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Kim E, Worley MM, Law AV. Pharmacist roles in the medication use process: Perceptions of patients, physicians, and pharmacists. J Am Pharm Assoc (2003) 2023; 63:1120-1130. [PMID: 37207709 DOI: 10.1016/j.japh.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/25/2023] [Accepted: 05/12/2023] [Indexed: 05/21/2023]
Abstract
OBJECTIVES It is uncertain whether stakeholder perceptions of pharmacist roles in the medication use process (MUP) have evolved alongside pharmacist advanced scope of practice. This study aimed to examine patient, pharmacist, and physician perceptions of pharmacist roles in the MUP. DESIGN This IRB-approved study used a cross-sectional design with online panels of patients, pharmacists, and physicians. SETTING AND PARTICIPANTS A Qualtrics panel of 1,004 patients, 205 pharmacists, and 200 physicians completed the surveys between August-November 2021. OUTCOME MEASURES Using role theory as framework, 12-item surveys were developed to examine perceptions regarding effectiveness of and best choice for improving each MUP step. Data analysis included descriptive statistics, correlations, and comparisons. RESULTS Majority of the physician, pharmacist, and patient samples believed that physicians prescribe the best possible medications (93.5%, 83.4%, 89.0% respectively), prescriptions are filled accurately (59.0%, 61.4%, 92.6% respectively) and timely (86.0%, 68.8, 90.2% respectively). Majority of physicians (78.5%) opined prescriptions are generally error free and patients are monitored (71%); fewer pharmacists agreed (42.9%, 51%; p<0.05). Most patients (92.4%) reported taking medications as directed; only 60% professionals agreed (p<0.05). Physicians selected 'pharmacists' as top choice for reducing dispensing errors, providing counseling, and helping patients take medications as directed. Patients wanted pharmacists to help manage their medications (87.0%) and 'someone' to periodically check on their health (100%). All 3 groups agreed physician-pharmacist collaboration was important to improve patient care and outcomes (90.0%-97.1%); however, 24% of physicians were uninterested in collaboration. Both professionals reported lack of time, appropriate setup, and interprofessional communication as challenges to collaboration. CONCLUSION Pharmacists believe their roles have evolved to align with expanded opportunities. Patients perceived pharmacists play comprehensive roles in medication management through counseling and monitoring. Physicians recognized pharmacist roles in dispensing and counseling, but not in prescribing or monitoring. Clarity in role expectations amongst these stakeholders is critical to optimizing pharmacist roles and patient outcomes.
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Bodein I, Forestier M, Le Borgne C, Lefebvre JM, Pinçon C, Garat A, Standaert A, Décaudin B. [Evaluation of simulation-based training program intended to improve interprofessional communication skills of community pharmacy and general medicine students]. ANNALES PHARMACEUTIQUES FRANÇAISES 2023; 81:354-365. [PMID: 35792148 DOI: 10.1016/j.pharma.2022.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 05/30/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES The objective of this work is to assess the impact of a simulation session on the ability of pharmacy and medicine students in general practice to communicate in the resolution of patient-facing situations. METHODS The evaluation of the impact of the session on the representation of the professions used a questionnaire to be completed before and after the session by the students. The evaluation of the impact of the session on the perception of communication and associated skills was based on an audio recording of the debriefings, which, after transcription and thematic analysis, was used as a preliminary analysis for the drafting of a questionnaire proposed the following year. This questionnaire focused on the issues of interprofessional communication and on the seminar process. RESULTS During the 2018 and 2019 seminars, 518 students attended, 39% were pharmacy students (n=201) and 61% were medical students (n=317). The majority of medical students initially responded that physician-pharmacist communication was confraternal and rare. More pharmacy students felt that the quality of the physician-pharmacist relationship was poor. However, there was a marked improvement for all students on this aspect of communication after the seminar. Both groups also generally agreed that this relationship could be improved. CONCLUSIONS The evaluation shows that an interprofessional simulation program improves the ability of pharmacy and general practice students to communicate in patient-facing situations.
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Affiliation(s)
- I Bodein
- Département de médecine générale, faculté de médecine, university Lille, UFR3S, 59000 Lille, France
| | - M Forestier
- Département de médecine générale, faculté de médecine, university Lille, UFR3S, 59000 Lille, France
| | - C Le Borgne
- Département de médecine générale, faculté de médecine, university Lille, UFR3S, 59000 Lille, France
| | - J-M Lefebvre
- Département de médecine générale, faculté de médecine, university Lille, UFR3S, 59000 Lille, France
| | - C Pinçon
- Département de pharmacie officinale, faculté de pharmacie, university Lille, UFR3S, 59000 Lille, France; ULR2694 (METRICS : évaluation des technologies de santé et des pratiques médicales), university Lille, CHU Lille, 59000 Lille, France
| | - A Garat
- Département de pharmacie officinale, faculté de pharmacie, university Lille, UFR3S, 59000 Lille, France; Institut Pasteur de Lille, ULR 4483 - IMPECS - IMPact de l'environnement chimique sur la santé, university Lille, CHU Lille, 59000 Lille, France
| | - A Standaert
- Département de pharmacie officinale, faculté de pharmacie, university Lille, UFR3S, 59000 Lille, France; Inserm, U1286 - INFINITE - Institute for translational research in inflammation, university Lille, CHU Lille, 59000 Lille, France
| | - B Décaudin
- Département de pharmacie officinale, faculté de pharmacie, university Lille, UFR3S, 59000 Lille, France; ULR 7365 - GRITA - Groupe de recherche sur les formes injectables et les technologies associées, university Lille, CHU Lille, 59000 Lille, France.
