1
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Rangi P, Marra C, Scahill S, Anwar M. Impact of Promotional Videos on Public Perception of Pharmacy Services. J Pharm Pract 2024; 37:712-721. [PMID: 37192543 DOI: 10.1177/08971900231177201] [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: 05/18/2023]
Abstract
Background: Promotional videos are an effective means of marketing products or services in this era of social media. However, little is known if such videos can be a useful tool to promote pharmacy services. Objective: To assess the impact of promotional videos on public awareness of the health services provided by New Zealand pharmacists. Methods: This experimental study used an online questionnaire and promotional videos developed by the Pharmaceutical Society of New Zealand as an intervention to assess the public's perspectives about pharmacy services before and after the intervention. The survey was sent out to 1 127 randomly selected members of the public aged 18 and above from all over New Zealand. Data were analysed using descriptive statistics and thematic analysis. Results: A total of 313 participants completed the survey. The majority (95.8%) had not heard of the promotional videos before. However, 84.3% found the videos informative and nearly three-quarters (74.1%) reported a change in their perception of pharmacy services after watching the video. Similarly, 63.2% reported that they or a family member would be more likely to visit a pharmacy in the future after watching the promotional video. Less than half (40%) of the participants reported that the videos were too long and only 11.5% found them boring. Conclusion: The PSNZ videos were found to be an effective tool for educating New Zealanders on different pharmacy services and the pharmacy profession, however, there is a need to choose the advertising platform carefully so as to enhance the coverage.
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Affiliation(s)
- Paige Rangi
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Carlo Marra
- School of Pharmacy, University of Otago, Dunedin, New Zealand
| | - Shane Scahill
- School of Pharmacy, University of Auckland, Auckland, New Zealand
| | - Mudassir Anwar
- School of Pharmacy, University of Otago, Dunedin, New Zealand
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2
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d'Entremont-Harris M, MacNabb K, Wilby KJ, Ramsey TD. Pharmacy-based sexually transmitted infection service implementation considerations: A scoping review. J Am Pharm Assoc (2003) 2024; 64:186-196.e2. [PMID: 38453662 DOI: 10.1016/j.japh.2023.10.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND Rates of sexually transmitted infections (STIs) are rising despite significant management efforts in traditional healthcare settings. The growing number of individuals affected by STIs demonstrates a gap in care. Pharmacy-based STI clinical services are a potential solution to improve care. OBJECTIVE To identify and summarize research about the implementation of pharmacy-based STI services, focusing on program characteristics, barriers, facilitators, and pharmacist and patient experiences. METHODS A search of PubMed, Embase, and Cochrane Database of Systematic Reviews was conducted for papers evaluating STI expanded-scope clinical services performed by regulated pharmacists in an outpatient/community pharmacy setting. Study setting, design, data collection method, outcomes, target infection, services offered, patient population, and barriers and facilitators are reported. RESULTS Twelve studies, 11 cross-sectional and 1 randomized control trial, were identified in this review. All studies focused on chlamydia, and two included gonorrhea and trichomoniasis or syphilis. Eleven services investigated STI screening, with four also offering treatment, and two offering partner treatment. Overall, patients reported positive experiences, found the services accessible, and trusted pharmacists. Pharmacists recognized the importance of STI services, were keen, and felt comfortable performing clinical tasks. Patients described convenience as a key facilitator, and concerns about privacy, particularly at the pharmacy counter, and the stigma and fear of judgement associated with STIs as primary barriers. For facilitators, pharmacists reported increased job satisfaction and a sense of relieving the burden on traditional STI services; for barriers, pharmacists highlighted patient recruitment, communication challenges, and lack of remuneration. CONCLUSION Research on pharmacy-based STI services includes predominately small-scale, cross-sectional studies, and focuses on chlamydia screening. Both patients and pharmacists perceive these services to be acceptable and feasible, though strategies addressing patient privacy and recruitment, pharmacist competency, training, and remuneration must be considered to support the success of pharmacy-based STI services.
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3
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Turbyfill C, Thomas I, Agravat N, Prasher JM, Nett RJ, Stevens M, Ricaldi JN, Dunams TM, Brickhouse-Frazier L, Carter MD, Gebru Y, King A, May CS, Miller JD, Oguh C, Pullman A, Roman K, Rose C, Scherr R, Sidibe T, Soelaeman R, Weinstein J, Wilson T, Tran CH. The Impact of Community-Based Testing Sites and Gift Incentives on COVID-19 Testing Uptake in Maryland, April 29 - May 9, 2021. Am J Health Promot 2023; 37:228-232. [PMID: 36007095 PMCID: PMC9412132 DOI: 10.1177/08901171221119796] [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] [Indexed: 02/03/2023]
Abstract
PURPOSE Information on incentives for COVID-19 testing is needed to understand effective practices that encourage testing uptake. We describe characteristics of those who received an incentive after performing a rapid antigen test. DESIGN Cross-sectional descriptive analysis of survey data. SETTING During April 29-May 9, 2021, COVID-19 rapid antigen testing was offered in 2 Maryland cities. SAMPLE Convenience sample of 553 adults (≥18 years) who tested and received an incentive; 93% consented to survey. MEASURES Survey questions assessed reasons for testing, testing history, barriers, and demographics. ANALYSIS Robust Poisson regressions were used to determine characteristic differences based on testing history and between participants who would re-test in the future without an incentive vs participants who would not. RESULTS The most common reasons for testing were the desire to be tested (n = 280; 54%) and convenience of location (n = 146; 28%). Those motivated by an incentive to test (n = 110; 21%) were 5.83 times as likely to state they would not test again without an incentive, compared to those with other reasons for testing (95% CI: 2.67-12.72, P < .001). CRITICAL LIMITATIONS No comparative study group. CONCLUSION Results indicate internal motivation and convenience were prominent factors supporting testing uptake. Incentives may increase community testing participation, particularly among people who have never tested. Keywords COVID-19, pandemic, incentives, health behavior, community testing.
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Affiliation(s)
- Caitlin Turbyfill
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA,Oak Ridge Associated Universities, ORISE Fellowship, Oak Ridge, TN,
USA
| | - Isabel Thomas
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA,Oak Ridge Associated Universities, ORISE Fellowship, Oak Ridge, TN,
USA
| | - Namita Agravat
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA,Namita Agravat, MPH, CDC ELC Project
Officer, 1600 Clifton Rd., Atlanta, DGA, 30333, USA.
| | - Joanna M Prasher
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Randall J Nett
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Melody Stevens
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | | | - Tambra M Dunams
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | | | | | - Yonathan Gebru
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Ashley King
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Coral S May
- eTrueNorth with Health and Human
Services (HHS), Washington, DC, USA
| | | | - Chigo Oguh
- Maryland Department of Health
(MDH), Baltimore, ML, USA
| | - Amanda Pullman
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Kaylin Roman
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Charles Rose
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Robert Scherr
- eTrueNorth with Health and Human
Services (HHS), Washington, DC, USA
| | | | - Rieza Soelaeman
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | | | - Todd Wilson
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
| | - Cuc H Tran
- Centers for Disease Control and
Prevention (CDC), Atlanta, GA, USA
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4
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Ahmaro L, Lindsey L, Forrest S, Whittlesea C. Investigating community pharmacists' perceptions of delivering chlamydia screening to young people: a qualitative study using normalisation process theory to understand professional practice. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:507-513. [PMID: 35867030 DOI: 10.1093/ijpp/riac057] [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: 01/12/2022] [Accepted: 07/06/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Some community pharmacies in England provide free chlamydia testing to young people, yet testing activity in the setting is low. This study aims to increase understanding of why that is, by investigating community pharmacists' perceptions of barriers to delivering the service, and the reasons why some do not offer testing. METHODS Semi-structured interviews were conducted with 22 community pharmacists in North East England between November 2018 and May 2019. The sample comprised both those who provided and did not provide chlamydia testing at the time of the interview. Data were subjected to thematic analysis, utilising the constructs of the normalisation process theory. KEY FINDINGS Pharmacists found it challenging to sustain delivery of chlamydia testing, as very few young people either requested the test or accepted it when it was offered during consultations on other sexual health services. Pharmacists were cautious about offering the test, having concerns about making clients feel uncomfortable. They identified the value of training to enable them to communicate confidently with clients about testing. Pharmacists supported the suggestion that treatment for chlamydia be offered as part of a 'test and treat' package, as they felt that it aligned to their role in the provision of medicines advice. CONCLUSIONS Community pharmacies are well-placed to deliver chlamydia testing but are not operating as effectively as they might do. The provision of training on communicating with young people, integrating testing with more sexual health services, and providing 'test and treatment' for chlamydia could contribute to greater testing activity.
