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Presley B, Groot W, Pavlova M. Pharmacists' preferences for the provision of services to improve medication adherence among patients with diabetes in Indonesia: Results of a discrete choice experiment. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e161-e174. [PMID: 34009714 PMCID: PMC9292582 DOI: 10.1111/hsc.13423] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 03/22/2021] [Accepted: 04/22/2021] [Indexed: 06/12/2023]
Abstract
Little is known about pharmacists' preferences for services to improve medication adherence in patients with diabetes in Indonesia. Identification of such preferences can provide valuable insights on suitable services from a pharmacist's perspective. This study elicits pharmacists' preferences for services to improve medication adherence among their patients. A discrete choice experiment (DCE) method was used to survey pharmacists in all community health centres and three hospitals in Surabaya, Indonesia. Four attributes of consultation, namely duration of consultation, place of consultation, access to a pharmacist and patient copayment, and two attributes on additional services (educational and behavioural-based services) were included. The 16 profiles generated for DCE were partially balanced and partially without overlap. A random-effect logistic regression was used in the analysis. In total, 99 pharmacists completed the questionnaire, but only 80 were included in the study based on a consistency check. All attributes were found to determine preferences for a pharmacist service package. Pharmacists preferred a consultation with a shorter duration accompanied by flexible access to the pharmacist as well as a private consultation room and a lower patient copayment. Providing the patient with a brochure/leaflet was the most preferred additional service to help improve medication adherence. Patient group discussion and medication review were also preferred in combination with a consultation. Pharmacists' socio-demographic background characteristics influence preferences. These findings can be considered in evaluating current practice and designing pharmacist services to help improve medication adherence among patients with diabetes.
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Affiliation(s)
- Bobby Presley
- Department of Health Services Research (HSR)Faculty of Health, Medicine and Life Sciences (FHML)Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+)Maastricht UniversityMaastrichtThe Netherlands
- Department of Clinical and Community PharmacyFaculty of PharmacyCenter for Medicines Information and Pharmaceutical Care (CMIPC)University of SurabayaSurabayaIndonesia
| | - Wim Groot
- Department of Health Services Research (HSR)Faculty of Health, Medicine and Life Sciences (FHML)Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+)Maastricht UniversityMaastrichtThe Netherlands
| | - Milena Pavlova
- Department of Health Services Research (HSR)Faculty of Health, Medicine and Life Sciences (FHML)Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Center (MUMC+)Maastricht UniversityMaastrichtThe Netherlands
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Naidoo V, Suleman F, Bangalee V. Roles and reimbursement of pharmacists as South Africa transitions towards Universal Health Coverage (UHC): An online survey-based study. PLoS One 2021; 16:e0257348. [PMID: 34555058 PMCID: PMC8459985 DOI: 10.1371/journal.pone.0257348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 08/27/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The implementation of Universal Health Coverage in SA has sought to focus on promoting affordable health care services that are accessible to all citizens. In this regard, pharmacists are expected to play a pivotal function in the revitalization of primary health care (PHC) during this transition by the expansion of their practice roles. OBJECTIVES To assess the readiness and perceptions of pharmacists to expand their roles in an integrated health care system. To determine the availability and pricing of primary health care services currently provided within a community pharmacy environment and to evaluate suitable reimbursement for the provision of such services by a community pharmacist. METHODS Community pharmacists' across SA were invited to participate in an online survey-based study. The survey consisted of both open- and closed-ended questions. Descriptive statistics for closed-ended questions were generated and analysed using Microsoft Excel® and Survey Monkey®. Responses for the open-ended questions were transcribed, analysed, and reported as emerging themes. RESULTS Six hundred and sixty-four pharmacists' responded to the online survey. Seventy-five percent of pharmacists' reported that with appropriate training, a transition into a more patient-centered role might be beneficial in the re-engineering of the PHC system. However, in order to adopt these new roles, appropriate reimbursement structures are required. The current fee levied by pharmacists in community pharmacies that offered these PHC services was found to be lower to that recommended by the South African Pharmacy Council; this disparity is primarily due to a lack of information and policy standardisation. Therefore, in order to ensure that fees levied are fair, comprehensive service package guidelines are required. CONCLUSIONS This study provides baseline data for policy makers on pharmacists' readiness to transition into expanded roles. Furthermore, it can be used as a foundation to establish appropriate reimbursement frameworks for pharmacists providing PHC services.
