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Karakolias S, Georgi C, Georgis V. Patient Satisfaction With Public Pharmacy Services: Structural and Policy Implications From Greece. Cureus 2024; 16:e58654. [PMID: 38770511 PMCID: PMC11103120 DOI: 10.7759/cureus.58654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2024] [Indexed: 05/22/2024] Open
Abstract
Objectives This study aimed at investigating patient satisfaction with services offered by a certain type of public pharmacies in Greece (National Organisation for Healthcare Provision (EOPYY) pharmacies), tasked with dispensing mostly high-cost drugs, in an effort to highlight the aspects to be optimized. Methods The Patient Satisfaction with Pharmacist Services Questionnaire 2.0 (PSPSQ 2.0) questionnaire was the main instrument of our research. We received 201 full responses from patients themselves and patients' companions who had visited EOPYY pharmacies in Athens, the capital city of Greece, from October 2022 to January 2023. Results Patients seem satisfied with public pharmacies in general. In fact, the professionalism of the pharmacists, the respect that patients have received from them, and the information and explanations that were given by pharmacists, received a very high score. On the other hand, the parameters referred to the information that patients received from pharmacists for the overall improvement of their health had the lowest score, revealing an apparent lag in the field of medicinal advice. Conclusion Without any doubt, patients expect their pharmacists to be more guiding and to better communicate this role. This requires more time to be spent with patients, focused training, teamwork, layout, and other organizational interventions.
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Affiliation(s)
- Stefanos Karakolias
- Post-Graduate Program in Health Care Management, Hellenic Open University, Patras, GRC
| | - Christina Georgi
- Business Administration Department, University of Patras, Patras, GRC
| | - Vasileios Georgis
- Post-Graduate Program in Health Care Management, Hellenic Open University, Patras, GRC
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2
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Carter M, Abutheraa N, Ivers N, Grimshaw J, Chapman S, Rogers P, Simeoni M, Antony J, Watson MC. Audit and feedback interventions involving pharmacists to influence prescribing behaviour in general practice: a systematic review and meta-analysis. Fam Pract 2023; 40:615-628. [PMID: 36633309 PMCID: PMC10745261 DOI: 10.1093/fampra/cmac150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
INTRODUCTION Pharmacists, as experts in medicines, are increasingly employed in general practices and undertake a range of responsibilities. Audit and feedback (A&F) interventions are effective in achieving behaviour change, including prescribing. The extent of pharmacist involvement in A&F interventions to influence prescribing is unknown. This review aimed to assess the effectiveness of A&F interventions involving pharmacists on prescribing in general practice compared with no A&F/usual care and to describe features of A&F interventions and pharmacist characteristics. METHODS Electronic databases (MEDLINE, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, (Social) Science Citation Indexes, ISI Web of Science) were searched (2012, 2019, 2020). Cochrane systematic review methods were applied to trial identification, selection, and risk of bias. Results were summarized descriptively and heterogeneity was assessed. A random-effects meta-analysis was conducted where studies were sufficiently homogenous in design and outcome. RESULTS Eleven cluster-randomized studies from 9 countries were included. Risk of bias across most domains was low. Interventions focussed on older patients, specific clinical area(s), or specific medications. Meta-analysis of 6 studies showed improved prescribing outcomes (pooled risk ratio: 0.78, 95% confidence interval: 0.64-0.94). Interventions including both verbal and written feedback or computerized decision support for prescribers were more effective. Pharmacists who received study-specific training, provided ongoing support to prescribers or reviewed prescribing for individual patients, contributed to more effective interventions. CONCLUSIONS A&F interventions involving pharmacists can lead to small improvements in evidence-based prescribing in general practice settings. Future implementation of A&F within general practice should compare different ways of involving pharmacists to determine how to optimize effectiveness.PRISMA-compliant abstract included in Supplementary Material 1.
