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De Bellis A, McCloud C, Giles J, Apollloni M, Abigail W, Hill P. Rural and remote pharmacists' perspectives of grey nomads with diabetes travelling in Australia. Aust J Rural Health 2024. [PMID: 38766684 DOI: 10.1111/ajr.13139] [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: 10/22/2023] [Revised: 04/26/2024] [Accepted: 05/07/2024] [Indexed: 05/22/2024] Open
Abstract
OBJECTIVE The objective of the research was to explore rural and remote pharmacists' experiences of encountering grey nomads with diabetes. DESIGN A qualitative Interpretive Description design was used to explore and capture the experiences of rural and remote pharmacists interacting with grey nomads who had diabetes. Data from the interviews were analysed thematically. SETTING The Pharmacy Guild of Australia was approached and through their membership rural and remote pharmacists were invited to participate in the research. PARTICIPANTS Nine rural and remote pharmacists who had encounters and provided services to grey nomads with diabetes responded to be interviewed. RESULTS The analysed findings established four major themes including: the influence of rural and remote locations on services; common problems encountered by the pharmacists; preparation for travel by grey nomads with diabetes; and pharmacists' preparedness to support grey nomads with diabetes. CONCLUSION The findings of this study identified that pharmacists needed remuneration for services provided to grey nomads with diabetes. Also, further development of the My Health record and telehealth to include pharmacists would be advantageous for grey nomads who have diabetes. Pharmacists stated there was a need for further education and a continuing professional development module specifically designed for pharmacists on diabetes self-management that moved beyond medications. A pre-travel checklist for grey nomads with diabetes travelling in rural and remote Australia would benefit all stakeholders through better preparation of travellers with diabetes to self-manage, thereby reducing the demand for health services including pharmacies.
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Affiliation(s)
- Anita De Bellis
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
- Caring Futures Institute, Flinders University, Adelaide, South Australia, Australia
| | - Christine McCloud
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Jane Giles
- Rural and Remote Health, SAHealth, Adelaide, South Australia, Australia
| | - Marc Apollloni
- Pharmacy Guild South Australia, Adelaide, South Australia, Australia
| | - Wendy Abigail
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Pauline Hill
- College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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Thai T, Lancsar E, Spinks J, Freeman C, Chen G. Understanding Australian pharmacy degree holders' job preferences through the lens of motivation-hygiene theory. Soc Sci Med 2024; 348:116832. [PMID: 38569288 DOI: 10.1016/j.socscimed.2024.116832] [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: 10/02/2023] [Revised: 02/27/2024] [Accepted: 03/23/2024] [Indexed: 04/05/2024]
Abstract
Increasing the contribution of pharmacists to primary care has been long discussed, particularly in the context of health workforce shortages and the push to better integrate all providers across primary care. This study examines the employment preferences of Australian pharmacy degree holders (PDHs) elicited through a discrete choice experiment (DCE), to better understand the drivers of current labour force choices. A labelled DCE was developed incorporating the six employment sectors: hospital pharmacy, community pharmacy, primary healthcare settings, pharmaceutical industry, government/academia, and non-pharmacy-related sector. Each alternative was described by five attributes using Herzberg's Two Factor Theory as a conceptual framework. They include motivators - role and career opportunities, and hygiene factors-flexible work schedule, geographic location, and salary. Unforced choice data were analysed using conditional logit and mixed logit models. Based on a sample of 678 PDHs in Australia, our findings indicated pharmaceutical industry is the least preferred sector, followed by non-pharmacy-related sector. Motivators in the form of role and career opportunities are the most important attributes in hospital pharmacy while hygiene factors - geographic location and salary significantly drive the choice of community pharmacy and primary care settings. We provided evidence of a willingness to adopt expanded roles in community pharmacy. This unique interpretation of the key drivers of employment preference in light of motivators and hygiene factors provides policy makers with important information when designing policies to attract and retain PDHs across employment sectors.
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Affiliation(s)
- Thao Thai
- Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Level 4, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| | - Emily Lancsar
- Department of Health Services Research & Policy, Research School of Population Health, College of Health & Medicine, The Australian National University, 63A Eggleston Road, Acton ACT, 2601, Australia
| | - Jean Spinks
- Centre for the Business and Economics of Health, Lev 5, Bld 14, The University of Queensland, St Lucia Campus, Brisbane, QLD, 4072, Australia
| | - Christopher Freeman
- The University of Queensland, School of Pharmacy, Brisbane, QLD, Australia; The University of Queensland, Faculty of Medicine, Brisbane, QLD, Australia; Metro North Hospital and Health Service, Brisbane, QLD, Australia
| | - Gang Chen
- Centre for Health Economics, Monash Business School, Monash University, Level 5, Building H, Caulfield Campus, 900 Dandenong Road, Caulfield East, VIC, 3145, Australia
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Riboulet M, Clairet AL, Bennani M, Nerich V. Patient Preferences for Pharmacy Services: A Systematic Review of Studies Based on Discrete Choice Experiments. THE PATIENT 2024; 17:13-24. [PMID: 38093090 DOI: 10.1007/s40271-023-00652-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/09/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND AND OBJECTIVE In recent years, the mission of pharmacists has evolved and the model of the caregiver-patient relationship has been challenged by a new patient-centered approach. A challenge to providing personalized care is the assessment of patient preferences. We aimed to systematically identify published discrete choice experiments related to patient preferences for pharmacy services and to assess the quality of the selected articles. METHODS A systematic review of the literature was conducted in two databases (PubMed and Embase, until March 2023) according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. The quality of the selected articles was assessed according to the International Society for Pharmacoeconomics and Outcomes Research conjoint analysis checklist. RESULTS Among the 421 articles identified, 16 published studies were included and analyzed. They were mostly published in pharmaceutical (n = 6), economic (n = 4), and public health (n = 4) journals. Only two articles concerned the field of hospital pharmacy. Only five presented the specific pharmacy service studied: filling of prescriptions, management of symptoms, treatment delivery, and components of pharmacist counseling. Five articles focused on pharmacy services related to a specific disease. None fully fulfilled the International Society for Pharmacoeconomics and Outcomes Research checklist, only partially fulfilled. CONCLUSIONS According to the identified studies, cost, time, logistics (organizational criteria), and pharmacists' courtesy and skills were consistently cited as factors influencing patient preferences for pharmacy services. The disclosure of patient preferences is a complex and under-researched topic, especially in the field of pharmacy, but interest is growing. As the mission of pharmacists evolves to bring them closer to patients, the better understanding of patient preferences in pharmacy services will allow for better targeting and better integration of patient profiles in patient management.
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Affiliation(s)
| | - Anne-Laure Clairet
- Université de Franche-Comté, CHU Besançon, INSERM, EFS BFC, UMR1098, RIGHT, Pôle Pharmacie, F-25030, Besançon Cedex, France
| | | | - Virginie Nerich
- Université de Franche-Comté, CHU Besançon, INSERM, EFS BFC, UMR1098, RIGHT, Pôle Pharmacie, F-25030, Besançon Cedex, France.
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Costa S, Guerreiro J, Teixeira I, Helling DK, Mateus C, Pereira J. Patient preferences and cost-benefit of hypertension and hyperlipidemia collaborative management model between pharmacies and primary care in Portugal: A discrete choice experiment alongside a trial (USFarmácia®). PLoS One 2023; 18:e0292308. [PMID: 37796918 PMCID: PMC10553278 DOI: 10.1371/journal.pone.0292308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 09/18/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND Little is known about patient preferences and the value of pharmacy-collaborative disease management with primary care using technology-driven interprofessional communication under real-world conditions. Discrete Choice Experiments (DCEs) are useful for quantifying preferences for non-market services. OBJECTIVES 1) To explore variation in patient preferences and estimate willingness-to-accept annual cost to the National Health Service (NHS) for attributes of a collaborative intervention trial between pharmacies and primary care using a trial exit DCE interview; 2) to incorporate a DCE into an economic evaluation using cost-benefit analysis (CBA). METHODS We performed a DCE telephone interview with a sample of hypertension and hyperlipidemia trial patients 12 months after trial onset. We used five attributes (levels): waiting time to get urgent/not urgent medical appointment (7 days/45 days; 48 hrs./30 days; same day/15 days), model of pharmacy intervention (5-min. counter basic check; 15-min. office every 3 months for BP and medication review of selected medicines; 30-min. office every 6 months for comprehensive measurements and medication review of all medicines), integration with primary care (weak; partial; full), chance of having a stroke in 5 years (same; slightly lower; much lower), and annual cost to the NHS (0€; 30€; 51€; 76€). We used an experimental orthogonal fractional factorial design. Data were analyzed using conditional logit. We subtracted the estimated annual incremental trial costs from the mean WTA (Net Benefit) for CBA. RESULTS A total of 122 patients completed the survey. Waiting time to get medical appointment-on the same day (urgent) and within 15 days (non-urgent)-was the most important attribute, followed by 30-minute pharmacy intervention in private office every 6 months for point-of-care measurements and medication review of all medicines, and full integration with primary care. The cost attribute was not significant. Intervention patients were willing to accept the NHS annual cost of €877 for their preferred scenario. The annual net benefit per patient is €788.20 and represents the monetary value of patients' welfare surplus for this model. CONCLUSIONS This study is the first conducted in Portugal alongside a pharmacy collaborative trial, incorporating DCE into CBA. The findings can be used to guide the design of pharmacy collaborative interventions with primary care with the potential for reimbursement for uncontrolled or at-risk chronic disease patients informed by patient preferences. Future DCE studies conducted in community pharmacy may provide additional contributions. TRIAL REGISTRATION Current Controlled Trials (ISRCTN): ISRCTN13410498, retrospectively registered on 12 December 2018.