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Affiliation(s)
- Lara Ahmaro
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Lindsey
- School of Pharmacy and Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Simon Forrest
- Department of Sociology, College of St Hild and St Bede, Durham University, Durham, UK
| | - Cate Whittlesea
- Research Department of Practice and Policy, UCL School of Pharmacy, University College London, London, UK
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El-Den S, Lee YLE, Gide DN, O'Reilly CL. Stakeholders' Acceptability of Pharmacist-Led Screening in Community Pharmacies: A Systematic Review. Am J Prev Med 2022; 63:636-646. [PMID: 35688723 DOI: 10.1016/j.amepre.2022.04.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 03/30/2022] [Accepted: 04/15/2022] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Community pharmacists are among the most accessible healthcare providers. Community pharmacist-led screening may facilitate the early detection of illnesses/medical risk factors, optimizing health outcomes. However, it is important to assess the acceptability of screening services to ensure uptake by key stakeholders. The aim of this review was to explore the acceptability of community pharmacist-led screening by all stakeholders (i.e., patients, pharmacists, and other healthcare professionals) and identify the methods used to evaluate the acceptability of screening. METHODS A systematic search was conducted in Embase, MEDLINE, International Pharmaceutical Abstracts, and Scopus in April 2020 since inception. Studies that explored the acceptability of pharmacist-led screening for any risk factor/medical condition(s) within community pharmacies were included. RESULTS A total of 44 studies met the inclusion criteria. A total of 17 studies identified community pharmacies as appropriate screening locations. Seven studies reported that patients were comfortable with participating in pharmacist-led screening. Eight studies explored acceptability from the perspective of medical practitioners and other healthcare professionals, with 6 reporting high recommendation acceptance rates and/or acceptability of pharmacist-led screening. Barriers to pharmacist-led screening included time and privacy constraints, whereas adequate remuneration was considered an important enabler. DISCUSSION Community pharmacist-led screening appears to be acceptable to patients, pharmacists, and other healthcare professionals. However, no uniform psychometrically sound measure of acceptability was used consistently across studies, rendering comparisons difficult and showing the need for future research exploring the psychometric properties of acceptability measures. Findings, including barriers and enablers to pharmacist-led screening, are important to consider when providing screening services in community pharmacies.
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Affiliation(s)
- Sarira El-Den
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Yee Lam Elim Lee
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Duha N Gide
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Claire L O'Reilly
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
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6
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Advances in Pharmacy Practice: A Look towards the Future. PHARMACY 2022; 10:pharmacy10050125. [PMID: 36287446 PMCID: PMC9608826 DOI: 10.3390/pharmacy10050125] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/21/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022] Open
Abstract
This review looks at the factors that may influence practice in the future. Transformation could occur at 3 levels. Firstly, the traditional profession of the pharmacist as a dispenser of medicines is expanding. Secondly, the pharmacist’s activities are progressing into new healthcare fields. Thirdly, other changes are stimulated by global developments. This review may be helpful for pharmacy and healthcare leaders looking at the future configuration and aims of their pharmacy services.
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7
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Ahmaro L, Lindsey L, Forrest S, Whittlesea C. Young people's perceptions of accessing a community pharmacy for a chlamydia testing kit: a qualitative study based in North East England. BMJ Open 2021; 11:e052228. [PMID: 34489295 PMCID: PMC8422476 DOI: 10.1136/bmjopen-2021-052228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 08/26/2021] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES Chlamydia testing among young people in community pharmacies in North East England has been low compared with other remote settings offering testing for the past few years. To understand why this may be, to maximise service provision, the perceptions of young men and women about pharmacy testing and possible chlamydia treatment were gathered and interpreted. DESIGN Indepth, semistructured interviews. SETTING Four youth centres in North East England. PARTICIPANTS The study included 26 young people aged 16-23. The sample of participants comprised those with a history of chlamydia testing as well as those never tested. INTERVIEWS Face-to-face interviews were conducted between October 2018 and May 2019. The interview schedule covered young people's perceptions of sexually transmitted infections, provision of pharmacy sexual and reproductive health and chlamydia testing, and potential chlamydia treatment. Data from the interviews were subjected to thematic analysis. RESULTS The geographical accessibility and long opening times of community pharmacies in North East England were perceived benefits of the service. However, young people had concerns about being judged by pharmacy staff or overheard by customers when requesting the test. Men did not want to be seen by their peers accessing the pharmacy. These barriers were associated with a perceived stigma of chlamydia. Despite this, young people thought that pharmacist advice on the test kit would be important to ensure they complete it correctly. Those never tested favoured how the kit could be taken home to complete the urine sample. The option of including chlamydia treatment was reported to be convenient and comforting. CONCLUSION Supporting pharmacies in North East England to offer a confidential chlamydia testing service is necessary to overcome young people's perceived barriers to testing. Delivering testing as an integrated sexual health package with other pharmacy services, together with treatment where suitable, will increase acceptance for testing and timely access to treatment.
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Affiliation(s)
- Lara Ahmaro
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Laura Lindsey
- School of Pharmacy and Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Simon Forrest
- College of St Hild & St Bede, and Sociology Department, Durham University, Durham, UK
| | - Cate Whittlesea
- Research Department of Practice and Policy, University College London, School of Pharmacy, London, UK
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8
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Navarrete J, Yuksel N, Schindel TJ, Hughes CA. Sexual and reproductive health services provided by community pharmacists: a scoping review. BMJ Open 2021; 11:e047034. [PMID: 34312200 PMCID: PMC8314704 DOI: 10.1136/bmjopen-2020-047034] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES Pharmacists are increasingly providing patient-focused services in community pharmacies, including in the area of sexual and reproductive health (SRH). Specific SRH areas have been the focus of research, but a broader perspective is needed to position pharmacists as SRH providers. This review explored research that described and evaluated professional pharmacy services across a broad range of SRH areas. DESIGN Scoping review DATA SOURCES: Medline, EMBASE, CINAHL, Web of Science, Scopus and Cochrane Library (January 2007-July 2020). STUDY SELECTION Studies reporting on the description and evaluation of professional pharmacy SRH services provided by community pharmacists. DATA EXTRACTION Two investigators screened studies for eligibility, and one investigator extracted the data. Data were analysed to primarily describe professional pharmacy services and intervention outcomes. RESULTS Forty-one studies were included. The main SRH areas and professional pharmacy services reported were sexually transmitted and bloodborne infections (63%) and screening (39%), respectively. Findings showed that pharmacists' delivery of SRH services was feasible, able to reach vulnerable and high-risk groups, and interventions were highly accepted and valued by users. However, integration into daily workflow, pharmacist remuneration, cost and reimbursement for patients, and policy regulations were some of the barriers identified to implementing SRH services. Studies were primarily in specific areas such as chlamydia screening or hormonal contraception prescribing, while studies in other areas (ie, medical abortion provision, long-acting reversible contraception prescribing and vaccine delivery in pregnant women) were lacking. CONCLUSION This scoping review highlights the expansion of pharmacists' roles beyond traditional product-focused services in a number of SRH areas. Given the potential feasibility, users' acceptability and reach, pharmacists are ideally situated to enhance SRH care access. Future research describing implementation and evaluation of professional pharmacy services in all SRH areas is needed to promote access to these services through community pharmacies and position pharmacists as SRH providers worldwide.
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Affiliation(s)
- Javiera Navarrete
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Nese Yuksel
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Theresa J Schindel
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Christine A Hughes
- Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada
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9
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Wong WCW, Lau STH, Choi EPH, Tucker JD, Fairley CK, Saunders JM. A Systematic Literature Review of Reviews on the Effectiveness of Chlamydia Testing. Epidemiol Rev 2020; 41:168-175. [PMID: 31565737 DOI: 10.1093/epirev/mxz007] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 02/14/2019] [Accepted: 02/22/2019] [Indexed: 11/13/2022] Open
Abstract
Chlamydia trachomatis is the most common bacterial sexually transmitted infection, causing significant morbidity and economic burden. Strategies like national screening programs or home-testing kits were introduced in some developed countries, yet their effectiveness remains controversial. In this systematic review, we examined reviews of chlamydia screening interventions to assess their effectiveness and the elements that contribute to their success to guide public policy and future research. We assessed English material published after 2000 in PubMed, the Cochrane Library, the British Nursing Index, Medical Database, and Sociological Abstracts, in addition to World Health Organization Global Health Sector Strategies, the European Center for Disease Prevention and Control guidelines, and the Prospective Register of Systematic Reviews. Systematic reviews that focused on chlamydia screening interventions were included. Using the socioecological model, we examined the levels of interventions that may affect the uptake of chlamydia screening. A total of 19 systematic reviews were included. Self-collection in home-testing kits significantly increased screening among girls and women 14-50 years of age. At the organizational level, using electronic health records and not creating additional costs facilitated testing. At the community level, outreach interventions in community and parent centers and homeless shelters achieved high screening rates. At the policy level, interventions with educational and advisory elements could result in significant improvements in screening rates.