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Affiliation(s)
- Vivian Naidoo
- Discipline of Pharmaceutical Sciences, Westville Campus, University of KwaZulu-Natal, Durban, South Africa
| | - Fatima Suleman
- Discipline of Pharmaceutical Sciences, Westville Campus, University of KwaZulu-Natal, Durban, South Africa
| | - Varsha Bangalee
- Discipline of Pharmaceutical Sciences, Westville Campus, University of KwaZulu-Natal, Durban, South Africa
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Raghunandan R, Howard K, Marra CA, Tordoff J, Smith A. Identifying Community Pharmacist Preferences For Prescribing Services in Primary Care in New Zealand: A Discrete Choice Experiment. APPLIED HEALTH ECONOMICS AND HEALTH POLICY 2021; 19:253-266. [PMID: 33073328 DOI: 10.1007/s40258-020-00615-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Given increasing patient populations, general practitioner (GP) workforce constraints and increasing demand for health services in New Zealand (NZ), the development and provision of pharmacist prescribing services may need to increase to improve people's access to medicines. A discrete choice experiment (DCE) was utilised to determine community pharmacist preferences for prescribing services in primary care in NZ, and to understand how these factors could improve the provision of pharmacist prescribing services. METHODS A D-efficient design generated 30 labelled choice questions in three blocks of ten, and three alternatives per choice question. The online DCE was emailed to practising community pharmacists in NZ. The DCE included two attributes with five levels (prescribing model, educational requirements) and three attributes with three levels (location, professional fee, change in income). A mixed multinomial logit model was used to estimate preferences. RESULTS A total of 264 respondents completed the survey with 2640 observations for analyses. This DCE found pharmacists preferred pharmacy services with the following characteristics: ability to prescribe using minor ailments and independent prescribing models relative to the pharmacist-only medicines prescribing model; prescribing education by accredited learning modules relative to PGDipClinPharm + PGCertPharmPres; remuneration via a professional fee; and pharmacist prescribing services located in community pharmacies rather than in GP practices. CONCLUSIONS Prescribing policy could incorporate these pharmacist preferences to help develop accessible and effective pharmacist prescribing services that not only improve access to medicines, but also address inequity of access to medicines in NZ. These DCE results are encouraging as they signal that the community pharmacists also see themselves and their pharmacies as part of the prescribing team in primary care in NZ.
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Affiliation(s)
- Rakhee Raghunandan
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand.
| | - Kirsten Howard
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Carlo A Marra
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand
| | - June Tordoff
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand
| | - Alesha Smith
- School of Pharmacy, University of Otago, PO Box 56, Dunedin, 9054, Otago, New Zealand
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Taylor S, Cairns A, Glass B. Expanded practice in rural community pharmacy in Australia: pharmacists’ perspectives. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2020. [DOI: 10.1002/jppr.1688] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Affiliation(s)
- Selina Taylor
- Centre for Rural & Remote Health James Cook University Mount Isa Australia
| | - Alice Cairns
- Centre for Rural & Remote Health James Cook University Weipa Australia
| | - Beverley Glass
- College of Medicine and Dentistry James Cook University Townsville Australia
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Sato N, Fujita K, Kushida K, Chen TF. Exploring the factors influencing the quality of "Health Support Pharmacy" services in Japan: Perspectives of community pharmacists. Res Social Adm Pharm 2020; 16:1686-1693. [PMID: 32147461 DOI: 10.1016/j.sapharm.2020.02.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Revised: 02/05/2020] [Accepted: 02/19/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND Internationally, community pharmacists play a key role in public health services. In Japan, a new system called Health Support Pharmacy (HSP) was introduced in 2016, to promote responsible self-medication with non-prescription medicines and increase awareness of public health activities provided through community pharmacies. The number of HSP services provided has been increasing; however, the service quality varies depending on pharmacies and/or pharmacists. Thus, it is important to identify factors that influence HSP service quality. OBJECTIVE To identify factors that can impact on the quality of HSP services provided by community pharmacists in Japan. METHODS In-depth semi-structured online interviews were conducted with twenty-four community pharmacists from across Japan. Interviews were audio-recorded, transcribed verbatim, and thematically analysed. All themes identified were deductively categorised into 3 domains using Donabedian's framework of structure, process and outcome. RESULTS Participants identified 8 key themes and 23 sub-themes pertaining to the quality of pharmacy public health services. For the structure domain these were: adequate resources, professional expertise, and policy and procedures. For the process domain these were: provision of individual services, provision of community health education and other events, and collaboration with other professionals. For the outcome domain these were: impact on individuals and the general public, and impact on other professionals. CONCLUSIONS This study identified factors which can impact HSP service quality by community pharmacists in Japan. Whilst the major themes identified align with those reported in other studies pertaining to expanded roles for community pharmacists, this study also identified findings which appear to be unique to the Japanese context. These findings, based on Donabedian's framework, may be used to better understand the scope and quality of HSP services delivered in Japan.
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Affiliation(s)
- Noriko Sato
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Camperdown, New South Wales, 2006, Australia.
| | - Kenji Fujita
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Camperdown, New South Wales, 2006, Australia.
| | - Kazuki Kushida
- Showa Pharmaceutical University, Faculty of Pharmacy, Tokyo, 194-8543, Japan.
| | - Timothy F Chen
- The University of Sydney School of Pharmacy, Faculty of Medicine and Health, Camperdown, New South Wales, 2006, Australia.
