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Ogundipe A, Sim TF, Emmerton L. Health information communication technology evaluation frameworks for pharmacist prescribing: A systematic scoping review. Res Social Adm Pharm 2023; 19:218-234. [PMID: 36220754 DOI: 10.1016/j.sapharm.2022.09.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 09/07/2022] [Accepted: 09/18/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND Information communication technology (ICT) is instrumental in pharmacists' current practice and emerging roles. One such role is prescribing, which requires the use of clinical guidelines and documentation of decision-making, commonly via ICT. Development and refinement of ICT should be guided by evaluation frameworks that describe or measure features of ICT and its implementation. In the context of pharmacist prescribing, these evaluation frameworks should be specific to health stakeholders and the pharmacy setting. OBJECTIVES To identify ICT evaluation frameworks from health-related literature and review frameworks relevant to the development, implementation, and evaluation of pharmacist prescribing. METHODS A database search of CINAHL, Cochrane Library, EMBASE, Medline (Ovid), ProQuest, Scopus, Web of Science and grey literature was conducted, using combinations of keywords relating to 'ICT', 'utilization', 'usability', and 'evaluation framework'. Abstracts and titles were screened according to inclusion criteria. Identified evaluation frameworks were critiqued for relevance to pharmacy practice. RESULTS Twenty-two articles were identified, describing the development or application of 20 evaluation frameworks. None of the frameworks was developed specifically for pharmacy practice. The Technology Acceptance Model (TAM), describing use behavior, behavior intention, perceived usefulness, and perceived ease of use, was the most widely utilized framework. The Information System Success (ISS) and Human-Organization and Technology Fit (HOT-fit) are notable evaluation frameworks that address user and organizational influences in health ICT utility, and factors of both can address the limitation of TAM. CONCLUSIONS The findings call for development of an agile evaluation framework for the system under review; however, this can prove difficult due to the heterogenicity and complexity of the healthcare system, particularly contemporary pharmacy practice. While the TAM appears useful to evaluate user attitudes and intentions towards ICT, its relevance to ICT in contemporary community pharmacy practice requires exploration.
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Affiliation(s)
- Ayomide Ogundipe
- Curtin Medical School, Curtin University, Kent Street, 6102, Western Australia, Australia.
| | - Tin Fei Sim
- Curtin Medical School, Curtin University, Kent Street, 6102, Western Australia, Australia
| | - Lynne Emmerton
- Curtin Medical School, Curtin University, Kent Street, 6102, Western Australia, Australia
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Zhou M, Desborough J, Parkinson A, Douglas K, McDonald D, Boom K. Barriers to pharmacist prescribing: a scoping review comparing the UK, New Zealand, Canadian and Australian experiences. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2019; 27:479-489. [DOI: 10.1111/ijpp.12557] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Revised: 05/07/2019] [Accepted: 06/03/2019] [Indexed: 12/01/2022]
Abstract
Abstract
Objectives
Non-medical prescribers, including pharmacists, have been found to achieve comparable clinical outcomes with doctors for certain health conditions. Legislation supporting pharmacist prescribing (PP) has been implemented in the United Kingdom (UK), Canada and New Zealand (NZ); however, to date, Australian pharmacists have not been extended prescribing rights. The purpose of this review was to describe the barriers to PP found in the literature from the UK, Canada, NZ and Australia, and examine the implications of these for the development of PP in Australia.
Methods
We conducted a scoping review, which included peer-reviewed and grey literature, and consultation with stakeholders. Sources – Scopus, PubMed and CINAHL; Google Scholar, OpenGrey and organisational websites from January 2003 to March 2018 in the UK, Canada, NZ and Australia. Inclusion criteria – articles published in English, related to implementation of PP and articulated barriers to PP.