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Affiliation(s)
- Suzete Costa
- NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, Lisboa, Portugal
- Institute for Evidence-Based Health (ISBE), Lisboa, Portugal
- Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal
| | - José Guerreiro
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, Lisboa, Portugal
| | - Inês Teixeira
- Centre for Health Evaluation & Research (CEFAR), Infosaúde, Associação Nacional das Farmácias, Lisboa, Portugal
| | - Dennis K. Helling
- Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Denver, Colorado, United States of America
| | - Céu Mateus
- Health Economics at Lancaster, Division of Health Research, Lancaster University, Lancaster, United Kingdom
| | - João Pereira
- NOVA National School of Public Health (ENSP), Universidade NOVA de Lisboa, Lisboa, Portugal
- Public Health Research Centre (PHRC/CISP), Comprehensive Health Research Centre (CHRC), Lisboa, Portugal
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Juperi RNAA, Goh HP, Rehman IU, Lee KS, Ming LC, Hermansyah A. Evaluating healthcare professionals' perceptions of dispensing separation and sale of pharmacy medicine in Brunei Darussalam. J Pharm Policy Pract 2023; 16:101. [PMID: 37620839 PMCID: PMC10463969 DOI: 10.1186/s40545-023-00594-5] [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: 05/19/2023] [Accepted: 06/30/2023] [Indexed: 08/26/2023] Open
Abstract
BACKGROUND Pharmacy medicine (P) is obtained exclusively from a pharmacy under the supervision of a pharmacist. This study aims to understand the perception of healthcare professionals towards the dispensing separation, as well as the dispensing of pharmacy medicine by community pharmacies to enhance patient health outcomes in Brunei Darussalam. METHODS A cross-sectional study was conducted between 1st March 2023 and 20th April 2023 among healthcare professionals. A newly designed and validated questionnaire was used. Its face and content validity, along with internal consistency, was adequately established. Convenient sampling was employed to recruit participants for the study. Statistical analysis using one-way ANOVA was performed, considering a p-value < 0.05 as statistically significant. RESULTS The study compiled data from 108 participants, comprising doctors (38.9%) and pharmacy technicians (45.4%). Approximately 28.7% of respondents had 11-20 years of healthcare experience, while 25.9% had less than 5 years. Nearly all respondents (98.1%) agreed on the vital role pharmacists and pharmacy technicians play in prescription checks. A significant number of participants (93.5%) agreed that Brunei's current medicine dispensing system needs improvement. The mean total score for the perception of medicine dispensing in Brunei was 3.79 ± 1.103. A statistically significant difference was found between the perception score and the respondents' profession (p = 0.018), but not with their age, experience, or place of work. Respondents' awareness score showed no statistically significant correlation with their profession, age, experience, or place of work. CONCLUSION The study underscores the necessity for more patient-centered care in community pharmacies in Brunei Darussalam. The country's healthcare professionals should recognize the potential advantages of expanding pharmacy services. However, to implement these services successfully, regulatory restrictions and infrastructure limitations must be addressed.
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Affiliation(s)
| | - Hui Poh Goh
- PAP Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, BE1410, Brunei.
| | - Inayat Ur Rehman
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, 23200, Pakistan
| | - Kah Seng Lee
- Faculty of Pharmacy, University of Cyberjaya, Cyberjaya, Malaysia
| | - Long Chiau Ming
- PAP Rashidah Sa'adatul Bolkiah Institute of Health Sciences, Universiti Brunei Darussalam, Gadong, BE1410, Brunei
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, 60115, Indonesia
- School of Medical and Life Sciences, Sunway University, Bandar Sunway, 47500, Petaling Jaya, Selangor, Malaysia
| | - Andi Hermansyah
- Department of Pharmacy Practice, Faculty of Pharmacy, Universitas Airlangga, Surabaya, 60115, Indonesia.
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Mulder F, Löwinger D, Jenkinson SP, Kaiser E, Scharf T, Maire M, Duss S, Bassetti C, Heinzer R, Auer R, Meyer-Massetti C. Counselling for Chronic Insomnia in Swiss Pharmacies: A Survey Study Based on Case Vignettes. PHARMACY 2023; 11:105. [PMID: 37368431 DOI: 10.3390/pharmacy11030105] [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: 05/14/2023] [Revised: 05/22/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023] Open
Abstract
(1) Introduction: Chronic insomnia (CI) reduces quality of life and may trigger depression and cardiovascular diseases. The European Sleep Research Society recommends cognitive behavioural therapy (CBT-I) as the first-line treatment. Because a recent study in Switzerland demonstrated that this recommendation was inconsistently followed by primary care physicians, we hypothesised that pharmacists also deviate from these guidelines. The aim of this study is to describe current treatment practices for CI recommended by pharmacists in Switzerland, compare them to guidelines and examine their attitudes towards CBT-I. (2) Methods: A structured survey was sent to all the members of the Swiss Pharmacists Association, containing three clinical vignettes describing typical CI pharmacy clients. Treatments had to be prioritised. The prevalence of CI, and the pharmacists' knowledge and interest in CBT-I were assessed. (3) Results: Of 1523 pharmacies, 123 pharmacists (8%) completed the survey. Despite large variations, valerian (96%), relaxation therapy (94%) and other phytotherapies (85%) were most recommended. Although most pharmacists did not know about CBT-I (72%) and only 10% had recommended it, most were very interested (64%) in education. Missing financial compensation hampers the recommendation of CBT-I. (4) Conclusions: Contrary to existing European guidelines, community pharmacists in Switzerland mostly recommended valerian, relaxation therapy and other phytotherapies for treating CI. This might be connected to the client's expectation of pharmacy services, e.g., medication dispensing. While pharmacists recommend sleep hygiene regularly, most did not know of CBT-I as an overarching concept but were willing to learn. Future studies should test the effects of dedicated training about CI and changes in the financial compensation for counselling for CI in pharmacies.
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Affiliation(s)
- Fanny Mulder
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Graduate School of Health sciences GHS, University of Bern, 3012 Bern, Switzerland
| | - Dimitri Löwinger
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Stephen P Jenkinson
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Estelle Kaiser
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
| | - Tamara Scharf
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Graduate School of Health sciences GHS, University of Bern, 3012 Bern, Switzerland
| | - Micheline Maire
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Department of Internal Medicine, Cantonal Hospital of Zug, 6340 Baar, Switzerland
| | - Simone Duss
- Interdisciplinary Sleep-Wake-Epilepsy-Center and Swiss Sleep House Bern, Inselspital-University Hospital of Bern, University of Bern, 3010 Bern, Switzerland
| | - Claudio Bassetti
- Interdisciplinary Sleep-Wake-Epilepsy-Center and Swiss Sleep House Bern, Inselspital-University Hospital of Bern, University of Bern, 3010 Bern, Switzerland
| | - Raphaël Heinzer
- Service for Pneumology and Sleep Research Center (CIRS), Lausanne University Hospital (CHUV), 1011 Lausanne, Switzerland
| | - Reto Auer
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Centre for Primary Care and Public Health (Unisanté), 1011 Lausanne, Switzerland
| | - Carla Meyer-Massetti
- Institute of Primary Health Care (BIHAM), University of Bern, 3012 Bern, Switzerland
- Clinical Pharmacology and Toxicology, Department of General Internal Medicine, Inselspital-University Hospital of Bern, 3010 Bern, Switzerland
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Murry LT, Viyurri B, Chapman CG, Witry MJ, Kennelty KA, Nayakankuppam D, Doucette WR, Urmie J. Patient preferences and willingness-to-pay for community pharmacy-led Medicare Part D consultation services: A discrete choice experiment. Res Social Adm Pharm 2023; 19:764-772. [PMID: 36710174 DOI: 10.1016/j.sapharm.2023.01.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/10/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Community pharmacies currently offer Medicare Part D consultation services, often at no-cost. Despite facilitating plan-switching behavior, identifying potential cost-savings, and increasing medication adherence, patient uptake of these services remains low. OBJECTIVES To investigate patient preferences for specific service-offering attributes and marginal willingness-to-pay (mWTP) for an enhanced community pharmacy Medicare Part D consultation service. METHODS A discrete choice experiment (DCE) guided by the SERVQUAL framework was developed and administered using a national online survey panel. Study participants were English-speaking adults (≥65 years) residing in the United States enrolled in a Medicare Part D or Medicare Advantage plan and had filled a prescription at a community pharmacy within the last 12 months. An orthogonal design resulted in 120 paired-choice tasks distributed equally across 10 survey blocks. Data were analyzed using mixed logit and latent class models. RESULTS In total, 540 responses were collected, with the average age of respondents being 71 years. The majority of respondents were females (60%) and reported taking four or more prescription medication (51%). Service attribute levels with the highest utility were: 15-min intervention duration (0.392), discussion of services + a follow-up phone call (0.069), in-person at the pharmacy (0.328), provided by a pharmacist the patient knew (0.578), and no-cost (3.382). The attribute with the largest mWTP value was a service provided by a pharmacist the participant knew ($8.42). Latent class analysis revealed that patient preferences for service attributes significantly differed by gender and difficulty affording prescription medications. CONCLUSIONS Quantifying patient preference using discrete choice methodology provides pharmacies with information needed to design service offerings that balance patient preference and sustainability. Pharmacies may consider providing interventions at no-cost to subsets of patients placing high importance on a service cost attribute. Further, patient preference for 15-min interventions may inform Medicare Part D service delivery and facilitate service sustainability.
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Affiliation(s)
- Logan T Murry
- The University of Iowa College of Pharmacy, 180 S Grand Ave, Iowa City, IA, 52242, USA.
| | - Brahmendra Viyurri
- The University of Iowa College of Pharmacy, 180 S Grand Ave, Iowa City, IA, 52242, USA
| | - Cole G Chapman
- The University of Iowa College of Pharmacy, 180 S Grand Ave, Iowa City, IA, 52242, USA
| | - Matthew J Witry
- The University of Iowa College of Pharmacy, 180 S Grand Ave, Iowa City, IA, 52242, USA
| | - Korey A Kennelty
- The University of Iowa College of Pharmacy, 180 S Grand Ave, Iowa City, IA, 52242, USA
| | - Dhananjay Nayakankuppam
- The University of Iowa Tippie College of Business, 21 E Market St, Iowa City, IA, 52242, USA
| | - William R Doucette
- The University of Iowa College of Pharmacy, 180 S Grand Ave, Iowa City, IA, 52242, USA
| | - Julie Urmie
- The University of Iowa College of Pharmacy, 180 S Grand Ave, Iowa City, IA, 52242, USA
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Algarni MA, Alsheikh MY, Fathelrahman AI, Alzaidi MS, Faqeeh FJ, Althobaiti AM, Alshahrani AM. Home Drug Delivery Service from the Perspective of Community Pharmacy Staff in Saudi Arabia. PHARMACY 2022; 10:pharmacy10060162. [PMID: 36548317 PMCID: PMC9784326 DOI: 10.3390/pharmacy10060162] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 11/17/2022] [Accepted: 11/25/2022] [Indexed: 12/02/2022] Open
Abstract
Background: In response to COVID-19, many big pharmacy chains in Saudi Arabia have started to provide home drug delivery services. This study aims to understand home drug delivery service from the perspective of community pharmacists in Saudi Arabia. Also, the study investigates the obstacles that may limit the use of home drug delivery service. Methods: A cross-sectional self-reported survey was distributed from February 2021 to May 2021. Descriptive analysis of sociodemographic characteristics was conducted and presented. Frequencies and percentages were calculated for all variables. Results: A total of 965 community pharmacists were surveyed. Most of the pharmacists, (73.5%) were young, aged 23 to 34 years old. The vast majority of the participants, (93.6%), said that the service will improve drug adherence. The lack of required knowledge and skills among pharmacists could be the main obstacle to implement home drug delivery service (34%). A shortage in the number of community pharmacists was the second main obstacle (24%). Conclusion: Home delivery services in the future may largely replace the tradition of going in person to the pharmacy. There are obstacles that may limit the full use of the service like shortage in number of pharmacists and the lack of required training.