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Affiliation(s)
- William Chi Wai Wong
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.,Department of General Practice, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Stephanie Tsz Hei Lau
- Department of Family Medicine and Primary Care, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Edmond Pui Hang Choi
- School of Nursing, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Joseph D Tucker
- Division of Infectious Diseases, Department of Medicine, University of North Carolina School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.,Faculty of Infectious and Tropical Diseases, The London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Christopher K Fairley
- Melbourne Sexual Health Centre, Alfred Health, Melbourne, Victoria, Australia.,Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - John M Saunders
- University College London Centre for Clinical Research in Infection and Sexual Health, Institute for Global Health, London, United Kingdom
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Wood H, Gudka S. Pharmacist-led screening in sexually transmitted infections: current perspectives. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2018; 7:67-82. [PMID: 29942790 PMCID: PMC6007388 DOI: 10.2147/iprp.s140426] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Sexually transmitted infection (STI) screening is a crucial initiative that aims to reduce the increasing global prevalence of many common STIs such as chlamydia, gonorrhea, and herpes simplex virus (HSV). Many STIs are either asymptomatic or show mild symptoms that are often attributed to other infections; hence, screening is the only way to identify – and by extension, treat – them. In this way, the spread of STIs can be reduced, and the health implications of an untreated STI are minimized. Community pharmacies could provide an avenue to convenient, confidential STI screening by using noninvasive or minimally invasive sample collection techniques that are used by the consumer or pharmacist. We identified the most common STIs found globally and investigated the current and potential role of pharmacists in provision of STI screening interventions. Discussion There is sufficient evidence for pharmacy-based chlamydia screening, with many consumers and pharmacists finding it an acceptable and highly valued service. Some evidence was found for pharmacy-based gonorrhea, hepatitis B virus (HBV), and human immunodeficiency virus (HIV) screening. Appropriate sample collection for gonorrhea screening needs to be further examined in a pharmacy setting. HBV screening presented an increased risk of personal injury to pharmacists through the collection of whole blood specimens, which could be reduced through consumer self-sampling. Pharmacist-collected specimens for HIV is less risky as an oral swab can be used, nullifying the risk of transmission; but pre- and post-screen consultations can be time-intensive; hence, pharmacists would require remuneration to provide an ongoing HIV screening service. Not enough evidence was found for syphilis screening through community pharmacies; more studies are required that consider sampling methods other than pharmacist-collected whole blood specimens. There is no evidence to date for pharmacist-led trichomoniasis or HSV screening. Conclusion Pharmacists are well-positioned to provide STI screening services, but further investigations are needed to overcome financial, safety, and confidentiality barriers.
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Affiliation(s)
- Helen Wood
- School of Allied Health, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Sajni Gudka
- School of Allied Health, Faculty of Health and Medical Sciences, The University of Western Australia, Perth, WA, Australia
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11
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Arnet I, Gudka S, Salter S, Hersberger KE, Clifford R. Readiness of pharmacists and consumers for pharmacy-based chlamydia screening in Australia and Switzerland. SEXUAL & REPRODUCTIVE HEALTHCARE 2018; 16:138-153. [PMID: 29804758 DOI: 10.1016/j.srhc.2018.03.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 02/21/2018] [Accepted: 03/27/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To assess chlamydia knowledge, willingness to undertake pharmacy-based chlamydia testing, and facilitators and barriers to such testing in consumers and community pharmacists, in Australia (AUS) and Switzerland (CH). METHODS Statements of interest were retrieved from literature and assembled into a 12-item online survey (English and German versions). Survey was disseminated through Facebook, pharmacies' publicly available emails and professional websites (March 2015). RESULTS Consumers and pharmacists (AUS: ncons = 198, npharm = 162; CH: ncons = 209, npharm = 223) were predominantly female (>65%). Mean chlamydia knowledge scores (maximum of 8) were higher in Australia in consumers (AUS: 6.8 ± 1.5 vs CH: 4.2 ± 2.4; p < 0.001) and in pharmacists (AUS: 7.1 ± 1.1 vs CH: 6.1 ± 1.4; p < 0.001). High willingness of consumers to seek testing (AUS: 79.3% vs CH: 83.3%, p = 0.3) and of pharmacists to provide testing (AUS: 95.7% vs CH: 80.3%, p < 0.001) was observed. Greatest barrier for consumers was "Embarrassed about asking for a test" (AUS: 47.8% vs CH: 51.2%, p = 0.7) and "No remuneration" for pharmacists (AUS: 40.7% vs CH: 31.8%, p = 0.07). CONCLUSION The majority of consumers and pharmacists support pharmacy-based chlamydia testing. There is now emerging evidence that the policy makers in Australia and Switzerland need to develop pharmacy-based chlamydia testing as core business.
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Affiliation(s)
- Isabelle Arnet
- Department of Pharmaceutical Sciences, Pharmaceutical Care Research Group, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland.
| | - Sajni Gudka
- School of Allied Health, M315 Pharmacy, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
| | - Sandra Salter
- School of Allied Health, M315 Pharmacy, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
| | - Kurt E Hersberger
- Department of Pharmaceutical Sciences, Pharmaceutical Care Research Group, University of Basel, Klingelbergstrasse 50, 4056 Basel, Switzerland.
| | - Rhonda Clifford
- School of Allied Health, M315 Pharmacy, University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia.
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12
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Lowres N, Neubeck L, Salkeld G, Krass I, McLachlan AJ, Redfern J, Bennett AA, Briffa T, Bauman A, Martinez C, Wallenhorst C, Lau JK, Brieger DB, Sy RW, Freedman SB. Feasibility and cost-effectiveness of stroke prevention through community screening for atrial fibrillation using iPhone ECG in pharmacies. Thromb Haemost 2017; 111:1167-76. [DOI: 10.1160/th14-03-0231] [Citation(s) in RCA: 355] [Impact Index Per Article: 50.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Accepted: 03/18/2014] [Indexed: 11/05/2022]
Abstract
SummaryAtrial fibrillation (AF) causes a third of all strokes, but often goes undetected before stroke. Identification of unknown AF in the community and subsequent anti-thrombotic treatment could reduce stroke burden. We investigated community screening for unknown AF using an iPhone electrocardiogram (iECG) in pharmacies, and determined the cost-effectiveness of this strategy. Pharmacists performed pulse palpation and iECG recordings, with cardiologist iECG over-reading. General practitioner review/12-lead ECG was facilitated for suspected new AF. An automated AF algorithm was retrospectively applied to collected iECGs. Cost-effectiveness analysis incorporated costs of iECG screening, and treatment/outcome data from a United Kingdom cohort of 5,555 patients with incidentally detected asymptomatic AF. A total of 1,000 pharmacy customers aged ≥65 years (mean 76 ± 7 years; 44% male) were screened. Newly identified AF was found in 1.5% (95% CI, 0.8–2.5%); mean age 79 ± 6 years; all had CHA2DS2-VASc score ≥2. AF prevalence was 6.7% (67/1,000). The automated iECG algorithm showed 98.5% (CI, 92–100%) sensitivity for AF detection and 91.4% (CI, 89–93%) specificity. The incremental cost-effectiveness ratio of extending iECG screening into the community, based on 55% warfarin prescription adherence, would be $AUD5,988 (€3,142; $USD4,066) per Quality Adjusted Life Year gained and $AUD30,481 (€15,993; $USD20,695) for preventing one stroke. Sensitivity analysis indicated cost-effectiveness improved with increased treatment adherence. Screening with iECG in pharmacies with an automated algorithm is both feasible and cost-effective. The high and largely preventable stroke/thromboembolism risk of those with newly identified AF highlights the likely benefits of community AF screening. Guideline recommendation of community iECG AF screening should be considered.Previous Presentation: This study was presented in part as an oral presentation at the Cardiac Society of Australia and New Zealand Conference; 9 August 2013; Sydney, Australia, abstract published in Heart Lung Circulation 2013;22:S223.Trial registration: Australian New Zealand clinical trials registry: ACTRN12612000406808.
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Hindi AMK, Schafheutle EI, Jacobs S. Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review. Health Expect 2017; 21:409-428. [PMID: 29114971 PMCID: PMC5867331 DOI: 10.1111/hex.12639] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2017] [Indexed: 11/30/2022] Open
Abstract
Background The United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. However, patient and public awareness of community pharmacy services has been limited. Objective To identify and synthesize the research literature pertaining to patient and public perspectives on: existing community pharmacy services, extended pharmacist roles and strategies to raise awareness of community pharmacy services. Search strategy Systematic search of 8 electronic databases; hand searching of relevant journals, reference lists and conference proceedings. Inclusion criteria UK studies investigating patient or public views on community pharmacy services or pharmacist roles from 2005 to 2016. Data extraction and synthesis Data were extracted into a grid and subjected to narrative synthesis following thematic analysis. Main results From the 3260 unique papers identified, 30 studies were included. Manual searching identified 4 additional studies. Designs using questionnaires (n = 14, 41%), semi‐structured interviews (n = 8, 24%) and focus groups (n = 6, 18%) made up the greatest proportion of studies. Most of the studies (n = 28, 82%) were published from 2010 onwards and covered perceptions of specific community pharmacy services (n = 31). Using a critical appraisal checklist, the overall quality of studies was deemed acceptable. Findings were grouped into 2 main themes “public cognizance” and “attitudes towards services” each with 4 subthemes. Discussion and conclusions Patients and the public appeared to view services as beneficial. Successful integration of extended pharmacy services requires pharmacists’ clinical skills to be recognized by patients and physicians. Future research should explore different approaches to increase awareness.
