Public attitudes towards community pharmacy attributes and preferences for methods for promotion of public health services

Development of a Questionnaire to Measure Public Perceptions of the Role of Community Pharmacy in Public Health (PubPharmQ)

BACKGROUND

Community pharmacies are well placed to provide public-health interventions within primary care settings. This study aimed to establish the general public's perceptions of community pharmacy-based public-health services in the UK by designing a structured questionnaire to assess the barriers and facilitators to optimizing this role.

METHODS

A standardized questionnaire was developed informed by the literature, additional semi-structured interviews, and synthesis of key findings with the authors' previous research based on data generated from eight focus groups. The original 42-item questionnaire was distributed online from May to June 2021 via social media platforms to capture the views of non-regular pharmacy users. Following exploratory factor analysis, and Cronbach's alpha analysis, total Likert scale response scores were calculated.

RESULTS

Of the 306 responders, 76.8% were female with a mean age of 34.5 years (SD = 15.09). The most prevalent pharmacy use reported was 1-2 times a year (28.1%). Exploratory factor analysis revealed four scales: Expertise, Role in Public Health, Privacy, and Relationship (18 items) with acceptable internal consistency and good face and content validity. Awareness of well-established pharmacy services was high; however, responders demonstrated poor awareness of public-health-related services and low recognition of pharmacy expertise for this role. A lack of an established relationship with community pharmacies and privacy concerns were also perceived barriers.

CONCLUSIONS

Based on these findings, considerable effort is needed to increase public awareness and address these concerns if strategic plans to utilize community pharmacy in the delivery of public-health policy are to be successful. The PubPharmQ provides a novel, structured questionnaire to measure the public's perceptions of community pharmacy's role in public health.

Provision of primary care pharmacy operated by hospital pharmacist

A primary care pharmacy (PCP) is operated by hospital pharmacists in Thailand. This study aims to explore the level of PCP provisions operated by hospital pharmacists, to identify health service components that affect PCP operation and to collect opinions from pharmacists regarding factors influencing PCP operation. A postal survey was conducted in northeastern Thailand. A questionnaire included: (1) the PCP checklist (36 items), (2) questions investigating the health service components required for PCP operation (13 items), and (3) queries to pharmacists concerning factors influencing PCP operation (16 items). Questionnaires were mailed to 262 PCP pharmacists. The PCP provision score was calculated with a max score of 36, and reaching at least 28.8 points was deemed as having 'met expectation'. Multivariate logistic regression with a backward approach was used to determine health service components which affected PCP operation. Most respondents were female (72, 60.0%), aged 36.0 years (IQR 31.0-41.0) and PCP work experience of 4.0 years (IQR 2.0-10.0). Overall, the PCP provision score had met expectation (median = 29.00, Q₁-Q₃ = 26.50-32.00). Tasks that met expectation involved managing the medicine supply, a home visit with a multidisciplinary team and protecting consumer health. Improving medicine dispensary and promotion of self-care and herbal use were below expectation. PCP operation depended on doctor involvement (OR = 5.63 95% CI 1.07-29.49) and public health practitioner involvement (OR = 3.12 95% CI 1.27-7.69). The pharmacist's responsibility, i.e., a good relationship with the community, likely increased PCP provision. The PCP has been widely instituted in Northeast Thailand. Doctors and public health practitioners should get involved regularly. Further research is needed to monitor the outcomes and value of PCPs.

Assessing the digital literacy levels of the community pharmacy workforce using a survey tool

OBJECTIVES

To investigate the digital literacy of staff in London, UK, community pharmacies and to explore their perceptions about the use of eHealth tools.

METHODS

The study population was community pharmacy staff (N = 21,346) in Greater London. A survey tool was divided into six sections: Use of the internet; Use of social media; Use of mobile health applications (MHAs); Perception of and practical use of digital health tools; Scenario-based questions and demographics. Responses were analysed in SPSS. Following data collection, Health Education England's (HEE's) Digital Capabilities Framework (DCF) was published. The authors mapped the survey tool retrospectively to the framework.