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Kavanagh ON, Courtenay A, Khan F, Lowry D. Providing pharmaceutical care remotely through medicines delivery services in community pharmacy. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 8:100187. [PMID: 36277308 PMCID: PMC9579036 DOI: 10.1016/j.rcsop.2022.100187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/05/2022] [Accepted: 10/05/2022] [Indexed: 11/07/2022] Open
Abstract
Background The delivery of pharmaceutical care - and what that means - has been at the centre of many transformations of the pharmacy profession in the last century. Today, the exponential growth of pharmacies which provide pharmaceutical care exclusively online has placed increased scrutiny on the quality of the care they provide. Aim As more patients are managed by remote pharmaceutical care (via medicines delivery services), we sought to critically evaluate this service to identify new research directions. Methods The COnsolidated criteria for REporting Qualitative research and Standards for reporting qualitative research guideline provided the methodological framework throughout this process. Results We reveal that although home delivery services ensure that many patients have access to their medicines, it may reduce time available to provide comprehensive pharmaceutical care, particularly in traditional brick-and-mortar pharmacies. Conclusion We highlight a critical need for research in this area and suggest a variety of research directions: is remote pharmaceutical care a matter of convenience? Does remote pharmaceutical care help patients adhere to their medicines? How do digital health innovations impact care across patient demographics? What does comprehensive pharmaceutical care mean for patients?
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Affiliation(s)
- Oisín N. Kavanagh
- School of Pharmacy, Newcastle University, United Kingdom.,Corresponding author.
| | - Aaron Courtenay
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Ireland.
| | - Fatimah Khan
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Ireland.
| | - Deborah Lowry
- School of Pharmacy and Pharmaceutical Sciences, Ulster University, Ireland.
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AbuBlan RS, Awad W, Agha R, Hejawi N, Srouji H, Hammoudeh S, Nazer LH. Impacts of a Mail-Order Service for Refilling Prescriptions on Patient Satisfaction and Operational Load at a Comprehensive Cancer Center in Jordan. Hosp Pharm 2021; 56:543-549. [PMID: 34720159 DOI: 10.1177/0018578720928266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Mail-order services for refilling prescriptions for medications have been established in many countries and have increased patient satisfaction. We developed a mail-order service for the outpatient pharmacy of a comprehensive cancer center in Jordan. Objective To describe the implementation of a mail-order service and to report the impact of the service on patient satisfaction and the pharmacy workload. Methods A multidisciplinary team was formed to plan a mail-order service for refilling prescriptions for medications, and a survey was designed to evaluate patient satisfaction with the service. Patients were instructed to call the refill call center and order their medications at least 48 hours before their refill is due. The pharmacy workflow for refilling prescriptions was evaluated, and the time required with and without the mail-order service was documented, with a calculation of the time saved. Results At 1 year after the mail-order service had been established, 14 200 prescriptions had been refilled through the service, with the majority (97.5%) dispensed within 48 hours of the order time. As per the survey conducted with 219 patients, on the overall satisfaction, 69.4% reported being highly satisfied with the service and 27.9% reported being satisfied. The problems reported with the service were delay in arrival (n = 23, 10.5%), medication-related errors (n = 9, 4.1%), cash-related error (n = 1, 0.45%), improper storage condition (n = 1, 0.45%), and delivery to the wrong address (n = 4, 1.8%). The service was also associated with reduced overall time for processing in the outpatient pharmacy service; for patients receiving their medications from the pharmacy, resulting in reduced patients' overall waiting time (from 11.4 to 8.2 minutes). The service resulted in saving of 0.4 full-time employee at 1 year of implementation. Conclusions A mail-order service for refilling prescriptions within a hospital setting had positive outcomes on both patient satisfaction and the pharmacy workflow. The major issues were related to transportation and logistics.
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Affiliation(s)
| | - Wedad Awad
- King Hussein Cancer Center, Amman, Jordan
| | - Randa Agha
- King Hussein Cancer Center, Amman, Jordan
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Chew LS, Yeo YL, Chang CT, Chew CC, George D, Rajan P. Satisfaction among patients and caregivers receiving value-added services during the COVID-19 pandemic outbreak in a tertiary hospital in the Perak state of Malaysia. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2021. [DOI: 10.1093/jphsr/rmab057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Abstract
Objectives
Patient satisfaction was used as an indicator of service quality in the public hospitals. The pharmacy value-added services (VAS) were intensified after the COVID-19 outbreak, and evaluation of user’s satisfaction was important for service improvement.
Methods
This was a single-centre, cross-sectional, web-based study in the outpatient pharmacy in a tertiary hospital in the Perak state of Malaysia. Patients and caregivers aged 18 years and above, received at least one prescription refill using the pharmacy VAS from April to September 2020, were included. The questionnaire was adapted from a validated tool, underwent face and content validation before dissemination. The link was disseminated to the targeted population through short messages service (SMS).
Key findings
Out of 1200 invited people, 303 agreed to participate. Majority of the respondents were male (160, 52.8%), Chinese (156, 51.5%), with tertiary education (201, 66.3%) and retiree (112, 37.0%). Out of a maximum score of 5, the overall mean satisfaction score was 4.42 (SD: 0.55). The respondents were most agreeable to time-saving benefits of the pharmacy VAS (4.56 ± 0.63). Majority of the respondents felt that pharmacy VAS had made their life easier (290, 95.7%) and planned to recommend the pharmacy VAS to others (292, 96.4%) Respondents aged more than 60 (versus age 18–35, β = 2.375, P < 0.001) and those who used drive-through service (versus SPUB, β = 2.272, P = 0.001) reported higher satisfaction scores. Several suggestions were made for service improvement, including longer operating hours (18, 6.0%), upgraded communication system (9, 3.0%), smoother registration process (9, 3.0%), more polite staff (9, 3.0%), selection of preferred postage delivery time (6, 2.0%) and promotion of VAS (4, 1.3%)
Conclusions
Majority of the respondents were highly satisfied towards the pharmacy VAS. Future studies should compare the satisfaction of VAS with traditional counter service to compare the level and factors that contributed to the users’ satisfaction.
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Affiliation(s)
- Lan-Sim Chew
- Pharmacy Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
| | - Yee-Ling Yeo
- Pharmacy Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
| | - Chee-Tao Chang
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
| | - Chii-Chii Chew
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
| | - Doris George
- Pharmacy Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
| | - Philip Rajan
- Clinical Research Centre, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
- Otolaryngology Department, Hospital Raja Permaisuri Bainun, Ministry of Health Malaysia, Ipoh, Perak, Malaysia
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van de Pol JM, Heringa M, Koster ES, Bouvy ML. Preferences of patients regarding community pharmacy services: A discrete choice experiment. Health Policy 2021; 125:1415-1420. [PMID: 34503844 DOI: 10.1016/j.healthpol.2021.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Revised: 07/04/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND The community pharmacy profession is in transition, with emphasis on the provision of cognitive pharmaceutical services (CPS). In contrast, previous research showed that the general public prefers more convenience related services. However, this was based on currently available services and not on innovative services. OBJECTIVE To identify patients' preferences regarding innovative pharmacy services and whether they tend towards convenience related or CPS. DESIGN Online survey using a discrete choice experiment (DCE). PARTICIPANTS Participants were from the AMP pharmacy patient panel. MAIN OUTCOME MEASURES Preferences (utility scores) and the identification of specific classes (latent class analysis). RESULTS In total 2462 panel members (27.3%) filled out the completed the online DCE questionnaire. The majority of participants were male (54.1%) with an average age of 65.3 years and used on average 4.6 medicines. Four patient classes were distinguished based on preferences for services. Highly preferred were an online mediation record, prescription drugs for minor ailments without a doctors' prescription and clinical testing with diagnosis by the pharmacist. DISCUSSION AND CONCLUSION The majority of participants tend towards a more CPS focused approach by the community pharmacist. Patients visiting community pharmacies can have a diverging set of preferences regarding services being provided. In daily practice, community pharmacists should provide both convenience and CPS related services to address this diverse set of preferences.
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Affiliation(s)
- Jeroen M van de Pol
- Division of Pharmaco epidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands.
| | - Mette Heringa
- Division of Pharmaco epidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands; SIR Institute for Pharmacy Practice and Policy, Theda Mansholtstraat 5B, 2331 JE, Leiden, The Netherlands.
| | - Ellen S Koster
- Division of Pharmaco epidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands.
| | - Marcel L Bouvy
- Division of Pharmaco epidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, the Netherlands.
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El Hadidi S, Sabra K. What We Learnt After Looking Back At the Community Pharmacists' Experiences Worldwide in COVID-19 Pandemic. J Pharm Pract 2021; 36:198-202. [PMID: 34325564 PMCID: PMC10064179 DOI: 10.1177/08971900211036093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Community pharmacists are key players in COVID-19 response. Community pharmacies are often the first port of call for people who are feeling ill. They are well placed within their communities to offer advice and reinforce essential messages about hand and respiratory hygiene and physical distancing. There are no approved clinical practice guidelines for COVID-19, and pharmacies must therefore play their part in helping to contain the spread of false claims and misinformation circulating in their communities.