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Affiliation(s)
- Ali M K Hindi
- Centre for Pharmacy Workforce Studies, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Ellen I Schafheutle
- Centre for Pharmacy Workforce Studies, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Sally Jacobs
- Centre for Pharmacy Workforce Studies, Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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14
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Debattista J, Hayes M, Marshall P, Pouchkareff N, Gordon R, Priddle A. A trial of pharmacy-based testing forChlamydia trachomatisusing postal specimen kits. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2016. [DOI: 10.1002/jppr.1221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Joseph Debattista
- Metro North Public Health Unit; Metro North Hospital & Health Service; Brisbane Queensland Australia
| | - Meghan Hayes
- The Pharmacy Guild of Australia (QLD Branch); Brisbane Queensland Australia
| | - Penelope Marshall
- Metro North Public Health Unit; Metro North Hospital & Health Service; Brisbane Queensland Australia
| | - Nickolas Pouchkareff
- Children's Health Queensland Hospital and Health Service; Brisbane Queensland Australia
| | - Rose Gordon
- Sexual Health Services; Townsville Hospital & Health Service; Townsville Queensland Australia
| | - Alannah Priddle
- The Pharmacy Guild of Australia (QLD Branch); Brisbane Queensland Australia
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15
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Habel MA, Scheinmann R, Verdesoto E, Gaydos C, Bertisch M, Chiasson MA. Exploring pharmacy and home-based sexually transmissible infection testing. Sex Health 2015; 12:472-9. [PMID: 26409484 PMCID: PMC4809773 DOI: 10.1071/sh15031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 07/22/2015] [Indexed: 11/23/2022]
Abstract
UNLABELLED Background This study assessed the feasibility and acceptability of pharmacy and home-based sexually transmissible infection (STI) screening as alternate testing venues among emergency contraception (EC) users. METHODS The study included two phases in February 2011-July 2012. In Phase I, customers purchasing EC from eight pharmacies in Manhattan received vouchers for free STI testing at onsite medical clinics. In Phase II, three Facebook ads targeted EC users to connect them with free home-based STI test kits ordered online. Participants completed a self-administered survey. RESULTS Only 38 participants enrolled in Phase I: 90% female, ≤29 years (74%), 45% White non-Hispanic and 75% college graduates; 71% were not tested for STIs in the past year and 68% reported a new partner in the past 3 months. None tested positive for STIs. In Phase II, ads led to >45000 click-throughs, 382 completed the survey and 290 requested kits; 28% were returned. Phase II participants were younger and less educated than Phase I participants; six tested positive for STIs. Challenges included recruitment, pharmacy staff participation, advertising with discretion and cost. CONCLUSIONS This study found low uptake of pharmacy and home-based testing among EC users; however, STI testing in these settings is feasible and the acceptability findings indicate an appeal among younger women for testing in non-traditional settings. Collaborating with and training pharmacy and medical staff are key elements of service provision. Future research should explore how different permutations of expanding screening in non-traditional settings could improve testing uptake and detect additional STI cases.
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Affiliation(s)
- Melissa A. Habel
- Centers For Disease Control and Prevention, 1600 Clifton Road, Mailstop E-44, Atlanta, GA, USA
| | | | | | - Charlotte Gaydos
- Johns Hopkins University School of Medicine, 855 Wolfe Street, 530 Rangos Building, Baltimore, MD, USA
| | - Maggie Bertisch
- New York Walk-In Medical Group, 1627 Broadway, New York, NY, USA
| | - Mary Ann Chiasson
- Public Health Solutions, 40 Worth Street, 5th Floor, New York, NY, USA
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16
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Peckham S, Falconer J, Gillam S, Hann A, Kendall S, Nanchahal K, Ritchie B, Rogers R, Wallace A. The organisation and delivery of health improvement in general practice and primary care: a scoping study. HEALTH SERVICES AND DELIVERY RESEARCH 2015. [DOI: 10.3310/hsdr03290] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BackgroundThis project examines the organisation and delivery of health improvement activities by and within general practice and the primary health-care team. The project was designed to examine who delivers these interventions, where they are located, what approaches are developed in practices, how individual practices and the primary health-care team organise such public health activities, and how these contribute to health improvement. Our focus was on health promotion and ill-health prevention activities.AimsThe aim of this scoping exercise was to identify the current extent of knowledge about the health improvement activities in general practice and the wider primary health-care team. The key objectives were to provide an overview of the range and type of health improvement activities, identify gaps in knowledge and areas for further empirical research. Our specific research objectives were to map the range and type of health improvement activity undertaken by general practice staff and the primary health-care team based within general practice; to scope the literature on health improvement in general practice or undertaken by health-care staff based in general practice and identify gaps in the evidence base; to synthesise the literature and identify effective approaches to the delivery and organisation of health improvement interventions in a general practice setting; and to identify the priority areas for research as defined by those working in general practice.MethodsWe undertook a comprehensive search of the literature. We followed a staged selection process involving reviews of titles and abstracts. This resulted in the identification of 1140 papers for data extraction, with 658 of these papers selected for inclusion in the review, of which 347 were included in the evidence synthesis. We also undertook 45 individual and two group interviews with primary health-care staff.FindingsMany of the research studies reviewed had some details about the type, process or location, or who provided the intervention. Generally, however, little attention is paid in the literature to examining the impact of the organisational context on the way services are delivered or how this affects the effectiveness of health improvement interventions in general practice. We found that the focus of attention is mainly on individual prevention approaches, with practices engaging in both primary and secondary prevention. The range of activities suggests that general practitioners do not take a population approach but focus on individual patients. However, it is clear that many general practitioners see health promotion as an integral part of practice, whether as individual approaches to primary or secondary health improvement or as a practice-based approach to improving the health of their patients. Our key conclusion is that there is currently insufficient good evidence to support many of the health improvement interventions undertaken in general practice and primary care more widely.Future ResearchFuture research on health improvement in general practice and by the primary health-care team needs to move beyond clinical research to include delivery systems and be conducted in a primary care setting. More research needs to examine areas where there are chronic disease burdens – cancer, dementia and other disabilities of old age. Reviews should be commissioned that examine the whole prevention pathway for health problems that are managed within primary care drawing together research from general practice, pharmacy, community engagement, etc.FundingThe National Institute for Health Research Health Services and Delivery Research programme.
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Affiliation(s)
- Stephen Peckham
- Centre for Health Services Studies, University of Kent, Kent, UK
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Jane Falconer
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Steve Gillam
- Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Alison Hann
- Public Health and Policy Studies, Swansea University, Swansea, UK
| | - Sally Kendall
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK
| | - Kiran Nanchahal
- Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine, London, UK
| | - Benjamin Ritchie
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Rebecca Rogers
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
| | - Andrew Wallace
- Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK
- Department of Social Policy, University of Lincoln, Lincoln, UK
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Mackridge A, Krska J, Stokes E, Heim D. Towards improving service delivery in screening and intervention services in community pharmacies: a case study of an alcohol IBA service. J Public Health (Oxf) 2015; 38:92-8. [DOI: 10.1093/pubmed/fdv010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fuller JM, Wong KK, Grunstein R, Krass I, Patel J, Saini B. A comparison of screening methods for sleep disorders in Australian community pharmacies: a randomized controlled trial. PLoS One 2014; 9:e101003. [PMID: 24978952 PMCID: PMC4076224 DOI: 10.1371/journal.pone.0101003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 05/27/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Community pharmacies may potentially assist in screening for chronic conditions such as sleep disorders, which remain both under-diagnosed and untreated. We aimed to compare a subjective risk-assessment-only questionnaire (RAO) for common sleep disorder screening against the same risk-assessment questionnaire plus a nasal flow monitor as an objective marker of possible underlying obstructive sleep apnea (OSA) (RA+) in a community pharmacy setting. The primary outcome was the number of participants identified in RAO or RA+ group who were likely to have and consequently be diagnosed with OSA. Further outcomes included the number of participants identified as being at risk for, referred for, taking-up referral for, and then diagnosed with OSA, insomnia, and/or restless legs syndrome (RLS) in either group. METHODS In a cluster-randomized trial, participants were recruited through 23 community pharmacies. Using validated instruments, 325 (RAO = 152, RA+ = 173) participants were screened for OSA, insomnia, and RLS. FINDINGS 218 (67%) participants were at risk of OSA, insomnia or RLS and these participants were referred to their primary physician. The proportion of screened participants identified as being at risk of OSA was significantly higher in the RA+ group (36% in RAO vs. 66% in RA+, OR 3.4, 95% CI (1.8-6.5), p<0.001). A 12-month follow-up was completed in 125 RAO and 155 RA+ participants. Actual referral uptake was 34% RAO, 26% RA+, OR 4.4, 95% CI (1.4-19.2), p = 0.31. The OSA diagnosis rate was higher in the RA+ arm (p = 0.01). To yield a single additional confirmed OSA diagnosis, 16 people would need to be screened using the RA+ protocol. CONCLUSIONS These results demonstrate that utilising either screening method is feasible in identifying individuals in the community pharmacy setting who are likely to have OSA, insomnia and/or RLS. Secondly, adding an objective marker of OSA to a questionnaire-based prediction tool resulted in more confirmed OSA diagnoses. TRIAL REGISTRATION ACTR.org.au ACTRN12608000628347.
