1
|
Mahmoud A, Mullen R, Penson PE, Morecroft C. Patient experiences of their current asthma care and their views toward providing support for patients with asthma in community pharmacy: A Qualitative study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2024; 14:100454. [PMID: 38845612 PMCID: PMC11153897 DOI: 10.1016/j.rcsop.2024.100454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Revised: 04/18/2024] [Accepted: 05/21/2024] [Indexed: 06/09/2024] Open
Abstract
Background An estimated 300 million people live with asthma globally. In England, a significant percentage live with poorly controlled asthma symptoms. Community pharmacists might be able to play a role in filling gaps in asthma care as they have the expertise and are in regular contact with patients with long term conditions. This study described patients' experiences of the management of their asthma in the general physician (GP) practice and community pharmacy settings and explored patients' views on providing support for them in community pharmacy. Method This is a descriptive qualitative study. Thirteen adult asthma patients were recruited from a GP practice in the Northwest of England. Semi-structured qualitative interviews were conducted face-to-face or by telephone. The interviews were recorded, transcribed and analysed using a thematic analysis approach. Ethics approval was obtained before the study commenced and all participants gave informed written consent to participate. Results We identified challenges in the current asthma care provided to patients with asthma including lack of continuity of care, inability to book an appointment and other experienced differences in the quality of asthma care provided to them and/or access to annual asthma reviews across different GP practices. Additionally, there is lack of awareness of services provided in community pharmacy. These challenges along with having comorbidities alongside asthma may negatively affect asthma patients' engagement with their asthma appointments and their behaviour toward their asthma. Conclusions Patients showed trust in community pharmacists same as other HCPs to support them with their asthma care. Patients thought that being provided with regular asthma care including reviews in community pharmacy might be a suitable approach to respond to patients' needs and preferences in terms of their asthma management because of ease of access to community pharmacy. Pharmacists could be involved in the provision of community pharmacy-based asthma interventions that involve more than inhaler technique education. Further research should focus on developing structured approaches for asthma patient education that can be implemented consistently in the context of community pharmacy in England.
Collapse
Affiliation(s)
- Aseel Mahmoud
- Faculty of Health and Life Sciences, University of Exeter, Exeter, United Kingdom
| | - Rachel Mullen
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
- Centre of Pharmacy Innovation, Liverpool John Moores University, Liverpool, United Kingdom
| | - Peter E. Penson
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
- Centre of Pharmacy Innovation, Liverpool John Moores University, Liverpool, United Kingdom
| | - Charles Morecroft
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
- Centre of Pharmacy Innovation, Liverpool John Moores University, Liverpool, United Kingdom
| |
Collapse
|
2
|
Lin G, Chau CI, Hu H, Ung COL. Pharmacist intervention for pediatric asthma: A systematic literature review and logic model. Res Social Adm Pharm 2023; 19:1487-1510. [PMID: 37679253 DOI: 10.1016/j.sapharm.2023.08.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Revised: 08/04/2023] [Accepted: 08/20/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Asthma is highly prevalent in children. Evidence about pharmacist-led interventions in the management of pediatric asthma is emerging. OBJECTIVE To summarize empirical evidence of pharmacist-led interventions for pediatric asthma patients, and to identify the components of a logic model, which can inform evidence-based pharmacy practice. METHODS PubMed, Web of Science, Embase Scopus, ScienceDirect, Medline and CNKI were searched. Studies concerning pharmacist-led interventions for pediatric asthma patients with an interventional design published between January 2013 and February 2023 were selected for analysis. Literature was searched and retrieved according to PRISMA guidelines. Components of pharmacist-led interventions were compiled into a logic model comprising input, activity, output, outcome and contextual factors. RESULTS The initial search retrieved 2291 records and 35 were included in the analysis. The main interventional activities included optimising medicines use and prevention and control of asthma. Commonly reported outputs were medication adherence, knowledge and inhaler technique. The main economic outcomes included cost of medication and hospitalization; clinical outcomes included Childhood Asthma Control Test/Asthma Control Test scores and lung function in FEV1% and PEF%; humanistic outcomes included patients' quality of life and satisfaction. Social, economic, political, and technological factors were identified as contextual factors. CONCLUSION The logic model summarized components of interventions evaluated in literature. It provides a blueprint for pharmacist-led management of pediatric asthma. Further research can focus on the pharmacists' role in a multidisciplinary healthcare professional team and transition of care in patient-centered management of pediatric asthma.
Collapse
Affiliation(s)
- Guohua Lin
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao
| | - Chi Ian Chau
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao; Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Macao; Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Macao.
| |
Collapse
|
3
|
Ghozali MT, Urrohmah UA. Determining the relationship between the knowledge on self-management and levels of asthma control among adult asthmatic patients: a cross-sectional study. J Med Life 2023; 16:442-446. [PMID: 37168308 PMCID: PMC10165522 DOI: 10.25122/jml-2022-0333] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 01/07/2023] [Indexed: 05/13/2023] Open
Abstract
The primary aim of asthma management is to improve the patient's quality of life and keep the symptoms under control, therefore improving the patient's daily activities. Asthmatic patients who know and understand how to control their symptoms could be able to prevent further attacks. Many previous studies have shown the role of patient knowledge regarding asthma self-management in improving asthma control. It was why this study mainly aimed to determine the relationship between patient knowledge of self-management and asthma control levels among adult asthmatic patients in the rural community. The design used analytical observation with a cross-sectional approach to collect data. It involved 100 asthmatic outpatients from two private hospitals owned by the Muhammadiyah Society in the Special Region of Yogyakarta, Indonesia, from February to August 2022. Most participants had a low level of knowledge (66%;n=66), followed by a good level of knowledge (34%;n=34). Regarding the levels of asthma control, it could be confirmed that 61% (n=61) of study participants had uncontrolled asthma, followed by partially controlled (35%;n=35), and controlled (4%;n=4). In terms of the relationship between two variables (patient knowledge of self-management and asthma control levels), the results of Pearson Chi-Square showed a p-value of 0.001, highlighting a relationship between the patient's knowledge of self-management and levels of asthma control. This study concluded that there was a strong relationship between knowledge regarding asthma self-management and asthma control levels.