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Affiliation(s)
- Seif El Hadidi
- 110118Future University in Egypt, New Cairo, Cairo, Egypt
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14
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Raghunandan R, Howard K, Marra CA, Tordoff J, Smith A. Identifying New Zealand Public Preferences for Pharmacist Prescribers in Primary Care: A Discrete Choice Experiment. PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2021; 15:77-92. [PMID: 34109570 DOI: 10.1007/s40271-021-00529-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND OBJECTIVE Given increasing patient populations, general practitioner workforce constraints and the growing demand for health services in New Zealand (NZ), the development and provision of pharmacist prescribing services could be used to improve people's access to medicines. A discrete choice experiment (DCE) was utilised to determine NZ public preferences for pharmacist prescribing services in primary care in NZ. METHODS A D-efficient DCE design generated 20 choice questions in four blocks of five questions with three labelled alternatives per choice question. The online DCE used a NZ general public online research panel administered by an external organisation (SurveyEngine). The DCE included six attributes with two attributes each with two levels (location of consultation and consultation type), three levels (type of service and operating hours) and four levels (waiting time and cost). RESULTS Nine hundred and twenty-four respondents completed the survey with 4620 observations available for analyses. Respondents preferred pharmacist prescribing services with the following characteristics: optimisation of medicines and changes to only current medicine service types (relative to repeat prescribing); lower consultation costs, shorter waiting times, longer operating hours and consultation by appointment (relative to walk-in and wait clinic). CONCLUSIONS Prescribing policy could incorporate these public preferences to help develop accessible and effective primary care prescribing services utilising the skills of pharmacist prescribers to improve and reduce inequities in access to medicines in NZ. These results suggest the NZ public see pharmacists as part of the primary care prescribing team and are willing to utilise them if these services are implemented.
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Affiliation(s)
- Rakhee Raghunandan
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, Otago, 9054, New Zealand.
| | - Kirsten Howard
- School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Carlo A Marra
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, Otago, 9054, New Zealand
| | - June Tordoff
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, Otago, 9054, New Zealand
| | - Alesha Smith
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, Otago, 9054, New Zealand
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15
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Raghunandan R, Howard K, Marra CA, Tordoff J, Smith A. Identifying Community Pharmacist Preferences For Prescribing Services in Primary Care in New Zealand: A Discrete Choice Experiment. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:253-266. [PMID: 33073328 DOI: 10.1007/s40258-020-00615-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Given increasing patient populations, general practitioner (GP) workforce constraints and increasing demand for health services in New Zealand (NZ), the development and provision of pharmacist prescribing services may need to increase to improve people's access to medicines. A discrete choice experiment (DCE) was utilised to determine community pharmacist preferences for prescribing services in primary care in NZ, and to understand how these factors could improve the provision of pharmacist prescribing services. METHODS A D-efficient design generated 30 labelled choice questions in three blocks of ten, and three alternatives per choice question. The online DCE was emailed to practising community pharmacists in NZ. The DCE included two attributes with five levels (prescribing model, educational requirements) and three attributes with three levels (location, professional fee, change in income). A mixed multinomial logit model was used to estimate preferences. RESULTS A total of 264 respondents completed the survey with 2640 observations for analyses. This DCE found pharmacists preferred pharmacy services with the following characteristics: ability to prescribe using minor ailments and independent prescribing models relative to the pharmacist-only medicines prescribing model; prescribing education by accredited learning modules relative to PGDipClinPharm + PGCertPharmPres; remuneration via a professional fee; and pharmacist prescribing services located in community pharmacies rather than in GP practices. CONCLUSIONS Prescribing policy could incorporate these pharmacist preferences to help develop accessible and effective pharmacist prescribing services that not only improve access to medicines, but also address inequity of access to medicines in NZ. These DCE results are encouraging as they signal that the community pharmacists also see themselves and their pharmacies as part of the prescribing team in primary care in NZ.
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Affiliation(s)
- Rakhee Raghunandan
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand.
| | - Kirsten Howard
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Carlo A Marra
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand
| | - June Tordoff
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand
| | - Alesha Smith
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand
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Hu Q, Hu H, Hu M, Yang Y, Wu Z, Zhou N. Patient Preferences For Specialty Pharmacy Services: A Stated Preference Discrete-Choice Experiment in China. Front Public Health 2020; 8:597389. [PMID: 33363089 PMCID: PMC7755860 DOI: 10.3389/fpubh.2020.597389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 11/16/2020] [Indexed: 11/24/2022] Open
Abstract
Objectives: To survey, analyze, and ascertain the preferences for specialty pharmacy services among patients requiring complex care and to provide evidence to support specialty pharmacy service decision-making in China. Methods: To identify essential service attributes and levels, a review of the literature, discussions with specialty pharmacy managers and a pilot questionnaire were conducted. A D-efficient fractional factorial design was used to generate the discrete-choice experiment (DCE) questionnaire. A face-to-face survey of patients with chronic illness and their families or friends was conducted at three specialty pharmacies in Chengdu and Qingdao, China. A mixed logit model was used for estimation. Results: Six relevant attributes were identified and incorporated into the DCE questionnaire. A total of 417 participants completed the survey (mean age 43 years, 45.1% males), and 32.1% had lung cancer. The conditional relative importance showed that the most critical attribute was “frequency of telephone follow-up to monitor adverse drug reactions (ADRs), “followed by “mode of drug delivery,” “provider of medication guidance services,” and “availability of medical insurance consultation”; the least important attribute was “business hours.” A 1 min increase in time spent led to a 0.73% decrease in the probability that a service profile would be chosen. Negative preferences were noted for ADR monitoring by telephone follow-up once a year (β = −0.23, p < 0.001) and business hours [8:30–20:00 (Monday to Friday), 8:30–17:30 (weekend)] (β = −0.12, p < 0.001). Compared with women, men had a higher preference for service monitoring ADRs once every 3 months. Conclusions: Preference measurements showed that “frequency of telephone follow-up to monitor ADRs” had the most critical impact on decisions, followed by “mode of drug delivery.” Specialty pharmacies in China need to take these findings into account to improve their design to increase uptake and patient loyalty.
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Affiliation(s)
- Qinyuan Hu
- West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China
| | - Haiyao Hu
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, China
| | - Ming Hu
- West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China
| | - Yumei Yang
- West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China
| | - Zhiang Wu
- Yeehong Business School, Shenyang Pharmaceutical University, Beijing, China
| | - Naitong Zhou
- West China School of Pharmacy, Sichuan University, Chengdu, Sichuan, China
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How does perceived cost and value influence pharmacy patronage? A scoping review. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2020. [DOI: 10.1108/ijphm-12-2019-0077] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
To date, community pharmacy research has largely focused on the impact of service quality elements on patronage behavior. Investigation into the influence of cost and value is limited. The purpose of this study is to explore what is known about customers’ perceptions of cost and value, and how these influence patronage patterns in community pharmacy.
Design/methodology/approach
A scoping review framework was used to conduct a systematic search of four databases with the addition of articles sourced from reference lists. The database search was reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews protocol. Studies were analyzed in terms of author name, date of publication, study location, study population, methods and key findings.
Findings
The 26 studies retrieved were qualitative or quantitative in nature and included a broad sample population. Both cost and value were found to be key factors influencing pharmacy choice. Pharmacy customers were found to perceive costs in terms of monetary, psychological, emotional and convenience-related sacrifices. Value was either perceived as relating to the worth or utility of a good or service, or in terms of a trade-off relationship between what was received and given up by the consumer.
Research limitations/implications
A comprehensive interrogation into the true meaning of “value” to consumers is warranted to improve quantitative measurement instruments.
Practical implications
Pharmacies may attempt to influence customer behavior by minimizing unfixed costs to the consumer such as the price of goods and services and time costs.
Originality/value
This review highlights the need for academic enquiry into how consumers trade-off perceived costs for service in community pharmacy.
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18
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Yong FR, Garcia-Cardenas V, Williams KA, (Charlie) Benrimoj SI. Factors affecting community pharmacist work: A scoping review and thematic synthesis using role theory. Res Social Adm Pharm 2020; 16:123-141. [DOI: 10.1016/j.sapharm.2019.05.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/03/2019] [Accepted: 05/05/2019] [Indexed: 10/26/2022]
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19
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Patel PM, Vaidya V, Osundina F, Comoe DA. Determining patient preferences of community pharmacy attributes: A systematic review. J Am Pharm Assoc (2003) 2019; 60:397-404. [PMID: 31780193 DOI: 10.1016/j.japh.2019.10.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 10/11/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Patient selection of community pharmacy is based on a multitude of factors. With increasing competition and rapidly changing face of pharmacy, identification of these factors is critical for patient satisfaction and financial success. This systematic review summarizes patient preferences for different attributes of community pharmacy. DATA SOURCES Systematic review of peer-reviewed studies conducted on U.S. population, published from 2005 to 2018 in EBSCO, PubMed, and EMBASE, was conducted to identify attributes of community pharmacy that determine patient patronage. STUDY SELECTION Studies conducted between 2005 and 2018 on U.S. population that examined attributes in choosing a pharmacy were eligible for this systematic review. DATA EXTRACTION Data were independently extracted, assessed, and evaluated by 2 reviewers. Any disagreements were resolved by the third reviewer. Data obtained included year, setting, number of patients, data collection and evaluation methods, and relevant results and outcomes. RESULTS Of the 713 papers identified, 10 articles met the inclusion criteria and were included in this systematic review. Majority of the studies used surveys to examine key attributes that influence patients' selection of a pharmacy. Pharmacist traits like friendly, helpful, trustworthy, professional, competent, caring, knowledgeable, responsive, and approachable are critical attributes that influence a patient's selection of pharmacy. Convenience (i.e., location, hours of operation, wait time, stock availability) also influenced patients' selection of pharmacy. Cost and contract with insurance were other important factors. Availability of auto-refills appeared consistently in the studies. Medication safety (detecting drug interactions) quality metrics also appeared high among patients' preferences. CONCLUSION The results of this review found that a relationship with a respectful, friendly, competent pharmacist represents important pharmacist-related attributes in the process of pharmacy selection. Important pharmacy-related attributes include cost, convenience, and wait times. Availability of auto-refill service was also a frequently reported attribute in this review.