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Affiliation(s)
- Joanne M. Fuller
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
- The Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, NSW, Australia
- * E-mail:
| | - Keith K. Wong
- The Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, NSW, Australia
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
- The Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Ronald Grunstein
- The Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, NSW, Australia
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
- The Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Ines Krass
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Jayshree Patel
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Bandana Saini
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
- The Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, NSW, Australia
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The views of general practitioners and practice nurses towards the barriers and facilitators of proactive, internet-based chlamydia screening for reaching young heterosexual men. BMC FAMILY PRACTICE 2014; 15:127. [PMID: 24972919 PMCID: PMC4096584 DOI: 10.1186/1471-2296-15-127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 06/24/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Chlamydia trachomatis is a common bacterial sexually transmitted infection (STI), which disproportionately affects young people under 25 years. Commonly, more women are offered screening than men. This study obtained the views of general practitioners and practice nurses towards Internet-based screening and assessed levels of support for the development of proactive screening targeting young heterosexual men via the Internet. METHODS Semi-structured telephone interviews with 10 general practitioners and 8 practice nurses, across Central Scotland. Topics covered: experience of screening heterosexual men for chlamydia, views on the use of the Internet as a way to reach young men for chlamydia screening, beliefs about the potential barriers and facilitators to Internet-based screening. Transcripts from audio recordings were analysed with Framework Analysis, using QSR NVivo10. RESULTS Experiences of chlamydia screening were almost exclusively with women, driven by the nature of consultations and ease of raising sexual health issues with female patients; few practice nurses reported seeing men during consultations. All participants spoke in favour of Internet-based screening for young men. Participants reported ease of access and convenience as potential facilitators of an Internet-based approach but anonymity and confidentiality could be potential barriers and facilitators to the success of an Internet approach to screening. Concerns over practical issues as well as those pertaining to gender and socio-cultural issues were raised. CONCLUSIONS Awareness of key barriers and facilitators, such as confidentiality, practicality and socio-cultural influences, will inform the development of an Internet-based approach to screening. However, this approach may have its limits in terms of being able to tackle wider social and cultural barriers, along with shifts in young people's and health professionals' attitudes towards screening. Nevertheless, employing innovative efforts as part of a multi-faceted approach is required to ensure effective interventions reach the policy agenda.
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20
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Hocking JS, Guy R, Walker J, Tabrizi SN. Advances in sampling and screening for chlamydia. Future Microbiol 2013; 8:367-86. [PMID: 23464373 DOI: 10.2217/fmb.13.3] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Chlamydia is the most commonly diagnosed bacterial sexually transmitted infection in the developed world, with diagnosis rates continuing to increase each year. As chlamydia is largely asymptomatic, screening and treatment is the main way to detect cases and reduce transmission. Recent advances in self-collected specimens and laboratory tests has made chlamydia screening easier to implement as well as possible in nonclinical settings. This review will discuss new approaches to specimen collection and how these have expanded opportunities for reaching target populations for chlamydia screening. Furthermore, it will discuss how advanced molecular microbiological methods can be used with self-collected specimens to further our knowledge of the epidemiology of chlamydia and the dynamics of transmission.
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Affiliation(s)
- Jane S Hocking
- Centre for Women's Health, Gender & Society, University of Melbourne, Victoria, Australia
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21
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Gudka S, Marshall L, Creagh A, Clifford RM. To develop and measure the effectiveness and acceptability of a pharmacy-based chlamydia screening intervention in Australia. BMJ Open 2013; 3:e003338. [PMID: 23955190 PMCID: PMC3752050 DOI: 10.1136/bmjopen-2013-003338] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To develop and measure the effectiveness and acceptability of a pharmacy-based chlamydia screening intervention called Emergency Contraception Mediated Pharmacy Access to Chlamydia Testing (ECOMPACT). DESIGN Selective, opportunistic and cross-sectional study targeting asymptomatic women requesting emergency contraception (EC). SETTING 20 community pharmacies in the Perth metropolitan region, Australia. METHODS ECOMAPCT was developed through literature review and stakeholder consensus. Pharmacists were trained to offer ECOMPACT after the EC consultation. Women with signs and symptoms of sexually transmitted infections (STI) were referred to a physician for a full sexual health check. Asymptomatic women were offered a free ECOMPACT testing kit. The women self-collected a low-vaginal swab and returned their pathological specimen to designated drop-off sites. A pathology service analysed the specimens and sent the results to a sexual health physician. The effectiveness of ECOMPACT was determined by the uptake of the intervention and how well the target population was reached. An effective screening rate was calculated. Qualitative analysis was undertaken to understand acceptability issues from the perspective of the consumer and the pharmacists. RESULTS Of the 769 EC consultations in a 6-month period, 569 (78%) women were given information on chlamydia screening. All 247 (41%) agreed to participate. 81 (33%) of these women were ineligible. They were either symptomatic (n=33; 41%), or were under 18 years of age (n=48; 59%). Pharmacists successfully requested 166 (67%) pathology tests, of which 46 (28%) were returned to a pathology drop-off site. All tested negative for Chlamydia trachomatis. The effective screening rate was 6%. Consumers and pharmacists considered ECOMPACT to be highly convenient and the time taken to offer a chlamydia test along with an EC consultation as highly appropriate. CONCLUSIONS ECOMPACT was found to be simple, effective and acceptable. Given the opportunity, adequate training and support, community pharmacists in Australia were capable of requesting direct-to-consumer chlamydia tests.
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Affiliation(s)
- Sajni Gudka
- Centre for Optimisation of Medicines, Pharmacy, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
| | - Lewis Marshall
- School of Medicine and Pharmacology Medicine, University of Western Australia, Crawley, Western Australia, Australia
| | - Alison Creagh
- Family Planning Western Australia Sexual Health Services, Perth, Western Australia, Australia
| | - Rhonda M Clifford
- Centre for Optimisation of Medicines, Pharmacy, School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia
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22
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Gudka S, Bourdin A, Watkins K, Eshghabadi A, Everett A, Clifford RM. Self-reported risk factors for chlamydia: a survey of pharmacy-based emergency contraception consumers. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2013; 22:13-9. [PMID: 23711359 DOI: 10.1111/ijpp.12042] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Accepted: 04/09/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate the self-reported risk factors for Chlamydia trachomatis in pharmacy-based emergency contraception (EC) consumers, evaluate their pharmacy experience and determine whether they would be willing to accept a chlamydia test from the pharmacy. METHODS A survey for women to complete after their EC consultation was developed from themes identified in a literature search. Nineteen pharmacies in the Perth metropolitan region and 13 pharmacies in rural, regional and remote Western Australia (WA) participated in this study. KEY FINDINGS From the 113 surveys completed (n = 75 from Perth metropolitan; n = 38 from rural, regional and remote WA), 85% of respondents were between 16 and 29 years of age and all (100%) of the women had inconsistent barrier contraception. Almost all (94%) of the women had at least two, and nearly half (47%) had at least three out of the four risk factors for chlamydia. Nearly 70% of the women found it very easy/easy to access a pharmacy and felt very comfortable/comfortable discussing EC with the pharmacist. Significantly more women said they would be willing to accept a chlamydia test from a rural, regional and remote WA pharmacy than from a Perth metropolitan pharmacy (P = 0.003). CONCLUSION Pharmacy-based EC consumers are at high risk of chlamydia and would be willing to accept a chlamydia test from the pharmacy. There is an urgent need to re-orientate health services in Australia so that all EC consumers, including those obtaining EC from pharmacies, have the opportunity to be tested for chlamydia.
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Affiliation(s)
- Sajni Gudka
- Division of Pharmacy, School of Medicine and Pharmacology, University of Western Australia, Perth, WA, Australia
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Gudka S, Misaghian J, Clifford RM. Future Pharmacy-Based Chlamydia Screening: Consumer Preference. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2013. [DOI: 10.1002/j.2055-2335.2013.tb00208.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Rhonda M Clifford
- School of Medicine and Pharmacology; The University of Western Australia; Crawley Western Australia
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Kapadia MZ, Warner P, Fairhurst K, Muir A, Glasier A. Assessing competencies and training needs of pharmacy staff to deliver chlamydia screening in community pharmacies. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2012. [DOI: 10.1111/j.1759-8893.2012.00101.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Abstract
Objective
In the UK community pharmacies have become involved in providing chlamydia testing and treatment (CT&T) to young people. Our objective was to ascertain among pharmacy staff their self-reported competencies and training needs prior to implementation of a pharmacy-based CT&T service.