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White A, Fulda KG, Blythe R, Chui MA, Reeve E, Young R, Espinoza A, Hendrix N, Xiao Y. Defining and enhancing collaboration between community pharmacists and primary care providers to improve medication safety. Expert Opin Drug Saf 2022; 21:1357-1364. [PMID: 36377503 PMCID: PMC9850835 DOI: 10.1080/14740338.2022.2147923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Over 4 billion prescriptions are dispensed each year to patients in the United States, with the number of prescriptions continuing to increase. There is a growing recognition of pharmacists' potential in improving medication safety in community settings, in collaboration with primary care providers (PCPs). However, the nature of collaboration has not been well defined, and barriers and strategies are not articulated. AREA COVERED For this narrative review, published studies were retrieved from PubMed between January 2000 and December 2020. Search terms included "patient safety," "medication safety," "collaboration," "primary care physician," and "community pharmacy." Resulting articles were categorized as follows: defining collaboration, types of collaboration, and barriers and solutions to collaboration. EXPERT OPINION It is important to understand the factors within a community pharmacy setting that limit or facilitate community pharmacists' participation in medication safety activities. Strategies such as medication review are a common form of collaboration. Barriers to collaboration include misconceptions regarding roles and differences in access to clinical information and community pharmacy practice variability. Future recommendations include increasing training and utilization of pharmacists/PCP teams, increasing community pharmacists' practice in emerging roles, and expanding the community pharmacist role in transitions of care from the hospital to the community.
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Affiliation(s)
- Annesha White
- Department of Pharmacotherapy, University of North Texas Health Science Center College of Pharmacy, Fort Worth, TX, USA
| | - Kimberly G. Fulda
- University of North Texas Health Science Center, Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network (NorTex), Texas College of Osteopathic Medicine, Fort Worth, TX, USA
| | - Rachel Blythe
- Department of Pharmacotherapy, University of North Texas Health Science Center College of Pharmacy, Fort Worth, TX, USA
| | - Michelle A. Chui
- Social and Administrative Sciences Division, University of Wisconsin – Madison School of Pharmacy, Madison, WI, USA
| | - Emily Reeve
- Quality Use of Medicines and Pharmacy Research Centre, School of Pharmacy and Medical Science, University of South Australia, Adelaide, Australia,Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Parkville, Australia
| | - Richard Young
- JPS Hospital, Department of Family Medicine, Residency Program, Fort Worth, TX, USA
| | - Anna Espinoza
- University of North Texas Health Science Center, Department of Family Medicine and Osteopathic Manipulative Medicine, North Texas Primary Care Practice-Based Research Network (NorTex), Texas College of Osteopathic Medicine, Fort Worth, TX, USA
| | - Noah Hendrix
- University of Texas at Arlington, Arlington, TX, USA
| | - Yan Xiao
- University of Texas at Arlington, Arlington, TX, USA
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Soares N, Mitchell R, McGoff T, Bailey T, Wellman GS. Taste Perceptions of Common Pediatric Antibiotic Suspensions and Associated Prescribing Patterns in Medical Residents. J Pediatr Pharmacol Ther 2022; 27:316-323. [DOI: 10.5863/1551-6776-27.4.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/02/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVE
Palatability of medication is an important factor for adherence, especially in pediatric populations that tend to use oral suspensions for antibiotic therapy. Our study is the first to evaluate the impact of taste on prescribing patterns of antibiotic suspensions. The objective was to determine if taste testing common antibiotic suspensions altered prescribing patterns of medical residents, through data extracted from the electronic health record.
METHODS
After assessing 5 “primer” tastes (sweet, salty, bitter, sour, umami [savory]), residents were randomized to sample 6 antibiotic suspensions to rate their taste perception. A 12-month retrospective and prospective analysis of outpatient prescribing practices of the residents followed, and the results were compared to the resident cohort randomized to no taste test.
RESULTS
The 43 residents prescribed 207 liquid antibiotic prescriptions for 176 patients, with no difference in patient characteristics between residents in the taste test versus non–taste test group. Although amoxicillin was most preferable and amoxicillin-clavulanate least, the only significant finding was a greater prescribing rate of cefdinir among those who had tasted it and an inverse relationship between cephalexin taste preference and percentage prescribing amoxicillin in the taste group. Residents who tasted were poor in identifying primer tastes, but this did not impact prescribing patterns.
CONCLUSIONS
Among 6 commonly prescribed antibiotic suspensions, amoxicillin remains a highly preferred taste among prescribers. Interestingly, after the taste test there was a significantly greater prescribing rate of cefdinir among those who had tasted it and somewhat lower prescribing rate for amoxicillin-clavulanate.
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Affiliation(s)
- Neelkamal Soares
- Department of Pediatric and Adolescent Medicine (NS), Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI
| | - Rachel Mitchell
- Ferris State University College of Pharmacy (RM, TB, GSW), Big Rapids, MI
| | - Theresa McGoff
- Department of Biomedical Informatics (TM), Western Michigan University Homer Stryker M.D. School of Medicine, Kalamazoo, MI
| | - Teresa Bailey
- Ferris State University College of Pharmacy (RM, TB, GSW), Big Rapids, MI
| | - Gregory S. Wellman
- Ferris State University College of Pharmacy (RM, TB, GSW), Big Rapids, MI
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Mohammed RA, Marouf BH. Physicians’ attitude towards community pharmacists’ contribution in the treatment decision making. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e201095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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Waszyk-Nowaczyk M, Guzenda W, Kamasa K, Pawlak K, Bałtruszewicz N, Artyszuk K, Białoszewski A, Merks P. Cooperation Between Pharmacists and Physicians - Whether It Was Before and is It Still Ongoing During the Pandemic? J Multidiscip Healthc 2021; 14:2101-2110. [PMID: 34393489 PMCID: PMC8357703 DOI: 10.2147/jmdh.s318480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 06/28/2021] [Indexed: 12/23/2022] Open
Abstract
Nowadays, it is very important to put an emphasis on widely understood teamwork. This is of great importance for achieving and maintaining success in all areas, especially in medicine. This kind of unity has many advantages, including unique ideas that are very helpful in a competitive environment, improve performance and knowledge, and create stronger supportive work relationships. Patient’s health can be improved by using comprehensive treatment. This provides an urgent need for multidisciplinary partnership in the medical community. Optimal pharmacological treatment is crucial to achieving treatment goals. To ensure excellent quality of medical care, interprofessional cooperation between physicians and pharmacists and/or other medical professionals is necessary. Their complementary knowledge and experience can lead to improved health outcomes and can also reduce treatment costs. There are also many barriers and difficulties in legal systems that would allow for more effective inter-professional cooperation. The COVID-19 pandemic contributed to emphasizing the role of the pharmacist, increasing powers, and at the same time to teamwork, sometimes forced by the situation. The purpose of this publication is to view the literature on the cooperation of physicians and pharmacists in the provision of medical services for patients. Professional cooperation has been well known in many countries for years, as it is a key medium supporting optimized patient care. Analyzing the challenges and approaches can lead to better and improved health care.