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Policarpo V, Romano S, António JHC, Correia TS, Costa S. A new model for pharmacies? Insights from a quantitative study regarding the public's perceptions. BMC Health Serv Res 2019; 19:186. [PMID: 30898124 PMCID: PMC6429700 DOI: 10.1186/s12913-019-3987-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2018] [Accepted: 03/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Worldwide community pharmacies are shifting their role in the healthcare system from simple medication dispensers to health care providers. High levels of satisfaction with pharmacy services were found in previous studies. This study has two main goals. The primary goal is to describe the levels of satisfaction and knowledge regarding pharmacy services in Portugal. The secondary goal is to explore the perceptions and the utilisation of pharmacy services by the Portuguese. This statement includes exploring the impact of a set of variables on both perceptions and uses of pharmacies in regard to services that are currently offered as well as to new services that may be provided in the future. METHODS A face-to-face survey of closed-ended questions was applied to a nationwide representative sample of the Portuguese population in September 2015. The sample was weighted based on population distribution across regions, habitat, age and gender. Data analysis comprises descriptive statistics and Multiple Correspondence Analysis to explore different typologies of respondent's orientation toward community pharmacy. RESULTS A total of 1114 interviews comprised the study. Of the respondents, 36% used the pharmacy as a first resource when seeking to treat a minor ailment, and 54% reported that they use the pharmacy as a first resource when seeking answers about medicines. Of those who visited their pharmacy at least once in the previous year, 94% were either globally satisfied or very satisfied. The level of acknowledgement of pharmacy services' was also high among the Portuguese. Of the participants, 29% considered there could be more services available in pharmacies that are currently provided by other health care facilities. The construction of a typology of orientations towards community pharmacy practice resulted in three outcome groups: "Motivated" (63%), those with a connection to a pharmacy; "Settled" (23%), mainly those who had a pharmacy nearby; and "Demobilised" (14%), those who are weakly tied to a pharmacy. CONCLUSIONS The vast majority of the Portuguese population has a strong positive attitude towards their community pharmacy, as expressed by the high levels of satisfaction with, and positive evaluation of, the pharmacy's services.
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Affiliation(s)
- Verónica Policarpo
- Instituto de Ciências Sociais, Universidade de Lisboa, Av. Prof. Aníbal de Bettencourt, 9, 1600-189, Lisbon, Portugal
| | - Sónia Romano
- Centre for Health Evaluation & Research (CEFAR), Associação Nacional das Farmácias (ANF), Rua Marechal Saldanha 1, 1249-069, Lisbon, Portugal.
| | - João H C António
- Research Centre of Public Opinion, Universidade Católica Portuguesa (CESOP), Palma de Cima, 1649-023, Lisbon, Portugal
| | - Tânia Sofia Correia
- Research Centre of Public Opinion, Universidade Católica Portuguesa (CESOP), Palma de Cima, 1649-023, Lisbon, Portugal
| | - Suzete Costa
- USFarmácia® Collaborative Care Project, Associação Nacional das Farmácias (ANF), Rua Marechal Saldanha 1, 1249-069, Lisbon, Portugal
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McMillan SS, King MA, Sav A, Wheeler AJ, Kelly F. Support for Australian carers from community pharmacy: Insight into carer perspectives of a novel service. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:320-329. [PMID: 30187990 DOI: 10.1111/hsc.12649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Revised: 06/14/2018] [Accepted: 07/16/2018] [Indexed: 06/08/2023]
Abstract
The feasibility of an individualised carer support service delivered in community pharmacies was assessed from the perspective of carer participants using a pre-post questionnaire and semistructured interviews. Eligible pharmacies were required to offer a medication management service relevant to carers and have a semiprivate space for conversations. Carers were required to self-identify as an unpaid support person for someone with a chronic condition or disability. Between September 2016 and March 2017, staff from 11 community pharmacies in South-East Queensland, Australia were trained, and provided with ongoing mentoring from a pharmacist and carer to support service implementation. Identification of carers and support to achieve a personal and care-giving goal were key features of the service. Questionnaires included the EQ-5D-3L, the Bakas Caregiving Outcomes Scale, and questions relating to goal achievement, carer roles, and responsibilities. Seven follow-up carer interviews were undertaken between March and May 2017 and analysed thematically. Pre-post questionnaires were available for 17 carers (one withdrew, two incomplete). Of the 29 goals set, 10 were achieved and 14 partially achieved. EQ-5D-3L scores were unchanged, while 7 of the 15 items comprising the Bakas score improved (p < 0.05). Carer service evaluation was generally favourable, and these two main interview themes were the impact of caring and pharmacy experience. The impact of caring, while variable, was significant. Pharmacy experiences were mostly positive and the opportunity for carers to further engage with pharmacy staff was appreciated. The service was feasible and initial reported benefits to carers may support further research potentially in terms of a larger controlled trial.
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Affiliation(s)
- Sara S McMillan
- Griffith University, Quality Use of Medicines Network, Menzies Health Institute Queensland, Southport, Queensland, Australia
| | - Michelle A King
- Griffith University, Quality Use of Medicines Network, Menzies Health Institute Queensland, Southport, Queensland, Australia
| | - Adem Sav
- School of Public Health and Social Work, Faculty of Health, Institute of Health and Biomedical Innovation (IHBI), Queensland University of Technology, Brisbane, Queensland, Australia
| | - Amanda J Wheeler
- Griffith University, Quality Use of Medicines Network, Menzies Health Institute Queensland, Nathan, Queensland, Australia
- School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Fiona Kelly
- Griffith University, Quality Use of Medicines Network, Menzies Health Institute Queensland, Southport, Queensland, Australia
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Soekhai V, de Bekker-Grob EW, Ellis AR, Vass CM. Discrete Choice Experiments in Health Economics: Past, Present and Future. PHARMACOECONOMICS 2019; 37:201-226. [PMID: 30392040 PMCID: PMC6386055 DOI: 10.1007/s40273-018-0734-2] [Citation(s) in RCA: 375] [Impact Index Per Article: 75.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Discrete choice experiments (DCEs) are increasingly advocated as a way to quantify preferences for health. However, increasing support does not necessarily result in increasing quality. Although specific reviews have been conducted in certain contexts, there exists no recent description of the general state of the science of health-related DCEs. The aim of this paper was to update prior reviews (1990-2012), to identify all health-related DCEs and to provide a description of trends, current practice and future challenges. METHODS A systematic literature review was conducted to identify health-related empirical DCEs published between 2013 and 2017. The search strategy and data extraction replicated prior reviews to allow the reporting of trends, although additional extraction fields were incorporated. RESULTS Of the 7877 abstracts generated, 301 studies met the inclusion criteria and underwent data extraction. In general, the total number of DCEs per year continued to increase, with broader areas of application and increased geographic scope. Studies reported using more sophisticated designs (e.g. D-efficient) with associated software (e.g. Ngene). The trend towards using more sophisticated econometric models also continued. However, many studies presented sophisticated methods with insufficient detail. Qualitative research methods continued to be a popular approach for identifying attributes and levels. CONCLUSIONS The use of empirical DCEs in health economics continues to grow. However, inadequate reporting of methodological details inhibits quality assessment. This may reduce decision-makers' confidence in results and their ability to act on the findings. How and when to integrate health-related DCE outcomes into decision-making remains an important area for future research.
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Affiliation(s)
- Vikas Soekhai
- Section of Health Technology Assessment (HTA) and Erasmus Choice Modelling Centre (ECMC), Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam (EUR), P.O. Box 1738, Rotterdam, 3000 DR The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA The Netherlands
| | - Esther W. de Bekker-Grob
- Section of Health Technology Assessment (HTA) and Erasmus Choice Modelling Centre (ECMC), Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam (EUR), P.O. Box 1738, Rotterdam, 3000 DR The Netherlands
| | - Alan R. Ellis
- Department of Social Work, North Carolina State University, Raleigh, NC USA
| | - Caroline M. Vass
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
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Holdford DA. Resource-based theory of competitive advantage - a framework for pharmacy practice innovation research. Pharm Pract (Granada) 2018; 16:1351. [PMID: 30416633 PMCID: PMC6207354 DOI: 10.18549/pharmpract.2018.03.1351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Accepted: 09/01/2018] [Indexed: 12/18/2022] Open
Abstract
A growing body of research demonstrates the effectiveness of evidence-based pharmacy practice, but too many practice innovations fail to survive past the initial implementation and study phase. This paper presents the resource-based theory of competitive advantage as a framework for describing, understanding, and predicting the adoption and dissemination pharmacy service innovations into routine practice. The theory argues that the sustainability of any business innovation (e.g., pharmacy service) is based upon (1) the internal resources of the firm offering it, (2) the firm's capabilities in using those resources, (3) the competitive advantage to the firm of its resources and capabilities, (4) the attractiveness of the market in which it competes, and (5) the innovation's contribution to financial performance of the firm. This paper argues that the resource-based theory of competitive advantage provides a foundation for comparing findings from different research frameworks and studies relating to innovations in services, service processes, and service business models. The paper also poses a number of research questions related to the theory that can be used to further the literature about pharmacy practice innovations. Finally, it makes a case that competition is a fundamental aspect of pharmacy practice and the resource-based theory of competitive advantage can serve as a general theory for studying innovations in pharmacy practice and in the social and administrative sciences.
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Affiliation(s)
- David A Holdford
- Center for Pharmacy Practice Innovation (CPPI), Department of Pharmacotherapy & Outcomes Science, School of Pharmacy, Virginia Commonwealth University. Richmond, VA (United States).
