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Murphy AL, Suh S, Gillis L, Morrison J, Gardner DM. Pharmacist Administration of Long-Acting Injectable Antipsychotics to Community-Dwelling Patients: A Scoping Review. PHARMACY 2023; 11:pharmacy11020045. [PMID: 36961024 PMCID: PMC10037648 DOI: 10.3390/pharmacy11020045] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/14/2023] [Accepted: 02/21/2023] [Indexed: 03/03/2023] Open
Abstract
Long-acting injectable antipsychotics (LAIAs) have demonstrated positive outcomes for people with serious mental illnesses. They are underused, and access to LAIAs can be challenging. Pharmacies could serve as suitable environments for LAIA injection by pharmacists. To map and characterize the literature regarding the administration of LAIAs by pharmacists, a scoping review was conducted. Electronic-database searches (e.g., PsycINFO, Ovid Medline, Scopus, and Embase) and others including ProQuest Dissertations & Theses Global and Google, were conducted. Citation lists and cited-reference searches were completed. Zotero was used as the reference-management database. Covidence was used for overall review management. Two authors independently screened articles and performed full-text abstractions. From all sources, 292 studies were imported, and 124 duplicates were removed. After screening, 13 studies were included for abstraction. Most articles were published in the US since 2010. Seven studies used database and survey methods, with adherence and patient satisfaction as the main patient-outcomes assessed. Reporting of pharmacists' and patients' perspectives surrounding LAIA administration was minimal and largely anecdotal. Financial analyses for services were also limited. The published literature surrounding pharmacist administration of LAIAs is limited, providing little-to-no guidance for the development and implementation of this service by others.
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Affiliation(s)
- Andrea L Murphy
- College of Pharmacy, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada
| | - Sowon Suh
- College of Pharmacy, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Louise Gillis
- W.K. Kellogg Health Sciences Library, Dalhousie University, Halifax, NS B3H 4R2, Canada
| | - Jason Morrison
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada
| | - David M Gardner
- College of Pharmacy, Dalhousie University, Halifax, NS B3H 4R2, Canada
- Department of Psychiatry, Dalhousie University, Halifax, NS B3H 2E2, Canada
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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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Egieyeh E, van Huyssteen M, Coetzee R, Bheekie A. Evaluating pharmacy students' knowledge and skills in reproductive, maternal, new-born and child health care at a South African university. BMC MEDICAL EDUCATION 2021; 21:34. [PMID: 33413294 PMCID: PMC7791779 DOI: 10.1186/s12909-020-02476-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 12/23/2020] [Indexed: 05/03/2023]
Abstract
BACKGROUND Maternal and child mortality is a global concern and one of South Africa's quadruple burdens of disease. As easily accessible frontline healthcare workers, pharmacists play an important role in the continuum of maternal and child health (MCH) care according to recommendations by international health regulatory bodies. Pharmacy schools are obliged to train pharmacy students to meet the priority health needs of the population so that graduates are 'fit for purpose'. The baseline study aimed to evaluate the knowledge and skills of 2017 final year pharmacy students who were exposed to a fragmented MCH care curriculum at a university in South Africa to inform curriculum review. METHODS A descriptive, quantitative, non-randomized study was conducted among final year pharmacy students using a self-administered structured questionnaire. The questionnaire was designed in sections to assess participants' knowledge of reproductive and sexual health (RSH), maternal and antenatal care (MAC), neonatal and child care (NCC) and skills related to infant growth assessment procedures. Data was analysed descriptively using frequencies and percentages. A score of 50% in each section of the questionnaire indicated a pass. Participants assessed their exposure to MCH topics in the curriculum. RESULTS Of the 89 available students, 61% consented to participate in the study. The average scores attained for each section were; 62.4% for RSH, 54.5% for MAC, 50.4% for NCC and 25.3% for infant growth assessment. The pass rate was 78% for RSH, 56% for MAC, 57% for NCC, and 19% for infant growth assessment. About 13% of the participants passed all the knowledge and the skills sections. Age, gender, being a parent or doing locums did not have any influence on participants' performance. Participants reported that they had more on-campus curriculum content exposure to RSH compared to other MCH care topics. CONCLUSION Final year pharmacy students showed adequate knowledge of RSH with adequate curriculum exposure. Average knowledge of MAC, NCC and poor skills in infant growth assessment which corresponded to curriculum exposure was observed. The results suggest the need for improvement in the current curriculum in the affected areas to adequately equip students to render desirable services.