Key findings
Of 863 unique records, 120 were reviewed and 64 articles were eligible for inclusion. Three key themes emerged: (1) Socio-political context, (2) Resourcing issues and (3) Prescriber competence. The most common barriers were inadequate training regarding diagnostic knowledge and skills, inadequate support from authorities and stakeholders, and insufficient funding/reimbursement.
Conclusions
If implementation of PP is to occur, attention needs to be focused on addressing identified barriers to PP implementation, including fostering a favourable socio-political context and prescriber competence. As such, a concerted effort is required to develop clear policy pathways, including targeted training courses, raising stakeholder recognition of PP and identifying specific funding, infrastructure and resourcing needs to ensure the smooth integration of pharmacist prescribers within interprofessional clinical teams.
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Affiliation(s)
- Mingming Zhou
- People’s Hospital of Xinjiang Uygur Autonomous Region, Urumqi, China
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Jane Desborough
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Anne Parkinson
- Department of Health Services Research and Policy, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Kirsty Douglas
- Academic Unit of General Practice, ANU Medical School, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - David McDonald
- National Centre for Epidemiology and Population Health, Research School of Population Health, College of Health and Medicine, Australian National University, Canberra, ACT, Australia
| | - Katja Boom
- Independent Consultant/Accredited Australian Pharmacist Working in General Practice, Canberra, ACT, Australia
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Aquilina A, Wirth F, Attard Pizzuto M, Grech L, Camilleri L, Azzopardi LM, Serracino-Inglott A. Preparing for pharmacist prescribing in Maltese hospitals. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2018. [DOI: 10.1111/jphs.12239] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Abigail Aquilina
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Francesca Wirth
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Maresca Attard Pizzuto
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Louise Grech
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
| | - Liberato Camilleri
- Department of Statistics and Operations Research; Faculty of Science; University of Malta; Msida Malta
| | - Lilian M. Azzopardi
- Department of Pharmacy; Faculty of Medicine and Surgery; University of Malta; Msida Malta
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There is still a case for a generic qualitative approach in some pharmacy practice research. Res Social Adm Pharm 2016; 13:266-268. [PMID: 27503243 DOI: 10.1016/j.sapharm.2016.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 06/10/2016] [Indexed: 11/23/2022]
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Penm J, Chaar B, Moles RJ. Use of the International Pharmaceutical Federation's Basel Statements to Assess and Advance Hospital Pharmacy Practice: A Scoping Review. Can J Hosp Pharm 2016; 69:131-7. [PMID: 27168634 DOI: 10.4212/cjhp.v69i2.1540] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND The Basel statements of the International Pharmaceutical Federation, which provide the first global, unified vision for the hospital pharmacy profession, have recently been revised. Originally released in 2008, the Basel statements have since been made available in 21 languages, and thus have the potential for great impact around the world. OBJECTIVE To conduct a scoping review to examine the extent and nature of research activity related to the Basel statements. METHODS Google Scholar, PubMed, and International Pharmaceutical Abstracts were searched using the key term "Basel statements" for relevant research articles. From each included study, data were extracted on geographic location, study design, study outcomes, and use of the Basel statements. RESULTS The search strategy generated 113 results. Further refinement resulted in 14 English-language articles that met the inclusion criteria. Four of these articles focused on adapting the Basel statements to European practice, an initiative of the European Association of Hospital Pharmacists that led to development of the European statements of Hospital Pharmacy. Six studies focused on monitoring hospital pharmacy practice in Uganda, the Pacific island countries, and the Western Pacific Region. These studies provide valuable baseline data to measure and track the development of hospital pharmacy practices in their respective countries and regions. The remaining 4 studies used qualitative methods to explore the barriers to and facilitators of implementation of the Basel statements in South Africa, China, and Australia. CONCLUSION The Basel statements have led to multiple initiatives around the world, involving more than 70 countries. The European and Western Pacific regions have been the most active. Current initiatives should be continued to ensure identification and resolution of issues related to sustaining their use over time.
