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van Paassen JG, Tan JP, Deneer VHM, Bouvy ML. Exploring the pharmacists' role in optimising antithrombotic therapy in primary care: a qualitative study. BMJ Open 2024; 14:e079018. [PMID: 38508648 PMCID: PMC10952980 DOI: 10.1136/bmjopen-2023-079018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE In antithrombotic therapy, the balance between efficacy and safety is delicate, which makes it challenging for healthcare professionals, including pharmacists, to optimise therapy. Pharmacists may play an important role in optimising antithrombotic therapy, but especially in primary care, this role has not been elucidated. Here, we study how community pharmacists (pharmacists in primary care) perceive their current and future role in antithrombotic therapy. DESIGN We conducted a qualitative study using semi-structured interviews. The interview protocol and subsequent analysis were based on the Theoretical Domains Framework, and the findings were interpreted with the Capability Opportunity Motivation - Behaviour System. SETTING AND PARTICIPANTS The interview participants were community pharmacists, located across the Netherlands, from the Utrecht Pharmacy Practice network for Education and Research. RESULTS We interviewed 16 community pharmacists between February and August 2021 and identified several major themes which were important for the pharmacist's role in antithrombotic therapy. Pharmacists felt responsible for the outcome of antithrombotic treatment and intended to invest in their role in antithrombotic therapy. Pharmacists did, however, experience barriers to their role in antithrombotic therapy, like a lack of access to clinical information such as the indication of antithrombotic treatment and a lack of specific knowledge on this treatment. CONCLUSION Community pharmacists perceive a role for themselves in antithrombotic therapy. To fulfil this role, several preconditions must be met.
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Affiliation(s)
- Jacqueline G van Paassen
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Jaïr P Tan
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
| | - Vera H M Deneer
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
- Department of Clinical Pharmacy, Division Laboratories, Pharmacy and Biomedical Genetics, University Medical Centre Utrecht, Utrecht, Netherlands
| | - Marcel L Bouvy
- Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University, Utrecht, Netherlands
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Keating D, McWilliams S, Clarke M, Strawbridge J. Pharmacy student attitudes to mental illness and the provision of mental health care: a repeated cross-sectional survey. Int J Clin Pharm 2023; 45:1231-1240. [PMID: 37805530 DOI: 10.1007/s11096-023-01651-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 09/08/2023] [Indexed: 10/09/2023]
Abstract
BACKGROUND Attitudes to mental illness are an important factor in the willingness of professionals to engage in mental health care. AIM The aim of this study was to understand attitudes of undergraduate pharmacy students in Ireland to severe mental illness and the provision of medicines optimisation services as well as the variation in these attitudes throughout the undergraduate course. METHOD A survey instrument was compiled using existing published research and validated questionnaires. The survey was distributed to students in their first, third and Master of Pharmacy years annually between 2014 and 2019. Although designed as a longitudinal study, following the matching process there were a limited number of students who completed more than one survey and therefore data were treated as independent samples. RESULTS The overall average response rate was 25% per survey (n = 191 participants) Notwithstanding generally positive attitudes, a sizeable proportion of students felt people with severe depression and schizophrenia were hard to talk to (n = 48, 25.3%; n = 54, 29.2%) Less than half of MPharm students expressed confidence and competence in caring for people with more severe mental illnesses such as bipolar disorder and schizophrenia and 29% (n = 60) of students would feel awkward asking someone about their antipsychotic medication. Almost two thirds (n = 120, 63.8%) expressed an interest in a career in mental health. CONCLUSION Irish pharmacy students have generally positive attitudes towards people with severe mental illness and provision of medicines optimisation services. There is an opportunity to improve pharmacy graduates perceived competence and confidence to provide mental health services.
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Affiliation(s)
- Dolores Keating
- Saint John of God Hospital, Stillorgan, Co Dublin, Ireland.
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland.
| | - Stephen McWilliams
- Saint John of God Hospital, Stillorgan, Co Dublin, Ireland
- School of Medicine, University College Dublin, Dublin 4, Ireland
| | - Mary Clarke
- School of Medicine, University College Dublin, Dublin 4, Ireland
- DETECT Early Intervention in Psychosis Service, Blackrock, Co Dublin, Ireland
| | - Judith Strawbridge
- School of Pharmacy and Biomolecular Science, Royal College of Surgeons in Ireland, 123 St Stephen's Green, Dublin 2, Ireland
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Howe J, Lindsey L. The role of pharmacists in supporting service users to optimise antipsychotic medication. Int J Clin Pharm 2023; 45:1293-1298. [PMID: 37704913 PMCID: PMC10600309 DOI: 10.1007/s11096-023-01630-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 07/22/2023] [Indexed: 09/15/2023]
Abstract
Pharmacists have a contribution to make in improving optimising medication use for people on antipsychotic medication. The rates of prescribing antipsychotics have increased in England with an 18% rise from 2015 to 2020. People on antipsychotic medication are not treated as equal partners in conversations about their medications. This can leave people to make decisions about their antipsychotic medications without input from their prescribers which can have significant consequences for individuals. Involving people in the decision-making process, as experts on their own condition, has the potential to improve treatment outcomes. The evidence suggests that involving pharmacists in supporting people with serious mental illnesses will lead to improved clinical outcomes. Key areas for pharmacist involvement are providing information, education and counselling on antipsychotic medication and the side effects and reducing polypharmacy especially when antipsychotics are prescribed off license.
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Affiliation(s)
- Jo Howe
- School of Pharmacy, Aston University, Birmingham, B4 7ET, England.
| | - Laura Lindsey
- Faculty of Medical Sciences, School of Pharmacy, Newcastle University, Newcastle upon Tyne, NE1 7RU, England
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Rens E, Scheepers J, Foulon V, Hutsebaut C, Ghijselings A, Van den Broeck K. Building Bridges between Pharmacy and Psychosocial Care: Supporting and Referring Patients with Psychosocial Needs in a Pilot Study with Community Pharmacists. Int J Integr Care 2023; 23:15. [PMID: 37781047 PMCID: PMC10540865 DOI: 10.5334/ijic.7531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Accepted: 09/15/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction Community pharmacists are accessible primary care providers and therefore in a good position to detect unmet psychosocial needs of their patients and pharmacy visitors. Description A collaboration between pharmacists and psychosocial work was set up in Flanders, Belgium. Community pharmacists were trained to discuss psychosocial needs, to inform patients about possible help and refer them to a Center for General Wellbeing if needed. During the pilot of the project between October 2021 and January 2022, the feasibility and potential of this collaboration were examined. Discussion A total of 79 patient contacts about psychosocial wellbeing were reported using an online registration form, the majority of which concerned women. Family problems and mental health problems were most often reported. Focus group discussions with 28 participating pharmacists showed that they experience their role in psychosocial care as fulfilling and of valuable. Patient satisfaction was mentioned to be a major motivating factor, while time and privacy are barriers. Adequate training in psychosocial wellbeing and care was considered crucial. Conclusion Pharmacists can be valuable partners in the recognition and referral of patients with unmet psychosocial needs. Structural collaborations between community pharmacy and psychosocial care should be further supported.