KEY FINDINGS

Almost all respondents (98.0%, n = 551/562) used eHealth tools at work, mainly to access medicine information (89.8%, n = 495/551). Almost one-third (31.7%, N = 178/562) used social media regularly, while many (79.4%, N = 446/562) were aware of MHAs. Self-perceived digital literacy indicated that 63.3% (n = 356/562) deemed themselves to be above average. Under 35s rated their digital literacy more highly than over 35s (P < 0.001). HEE's DCF indicated that actual digital literacy was lower than that of self-perceived. Despite the high use of eHealth tools, respondents were reluctant to recommend these to the public for health advice.

CONCLUSIONS

Community pharmacy staff self-report their digital literacy to be high yet do not use these skills for public health purposes. Furthermore, these self-reported skills appear to be over-estimated. Despite high levels of use of digital tools at work, staff do not use them for public health, therefore, further training to build confidence to better utilise them is recommended.

Applying a whole systems lens to the general practice crisis: cross-sectional survey looking at usage of community pharmacy services in England by patients with long-term respiratory conditions

OBJECTIVE

UK policy initiatives aiming to extend community pharmacy services to moderate patient demands and to reduce general practitioners' (GPs) workload have had limited success. This study used marketing theory to identify factors that could influence patients to make better use of community pharmacies within the primary care pathway.

DESIGN

Cross-sectional postal survey design applying the '7Ps marketing mix' ('product', 'price', 'place', 'promotion', 'people', 'process' and 'physical evidence').

SETTING

Greater Manchester, England.

PARTICIPANTS

Patients with asthma or chronic obstructive pulmonary disease registered at two GP practices.

PRIMARY OUTCOME

Patient preference for community pharmacy services.

RESULTS

The response rate was 29% (289/1003). Most respondents preferred to use GP practices for invasive/diagnostic services (product) while preferring using community pharmacy for medicines supply and minor ailments (place). Stronger preference for using GP practices over community pharmacy was significantly associated with gender (male>female), age group (≥65 years) and healthcare services previously accessed at the pharmacy. Respondents perceived they would be more likely to use community pharmacy services if pharmacists offered them enough time to discuss any concerns (73.3%) (price), if community pharmacies had private/clean consultation rooms (70%-73%) (physical evidence) and if pharmacy staff had strong interpersonal skills (68%-70%) (people). Respondents were divided on likelihood of using community pharmacy services if pharmacists could access their whole medical record but wanted pharmacists to add information about their visit (59.6%) (process). Respondents would be encouraged to use community pharmacy for healthcare services if they were offered services by pharmacy staff or recommended/referred to services by their GP (44%) (promotion).

CONCLUSIONS

Using the 7Ps marketing mix highlighted that community pharmacies having staff with strong interpersonal skills, good quality consultation rooms and integrated information systems could positively influence patients to use community pharmacies for management of long-term conditions. There are opportunities for community pharmacies to alleviate GP workload, but a whole system approach will be necessary.

The community pharmacy setting for diabetes prevention: A mixed methods study in people with 'pre-diabetes'

BACKGROUND

Diabetes Prevention Programs (DPPs) comprising intensive lifestyle interventions may delay or even prevent the onset of type 2 diabetes in people with pre-diabetes. However, engagement with DPPs is variable with session times and transportation being reported amongst barriers; this may be addressed by community pharmacy (CP) involvement given its recognition for accessibility.

OBJECTIVES

To explore factors influencing engagement with the National Health Service (NHS) DPP and the role of CP in diabetes prevention.