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Affiliation(s)
- Magdalena Waszyk-Nowaczyk
- Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Weronika Guzenda
- Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Karolina Kamasa
- Student's Pharmaceutical Care Group, Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Kornel Pawlak
- Student's Pharmaceutical Care Group, Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Natalia Bałtruszewicz
- Student's Pharmaceutical Care Group, Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Karolina Artyszuk
- Student's Pharmaceutical Care Group, Pharmacy Practice Division, Department of Pharmaceutical Technology, Poznan University of Medical Sciences, Poznan, 60-780, Poland
| | - Artur Białoszewski
- Department of the Prevention of Environmental Hazards and Allergology, Medical University of Warsaw, Warsaw, 02-091, Poland
| | - Piotr Merks
- Faculty of Medicine, Cardinal Stefan Wyszyński University, Warsaw, 01-938, Poland
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Rakvaag H, SØreide GE, Meland E, Kjome RL. Complementing or conflicting? How pharmacists and physicians position the community pharmacist. Pharm Pract (Granada) 2020; 18:2078. [PMID: 33029263 PMCID: PMC7523557 DOI: 10.18549/pharmpract.2020.3.2078] [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: 07/10/2020] [Accepted: 09/06/2020] [Indexed: 01/09/2023] Open
Abstract
Background: Interprofessional collaboration between pharmacists and physicians in primary
care has been linked to improved patient outcomes. How professionals
position themselves and each other can shed light upon their relationship,
and positioning theory can be used as a tool to better understand intergroup
relations. Objectives: 1) To identify how community pharmacists position themselves, and how they
are positioned by general practitioners. 2) To assess how well these
positions correspond, how the positions align with a proactive position for
the pharmacists, and discuss how the positions could potentially impact
collaboration. Methods: In this qualitative study, data were collected through six focus group
interviews held between June and October 2019, three with pharmacists and
three with physicians. The focus group interviews were conducted using a
semi-structured interview guide. Data were audio recorded, transcribed
verbatim, and analyzed using the Systematic text condensation method.
Positioning theory was used as a theoretical framework to identify the
positions assigned to community pharmacists by the pharmacists themselves
and by the physicians. Results: Twelve pharmacists and ten physicians participated. The pharmacists
positioned themselves as the “last line of defense”,
“bridge-builders”, “outsiders” – with
responsibility, but with a lack of information and authority – and
“practical problem solvers”. The physicians positioned
pharmacists as “a useful checkpoint”,
“non-clinicians” and “unknown”. Conclusions: The study revealed both commonalities and disagreements in how community
pharmacists position themselves and are positioned by general practitioners.
Few of the positions assigned to pharmacists by the physicians support an
active role for the pharmacists, while the pharmacists´ positioning
of themselves is more diverse. The physicians´ positioning of
pharmacists as an unknown group represents a major challenge for
collaboration. Increasing the two professions´ knowledge of each
other may help produce new positions that are more coordinated, and thus
more supportive towards collaboration.
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Affiliation(s)
- Hilde Rakvaag
- MPharm. Department of Global Public Health and Primary Care, Centre for Pharmacy, University of Bergen. Bergen (Norway).
| | - Gunn E SØreide
- Dr.Phil. Associate Professor. Department of Education, University of Bergen. Bergen (Norway).
| | - Eivind Meland
- MD, PhD. Emeritus Professor. Department of Global Public Health and Primary Care, University of Bergen. Bergen (Norway).
| | - Reidun L Kjome
- MPharm, PhD. Associate Professor. Department of Global Public Health and Primary Care, Centre for Pharmacy, University of Bergen. Bergen (Norway).
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Albassam A, Almohammed H, Alhujaili M, Koshy S, Awad A. Perspectives of primary care physicians and pharmacists on interprofessional collaboration in Kuwait: A quantitative study. PLoS One 2020; 15:e0236114. [PMID: 32687539 PMCID: PMC7371165 DOI: 10.1371/journal.pone.0236114] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Accepted: 06/29/2020] [Indexed: 11/19/2022] Open
Abstract
Collaborative practice between physicians and pharmacists has a positive effect on healthcare outcomes. Understanding the local data related to this collaboration is vital in establishing efficient collaboration. Therefore, this study was designed to assess the collaborative relationships between physicians and pharmacists working in the primary healthcare centres regarding their attitudes and experiences, preferred methods of communication, perceptions related to the role of pharmacists, areas of potential further collaboration, and perceived barriers. A cross-sectional study was conducted using two parallel pretested self-administered questionnaires on a sample of 518 randomly selected physicians and pharmacists. Descriptive and comparative analyses were used in data analysis. The overall response rate was 86.3%. Although over 98% of respondents agreed that physician-pharmacist collaboration improves patient outcomes, more than half of the physicians (52.1%) and pharmacists (55.7%) had never practised collaboratively. Both groups preferred to communicate face-to-face (76.7%) or via telephone (76.5%). Both professions showed good agreement on pharmacists' roles related to managing side effects, improving adherence, assisting in dosage adjustment, providing advice regarding drug interactions, and providing drug information to physicians. They indicated disagreements on the importance of dispensing of prescriptions and providing advice to physicians regarding modification of drug therapy. Both groups expressed overall positive perceptions of the potential for further collaboration in areas related to the clinical roles of pharmacists, which were significantly higher among those with practice experience of < 10 years and those aged < 40 years (p<0.05). The top four perceived barriers to collaborative practice were lack of time (84.1%), lack of financial compensation (76.3%), lack of face-to-face communication (68.9%), and the possible fragmentation of patient care by the involvement of multiple healthcare professionals (68.9%). The present findings provide valuable input that could be a catalyst to enhance or establish physician-pharmacist collaboration in primary healthcare settings in Kuwait.