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Affiliation(s)
- Eva Rens
- Family and Population Health (FAMPOP), University of Antwerp, Belgium
| | - Janne Scheepers
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium
| | - Veerle Foulon
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium
| | - Caroline Hutsebaut
- Department of Pharmaceutical and Pharmacological Sciences, KU Leuven, Belgium
| | - Aline Ghijselings
- Vlaams Apothekersnetwerk (Flemish Association of Pharmacists), Belgium
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Alshammari MK, Alotaibi NM, Al Suroor SN, Al Saed RS, Al-Hamoud AA, Alluwaif MA, Alamry MA, Alshehri NM, Alfaidi BE, Alzahrani RA, Almutiri BB, Alosaimi YS, Alosman AS, Alharbi AA, Alenezi AM. Global Advancement in Pharmacy Services for Mental Health: A Review for Evidence-Based Practices. Healthcare (Basel) 2023; 11:healthcare11081082. [PMID: 37107916 PMCID: PMC10137606 DOI: 10.3390/healthcare11081082] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 04/29/2023] Open
Abstract
The symptoms of psychiatric infirmities have variability, and selected drug regimens for mental illness are comparatively complex and individualized; therefore, pharmacy services vary with respect to patients, diseases, healthcare settings, community structures, and countries. Clinical pharmacy services for mental health (MH) are continuously being upgraded. A structured search of the literature was performed in the Cochrane, PubMed (Medline), PsycINFO, Google scholar, Scopus, Science Direct, and Springer Links databases. The title and abstract of each retrieved article were evaluated for relevance. To remove uncertainty and ambiguity, the full-text articles were retrieved and examined for relevance. The articles were further assessed on the basis of inclusion and exclusion criteria. Narrative synthesis was performed, creating new categories and relevant subcategories and further subsections. The articles and the results were assessed for quality and bias. Pharmacists have a range of expertise in psychiatric care. The services can be classified as conventional, extended, and advanced pharmacy services. Conventional services include the quality use of medicines in healthcare settings and medication support services in communities that ensure medication adherence. Pharmacists perform extended roles in collaborative medication therapy management, multidisciplinary community mental health teams, collaborative care, patient education, home medication review, hospital-to-home transit, and screening services. In the USA, the role of pharmacists was advanced by prescribing as collaborative and interim prescribers. Australia launched an accredited program for psychiatric first-aid pharmacists. Pharmacists can provide mental care to rural populations using health technology. The role of pharmacists in MH is appreciated either independently or as a team member. Patients and healthcare providers rank the services of pharmacists in MH highly. Still, there is a margin for improvement in the training of pharmacists. Pharmacists cannot provide sufficient time to their patients. Public awareness about the role of pharmacists in MH needs more attention. Moreover, the training of psychiatric pharmacists should be standardized around the world.
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Affiliation(s)
| | - Nawaf M Alotaibi
- Department of Clinical Pharmacy, Faculty of Pharmacy, Northern Border University, Rafha 73213, Saudi Arabia
| | | | - Rami Saleh Al Saed
- Department of Pharmacy, Maternity and Children Hospital Dammam, Dammam 63400, Saudi Arabia
| | - Aliaa Ali Al-Hamoud
- Department of Pharmacy, Maternity and Children Hospital Dammam, Dammam 63400, Saudi Arabia
| | - Mawahb Ahmed Alluwaif
- Department of Pharmacy, Maternity and Children Hospital Dammam, Dammam 63400, Saudi Arabia
| | - Mona Awadh Alamry
- Department of Pharmacy, Khamis Mushait General Hospital, Khamis Mushait 62441, Saudi Arabia
| | | | - Bashaier Eed Alfaidi
- Department of Pharmacy, Umluj General Hospital, Ministry of Health, Northern Region, Umluj City 48312, Saudi Arabia
| | | | | | - Yousef Saud Alosaimi
- Department of Pharmacy, Dr. Sulaiman Al Habib Hospital, Riyadh 14926, Saudi Arabia
| | - Amal Saeed Alosman
- Department of Pharmacy, King Khalid University, South Zone, Abha 62541, Saudi Arabia
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Bakos-Block CR, Al Rawwad T, Cardenas-Turanzas M, Champagne-Langabeer T. Contact based intervention reduces stigma among pharmacy students. CURRENTS IN PHARMACY TEACHING & LEARNING 2022; 14:1471-1477. [PMID: 36402691 DOI: 10.1016/j.cptl.2022.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 08/15/2022] [Accepted: 10/23/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Interventions to reduce the stigma of substance use disorders by health professionals often include didactic instruction combined with an interactive component that includes a guest speaker in recovery. Few interactive studies have focused on pharmacy students. Community pharmacists are moving to the front lines to battle the opioid epidemic; therefore, pharmacy students should be included in interventions aimed at reducing stigma by health professionals. METHODS This study examined the effects of a contact-based interactive intervention delivered by a peer recovery support specialist on perceived stigma of opioid use disorder among third-year pharmacy students (N = 115) enrolled in an integrative psychiatry course. Stigma was measured using the Brief Opioid Stigma Scale. RESULTS Our study found significant differences in students' perceived stigma, both with their personal beliefs and their beliefs regarding the public, supporting the use of interactive presentations by peer recovery support specialists to decrease perceived stigma of opioid use disorder by health professionals. CONCLUSIONS This type of intervention for pharmacy students shows promise in reducing substance use disorder stigma and should be further explored.
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Affiliation(s)
- Christine R Bakos-Block
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, United States.
| | - Tamara Al Rawwad
- University of Texas Rio Grande Valley, 1201 W. University Dr, Edinburg, TX 78539, United States.
| | - Marylou Cardenas-Turanzas
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, United States.
| | - Tiffany Champagne-Langabeer
- School of Biomedical Informatics, University of Texas Health Science Center at Houston, 7000 Fannin St., Houston, TX 77030, United States.
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Rotimi K, Edeh FK, Aiden J, Itiola AJ, Obamiro K. Factors that influence pharmacists' efforts in addressing substance use in Nigeria: An exploratory study. EXPLORATORY RESEARCH IN CLINICAL AND SOCIAL PHARMACY 2022; 8:100189. [PMID: 36311825 PMCID: PMC9615029 DOI: 10.1016/j.rcsop.2022.100189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 10/08/2022] [Accepted: 10/08/2022] [Indexed: 11/25/2022] Open
Abstract
Introduction Substance use is a major global public health problem. Over the years, the burden of substance use has increased worldwide, with Nigeria having a prevalence that is substantially above the global average. Tackling this challenge requires a collaborative effort between different health professionals. Despite the critical roles pharmacists could play in substance use prevention and management, exploration of pharmacists' role in mitigating substance use in society has received limited attention in most sub-Saharan countries. In this study, we explored the experiences of pharmacists in substance use prevention and management. Methods We conducted semi-structured interviews to explore pharmacists' perceptions of their roles in the prevention and management of substance use in Nigeria. Following data transcription, we conducted a thematic content analysis. Results The four major themes that emerged included 1) the extent of pharmacists' involvement in the decision-making process for addressing substance use, 2) factors that influence pharmacists efforts in addressing substance use in Nigeria, 3) how to improve rational prescribing practices and, 4) capacity building to enhance pharmacists participation in addressing substance use. Conclusion Pharmacists have the opportunity to play critical roles in the prevention and management of substance use, but several individual and systemic challenges limit their full potential. Addressing these challenges is crucial in increasing pharmacists' participation in preventing and managing substance use.
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Affiliation(s)
- Kunle Rotimi
- Malaria Consortium, Nigeria,Corresponding author.
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8
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Akour A, Halloush S, Nusair MB, Barakat M, Abdulla F, Al Momani M. Gaps in pharmaceutical care for patients with mental health issues: A cross-sectional study. Int J Clin Pharm 2022; 44:904-913. [PMID: 35364752 PMCID: PMC8974808 DOI: 10.1007/s11096-022-01391-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 02/12/2022] [Accepted: 02/17/2022] [Indexed: 11/05/2022]
Abstract
Background Mental health issues such as depression and anxiety are often underdiagnosed and undertreated. Medications are a primary method of managing mental health problems, and pharmacists therefore have a vital role in supporting patients and providing them with information about the safety and efficacy of mental health medications. However, the potential role of pharmacists in managing mental health issues in Jordan has not been well established. Aim This study aimed to assess Jordanian pharmacists’ attitudes and actual practices related to the provision of mental health services. Method This was an exploratory cross-sectional study that used a self-report questionnaire among a convenience sample of 347 pharmacists in Amman, the capital of Jordan. Results The participating pharmacists had positive attitudes towards providing care for patients with mental health problems. However, their actual practices did not resonate with their enthusiasm, particularly in terms of the long-term follow-up of disease symptoms and medication side effects and adherence. The participating pharmacists showed an eagerness to collaborate with their colleagues, but their level of actual cooperation was lower than desired. The most reported barrier to providing care for patients with mental health problems was the lack of education on mental health issues (71.5%), followed by the lack of privacy in pharmacy settings (53.9%). Conclusion To be effectively involved in the provision of care to mental health patients, pharmacists should receive adequate education/training related to mental health issues, and pharmacies should be redesigned to provide private areas for patient counseling.