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Affiliation(s)
- Mary Carter
- Department of Life Sciences, University of Bath, Bath, United Kingdom
| | - Nouf Abutheraa
- School of Medicine, University of Aberdeen, Aberdeen, United Kingdom
| | - Noah Ivers
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Jeremy Grimshaw
- Centre for Implementation Research, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Sarah Chapman
- Department of Life Sciences, University of Bath, Bath, United Kingdom
| | - Philip Rogers
- Department of Life Sciences, University of Bath, Bath, United Kingdom
| | | | - Jesmin Antony
- Women’s College Research Institute, Women’s College Hospital, Toronto, Ontario, Canada
| | - Margaret C Watson
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, United Kingdom
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3
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Macé F, De Vriese C, Nelissen-Vrancken M, Ruggli M, Brülhart M, Peyron C. General practitioners-community pharmacists pharmacotherapy discussion groups: Analysis of their implementation through a series of case studies. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2023; 12:100331. [PMID: 37772034 PMCID: PMC10523268 DOI: 10.1016/j.rcsop.2023.100331] [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: 06/24/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/30/2023] Open
Abstract
Background The evolution of primary care practice has led to the implementation of pharmacotherapy discussion groups between general practitioners and community pharmacists (PPPDGs) in some countries. The aim of these groups is to improve drug prescribing practices and strengthen interprofessional relationships. Objective To gain more insight into factors involved in successful implementation of PPPDGs. Methods PPPDG implementation in three countries (Belgium, the Netherlands, Switzerland), was analyzed in a series of case studies. A grid describing different evaluation criteria was completed by stakeholders in their respective country. The data collection was followed by a literature review. Results Various models were used to implement PPPDGs within each country and different dynamics were encountered. PPPDGs lead to positive effects on the quality and cost-effectiveness of drug prescribing and on the collaboration between general practitioners (GPs) and community pharmacists (CPs). Factors involved in implementation were also identified, such as expectations of GPs and CPs, configuration of the implemented model, and the role of CPs in the healthcare organization. Conclusions This study provides insight into the factors involved in successful implementation of PPPDGs in Belgium, the Netherlands and Switzerland. The findings can be used by healthcare professionals to improve the safety, cost-effectiveness of drug prescriptions and systems in primary care. This study offers a starting point for further research in the field.
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Affiliation(s)
- Florent Macé
- Economics Laboratory of Dijon, University of Burgundy, Dijon, France
| | - Carine De Vriese
- Department of Pharmacotherapy and Pharmaceutics, Faculty of Pharmacy, Université Libre de Bruxelles, Brussels, Belgium
| | | | - Martine Ruggli
- President of pharmaSuisse, Swiss Society of Pharmacists, Berne-Liebefeld, Switzerland
| | - Mélanie Brülhart
- Project manager Quality Circles, Swiss Society of Pharmacists, pharmaSuisse, Berne-Liebefeld, Switzerland
| | - Christine Peyron
- Economics Laboratory of Dijon, University of Burgundy, Dijon, France
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4
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Sudeshika T, Deeks LS, Naunton M, Peterson GM, Kosari S. Evaluating the potential outcomes of pharmacist-led activities in the Australian general practice setting: a prospective observational study. Int J Clin Pharm 2023:10.1007/s11096-023-01604-x. [PMID: 37269443 PMCID: PMC10239215 DOI: 10.1007/s11096-023-01604-x] [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: 02/10/2023] [Accepted: 05/10/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Pharmacists have been co-located in general practice teams to support the quality use of medicines and optimise patient health outcomes. Evidence of the impact of pharmacist-led activities in Australian general practices is sparse. AIM This study aimed to evaluate the potential outcomes of pharmacist-led activities in Australian general practices. METHOD A prospective observational study was conducted in eight general practices in the Australian Capital Territory, where each general practice employed a pharmacist on a part-time basis for 18 months. A recommended, but flexible, list of activities was provided for pharmacists. Descriptive information on general practice pharmacist-led activities, collected with an online diary, was analysed. The potential clinical, economic, and organisational impact of pharmacist-led clinical activities was evaluated using the CLinical Economic Organisational (CLEO) tool, with a modified economic dimension. RESULTS Nine pharmacists reported 4290 activities over 3918.5 work hours in general practice. Medication management services were the primary clinical activity of pharmacists. In medication reviews, 75% of the pharmacists' recommendations were fully accepted by general practitioners. Conducting clinical audits, updating patients' medical records, and providing information to patients and staff were other major activities of pharmacists. Of 2419 clinical activities, around 50% had the potential for a moderate or major positive clinical impact on patients. Sixty-three per cent of activities had the potential to decrease healthcare costs. Almost all the pharmacist-led clinical activities had a positive organisational impact. CONCLUSION Most pharmacist-led clinical activities in general practice had the potential for a positive impact on patients and reduction in healthcare costs, supporting the expansion of this model in Australia.
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Affiliation(s)
- Thilini Sudeshika
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia.
- Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, 20400, Sri Lanka.
| | - Louise S Deeks
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
| | - Mark Naunton
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
| | - Gregory M Peterson
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS, 7005, Australia
| | - Sam Kosari
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT, 2617, Australia
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5
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Sudeshika T, Naunton M, Peterson GM, Deeks LS, Guénette L, Sharma R, Freeman C, Niyonsenga T, Kosari S. Interprofessional Collaboration and Team Effectiveness of Pharmacists in General Practice: A Cross-National Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:394. [PMID: 36612716 PMCID: PMC9819811 DOI: 10.3390/ijerph20010394] [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: 10/28/2022] [Revised: 12/17/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
As team-based care continues to evolve, pharmacists have been included in general practice teams in many countries, to varying extents, to improve medication use and patient safety. However, evidence on interprofessional collaboration and team effectiveness of pharmacists in general practice is sparse. This study aimed to compare the extent of interprofessional collaboration and team effectiveness of general practice pharmacists in Australia with international sites (Canada and the UK), and identify the factors associated with interprofessional collaboration and team effectiveness. General practice pharmacists from Australia, Canada, and the UK were identified through professional organisations and networks, and invited to participate in an online survey, adapted from existing validated tools. The survey explored interprofessional collaboration through four sub-domains (professional interactions, relationship initiation, trust and role clarity, and commitment to collaboration) and team effectiveness of general practice pharmacists. Of the 101 respondents (26 from Australia, 44 from Canada and 31 from the UK), 79% were female and 78% were aged below 50 years. Interprofessional collaboration and team effectiveness appeared to be high and similar between countries. Total scores for collaboration of pharmacists were 86.1 ± 7.4 in Australia, 88.5 ± 7.5 in the UK, and 89.1 ± 7.3 in Canada (mean ± SD, where higher scores represent more advanced collaboration), while the team effectiveness scores of the pharmacists were 88.6 ± 14.6 in Canada, 91.8 ± 14.6 in Australia and 97.5 ± 14.0 in the UK. Pharmacists who had worked in general practice for a longer time showed advanced interprofessional collaboration while those who worked exclusively in general practice had higher scores for team effectiveness. Overall, general practice pharmacists in the three countries were highly collaborative with general practitioners. Long-term employment and longer work hours could enhance interprofessional collaboration and team effectiveness in general practice pharmacists by improving trust and working relationships over time.
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Affiliation(s)
- Thilini Sudeshika
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
- Department of Pharmacy, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya 20400, Sri Lanka
| | - Mark Naunton
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
| | - Gregory M. Peterson
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, TAS 7005, Australia
| | - Louise S. Deeks
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
| | - Line Guénette
- Faculty of Pharmacy, Laval University, Quebec, QC GIV 0A6, Canada
| | - Ravi Sharma
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
- Bedfordshire Hospitals NHS Foundation Trust, Luton LU4 0DZ, UK
| | - Christopher Freeman
- School of Pharmacy, Faculty of Health and Behavioural Sciences, University of Queensland, Woolloongabba, QLD 4102, Australia
- Faculty of Medicine, The University of Queensland, Herston, QLD 4006, Australia
- Metro North Hospital and Health Service, Herston, QLD 4006, Australia
| | - Theo Niyonsenga
- Health Research Institute, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
| | - Sam Kosari
- Discipline of Pharmacy, Faculty of Health, University of Canberra, Bruce, ACT 2617, Australia
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6
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Murugesu K, Massé O, Maheu A, Guénette L. What is community pharmacists’ level of comfort and interest in managing patients with or at risk of major neurocognitive disorders? Can Pharm J (Ott) 2022; 155:302-308. [DOI: 10.1177/17151635221128552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 06/09/2022] [Accepted: 06/24/2022] [Indexed: 11/17/2022]
Affiliation(s)
| | - Olivier Massé
- Faculté de pharmacie, Université de Montréal, Montréal
- Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Nord-de-l’île-de-Montréal, Montréal
| | - Anne Maheu
- Faculté de pharmacie, Université de Montréal, Montréal
- Centre intégré universitaire de santé et de services sociaux (CIUSSS) du Nord-de-l’île-de-Montréal, Montréal
| | - Line Guénette
- Faculté de pharmacie, Université Laval, Québec
- Centre de Recherche du CHU de Québec, Axe Santé des Populations et Pratiques Optimales en Santé, Québec, Québec
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7
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Guénette L, Kröger E, Bonnan D, Maheu A, Morin M, Bélanger L, Vedel I, Wilchesky M, Sirois C, Durand É, Couturier Y, Sourial N. Reorganizing pharmaceutical care in family medicine groups for seniors with or at risk of major neurocognitive disorders: a mixed-methods study protocol (Preprint). JMIR Res Protoc 2022; 11:e42577. [DOI: 10.2196/42577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/05/2022] [Accepted: 10/20/2022] [Indexed: 11/07/2022] Open