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Affiliation(s)
- Abdullah Albassam
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
| | - Hamad Almohammed
- Drug and Food Control Administration, Ministry of Health, Kuwait, Kuwait
| | - Malak Alhujaili
- Department of Pharmacy, Jaber Alahmad Polyclinic, Ministry of Health, Kuwait, Kuwait
| | - Samuel Koshy
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
| | - Abdelmoneim Awad
- Department of Pharmacy Practice, Faculty of Pharmacy, Kuwait University, Kuwait, Kuwait
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9
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Qazi A, Saba M, Armour C, Saini B. Perspectives of pharmacists about collaborative asthma care model in primary care. Res Social Adm Pharm 2020; 17:388-397. [PMID: 32284301 DOI: 10.1016/j.sapharm.2020.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 03/12/2020] [Accepted: 03/14/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The newly recognized General Practice Pharmacist (GPP) model in Australia, where non-dispensing pharmacists work in collaboration with general practitioners (primary care physicians) within their general practice/clinics represent an efficient yet novel approach for the management of chronic diseases. In chronic conditions, such as asthma, these models can help achieve optimal health outcomes, given current gaps between guidelines and practice. OBJECTIVE The aim of this study was to elicit pharmacists' views and recommendations about pragmatic models of collaboration between GPPs and general practitioners in providing asthma management services in future service delivery models. METHODS Community pharmacists were recruited via convenience sampling and passive snowballing techniques. Qualitative, semi-structured, in-depth interviews were conducted. Recorded interviews were transcribed verbatim and analyzed utilizing NVivo® 11 software. Obtained data were content analyzed for emergent themes using the Braun and Clarke framework. RESULTS Twenty-five interviews were conducted. Asthma management challenges in current practice and the implementation practicality of asthma care GPP models comprised the two major emerging themes. Pharmacists' time and workload constraints and patients' reluctance to seek pharmacists' assistance to dispel misconceptions about asthma control were reported to be major barriers for the implementation of optimal asthma management services in community pharmacy. While a GPP dependent on several criteria. The development of specified channels for inter-professional communication for sharing of patient information and the willingness of stakeholders to accept and access such a model were reported. Funding and remuneration were considered critical factors by most participants. The professional self-autonomy of each healthcare professional involved in the GPP model was also highlighted as pertinent issue. CONCLUSIONS This study provides significant insights to create pragmatic scalable versions of a GPP care model that could facilitate better asthma care after key barriers and facilitators identified by participants are carefully addressed.
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Affiliation(s)
- Anila Qazi
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia.
| | - Maya Saba
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Carol Armour
- The Woolcock Institute of Medical Research, Glebe, NSW, 2037, Australia
| | - Bandana Saini
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, 2006, Australia; The Woolcock Institute of Medical Research, Glebe, NSW, 2037, Australia
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Murshid MA, Mohaidin Z, Zayed M. Development and validation of an instrument designed to measure factors influencing physician prescribing decisions. Pharm Pract (Granada) 2020; 17:1616. [PMID: 31897258 PMCID: PMC6935548 DOI: 10.18549/pharmpract.2019.4.1616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 12/08/2019] [Indexed: 12/02/2022] Open
Abstract
Background: Previous attempts to develop an instrument to measure factors that influence prescribing decisions among physicians were relatively insufficient and lacked validation scale. Objective: We present a new tool that attempts to address this shortcoming. Hence, this study aims to develop and validate a self-administrated instrument to explain factors that influence the prescribing decisions of physicians. Methods: The questionnaire was developed based on literature and then subjected to an exhaustive assessment by a board of professionals and a pilot examination before being administered to 705 physicians. Three pre-tests were carried out to evaluate the quality of the survey items. In pre-test 1, after items are generated and the validity of their content is assessed by academics and physicians. In pre-test 2, the scale is carried out with a small sample of 20 respondents of physicians. In pre-test 3, fifty drop-off questionnaires were piloted amongst physicians to test the reliability. Results: On the basis of partial least squares structural equation modelling (PLS-SEM) analyses using SmartPLS 3, the content and convergent validity of the instrument were confirmed with 44 items grouped into four categories, namely, marketing efforts, patient characteristics, pharmacist variables, and contextual factors with 13 reflective constructs. Conclusions: The study outcomes prove that the scale is more valid and reliable for measuring factors that influence the decision of the physician to prescribe the drug. The development and presentation of a scale of thirteen factors related to physicians prescribing decisions help to ensure valid findings and facilitates comparisons of studies and research settings.
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Affiliation(s)
- Mohsen Ali Murshid
- PhD. Faculty of Administrative Sciences, Thamar University. Dhamar (Yemen). mohsen092@gmail
| | - Zurina Mohaidin
- PhD. Senior lecturer. Graduate School of Business (GSB), University of Science Malaysia. Penang (Malaysia).
| | - Mohammad Zayed
- PhD. Graduate School of Business, University of Science Malaysia. Penang (Malaysia).
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11
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Nørgaard JD, Sporrong SK. Views on the role of community pharmacy in local communities: a case study of stakeholders' attitudes. Pharm Pract (Granada) 2019; 17:1419. [PMID: 31275494 PMCID: PMC6594432 DOI: 10.18549/pharmpract.2019.2.1419] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Accepted: 04/08/2019] [Indexed: 11/14/2022] Open
Abstract
Objectives To investigate the view of the role of community pharmacy by selected stakeholders in local Danish communities. Methods A mixed method approach combining qualitative and quantitative methods was used: observations at pharmacies, questionnaires for pharmacy staff and customers, and interviews with pharmacy owners, general practitioners (GPs) and politicians. Role theory was the theoretical foundation. Data was analyzed using directed content analysis and descriptive statistics. Results Five Danish towns were visited, resulting in five pharmacist interviews, 48 questionnaire replies from pharmacy staff, 59 customer interviews, three GP interviews and four interviews with local politicians. All stakeholders found the pharmacy to have a medical focus, although to a differing degree. While pharmacy staff and GPs had the greatest knowledge and expectations regarding the pharmacy staff's level of medical knowledge, local politicians had the least. Pharmacy staff wanted to take on more responsibility. Customers generally considered the pharmacy part of the healthcare sector with a high level of knowledge on medications. GPs' attitudes appeared to be related to the amount of communication between GP office and pharmacy. Local politicians interviewed did not seem to be aware of the competencies within the pharmacy, but once informed were open to using the pharmacy as an integrated part of the local healthcare system. Conclusions There was general consensus between stakeholder groups that medicine is the main area of focus at the pharmacy. However, investigated stakeholders did not appear to be aware of the full extent of the competencies within the pharmacy, and there was a general lack of consensus about the services the pharmacy should perform. If the competencies within the pharmacy are to be fully utilized, the pharmacy must not only tell but also show the local community what they can do.