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Affiliation(s)
- Amal Akour
- Department of Biopharmaceutics and Clinical Pharmacy, The School of Pharmacy, The University of Jordan, Amman, Jordan. .,Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Abu Dhabi, United Arab Emirates.
| | - Shiraz Halloush
- Department of Clinical Pharmacy and Therapeutics, The School of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Mohmmad B Nusair
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
| | - Muna Barakat
- Department of Clinical Pharmacy and Therapeutics, The School of Pharmacy, Applied Science Private University, Amman, Jordan
| | - Fatima Abdulla
- Department of Public Health, The School of Medicine, The University of Jordan, Amman, Jordan
| | - Malik Al Momani
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, Yarmouk University, Irbid, Jordan
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Rimal R, Lin J, Yan Chan AH, Chen TF, Sheridan J, Sundram F. A national study of the mental health literacy of community pharmacists. Res Social Adm Pharm 2022; 18:3303-3311. [PMID: 35027306 DOI: 10.1016/j.sapharm.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Community pharmacists are in a prime position to communicate with and assist those with mental health needs. However, mental health literacy, which includes beliefs and knowledge of mental health conditions, can impact the provision of pharmacy services. The mental health literacy of community pharmacists in New Zealand is currently unknown. OBJECTIVES To assess the mental health literacy of community pharmacists in New Zealand. METHODS We employed a national cross-sectional online survey, evaluating attitudes towards mental illness, ability to recognise depression using a vignette and followed by questions related to the helpfulness of various interventions, and willingness to provide pharmacy services for people with mental illness in comparison to cardiovascular diseases. Additionally, opportunities for mental health training were explored. Participants were community pharmacists working in New Zealand contacted via mailing lists of professional bodies. RESULTS We received responses from 346 participants. The majority of participants showed positive attitudes towards mental illness and correctly identified depression in the vignette (87%). Participants rated counsellors (84%) and physical activity (92%) as the most helpful professionals and intervention respectively while only 43% considered antidepressants as helpful for depression. When compared to other people in the community, long-term functioning of the individual described in the vignette was rated poorly, especially in terms of increased likelihood to attempt suicide (85%) and reduced likelihood to be a productive worker (64%). Approximately 30% of participants reported reduced confidence/comfort while approximately half of participants reported greater interest in providing mental health-related care compared to cardiovascular disease. The participants also highlighted several areas for future mental health training they wished to undertake. CONCLUSIONS We have identified positive attitudes towards mental illness in our study. Participants correctly identified and supported evidence-based interventions for mild to moderate depression. However, we highlighted the need for ongoing mental health training to address knowledge gaps and enhance the confidence in providing mental health-related care.
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Affiliation(s)
- Retina Rimal
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand
| | - Joanne Lin
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand; Centre for Addiction Research, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Amy Hai Yan Chan
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand
| | - Timothy F Chen
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Australia
| | - Janie Sheridan
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand; Centre for Addiction Research, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
| | - Frederick Sundram
- Department of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand; Centre for Addiction Research, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand; Centre for Brain Research, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.
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OUP accepted manuscript. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:305-314. [DOI: 10.1093/ijpp/riac041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 04/26/2022] [Indexed: 11/13/2022]
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Gordijn R, Teichert M, Nicolai MPJ, Elzevier HW, Guchelaar HJ, Hughes CM. Learning From Consultations Conducted by Community Pharmacists in Northern Ireland for Nonprescription Sildenafil: A Qualitative Study Using the Theoretical Domains Framework. Sex Med 2021; 9:100440. [PMID: 34628114 PMCID: PMC8766262 DOI: 10.1016/j.esxm.2021.100440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/27/2021] [Accepted: 08/29/2021] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Nonprescription sildenafil was introduced to the United Kingdom in 2018 as the first pharmacy service concerning sexual function, an important but often ignored factor for quality of life. AIM This study aimed to evaluate pharmacists' views on providing nonprescription sildenafil, their perceptions of the barriers and facilitators to provide this service and strategies to overcome potential barriers, using a theory-based approach. METHODS Community pharmacists were purposefully sampled in Northern Ireland, followed by snowball sampling. Face-to-face interviews were conducted between October 2019 and January 2020. The semi-structured interviews used a piloted topic guide based on the 14-domain Theoretical Domains Framework (TDF). All interviews were audio-recorded, transcribed verbatim and anonymized. Transcripts were analyzed deductively in NVivo 13, utilizing the TDF domains as coding categories. Within each domain, content analysis was utilized to identify barriers and facilitators. MAIN OUTCOME MEASURE Barriers and facilitators within the TDF domains for pharmacists to provide nonprescription sildenafil. RESULTS Ten pharmacists were interviewed to reach data saturation. Eight pharmacists had experience with dispensing nonprescription sildenafil. They valued nonprescription sildenafil as an additional service ("Social/professional role and identity"). Training, concise product guidelines, and private consultation areas were important facilitators ("Environmental context and resources"). The service required trusting clients ("Optimism"), with concerns about abuse and men not visiting their GP. From experience gained, pharmacists became more confident dealing with difficult situations such as patients being vague about their medical history or alcoholism or mental problems as causes for erectile disfunction (ED) ("Skills" and "Beliefs about capabilities"). Pharmacists considered lifestyle and medication causes of ED important but preferred to focus on safe supply. In general, pharmacists were satisfied with the perceived professional recognition, using their clinical knowledge or helping patients resume sexual relationships ("Beliefs about consequences"). CONCLUSION Pharmacists welcomed nonprescription sildenafil to enhance their role as easily accessible healthcare providers for patients. Gordijn R, Teichert M, Nicolai MPJ, et al. Learning From Consultations Conducted by Community Pharmacists in Northern Ireland for Nonprescription Sildenafil: A Qualitative Study Using the Theoretical Domains Framework. Sex Med 2021;9:100440.
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Affiliation(s)
- Rineke Gordijn
- Leiden University Medical Center, Department of Clinical Pharmacy & Toxicology, Leiden, The Netherlands.
| | - Martina Teichert
- Leiden University Medical Center, Department of Clinical Pharmacy & Toxicology, Leiden, The Netherlands
| | - Melianthe P J Nicolai
- Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Department of Urology, Amsterdam, The Netherlands
| | - Henk W Elzevier
- Leiden University Medical Center, Department of Urology and Department of Medical Decision Making, Leiden, The Netherlands
| | - Henk-Jan Guchelaar
- Leiden University Medical Center, Department of Clinical Pharmacy & Toxicology, Leiden, The Netherlands
| | - Carmel M Hughes
- Primary Care Research Group, School of Pharmacy, Queen's University Belfast, Belfast, Northern Ireland
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Roles, barriers and behavioral determinants related to community pharmacists' involvement in optimizing opioid therapy for chronic pain: a qualitative study. Int J Clin Pharm 2021; 44:180-191. [PMID: 34599720 PMCID: PMC8486957 DOI: 10.1007/s11096-021-01331-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/15/2021] [Indexed: 11/29/2022]
Abstract
Background Opioid are currently widely used to manage chronic non-malignant pain (CNMP), but there is a growing concern about harm resulting from opioid misuse and the need for medicine optimization, in which pharmacists could potentially play a key role. Objective This study explored pharmacists' roles, barriers and determinants related to their involvement in optimizing prescribed opioids for patients with chronic pain. Setting Community pharmacies in the United Kingdom. Method Semi-structured interviews based on the Theoretical Domains Framework were conducted between January and May 2020 with 20 community pharmacists recruited through professional networks. Data were analysed thematically. Main outcome measure: Pharmacists’ perceived roles, barriers and behavioural determinants in relation to opioid therapy optimization. Result Pharmacists demonstrated desire to contribute to opioid therapy optimization. However, they described that they were often challenged by the lack of relevant knowledge, skills and training, inadequate time and resources, systemic constraints (such as lack of access to medical records and information about diagnosis), and other barriers including relationships with doctors and patients. Conclusion The contribution of community pharmacists to optimize opioid therapy in CNMP is unclear and impeded by lack of appropriate training and systemic constraints. There is a need to develop innovative practice models by addressing the barriers identified in this study to enhance the contribution of community pharmacists in optimization of opioid therapy for chronic pain.