Collapse
Affiliation(s)
- Muhammad Thesa Ghozali
- Department of Pharmaceutical Management, School of Pharmacy, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
- Corresponding Author: Muhammad Thesa Ghozali, Department of Pharmaceutical Management, School of Pharmacy, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia. E-mail:
| | - Ulfah Aulia Urrohmah
- Department of Pharmaceutical Management, School of Pharmacy, Faculty of Medicine and Health Sciences, Universitas Muhammadiyah Yogyakarta, Yogyakarta, Indonesia
| |
Collapse
|
4
|
Eldooma I, Maatoug M, Yousif M. Pharmaceutical Care Within Community Pharmacies: Tools Availability and Pharmacists' Views, Wad-Medani, Sudan. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2023; 12:37-47. [PMID: 36818198 PMCID: PMC9930573 DOI: 10.2147/iprp.s399265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 02/01/2023] [Indexed: 02/12/2023] Open
Abstract
Background Pharmaceutical Care (PhC) services within community pharmacies (CPs) have become a vital issue in many developed countries. Purpose This study assessed the availability of PhC tools and pharmacists' views towards PhC services within CPs in Sudan. Methods A cross-sectional study was conducted from December 2019 to August 2020 using a pretested self-administered questionnaire. The participants were 120 community pharmacists. Results Fifty-eight percent of respondents used to work in pharmacies near homes rather than within the marketplace. The study revealed that the overall tool availability of the assessed components and items was only 25% (Counselling areas 3%, Records 5%, Pharmacist identity 3%, Pharmacy phones 15%, Medical devices 38%, and Staff 29%). The result of pharmacists' views towards the PhC concept, roles, and responsibilities showed a high level of agreement, at 88%, with a statistically insignificant difference between participants. Conclusion Tools available within CPs were lower than required. However, pharmacists' views showed a high agreement level towards PhC concept roles and responsibilities. Community pharmacists, academic sectors, and regulatory authorities must start initiatives to improve the provision of PhC tools for better patient care service delivery.
Collapse
Affiliation(s)
- Ismaeil Eldooma
- National Health Insurance Fund. Planning, Research, and Information, Gezira State, Sudan
- Clinical Pharmacy & Pharmacy Practice Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan
| | - Maha Maatoug
- Clinical Pharmacy & Pharmacy Practice Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan
| | - Mirghani Yousif
- Clinical Pharmacy & Pharmacy Practice Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan
| |
Collapse
|
5
|
Addressing sex and gender to improve asthma management. NPJ Prim Care Respir Med 2022; 32:56. [PMID: 36539451 PMCID: PMC9764319 DOI: 10.1038/s41533-022-00306-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 09/29/2022] [Indexed: 12/24/2022] Open
Abstract
Sex (whether one is 'male' or 'female', based on biological characteristics) and gender (defined by socially constructed roles and behaviors) influence asthma diagnosis and management. For example, women generally report more severe asthma symptoms than men; men and women are exposed to different asthma-causing triggers; men tend to be more physically active than women. Furthermore, implicit, often unintended gender bias by healthcare professionals (HCPs) is widespread, and may result in delayed asthma diagnosis, which can be greater in women than men. The sex and gender of the HCP can also impact asthma management. Pregnancy, menstruation, and menopause can all affect asthma in several ways and may be associated with poor asthma control. This review provides guidance for considering sex- and gender-associated impacts on asthma diagnosis and management and offers possible approaches to support HCPs in providing personalized asthma care for all patients, regardless of their sex or gender.
Collapse
|
6
|
Coteur K, Matheï C, Schoenmakers B, Van Nuland M. Co-design to increase implementation of insomnia guidelines in primary care. PATIENT EDUCATION AND COUNSELING 2022; 105:3558-3565. [PMID: 36075810 PMCID: PMC9425708 DOI: 10.1016/j.pec.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 07/05/2022] [Accepted: 08/27/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Sleep disorders, including insomnia, are widespread problems, which have increased during the COVID-19 pandemic. Guidelines for the treatment of insomnia prioritize non-pharmacological interventions. Nevertheless, primary care professionals lack well-developed material for patient education, that could help implement the treatment guidelines in Flanders, Belgium. OBJECTIVE This project's purpose is to develop complementary, written educational material, grounded in the principles of evidence-based practice, for primary care. PATIENT INVOLVEMENT This co-design project involved patients and health professionals. Special attention was given to including patients with low health literacy, and empowering patients when designing in mixed groups. METHODS Based on the framework of Sanders and Stappers (2014), data were collected and analyzed in four phases. Pre-design, needs were explored using think-aloud studies and focus groups. Next, for generative purposes, the design studio method was used. Then, evaluation of the prototype happened with another series of think-aloud studies. Finally, post-design, implementation of the product was evaluated with a short survey. RESULTS Twenty-five participants (10 patients and 15 healthcare professionals) contributed to the development of an educational patient leaflet called Sssssst. How do you sleep (at night)? Out of 30 professionals who received the printed leaflet for use in practice, 17 provided feedback after six months. Generally, the leaflet was well received. Visual design aspects stimulated use in practice. DISCUSSION Written and visual materials aid primary care professionals to educate patients on sleep and insomnia. This supporting tool also stimulates self-management in patients. Although inspiring and educational for all stakeholders, a co-design approach is no guarantee for the product to "fit all".