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Hurley E, Gleeson LL, Byrne S, Walsh E, Foley T, Dalton K. General practitioners' views of pharmacist services in general practice: a qualitative evidence synthesis. Fam Pract 2022; 39:735-746. [PMID: 34564715 PMCID: PMC9295606 DOI: 10.1093/fampra/cmab114] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Pharmacist services in general practice are expanding worldwide, with evidence to show pharmacists' presence in general practice has financial, workload, and clinical benefits. Yet, little is known globally about general practitioners' (GPs') views on their presence in general practice. OBJECTIVE To synthesize the qualitative research evidence on GPs' views of pharmacist services in general practice. METHODS Qualitative evidence synthesis; 8 electronic databases were searched from inception to April 2021 for qualitative studies that reported the views of GPs regarding pharmacist services in general practice. Data from included studies were analyzed using thematic synthesis. The Confidence in the Evidence from Reviews of Qualitative research (CERQual) approach was used to assess the confidence in individual review findings. RESULTS Nineteen studies were included, which captured the views of 159 GPs from 8 different countries. Four analytical themes describing the factors that should be considered in the development or optimization of pharmacist services in general practice, based on the views of GPs, were developed from the coded data and descriptive themes: (i) optimal environment for a pharmacist, (ii) the ideal pharmacist characteristics, (iii) complex stakeholder relationships, and (iv) benefits of an effective pharmacist. CONCLUSION Based on the synthesis of GPs' views, we have created a conceptual model of factors that should be considered by policymakers, GPs, pharmacists, and other relevant stakeholders when developing or optimizing pharmacist services in general practice going forward.
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Affiliation(s)
- Eoin Hurley
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Laura L Gleeson
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Stephen Byrne
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
| | - Elaine Walsh
- Department of General Practice, University College Cork, Cork, Ireland
| | - Tony Foley
- Department of General Practice, University College Cork, Cork, Ireland
| | - Kieran Dalton
- Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland
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9
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Gazda NP, Vest TA, Peek GK, Eckel SF. A new perspective: Practice-enhancing publications about the ambulatory care medication-use process in 2020. Am J Health Syst Pharm 2022; 79:1697-1727. [PMID: 35764076 DOI: 10.1093/ajhp/zxac177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
DISCLAIMER In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE This article identifies, prioritizes, and summarizes published literature on the ambulatory care medication-use process (ACMUP) from calendar year 2020 that can impact ambulatory pharmacy practice. SUMMARY The medication-use process is the foundational system that provides the framework for safe medication utilization within the healthcare environment and was reimagined to focus on new innovations and advancements in ambulatory pharmacy practice. The ACMUP is defined in this article as having the following components: transitions of care, prescribing and collaborative practice, accessing care, adherence, and monitoring and quality. Articles evaluating at least one step of the ACMUP were assessed for their usefulness toward practice improvement. A PubMed search covering calendar year 2020 was conducted in January 2021 using targeted Medical Subject Headings (MeSH) keywords and the table of contents of selected pharmacy journals, providing a total of 9,433 articles. A thorough review identified 65 potentially practice-enhancing articles: 14 for transitions of care, 19 for prescribing and collaborative practice, 10 for adherence, 6 for accessing care, and 16 for monitoring and quality. Ranking of the articles for importance by peers led to the selection of key articles from each category. The highest-ranked articles are briefly summarized, with a mention of why each article is important. The other articles are listed for further review and evaluation. CONCLUSION It is important to routinely review the published literature and to incorporate significant findings into daily practice. This article is the first to define and evaluate the currently published literature pertinent to the ACMUP. As healthcare continues to advance and care shifts to ambulatory settings, the ACMUP will continue to be a crucial process to evaluate.
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Affiliation(s)
| | - Tyler A Vest
- Duke University Hospital, Durham, NC, and University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Grayson K Peek
- Vanderbilt University Medical Center, Nashville, TN, USA
| | - Stephen F Eckel
- University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, and University of North Carolina Medical Center, Chapel Hill, NC, USA
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10
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Deploying and Maintaining Standards of New Pharmacy Services Provision in Poland-Introducing the National Pharmacist Competencies Assessment Tool: Pre-Registration Exam–Results of the Pilot Project. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19137809. [PMID: 35805468 PMCID: PMC9266189 DOI: 10.3390/ijerph19137809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 02/04/2023]
Abstract
Despite the functioning of the Bologna Declaration, the knowledge and skills of graduates educated in different countries may differ significantly. Therefore, this article aims to present the differences in results of the final exam in pharmacy among Polish pharmacy students. This exam was modeled on the British national exam supervised by the General Pharmaceutical Council. The exam was conducted in three cities in Poland, among a total of 175 final-year students (a full sample of those eligible was 451 with 276 refusals (38.58% response rate)). Taking the exam was voluntary and anonymous. The results indicate that none of the Polish students achieved the 70% mark required to pass the Great Britain exam. Significant differences in test results were noticed between cities. Students achieved the best average exam result in Bydgoszcz (46.35%), then in Warsaw (38.81%) and Łódź (38.35%). The pharmaceutical education system in Poland requires complete changes that will prepare future pharmacists for clinical work.