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Hughes CA, Breault RR, Schindel TJ. A qualitative case study exploring the implementation of pharmacist care planning services in community pharmacies. J Am Pharm Assoc (2003) 2020; 60:580-588.e2. [PMID: 31953119 DOI: 10.1016/j.japh.2019.12.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 11/27/2019] [Accepted: 12/12/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVES To describe the comprehensive annual care plan (CACP) process and to conceptualize how remunerated CACP services were implemented by community pharmacists. DESIGN A comparative, multiple case study approach with data comprising document review, observation, and semistructured interviews. SETTING AND PARTICIPANTS Pharmacists, pharmacy technicians and staff, and student pharmacists from 4 different community pharmacy sites in Alberta, Canada, including independent, franchise, and corporate chain pharmacies. In addition, patients and other health care providers were included in the interviews. OUTCOME MEASURES Constructivist grounded theory was used to understand how care planning services were implemented in the real-world context of community pharmacies and how pharmacists provided CACPs within their practice. RESULTS Between May 2016 and January 2018, a total of 77 interviews and 94 hours of observations were completed at the 4 pharmacy sites, and 61 documents were collected. The CACP service required adaptation of the workflow at each of the sites. However, pharmacists and other pharmacy staff recognized benefits of the service with respect to pharmacists' role expansion. The overarching grounded theory concept was changing the status quo. The following 4 themes emerged representing how the service was implemented: engaging patients, professional development and learning from experience, creating a supportive environment, and building community connections. CONCLUSION This study found that practice change or changing the status quo was needed to implement remunerated care planning services in community pharmacies. The results of this study may be of interest to community pharmacists, pharmacy managers, and policy makers who are implementing remunerated care planning services in other jurisdictions.
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Parker T, Tak CR, Kim K, Feehan M, Munger MA. Consumer awareness and utilization of clinical services, and their satisfaction and loyalty with community pharmacies: Analysis of a US nationwide survey. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019. [DOI: 10.1002/jac5.1137] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Tavan Parker
- Department of Pharmacotherapy University of Utah Salt Lake City Utah
| | - Casey R. Tak
- Division of Pharmaceutical Outcomes and Policy, Eshelman School of Pharmacy University of North Carolina at Chapel Hill Chapel Hill North Carolina
- UNC Health Sciences at MAHEC Asheville North Carolina
| | - Kibum Kim
- Department of Pharmacotherapy University of Utah Salt Lake City Utah
| | | | - Mark A Munger
- Department of Pharmacotherapy and Internal Medicine University of Utah Salt Lake City Utah
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Schommer JC, Olson AW, Isetts BJ. Transforming community-based pharmacy practice through financially sustainable centers for health and personal care. J Am Pharm Assoc (2003) 2019; 59:306-309. [DOI: 10.1016/j.japh.2018.10.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 10/02/2018] [Accepted: 10/11/2018] [Indexed: 10/27/2022]
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Soekhai V, de Bekker-Grob EW, Ellis AR, Vass CM. Discrete Choice Experiments in Health Economics: Past, Present and Future. PHARMACOECONOMICS 2019; 37:201-226. [PMID: 30392040 PMCID: PMC6386055 DOI: 10.1007/s40273-018-0734-2] [Citation(s) in RCA: 408] [Impact Index Per Article: 81.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVES Discrete choice experiments (DCEs) are increasingly advocated as a way to quantify preferences for health. However, increasing support does not necessarily result in increasing quality. Although specific reviews have been conducted in certain contexts, there exists no recent description of the general state of the science of health-related DCEs. The aim of this paper was to update prior reviews (1990-2012), to identify all health-related DCEs and to provide a description of trends, current practice and future challenges. METHODS A systematic literature review was conducted to identify health-related empirical DCEs published between 2013 and 2017. The search strategy and data extraction replicated prior reviews to allow the reporting of trends, although additional extraction fields were incorporated. RESULTS Of the 7877 abstracts generated, 301 studies met the inclusion criteria and underwent data extraction. In general, the total number of DCEs per year continued to increase, with broader areas of application and increased geographic scope. Studies reported using more sophisticated designs (e.g. D-efficient) with associated software (e.g. Ngene). The trend towards using more sophisticated econometric models also continued. However, many studies presented sophisticated methods with insufficient detail. Qualitative research methods continued to be a popular approach for identifying attributes and levels. CONCLUSIONS The use of empirical DCEs in health economics continues to grow. However, inadequate reporting of methodological details inhibits quality assessment. This may reduce decision-makers' confidence in results and their ability to act on the findings. How and when to integrate health-related DCE outcomes into decision-making remains an important area for future research.