Collapse
Affiliation(s)
- Kristien Coteur
- Department of Public Health and Primary Care, KU Leuven, Belgium.
| | - Catharina Matheï
- Department of Public Health and Primary Care, KU Leuven, Belgium
| | | | - Marc Van Nuland
- Department of Public Health and Primary Care, KU Leuven, Belgium
| |
Collapse
|
7
|
Nguyen C, Naunton M, Thomas J, Todd L, Bushell M. Novel pictograms to improve pharmacist understanding of the number needed to treat (NNT). CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:1229-1245. [PMID: 36283794 DOI: 10.1016/j.cptl.2022.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Revised: 08/01/2022] [Accepted: 09/06/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Number needed to treat (NNT) is a clinically useful "yardstick" used to gauge the efficacy of therapeutic interventions. The objective of this project was to develop and pilot a series of pictograms and assess their impact on pharmacist understanding of the NNT. METHODS Three decision aids containing NNT pictograms were developed following a preliminary literature review and three focus groups with current Australian-registered pharmacists and pharmacist interns. Pharmacists then tested the pictograms in a research pilot in clinical encounters until (1) ≥ 3 sessions had occurred or (2) a two-week period had elapsed from commencement. Knowledge assessment was administered both pre- and post-pilot. Transcription and inductive thematic analysis were applied to focus group data. Descriptive statistics, Wilcoxon signed rank, and McNemar's tests were used to analyse the pilot data. RESULTS Six core themes regarding NNT decision aid development were identified with >80% consensus across three focus groups (N = 11). Comparison of the pre-post measures (n = 10) showed an increase in median scores after use of NNT decision aids, correlating to a moderate Cohen classified effect size (d = 0.54). Wilcoxon matched pairs test demonstrated a statistically insignificant influence of NNT pictograms on the knowledge assessment survey (P > .05). CONCLUSIONS While the NNT is not a new concept, its incorporation as part of pictograms for health practitioner enrichment is novel. This pilot study suggests that utilizing decision aids with NNT pictograms as counselling adjuncts appears promising in the realm of enhancing pharmacists' understanding of the NNT.
Collapse
Affiliation(s)
- Cassandra Nguyen
- University of Canberra, Discipline of Pharmacy, Faculty of Health, Australian Capital Territory, Australia.
| | - Mark Naunton
- Head of School - Health Sciences, University of Canberra, Faculty of Health, Australian Capital Territory, Australia.
| | - Jackson Thomas
- University of Canberra, Discipline of Pharmacy, Faculty of Health, Australian Capital Territory, Australia.
| | - Lyn Todd
- University of Canberra, Discipline of Pharmacy, Faculty of Health, Australian Capital Territory, Australia.
| | - Mary Bushell
- University of Canberra, Discipline of Pharmacy, Faculty of Health, Australian Capital Territory, Australia.
| |
Collapse
|
8
|
Usami O. Improved inhaler handling after repeated inhalation guidance for elderly patients with bronchial asthma and chronic obstructive pulmonary disease. Medicine (Baltimore) 2022; 101:e30238. [PMID: 36107520 PMCID: PMC9439803 DOI: 10.1097/md.0000000000030238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Accurate evaluation of inhaler handling is essential for improved treatment of bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). Many studies have described the correlation between age, inhalation guidance, and procedure improvement. Elderly patients should receive proper inhalation guidance. This was a retrospective open cohort study conducted at a single hospital with outpatient open pharmacies that provided inhalation guidance to patients of BA and COPD. A total of 525 cases were included in the study. The median age was 71 years with no significant difference between genders (males: 71 ± 16.0 years; females: 72 ± 16.1 years; P = .24). There were 226 males (43.0%) and 299 females (57.0%; P = .03). BA was significantly more prevalent than COPD (P < .001). There was no significant difference in dry powder inhaler (DPI) and pressurized metered-dose inhaler (pMDI) visits in those <60 years of age (P = .23). pMDI was used significantly more often than DPI in those aged 60 to 90 years of age (P < .001). In both <70 and >70 years of age, the most common error with DPI use was improper inhalation speed, which reduced (improved) at the third visit. Gargling errors were most common with DPI use at the second visit and with pMDI at the first visit in both age groups, which subsequently reduced rapidly. Continuous repeated guidance steadily and significantly decreased errors with all devices (P < .001 for DPI, pMDI, and soft mist inhaler). Elderly cases (>70 years of age) should undergo continuous repeated guidance to reduce inhalation errors like inhalation speed and gargling errors.
Collapse
Affiliation(s)
- Osamu Usami
- Department of Respiratory Medicine of the Kurihara Central Hospital, Miyagi, Japan
- *Correspondence: Osamu Usami, Department of Respiratory Medicine, Kurihara Central Hospital, Miyano Cyuo 3-11, Tsukidate, Kurihara, Miyagi 987-2205, Japan (e-mail: )
| |
Collapse
|
9
|
Saleem SS, Khan A, Aman R, Saleem SS, Bibi A, Ahmad N, Mushtaq S, Mehsud S, Green IR, Rashid SA, Khan A, Shah KU. Impact of pharmacist-led educational intervention on knowledge of self-management among asthmatic patients: a prospective cohort study. BMJ Open 2022; 12:e058861. [PMID: 35705337 PMCID: PMC9204400 DOI: 10.1136/bmjopen-2021-058861] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES Poor control of asthma in the majority of patients could be partly due to their lack of knowledge concerning disease management, its triggering agents and when to seek advice from the healthcare provider. This study aims to assess the impact of pharmacist-led educational intervention on knowledge of self-management among asthmatic patients. DESIGN A pre-post cohort study. SETTING Outpatient department of a tertiary care hospital affiliated with Quaid-i-Azam University, Pakistan. PARTICIPANTS Approximately 265 adult asthmatic patients selected through a spirometry process, aged ≥18 years, were approached. 240 patients gave consent to participate in the study and were divided into control and treatment groups. INTERVENTIONS The educational intervention consisted of individual patient counselling using educational material with time varied according to each patient's comprehension and previous knowledge. PRIMARY AND SECONDARY OUTCOME MEASURES Assessment consisted of a 14-item Asthma Self-Management Knowledge Questionnaire (ASMQ) quantifying a patient's self-management knowledge through an ASMQ score and its change following an educational intervention. RESULTS Disease self-management knowledge was low with an average raw ASMQ score of 4.1 (max 14); which equates to a transformed score of 29.34 (max 100) and the proportion of patients who correctly answered more than 50% of questions were 16.7% preintervention. More than half of the participants (55%) did not know that asthma cannot be cured. The administration of educational intervention protocols resulted in significantly improved level of knowledge of asthma self-management (<0.001) in the treatment group (mean ASMQ score improved from 4.20 to 9.77). CONCLUSION On baseline visit, patients possessed a poor knowledge about asthma self-management. Educational intervention protocols had a positive impact on improving patients' knowledge about disease self-management. This would suggest that education and self-management skills should be seen as an integral component of asthma management and should be incorporated in structured patient care to achieve optimal asthma control.