Methods
Self-complete questionnaires were posted to 166 community pharmacies in Lothian, Scotland. Questions included socio-demographic information and four-point Likert-type scale items addressing self-judged competencies and training needs for the provision of a CT&T service. Each competency item was transformed to a binary variable ‘insufficiently competent’ (comprising responses of ‘not at all’ or ‘somewhat’), and each training need item to a binary variable ‘substantial training need’ (responses of ‘full’ or ‘top-up’ training needed).
Results
Forty-one per cent of the 235 respondents were pharmacists, 32% technicians and 26% counter assistants. In respect of ‘insufficient’ competency, more than half of all staff responses were thus categorised for four competencies regarding offering and giving instructions for screening (60% to 83%), knowing the signs/symptoms of chlamydia (60%), raising the issue of sexual health (58%) and responding to a request for sexual health information (53%). ‘Substantial training need’ was identified for the majority of respondents, for all but two items, highest rates being for the four inter-communicative competencies: giving guidance on use of the kit, offering test to men, or to women, and advising regarding screening (71% to 83%). For pharmacist-only competencies the highest rates of substantial training need were for clarity regarding medico-legal aspects (Fraser guidelines), criteria for referral, and ability to take a sexual history and to review staff competencies for CT&T service (74% to 83%).
Conclusions
Insufficient competency with respect to specifics of service procedure was not surprising, given that no training had yet been given and pharmacists and their support staff had not had any practical experience in the provision of the CT&T service. Substantial training need is particularly indicated for inter-communicative aspects specific to sexual health.
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Affiliation(s)
- Mufiza Zia Kapadia
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Pamela Warner
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | - Karen Fairhurst
- Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK
| | | | - Anna Glasier
- Centre for Reproductive Biology, University of Edinburgh, Edinburgh, UK
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Habel MA, Leichliter JS. Emergency contraception and risk for sexually transmitted infections among U.S. women. J Womens Health (Larchmt) 2012; 21:910-6. [PMID: 22731690 PMCID: PMC6737533 DOI: 10.1089/jwh.2011.3441] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Since Food and Drug Administration (FDA) licensure of emergency contraception (EC) over-the-counter (OTC) in 2006, this is the first U.S. study to use a nationally representative sample of reproductive-aged women (15-44) to explore the relationship between receipt and use of EC and sexually transmitted infection (STI)-related health services. METHODS Using a sample of 6329 women from the National Survey of Family Growth 2006-2008, we examined the relationship between lifetime EC use and recent receipt of EC and demographics, sexual behaviors, and STI-related services. Variables significant at p<0.10 in bivariate analyses were examined using multivariable logistic regression models. RESULTS Overall, 10% (704) of the sample had ever used EC. Most EC users had received EC from a family planning clinic (51%), drugstore (23%), or doctor's office (17%). In adjusted analyses, demographic factors associated with receipt of EC in the past 12 months included never married (adjusted odds ratio [AOR] 4.0) and living in a metropolitan statistical area (AOR 4.2). Women reporting multiple partners (2+) (AOR 2.4), inconsistent condom use (AOR 3.4), and having recently been tested for chlamydia (AOR 2.0) had higher odds of receiving EC in the past 12 months. Findings among women ever reporting EC use were similar, except women who had 4+ lifetime partners (AOR 2.5) and had recently received a chlamydia diagnosis (AOR 2.2) had higher odds of ever having used EC. CONCLUSIONS EC recipients were no more likely than nonrecipients to have received STI counseling or screening despite greater numbers of sex partners in the past year. This research indicates that women are accessing EC in pharmacies, which may be a missed opportunity for counseling and testing.
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Affiliation(s)
- Melissa A Habel
- Division of STD Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA.
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Dabrera G, Pinson D, Whiteman S. Missed opportunities for chlamydia screening by community pharmacists. Sex Health 2012; 9:297. [PMID: 22697148 DOI: 10.1071/sh11109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2011] [Accepted: 09/16/2011] [Indexed: 11/23/2022]
Abstract
Provision of Emergency Hormonal Contraception (EHC) is an ideal opportunity for offering Chlamydia screening (CS) to sexually active young women. We audited 3 months of CS activity in community pharmacies. This identified low rates of offers and uptake of CS in community pharmacies providing EHC to young women. This highlights the potential for significant improvement in CS uptake among this at-risk group in the pharmacy setting.
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Brown D, Portlock J, Rutter P. Review of services provided by pharmacies that promote healthy living. Int J Clin Pharm 2012; 34:399-409. [PMID: 22527479 DOI: 10.1007/s11096-012-9634-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 03/29/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND The recognition that community pharmacies have the potential to make a greater contribution to promoting public health has led to a new concept, called the Healthy Living Pharmacy (HLP). These are designed to meet public health needs through a tiered commissioning framework delivering health and well being services through community pharmacy, tailored to local requirements for tackling health inequalities. AIM To search the literature for quality evidence to support the inclusion of services in the HLP portfolio and suggest areas where more evidence is required. METHOD A systematic review of the research literature covering the period January 1990-August 2011 inclusive, using MEDLINE, EMBASE, Pharmline, NHS Evidence and the Cochrane databases. On-line searching of the grey literature (e.g. conference proceedings) was also carried out. Standard methods of assessing quality were employed. RESULTS A total of 377 papers were included. Over time, there was a marked increase in frequency of publications reflecting a growing pharmacy interest in the public healthcare agenda; over a third (35 %) of papers appeared in the last three-year study period. The body of research had a wide geographical basis; contributions were as follows: UK (51.5 %), US (20.4 %), Australia/New Zealand (9.8 %), Europe (7.7 %) and Canada (7.2 %). The topics of contraception, cardiovascular disease prevention, diabetes and smoking cessation accounted for 40 % of included papers. The literature supports the introduction of specific community pharmacy services, targeted at customer groups, both with and without pre-existing diseases. Good evidence exists for smoking cessation, cardiovascular disease prevention, hypertension and diabetes. Some good evidence exists for interventions on asthma and heart failure. The evidence supporting weight management, sexual health, osteoporosis detection, substance abuse and chronic obstructive pulmonary disease is weak and needs development. CONCLUSION There is strong evidence for the role of community pharmacy in a range of services, not only aimed at improving general health, but also maintaining the health of those with existing disease. In other areas, the evidence is less strong and further research is required to justify their inclusion in a HLP portfolio.
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Affiliation(s)
- David Brown
- University of Portsmouth, Portsmouth, Hampshire, UK.
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Khdour MR, Hallak HO. Societal perspectives on community pharmacy services in West Bank - Palestine. Pharm Pract (Granada) 2012; 10:17-24. [PMID: 24155812 PMCID: PMC3798164 DOI: 10.4321/s1886-36552012000100004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2011] [Accepted: 01/17/2012] [Indexed: 11/12/2022] Open
Abstract
Background Understanding the public's view of professional competency is extremely
important; however little has been reported on the public's perception
of community pharmacists in Palestine Objective To determine the perception of Palestinian consumers of the community
pharmacist and the services they offer. Methods This project used the survey methodology administered by structured
interviews to consumers who attended the 39 randomly selected pharmacies, in
six main cities in Palestine. The questionnaire had range of structured
questions covering: Consumers' patronage patterns, consumers’
interaction with community pharmacists, consumers’ views on how the
pharmacist dealt with personal health issues, procedure with regard to
handling private consultations. Results Of 1,017 consumers approached, 790 consumers completed the questionnaire
(77.7 %). Proximity to home and presence of knowledgeable pharmacist were
the main reasons for patients to visit the same pharmacy. Physicians were
identified as the preferred source of advice by 57.2% and pharmacists by
23.8%. Only 17% of respondents considered pharmacists as health
professionals who know a lot about drugs and are concerned about and
committed to caring for the public. In addition, 49% indicated that
pharmacists spoke more quietly cross the counter during counseling and
almost one third reported that the pharmacist used a private area within the
pharmacy. The majority of respondents would be happy to receive different
extended services in the community pharmacy like blood pressure
monitoring. Conclusions Palestinian consumers have a positive overall perception of community
pharmacists and the services they offer. Awareness should be created amongst
the public about the role of pharmacist and the added value they can provide
as health care professional. There is a need to consider privacy when giving
patient counseling to increase user satisfaction.
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Affiliation(s)
- Maher R Khdour
- Faculty of Pharmacy, Al-Quds University. Abu Deis, Jerusalem, (Palestine)
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Friedman AL, Bloodgood B. Exploring the feasibility of alternative STD-testing venues and results delivery channels for a national screening campaign. Health Promot Pract 2011; 14:96-104. [PMID: 21965593 DOI: 10.1177/1524839911404226] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
UNLABELLED Annual chlamydia screening is recommended for sexually active women aged 25 years and younger, though less than half of eligible women are screened each year. If acceptable to young women, nontraditional testing venues and new communication technologies could promote efficiencies in sexually transmitted disease (STD) screening and facilitate screening by overcoming barriers at systems and patient levels. OBJECTIVE This study sought to explore young women's technology use, preferences for STD-testing venues, attitudes toward nontraditional venues, and acceptability of test results delivery options. METHOD A total of 80 ethnographic one-on-one telephone interviews were conducted with African American, Caucasian, and Latina women, aged 15 to 25 years, in 10 metropolitan areas of the United States. Interviews were recorded, transcribed, and analyzed using NVivo2. RESULTS Alternative STD-testing venues and results delivery channels are valued by young women for their convenience and accessibility, but they must also offer privacy, confidentiality, and emotional/informational support to be acceptable. Assuring provider (or self) competence and valid/accurate test results is also important. CONCLUSIONS Although new technologies have been embraced by young women for personal and social uses, they may not be as readily embraced for the provision of STD-related services. Additional social marketing efforts may be needed to promote acceptance of nontraditional STD-testing settings and results delivery methods.