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Kretchy IA, Blewuada EK, Debrah AB. A qualitative study exploring community pharmacists’ perspectives of child and adolescent mental healthcare. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2021.e00969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Harris SC, Bostwick JR, Werremeyer AB, Goldstone LW, Cates ME, Caley CF. Addressing the Conflict Between Promoting Wellness, Perpetuating Mental Illness Stigma and Making Psychiatric Pharmacy Education Less Intense. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2021; 85:8354. [PMID: 34544737 PMCID: PMC8499653 DOI: 10.5688/ajpe8354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 02/05/2021] [Indexed: 06/13/2023]
Abstract
One in five Americans has a diagnosable mental illness, and pharmacists encounter these patients daily. This commentary addresses the conflict between the profession's wellness movement and its ongoing contribution to mental illness stigma. The need for improved pharmacist wellness is based on the profession's risk for burnout and development of related mental illness. The presence of stigma towards patients with mental illness among pharmacists is multi-factorial and complex. Risk of those within the profession perpetuating mental illness stigma could be diminished by developing pharmacy curricula that provide greater opportunities for students to learn more completely about mental illness, how to effectively engage persons with mental illness, and how to take care of themselves, express vulnerability, and talk about mental illness. While reducing mental illness stigma through curricular revision is best achieved through in-person learning experiences, elective coursework and cocurricular activities may also help achieve this goal. Examples of evidence-based best practices are provided.
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Affiliation(s)
- Suzanne C Harris
- University of North Carolina, Eshelman School of Pharmacy, Chapel Hill, North Carolina
| | | | - Amy B Werremeyer
- North Dakota State University, School of Pharmacy, Fargo, North Dakota
| | - Lisa W Goldstone
- University of Southern California, School of Pharmacy, Los Angeles, California
| | - Marshall E Cates
- Samford University, McWhorter School of Pharmacy, Birmingham, Alabama
| | - Charles F Caley
- Western New England University, College of Pharmacy and Health Sciences, Springfield, Massachusetts
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15
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Vadiei N, Eldridge LA, Meyerson BE, Agley J. "The gatekeepers in prevention": Community pharmacist perceptions of their role in the opioid epidemic. Subst Abus 2021; 43:319-327. [PMID: 34214407 DOI: 10.1080/08897077.2021.1941516] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Community pharmacists are at the frontline of patient care, yet their role in the opioid epidemic remains unclear. This qualitative study examines the perception of community pharmacists about their role in the opioid epidemic and challenges to fulfilling this role. Methods: A secondary analysis of cross-sectional survey data from an Indiana census of community managing pharmacists was conducted. Qualitative data were coded using a priori and emergent themes. A priori categories included the perceived role of pharmacists in the opioid epidemic and perception of practice barriers. Results: A total of 215 Indiana community managing pharmacists participated in this study. Pharmacists understood themselves as gatekeepers in preventing opioid misuse and overdose. Reported pharmacy practices included providing patient education and communicating with prescribers. Challenges to fulfilling this role included pharmacy structure and operation, lack of patient and provider clarity about pharmacist scope of practice, and pharmacist perception that that there is no available discretionary time to support additional services. Conclusion: Pharmacists believe they have a vital role in combatting opioid misuse and overdose but are hampered by structural aspects of pharmacy practice and lack of recognition of their role. Pharmacy associations and policy partners are encouraged to identify opportunities to address these barriers.
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Affiliation(s)
- Nina Vadiei
- Department of Pharmacy Practice and Science, The University of Arizona College of Pharmacy, Tucson, AZ, USA
| | - Lori Ann Eldridge
- Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA.,Prevention Insights, Institute for Research on Addictive Behavior, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA
| | - Beth E Meyerson
- Southwest Institute for Research on Women, College of Social & Behavioral Sciences, The University of Arizona, Tucson, AZ, USA.,Family & Community Medicine, College of Medicine, The University of Arizona, Tucson, AZ, USA
| | - Jon Agley
- Department of Applied Health Science, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA.,Prevention Insights, Institute for Research on Addictive Behavior, Indiana University School of Public Health - Bloomington, Bloomington, IN, USA
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16
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McMillan SS, Chan H, Hattingh LH. Australian Community Pharmacy Harm-Minimisation Services: Scope for Service Expansion to Improve Healthcare Access. PHARMACY 2021; 9:pharmacy9020095. [PMID: 33926030 PMCID: PMC8167599 DOI: 10.3390/pharmacy9020095] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/23/2021] [Accepted: 04/24/2021] [Indexed: 11/16/2022] Open
Abstract
Community pharmacies are well positioned to participate in harm-minimisation services to reduce harms caused by both licit and illicit substances. Considering developments in pharmacist practices and the introduction of new professional pharmacy services, we identified a need to explore the contemporary role of community pharmacy in harm minimisation. Semi-structured interviews were undertaken to explore the opinions of stakeholders, pharmacy staff, and clients about the role of community pharmacy in harm minimisation, including provision of current services, experiences, and expectations. Participants (n = 28) included 5 stakeholders, 9 consumers, and 14 staff members from seven community pharmacies. Three over-arching themes were identified across the three participants groups: (i) scope and provision, (ii) complexity, and (iii) importance of person-centred advice and support in relation to community pharmacy harm minimisation services. Community pharmacies are valuable healthcare destinations for delivery of harm minimisation services, with scope for service expansion. Further education, support, and remuneration are needed, as well as linkage to other sector providers, in order to ensure that pharmacists and pharmacy staff are well equipped to provide a range of harm minimisation services.
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Affiliation(s)
- Sara S. McMillan
- Gold Coast Campus, School of Pharmacy and Pharmacology, Griffith University, Southport 4215, Australia;
| | - Hidy Chan
- The Pharmacy Guild of Australia, Queensland Branch, Brisbane 4000, Australia;
| | - Laetitia H. Hattingh
- Gold Coast Campus, School of Pharmacy and Pharmacology, Griffith University, Southport 4215, Australia;
- Gold Coast Hospital and Health Service, Southport 4215, Australia
- Correspondence:
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17
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Spillane D, Courtenay M, Chater A, Family H, Whitaker A, Acton JH. Factors influencing the prescribing behaviour of independent prescriber optometrists: a qualitative study using the Theoretical Domains Framework. Ophthalmic Physiol Opt 2021; 41:301-315. [PMID: 33608897 DOI: 10.1111/opo.12782] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 12/10/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Whilst the number of independent prescriber (IP) optometrists in the United Kingdom is increasing, there is limited evidence describing the experiences of these individuals. The Theoretical Domains Framework (TDF) provides an evidence-based approach to understand determinants of behaviour. This conceptual framework can enable mapping to the COM-B behaviour change model and the wider Behaviour Change Wheel to develop interventions to optimise behaviour-change and healthcare processes more systematically. The study aimed to use the TDF to identify the factors that influence independent prescribing behaviour, and to map these findings to the COM-B system to elucidate the relevant intervention functions, in order to identify the support required by optometrist prescribers. METHODS Using a qualitative design, semi-structured interviews based on the TDF were undertaken with independent prescriber optometrists. Thematic analysis was used to identify themes inductively, which were then deductively mapped to the TDF and linked to the COM-B. RESULTS Sixteen participants (9 male, 7 female; median age 45 years, range 28-65 years), based in community (n = 10) and hospital (n = 6) settings, were interviewed. Eleven of the TDF domains were found to influence prescribing behaviour. Findings highlighted the need for good communication with patients (TDF domain: Skills, COM-B: Capability); confidence (TDF domain: Beliefs about capabilities, COM-B: Motivation); good networks and relationships with other healthcare professionals, e.g., general practitioners (TDF domain: Social influences, COM-B: Opportunity; TDF domain: Social/professional role and identity, COM-B: Motivation); the need for appropriate structure for remuneration (TDF domain: Reinforcement, COM-B: Motivation; TDF domain: Social/professional role and identity, COM-B: Motivation) and the provision of professional guidelines (TDF domain: Knowledge, COM-B: Capability; TDF domain: Environmental context and resources, COM-B Opportunity). CONCLUSIONS Having identified theory-derived influencers on prescribing decisions by optometrists, the findings can be used to develop a structured intervention, such as a support package to help optimise prescribing by optometrists, with the ultimate goal of eye care quality improvement.