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Affiliation(s)
- Elizabeth Egieyeh
- Discipline of Pharmacology and Clinical Pharmacy, School of Pharmacy, University of the Western Cape, Cape Town, 7535 South Africa
| | - Mea van Huyssteen
- Discipline of Pharmacology and Clinical Pharmacy, School of Pharmacy, University of the Western Cape, Cape Town, 7535 South Africa
| | - Renier Coetzee
- Discipline of Pharmacology and Clinical Pharmacy, School of Pharmacy, University of the Western Cape, Cape Town, 7535 South Africa
| | - Angeni Bheekie
- Discipline of Pharmacology and Clinical Pharmacy, School of Pharmacy, University of the Western Cape, Cape Town, 7535 South Africa
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El-Den S, McMillan SS, Wheeler AJ, Ng R, Roennfeldt H, O'Reilly CL. Pharmacists' roles in supporting people living with severe and persistent mental illness: a systematic review protocol. BMJ Open 2020; 10:e038270. [PMID: 32665350 PMCID: PMC7359051 DOI: 10.1136/bmjopen-2020-038270] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/12/2020] [Accepted: 05/15/2020] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Severe and persistent mental illness (SPMI) can significantly impact a person's social, personal and professional life. Previous studies have demonstrated pharmacists' roles in mental healthcare; however, limited studies to date have focused on pharmacists' roles in providing healthcare services, specifically, to people living with SPMI. The aim of this systematic review is to explore the pharmacists' roles in providing support to people living with SPMI. METHODS AND ANALYSIS A systematic search will be conducted in Medline, Embase (Ovid), PsycINFO, CINAHL, Web of Science, Scopus, Cochrane Library, International Pharmaceutical Abstracts and ProQuest Dissertations and Theses to identify potentially relevant primary research for inclusion. This will be guided by the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols checklist for systematic reviews. All primary research publications regardless of study design exploring or reporting on pharmacists' involvement in supporting people living with SPMI will be considered for inclusion. A tabular summary will be completed using data extracted from each included publication. Data synthesis and quality assessment methods will be chosen based on included study designs. ETHICS AND DISSEMINATION The results will be published in a peer-reviewed journal and used to inform the development of a pharmacist-specific training package to support people living with SPMI. PROSPERO REGISTRATION NUMBER CRD42020170711.
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Affiliation(s)
- Sarira El-Den
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sara S McMillan
- School of Pharmacy and Pharmacology, Griffith University, Southport, Queensland, Australia
- Menzies Health Institute, Griffith University, Nathan, Queensland, Australia
| | - Amanda J Wheeler
- Menzies Health Institute, Griffith University, Nathan, Queensland, Australia
- Faculty of Health and Medical Sciences, University of Auckland, Auckland, New Zealand
| | - Ricki Ng
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Helena Roennfeldt
- Menzies Health Institute, Griffith University, Nathan, Queensland, Australia
- The University of Melbourne Centre for Psychiatric Nursing, Carlton, Victoria, Australia
| | - Claire L O'Reilly
- Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Hope DL, Hattingh L, King MA. Emergency contraception awareness in an at‐risk population. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2019. [DOI: 10.1002/jppr.1554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Denise L. Hope
- Menzies Health Institute Queensland, Griffith University Gold Coast Australia
- Quality Use of Medicines Network Griffith University Gold Coast Australia
- School of Pharmacy and Pharmacology Griffith University Gold Coast Australia
| | - Laetitia Hattingh
- Quality Use of Medicines Network Griffith University Gold Coast Australia
- School of Pharmacy and Pharmacology Griffith University Gold Coast Australia
- Gold Coast Health Service Gold Coast Australia
| | - Michelle A. King
- Menzies Health Institute Queensland, Griffith University Gold Coast Australia
- Quality Use of Medicines Network Griffith University Gold Coast Australia
- School of Pharmacy and Pharmacology Griffith University Gold Coast Australia
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Hall N, Mooney JD, Sattar Z, Ling J. Extending alcohol brief advice into non-clinical community settings: a qualitative study of experiences and perceptions of delivery staff. BMC Health Serv Res 2019; 19:11. [PMID: 30616659 PMCID: PMC6323768 DOI: 10.1186/s12913-018-3796-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 12/05/2018] [Indexed: 11/25/2022] Open
Abstract