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Affiliation(s)
| | - Sofia K Sporrong
- Department of Pharmacy, University of Copenhagen, Copenhagen (Denmark).
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12
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Murshid MA, Mohaidin Z. Influence of the expertise, collaborative efforts and trustworthiness of pharmacists on the prescribing decisions of physicians. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2019. [DOI: 10.1002/jppr.1492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Zurina Mohaidin
- Graduate School of Business Universiti Sains Malaysia Penang Malaysia
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Islam MA, Khan SA, Gunaseelan S, Talukder RM. Physician perceptions of integrating pharmacists into health care in Bangladesh. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2018. [DOI: 10.1002/jppr.1401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Mohammed A. Islam
- Department of Pharmaceutical Sciences; West Coast University School of Pharmacy; Los Angeles California USA
| | - Seher A. Khan
- Lake Erie College of Osteopathic Medicine School of Pharmacy; Erie Pennsylvania USA
| | - Simi Gunaseelan
- Department of Pharmaceutical Sciences; Ben and Maytee Fisch College of Pharmacy; The University of Texas at Tyler; Tyler Texas USA
| | - Rahmat M. Talukder
- Department of Pharmaceutical Sciences; Ben and Maytee Fisch College of Pharmacy; The University of Texas at Tyler; Tyler Texas USA
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Luetsch K. From enforcement to advocacy - Developing a Foucauldian perspective of pharmacists' reflections on interactions with complex patients. Res Social Adm Pharm 2018; 15:528-535. [PMID: 29980482 DOI: 10.1016/j.sapharm.2018.06.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2018] [Revised: 05/31/2018] [Accepted: 06/28/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND Pharmacists are extending their engagement in health care beyond the supply and monitoring of medicines. Extended roles for pharmacists propose participation in health promotion, disease monitoring and other health surveillance activities, involving them more closely in the lives of patients. OBJECTIVES To explore pharmacists' written reflections on patient-centred practice after interactions with people who experience complexity and difficulties to participate in their health care, using a Foucauldian approach. METHODS For this qualitative study, pharmacists enrolled in a postgraduate program first watched a video introducing them to the concept of complexity and conflicting patient priorities in health care. They then interacted with patients and reflected on these encounters, their understanding and practice of patient-centeredness. The reflective texts were thematically analysed, using the constant comparison method. Foucault's method of problematisation was used to construct and interpret themes. RESULTS Sixty-six pharmacists provided reflective accounts of their patient interaction. Main themes showed how pharmacists emphasised adherence to prescribed medicines, disease monitoring and other desirable health behaviours over tailoring advice to patients' priorities. The Foucauldian analysis elucidated how they prioritised supporting individual patient responsibility over addressing complexity in medication regimens and prescribed health care, risking normalisation of an enforcing role. Pharmacists acknowledged a discrepancy in their patient-centred practice when taking responsibility for patients' medication taking behaviour while encouraging the adoption of certain disciplines to achieve compliance. When pharmacists respected patients' agency and tailored advice and professional support to the needs, wishes and capacities of patients, they developed opportunities for advocacy via increased patient-centeredness. CONCLUSION Pharmacists' discursive practices as described in their reflections raise questions of how they employ their sociological and professional roles in negotiating the relatively best outcomes for patients. Pharmacists increasing their awareness of how they conduct themselves may enhance their patient-centeredness when extending participation in disease monitoring and surveillance.
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Affiliation(s)
- Karen Luetsch
- School of Pharmacy, The University of Queensland, 20 Cornwall St, Woolloongabba, Qld, 4102, Australia.
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Saw PS, Nissen L, Freeman C, Wong PS, Mak V. A qualitative study on pharmacists' perception on integrating pharmacists into private general practitioner's clinics in Malaysia. Pharm Pract (Granada) 2017; 15:971. [PMID: 28943979 PMCID: PMC5597807 DOI: 10.18549/pharmpract.2017.03.971] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Accepted: 08/22/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Private general practitioners in Malaysia largely operates as solo practices - prescribing and supplying medications to patients directly from their clinics, thus posing risk of medication-related problems to consumers. A pharmacy practice reform that integrates pharmacists into primary healthcare clinics can be a potential initiative to promote quality use of medication. This model of care is a novel approach in Malaysia and research in the local context is required, especially from the perspectives of pharmacists. OBJECTIVE To explore pharmacists' views in integrating pharmacists into private GP clinics in Malaysia. METHODS A combination of purposive and snowballing sampling was used to recruit community and hospital pharmacists from urban areas in Malaysia to participate either in focus groups or semi-structured interviews. A total of 2 focus groups and 4 semi-structured interviews were conducted. Sessions were audio recorded, transcribed verbatim and thematically analysed using NVivo 10. RESULTS Four major themes were identified: (1) Limited potential to expand pharmacists' roles, (2) Concerns about non-pharmacists dispensing medicines in private GP clinics, (3) Lack of trust from consumers and private GPs, (4) Cost implications. Participants felt that there was a limited role for pharmacists in private GP clinics. This was because the medication supply role is currently undertaken in private GP clinics without the need of pharmacists. The perceived lack of trust from consumers and private GPs towards pharmacists arises from the belief that healthcare is the GPs' responsibility. This suggests that there is a need for increased public and GP awareness towards the capabilities of pharmacists' in medication management. Participants were concerned about an increase in cost to private GP visits if pharmacists were to be integrated. Nevertheless, some participants perceived the integration as a means to reduce medical costs through improved quality use of medicines. CONCLUSION Findings from the study provided a better understanding to help ascertain pharmacists' views on their readiness and acceptance in a potential new model of practice.