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Affiliation(s)
- Jonathan Penm
- BPharm(Hons), PhD, is a postdoctoral fellow at the James L Winkle College of Pharmacy, University of Cincinnati, Cincinnati, Ohio
| | - Betty Chaar
- BPharm, MHLaw, PhD, is a Senior Lecturer with the Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia
| | - Rebekah J Moles
- BPharm, DipHospPharm, PhD, GradCertEdStud(Higher Ed), is a Senior Lecturer with the Faculty of Pharmacy, University of Sydney, Sydney, New South Wales, Australia. She is also an Associate Editor with the CJHP
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Chanakit T, Low BY, Wongpoowarak P, Moolasarn S, Anderson C. Does a transition in education equate to a transition in practice? Thai stakeholder's perceptions of the introduction of the Doctor of Pharmacy programme. BMC MEDICAL EDUCATION 2015; 15:205. [PMID: 26585968 PMCID: PMC4653906 DOI: 10.1186/s12909-015-0473-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 10/22/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND Pharmacy education and pharmacy practice are facing remarkable changes following new scientific discoveries, evolving patient needs and the requirements of advanced pharmacy competency for practices. Many countries are introducing or undertaking major transformations in pharmacy education. The Thai pharmacy curriculum has been changed from a 5-year BPharm and a 6-year PharmD to only a 6-year PharmD programme. Curriculum change processes usually involve stakeholders, including both internal and external educational institutions, at all levels. This study aims to understand the experiences and perceptions of stakeholders regarding the transition to an all-PharmD programme in Thailand. METHODS Semi-structured interviews were conducted in Thailand with 130 stakeholders (e.g., policy makers, pharmacy experts, educators, health care providers, patients, students and parents) from August-October 2013. The interviews were audio recorded, transcribed verbatim and analysed using an inductive thematic analysis. RESULTS Three main themes were derived from the findings: 1. influences on curriculum change (e.g., the needs of pharmacists to provide better patient care, the US-Thai consortium for the development of pharmacy education); 2. perceived benefits (e.g., improve pharmacy competencies from generalists to specialists, ready to work after graduation, providing a high quality of patient care); and 3. concerns (e.g., the higher costs of study for a longer period of time, the mismatch between the pharmacy graduates' competency and the job market's needs, insufficient preceptors and training sites, lack of practical experience of the faculty members and issues related to the separate licenses that are necessary due to the difference in the graduates' specialties). CONCLUSIONS This is the first study to highlight the issues surrounding the transition to the 6-year PharmD programme in Thailand, which was initiated due to the need for higher levels of competency among the nation's pharmacists. The transition was influenced by many factors. Many participants perceived benefits from the new pharmacy curriculum. However, some participants were concerned about this transition. Although most of the respondents accepted the need to go forward to the 6-year PharmD programme, designing an effective curriculum, providing a sufficient number of qualified PharmD preceptors, determining certain competencies of pharmacists in different practices and monitoring the quality of pharmacy education still need to be addressed during this transitional stage of pharmacy education in Thailand.