Background At a population level, the majority of alcohol-related harm is attributable to drinkers whose consumption exceeds recommended drinking levels, rather than those with severe alcohol dependency. Identification and Brief Advice (IBA) interventions offer a cost-effective approach for reducing this harm. Traditionally, IBA interventions have been delivered in healthcare settings and therefore contextual influences on their use in non-clinical settings are not well understood. Methods Qualitative face-to-face and telephone interviews with staff responsible for delivering a pilot IBA intervention across community settings in the UK. Interviews were recorded and transcribed verbatim. Inductive thematic analysis was used to identify key issues and the constant comparison method was employed to compare barriers and facilitators to implementation across and within settings. Results A number of facilitators and barriers to delivery and implementation was identified across settings. These included familiarity with the customer base, working within public spaces, and assimilation of the intervention within existing role boundaries. Despite underlying concerns relating to the sensitive nature of the topic, most delivery staff felt their respective settings were appropriate for the delivery of the intervention and had proactively engaged members of the public with varying levels of risky drinking and readiness for behaviour change. Perceptions of actual or potential intervention success were conceptualised in relation to existing day-to-day role boundaries and responsibilities and the contexts in which they took place. Conclusions Findings support the potential value of multi-setting community approaches to facilitate more inclusive engagement with IBA. By comparing experiences and views from staff responsible for delivering the intervention across different community settings, our findings provide insight into how intervention acceptability and success are framed across settings, and how the intervention is assimilated within everyday practice and role boundaries. This study also highlights key areas to be addressed when implementing IBAs in non-clinical community settings by staff with diverse levels of health-related knowledge, skills and support needs. Although essential, the need for adaptable training and delivery approaches across different setting types is likely to result in methodological challenges that need to be addressed when evaluating future interventions and setting-specific influences on behaviour change and health outcomes.
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Affiliation(s)
- Nicola Hall
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England.
| | - John D Mooney
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England
| | - Zeibeda Sattar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England.,Faculty of Health and Life Sciences, Northumbria University, Newcastle, NE1 8ST, UK, England
| | - Jonathan Ling
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sciences Complex, Sunderland, SR1 3SD, UK, England
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Murphy AL, Gardner DM, Jacobs LM. Patient care activities by community pharmacists in a capitation funding model mental health and addictions program. BMC Psychiatry 2018; 18:192. [PMID: 29898682 PMCID: PMC6000927 DOI: 10.1186/s12888-018-1746-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Accepted: 05/14/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Community pharmacists are autonomous, regulated health care professionals located in urban and rural communities in Canada. The accessibility, knowledge, and skills of community pharmacists can be leveraged to increase mental illness and addictions care in communities. METHODS The Bloom Program was designed, developed, and implemented based on the Behaviour Change Wheel and a program of research in community pharmacy mental healthcare capacity building. We evaluated the Bloom Program as a demonstration project using mixed methods. A retrospective chart audit was conducted to examine outcomes and these are reported in this paper. RESULTS We collected 201 patient charts from 23 pharmacies in Nova Scotia with 182 patients having at least one or more follow-up visits. Anxiety (n = 126, 69%), depression (n = 112, 62%), and sleep disorders (n = 64, 35%) were the most frequent mental health problems. Comorbid physical health problems were documented in 57% (n = 104). The average number of prescribed medications was 5.5 (range 0 to 24). Sixty seven percent (n = 122) were taking multiple psychotropics and 71% (n = 130) reported taking more than one medication for physical health problems. Treatment optimization was the leading reason for enrollment with more than 80% seeking improvements in symptom management and daily functioning. There were a total of 1233 patient-care meetings documented, of which the duration was recorded in 1098. The median time for enrolling, assessing, and providing follow-up care by pharmacists was 142 min (mean 176, SD 128) per patient. The median follow-up encounter duration was 15 min. A total of 146 patient care encounters were 60 min or longer, representing 13.3% of all timed encounters. CONCLUSIONS Pharmacists work with patients with lived experience of mental illness and addictions to improve medication related outcomes including those related to treatment optimization, reducing polytherapy, and facilitating withdrawal from medications. Pharmacists can offer their services frequently and routinely without the need for an appointment while affording patient confidentiality and privacy. Important roles for pharmacists around the deprescribing of various medications (e.g., benzodiazepines) have previously been supported and should be optimized and more broadly implemented. Further research on the best mechanisms to incentivize pharmacists in mental illness and addiction's care should be explored.