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Affiliation(s)
- Pui S Saw
- School of Pharmacy, Monash University Malaysia. Selangor (Malaysia).
| | - Lisa Nissen
- Professor and Head, School of Clinical Sciences, Queensland University of Technology, Brisbane QLD (Australia).
| | - Christopher Freeman
- Clinical Senior Lecturer in QUM, School of Pharmacy, University of Queensland. St Lucia, QLD (Australia).
| | - Pei S Wong
- Senior lecturer, School of Pharmacy, International Medical University. Kuala Lumpur (Malaysia).
| | - Vivienne Mak
- Lecturer, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University. Parkville (Australia).
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Al-Jumaili AA, Al-Rekabi MD, Doucette W, Hussein AH, Abbas HK, Hussein FH. Factors influencing the degree of physician-pharmacist collaboration within Iraqi public healthcare settings. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2017; 25:411-417. [PMID: 28181318 DOI: 10.1111/ijpp.12339] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 11/28/2016] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Medication safety and effectiveness can be improved through interprofessional collaboration. The goals of this study were to measure the degree of physician-pharmacist collaboration within Iraqi governmental healthcare settings and to investigate factors influencing this collaboration. METHODS This cross-sectional study was conducted in Al-Najaf Province using the Collaborative Working Relationship Model and Physician-Pharmacist Collaborative Instrument (PPCI). Four pharmacists distributed paper surveys with a 7-point Likert scale to a convenience sample of physicians and pharmacists working in seven public hospitals and two outpatient clinics. The questionnaire (in English) covered individual (demographics, practising years and academic affiliation), context (practice setting) and PPCI characteristics (trustworthiness, role specification and relationship initiation) in addition to collaborative care items: one for pharmacists and one for physicians. Separate multiple regressions were used to assess the association of the factors with collaborative care for physicians and for pharmacists. KEY FINDINGS Seventy-seven physicians and 86 pharmacists returned usable surveys (81.5% response rate). The majority of physicians were male (84%), while the majority of pharmacists were female (58%). The mean age of the physicians was (37.99 years) older than that of the pharmacists (30.35 years). The physicians had a longer period of practice (11.32 years) than pharmacists (5.45 years). Most (90%) of the providers were practising in hospitals. Pharmacist academic affiliation was significantly associated with collaborative care. The pharmacist and physician regressions indicated significant (P < 0.05) associations between collaborative care and two PPCI domains (role specification and relationship initiation for physicians; role specification and trustworthiness for pharmacists). CONCLUSIONS This study focused on physician-pharmacist collaboration within hospitals, and it was the first study measuring interprofessional collaboration in Iraq. The results showed there is physician-pharmacist collaboration within Iraqi hospitals and exchange characteristics had significant influence on this collaboration.
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Affiliation(s)
- Ali Azeez Al-Jumaili
- The University of Iowa College of Pharmacy, Health Service Research Division, Iowa City, IA, USA
| | | | - William Doucette
- The University of Iowa College of Pharmacy, Health Service Research Division, Iowa City, IA, USA
| | - Ahmed H Hussein
- Faculty of Pharmacy, Humanity Studies University College, Al-Najaf, Iraq
| | - Hayder K Abbas
- Faculty of Pharmacy, Humanity Studies University College, Al-Najaf, Iraq
| | - Furqan H Hussein
- Faculty of Pharmacy, Humanity Studies University College, Al-Najaf, Iraq
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17
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Bryant L, Maney J, Martini N. Changing perspectives of the role of community pharmacists: 1998 – 2012. J Prim Health Care 2017. [DOI: 10.1071/hc16032] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
ABSTRACT INTRODUCTION In New Zealand, extended medicines management roles proposed for pharmacists include the optimisation and monitoring of medicines in patients with long-term conditions through greater collaboration with general practitioners (GPs). Although some collaborative roles have been successfully implemented in hospitals, barriers for both pharmacists and GPs hinder interprofessional working relationships in the community. AIM To compare data from a 2012 study with two previous studies (1998, 2002) examining perceptions of community pharmacists and GPs of the expanding medicines management roles of community pharmacists. METHODS In 2012, a survey, modelled on the 1998 and 2002 studies, was sent to 600 community pharmacists and 600 GPs. Analyses considered the five-point Likert scale to be a continuous variable. A change of ≥ 10% between any two surveys indicated a relevant change for comparison. RESULTS Increasing agreement, which differed considerably between professions, was apparent for most expanding medicine management roles over the 14 study years. In all three studies, pharmacists were open to expanding their roles to include monitoring, screening, advisory and prescribing roles. GPs were most accepting of the traditional dispensing role with a positive shift towards pharmacists’ involvement in medicines management over time. DISCUSSION Over 14 years, GPs became more accepting of community pharmacists’ involvement in extended medicines management roles, although still had low acceptance of the more clinical roles. Pharmacists considered increased involvement in medicines management as their role, but appeared to lack confidence in their ability to do this role.
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Bradley CL, Luder HR, Beck AF, Bowen R, Heaton PC, Kahn RS, Mansour M, Obszarski S, Frede SM. Pediatric asthma medication therapy management through community pharmacy and primary care collaboration. J Am Pharm Assoc (2003) 2016; 56:455-60. [PMID: 27245855 DOI: 10.1016/j.japh.2016.03.007] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Revised: 03/17/2016] [Accepted: 03/20/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To design and implement a collaborative medication therapy management (MTM) program targeting pediatric patients with high-risk asthma in a community pharmacy. SETTING Underserved inner city of Cincinnati, OH. PRACTICE DESCRIPTION A large national grocery store chain pharmacy and an academic hospital developed a partnership aimed at improving asthma care for shared patients. An interdisciplinary project team was formed, including 2 clinical pharmacists, 1 pharmacy district clinical coordinator, 1 pharmacy division clinical coordinator, 1 associate professor at a college of pharmacy, 1 pharmacy resident, and 3 pediatric physicians. This pilot project involved 2 Kroger Pharmacy sites and Cincinnati Children's Hospital Medical Center's (CCHMC) 3 pediatric primary care centers. PRACTICE INNOVATION Kroger and CCHMC staff identified shared high-risk asthma patients (those cared for at the included primary care centers who used Kroger for their medication fills) with the use of information from validated symptom assessments (Asthma Control Test), refill history, and recent health care utilization. Community pharmacists recruited jointly identified patients and provided a targeted MTM intervention. Education focused on asthma diagnosis, types of asthma medications, appropriate medication administration, and environmental triggers. Pharmacists suggested medication changes to prescribers via facsimile. Pharmacists followed up with patients in 30 days to assess asthma control, provide additional education, and propose further recommendations. EVALUATION Outcomes evaluated included the average number of recommendations made to patients and prescribers and acceptance rates for each of those measures. RESULTS Six patients completed the project. Pharmacists provided an average of 3.7 recommendations to each patient and 1.5 to prescribers for each patient; 77.3% and 100% recommendations were accepted, respectively. CONCLUSION This pilot project describes the design and implementation of a pharmacist-physician collaborative program for high-risk pediatric asthma patients. The greatest outcome of this project was the formation of a collaborative team between pharmacists and physicians that continues to work together on additional family-centered initiatives.