METHODS

Nine hundred and sixty-two questionnaires were posted to people with pre-diabetes identified from five general practices in Norfolk, England between November 2017 and May 2018. Follow-up semi-structured interviews (n = 10) and a focus group (n = 6) were conducted with a sample of questionnaire respondents. Questionnaire data were analysed quantitatively using SPSS and qualitative data analysed inductively using thematic analysis. Themes relating to engagement and the role of CP in pre-diabetes were further analysed using the COM-B model of behaviour change.

RESULTS

A total of 181 (18.8%) questionnaire responses were received, a quarter of whom reported to have either dropped out or declined attending the national DPP. DPP engagers were more likely to report the program location and session times as convenient. Community pharmacy was perceived as an acceptable setting for delivering diabetes prevention services (DPS) and a preferable alternative for regular pharmacy users and people with work and social commitments. Participants felt that opportunity to engage with CP DPS is enhanced by its accessibility and flexibility in making appointments. Knowledge about the DPS provided in CP and previous experience with CP services were central influences of capability and motivation to engage respectively.

CONCLUSIONS

This research outlines factors that could influence engagement with community pharmacy-based DPS and provides evidence to inform intervention development. Further research would be required to determine the feasibility and cost-effectiveness of such interventions.

Public views of different sources of health advice: pharmacists, social media and mobile health applications

OBJECTIVES

Investigating public perceptions of community pharmacists (CP) in public health and their use of social media (SM) and mobile health applications (MH apps) in that regard.

METHODS

Two surveys were created. One sought public perceptions of SM and the other of MH apps for health advice. Both included a section on perceptions of the role of CPs in public health. A convenience sampling strategy, based on proximity, was used.The study population was the public (n = 8 500 000) living in Greater London. The general public were recruited face-to-face in public spaces. A minimum sample (95% confidence interval/5% margin of error) of 385 was needed. Ethical approval was obtained from the university ethics committee. Responses were analysed in SPSS.

KEY FINDINGS

About 820/1800 (45.6%) completed one/both surveys. Respondents seek health advice primarily from GPs, followed by digital mediums and then CPs. Under 35s use digital mediums more frequently (P = 0.039). Those who had used SM (41.7%) or MH apps (61.8%) for health information did not confirm its accuracy with a healthcare professional (HCP). Of those that did (MH apps = 39.2%; SM = 58.3%), the HCP disagreed with the information on MH apps and SM on 19.6% and 36.7% of occasions, respectively. Nevertheless, 64.5% stated that if a SM page was maintained by an HCP they would use it.

CONCLUSIONS

The public are using digital mediums for health advice instead of speaking to an HCP. If CPs want to have an impact on public health they must start imbedding digital mediums into their services.

Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review

Background

The United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. However, patient and public awareness of community pharmacy services has been limited.

Objective

To identify and synthesize the research literature pertaining to patient and public perspectives on: existing community pharmacy services, extended pharmacist roles and strategies to raise awareness of community pharmacy services.

Search strategy

Systematic search of 8 electronic databases; hand searching of relevant journals, reference lists and conference proceedings.

Inclusion criteria

UK studies investigating patient or public views on community pharmacy services or pharmacist roles from 2005 to 2016.

Data extraction and synthesis

Data were extracted into a grid and subjected to narrative synthesis following thematic analysis.

Main results

From the 3260 unique papers identified, 30 studies were included. Manual searching identified 4 additional studies. Designs using questionnaires (n = 14, 41%), semi‐structured interviews (n = 8, 24%) and focus groups (n = 6, 18%) made up the greatest proportion of studies. Most of the studies (n = 28, 82%) were published from 2010 onwards and covered perceptions of specific community pharmacy services (n = 31). Using a critical appraisal checklist, the overall quality of studies was deemed acceptable. Findings were grouped into 2 main themes “public cognizance” and “attitudes towards services” each with 4 subthemes.

Discussion and conclusions

Patients and the public appeared to view services as beneficial. Successful integration of extended pharmacy services requires pharmacists’ clinical skills to be recognized by patients and physicians. Future research should explore different approaches to increase awareness.