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Affiliation(s)
| | - Bee Yean Low
- School of Pharmacy, Faculty of Science, University of Nottingham Malaysia Campus, Semenyih, Selangor Darul Ehsan, Malaysia
| | - Payom Wongpoowarak
- Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Songkhla, Thailand
| | - Summana Moolasarn
- Faculty of Pharmaceutical Sciences, Ubon Ratchathani University, Warin Chamrap, Ubon Ratchathani, Thailand
| | - Claire Anderson
- School of Pharmacy, University of Nottingham, Nottingham, UK
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Penm J, Chaar B, Rose G, Moles R. Pharmacists' influences on prescribing: validating a clinical pharmacy services survey in the Western Pacific Region. Res Social Adm Pharm 2014; 11:63-73. [PMID: 25042568 DOI: 10.1016/j.sapharm.2014.04.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Revised: 04/02/2014] [Accepted: 04/02/2014] [Indexed: 11/30/2022]
Abstract
BACKGROUND Hospital pharmacists around the world are becoming increasingly involved in promoting the responsible use of medicines through clinical pharmacy services. This is reflected in the Basel Statements developed by the International Pharmaceutical Federation Hospital Pharmacy Section, particularly the theme 'Influences on Prescribing.' Some countries, particularly in Asia, are currently establishing clinical pharmacy services and would benefit from identification of facilitators. OBJECTIVES To validate a survey exploring clinical pharmacy services focusing on pharmacists' influences on prescribing, based on Basel Statements 28-31, and the factors that affect their implementation in the Western Pacific Region (WPR). METHODS Content and face validity of the survey (BS28-31) was established. This resulted in the BS28-31 consisting of 20 questions, which included a Clinical Pharmacy Services Facilitators (CPSF) scale (25 items) to measure respondents' perceptions of facilitators of clinical pharmacy services. The BS28-31 was emailed to hospital pharmacy directors in the WPR. The survey was made available in English, Japanese, Chinese, Vietnamese, Lao, Khmer, French and Mongolian. Principal components and internal consistency analyses were conducted to assess the reliability and construct validity of the CPSF scale. RESULTS The final survey was sent to a total of 2525 hospital pharmacy directors in the WPR of which 726 were returned from 31 nations yielding a response rate of 29%. Two items in the scale were removed due to low communalities (0.22 and 0.16). The resulting 23 item scale produced a parsimonious two-factor solution, divided into internal (e.g. individual pharmacist traits and pharmacy departmental structure/resources) and environmental facilitators (e.g. government support, patient and physician expectations). This two factor solution explained 51.5% of the variance. In addition, the Cronbach's α for the internal and environmental subscales were 0.94 and 0.78 respectively. CONCLUSION The BS28-31 survey was found to be a reliable and valid instrument for assessing hospital pharmacy directors' perceptions of clinical pharmacy services regarding pharmacists' influences on prescribing and their facilitators in the WPR.
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Affiliation(s)
- Jonathan Penm
- Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, The University of Sydney, Camperdown, NSW 2006, Australia.
| | - Betty Chaar
- Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, The University of Sydney, Camperdown, NSW 2006, Australia
| | - Grenville Rose
- Aftercare, Rozelle Hospital, Church Street, Lilyfield, NSW, Australia
| | - Rebekah Moles
- Faculty of Pharmacy, World Hospital Pharmacy Research Consortium, The University of Sydney, Camperdown, NSW 2006, Australia
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Whitty JA, Kendall E, Sav A, Kelly F, McMillan SS, King MA, Wheeler AJ. Preferences for the delivery of community pharmacy services to help manage chronic conditions. Res Social Adm Pharm 2014; 11:197-215. [PMID: 25116938 DOI: 10.1016/j.sapharm.2014.06.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2014] [Revised: 06/27/2014] [Accepted: 06/27/2014] [Indexed: 11/27/2022]
Abstract
BACKGROUND To optimize positive outcomes, the design of new pharmacy services should consider the preferences of consumers with chronic condition(s) and their carers. OBJECTIVES (i) To evaluate the relative importance of community pharmacy service characteristics, from the perspective of consumers with chronic condition(s) and carers; (ii) To compare consumer and carer preferences to health professional beliefs about ideal service characteristics for consumers. METHOD A discrete choice experiment was completed by consumers with chronic condition(s) and/or carers (n = 602) and health professionals (n = 297), recruited from four regions in Australia. Participants were each randomized to one survey version containing four (from a total 72) different choices between two new pharmacy services. Consumer and carer participants were also given an 'opt out' alternative of current service. Each service was described using six attributes related to pharmacy service characteristics: continued medicines supply, continuity and coordinated care, location, medication management, education and information, and cost. RESULTS Consumers and carers placed highest priority on continued medicines supply by a pharmacist for regular and symptom flare up medicines (100 priority points), a pharmacy located within a 'one-stop' health center (61 points) and home delivery of medicines (52 points). Although continued medicines supply was most important for consumers and carers, pharmacy location was perceived by health professionals to be the most important characteristic for consumers. Participants were less inclined to choose new services if their current pharmacy offered high quality services that were person-centered, easy to access and responsive to their needs. Younger, more highly educated and employed participants, and those with established condition(s) were more likely to choose new services. CONCLUSIONS Person-centered care is a fundamental tenet for pharmacy services. The provision of continued medicines supply (e.g. through pharmacist prescribing), convenient and coordinated care delivered through a one stop health centre, and home delivery of medicines, should be prioritized when planning pharmacy services to best assist consumers to manage chronic conditions.