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Arora PG, Connors EH, Biscardi KA, Hill AM. School mental health professionals’ training, comfort, and attitudes toward interprofessional collaboration with pediatric primary care providers. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/1754730x.2016.1181526] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Bosnic-Anticevich SZ. Asthma management in primary care: caring, sharing and working together. Eur Respir J 2016; 47:1043-6. [DOI: 10.1183/13993003.00240-2016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 02/14/2016] [Indexed: 01/08/2023]
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21
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Haga SB, Moaddeb J. Proposal for a pharmacogenetics certificate program for pharmacists. Pharmacogenomics 2016; 17:535-9. [PMID: 27020330 DOI: 10.2217/pgs.16.11] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Susanne B Haga
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, North Building, Room #262, Box 90141, Durham, NC 27708, USA
| | - Jivan Moaddeb
- Center for Applied Genomics & Precision Medicine, Duke University School of Medicine, 304 Research Drive, North Building, Room #262, Box 90141, Durham, NC 27708, USA
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Puspitasari HP, Costa DS, Aslani P, Krass I. An explanatory model of community pharmacists' support in the secondary prevention of cardiovascular disease. Res Social Adm Pharm 2016; 12:104-118. [DOI: 10.1016/j.sapharm.2015.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 04/15/2015] [Indexed: 10/23/2022]
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Enz S, Frosch DR. Effect of Collaborative vs. Noncollaborative Quizzes on Examination Scores in a Pharmaceutical Calculations Course. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2015; 79:66. [PMID: 26396275 PMCID: PMC4571041 DOI: 10.5688/ajpe79566] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2014] [Accepted: 12/08/2014] [Indexed: 06/01/2023]
Abstract
OBJECTIVE To determine if midterm and final examination scores in a pharmaceutical calculations course differ among students who take weekly quizzes collaboratively, noncollaboratively, or half-collaboratively/half-noncollaboratively ("mixed"). METHODS One hundred twenty-three students enrolled in one of 4 laboratory sections: collaborative, noncollaborative, or mixed sections. Students working noncollaboratively completed a 15-minute quiz at the end of weekly laboratories. Students working collaboratively were randomly allocated into groups of 4 and worked independently for 5 minutes before working collaboratively for 10 minutes. Students in mixed sections worked collaboratively during one half of the semester and noncollaboratively during the other half of the semester in a crossover design to control for order effect. All students took midterm and final examinations independently. RESULTS Mean scores for a pretest did not significantly differ between the 4 laboratory sections at the study's onset. Multivariate analysis of variance (MANOVA) revealed a significant multivariate effect for the 9 laboratory quizzes in relation to group assignment. Mean scores on the midterm examination did not significantly differ between collaborative and noncollaborative groups. On the final examination, the two mixed groups significantly outperformed the collaborative group, but did not significantly differ from one another or from the noncollaborative group. CONCLUSION Peer collaboration improves quiz scores, is favorably perceived by students and enhances their course satisfaction, but does not improve subsequent performance on midterm and final examinations taken noncollaboratively.
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Affiliation(s)
- Stephanie Enz
- Butler University College of Pharmacy and Health Sciences, Indianapolis, Indiana
| | - Donald R Frosch
- Butler University College of Pharmacy and Health Sciences, Indianapolis, Indiana
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Bardet JD, Vo TH, Bedouch P, Allenet B. Physicians and community pharmacists collaboration in primary care: A review of specific models. Res Social Adm Pharm 2014; 11:602-22. [PMID: 25640887 DOI: 10.1016/j.sapharm.2014.12.003] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Revised: 12/12/2014] [Accepted: 12/12/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Since 2008, French healthcare reform encourages community pharmacists (CP) to develop collaborative care with other health care providers through new cognitive pharmacy services. OBJECTIVES This review is aimed to identify theoretical models that have been developed to understand the physician-CP collaboration (PCPC) and to identify the associated determinants. METHODS English-written abstracts research was conducted on Pubmed/Medline, PsycINFO, Sociological Abstracts, and CINAHL from January 1990 to June 2013. Keywords were based on common terminology of inter-professional relations and community pharmacy. RESULTS Of the 1545 single articles identified, the final review was conducted on 16 articles. Four specific models of collaboration centered on PCPC were identified: (i) the Collaborative Working Relationship Model (CWR), (ii) the Conceptual model of GPCP collaboration, (iii) the CP Attitudes towards Collaboration with GPs Model (ATC-P), (iv) the GP Attitudes towards collaboration with CPs (ATC-GP). The analysis of these four PCPC models shows that their respective factors might cover the same concepts, especially for relational and interactional determinants. These key elements are: trust, interdependence, perceptions and expectations about the other HCP, skills, interest for collaborative practice, role definition and communication. CONCLUSION A meta-model for PCPC has been postulated. It can be used for qualitative exploration of PCPC, in a context of implementation of collaborative practice including CPs, in the primary care.