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Affiliation(s)
- Daniel Spillane
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - Molly Courtenay
- School of Healthcare Sciences, Cardiff University, Cardiff, UK
| | - Angel Chater
- Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedford, UK.,Centre for Behavioural Medicine, University College London School of Pharmacy, London, UK
| | - Hannah Family
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Angela Whitaker
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
| | - Jennifer H Acton
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, UK
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18
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Okuyan B, Balta E, Ozcan V, Durak Albayrak O, Turker M, Sancar M. Turkish community pharmacists' behavioral determinants in provision of pharmaceutical care to elderly patients. Int J Clin Pharm 2021; 43:1024-1035. [PMID: 33411182 DOI: 10.1007/s11096-020-01211-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 11/26/2020] [Indexed: 11/30/2022]
Abstract
Background It is crucial to develop and implement community pharmacist-led pharmaceutical care services in primary care that could prevent and detect potentially inappropriate prescribing and promote medication adherence in older patients. Objective The aim of this study was to determine community pharmacists' perceived barriers and facilitators face during the provision of pharmaceutical care to older patients by using a theoretical domains framework. Method A cross-sectional online survey was conducted among community pharmacists in Turkey. A Turkish version of the 50-item Determinants of Implementation Behavior Questionnaire was developed to evaluate behavioral determinants of community pharmacists on delivering pharmaceutical care to older patients. Main outcome measures The behavioral determinants of community pharmacists. Results A total of 354 community pharmacists answered the questionnaire. The mean age was 43.2 (standard deviation = 11.1), and 227 (64%) of the pharmacists were female. Community pharmacists' positive opinions on pharmaceutical care service outcomes in older patients and feedback were regarded as facilitators. Community pharmacists' motivational level and emotions were additional determinant facilitators in delivering pharmaceutical care to older patients. Their negative opinions on the impact and action of pharmaceutical care in older patients were regarded as barriers. Conclusion In primary health care, a theory-based e-distant training program for community pharmacists and the guidelines for standard pharmaceutical care services led by community pharmacists could be designed by addressing barriers related to the impact and action of pharmaceutical care in older patients.
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Affiliation(s)
- Betul Okuyan
- Clinical Pharmacy Department, Faculty of Pharmacy, Marmara University, Maltepe, Istanbul, Turkey.
| | - Ecehan Balta
- Turkish Pharmacists' Association, Ankara, Turkey
| | - Vildan Ozcan
- Turkish Pharmacists' Association, Ankara, Turkey
| | | | | | - Mesut Sancar
- Clinical Pharmacy Department, Faculty of Pharmacy, Marmara University, Maltepe, Istanbul, Turkey
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19
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Witry MJ, Fadare O, Pudlo A. Pharmacy professionals' preparedness to use Mental Health First Aid (MHFA) behaviors. Pharm Pract (Granada) 2020; 18:2102. [PMID: 33294061 PMCID: PMC7699831 DOI: 10.18549/pharmpract.2020.4.2102] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/25/2020] [Indexed: 11/17/2022] Open
Abstract
Background: There is a need to train healthcare professionals to provide first aid to
people experiencing a mental health crisis. Research testing the association
between Mental Health First Aid (MHFA) training and the use of MHFA
behaviors could provide evidence of program effectiveness in the pharmacy
setting. Objectives: The objectives of this study were to measure the preparedness of pharmacy
professionals to function in a MHFA role, and compare preparedness and the
use of MHFA behaviors based on demographic characteristics. Methods: Pharmacists and student pharmacists attended MHFA training under a
multi-state pharmacy initiative in 2018. An anonymous electronic survey was
administered to 227 participants using 4 contacts in May to June, 2019. The
survey evaluated if participants had recommended MHFA to others, their
preparedness to engage in MHFA behaviors (13 items), and their frequency of
performing a set of MHFA behaviors (7 items). Descriptive statistics,
bivariate analysis, and ANOVA were used to describe the sample and compare
these variables across groups. Results: The analysis was based on 96 responses (42.3%). Almost all respondents
(96%) had recommended MHFA training to others. Respondents reported
that the training program prepared them to provide a range of MHFA behaviors
for multiple mental health conditions, particularly for depression and
anxiety. Participants most often reported asking about a distressed mood and
listening non-judgmentally. Almost half of participants had asked someone if
they were considering suicide and a similar percent had referred someone
considering suicide to resources. Those reporting the highest levels of
preparedness engaged in significantly more MHFA behaviors than those with
lower levels of preparedness (p=0.017). Preparedness and use of MHFA
behaviors were not significantly associated with respondent demographic
characteristics. Conclusion: These data suggest that pharmacy professionals who had MHFA training felt
prepared to engage in MHFA and many used behaviors like asking about suicide
and making referrals since being trained in MHFA. Research is warranted to
better understand what makes someone feel maximally prepared to use MHFA
behaviors compared to lower feelings of preparedness.
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Affiliation(s)
- Matthew J Witry
- PharmD, PhD. Assistant Professor, Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa. Iowa City, IA (United States).
| | - Olajide Fadare
- BPharm. Department of Pharmacy Practice and Science, College of Pharmacy, University of Iowa. Iowa City, IA (United States).
| | - Anthony Pudlo
- PharmD, MBA. Vice President. Professional Affairs, Iowa Pharmacy Association. Des Moines, IA (United States).
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20
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Hays C, Sparrow M, Taylor S, Lindsay D, Glass B. Pharmacists' "Full Scope of Practice": Knowledge, Attitudes and Practices of Rural and Remote Australian Pharmacists. J Multidiscip Healthc 2020; 13:1781-1789. [PMID: 33293821 PMCID: PMC7718969 DOI: 10.2147/jmdh.s279243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 10/22/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Poor health outcomes for patients living in rural and remote areas of Australia are often attributed to the lack of a range of accessible health professionals delivering health services. Community pharmacists are already an integral part of these communities and as such are often the most frequently consulted health professionals. The aim of this study was to explore rural pharmacist knowledge and experiences of expanded pharmacy and to identify the barriers and enablers to remote pharmacists providing expanded pharmacy services (EPS), which can be described as services outside of usual medication management tasks. Methods Rural and remote pharmacists (Modified Monash Model (MMM) categories 2–7) participated in an online survey. Descriptive statistics and chi-squared tests were performed and data from open-ended questions were analyzed, categorized into themes and quantitized. Results Two-thirds (n=13, 68%) of rural pharmacists surveyed (n=19) had knowledge of EPS in rural pharmacies and the majority (n=17, 89%) agreed that these services would benefit rural communities. Mental health service referral was considered very/extremely important by the majority (n=16, 84%) of respondents; however, no pharmacists were currently providing mental health screening services while (n=15, 79%) were willing to provide these services. While staff shortages, costs, time and training were indicated to be the main barriers to the provision of EPS, enablers included accessibility of rural pharmacies and a perceived need. Conclusion This study indicated that pharmacists are already providing some EPS and see value in their implementation; however, what constitutes an expanded service was unclear to some participants. Mental health services were highlighted as most important demonstrating a recognized burden of mental illness in rural and remote locations. Findings from this pilot study will provide further understanding for future development of the pharmacist’s scope of practice and implementation of EPS.