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Affiliation(s)
- Andrea L. Murphy
- 0000 0004 1936 8200grid.55602.34College of Pharmacy and Department of Psychiatry, Dalhousie University, 5968 College St, PO Box 15000, Halifax, NS B3H 4R2 Canada
| | - David M. Gardner
- 0000 0004 1936 8200grid.55602.34Department of Psychiatry and College of Pharmacy, Dalhousie University, QEII HSC, AJLB 7517, 5909 Veterans’ Memorial Lane, Halifax, NS B3H 2E2 Canada
| | - Lisa M. Jacobs
- Independent Evaluator, Contact Consulting, Halifax, NS Canada
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Hattingh HL, Tait RJ. Pharmacy-based alcohol-misuse services: current perspectives. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2018; 7:21-31. [PMID: 29732288 PMCID: PMC5927143 DOI: 10.2147/iprp.s140431] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Context Globally, the use of alcohol is a leading cause of mortality and morbidity. Opportunistic screening and brief interventions (SBIs) have been shown to be effective in reducing alcohol consumption in certain primary care settings and provide a means of reaching some of those who do not seek treatment for alcohol-related problems. Further, community pharmacies have the potential to reach consumers at an early stage of their alcohol use and incorporate intervention and advice into their role in providing medications. Aim The purpose of this review was to inform pharmacists and stakeholders of the evidence base for SBI in community pharmacy settings. To date, there has been limited research on the effectiveness of alcohol SBI in community pharmacies, with a systemic review only identifying two randomized trials. Methods This narrative review reports on the period 2007–2017, covering feasibility studies, pilot programs, and surveys of consumers and pharmacy staff attitudes relating to alcohol SBI in this setting. Studies were identified via MEDLINE, CINAHL, Google Scholar, and reference lists of relevant publications. Findings The findings indicated that the provision of community pharmacy alcohol SBI requires training in communication and intervention skills and in some cases increasing confidence and alcohol-related knowledge. Consumers were generally receptive to the SBI approach but requested private areas for delivery of such. Conclusion The high prevalence of “at risk” alcohol use in many countries and the low level of treatment seeking by this group means that novel approaches to engage opportunistically with these people is imperative in reducing alcohol-related harms. However, before committing routine health funding, these novel approaches need rigorous evaluation.
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Affiliation(s)
- Hendrika L Hattingh
- School of Pharmacy and Pharmacology, Griffith Health, Griffith University, Gold Coast, QLD
| | - Robert J Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
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Sullivan C, Martin N, White C, Newbury-Birch D. Assessing the delivery of alcohol screening and brief intervention in sexual health clinics in the north east of England. BMC Public Health 2017; 17:884. [PMID: 29149878 PMCID: PMC5693529 DOI: 10.1186/s12889-017-4878-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Accepted: 10/26/2017] [Indexed: 11/10/2022] Open
Abstract
Background Risky drinking is associated with risky sexual experiences, however the relationship between alcohol and sex is complex. The aim of the study was to assess the feasibility of delivering alcohol screening and brief interventions in genitourinary medicine (GUM) clinics. The objectives were to; understand the levels of alcohol use amongst patients; report on the number of alcohol interventions delivered; and to analyse the relationship between alcohol use with demographic data as well as diagnosed sexually transmitted infections (STIs) to see if there were any associations. Methods All new patients attending GUM between April 2012 and March 2013 self-completed the Alcohol Use Disorder Identification Test (AUDIT) prior to their clinical consultation. Where appropriate (scoring 8+ on AUDIT) the clinician would deliver up to 2–3 min of alcohol brief intervention. Descriptive statistics, t-tests, ANOVA and logistic regression were carried out as appropriate. Results AUDIT scores were available for 90% of all new patients (3058/3390) with an average mean score of 7.75. Of those who drank alcohol, 44% were categorised as being AUDIT positive, including 2% who had a score indicative of probable alcohol dependence (20+). 55 % (n = 638) of patients who screened positive on the AUDIT received a brief intervention whilst 24% (n = 674) of drinkers were diagnosed with a STI. Logistic regression modelling revealed that males, younger age groups and those of ‘white’ ethnicity were more likely to score positive on AUDIT. Patients classified as non-students, living in deprivation quintiles one to four and categorised as probable alcohol dependence on the AUDIT were more likely to be diagnosed with an STI. Conclusion It is possible to embed alcohol screening into routine practice within sexual health services however further work is required to embed brief interventions particularly amongst increasing risk drinkers. If resources are limited, services may consider more targeted rather than universal alcohol screening to specific population groups. The study was undertaken in one GUM service in the North East of England and therefore findings may not be generalizable. The study did not assess efficacy of alcohol brief intervention in this setting.