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11
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Guénette L, Maheu A, Vanier MC, Dugré N, Rouleau L, Roy-Petit J, Lalonde L. Pharmacists practising in family medicine groups: An evaluation 2 years after experiencing a virtual community of practice. Can Pharm J (Ott) 2022; 155:39-49. [PMID: 35035641 PMCID: PMC8756373 DOI: 10.1177/17151635211049235] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background: In 2018, a virtual community of practice (CoP) for pharmacists working in family medicine groups (FMGs) in Quebec province was developed. The aim of this CoP—called Réseau Québécois des Pharmaciens GMF (RQP GMF)—was to foster best practices by supporting FMG pharmacists. This study assesses the processes and outcomes of this CoP 2 years after its creation. Methods: We performed a cross-sectional web-based study from March to May 2020. All FMG pharmacists who were registered as members of the RQP GMF (n = 326) were sent an invitation via a newsletter. The link to the questionnaire was also publicized in the CoP Facebook group. The questionnaire comprised a 38-item validated instrument assessing 8 dimensions of the CoP. A descriptive analysis was performed. Results: A total of 112 FMG pharmacists (34.4%) completed the questionnaire. Respondents agreed that the RQP GMF was a joint enterprise (mean score, 4.18/5), that members shared their knowledge (mean score, 3.94/5) and engaged mutually (mean score, 3.50/5) and that the RQP GMF provided support (mean score, 3.92/5) and capacity building (mean score, 4.01/5). In general, they were satisfied with the implementation process (mean score, 3.68/5) and with activities proposed (mean score, 3.79/5). A lower proportion of respondents agreed that their participation in the RQP GMF generated external impacts, which led to a smaller mean score (3.37/5) for this dimension. Conclusion: The RQP GMF, one of the first communities of practice for pharmacists practising in family medicine groups, attained most of the objectives initially intended by the CoP. These results will facilitate the adaptation of processes and activities to better fulfil members’ needs. Can Pharm J (Ott) 2021;154:xx-xx.
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Affiliation(s)
| | - Anne Maheu
- Centre intégré universitaire de santé et de services sociaux du Nord-de-l'île-de-Montréal
| | | | - Nicolas Dugré
- Centre intégré universitaire de santé et de services sociaux du Nord-de-l'île-de-Montréal
| | | | | | - Lyne Lalonde
- Faculté de pharmacie, Université de Montréal, Montréal
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12
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Cossette B, Ricard G, Poirier R, Gosselin S, Langlois MF, Imbeault P, Breton M, Couturier Y, Sirois C, Lessard-Beaudoin M, Rodrigue C, Teasdale J, Turcotte JP, Mallet L. Pharmacist-led transitions of care between hospitals, primary care clinics, and community pharmacies. J Am Geriatr Soc 2021; 70:766-776. [PMID: 34817853 DOI: 10.1111/jgs.17575] [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: 07/17/2021] [Revised: 10/26/2021] [Accepted: 10/30/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Pharmacist-led transitions of care (TOC) interventions have been described as some of the most promising interventions to reduce medication-related harm (MRH) in older adults. This study analyzed the feasibility of pharmacist-led TOC interventions between hospitals, multidisciplinary primary care clinics (PCC), and community pharmacies. METHODS Adults aged 65 years and older at risk of MRH in three regions of Quebec, Canada, with contrasting contexts of care based on university affiliation were recruited in this multicenter, single arm, and prospective intervention cohort. The hospital pharmacist developed the pharmaceutical care plan in collaboration with the hospital physician and transferred this plan with the hospitalization summary, at hospital discharge, to the PCC family physician and to the community and PCC pharmacists. A consultation with the community pharmacist was scheduled within seven days of hospital discharge and with the PCC pharmacist when appropriate. Feasibility outcomes included the time to complete the interventions and their location. RESULTS The 123 eligible patients had a mean age of 78.5 years, and 63.4% were females. The most frequent inclusion criterion was 10 medications or more, including one high-risk medication for 90 patients (73%). Recruitment in one region was stopped after three months due to unsuccessful recruitment of key PCC. The hospital pharmacist interventions took a median of 165 min. The first consultations of the PCC and community pharmacists took a median of 15 and 50 min. Among the 96 patients with a post-discharge pharmacist follow-up, 23 (24.0%) had a consultation with a PCC pharmacist, with 65.2% of the consultations conducted at the PCC. The community pharmacists conducted a consultation with 88 patients (93%), with more than 70% of consultations conducted by phone. CONCLUSION Our study showed the feasibility of pharmacist-led TOC interventions between hospitals, PCC, and community pharmacies and detailed the novel role that PCC pharmacists played in optimizing TOC interventions.