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Affiliation(s)
- Catherine Hays
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia
| | - Melanie Sparrow
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Selina Taylor
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia
| | - Daniel Lindsay
- College of Public Health, Medical and Veterinary Science, James Cook University, Townsville, Queensland, Australia
| | - Beverley Glass
- Pharmacy, College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
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21
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Murphy AL, Jacobs LM, Gardner DM. Pharmacists' experiences with the Bloom Program application process. Can Pharm J (Ott) 2020; 154:42-51. [PMID: 33598059 DOI: 10.1177/1715163520968120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background The Bloom Program, which began as a demonstration project, is an ongoing community pharmacy-based mental illness and addictions program funded by the government of Nova Scotia. To be eligible to offer the Bloom Program, interested pharmacists were required to complete a 9-part application on behalf of their pharmacies. A process evaluation was conducted to inform future program implementation changes of program components, including the application process. Methods Qualitative interviews from 24 pharmacists were inductively analyzed to determine the challenges and opportunities in the program's application process. Results Key and impactful components of the application process included training, providing a mental health and addictions resource centre within the pharmacy and completing outreach activities with local mental health and addictions services and support organizations. The training content and format for the program was highly valued. Community outreach to local mental health and addictions resources, and other health care resources in the community, was particularly valuable in supporting patient navigation of the health care system and extending the pharmacists' networks. Components of the application process were challenging for many pharmacists but were beneficial personally and professionally. Dedicated resources (e.g., time and staffing) are required for the efficient completion of the application process. Conclusion Pharmacists viewed the Bloom Program application process as intensive yet necessary and relevant for preparing to deliver the Program. The demonstration project process evaluation was essential for elucidating the strengths of the application process and, importantly, identifying areas for improvement. Can Pharm J (Ott) 2021;154:xx-xx.
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22
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Plunger P, Heimerl K, Tatzer VC, Zepke G, Finsterwald M, Pichler B, Reitinger E. Developing dementia-friendly pharmacies in Austria: a health promotion approach. Health Promot Int 2020; 35:702-713. [PMID: 31292603 DOI: 10.1093/heapro/daz063] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The need for integrated, accessible and person-centred care for people with dementia to foster quality of life and facilitate life in the community has been voiced by health policy. Pharmacies have the potential to provide easily accessible information and support for people with dementia, caregivers and the public. The 'Dementia-friendly Pharmacy' programme aimed at re-orienting community pharmacy in Austria, focusing on stronger inclusion of professional counselling into core services. It followed principles of health promotion and person-centred care, aiming at empowering all actors involved, and at fostering quality of life. Methodologically, the programme was based on participatory health research, thus involving all relevant actors and consolidating their perspectives on issues related to dementia care. In the course of the programme, a workshop series covering topics relevant for dementia care in community pharmacy, as well as prototypes for small-scale projects were developed, and measures were taken for securing sustainability. Findings related to programme development and implementation encompass pharmacy staff's motivation to participate in the programme, counselling knowledge and skills development, experience with building community partnerships and cross-organizational development and sustainability. Furthermore, effectiveness of the programme has been established. These findings are discussed against the background of re-orienting pharmacies.
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Affiliation(s)
- Petra Plunger
- Department of Nursing Science, University of Vienna, Alserstraße 23/12, A 1080 Vienna, Austria
| | - Katharina Heimerl
- Department of Nursing Science, University of Vienna, Alserstraße 23/12, A 1080 Vienna, Austria
| | - Verena C Tatzer
- Department of Occupational Therapy, University of Applied Sciences Wiener Neustadt, Austria
| | | | | | - Barbara Pichler
- Department of Nursing Science, University of Vienna, Alserstraße 23/12, A 1080 Vienna, Austria
| | - Elisabeth Reitinger
- Department of Nursing Science, University of Vienna, Alserstraße 23/12, A 1080 Vienna, Austria
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23
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Salwan A, Hagemeier NE, Tudiver F, Dowling-McClay K, Foster KN, Arnold J, Alamian A, Pack RP. Community pharmacist engagement in opioid use disorder prevention and treatment behaviors: A descriptive analysis. J Am Pharm Assoc (2003) 2020; 60:e173-e178. [PMID: 32669219 DOI: 10.1016/j.japh.2020.06.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Revised: 06/03/2020] [Accepted: 06/09/2020] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This study describes community pharmacists' opioid analgesic and medication for opioid use disorder (MOUD) practice behaviors and behavioral intentions in the context of primary, secondary, and tertiary prevention of opioid use disorder (OUD). METHODS The study sampling frame consisted of 2302 Tennessee community-practice pharmacists who were asked to complete a mailed, paper questionnaire. Behavioral intentions were elicited by asking pharmacists to indicate the number of times (0 to 10) they engage in a behavior, given 10 patients in 3 distinct vignettes. Perceptions of evidence-based MOUD and pain management patient care practices were also elicited. RESULTS A response rate of 19.7% was achieved. Pharmacists reported using a brief questionnaire to evaluate risk of opioid misuse with 2.1 ± 3.7 (mean ± SD) out of 10 patients, screening 2.1 ± 3.7 patients for current opioid misuse, discussing co-dispensing of naloxone with 2.9 ± 3.4 to 3.3 ± 4 out of 10 patients at a risk of overdose, and dispensing buprenorphine/naloxone to a mean of 4.6 ± 4.2 patients when they presented a prescription. Respondents perceived 38% of pain management and 30% of MOUD prescribers in their area to practice evidenced-based care. CONCLUSION Pharmacists have an opportunity to improve the outcomes for patients prescribed opioids by increasing engagement across OUD prevention levels.
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24
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What predicts pharmacists' engagement with opioid-outcome screening? Secondary analysis from an implementation study in community pharmacy. Int J Clin Pharm 2020; 43:420-429. [PMID: 32533428 DOI: 10.1007/s11096-020-01074-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 05/28/2020] [Indexed: 10/24/2022]
Abstract
Background Pharmacists have a key role to play in identifying and responding to emerging clinical problems with prescribed opioids. A pilot study in Australia examined the implementation of screening and brief intervention (Routine Opioid Outcome Monitoring [ROOM]) to identify and respond to opioid-related problems in community pharmacies. In this implementation study, the rate of screening varied considerably between pharmacies. Objective The aim of this study was to examine pharmacist characteristics associated with implementation of ROOM. Setting Community pharmacies in Victoria and New South Wales, Australia. Methods We implemented a validated computer-facilitated screening (ROOM), combined with brief intervention for opioid-related problems based on a widely accepted framework for monitoring outcomes. In this analysis, we examined the correlates of ROOM completion for individual pharmacists. Negative binomial regression was used to identify baseline predictors of greater screening, with the number of ROOM screens as the dependent (outcome) variable and pharmacist demographics, knowledge, confidence and comfort responding to prescription opioids problems, and attitudes towards evidence based practice examined as independent (predictor) variables. Main outcome measure Number of screens completed by an individual pharmacist as reported in follow-up surveys by pharmacist. Results Fewer years of practice was associated with a greater number of screenings conducted. On average, each additional decade of practice was associated with a 31% (95% CI 0%, 53%) reduction in the number of screenings undertaken by pharmacists. A multivariable analysis revealed that each additional decade practicing, lower knowledge of naloxone and lower confidence in identifying unmanaged pain were all independently associated with reduced engagement in screening after controlling for other variables. Conclusion Findings from this pilot study identified potential barriers to implementing opioid outcome monitoring. Further studies could test different groups of community pharmacists' experience of different barriers when implementing monitoring outcomes with prescribed opioids, to inform future implementation and clinical practice.
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25
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Mospan CM, Gillette C. Student Pharmacists' Attitudes Toward Suicide and the Perceived Role of Community Pharmacists in Suicidal Ideation Assessment. AMERICAN JOURNAL OF PHARMACEUTICAL EDUCATION 2020; 84:7588. [PMID: 32577030 PMCID: PMC7298224 DOI: 10.5688/ajpe7588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 10/14/2019] [Indexed: 05/30/2023]
Abstract
Objective. To determine first-year Doctor of Pharmacy students' attitudes toward suicide and perceptions of the role of the pharmacist in assessing patients for suicidal ideation, and whether their previous pharmacy work experience influences these attitudes and perceptions. Methods. An anonymous online survey was administered to first-year student pharmacists at one school of pharmacy in North Carolina. Measures included gender, previous community pharmacy work experience, personal contact with suicide, and score on the Attitudes Toward Suicide (ATTS) scale. Results. Seventy-three student pharmacists (75%) completed the survey. The vast majority (92%) agreed or strongly agreed that suicide was a real disease. Similarly, most students (79%) agreed or strongly agreed that pharmacists have a professional responsibility to assess for suicidal ideation. There was not a significant association between ATTS score and previous community pharmacy work experience nor the perceived pharmacist's role in assessing for suicidal ideation. Additionally, there was no association between ATTS score and personal contact with suicide. Conclusion. First-year student pharmacists, while undecided on their personal attitudes toward suicide, overwhelmingly agreed that suicide is a disease and that pharmacists have an important role in assessing patients for suicidal ideation. Pharmacy schools should implement training programs to prepare student pharmacists to identify suicidal ideation, design interventions to address student pharmacists' personal beliefs that may impact their ability to provide patient care, and provide students with adequate support skills to care for patients experiencing mental health crises.