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Affiliation(s)
- C Sullivan
- Public Health England, North East Centre, Newcastle upon Tyne, UK.,Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - N Martin
- Balance, North East Alcohol Office, Durham, UK
| | - C White
- County Durham and Darlington NHS Foundation Trust, County Durham, UK
| | - D Newbury-Birch
- School of Health and Social Care, Teesside University, Constantine Building, Middlesbrough, TS1 3BA, UK.
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Saramunee K, Dewsbury C, Cutler S, Mackridge AJ, Krska J. Public attitudes towards community pharmacy attributes and preferences for methods for promotion of public health services. Public Health 2017; 140:186-195. [PMID: 27481066 DOI: 10.1016/j.puhe.2016.06.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 04/03/2016] [Accepted: 06/27/2016] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To identify attitudes towards pharmacy characteristics and promotional methods for selected pharmacy public health services (lifestyle advice and screening for cardiovascular risk factors) among different sectors of the general public. STUDY DESIGN Cross-sectional survey, using a previously validated questionnaire. METHODS Three survey methods were used, across 15 areas of England, to maximize diversity: face-to-face; telephone; and self-completion of paper questionnaires. Responses to closed questions regarding characteristics and promotion were quantified and differences among sub-groups explored by univariate and multivariate analysis. RESULTS In total, 2661 responses were available for analysis: 2047 face-to-face; 301 telephone; and 313 paper. There were strong preferences for a pharmacy near to home or doctor's surgery and for long opening hours, particularly among employed people and non-whites. Fifty percent preferred not to use a pharmacy in a supermarket, particularly older people, the retired, those of lower education and frequent pharmacy users. Personal recommendation by health professionals or family/friends was reported as most likely to encourage uptake of pharmacy public health services, with older people and males being less likely and frequent pharmacy users more likely to perceive any promotional method as influential. Posters/leaflets were preferred over mass-media methods, with fewer than 30% perceiving the latter as potentially influential. CONCLUSION Pharmacists, pharmacy companies and service commissioners should use promotional methods favoured by potential users of pharmacy public health services and be aware of differences in attitudes when trying to reach specific population sub-groups. For personal recommendation to be successful, good inter-professional working and a pro-active approach to existing customers are needed.
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Affiliation(s)
- K Saramunee
- Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Maha Sarakham, 44150, Thailand.
| | - C Dewsbury
- Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham, Kent, ME4 4TB, UK
| | - S Cutler
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - A J Mackridge
- School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, L3 3AF, UK
| | - J Krska
- Medway School of Pharmacy, The Universities of Greenwich and Kent at Medway, Chatham, Kent, ME4 4TB, UK
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Hattingh HL, Hallett J, Tait RJ. 'Making the invisible visible' through alcohol screening and brief intervention in community pharmacies: an Australian feasibility study. BMC Public Health 2016; 16:1141. [PMID: 27825369 PMCID: PMC5101702 DOI: 10.1186/s12889-016-3805-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 11/01/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Screening and brief interventions (SBI) for alcohol related problems have been shown to be effective in health settings such as general practice or emergency departments. Recent data from the United Kingdom and New Zealand suggest that SBI can be delivered through community pharmacies, but this approach has not been tested in Australia. This study assesses the feasibility of delivering alcohol SBI via community pharmacists. METHOD We recruited five pharmacies and developed an SBI training package to be delivered by pharmacy staff, who screened consumers and delivered the brief intervention where appropriate. Consumers also completed a questionnaire on the process. At three months consumers were telephoned to enable 'retention' to be quantified. After completing recruitment, a semi-structured interview was conducted with pharmacists on the process of delivering the intervention, potential improvements and sustainability. RESULTS Fifty consumer participants were screened, ten from each pharmacy. There were 28 (57 %) men and 21 (43 %) women with one not responding. Most (67 %) were aged 25-55 years. Their AUDIT scores had a range of 0 to 39 (mean 10.9, SD 9.8) with 11 categorised as 'hazardous (8-15)', four as 'harmful (16-19)' and eight as 'probably dependent (20+)' consumers of alcohol. Reactions to the process of SBI were generally favourable: for example 75 % agreed that it was either appropriate or very appropriate being asked about their alcohol consumption. With respect to follow-up interviews, 23 (46 %) agreed that they could be contacted, including five from the highest AUDIT category. Subsequently 11 (48 %) were contactable at three months. Three of the five non-low risk drinkers had reduced their level of risk over the three months. Ten pharmacists participated in semi-structured telephone interviews. Overall these pharmacists were positive about the intervention and five main themes emerged from the interviews: 1) flexibility applied in recruitment of participants, 2) easiness in use of AUDIT score to facilitate discussions, 3) perceived positive intervention impact, 4) enhanced role of community pharmacists and 5) facilitators and challenges experienced. CONCLUSIONS Pharmacy-based SBI appears to be acceptable to consumers and feasible for pharmacy staff to deliver. Challenges remain in translating this potential into actual services.