Collapse
Affiliation(s)
| | - Amjad Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | - Rubina Aman
- Department of Pulmonology, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | | | - Ayesha Bibi
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
- Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - Nafees Ahmad
- Department of Pharmacy Practice, Faculty of Pharmacy and Health Sciences, University of Balochistan, Quetta, Pakistan
| | - Saima Mushtaq
- Department of Healthcare Biotechnology, Atta-ur-Rahman School of Applied Biosciences, National University of Sciences and Technology, Islamabad, Pakistan
| | - Saifullah Mehsud
- Department of Pharmaceutical Sciences, Abbottabad University of Science and Technology, Havelian, Khyber Pakhtunkhwa, Pakistan
| | - Ivan R Green
- Department of Chemistry and Polymer Science, University of Stellenbosch, Stellenbosch, Western Cape, South Africa
| | - Sheikh Abdur Rashid
- Gomal Center of Pharmaceutical Sciences, Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan
| | - Ahmad Khan
- Department of Pharmacy, Quaid-i-Azam University, Islamabad, Pakistan
| | | |
Collapse
|
10
|
Said ASA, Hussain N, Kharaba Z, Al Haddad AHI, Abdelaty LN, Roshdy RRS. Knowledge, attitude, and practice of pharmacists regarding asthma management: a cross-sectional study in Egypt. J Pharm Policy Pract 2022; 15:35. [PMID: 35505447 PMCID: PMC9062855 DOI: 10.1186/s40545-022-00432-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/18/2022] [Indexed: 12/14/2022] Open
Abstract
Background Asthma is a significant public health issue that poses a substantial health and economic burden. Despite the availability of effective asthma medications, its management remain suboptimal. Recent asthma guidelines have highlighted the importance of pharmacist unique position and its interventional strategies in positively impacting asthma treatment outcomes. Therefore, this study aimed to assess the degree of Egyptian pharmacists’ knowledge, attitudes, as well as their practices towards asthma management in line with the recent asthma guidelines. Methods This cross-sectional study was conducted among 800 pharmacists working in different private and governmental sectors. The data were collected using a 37-item pre-validated self-administered KAP questionnaire. The data were analyzed using Student’s t-test and analysis of variance to assess the association between each KAP level and the sociodemographic variables at the significance level of 0.05. Results Of the 800 distributed questionnaire, a total of 550 participants (316 Male, and 234 Female) responded, representing a 68.7% response rate. The mean ± SD score of knowledge, attitude, practice, and barrier was 5.49 ± 1.65 (min = 0; max = 8), 23.5 ± 2.84 (min = 15, max = 30), 43.12 ± 8.61 (min = 28, max = 62), and 27.76 ± 3.72 (min = 17, max = 39), respectively. The results showed that poor knowledge, attitude, and practice scores were achieved by 30.54, 0, and 38.72% of participants, respectively. Conclusion Our findings revealed the inconsistencies between poor pharmacists’ knowledge and practices with respect to their positive attitudes. The lack of pharmacists’ knowledge and compliance to recent GINA guidelines in this study highlight the crucial need for effective Educational strategies that should better equip pharmacists for their potential role in asthma care.
Collapse
Affiliation(s)
- Amira S A Said
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE. .,AAU Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, UAE. .,Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni Suef, Egypt.
| | - Nadia Hussain
- AAU Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, UAE.,Department of Pharmaceutical Sciences, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE
| | - Zelal Kharaba
- Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Al Ain, Abu Dhabi, UAE.,AAU Health and Biomedical Research Center (HBRC), Al Ain University, Abu Dhabi, UAE
| | - Amal H I Al Haddad
- Chief Operations Office, Sheikh Shakbout Medical City (SSMC), Abu Dhabi, UAE
| | - Lamiaa N Abdelaty
- Department of Clinical Pharmacy, Faculty of Pharmacy, October 6 University, Cairo, Egypt
| | - Raghda R S Roshdy
- Department of Clinical Pharmacy, Faculty of Pharmacy, Beni-Suef University, Beni Suef, Egypt.,Department of Clinical Pharmacy, Faculty of Pharmacy, Modern University for Technology and Information, Cairo, Egypt
| |
Collapse
|
11
|
Alzayer R, Almansour HA, Basheti I, Chaar B, Al Aloola N, Saini B. Asthma patients in Saudi Arabia - preferences, health beliefs and experiences that shape asthma management. ETHNICITY & HEALTH 2022; 27:877-893. [PMID: 32931314 DOI: 10.1080/13557858.2020.1817868] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 08/23/2020] [Indexed: 06/11/2023]
Abstract
UNLABELLED Objectives: The aim of this study was to explore the experience of Saudi participants in managing their asthma and their perspectives about using future pharmacy-based services for asthma management. METHODS Semi-structured interviews were conducted with adult Saudis with asthma or those who were a carer of a child with asthma. Participants were recruited from medical practices and community centres in Riyadh, Saudi Arabia. Verbatim transcribed interviews were inductively analysed using thematic analysis. RESULTS Twenty-three Saudi participants with asthma or caring for those with asthma took part in interviews which lasted on average for 25 min. Most participants did not have well-controlled asthma. Thematic analyses of the interview transcripts highlighted four key emergent themes: participants experience of asthma, participants' beliefs and perceptions about health and medicines, perception of health professionals and advocacy and social support. Many participants expressed an emotional burden in their lived experience of asthma. Lack of self-management skills were evident in participants' reluctance to make decisions in emergency situations. Some participants had strong beliefs about using herbal medicines rather than western medicines. Using social media or consulting with their family members with asthma was a common preference, rather than consulting healthcare professionals. Participants' were rather unclear about pharmacy asthma care services and reported not having experienced such services in their pharmacies. CONCLUSION Inadequate self-management behaviours may affect the level of asthma control in people with asthma in Saudi Arabia. Improved primary care models with extensive focus on asthma education are needed to relieve the over-reliance on tertiary care help-seeking models that are currently the norm. Current evidence-based information also needs to be prepared in patient friendly formats and disseminated widely. Community pharmacists would need to be trained and skilled inpatient engagement and would have to win the public trust for viable asthma services provision.