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Affiliation(s)
- Jean-Didier Bardet
- Grenoble Alps University/CNRS/TIMC-IMAG UMR 5525/Themas, Grenoble F-38041, France.
| | - Thi-Ha Vo
- Grenoble Alps University/CNRS/TIMC-IMAG UMR 5525/Themas, Grenoble F-38041, France
| | - Pierrick Bedouch
- Grenoble Alps University/CNRS/TIMC-IMAG UMR 5525/Themas, Grenoble F-38041, France; Pharmacy Department, Grenoble University Hospital, Grenoble F-38043, France
| | - Benoît Allenet
- Grenoble Alps University/CNRS/TIMC-IMAG UMR 5525/Themas, Grenoble F-38041, France; Pharmacy Department, Grenoble University Hospital, Grenoble F-38043, France
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25
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Social psychology in an evolving profession: A research agenda for advancing clinical pharmacy services. Res Social Adm Pharm 2014; 10:701-3. [DOI: 10.1016/j.sapharm.2014.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2014] [Accepted: 06/25/2014] [Indexed: 11/18/2022]
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Mutie M, Naunton M, Cooper G, Kyle G, Zwar N. Role of pharmacists in collaborative care of travellers with chronic conditions. Travel Med Infect Dis 2014; 12:286-7. [DOI: 10.1016/j.tmaid.2014.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2014] [Accepted: 03/04/2014] [Indexed: 11/30/2022]
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Ninane V, Brusselle GG, Louis R, Dupont L, Liistro G, De Backer W, Schlesser M, Vincken W. Usage of inhalation devices in asthma and chronic obstructive pulmonary disease: a Delphi consensus statement. Expert Opin Drug Deliv 2013; 11:313-23. [PMID: 24344875 DOI: 10.1517/17425247.2014.872626] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES The study aimed to assess usage of inhalation devices in asthma and chronic obstructive pulmonary disease (COPD). METHODS In this two-round Delphi survey, 50 experts in asthma and COPD completed a 13-item, Internet-based, self-administered questionnaire about choice of inhalation device, training and monitoring of inhalation techniques, the interchangeability and the role of costs in the selection of inhalation devices. For each item, the median (central tendency) and interquartile ranges (degree of consensus) were calculated. RESULTS Experts considered that the choice of inhalation device was as important as that of active substance (very good consensus) and should be driven by ease of use (good to very good consensus) and teaching (very good consensus). Experts recommended giving oral and visual instructions (good consensus) and systematic monitoring inhalation techniques. Pulmonologists and paramedics have predominantly educational roles (very good consensus). Experts discouraged inhalation device interchangeability (good consensus) and switching for cost reasons (good to very good consensus) without medical consultation (good consensus). CONCLUSIONS The results of this survey thus suggested that inhalation devices are as important as active substances and training and monitoring are essential in ensuring effective treatment of asthma and COPD. Inhalation device switching without medical consultation should be avoided.
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Affiliation(s)
- Vincent Ninane
- Centre Hospitalier Universitaire Saint-Pierre, Department of Pneumology , Rue Haute, 322, B-1000 Brussels , Belgium +32 02 535 42 03 ; +32 02 535 33 62 ;
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Abstract
INTRODUCTION The Electronic Communications and Home Blood Pressure Monitoring trial (e-BP) demonstrated that team care incorporating a pharmacist to manage hypertension using secure E-mail with patients resulted in almost twice the rate of blood pressure (BP) control compared with usual care. To translate e-BP into community practices, we sought to identify contextual barriers and facilitators to implementation. METHODS Interviews were conducted with medical providers, staff, pharmacists, and patients associated with community-based primary care clinics whose physician leaders had expressed interest in implementing e-BP. Transcripts were analyzed using qualitative template analysis, incorporating codes derived from the Consolidated Framework for Implementation Research (CFIR). RESULTS Barriers included incorporating an unfamiliar pharmacist into the health care team, lack of information technology resources, and provider resistance to using a single BP management protocol. Facilitators included the intervention's perceived potential to improve quality of care, empower patients, and save staff time. Sustainability of the intervention emerged as an overarching theme. CONCLUSION A qualitative approach to planning for translation is recommended to gain an understanding of contexts and to collaborate to adapt interventions through iterative, bidirectional information gathering. Interviewees affirmed that web pharmacist care offers small primary care practices a means to expand their workforce and provide patient-centered care. Reproducing e-BP in these practices will be challenging, but our interviewees expressed eagerness to try and were optimistic that a tailored intervention could succeed.
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Kelly DV, Bishop L, Young S, Hawboldt J, Phillips L, Keough TM. Pharmacist and physician views on collaborative practice: Findings from the community pharmaceutical care project. Can Pharm J (Ott) 2013; 146:218-26. [PMID: 23940479 PMCID: PMC3734911 DOI: 10.1177/1715163513492642] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Strong working relationships between pharmacists and physicians are needed to optimize patient care. Understanding attitudes and barriers to collaboration between pharmacists and physicians may help with delivery of primary health care services. The objective of this study was to capture the opinions of family physicians and community pharmacists in Newfoundland and Labrador (NL) regarding collaborative practice. METHODS Two parallel surveys were offered to all community pharmacists and family physicians in NL. Surveys assessed the following: attitudes and experience with collaborative practice, preferred communication methods, perceived role of pharmacists, areas for more collaboration and barriers to collaborative practice. Results for both groups were analyzed separately, with comparisons between groups to compare responses with similar questions. RESULTS Survey response rates were 78.6% and 7.1% for pharmacists and physicians, respectively. Both groups overwhelmingly agreed that collaborative practice could result in improved patient outcomes and agreed that major barriers were lack of time and compensation and the need to deal with multiple pharmacists/physicians. Physicians indicated they would like more collaboration for insurance approvals and patient counselling, while pharmacists want to assist with identifying and managing patients' drug-related problems. Both groups want more collaboration to improve patient adherence. CONCLUSION Both groups agree that collaborative practice can positively affect patient outcomes and would like more collaboration opportunities. However, physicians and pharmacists disagree about the areas where they would like to collaborate to deliver care. Changes to reimbursement models and infrastructure are needed to facilitate enhanced collaboration between pharmacists and physicians in the community setting.
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Affiliation(s)
- Deborah V Kelly
- School of Pharmacy (Kelly, Bishop, Young, Hawboldt, Phillips), Memorial University, St. John's, Newfoundland and Labrador
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