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Affiliation(s)
- Benoit Cossette
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Canada.,Research Centre on Aging, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada.,Department of Pharmacy, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada
| | - Geneviève Ricard
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Canada.,Department of Medicine, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada
| | - Rolande Poirier
- Department of Pharmacy, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada
| | - Suzanne Gosselin
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Canada.,Department of General Medicine, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada
| | - Marie-France Langlois
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Canada.,Department of Medicine, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada.,CHUS Research Centre, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada
| | - Philippe Imbeault
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Canada
| | - Mylaine Breton
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Sherbrooke, Canada
| | - Yves Couturier
- Faculty of Arts and Human Sciences, University of Sherbrooke, Sherbrooke, Canada
| | | | - Mélissa Lessard-Beaudoin
- Research Centre on Aging, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada
| | - Claudie Rodrigue
- Research Centre on Aging, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada
| | - Julie Teasdale
- Research Centre on Aging, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada
| | - Jean-Philippe Turcotte
- Research Centre on Aging, Integrated University Health and Social Services Centre of Estrie, Sherbrooke, Canada
| | - Louise Mallet
- Faculty of Pharmacy, University of Montreal, Montreal, Canada.,Department of Pharmacy, McGill University Health Centre, Montreal, Canada
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Communication between hospitals, Family Medicine Groups and community pharmacists during transitions of care interventions. Res Social Adm Pharm 2021; 18:3290-3296. [PMID: 34607778 DOI: 10.1016/j.sapharm.2021.09.006] [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: 07/08/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Pharmacist-led transitions of care (TOC) interventions have been associated with improved health outcomes. Community pharmacists' (CP) TOC communications have been described whereas limited evidence is available for hospital pharmacists (HP) and none for non-dispensing pharmacists, integrated into Family Medicine Groups (FMG). OBJECTIVE To assess information needs and perceptions about TOC communications of HP, FMG pharmacists (FMG-P) and CP and to identify optimal TOC practices and their barriers. METHODS In a cross-sectional design, a survey was distributed via email to the 70 pharmacists who participated in a multicenter, single group, longitudinal TOC intervention study for older adults at risk of medication-related harm. All pharmacists were surveyed on their TOC practices before the TOC study, as part of usual care. Pharmacists who followed TOC study patients were also surveyed on their TOC practices during the TOC study. RESULTS Survey responses were received from 35 pharmacists (50%), including 8 HP, 6 FMG-P and 21 CP. The frequency of communication between pharmacists of different settings increased significantly during the TOC study, with more than 80% of pharmacists reporting satisfaction with the quality of the information provided. At hospital discharge, in optimal TOC, the FMG-P and CP reported that the most important information to transfer was the reasons of hospitalization, patient weight and height, and the therapeutic intent of the medications. The main barriers to TOC implementation were the lack of clinical information about patients for FMG-P and CP and understaffing for HP. FMG-P and CP reported a similar high degree of interest in assuming responsibility for the new extended scope of practice activities of medication adjustments according to therapeutic targets or laboratory results and the implementation of a plan for gradual dose increases or drug tapering. CONCLUSIONS The surveyed pharmacists reported an increased frequency of communication and satisfaction with the information exchanged between the pharmacists of different settings during the TOC study compared to usual care, before the study. The pharmacists extended scope of practice offers new opportunities to optimize TOC interventions.
