. Many encounters required the pharmacy staff to leave the prescription department, involved discussions about a variety of problems or symptoms, and lasted less than 3 minutes. Although the most prevalent encounter topic was locations of a particular product, about one-third of encounters involved either recommendations about a product or providing information about a product, and 41% involved communications about 2 or more topics. Finally, 11% of encounters generated a nondrug recommendation, and 8% resulted in a referral to a physician. CONCLUSION Pharmacists play a key role in ensuring that the benefits of OTC medications outweigh the risks, thereby providing an important resource for patient engagement about safe medication selection and use. Examining the features of OTC encounters creates an evidence base to promote best practices for OTC encounters, increasing pharmacists' ability to help people, especially older adults, navigate the intricacies of OTC medication use, without significantly increasing pharmacy staff workload.
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Mináriková D, Fazekaš T, Minárik P, Jurišová E. Assessment of patient counselling on the common cold treatment at Slovak community pharmacies using mystery shopping. Saudi Pharm J 2019; 27:574-583. [PMID: 31061627 PMCID: PMC6488828 DOI: 10.1016/j.jsps.2019.02.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Accepted: 02/09/2019] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Up to now, there have been no data on patient counselling in the Slovak community pharmacies. The literature provides a wide range of activities for which mystery shopping methodology be used, including assessment of patient counselling. AIMS AND OBJECTIVES To assess patient counselling on the common cold treatment with OTC medicine containing zinc provided by Slovak community pharmacists. To analyse this counselling considering the set scenarios, counsellors and their age. METHODS 54 pharmacy students visited 270 different community pharmacies throughout Slovakia in 2 weeks in October 2016 to conduct mystery shopping with set scenarios. For assessment of patient counselling, we defined Counselling Performance. It was conceptualised as weighted mean percentage counselling successes rate of its three categories (Identification, Information and Communication) and their weights. Individual perception of counselling evaluated separately. Student t-test and Person's chi-squared test (p < 0.05) and Cohen delta were used for comparing outcomes and effect size of counselling. A simple linear regression was used to find relationships. RESULTS The total Counselling Performance was 39.0 ± 22.4%, Identification 30.6 ± 28.7%, Information 39.8 ± 25.1% and Communication 74.3 ± 11.5%. 26.3% pharmacies achieved the average Counselling Performance (41-60%). Subjective Perception had a success rate of 73.4 ± 21.2%, but it could be predicted by the Counselling Performance and the success rate of the three categories only in 1/5 pharmacies. Spontaneous counselling was provided more by pharmacy technicians (p = 0.0009). The duration of counselling was similar when comparing both scenarios, counsellors and their age. The product-requested scenario achieved a higher success rate in the Information category (p = 0.0304; d = 0.27). Pharmacists achieved a higher Counselling Performance (p < 0.0001; d = 0.48) and success rate in categories Identification (p = 0.0001, d = 0.46), Information (p = 0.0004, d = 0.37), and Perception (p = 0.0007; d = 0.54). The estimated age of counsellors did not have any impact on the counselling. CONCLUSION Patient counselling on the common cold showed a suboptimal level, particularly considering its content. In the study, we found a significant relationship between the success of counselling and counsellors.
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Affiliation(s)
- Daniela Mináriková
- Department of Organisation and Management in Pharmacy, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-83232 Bratislava, Slovak Republic
| | - Tomáš Fazekaš
- Department of Physical Chemistry of Drugs, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-83232 Bratislava, Slovak Republic
| | - Peter Minárik
- St. Elisabeth University of Health and Social Work, Palackeho 1, 811 02 Bratislava, Slovak Republic
| | - Erika Jurišová
- Department of Languages, Faculty of Pharmacy, Comenius University in Bratislava, Odbojarov 10, SK-83232 Bratislava, Slovak Republic
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Philip M, Shaka N, Selhore N. Need of structural interventions for linking people who inject drugs with antiretroviral treatment: A qualitative study. JOURNAL OF SUBSTANCE USE 2019. [DOI: 10.1080/14659891.2019.1572806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Mary Philip
- Department of Psychology, Ambo University, Ambo, Ethiopia
| | - Nimona Shaka
- Department of Psychology, Ambo University, Ambo, Ethiopia
| | - Neville Selhore
- Sahara Center for Rehabilitation and Residential Care, New Delhi, India
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Dean S, Walsh S, Williams C, Zaslawski C, Morgan A, Levett-Jones T. The mystery shopper student learning experience in undergraduate health education: A case study. NURSE EDUCATION TODAY 2018; 70:69-76. [PMID: 30145537 DOI: 10.1016/j.nedt.2018.08.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 07/08/2018] [Accepted: 08/14/2018] [Indexed: 06/08/2023]
Affiliation(s)
- Sue Dean
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, 2007, Australia.