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Steckowych K, Smith M, Spiggle S, Stevens A, Li H. Building the Case: Changing Consumer Perceptions of the Value of Expanded Community Pharmacist Services. J Pharm Pract 2018; 32:637-647. [PMID: 29756535 DOI: 10.1177/0897190018771521] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The role of the community pharmacist has traditionally been a medication dispenser; however, community pharmacists' responsibilities must expand to include more direct patient care services in order to transform primary care practice. OBJECTIVES Use case-based scenarios to (1) determine factors that contribute to positive and negative consumer perceptions of expanded community pharmacist patient care roles, (2) identify facilitators and barriers that contribute to consumer perceptions of the value of expanded community pharmacist patient care services, and (3) develop a successful approach and strategies for increasing consumer advocacy for the value of expanded community pharmacist patient care services. METHODS Two consumer focus groups used scenario-based guided discussions and Likert scale questionnaires to elicit consumer reactions, facilitators, and barriers to expanded community pharmacist services. RESULTS Convenience, timeliness, and accessibility were common positive reactions across all 3 scenarios. Team approach to care and trust were viewed as major facilitators. Participant concerns included uncertainty about pharmacist training and qualifications, privacy, pharmacists' limited bandwidth to accept new tasks, and potential increased patient costs. Common barriers to service uptake included a lack of insurance payment and physician preference to provide the services. CONCLUSION Consumer unfamiliarity with non-traditional community pharmacist services is likely an influencer of consumers' hesitancy to utilize such services; therefore, an opportunity exists to engage consumers and advocacy organizations in supporting expanded community pharmacist roles. This study can inform consumers, advocates, community pharmacists, primary care providers, and community-based organizations on methods to shape consumer perceptions on the value of community pharmacist expanded services.
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Affiliation(s)
- Kathryn Steckowych
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Marie Smith
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Susan Spiggle
- Department of Marketing, University of Connecticut School of Business, Storrs, CT, USA
| | - Andrew Stevens
- Department of Pharmacy Practice, University of Connecticut School of Pharmacy, Storrs, CT, USA
| | - Hao Li
- Department of Statistics, University of Connecticut, Storrs, CT, USA
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Treatment Burden and Chronic Illness: Who is at Most Risk? PATIENT-PATIENT CENTERED OUTCOMES RESEARCH 2018; 9:559-569. [PMID: 27142372 DOI: 10.1007/s40271-016-0175-y] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND There is a need to ascertain the type and level of treatment burden experienced by people with co-morbidities. This is important to identify the characteristics of participants who are at most risk of treatment burden. OBJECTIVE The aim of this study is to identify the characteristics of participants who are at most risk of treatment burden. METHODS This cross-sectional study was part of a larger project and recruitment was conducted across four Australian regions: rural, semi-rural and metropolitan. Participants were asked about their treatment burden using an adapted version of a measure, which included the following five dimensions: medication, time and administrative, lifestyle change, social life and financial burden. RESULTS In total, 581 participants with various chronic health conditions reported a mean global treatment burden of 56.5 out of 150 (standard deviation = 34.5). Number of chronic conditions (β = .34, p < 0.01), age, (β = -.27, p < 0.01), the presence of an unpaid carer (β = .22, p < 0.001) and the presence of diabetes mellitus and other endocrine conditions (β = .13, p < 0.01) were significant predictors of overall treatment burden. For the five dimensions of treatment burden, social, medicine and administrative burden were predicted by the same cluster of variables: number of conditions, age, presence of an unpaid carer and diabetes. However, in addition to these variables, financial dimensions were also predicted by education level, ethnicity and health insurance. Educational level also influenced lifestyle burden. CONCLUSION A substantial proportion of community-dwelling adults with chronic conditions have considerable levels of treatment burden. Specifically, health professionals should provide greater focus on managing overall treatment burden for persons who are of young age, have an endocrine condition or an unpaid carer, or a combination of these factors.
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Feehan M, Walsh M, Godin J, Sundwall D, Munger MA. Patient preferences for healthcare delivery through community pharmacy settings in the USA: A discrete choice study. J Clin Pharm Ther 2017. [PMID: 28627110 DOI: 10.1111/jcpt.12574] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE In order to improve public health, it is necessary to facilitate patients' easy access to affordable high-quality primary health care, and one enhanced approach to do so may be to provide primary healthcare services in the community pharmacy setting. Discrete choice experiments to evaluate patient demand for services in pharmacy are relatively limited and have been hampered by a focus on only a few service alternatives, most focusing on changes in more traditional pharmacy services. The study aim was to gauge patient preferences explicitly for primary healthcare services that could be delivered through community pharmacy settings in the USA, using a very large sample to accommodate multiple service delivery options. METHODS An online survey was administered to a total of 9202 adult patients from the general population. A subsequent online survey was administered to 50 payer reimbursement decision-makers. The patient survey included a discrete choice experiment (DCE) which showed competing scenarios describing primary care service offerings. The respondents chose which scenario would be most likely to induce them to switch from their current pharmacy, and an optimal patient primary care service model was derived. The likelihood this model would be reimbursed was then determined in the payer survey. RESULTS AND DISCUSSION The final optimal service configuration that would maximize patient preference included the pharmacy: offering appointments to see a healthcare provider in the pharmacy, having access to their full medical record, provide point-of-care diagnostic testing, offer health preventive screening, provide limited physical examinations such as measuring vital signs, and drug prescribing in the pharmacy. The optimal model had the pharmacist as the provider; however, little change in demand was evident if the provider was a nurse-practitioner or physician's assistant. The demand for this optimal model was 2-fold higher (25.5%; 95% Bayesian precision interval (BPI) 23.5%-27.0%) than for a base pharmacy offering minimal primary care services (12.6%; 95% BPI 12.2%-13.2%), and was highest among Hispanic (30.6%; 95% BPI: 25.7%-34.3%) and African American patients (30.7%; 95% BPI: 27.1%-35.2%). In the second reimbursement decision-maker survey, the majority (66%) indicated their organization would be likely to reimburse the services described in the optimal patient model if provided in the pharmacy setting. WHAT IS NEW AND CONCLUSION This United States national study provides empirical support for a model of providing primary care services through community pharmacy settings that would increase access, with the potential to improve the public health.
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Affiliation(s)
- M Feehan
- Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA.,Kantar Millward Brown Inc., New York, NY, USA
| | - M Walsh
- Hall and Partners Inc., New York, NY, USA
| | - J Godin
- Hall and Partners Inc., New York, NY, USA
| | - D Sundwall
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT, USA
| | - M A Munger
- Department of Pharmacotherapy, University of Utah, Salt Lake City, UT, USA.,Department of Internal Medicine, University of Utah, Salt Lake City, UT, USA
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Harrison M, Milbers K, Hudson M, Bansback N. Do patients and health care providers have discordant preferences about which aspects of treatments matter most? Evidence from a systematic review of discrete choice experiments. BMJ Open 2017; 7:e014719. [PMID: 28515194 PMCID: PMC5623426 DOI: 10.1136/bmjopen-2016-014719] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVES To review studies eliciting patient and healthcare provider preferences for healthcare interventions using discrete choice experiments (DCEs) to (1) review the methodology to evaluate similarities, differences, rigour of designs and whether comparisons are made at the aggregate level or account for individual heterogeneity; and (2) quantify the extent to which they demonstrate concordance of patient and healthcare provider preferences. METHODS A systematic review searching Medline, EMBASE, Econlit, PsycINFO and Web of Science for DCEs using patient and healthcare providers. INCLUSION CRITERIA peer-reviewed; complete empiric text in English from 1995 to 31July 2015; discussing a healthcare-related topic; DCE methodology; comparing patients and healthcare providers. DESIGN Systematic review. RESULTS We identified 38 papers exploring 16 interventions in 26 diseases/indications. Methods to analyse results, determine concordance between patient and physician values, and explore heterogeneity varied considerably between studies. The majority of studies we reviewed found more evidence of mixed concordance and discordance (n=28) or discordance of patient and healthcare provider preferences (n=12) than of concordant preferences (n=4). A synthesis of concordance suggested that healthcare providers rank structure and outcome attributes more highly than patients, while patients rank process attributes more highly than healthcare providers. CONCLUSIONS Discordant patient and healthcare provider preferences for different attributes of healthcare interventions are common. Concordance varies according to whether attributes are processes, structures or outcomes, and therefore determining preference concordance should consider all aspects jointly and not a binary outcome. DCE studies provide excellent opportunities to assess value concordance between patients and providers, but assessment of concordance was limited by a lack of consistency in the approaches used and consideration of heterogeneity of preferences. Future DCEs assessing concordance should fully report the framing of the questions and investigate the heterogeneity of preferences within groups and how these compare.
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Affiliation(s)
- Mark Harrison
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
- Centre for Health Evaluation and Outcome Sciences, St Paul’s Hospital, Vancouver, Canada
| | - Katherine Milbers
- Centre for Health Evaluation and Outcome Sciences, St Paul’s Hospital, Vancouver, Canada
| | - Marie Hudson
- Department of Medicine, McGill University, Montréal, Canada
- Division of Rheumatology, Jewish General Hospital, Montréal, Canada
- Lady Davis Institute for Medical Research, Montréal, Canada
| | - Nick Bansback
- Centre for Health Evaluation and Outcome Sciences, St Paul’s Hospital, Vancouver, Canada
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
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Tan CL, Gan VB, Saleem F, Hassali MA. Building intentions with the Theory of Planned Behaviour: the mediating role of knowledge and expectations in implementing new pharmaceutical services in Malaysia. Pharm Pract (Granada) 2017; 14:850. [PMID: 28042358 PMCID: PMC5184380 DOI: 10.18549/pharmpract.2016.04.850] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 11/29/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Pharmacy value added services (PVAS) was introduced as a matter of public health policy by Malaysia's Ministry of Health to improve health outcomes through public healthcare services. For example, drive through pharmacy services is a major policy implementation of the Ministry. However, adoption rates are low and therefore hampering the achievement of national health policy goals. OBJECTIVE Our objective is to explore the key determinants and mediators of successful implementation of new public pharmaceutical services by investigating the cognitive perspectives of patients' intentions to adopt with the Theory of Planned Behavior as the theoretical framework. METHODS A two phase mixed methodology involving first a qualitative exploration and the second a quantitative phase was conducted in public health facilities in Negeri Sembilan, Malaysia. Multiple regression and mediation analysis were performed. RESULTS Subjective norms, perceived behavioural control, knowledge and expectations are found to be significant predictors of intentions to adopt PVAS. Knowledge and expectations are found to exert significant indirect effects on intentions. CONCLUSION Overall, we suggest that patient knowledge be enhanced through appropriate channels and expectations of service quality be met to increase intentions.