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Affiliation(s)
- Vikas Soekhai
- Section of Health Technology Assessment (HTA) and Erasmus Choice Modelling Centre (ECMC), Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam (EUR), P.O. Box 1738, Rotterdam, 3000 DR The Netherlands
- Department of Public Health, Erasmus MC, University Medical Center, P.O. Box 2040, Rotterdam, 3000 CA The Netherlands
| | - Esther W. de Bekker-Grob
- Section of Health Technology Assessment (HTA) and Erasmus Choice Modelling Centre (ECMC), Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam (EUR), P.O. Box 1738, Rotterdam, 3000 DR The Netherlands
| | - Alan R. Ellis
- Department of Social Work, North Carolina State University, Raleigh, NC USA
| | - Caroline M. Vass
- Manchester Centre for Health Economics, The University of Manchester, Manchester, UK
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Giannetti V, Caley CF, Kamal KM, Covvey JR, McKee J, Wells BG, Najarian DM, Dunn TJ, Vadagam P. Community pharmacists and mental illness: a survey of service provision, stigma, attitudes and beliefs. Int J Clin Pharm 2018; 40:1096-1105. [PMID: 29862460 DOI: 10.1007/s11096-018-0619-7] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 03/15/2018] [Indexed: 11/24/2022]
Abstract
Background Half of Americans experience mental illness during their lifetime. Significant opportunity exists for community pharmacists to deliver services to these patients; however, personal and practice-related barriers may prevent full engagement. Objective To assess the demographics, practice characteristics, service provision, stigma, attitudes and beliefs of a national sample of community pharmacists towards individuals with mental illness. Setting National random sample of 3008 community pharmacists in the USA. Method 101-item cross-sectional mailed survey questionnaire on: (1) demographics, (2) knowledge and practice characteristics, (3) provision of clinical pharmacy services, and (4) comparative opinions. Main outcome measure Scaled measures of service provision (comfort, confidence, willingness and interest) and comparative opinions (stigma, attitudes and beliefs) of mental illness, four linear regression models to predict service provision. Results A total of 239 responses were received (response rate 7.95%). Across pharmacy services, ratings for willingness/interest were higher than those for comfort/confidence. Pharmacists who reported providing medication therapy management (MTM) services for patients reported higher comfort (18.36 vs. 17.46, p < 0.05), confidence (17.73 vs. 16.01, p < 0.05), willingness (20.0 vs. 18.62, p < 0.05) and interest (19.13 vs. 17.66, p < 0.05). Pharmacists with personal experience with mental illness also resulted in higher scores across all four domains of service provision, lower levels of stigma (18.28 vs. 20.76, p < 0.05) and more positive attitudes (52.24 vs. 50.53, p < 0.01). Regression analyses demonstrated increased frequency of MTM service delivery and more positive attitudes as significantly predictive across all four models for comfort, confidence, willingness and interest. Increased delivery of pharmacy services was significantly associated with both willingness and interest to provide mental illness-specific services. Conclusion Despite willingness/interest to provide services to patients with mental illness, decreased levels of comfort/confidence remain service-related barriers for community pharmacists.
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Affiliation(s)
- Vincent Giannetti
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, 600 Forbes Ave, Pittsburgh, PA, 15282, USA.
| | - Charles F Caley
- Department of Pharmacy Practice, Western New England University College of Pharmacy and Health Sciences, 1215 Wilbraham Road, Springfield, MA, 01119, USA
| | - Khalid M Kamal
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, 600 Forbes Ave, Pittsburgh, PA, 15282, USA
| | - Jordan R Covvey
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, 600 Forbes Ave, Pittsburgh, PA, 15282, USA
| | - Jerry McKee
- Community Care of North Carolina, 2300 Rexwoods Drive, Raleigh, NC, 27607, USA
| | - Barbara G Wells
- The University of Mississippi School of Pharmacy, University, MS, 38677, USA
| | - Dean M Najarian
- Janssen Scientific Affairs, 1771 West Street, Wrentham, MA, 02093, USA
| | - Tyler J Dunn
- The University of Mississippi School of Pharmacy, University, MS, 38677, USA
| | - Pratyusha Vadagam
- Envision Pharma Group, 205 East 42nd Street, New York, NY, 10017, USA
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Munger MA, Sundwall DN, Feehan M. Integrating Family Medicine and Community Pharmacy to Improve Patient Access to Quality Primary Care and Enhance Health Outcomes. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2018; 82:6572. [PMID: 29867245 PMCID: PMC5972854 DOI: 10.5688/ajpe6572] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Accepted: 08/02/2017] [Indexed: 06/07/2023]
Affiliation(s)
- Mark A Munger
- University of Utah College of Pharmacy, Salt Lake City, Utah
| | | | - Michael Feehan
- University of Utah College of Pharmacy, Salt Lake City, Utah
- Kantar LLC, New York, New York
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