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Allin S, Martin E, Rudoler D, Church Carson M, Grudniewicz A, Jopling S, Strumpf E. Comparing public policies impacting prescribing and medication management in primary care in two Canadian provinces. Health Policy 2021; 125:1121-1130. [PMID: 34176672 DOI: 10.1016/j.healthpol.2021.06.002] [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: 12/21/2020] [Revised: 05/13/2021] [Accepted: 06/04/2021] [Indexed: 10/21/2022]
Abstract
The challenges of polypharmacy and inappropriate prescribing are recognized internationally. This study synthesizes and compares the policies related to these issues introduced in Canada's two most populous provinces - Ontario and Quebec - over the first two decades of the 21st century. Drawing on policy documents and consultations with experts, we found that while medication management to address polypharmacy and inappropriate prescribing has not been an explicit and consistent policy target in either province, some policy changes sought to directly or indirectly impact medication management. These changes include the introduction of primary care teams that include pharmacists, the introduction of a medication review performed by pharmacists (in Ontario), increased emphasis on quality improvement with some attention to potentially inappropriate medications (specifically opioids in Ontario), and investments in information technology to improve communication across providers and move toward electronic prescribing to improve medication safety and appropriateness. Despite growing evidence of the problem of polypharmacy and inappropriate prescribing, there has been limited policy attention targeting these problems directly, and policy changes with potential to improve prescribing and medication management may not have been fully realized. Further research to evaluate the impact of these changes on provider behaviours, and on patient outcomes, warrants attention.
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Affiliation(s)
- Sara Allin
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada.
| | - Elisabeth Martin
- Faculté des sciences infirmières, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine - local 3645 Québec (Québec), G1V 0A6, Canada.
| | - David Rudoler
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada; Faculty of Health Sciences, Ontario Tech University, 2000 Simcoe St N, Oshawa, ON L1G 0C5, Canada.
| | - Michael Church Carson
- Department of Economics and Department of Epidemiology, Biostatistics and Occupational Health, McGill University Leacock Building, Room 418 855 Sherbrooke Street West, Montreal, QC H3A 2T7, Canada.
| | - Agnes Grudniewicz
- Telfer School of Management / École de gestion Telfer, University of Ottawa / Université d'Ottawa, 55 Laurier Ave. E, Ottawa, ON K1N 6N5, Canada.
| | - Sydney Jopling
- Institute of Health Policy, Management and Evaluation, University of Toronto, 155 College St 4th Floor, Toronto, ON M5T 3M6, Canada
| | - Erin Strumpf
- Department of Economics and Department of Epidemiology, Biostatistics and Occupational Health, McGill University Leacock Building, Room 418 855 Sherbrooke Street West, Montreal, QC H3A 2T7, Canada
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15
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Karampatakis GD, Patel N, Stretch G, Ryan K. Patients' experiences of pharmacists in general practice: an exploratory qualitative study. BMC FAMILY PRACTICE 2021; 22:48. [PMID: 33673805 PMCID: PMC7935482 DOI: 10.1186/s12875-021-01393-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 02/09/2021] [Indexed: 02/02/2023]
Abstract
Background Since 2015, pharmacists have been integrating into English general practices and more recently into primary care networks. General practice-based pharmacists provide a range of patient-facing services, such as medication reviews, management of long-term conditions and minor ailments, prescribing duties and answering queries over the telephone. Literature reports patients’ satisfaction with general practice-based pharmacists’ services, however, previous research captured only limited experiences. The aim of the current study was to pursue an extensive exploration of patients’ experiences of pharmacists in general practice. Methods General practice-based pharmacists, working in practices in West London, Surrey and Berkshire, handed invitation packs to patients seen during consultations. Patients that wanted to take part in the study were invited to undertake a qualitative, in-depth, face-to-face, semi-structured interview within the practice with which each patient was registered. Interviews lasted from 15 min to more than 1 h and were audio-recorded. Recruitment continued until data saturation. Audio-recordings were transcribed verbatim and transcripts analysed thematically. Results Twenty participants were interviewed. Four themes were discerned: awareness (“I had been coming to this practice for 24 years and I didn’t know that there was a pharmacist”); accessibility (“People ring for a GP [general practitioner] appointment … it’s Monday and they [receptionist] tells you ‘We can slot you in on Friday’ … with a pharmacist on board, they can [instantly] look at you”); interactions (“I’ve always had a really good interaction with them [pharmacists] and they listen and they take on board what I’m trying to say”); and feedback (“It’s easier [to collect feedback instantly] because I could have forgotten half of what they [pharmacists] have told me in an hour or so’s time”). Conclusions Findings indicate that pharmacists’ integration into general practices could improve accessibility to, and the quality of, care received. The findings will assist policy development to provide general practice-based pharmacists’ services as per patients’ needs. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-021-01393-0.