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Affiliation(s)
- Christine L Tan
- Pharmaceutical Services Division (Pharmacy Practice & Development), Negeri Sembilan State Health Department, Ministry of Health Malaysia. Seremban ( Malaysia ).
| | - Vincent B Gan
- Graduate School of Management, Universiti Putra Malaysia . Selangor ( Malaysia ).
| | - Fahad Saleem
- Faculty of Pharmacy & Health Sciences, University of Balochistan . Quetta ( Pakistan ).
| | - Mohamed A Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia . Penang Island ( Malaysia ).
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How to best manage time interaction with patients? Community pharmacist workload and service provision analysis. Res Social Adm Pharm 2017; 13:133-147. [DOI: 10.1016/j.sapharm.2016.02.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 02/18/2016] [Accepted: 02/18/2016] [Indexed: 11/23/2022]
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Greenhalgh T, Macfarlane F, Steed L, Walton R. What works for whom in pharmacist-led smoking cessation support: realist review. BMC Med 2016; 14:209. [PMID: 27978837 PMCID: PMC5159995 DOI: 10.1186/s12916-016-0749-5] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 11/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND New models of primary care are needed to address funding and staffing pressures. We addressed the research question "what works for whom in what circumstances in relation to the role of community pharmacies in providing lifestyle interventions to support smoking cessation?" METHODS This is a realist review conducted according to RAMESES standards. We began with a sample of 103 papers included in a quantitative review of community pharmacy intervention trials identified through systematic searching of seven databases. We supplemented this with additional papers: studies that had been excluded from the quantitative review but which provided rigorous and relevant additional data for realist theorising; citation chaining (pursuing reference lists and Google Scholar forward tracking of key papers); the 'search similar citations' function on PubMed. After mapping what research questions had been addressed by these studies and how, we undertook a realist analysis to identify and refine candidate theories about context-mechanism-outcome configurations. RESULTS Our final sample consisted of 66 papers describing 74 studies (12 systematic reviews, 6 narrative reviews, 18 RCTs, 1 process detail of a RCT, 1 cost-effectiveness study, 12 evaluations of training, 10 surveys, 8 qualitative studies, 2 case studies, 2 business models, 1 development of complex intervention). Most studies had been undertaken in the field of pharmacy practice (pharmacists studying what pharmacists do) and demonstrated the success of pharmacist training in improving confidence, knowledge and (in many but not all studies) patient outcomes. Whilst a few empirical studies had applied psychological theories to account for behaviour change in pharmacists or people attempting to quit, we found no studies that had either developed or tested specific theoretical models to explore how pharmacists' behaviour may be affected by organisational context. Because of the nature of the empirical data, only a provisional realist analysis was possible, consisting of five mechanisms (pharmacist identity, pharmacist capability, pharmacist motivation and clinician confidence and public trust). We offer hypotheses about how these mechanisms might play out differently in different contexts to account for the success, failure or partial success of pharmacy-based smoking cessation efforts. CONCLUSION Smoking cessation support from community pharmacists and their staff has been extensively studied, but few policy-relevant conclusions are possible. We recommend that further research should avoid duplicating existing literature on individual behaviour change; seek to study the organisational and system context and how this may shape, enable and constrain pharmacists' extended role; and develop and test theory.
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Affiliation(s)
- Trisha Greenhalgh
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
| | - Fraser Macfarlane
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The LondonSchool of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Liz Steed
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The LondonSchool of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Robert Walton
- Asthma UK Centre for Applied Research, Centre for Primary Care and Public Health, Barts and The LondonSchool of Medicine and Dentistry, Queen Mary University of London, London, UK
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31
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Gammie SM, Rodgers RM, Loo RL, Corlett SA, Krska J. Medicine-related services in community pharmacy: public preferences for pharmacy attributes and promotional methods and comparison with pharmacists' perceptions. Patient Prefer Adherence 2016; 10:2297-2307. [PMID: 27877021 PMCID: PMC5108612 DOI: 10.2147/ppa.s112932] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Public awareness of pharmacy services designed to support the use of medicines is low, yet little is known about how the public view promotion of these services, or their preferences for the attributes of pharmacies from which they would like to receive them. OBJECTIVE To compare the public's preferred attributes of pharmacies and methods for promoting medicine-related services with community pharmacists' perceptions of their customers' views. METHODS Parallel surveys were conducted in South East England, using a street survey for the general public and a postal survey for community pharmacists. RESULTS Response rates were as follows: public 47.2% (1,000/2,012) and pharmacists 40.8% (341/836). Pharmacists' perceptions of customer preferences for using the same pharmacy, independent ownership, and personal knowledge of the pharmacist were higher than actual public preferences. More pharmacists than public respondents also believed that approachability and previous good service would be important. The public's desires for long opening hours and for a pharmacy with a good relationship with their doctor's surgery were higher than pharmacists believed. The majority of the public prefer not to interrupt a pharmacist who is busy in the dispensary, which was not perceived by pharmacists as a factor. Pharmacists' perceptions aligned more with the preferences of regular medicine users and frequent pharmacy users. Both groups viewed direct recommendation as the most effective approach for promoting pharmacy services, particularly by doctors and pharmacy staff. Pharmacists' expectations of the effectiveness of posters and mass media methods were much higher than those of the public. CONCLUSION Pharmacists and pharmacy owners must ensure good relationships with local medical practices to enable them to maximize opportunities for using the promotional methods judged most effective in encouraging the use of medicine-related services. Staff must be approachable and enable access to pharmacists, ensuring that perceptions of pharmacist busyness are not a deterrent.
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Affiliation(s)
- Shivaun M Gammie
- Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, Kent, UK
| | - Ruth M Rodgers
- Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, Kent, UK
| | - Ruey Leng Loo
- Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, Kent, UK
| | - Sarah A Corlett
- Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, Kent, UK
| | - Janet Krska
- Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, Kent, UK
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Whitty JA, Spinks J, Bucknall T, Tobiano G, Chaboyer W. Patient and nurse preferences for implementation of bedside handover: Do they agree? Findings from a discrete choice experiment. Health Expect 2016; 20:742-750. [PMID: 27804191 PMCID: PMC5512991 DOI: 10.1111/hex.12513] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2016] [Indexed: 11/30/2022] Open
Abstract
Objective To describe and compare patients' and nurses' preferences for the implementation of bedside handover. Design Discrete choice experiment describing handover choices using six characteristics: whether the patient is invited to participate; whether a family member/carer/friend is invited; the number of nurses present; the level of patient involvement; the information content; and privacy. Setting Two Australian hospitals. Participants Adult patients (n=401) and nurses (n=200) recruited from medical wards. Main outcome measures Mean importance scores for handover characteristics estimated using mixed multinomial logit regression of the choice data. Results Both patient and nurse participants preferred handover at the bedside rather than elsewhere (P<.05). Being invited to participate, supporting strong two‐way communication, having a family member/carer/friend present and having two nurses rather than the nursing team present were most important for patients. Patients being invited to participate and supporting strong two‐way communication were most important for nurses. However, contrary to patient preferences, having a family member/carer/friend present was not considered important by nurses. Further, while patients expressed a weak preference to have sensitive information handed over quietly at the bedside, nurses expressed a relatively strong preference for handover of sensitive information verbally away from the bedside. Conclusions All participants strongly support handover at the bedside and want patients to participate although patient and nurse preferences for various aspects of bedside handover differ. An understanding of these preferences is expected to support recommendations for improving the patient hospital experience and the consistent implementation of bedside handover as a safety initiative.
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Affiliation(s)
- Jennifer A Whitty
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, UK.,School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Qld, Australia
| | - Jean Spinks
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Nathan, Qld, Australia
| | - Tracey Bucknall
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health, Deakin University, Geelong, Vic., Australia.,National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia.,Alfred Health, Melbourne, Vic., Australia
| | - Georgia Tobiano
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
| | - Wendy Chaboyer
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Menzies Health Institute Queensland, Griffith University, Gold Coast, Qld, Australia
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From personal crisis care to convenience shopping: an interpretive description of the experiences of people with mental illness and addictions in community pharmacies. BMC Health Serv Res 2016; 16:569. [PMID: 27729051 PMCID: PMC5059973 DOI: 10.1186/s12913-016-1817-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The role of community pharmacists is changing globally with pharmacists engaging in more clinically-oriented roles, including in mental health care. Pharmacists' interventions have been shown to improve mental health related outcomes but various barriers can limit pharmacists in their care of patients. We aimed to explore the experiences of people with lived experience of mental illness and addictions in community pharmacies to generate findings to inform practice improvements. METHODS We used interpretive description methodology with analytic procedures of thematic analysis to explore the experiences of people with lived experience of mental illness and addictions with community pharmacy services. Participants were recruited through multiple mechanisms (e.g., paper and online advertisements), offered honorarium for their time, and given the option of a focus group or interview for participation in our study. Data were gathered during July to September of 2012. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed by two researchers. RESULTS We collected approximately nine hours of audio data from 18 individuals in two focus groups (n = 12) and six individual interviews. Fourteen participants were female and the average age was 41 years (range 24 to 57 years). Expectations, decision-making, and supports were identified as central themes underlying the community pharmacy experiences of people with lived experience of mental illness and addictions. Eight subthemes were identified including: relationships with pharmacy staff; patient's role in the pharmacist-patient relationship; crisis and triage; privacy and confidentiality; time; stigma and judgment; medication-related and other services; and transparency. CONCLUSIONS People with lived experience of mental illness and addictions demonstrate a high regard and respect for pharmacist's knowledge and abilities but hold conservative expectations of pharmacy health services shaped by experience, observations, and assumptions. To some extent, expectation management occurs with the recognition of the demands on pharmacists and constraints inherent to community pharmacy practice. Relationships with pharmacy staff are critical to people with lived experience and influence their decision-making. Research in the area of pharmacists' roles in crises and triage, especially in the area of suicide assessment and mitigation, is needed urgently.