Collapse
Affiliation(s)
- Reem Alzayer
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Hadi A Almansour
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Iman Basheti
- Vice President and Dean of the Faculty of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Betty Chaar
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Noha Al Aloola
- College of Pharmacy, Clinical Pharmacy Department, King Saud University, Riyadh, Saudi Arabia
| | - Bandana Saini
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| |
Collapse
|
12
|
Busse WW, Kraft M. Current unmet needs and potential solutions to uncontrolled asthma. Eur Respir Rev 2022; 31:210176. [PMID: 35082128 PMCID: PMC9488919 DOI: 10.1183/16000617.0176-2021] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 09/28/2021] [Indexed: 12/16/2022] Open
Abstract
Despite the availability of effective inhaled therapies, many patients with asthma have poor asthma control. Uncontrolled asthma presents a significant burden on the patient and society, and, for many, remains largely preventable. There are numerous reasons why a patient may remain uncontrolled despite access to therapies, including incorrect inhaler technique, poor adherence to treatment, oversight of triggers and suboptimal medical care. Shared decision-making, good patient-clinician communication, supported self-management, multidisciplinary patient education, new technology and risk stratification may all provide solutions to this major unmet need in asthma. Novel treatments such as biologics could benefit patients' lives, while the investigations into biomarkers, non-Type 2 asthma, treatable traits and disease modification give an exciting glimpse into the future of asthma care.
Collapse
Affiliation(s)
- William W Busse
- Dept of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Monica Kraft
- University of Arizona College of Medicine, Tucson, AZ, USA
| |
Collapse
|
13
|
Mahmoud A, Mullen R, Penson PE, Morecroft C. The management of asthma in adult patients in the community pharmacy setting: Literature review. Res Social Adm Pharm 2021; 17:1893-1906. [PMID: 33867279 DOI: 10.1016/j.sapharm.2021.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 03/26/2021] [Accepted: 04/03/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Asthma poses a public health concern, with an estimated 235 million people currently living with the condition globally. The provision of evidence-based, patient-centred services for adult asthma patients in community pharmacy which involves collaboration across the multidisciplinary team could improve their asthma control. OBJECTIVES A literature review was conducted to examine the evidence of asthma management in community pharmacy setting. METHODS Five databases were searched to identify relevant articles published before February 2021. Screening of the potential studies was performed to remove articles that did not comply with the inclusion criteria. Relevant data from all included studies was collected using a data extraction form to ensure consistency throughout the review. RESULTS Twenty studies were included in the review; all were conducted in community pharmacy settings in the period of 2001-2020, in different countries. The studies included randomised controlled trials, controlled trials and observational studies. Several successful community pharmacy-based services that were provided to asthma patients to improve their asthma management were highlighted in this review. These interventions consisted of one or more components and included: patient education, inhaler technique improvement, patient counselling, self-management plans, development and provision of asthma action plans and referral to other health care practitioners. None of the studies involved medication or dosage changes by community pharmacy. CONCLUSIONS The evidence discussed in this review showed that community pharmacists are well-placed to deliver services to asthma patients and many studies were conducted in the community pharmacy to improve asthma control in adult patients. However, further research could be conducted to explore further opportunities for community pharmacy to enhance asthma patients management of their condition.
Collapse
Affiliation(s)
- Aseel Mahmoud
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom; School of Pharmacy, Isra University, Amman, Jordan.
| | - Rachel Mullen
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom; Centre of Pharmacy Innovation, Liverpool John Moores University, Liverpool, United Kingdom
| | - Peter E Penson
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom; Centre of Pharmacy Innovation, Liverpool John Moores University, Liverpool, United Kingdom
| | - Charles Morecroft
- School of Pharmacy and Biomolecular Sciences, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom; Centre of Pharmacy Innovation, Liverpool John Moores University, Liverpool, United Kingdom
| |
Collapse
|
14
|
Consenso multidisciplinar para el seguimiento y control del asma mediante la telemedicina. El proyecto COMETA. OPEN RESPIRATORY ARCHIVES 2021. [PMID: 37497073 PMCID: PMC10369603 DOI: 10.1016/j.opresp.2021.100098] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Despite the therapeutic advances currently available, asthma control is poor. Such control is based on assessing the patient, adjusting treatment, and reviewing the response to treatment. In normal situations, asthma is monitored and controlled by sequential face-to-face visits. However, due to biosecurity and distancing measures to avoid disease transmission during a pandemic, such monitoring and control is limited. This is how tele-assistance, which is available from extensive published evidence in asthma, has emerged. Even so, it should not be understood as a substitute for face-to-face consultations, but as a complementary alternative to them, in which patients can be monitored when a face-to-face consultation is not necessary or cannot be carried out. Through the COMETA project (COntrol como Meta en la Era de la Telemedicina en el Asma, Control as a Goal in the Age of Telemedicine in Asthma), a group of experts addressed in depth the asthmatic pathology, analyzing in detail the existing problems in order to achieve control and propose solutions to situations such as those we are currently experiencing with the COVID-19 pandemic.