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Eades CE, Ferguson JS, O'Carroll RE. Public health in community pharmacy: a systematic review of pharmacist and consumer views. BMC Public Health 2011; 11:582. [PMID: 21777456 PMCID: PMC3146877 DOI: 10.1186/1471-2458-11-582] [Citation(s) in RCA: 318] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2010] [Accepted: 07/21/2011] [Indexed: 11/29/2022] Open
Abstract
Background The increasing involvement of pharmacists in public health will require changes in the behaviour of both pharmacists and the general public. A great deal of research has shown that attitudes and beliefs are important determinants of behaviour. This review aims to examine the beliefs and attitudes of pharmacists and consumers towards pharmaceutical public health in order to inform how best to support and improve this service. Methods Five electronic databases were searched for articles published in English between 2001 and 2010. Titles and abstracts were screened by one researcher according to the inclusion criteria. Papers were included if they assessed pharmacy staff or consumer attitudes towards pharmaceutical public health. Full papers identified for inclusion were assessed by a second researcher and data were extracted by one researcher. Results From the 5628 papers identified, 63 studies in 67 papers were included. Pharmacy staff: Most pharmacists viewed public health services as important and part of their role but secondary to medicine related roles. Pharmacists' confidence in providing public health services was on the whole average to low. Time was consistently identified as a barrier to providing public health services. Lack of an adequate counselling space, lack of demand and expectation of a negative reaction from customers were also reported by some pharmacists as barriers. A need for further training was identified in relation to a number of public health services. Consumers: Most pharmacy users had never been offered public health services by their pharmacist and did not expect to be offered. Consumers viewed pharmacists as appropriate providers of public health advice but had mixed views on the pharmacists' ability to do this. Satisfaction was found to be high in those that had experienced pharmaceutical public health Conclusions There has been little change in customer and pharmacist attitudes since reviews conducted nearly 10 years previously. In order to improve the public health services provided in community pharmacy, training must aim to increase pharmacists' confidence in providing these services. Confident, well trained pharmacists should be able to offer public health service more proactively which is likely to have a positive impact on customer attitudes and health.
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Affiliation(s)
- Claire E Eades
- Department of Psychology, University of Stirling, Stirling, FK9 4LA, Scotland, UK.
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Baraitser P, Brown KC, Gleisner Z, Pearce V, Kumar U, Brady M. 'Do it yourself' sexual health care: the user experience. Sex Health 2011; 8:23-9. [PMID: 21371379 DOI: 10.1071/sh10029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2010] [Accepted: 06/03/2010] [Indexed: 11/23/2022]
Abstract
OBJECTIVES To describe client experience of self-management within a busy walk-in, sexual health service. Self-management in this context is self-registration and take-home pregnancy tests, chlamydia (Chlamydia trachomatis) and gonorrhoea (Neisseria gonorrhoeae) tests, or condoms dispensed from a free vending machine. METHODS Twenty-four in-depth, semi-structured interviews with users; 19 structured written reports from mystery shoppers paid to visit the service and report their experience; demographic details of those using the self-management option from the clinic database and 40 h of recorded observation in the clinic waiting room. RESULTS Between 2 September 2008 and 1 September 2009, 18 657 people had 28 545 attendances at the service. Of these, 1845 (6.5%) attendances were self-managed by 1555 individuals (8.3% of all clients). Of those who self-managed, 646 (35%) obtained a chlamydia and gonorrhoea test only, 597 (32%) obtained condoms only and 488 (27%) obtained a pregnancy test only. Users valued the opportunity to self-manage because of the reduced waiting times, autonomy and privacy that such a service offers. Some prefer the additional support offered within a clinical consultation. Users made personalised decisions about self-management based on time pressure, need for additional services and preferred source of support. Users often required help and advice from client support workers to complete the self-management process. This created problems with confidentiality. CONCLUSIONS Self-management is an acceptable option within sexual health services if informal support is available. Self-management options in clinical services could mean that 8% of clients at 6% of visits do not need to see a clinician, thus freeing up clinical capacity.
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Brugha R, Balfe M, Jeffares I, Conroy RM, Clarke E, Fitzgerald M, O'Connell E, Vaughan D, Coleman C, McGee H, Gillespie P, O'Donovan D. Where do young adults want opportunistic chlamydia screening services to be located? J Public Health (Oxf) 2011; 33:571-8. [PMID: 21486871 DOI: 10.1093/pubmed/fdr028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND This study measured the acceptability of urine-based chlamydia screening to young adults, where young adults wanted opportunistic chlamydia screening services to be located, and by whom they wanted to be offered screening. METHODS A cross-sectional survey of 5685 university students and 400 young adult healthcares setting attendees (age: 18-29 years). RESULTS Ninety-six percent of males and 93% of females said that they would find it acceptable to be offered chlamydia screening. Seventy-six percent of males and 77% of females wanted to be offered screening by a doctor or nurse. Young women would prefer female staff. Most respondents preferred that screening be located in traditional healthcare settings such as General Practices, and offered by either doctors or nurses. More than 90% of respondents did not want screening services to be located in pharmacies and almost all rejected public non-health care screening settings. CONCLUSIONS Opportunistic chlamydia screening services should be located in traditional healthcare/medical settings, and screening should be offered by doctors and nurses.
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Affiliation(s)
- Ruairi Brugha
- Department of Epidemiology and Public Health Medicine, Royal College of Surgeons in Ireland, Dublin 2, Republic of Ireland
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The provision of current and future sexual health services from community pharmacies in Grampian, Scotland. Int J Clin Pharm 2011; 33:183-90. [PMID: 21744188 DOI: 10.1007/s11096-010-9458-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 11/15/2010] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Community pharmacies play a vital role in promoting, maintaining and improving the health of the local community. This study explored community pharmacists' activities and attitudes towards the provision of sexual health services (SHS) in North East Scotland, as well as their needs with regard to the delivery of current and future SHS. SETTING North East Scotland. METHODS A questionnaire was conducted of community pharmacists working in community pharmacies in Grampian (n = 128). MAIN OUTCOME MEASURES Self-reported provision of sexual health services; attitudes towards current and future sexual health services; previous training and perceived training needs; respondent demographics. RESULTS In total, 73% (94/128) of community pharmacists responded. The average number of SHS/products per pharmacy was six out of a possible 13 (range: 4-10). Respondents expressed positive attitudes towards the provision of current and future SHS. However, they also reported that they had received little or no sexual health training but that they would like to receive training in all areas of sexual health. Barriers to the provision of sexual health included workload, lack of training and the need for payment for additional services. CONCLUSION Community pharmacists already provide a limited range of sexual health services. Community pharmacists, their staff and their premises could be used in strategies to reduce unplanned pregnancies, the incidence of sexually transmitted infections and to promote respectful and responsible sexual behaviour.
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Anderson C, Thornley T. A pharmacy-based private chlamydia screening programme: results from the first 2 years of screening and treatment. Int J Clin Pharm 2011; 33:88-91. [PMID: 21365400 DOI: 10.1007/s11096-010-9460-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2010] [Accepted: 11/22/2010] [Indexed: 11/26/2022]
Abstract
OBJECTIVE A major UK Pharmacy chain private Chlamydia screening and treatment service began in October 2006. People pay for a screening kit, send off a urine sample, and are informed of their result directly. Treatment is accessed via the pharmacy chain or the National Health Service. We analysed data from the first 2 years of the service to describe the positivity rate by age and gender, profile of users and to determine if the program succeeded in reaching those who are currently being missed in other clinical settings. SETTING Three hundred and thirty-eight community pharmacies from a major pharmacy chain in England and Wales. METHODS Cross sectional study of the first 2 years screening and treatment data. Data was collected on number of tests, test results, age and gender. Data was also collected on treatment uptake by age and gender. Further Data regarding the treatment service including the site, was collected on customer record forms. Positivity data was analysed using χ(2). RESULTS A total of 14,378 private Chlamydia screening tests were performed in pharmacies during the 2 year period. Overall positivity rates in males (9.8%) were higher than females (6.8%). The positivity rate was significantly higher in the 16-24 age group than in the 25 and over age group. A total of 533 people accessed and paid for treatment from Boots out of a total of 1,131 people who tested positive (47.1%). Hundred and thirty three (25.0%) partners also accessed treatment. CONCLUSIONS The data further supports the feasibility and acceptability of pharmacy testing and treatment.