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Affiliation(s)
- Jennifer A Whitty
- School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia; Griffith Health Institute and Centre for Applied Health Economics, School of Medicine, Griffith University, Queensland, Australia.
| | - Elizabeth Kendall
- Centre of National Research on Disability and Rehabilitation Medicine, Griffith Health Institute, Griffith University, Queensland, Australia
| | - Adem Sav
- Griffith Health Institute, Griffith University, Queensland, Australia
| | - Fiona Kelly
- Griffith Health Institute, Griffith University, Queensland, Australia; Faculty of Medical and Health Sciences, University of Auckland, New Zealand
| | - Sara S McMillan
- Griffith Health Institute, Griffith University, Queensland, Australia
| | - Michelle A King
- School of Pharmacy, Griffith Health Institute, Griffith University, Gold Coast, Queensland, Australia
| | - Amanda J Wheeler
- Griffith Health Institute, Griffith University, Queensland, Australia; Faculty of Medical and Health Sciences, University of Auckland, New Zealand
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Hanna T, Bajorek B, Lemay K, Armour CL. Using scenarios to test the appropriateness of pharmacist prescribing in asthma management. Pharm Pract (Granada) 2014; 12:390. [PMID: 24644524 PMCID: PMC3955869 DOI: 10.4321/s1886-36552014000100009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2013] [Accepted: 03/08/2014] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE To explore the potential for community pharmacist prescribing in terms of usefulness, pharmacists' confidence, and appropriateness, in the context of asthma management. METHODS Twenty community pharmacists were recruited using convenience sampling from a group of trained practitioners who had already delivered asthma services. These pharmacists were asked to complete a scenario-based questionnaire (9 scenarios) modelled on information from real patients. Pharmacist interventions were independently reviewed and rated on their appropriateness according to the Respiratory Therapeutic Guidelines (TG) by three expert researchers. RESULTS In seven of nine scenarios (78%), the most common prescribing intervention made by pharmacists agreed with TG recommendations. Although the prescribing intervention was appropriate in the majority of cases, the execution of such interventions was not in line with guidelines (i.e. dosage or frequency) in the majority of scenarios. Due to this, only 47% (76/162) of the interventions overall were considered appropriate. However, pharmacists were deemed to be often following common clinical practice for asthma prescribing. Therefore 81% (132/162) of prescribing interventions were consistent with clinical practice, which is often not guideline driven, indicating a need for specific training in prescribing according to guidelines. Pharmacists reported that they were confident in making prescribing interventions and that this would be very useful in their management of the patients in the scenarios. CONCLUSIONS Community pharmacists may be able to prescribe asthma medications appropriately to help achieve good outcomes for their patients. However, further training in the guidelines for prescribing are required if pharmacists are to support asthma management in this way.
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Affiliation(s)
- Tamer Hanna
- The University of Sydney . Sydney, NSW ( Australia )
| | - Beata Bajorek
- University of Technology Sydney . Sydney, NSW ( Australia )
| | - Kate Lemay
- Woolcock Institute of Medical Research, The University of Sydney . Sydney, NSW ( Australia )
| | - Carol L Armour
- Woolcock Institute of Medical Research, The University of Sydney . Sydney, NSW ( Australia ).
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