Collapse
|
15
|
Hartley KA, Guthrie KD, Stoner SC, May JR, Hartwig DM, Liu Y. Community Pharmacist Telephonic Medication Reviews with Uncontrolled Asthma Patients: A Pilot Study. PHARMACY 2021; 9:pharmacy9010025. [PMID: 33499009 PMCID: PMC7838915 DOI: 10.3390/pharmacy9010025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 01/18/2021] [Accepted: 01/20/2021] [Indexed: 11/16/2022] Open
Abstract
This study reports the process of telephonic medication reviews conducted by community pharmacists for patients with asthma. The study occurred at an independent community chain in association with a Missouri Medicaid consulting group. Participants were identified utilizing claims data and met the National Quality Forum criteria for uncontrolled moderate-to-severe persistent asthma. A pharmacist performed the initial encounter via telephone which included a knowledge questionnaire, symptom control assessment, and medication review. Pharmacists identified drug-related problems (DRPs) and faxed recommendations to patients’ primary care providers (PCPs). Thirty days later, pharmacists called to follow up with the patients and faxed PCPs to resolve any outstanding DRPs, new DRPs, or recommendations. Questionnaire scores and symptom control assessments were compared and analyzed utilizing a paired t-test, Chi-squared test, or Fisher’s exact test. The number and categories of DRPs, recommendations made by pharmacists, and intervention time were reported. Fourteen participants completed initial encounters with twelve completing follow-up. The majority answered ‘yes’ to at least one symptom control assessment question indicating partially controlled to uncontrolled asthma. The average knowledge assessment score was 5.17 out of 7 initially and 5.42 for the follow-up. Pharmacists identified 43 DRPs and made 41 recommendations with a mean intervention time of 65 min.
Collapse
Affiliation(s)
- Kathryn A. Hartley
- Pharmacy, University of Kansas Health System, Kansas City, KS 66160, USA;
| | - Kendall D. Guthrie
- School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA; (S.C.S.); (Y.L.)
- Correspondence:
| | - Steven C. Stoner
- School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA; (S.C.S.); (Y.L.)
| | - Justin R. May
- Bothwell Regional Health Center, Sedalia, MO 65301, USA;
| | | | - Yifei Liu
- School of Pharmacy, University of Missouri-Kansas City, Kansas City, MO 64108, USA; (S.C.S.); (Y.L.)
| |
Collapse
|
16
|
Effect of a Multidimensional Pharmaceutical Care Intervention on Inhalation Technique in Patients with Asthma and COPD. Can Respir J 2020; 2020:8572636. [PMID: 33294083 PMCID: PMC7688368 DOI: 10.1155/2020/8572636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 10/19/2020] [Indexed: 11/26/2022] Open
Abstract
Background Inhalation therapy is the main treatment for asthma and chronic obstructive pulmonary disease (COPD) patients. Owing to the poor inhaler technique in using inhalers, we assessed the effect of a multidimensional pharmaceutical care on inhalation technique in patients with asthma and COPD. Materials and Methods A 3-month controlled parallel-group study was undertaken in asthma and COPD patients using dry powder inhalers (DPIs). Patients in the intervention group received multidimensional pharmaceutical care, including establishment of a special dispensing window, face-to-face demonstration and education, brochure education, videos education, online consultation and education, and follow-up reeducation. Patients in the control group received usual pharmaceutical care. The inhaler technique score, correctness of inhaler usage, beliefs about medicines questionnaire (BMQ) score, asthma control test (ACT), and COPD assessment test (CAT) were measured pre- and postintervention. Quality of life improvement evaluated according to score changes of ACT in asthma and CAT in COPD and patient satisfaction were measured postintervention. Results 259 patients finished the study with 133 in the intervention group and 126 in the control group. Compared to preintervention and control group postintervention, the inhaler technique score, correctness of inhaler usage, and ACT score significantly increased in the intervention group postintervention, while the BMQ score and CAT score decreased significantly (P < 0.05). Significant improvements in quality of life and patient satisfaction were found (P < 0.05). Conclusion This study showed the multidimensional pharmaceutical care for asthma and COPD patients were effective in improving inhalation technique. By providing pharmaceutical care, pharmacists might help asthma and COPD patients to acquire better quality of life.
Collapse
|
17
|
Impact of pharmacist-led educational interventions on asthma control and adherence: single-blind, randomised clinical trial. Int J Clin Pharm 2020; 43:689-697. [PMID: 33136254 DOI: 10.1007/s11096-020-01187-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Accepted: 10/24/2020] [Indexed: 12/12/2022]
Abstract
Background Asthma is an important cause of morbidity and mortality worldwide. Education is a critical component in the management of asthma. Objective This study sought to assess the impact of pharmacist-led educational interventions on asthma control and adherence. Setting Tertiary Hospitals in Nigeria Method This was a single-blind, three-arm, prospective, randomised, controlled, parallel-group study conducted in the Respiratory Units of the University of Nigeria Teaching Hospital, Enugu State and the Lagos University Teaching Hospital, Lagos State between March 2016 and September 2017. The three arms were: Usual Care, Individual Intervention, Caregiver-assisted Intervention (1:1:1 ratio). The Intervention arms received education for 6 months while the Usual Care arm received no education. The Asthma Control Test and the 8-item Morisky Medication Adherence Scale were filled at baseline, 3 months, and 6 months after baseline. Data were analyzed using the IBM SPSS Version 25.0 with statistical significance set as P < 0.05. Main outcome measure Asthma control and adherence. Results Seventy-eight (78) asthma patients participated; thirty-nine (39) per hospital; thirteen (13) in each arm. The Individual Intervention arm possessed significantly better asthma control compared to Usual Care at 3 months (21.42 Vs. 18.85; P = 0.004, t = 3.124, df = 25, 95% confidence interval = 0.88 - 4.28) and 6 months (21.81 Vs. 19.58; P = 0.003, t = 3.259, df = 25, 95% confidence interval = 0.82 - 3.64). The Individual Intervention arm also possessed significantly better adherence compared to Usual Care at 3 months (6.81 Vs. 4.94; P = 0.001, t = 3.706, df = 25, 95% confidence interval = 0.83 - 2.90) and 6 months (7.28 Vs. 5.13; P < 0.001, t = 4.094, df = 25, 95% confidence interval = 1.07 -3.24). The Caregiver-assisted Interventions had no significant improvement in asthma control and adherence. Conclusion The individualized educational interventions produced better improvements in asthma control and adherence.