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Affiliation(s)
- Claire Anderson
- Division of Social Research in Medicines and Health, School of Pharmacy, University of Nottingham, University Park, Nottingham NG7 2RD, UK.
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Cameron ST, Glasier A, Muir A, Scott G, Johnstone A, Quarrell H, Oroz C, McIntyre M, Miranda D, Todd G. Expedited partner therapy for Chlamydia trachomatis at the community pharmacy. BJOG 2010; 117:1074-9. [PMID: 20497415 DOI: 10.1111/j.1471-0528.2010.02573.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Expedited partner treatment (EPT) for uncomplicated Chlamydia trachomatis at the pharmacy is an alternative approach to partner notification that has not yet been evaluated within the UK. The aim of this study was to evaluate EPT for partners using pharmacies in Lothian. DESIGN A pilot study over 18 months. SETTING Selected healthcare settings and community pharmacies in Lothian, Scotland, UK. POPULATION Sexual partners of index cases with uncomplicated C. trachomatis. METHODS Index cases with uncomplicated C. trachomatis were given a pharmacy voucher to pass onto sexual partners. Partners could redeem vouchers for free treatment (azithromycin) at one of 90 pharmacies in the area. MAIN OUTCOME MEASURES The main outcome measure was the proportion of vouchers redeemed. Secondary outcomes included patient satisfaction, as determined at a telephone follow-up of a subgroup of female index cases from one study site, 1 month later. RESULTS In total 577 vouchers were issued to chlamydia-positive index patients of mean age 22.9 years (range 15-47 years). A total of 231 vouchers were redeemed (40%), at a median of 2 days after issue. Only 4% of partners attended a clinic for treatment. Most index patients surveyed reported that partners were satisfied with this method of treatment (48 out of 55; 87%). CONCLUSIONS Expedited partner treatment for uncomplicated chlamydia at a pharmacy is a popular choice, and increases options on where, when and how partners are treated.
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Affiliation(s)
- S T Cameron
- Dean Terrace Centre, NHS Lothian, Edinburgh, UK
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Kjome RLS, Nerhus K, Sandberg S. Implementation of a method for glucose measurements in community pharmacies. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2010; 18:13-9. [DOI: 10.1211/ijpp.18.01.0004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Abstract
Objectives
We aimed to implement a method for glucose measurements that could be used as a comparison method for asessing patients' self-monitoring of blood glucose. Further, we investigated whether pharmacies could achieve an analytical quality comparable to glucose measurements performed in general practice.
Methods
Sixteen Norwegian pharmacy employees were trained in glucose measurement, quality control and blood sampling. The comparison method, HemoCue Glucose 201+, was validated in four steps: (1) estimation of the variation between the HemoCue instruments to be used at the 16 pharmacies, (2) comparison between HemoCue results and a laboratory glucose method, (3) monitoring quality by internal quality controls and (4) an external quality-assessment scheme. The pharmacies' results of the external quality assessment were compared to those of 359 general practices.
Key findings
The coefficient of variation for HemoCue instruments was 6.1% at the low level and 1.7% at the normal and high levels. Bias was negligible at the normal level. The coefficients of variation for internal quality controls were 4.5, 1.5 and 1.2% for the low, normal and high levels, respectively. All pharmacies achieved good precision and acceptable or good trueness in the external quality assessment. The pharmacies exhibited significantly lower variation between sites (2.2 and 1.2%) than general practices (3.8 and 2.9%) on both external quality-assessment samples.
Conclusions
Given correct training and the establishment of a system of quality assurance, pharmacies are capable of obtaining glucose measurements that can be used as comparison measurements for controlling patients' meters. The pharmacies had external quality-assessment results comparable to general practice.
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Affiliation(s)
- Reidun L S Kjome
- Section for General Practice, Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Kari Nerhus
- Norwegian Centre for Quality Improvement of Primary Care Laboratories (NOKLUS), Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
| | - Sverre Sandberg
- Norwegian Centre for Quality Improvement of Primary Care Laboratories (NOKLUS), Department of Public Health and Primary Health Care, University of Bergen, Bergen, Norway
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Tran A, Fuller JM, Wong KK, Krass I, Grunstein R, Saini B. The development of a sleep disorder screening program in Australian community pharmacies. ACTA ACUST UNITED AC 2009; 31:473-480. [PMID: 19462256 DOI: 10.1007/s11096-009-9301-4] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2008] [Accepted: 04/28/2009] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To develop, pilot and determine the feasibility of a sleep-specific screening and awareness program in community pharmacies. SETTING The screening was piloted in five Australian community pharmacies. METHOD The Pharmacy Tool for Assessment of Sleep Health was constructed by drawing on known relationships between sleep disorders, and lifestyle factors, medical conditions and medications. Four validated instruments were used in the screening tool: the Epworth Sleepiness Scale (ESS), Insomnia Severity Index (ISI), Multivariable Apnea Prediction Index (MAPI) and International Restless Legs Syndrome Study Group Screening Criteria (IRLS). These instruments were used to predict the participant's risk of a sleep disorder and the results were compared with reported lifestyle, medical and medication factors. On-site training of consenting pharmacists was provided, followed by an eight week client recruiting and screening period. Feedback was elicited from participating pharmacists and clients. MAIN OUTCOME MEASURE The feasibility of, and trends found from, the developed screening tool and protocol. RESULTS Of 167 clients who requested or were invited to participate by pharmacists, 84 (50.3%) were screened. Analysis of collected data indicated that 33.3%, 21.4% and 27.4% of participants were at risk of having or developing insomnia, obstructive sleep apnea (OSA) and restless legs syndrome (RLS) respectively, while 38.1% were not at risk of any of the screened disorders. OSA odds increased 12.8 times (95% CI: 3.2-50.4) with diabetes and 4.9 times (1.2-20.9) with opioid use, while shift workers were 8.4 times (1.6-43.2) more likely to have insomnia. Participants and pharmacists reported the screening protocol and instrument was user friendly and feasible. CONCLUSION The development and pilot of this screening tool was successful. The prevalence of sleep disorders in the sampled population was high but generally consistent with previous studies on the general population. Furthermore, associations found may form a foundation for a clinical algorithm to identify those at a higher risk of having or developing a sleep disorder. Further work is required to validate this screening tool in the community pharmacy context.
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Affiliation(s)
- Adam Tran
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Joanne M Fuller
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Keith K Wong
- Sleep & Circadian Research Group, Woolcock Institute of Medical Research, Camperdown, Sydney, NSW, 2050, Australia
- Department of Respiratory & Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia
| | - Ines Krass
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Ron Grunstein
- Sleep & Circadian Research Group, Woolcock Institute of Medical Research, Camperdown, Sydney, NSW, 2050, Australia
- Department of Respiratory & Sleep Medicine, Royal Prince Alfred Hospital, Camperdown, Sydney, NSW, 2050, Australia
- Faculty of Medicine, University of Sydney, Sydney, Australia
| | - Bandana Saini
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, 2006, Australia.
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Brabin L, Thomas G, Hopkins M, O'Brien K, Roberts SA. Delivery of chlamydia screening to young women requesting emergency hormonal contraception at pharmacies in Manchester, UK: a prospective study. BMC WOMENS HEALTH 2009; 9:7. [PMID: 19323804 PMCID: PMC2667404 DOI: 10.1186/1472-6874-9-7] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/20/2008] [Accepted: 03/26/2009] [Indexed: 12/03/2022]
Abstract
Background More women are requesting Emergency Hormonal Contraception (EHC) at pharmacies where screening for Chlamydia trachomatis is not routinely offered. The objective of this study was to assess the uptake of free postal chlamydia screening by women under 25 years who requested EHC at pharmacies in Manchester, UK. Methods Six Primary Care Trusts (PCTs) that had contracted with pharmacies to provide free EHC, requested the largest EHC providers (≥ 40 doses annually) to also offer these clients a coded chlamydia home testing kit. Pharmacies kept records of the ages and numbers of women who accepted or refused chlamydia kits. Women sent urine samples directly to the laboratory for testing and positive cases were notified. Audit data on EHC coverage was obtained from PCTs to assess the proportion of clients eligible for screening and to verify the uptake rate. Results 33 pharmacies participated. Audit data for 131 pharmacy months indicated that only 24.8% (675/2718) of women provided EHC were also offered chlamydia screening. Based on tracking forms provided by pharmacies for the whole of the study, 1348/2904 EHC clients (46.4%) who had been offered screening accepted a screening kit. 264 (17.6%) of those who accepted a kit returned a sample, of whom 24 (9.1%) were chlamydia-positive. There was an increase in chlamydia positivity with age (OR: 1.2 per year; 1.04 to 1.44; p = 0.015). Conclusion Chlamydia screening for EHC pharmacy clients is warranted but failure of pharmacists to target all EHC clients represented a missed opportunity for treating a well defined high-risk group.
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Affiliation(s)
- Loretta Brabin
- Academic Unit of Obstetrics & Gynaecology, University of Manchester, Manchester, M13 OJH, UK.
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