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Affiliation(s)
| | - Jonathan Hallett
- School of Public Health, Curtin University, Kent Street, Bentley, Australia
| | - Robert J. Tait
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, 10 Selby Street, Shenton Park, Australia
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From personal crisis care to convenience shopping: an interpretive description of the experiences of people with mental illness and addictions in community pharmacies. BMC Health Serv Res 2016; 16:569. [PMID: 27729051 PMCID: PMC5059973 DOI: 10.1186/s12913-016-1817-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2015] [Accepted: 10/04/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The role of community pharmacists is changing globally with pharmacists engaging in more clinically-oriented roles, including in mental health care. Pharmacists' interventions have been shown to improve mental health related outcomes but various barriers can limit pharmacists in their care of patients. We aimed to explore the experiences of people with lived experience of mental illness and addictions in community pharmacies to generate findings to inform practice improvements. METHODS We used interpretive description methodology with analytic procedures of thematic analysis to explore the experiences of people with lived experience of mental illness and addictions with community pharmacy services. Participants were recruited through multiple mechanisms (e.g., paper and online advertisements), offered honorarium for their time, and given the option of a focus group or interview for participation in our study. Data were gathered during July to September of 2012. Interviews and focus groups were audio-recorded, transcribed verbatim, and analyzed by two researchers. RESULTS We collected approximately nine hours of audio data from 18 individuals in two focus groups (n = 12) and six individual interviews. Fourteen participants were female and the average age was 41 years (range 24 to 57 years). Expectations, decision-making, and supports were identified as central themes underlying the community pharmacy experiences of people with lived experience of mental illness and addictions. Eight subthemes were identified including: relationships with pharmacy staff; patient's role in the pharmacist-patient relationship; crisis and triage; privacy and confidentiality; time; stigma and judgment; medication-related and other services; and transparency. CONCLUSIONS People with lived experience of mental illness and addictions demonstrate a high regard and respect for pharmacist's knowledge and abilities but hold conservative expectations of pharmacy health services shaped by experience, observations, and assumptions. To some extent, expectation management occurs with the recognition of the demands on pharmacists and constraints inherent to community pharmacy practice. Relationships with pharmacy staff are critical to people with lived experience and influence their decision-making. Research in the area of pharmacists' roles in crises and triage, especially in the area of suicide assessment and mitigation, is needed urgently.