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Gregório J, Russo G, Lapão LV. Pharmaceutical services cost analysis using time-driven activity-based costing: A contribution to improve community pharmacies' management. Res Social Adm Pharm 2016; 12:475-85. [DOI: 10.1016/j.sapharm.2015.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Revised: 08/10/2015] [Accepted: 08/10/2015] [Indexed: 11/16/2022]
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Porteous T, Ryan M, Bond C, Watson M, Watson V. Managing Minor Ailments; The Public's Preferences for Attributes of Community Pharmacies. A Discrete Choice Experiment. PLoS One 2016; 11:e0152257. [PMID: 27031588 PMCID: PMC4816534 DOI: 10.1371/journal.pone.0152257] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2015] [Accepted: 03/11/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Demand for health services continues to rise. Greater use of community pharmacy services instead of medical services for minor ailments could help relieve pressure on healthcare providers in high-cost settings. Community pharmacies are recognised sources of treatment and advice for people wishing to manage these ailments. However, increasing the public's use of pharmacy services may depend on attributes of pharmacies and their staff. This study aimed to determine the general public's relative preferences for community pharmacy attributes using a discrete choice experiment (DCE). METHOD A UK-wide DCE survey of the general public was conducted using face-to-face computer-assisted personal interviews. Attributes and levels for the DCE were informed by a literature review and a cohort study of community pharmacy customers. The context for the experiment was a minor ailment scenario describing flu-like symptoms. The DCE choice sets described two hypothetical community pharmacy services; respondents were asked to choose which (if either) of the two pharmacies they would prefer to help them manage symptoms. Data from 1,049 interviews were analysed using an error components logit model. Willingness to pay (WTP), a monetary measure of benefit, was estimated for the different attribute levels. RESULTS When seeking help or treatment for flu-like symptoms, respondents most valued a pharmacy service that would improve their understanding and management of symptoms (WTP = £6.28), provided by staff who are trained (WTP (pharmacist) = £2.63: WTP(trained assistant) = £3.22), friendly and approachable (WTP = £3.38). Waiting time, pharmacy location and availability of parking also contributed to respondents' preferences. WTP for a service comprising the best possible combination of attributes and levels was calculated as £55.43. CONCLUSION Attributes of a community pharmacy and its staff may influence people's decisions about which pharmacy they would visit to access treatment and advice for minor ailments. In line with the public's preferences, offering community pharmacy services that help people to better understand and manage symptoms, are provided promptly by trained staff who are friendly and approachable, and in a local setting with easy access to parking, has the potential to increase uptake amongst those seeking help to manage minor ailments. In this way it may be possible to shift demand away from high-cost health services and make more efficient use of scarce public resources.
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Affiliation(s)
- Terry Porteous
- Health Services Research Unit, University of Aberdeen, Institute of Applied Health Sciences, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom
| | - Mandy Ryan
- Health Economics Research Unit, University of Aberdeen, Institute of Applied Health Sciences, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom
| | - Christine Bond
- Academic Primary Care, University of Aberdeen, Institute of Applied Health Sciences, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom
| | - Margaret Watson
- Health Services Research Unit, University of Aberdeen, Institute of Applied Health Sciences, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom
| | - Verity Watson
- Health Economics Research Unit, University of Aberdeen, Institute of Applied Health Sciences, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, United Kingdom
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Tan CL, Hassali MA, Saleem F, Shafie AA, Aljadhey H, Gan VB. Development, test-retest reliability and validity of the Pharmacy Value-Added Services Questionnaire (PVASQ). Pharm Pract (Granada) 2015; 13:598. [PMID: 26445622 PMCID: PMC4582746 DOI: 10.18549/pharmpract.2015.03.598] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 08/22/2015] [Indexed: 11/14/2022] Open
Abstract
Objective: (i) To develop the Pharmacy Value-Added Services Questionnaire (PVASQ) using emerging themes generated from interviews. (ii) To establish reliability and validity of questionnaire instrument. Methods: Using an extended Theory of Planned Behavior as the theoretical model, face-to-face interviews generated salient beliefs of pharmacy value-added services. The PVASQ was constructed initially in English incorporating important themes and later translated into the Malay language with forward and backward translation. Intention (INT) to adopt pharmacy value-added services is predicted by attitudes (ATT), subjective norms (SN), perceived behavioral control (PBC), knowledge and expectations. Using a 7-point Likert-type scale and a dichotomous scale, test-retest reliability (N=25) was assessed by administrating the questionnaire instrument twice at an interval of one week apart. Internal consistency was measured by Cronbach’s alpha and construct validity between two administrations was assessed using the kappa statistic and the intraclass correlation coefficient (ICC). Confirmatory Factor Analysis, CFA (N=410) was conducted to assess construct validity of the PVASQ. Results: The kappa coefficients indicate a moderate to almost perfect strength of agreement between test and retest. The ICC for all scales tested for intra-rater (test-retest) reliability was good. The overall Cronbach’ s alpha (N=25) is 0.912 and 0.908 for the two time points. The result of CFA (N=410) showed most items loaded strongly and correctly into corresponding factors. Only one item was eliminated. Conclusions: This study is the first to develop and establish the reliability and validity of the Pharmacy Value-Added Services Questionnaire instrument using the Theory of Planned Behavior as the theoretical model. The translated Malay language version of PVASQ is reliable and valid to predict Malaysian patients’ intention to adopt pharmacy value-added services to collect partial medicine supply.
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Affiliation(s)
- Christine L Tan
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia . Penang ( Malaysia ).
| | - Mohamed A Hassali
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia . Penang ( Malaysia ).
| | - Fahad Saleem
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia . Penang ( Malaysia ).
| | - Asrul A Shafie
- School of Pharmaceutical Sciences, Universiti Sains Malaysia . Penang ( Malaysia ).
| | - Hisham Aljadhey
- College of Pharmacy, King Saud University . Riyadh, ( Saudi Arabia ).
| | - Vincent B Gan
- Putra Business School, Universiti Putra Malaysia . Selangor ( Malaysia ).
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Dhippayom T, Krass I. Supporting self-management of type 2 diabetes: is there a role for the community pharmacist? Patient Prefer Adherence 2015; 9:1085-92. [PMID: 26257514 PMCID: PMC4527368 DOI: 10.2147/ppa.s88071] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Evidence supports the efficacy of pharmacy services in type 2 diabetes (T2D). However, little is known about consumer perspectives on the role of community pharmacists in diabetes care. The objectives of this study were to identify potential unmet needs and explore preferences for pharmacist-delivered support for T2D. METHODS A qualitative study using focus groups was conducted in Sydney, Australia. Patients with T2D who were members of the Australian Diabetes Council in Sydney, Australia, were recruited through a survey on medication use in T2D. Five focus groups with a total of 32 consumers with T2D were recorded, transcribed, and thematically analyzed. RESULTS The key themes were 1) the experiences of diabetes services received, 2) the potential to deliver self-management services, and 3) the suggested role of pharmacist in supporting diabetes management. Gaps in understanding and some degree of nonadherence to self-management signaled a potential for self-management support delivered by pharmacists. However, consumers still perceive that the main role of pharmacists in diabetes care centers on drug management services, with some enhancements to support adherence and continuity of supply. Barriers to diabetes care services included time constraints and a perceived lack of interest by pharmacists. CONCLUSION Given the unmet needs in diabetes self-management, opportunities exist for pharmacists to be involved in diabetes care. The challenge is for pharmacists to upgrade their diabetes knowledge and skills, organize their workflow, and become proactive in delivering diabetes care support.
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Affiliation(s)
- Teerapon Dhippayom
- Pharmaceutical Care Research Unit, Department of Pharmacy Practice, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Ines Krass
- Faculty of Pharmacy, The University of Sydney, Camperdown, NSW, Australia
- Correspondence: Ines Krass, Faculty of Pharmacy, The University of Sydney, Science Road, Camperdown, NSW 2006 Australia, Tel +61 2 9351 3507, Fax +61 2 9351 4391, Email
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McMillan SS, Kelly F, Sav A, King MA, Whitty JA, Wheeler AJ. Australian community pharmacy services: a survey of what people with chronic conditions and their carers use versus what they consider important. BMJ Open 2014; 4:e006587. [PMID: 25488098 PMCID: PMC4265097 DOI: 10.1136/bmjopen-2014-006587] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 11/18/2014] [Accepted: 11/19/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE To explore the purpose/s for which people with chronic conditions and their carers use Australian community pharmacies, and compare this to what pharmacy services they consider important, from the perspectives of both consumers and pharmacists. DESIGN An exploratory study involving a survey, which asked participants to indicate the pharmacy services they had ever used, and rate the importance of 22 pharmacy services to them, or the person they care for, or for their consumers if a pharmacist. SETTING Four regions of Australia: Logan-Beaudesert and Mt Isa/North West region, Queensland, Northern Rivers, New South Wales, and the Greater Perth area, Western Australia. PARTICIPANTS Surveys were undertaken with 602 consumers and 91 community pharmacists. RESULTS Community pharmacy is predominantly used to obtain advice about medication and whether a doctor's visit is necessary, as well as for monitoring and screening services. Pharmacy services that were patient centric were important, such as individualised medication advice and respectful care, as well as tools or procedures to facilitate streamlined medication access. Less important services included adult vaccinations and health and wellness programmes. Carers identified services that assisted them with their specific role/s to be important. Overall, community pharmacists had a good understanding of the services that were important to people with chronic conditions and their carers. CONCLUSIONS People with chronic conditions and their carers not only care about what services are delivered, but how they are delivered; they sought services that generally improved their access to medication and information, but in a way that was patient centred. Ultimately, pharmacists understood the importance of patient-centred care for people with chronic conditions and their carers, perhaps indicating a greater acceptance of integrating patient-centred care into their everyday practice.
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Affiliation(s)
- Sara S McMillan
- Griffith Health Institute, Griffith University, Meadowbrook, Queensland, Australia Griffith Health Institute, School of Pharmacy, Griffith University, Southport, Queensland, Australia
| | - Fiona Kelly
- Griffith Health Institute, Griffith University, Meadowbrook, Queensland, Australia School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - Adem Sav
- Griffith Health Institute, Griffith University, Meadowbrook, Queensland, Australia School of Allied Health, Australian Catholic University, Banyo, Queensland, Australia
| | - Michelle A King
- Griffith Health Institute, School of Pharmacy, Griffith University, Southport, Queensland, Australia
| | - Jennifer A Whitty
- Griffith Health Institute, Griffith University, Meadowbrook, Queensland, Australia School of Pharmacy, University of Queensland, Woolloongabba, Queensland, Australia
| | - Amanda J Wheeler
- Griffith Health Institute, Griffith University, Meadowbrook, Queensland, Australia School of Pharmacy, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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