Collapse
|
18
|
A Role for Primary Care Pharmacists in the Management of Inflammatory Bowel Disease? Lessons from Chronic Disease: A Systematic Review. PHARMACY 2020; 8:pharmacy8040204. [PMID: 33147771 PMCID: PMC7712000 DOI: 10.3390/pharmacy8040204] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 10/27/2020] [Accepted: 10/30/2020] [Indexed: 12/13/2022] Open
Abstract
Background and aims: Chronic disease, particularly inflammatory bowel disease (IBD), requires a multifaceted approach to managing patients, but it is apparent that primary care pharmacists are being underutilized. To demonstrate the benefits of pharmacist interventions in primary care, a systematic review was conducted of interventions in asthma and type 2 diabetes where pharmacists have a defined role in chronic disease management. We also explored potential opportunities for primary care pharmacists to deliver tailored care to patients with inflammatory bowel disease. Methods: The search strategy retrieved original research articles from seven databases; eligible articles were assessed for inclusion. Quality appraisal was performed independently by two reviewers. Results: Thirty-seven included studies were grouped into four categories of interventions: education/counseling (43%), medication management (34%), monitoring/follow-up (17%), and screening/risk prevention (6%). Education plus counseling was reported as the main intervention delivered by pharmacists. Three measurable outcomes were identified: clinical, humanistic (e.g., quality of life), and economic. Clinical outcomes (63%) were reported more commonly than humanistic (26%) and economic (11%) outcomes. Pharmacist interventions led to statistically significant improvements in control of disease, severity, and medication adherence, as well as improvements in overall patient satisfaction, quality of life among patients with asthma and type 2 diabetes. Conclusion: As one of the most accessible sources of primary health care, pharmacists are well-placed to minimize the impact of chronic diseases on patients and communities. Evidence suggests there are opportunities for primary care pharmacists to play a more active role in the management of chronic diseases such as IBD.
Collapse
|
19
|
Crilly P, Kayyali R. A Systematic Review of Randomized Controlled Trials of Telehealth and Digital Technology Use by Community Pharmacists to Improve Public Health. PHARMACY 2020; 8:E137. [PMID: 32759850 PMCID: PMC7559081 DOI: 10.3390/pharmacy8030137] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 12/31/2022] Open
Abstract
Community pharmacists (CPs) continue to have an important role in improving public health, however, advances in telehealth and digital technology mean that the methods by which they support their customers and patients are changing. The primary aim of this study was to identify which telehealth and digital technology tools are used by CPs for public health purposes and determine if these have a positive impact on public health outcomes. A systematic review was carried out using databases including PubMed and ScienceDirect, covering a time period from April 2005 until April 2020. The search criteria were the following: randomized controlled trials, published in English, investigating the delivery of public health services by community pharmacists using a telehealth or digital tool. Thirteen studies were included out of 719 initially identified. Nine studies detailed the use of telephone prompts or calls, one study detailed the use of a mobile health application, two studies detailed the use of a remote monitoring device, and one study detailed the use of photo-aging software. Public health topics that were addressed included vaccination uptake (n = 2), smoking cessation (n = 1), hypertension management (n = 2), and medication adherence and counseling (n = 8). More studies are needed to demonstrate whether or not the use of novel technology by CPs can improve public health.
Collapse
Affiliation(s)
| | - Reem Kayyali
- Department of Pharmacy, School of Life Sciences, Pharmacy and Chemistry, Kingston University, Kingston upon Thames KT1 2EE, UK;
| |
Collapse
|
20
|
Yande SD, Masurkar PP, Gopinathan S, S Sansgiry S. A naturalistic observation study of medication counseling practices at retail chain pharmacies. Pharm Pract (Granada) 2020; 18:1696. [PMID: 32206141 PMCID: PMC7075423 DOI: 10.18549/pharmpract.2020.1.1696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/19/2020] [Indexed: 01/24/2023] Open
Abstract
OBJECTIVE This study evaluated medication counseling procedures and trends at retail pharmacies in the Houston metropolitan area through a naturalistic observational study. METHODS A blinded cross-sectional observational study was conducted at retail pharmacies in the Houston metropolitan area. Data were collected by trained observers utilizing an observational log, to record various parameters that could have an impact on the duration of patient-pharmacist interaction in a naturalistic pharmacy practice setting. Additionally, indicators of counseling such as utilization of the counseling window and performance of show-and-tell were recorded. Statistical analyses included descriptive statistics, t-tests, Pearson correlations, ANOVAs, and multiple linear regressions. RESULTS One hundred and sixty-five interactions between patients and pharmacy staff were recorded at 45 retail pharmacies from 7 retail pharmacy chains. The counseling window was utilized in only 3 (1.81%) out of 165 observations and the show-and-tell process was observed in just 1(0.61%) interaction during this study. Mean (SD) interaction time between patient and pharmacists [159.50 (84.50)] was not statistically different (p>0.05) from the mean interaction time between patients and pharmacy technicians [139.30 (74.19)], irrespective of type of the retail chain observed. However, it was influenced by the number of patients waiting in queue. Patient wait time significantly differed by the time of the day the interaction was observed, weekends and weekdays had significantly different wait times and patient interaction times Multiple linear regression analyses indicated that, patient interaction time, pharmacy chain type, initial contact (pharmacist/technician), and time of the day, were significantly associated with patient wait time whereas patient wait time, pharmacy chain type, number of patients in queue, and number of pharmacy technician were significantly associated with interaction time. CONCLUSIONS Our study found that the key indicators of counseling including the use of the counseling window and the show-and-tell process were absent, suggesting lack of adequate pharmacists counseling. Further studies are needed to evaluate the validity of this conclusion and the role of pharmacy services and its value towards medication use and safety.