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Affiliation(s)
| | - Chris Gillette
- Wake Forest School of Medicine, Winston-Salem, North Carolina
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26
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Saka SA, Akanbi OS, Eze UIH. Perceptions of Nigerian final year undergraduate students of the adequacy of the pharmacy curriculum for mental health care. JOURNAL OF PHARMACY PRACTICE AND RESEARCH 2020. [DOI: 10.1002/jppr.1607] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Sule A. Saka
- Department of Clinical Pharmacy and Bio‐Pharmacy Olabisi Onabanjo University Sagamu Nigeria
| | - Oluwaseyi S. Akanbi
- Department of Clinical Pharmacy and Bio‐Pharmacy Olabisi Onabanjo University Sagamu Nigeria
| | - Uchenna I. H. Eze
- Department of Clinical Pharmacy and Bio‐Pharmacy Olabisi Onabanjo University Sagamu Nigeria
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27
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Perception of Community Pharmacists in Malaysia About Mental Healthcare and Barriers to Providing Pharmaceutical Care Services to Patients with Mental Disorders. Community Ment Health J 2020; 56:88-98. [PMID: 31667692 PMCID: PMC6942006 DOI: 10.1007/s10597-019-00496-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 10/17/2019] [Indexed: 01/16/2023]
Abstract
The aim of this study was to assess community pharmacists' (CPs) perceptions toward mental healthcare, and the barriers faced in providing pharmaceutical care (PC) services to these patients. A 40-item survey was posted to CPs. Ninety-six pharmacists participated. The majority (84.2%) agreed there is a role for CPs to play in mental health care, while approximately 60% agreed it is their responsibility to provide PC to these patients. The biggest barrier to providing this service is the lack of knowledge, cited by close to 50% of respondents. This corresponds with the revelation that close to 60% believe that they have a poor or fair understanding of mental disorders. About 30% of respondents said they do not stock psychotropic drugs at all, mainly due to medico-legal reasons, and low prescription requests. Our findings highlight the need for more training of CPs in managing patients with mental disorders.
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28
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Bratberg JP, Smothers ZPW, Collins K, Erstad B, Ruiz Veve J, Muzyk AJ. Pharmacists and the opioid crisis: A narrative review of pharmacists' practice roles. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019. [DOI: 10.1002/jac5.1171] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Jeffrey P. Bratberg
- Department of Pharmacy Practice; University of Rhode Island College of Pharmacy; Kingston Rhode Island
| | | | - Kathryn Collins
- Doctor of Pharmacy Program; Campbell University College of Pharmacy and Health Sciences; Buies Creek North Carolina
| | - Brian Erstad
- Department of Pharmacy Practice and Science; University of Arizona College of Pharmacy; Tucson Arizona
| | - Jennifer Ruiz Veve
- Doctor of Pharmacy Program; Campbell University College of Pharmacy and Health Sciences; Buies Creek North Carolina
| | - Andrew J. Muzyk
- Department of Pharmacy Practice; Campbell University College of Pharmacy and Health Sciences; Buies Creek North Carolina
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Haslam L, Gardner DM, Murphy AL. A retrospective analysis of patient care activities in a community pharmacy mental illness and addictions program. Res Social Adm Pharm 2019; 16:522-528. [PMID: 31327736 DOI: 10.1016/j.sapharm.2019.07.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Revised: 07/04/2019] [Accepted: 07/05/2019] [Indexed: 01/08/2023]
Abstract
BACKGROUND The Bloom Program, a community pharmacy-based mental health and addictions care program, was developed and implemented to optimize pharmacists' care of eligible patients. Characterizing pharmacists' activities in the Bloom Program can facilitate program quality improvement and contribute more broadly to the knowledge base regarding pharmacists' roles and contributions to patient care. OBJECTIVES To characterize the patient care activities of the pharmacists in the Bloom Program. METHODS A retrospective analysis of patient charts for participants enrolled in the program for three months or longer was conducted. Using all available documentation, pharmacists' activities were coded into eight non-mutually exclusive categories: navigation/resource support, urgent triage, medication management, collaboration/communication, education, social support, self-care, and other. RESULTS 2055 activities from 1144 patient care encounters were identified for 126 participants (48 ± 16 years of age, 61% female, 5 regular medications). Medication management was coded most often per encounter (73%). Each of social support, collaboration/communication, and education were coded in 20-25% of encounters. Frequency of navigation/resources, self-care, and urgent triage were 16.6%, 13.5%, and 2.8%, respectively. Non-medication management activities represented 59.4% of all pharmacist patient care services. CONCLUSIONS Medication management activities were coded in over 70% of patient encounters for pharmacists delivering a community pharmacy-based mental illness and addictions program. However, this accounted for 40.6% of activities with an average of 1.8 activities per encounter. Other activities were identified frequently (e.g., education, collaboration, social support, navigation and resource support) and help to characterize the nature of pharmacist-patient encounters and facilitates a better understanding of the role of the pharmacist in mental illness and addictions patient care.
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Affiliation(s)
- Lauren Haslam
- Dalhousie Medical School, Dalhousie University, Halifax, Nova Scotia, PO Box 15000, B3H 4R2, Canada.
| | - David M Gardner
- Department of Psychiatry, Dalhousie University, QEII HSC, AJLB 7517, 5909 Veterans' Memorial Lane, Halifax, Nova Scotia, B3H 2E2, Canada.
| | - Andrea Lynn Murphy
- College of Pharmacy, Dalhousie University, 5968 College St., PO Box 15000, Halifax, Nova Scotia, B3H 4R2, Canada.
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Ballou JM, Chapman AR, Roark AM, Huie CH, McKee J, Marciniak MW. Conducting depression screenings in a community pharmacy: A pilot comparison of methods. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2019. [DOI: 10.1002/jac5.1156] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Jordan M. Ballou
- UNC Eshelman School of Pharmacy; University of North Carolina at Chapel Hill; Chapel Hill North Carolina
- Brame Huie Pharmacy; North Wilkesboro North Carolina
| | | | | | - Cathy H. Huie
- Brame Huie Pharmacy; North Wilkesboro North Carolina
| | - Jerry McKee
- Community Care of North Carolina; Raleigh North Carolina
| | - Macary W. Marciniak
- UNC Eshelman School of Pharmacy; University of North Carolina at Chapel Hill; Chapel Hill North Carolina
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Murphy AL, Gardner DM. Pharmacists' acceptability of a men's mental health promotion program using the Theoretical Framework of Acceptability. AIMS Public Health 2019; 6:195-208. [PMID: 31297404 PMCID: PMC6606526 DOI: 10.3934/publichealth.2019.2.195] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 05/15/2019] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Community pharmacists are accessible, knowledgeable, and capable of providing mental health promotion and care in communities. This may not be a role that is recognized by the public, and men in particular. Differences between men and women exist in help seeking practices. Headstrong-Taking Things Head-On is a men's mental health promotion program for community pharmacies that was designed to increase the capacity of community pharmacists in caring for men with lived experience of mental illness and addictions. The program's core components included signage in pharmacies, education and training for pharmacists, and a website for use with patients. METHODS We applied the Theoretical Framework of Acceptability as the coding scheme to pharmacists' qualitative interviews to examine the acceptability of Headstrong for pharmacists. RESULTS Nine pharmacists consented to participate and all chose telephone interviews. With the exceptions of ethicality, affective attitude, and opportunity costs, all components from the TFA were coded in each of the nine transcripts. The most frequently coded constructs were perceived effectiveness of the intervention, burden, and self-efficacy. These were coded at least 20 times. The remaining categories ethicality, intervention coherence, affective attitude, and opportunity costs were coded between 11 to 17 times. Pharmacists' perceptions of the effectiveness of the program was mixed. The overall burden was perceived to be low, but opportunity costs appear to have limited the participation of some pharmacists in the program. CONCLUSION Use of the Theoretical Framework of Acceptability as a coding scheme for qualitative data from community pharmacists in a men's mental health program was helpful for identifying issues with the program that may require redesign (e.g., signage). Program design should consider how services are advertised in the pharmacy setting, how personal values of pharmacists influence intervention coherence, and whether minimizing the burden of an intervention negates issues related to opportunity costs.