| | - Sean Walsh
- University of Technology Sydney, School of Life Sciences, Faculty of Science, PO Box 123, Broadway, 2007, Australia.
| | - Claire Williams
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, 2007, Australia
| | - Chris Zaslawski
- University of Technology Sydney, School of Life Sciences, Faculty of Science, PO Box 123, Broadway, 2007, Australia.
| | - Adam Morgan
- University of Technology Sydney, Institute for Interactive Media and Learning, PO Box 123, Broadway, 2007, Australia.
| | - Tracy Levett-Jones
- University of Technology Sydney, Faculty of Health, PO Box 123, Broadway, 2007, Australia.
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Collins JC, Schneider CR, Naughtin CL, Wilson F, de Almeida Neto AC, Moles RJ. Mystery shopping and coaching as a form of audit and feedback to improve community pharmacy management of non-prescription medicine requests: an intervention study. BMJ Open 2017; 7:e019462. [PMID: 29247115 PMCID: PMC5735410 DOI: 10.1136/bmjopen-2017-019462] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES To determine whether repeated mystery shopping visits with feedback improve pharmacy performance over nine visits and to determine what factors predict an appropriate outcome. DESIGN Prospective, parallel, repeated intervention, repeated measures mystery shopping (pseudopatient) design. SETTING Thirty-six community pharmacies in metropolitan Sydney, Australia in March-October 2015. PARTICIPANTS Sixty-one University of Sydney pharmacy undergraduates acted as mystery shoppers. Students enrolled in their third year of Bachelor of Pharmacy in 2015 were eligible to participate. Any community pharmacy in the Sydney metropolitan region was eligible to take part and was selected through convenience sampling. INTERVENTION Repeated mystery shopping with immediate feedback and coaching. OUTCOME MEASURES Outcome for each given scenario (appropriate or not) and questioning scores for each interaction. RESULTS Five hundred and twenty-one visits were analysed, of which 54% resulted in an appropriate outcome. Questioning scores and the proportion of interactions resulting in an appropriate outcome significantly improved over time (P<0.001). Involvement of pharmacists, visit number, increased questioning score and the prescribed scenario were predictors of an appropriate outcome (P=0.008, P=0.022, P<0.001 and P<0.001, respectively). Interactions involving a pharmacist had greater scores than those without (P<0.001). CONCLUSIONS Repeated mystery shopping visits with feedback were associated with improved pharmacy performance over time. Future work should focus on the role of non-pharmacist staff and design interventions accordingly.
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Affiliation(s)
- Jack Charles Collins
- Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Frances Wilson
- Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Rebekah Jane Moles
- Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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Smets EMA, Deveugele M, Kripalani S, Cameron KA. New insights on information provision, decision making and patient autonomy. PATIENT EDUCATION AND COUNSELING 2016; 99:1439-1440. [PMID: 27578368 DOI: 10.1016/j.pec.2016.08.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Affiliation(s)
- Ellen M A Smets
- Department of Medical Psychology, Academic Medical Centre, University of Amsterdam, The Netherlands.
| | - Myriam Deveugele
- Faculty of Medicine and Health Sciences, Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium
| | - Sunil Kripalani
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA; Institute for Medicine and Public Health, Vanderbilt University, Nashville, TN, USA
| | - Kenzie A Cameron
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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