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Affiliation(s)
| | - Nilesh Patel
- School of Pharmacy, University of Reading, Whiteknights Campus, PO Box 226, Reading, RG6 6AP, UK.
| | - Graham Stretch
- Ealing GP Federation, 179C Bilton Road, Perivale, Greenford, Middlesex, UB6 7HQ, UK
| | - Kath Ryan
- School of Pharmacy, University of Reading, Whiteknights Campus, PO Box 226, Reading, RG6 6AP, UK
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Karampatakis GD, Patel N, Stretch G, Ryan K. Community pharmacy teams' experiences of general practice-based pharmacists: an exploratory qualitative study. BMC Health Serv Res 2020; 20:431. [PMID: 32423485 PMCID: PMC7236450 DOI: 10.1186/s12913-020-05245-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 04/21/2020] [Indexed: 11/30/2022] Open
Abstract
Background In England, since 2015, there has been a formal drive to integrate pharmacists into general practice as a new healthcare service. Research efforts have offered insights into how general practice-based professionals and patients view the service, however, they took no account of community pharmacy teams’ opinions. There have been anecdotal statements about opposition from community pharmacies to the service, due to fears of losing business. The aim of the current study was to identify the experiences and perceptions of community pharmacy teams regarding pharmacists’ presence in general practice. Methods The National Health Service Choices website was used to identify community pharmacies within a radius of two miles from eight West London general practices. The search resulted in 104 community pharmacies which were all contacted via telephone. Pharmacy staff who verbally expressed their interest to participate were then provided with the study’s documents. Qualitative, face-to-face, semi-structured interviews were conducted inside the pharmacy from which each participant was recruited. Interviews lasted 30 to 45 min and were audio-recorded. Audio-recordings were transcribed verbatim and transcripts analysed thematically. Results Forty-eight community pharmacy staff participated. Four themes were discerned: awareness (“I knew that [pharmacists] have already been implemented [in general practice] but I haven’t really followed it … where does the pharmacist role come?”); interactions (“I’m just so pleased that there’s a pharmacist professional in the general practice … because we speak the same language!”); patient care (“if I was a patient knowing that there is a general practitioner and a pharmacist [in general practice], I would … think ‘nothing can go wrong at the moment’”); and funding challenges (“if general practices take on the extra responsibility of stop smoking or flu vaccination campaigns … financially, this would affect this pharmacy”). Conclusions The current study revealed the perceived impact of general practice-based pharmacists on community pharmacies would be improved communication between pharmacies and practices. Findings will inform policy so that any future framing of pharmacists’ presence in general practice considers the needs of community pharmacies.
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Affiliation(s)
| | - Nilesh Patel
- School of Pharmacy, University of Reading, Whiteknights Campus, PO Box 226, Reading, RG6 6AP, UK
| | - Graham Stretch
- Ealing GP Federation, 179C Bilton Road, Perivale, Greenford, Middlesex, UB6 7HQ, UK
| | - Kath Ryan
- School of Pharmacy, University of Reading, Whiteknights Campus, PO Box 226, Reading, RG6 6AP, UK
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The Creation of a Practice-Based Network of Pharmacists Working in Family Medicine Groups (FMG). PHARMACY 2019; 7:pharmacy7030108. [PMID: 31387213 PMCID: PMC6789885 DOI: 10.3390/pharmacy7030108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Revised: 07/31/2019] [Accepted: 08/02/2019] [Indexed: 11/24/2022] Open
Abstract
A needs assessment study of pharmacists working in family medicine groups (FMG) demonstrated the necessity to build a practice-based network. This network would foster a faster integration into FMG and a more efficient collaborative practice. It would also take advantage of an existing practice-based research network (PBRN)—the STAT (Soutien Technologique pour l’Application et le Transfert des pratiques novatrices en pharmacie) network. A working group of nine FMG pharmacists from the different regions of the province of Quebec, Canada, and a committee of partners, including the key pharmacy organizations, were created. Between January 2018 and May 2019, nine meetings took place to discuss the needs assessment results and deploy an action plan. The practice-based network first year activities allowed identifying pharmacists working in FMGs across the province. A directory of these pharmacists was published on the STAT network. The vision, mission, mandate, name («Réseau Québécois des Pharmaciens GMF») and logo were developed. The first few activities include: Bi-monthly newsletters; a mentorship program; short evidence-based therapeutic letters (pharmacotherapeutic capsules) and a start-up kit to facilitate integration of these pharmacists. The Quebec FMG pharmacist practice-based network has been launched. It is planned to evaluate the members’ satisfaction in late Spring 2020 with regards to activities and resources provided.
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