Collapse
Affiliation(s)
- Soham D Yande
- BPharm. Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston. Houston, TX (United States).
| | - Prajakta P Masurkar
- MPharm. Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston. Houston, TX (United States).
| | - Suma Gopinathan
- MPharm. Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston. Houston, TX (United States).
| | - Sujit S Sansgiry
- MS, PhD, Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston. Houston, TX (United States).
| |
Collapse
|
21
|
Mishriky J, Stupans I, Chan V. Expanding the role of Australian pharmacists in community pharmacies in chronic pain management - a narrative review. Pharm Pract (Granada) 2019; 17:1410. [PMID: 31015881 PMCID: PMC6463420 DOI: 10.18549/pharmpract.2019.1.1410] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Accepted: 02/03/2019] [Indexed: 01/12/2023] Open
Abstract
Chronic pain is a condition where patients continuously experience pain symptoms for at least 3 to 6 months. It is one of the leading causes of disabilities across the globe. Failure to adequately manage chronic pain often results in additional health concerns that may directly contribute to the worsening symptoms of pain. Community pharmacists are an important healthcare resource that contributes to patient care, yet their roles in chronic pain management are often not fully utilised. This review aimed to investigate and explore pharmacist-driven chronic pain educational and medication management interventions in community pharmacies on an international level, and thereby identify if there are potential benefits in modelling and incorporating these interventions in the Australian community. We found a number of studies conducted in Europe and the United States investigated the benefits of pharmacist-driven educational and medication management interventions in the context of chronic pain management. Results demonstrated that there were improvements in the pain scores, depression/anxiety scales and physical functionality in patient groups receiving the pharmacist driven-interventions, thereby highlighting the clinical benefit of these interventions in chronic pain. In conclusion, pharmacists are trustworthy and responsible advocates for medication reviews and patient education. There are currently very limited formal nationally recognised pharmacist-driven intervention programs dedicated to chronic pain management in Australian community pharmacies. International studies have shown that pharmacist-driven chronic pain interventions undertaken in community pharmacies are of benefit with regards to alleviating pain symptoms and adverse events. Furthermore, it is also clear that research around the application of pharmacist-led chronic pain interventions in Australia is lacking. Modelling interventions that have been conducted overseas may be worth exploring in Australia. The implementation of similar intervention programs for Australian pharmacists in community pharmacies may provide enhanced clinical outcomes for patients suffering from chronic pain. The recently implemented Chronic Pain MedsCheck Trial may provide some answers.
Collapse
Affiliation(s)
- John Mishriky
- School of Health and Biomedical Sciences, Discipline of Pharmacy, RMIT University. Bundoora, VIC (Australia).
| | - Ieva Stupans
- Professor and Discipline Head of Pharmacy. School of Health and Biomedical Sciences, Discipline of Pharmacy, RMIT University. Bundoora, VIC (Australia).
| | - Vincent Chan
- School of Health and Biomedical Sciences, Discipline of Pharmacy, RMIT University. Bundoora, VIC (Australia).
| |
Collapse
|
22
|
Schwartzberg E, Nathan JP, Avron S, Marom E. Clinical and other specialty services offered by pharmacists in the community: the international arena and Israel. Isr J Health Policy Res 2018; 7:59. [PMID: 30501624 PMCID: PMC6271400 DOI: 10.1186/s13584-018-0251-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2018] [Accepted: 08/29/2018] [Indexed: 11/20/2022] Open
Abstract
The community pharmacy setting is a venue that is readily accessible to the public. In addition, it is staffed by a pharmacist, who is a healthcare provider, trained and capable of delivering comprehensive pharmaceutical care. As such, community pharmacists have a colossal opportunity to serve as key contributors to patients’ health by ensuring appropriate use of medications, preventing medication misadventures, identifying drug-therapy needs, as well as by being involved in disease management, screening, and prevention programs. This unique position gives the pharmacist the privilege and duty to serve patients in roles other than solely that of the stereotypical drug dispenser. Worldwide, as well as in Israel, pharmacists already offer a variety of pharmaceutical services and tend to patients’ and the healthcare system’s needs. This article provides examples of professional, clinical or other specialty services offered by community pharmacists around the world and in Israel and describes these interventions as well as the evidence for their efficacy. Examples of such activities which were recently introduced to the Israeli pharmacy landscape due to legislative changes which expanded the pharmacist’s scope of practice include emergency supply of medications, pharmacists prescribing, and influenza vaccination. Despite the progress already made, further expansion of these opportunities is warranted but challenging. Independent prescribing, as practiced in the United Kingdom or collaborative drug therapy management programs, as practiced in the United States, expansion of vaccination programs, or wide-spread recognition and reimbursement for medication therapy management (MTM) programs are unrealized opportunities. Obstacles such as time constraints, lack of financial incentives, inadequate facilities and technology, and lack of professional buy-in, and suggested means for overcoming these challenges are also discussed.
Collapse
Affiliation(s)
- Eyal Schwartzberg
- LIU Pharmacy (Arnold & Marie Schwartz College of Pharmacy and Health Sciences), Brooklyn, NY, USA. .,School of Pharmacy, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Joseph P Nathan
- LIU Pharmacy (Arnold & Marie Schwartz College of Pharmacy and Health Sciences), Brooklyn, NY, USA.
| | - Sivan Avron
- Pharmaceutical and Enforcement Divisions, Ministry of Health, Jerusalem, Israel
| | - Eli Marom
- Pharmaceutical and Enforcement Divisions, Ministry of Health, Jerusalem, Israel
| |
Collapse
|