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Moaddeb J, Mills R, Haga SB. Community pharmacists' experience with pharmacogenetic testing. J Am Pharm Assoc (2003) 2016; 55:587-594. [PMID: 26409205 DOI: 10.1331/japha.2015.15017] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Appendix 1 Statements of knowledge of correct medication use Appendix 2 Statements of self-efficacy of correct medication use Appendix 3 Statements of skills of correct medication use To characterize the experiences and feasibility of offering pharmacogenetic (PGx) testing in a community pharmacy setting. DESIGN Pharmacists were invited to complete a survey about PGx testing for each patient who was offered testing. If the patient consented, pharmacists were also asked to complete a follow-up survey about the process of returning PGx testing results to patients and follow-up with the prescribing provider. SETTING Community pharmacies in North Carolina from August through November 2014. PARTICIPANTS Pharmacists at five community pharmacies. MAIN OUTCOME MEASURES Patient consent for testing, time to introduce PGx testing initially and communicate results, interpretation of test results, and recommended medication changes. RESULTS Of the 69 patients offered testing, 56 (81%) consented. Pre-test counseling typically lasted 1-5 minutes (81%), and most patients (55%) did not have any questions about the testing. Most pharmacists reported test results to patients by phone (84%), with discussions taking less than 1 minute (48%) or 1-5 minutes (52%). Most pharmacists believed the patients understood their results either very well (54%) or somewhat well (41%). Pharmacists correctly interpreted 47 of the 53 test results (89%). All of the incorrect interpretations were for patients with test results indicating a dosing or drug change (6/19; 32%). Pharmacists reported contacting the ordering physician for four patients to discuss results indicating a dosage or drug change. CONCLUSION The provision of PGx services in a community pharmacy setting appears feasible, requiring little additional time from the pharmacist, and many patients seem interested in PGx testing. Additional training may be necessary to improve test result interpretation, as well as for communication with both patients and ordering physicians.
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Affiliation(s)
- Jivan Moaddeb
- Clinical Pharmacist, Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Rachel Mills
- Clinical Research Coordinator and Genetic Counselor, Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC
| | - Susanne B Haga
- Center for Applied Genomics and Precision Medicine, Department of Medicine, Duke University School of Medicine, Durham, NC.
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Murphy AL, Phelan H, Haslam S, Martin-Misener R, Kutcher SP, Gardner DM. Community pharmacists' experiences in mental illness and addictions care: a qualitative study. SUBSTANCE ABUSE TREATMENT PREVENTION AND POLICY 2016; 11:6. [PMID: 26821700 PMCID: PMC4730654 DOI: 10.1186/s13011-016-0050-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 01/18/2016] [Indexed: 11/10/2022]
Abstract
Background Community pharmacists are accessible health care professionals who encounter people with lived experience of mental illness and addictions in daily practice. Although some existing research supports that community pharmacists’ interventions result in improved patient mental health outcomes, gaps in knowledge regarding the pharmacists’ experiences with service provision to this population remain. Improving knowledge regarding the pharmacists’ experiences with mental illness and addictions service provision can facilitate a better understanding of their perspectives and be used to inform the development and implementation of interventions delivered by community pharmacists for people with lived experience of mental illness and addictions in communities. Methods We conducted a qualitative study using a directed content analysis and the Theoretical Domains Framework as part of our underlying theory of behaviour change and our analytic framework for theme development. The Theoretical Domains Framework facilitates understanding of behaviours of health care professionals and implementation challenges and opportunities for interventions in health care. Thematic analysis co-occurred throughout the process of the directed content analysis. We recruited community pharmacists, with experience dispensing psychotropics, at a minimum, through multiple mechanisms (e.g., professional associations) in a convenience sampling approach. Potential participants were offered the option of focus groups or interviews. Results Data were collected from one focus group and two interviews involving six pharmacists. Theoretical Domains Framework coding was primarily weighted in two domains: social/professional role and identity and environmental context and resources. We identified five main themes in the experiences of pharmacists in mental illness and addictions care: competing interests, demands, and time; relationships, rapport, and trust; stigma; collaboration and triage; and role expectations and clarity. Conclusions Pharmacists are not practicing to their full scope of practice in mental illness and addictions care for several reasons including limitations within the work environment and lack of structures and processes in place to be fully engaged as health care professionals. More research and policy work are needed to examine better integration of pharmacists as members of the mental health care team in communities. Electronic supplementary material The online version of this article (doi:10.1186/s13011-016-0050-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Andrea L Murphy
- College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Heather Phelan
- College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Scott Haslam
- College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Ruth Martin-Misener
- School of Nursing, Dalhousie University, 5869 University Ave., PO Box 15000, Halifax, NS, B3H 4R2, Canada.
| | - Stan P Kutcher
- Sun Life Financial Chair in Adolescent Mental Health, Dalhousie University/IWK Health Centre, 5850 University Ave., PO Box 9700, Halifax, NS, B3K 6R8, Canada.
| | - David M Gardner
- Department of Psychiatry, Dalhousie University, QEII HSC, AJLB 7517, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada.
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