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Affiliation(s)
- Andrea Lynn Murphy
- College of Pharmacy, Dalhousie University, 5968 College Street, PO Box 15000, Halifax, NS B3H 4R2, Canada
| | - David Martin Gardner
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Halifax, NS B3H 2E2, Canada
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Hindi AMK, Jacobs S, Schafheutle EI. Solidarity or dissonance? A systematic review of pharmacist and GP views on community pharmacy services in the UK. HEALTH & SOCIAL CARE IN THE COMMUNITY 2019; 27:565-598. [PMID: 30047617 DOI: 10.1111/hsc.12618] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/18/2018] [Accepted: 06/20/2018] [Indexed: 06/08/2023]
Abstract
There has been a strong policy emphasis over the past decade on optimising patient-centred care and reducing general practitioners' (GPs') workload by extending community pharmacy services and collaboration between pharmacists and GPs. Our aim was to review current evidence of pharmacists' and GPs' views of extended community pharmacy services and pharmacists' roles in the United Kingdom (UK). A systematic review was undertaken looking at UK studies investigating pharmacists' and/or GPs' views of community pharmacy services or roles from 2005 to 2017. A range of databases were searched including EMBASE, PubMed, Scopus, Web of Science, International Pharmaceutical Abstracts (IPA), PsycINFO, Science Direct and The Cumulative Index to Nursing and Allied Health Literature (CINAHL). In addition, reference lists of included studies were screened and grey literature was searched. Following the application of inclusion/exclusion criteria, the quality of papers was critically analysed, findings were extracted into a grid and subjected to narrative synthesis following thematic analysis. The search strategy yielded a total of 4,066 unique papers from which 60 were included. Forty-seven papers covered pharmacists' views, nine combined both pharmacists' and GPs' views and four covered GPs' views. Study designs included interviews (n = 31, 52%), questionnaire surveys (n = 17, 28%) and focus groups (n = 7, 12%). Three main themes emerged from the data: "attitudes towards services/roles", "community pharmacy organisations" and "external influences". Pharmacists and GPs perceived a number of barriers to successful implementation and integration of pharmacy services. Moreover, collaboration between pharmacists and GPs remains poor despite the introduction of extended services. Overall, extending community pharmacy services require quality-driven incentives and joint working between community pharmacists and GPs to achieve better integration within the patient's primary care pathway.
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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
| | - 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
| | - 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
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Fatani S, Dobson R, El-Aneed A. Qualitative exploration of the education and skill needs of community pharmacists in Saskatoon concerning substance use disorder. Can Pharm J (Ott) 2019; 152:117-129. [PMID: 30886664 PMCID: PMC6410432 DOI: 10.1177/1715163518816726] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Identifying the skills and educational needs of community pharmacists concerning addiction is critical to improving the services provided for people who suffer from addiction disease (PWSAD). METHODS Eleven one-to-one semi-structured interviews were conducted with community pharmacists practising in the Saskatoon Health Region, Canada. The interviews were recorded and transcribed verbatim and verified with the participants. Thematic analysis was employed to analyze the transcripts. RESULTS Four major themes were identified: 1) effect of the work setting on pharmacists' encounters with PWSAD, 2) pharmacists' knowledge of key aspects of addiction, 3) level of support within the health care system, and 4) educational and training needs. CONCLUSION Participants indicated that a lack of knowledge and training were major hindrances to improving the quality of the services provided to people who suffer from addiction disease. Additional practicum experience at the undergraduate level and interprofessional interactive educational sessions at the continuing educational level were key recommendations emerging from the study.
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Affiliation(s)
- Sarah Fatani
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan
| | - Roy Dobson
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan
| | - Anas El-Aneed
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan
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Isenor JE, Minard LV, Stewart SA, Curran JA, Deal H, Rodrigues G, Sketris IS. Identification of the relationship between barriers and facilitators of pharmacist prescribing and self-reported prescribing activity using the theoretical domains framework. Res Social Adm Pharm 2018; 14:784-791. [DOI: 10.1016/j.sapharm.2017.10.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Revised: 10/02/2017] [Accepted: 10/08/2017] [Indexed: 10/18/2022]
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Borchert JS, Phillips J, Thompson Bastin ML, Livingood A, Andersen R, Brasher C, Bright D, Fahmi-Armanious B, Leary MH, Lee JC. Best practices: Incorporating pharmacy technicians and other support personnel into the clinical pharmacist's process of care. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2018. [DOI: 10.1002/jac5.1029] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | | | | | | | - David Bright
- American College of Clinical Pharmacy; Lenexa Kansas
| | | | | | - James C. Lee
- American College of Clinical Pharmacy; Lenexa Kansas
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Community pharmacists' attitudes and opinions towards supplying clozapine. Int J Clin Pharm 2018; 40:1116-1130. [PMID: 29936642 DOI: 10.1007/s11096-018-0676-y] [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: 02/04/2018] [Accepted: 06/14/2018] [Indexed: 12/12/2022]
Abstract
Background Clozapine is very effective for treatment-resistant schizophrenia, but its use has been limited due to the risk of agranulocytosis. From July 2015, clozapine has been accessible from Australian community pharmacies following regulatory changes, but pharmacists' attitudes towards these changes remain unknown. Objective To explore pharmacists' perspectives and experiences in supplying clozapine. Setting Australian community pharmacists. Methods A cross-sectional study with a mixed methods approach involving two phases. An online survey containing Likert-type and open-response questions was distributed to community pharmacists (n = 134) via ClopineCentral™ (clozapine monitoring system). Participants were then invited to participate in semi-structured telephone interviews (n = 12) regarding clozapine supply. Quantitative data were statistically analysed, while qualitative responses were thematically content-analysed. Main outcome measures Pharmacists' responses to surveys and interviews. Results Community pharmacists were supportive towards supplying clozapine as it increased access for consumers. Better patient-pharmacist relationships and holistic care approach were identified to benefit both consumers and pharmacists. Pharmacists reported to be confident (89.6%), have adequate support (73.1%), knowledge (86.6%) and skills (93.3%) in dispensing clozapine. Training and support received facilitated pharmacists' roles, whereas administrative issues, especially in obtaining valid haematology results, posed challenges. Educational and technical improvements were suggested to improve service provision. Conclusion Community pharmacists welcomed the regulatory changes positively and were confident in supporting consumers taking clozapine. Despite challenges present, benefits and facilitators identified supported the feasibility of this service in community pharmacies. Future research should explore other aspects of clozapine supply, such as attitudes of other stakeholders, to improve current supply systems.
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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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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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Goodman CS, Smith TJ, LaMotte JM. A survey of pharmacists' perceptions of the adequacy of their training for addressing mental health-related medication issues. Ment Health Clin 2018; 7:69-73. [PMID: 29955501 DOI: 10.9740/mhc.2017.03.069] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Introduction The purpose of this study was to conduct a survey of North Carolina pharmacists' perceptions of their pharmacy training in mental health-related medication issues and how this influenced their perceived ability to address these issues in the provision of pharmaceutical care to their patients. Methods A survey consisting of 17 questions was developed and emailed to licensed pharmacists in North Carolina. Surveys that were returned were analyzed to see if conclusions could be made regarding the pharmacists' perceptions about their mental health-related medication training and its influence on their practice. Results A total of 848 pharmacists completed the survey (response rate of 7.9%). Of the survey participants, 489 (58.2%) reported that pharmacy school training adequately prepared them to provide basic pharmaceutical care to patients taking mental health-related medications. However, 350 (41.4%) reported feeling less comfortable providing medication counseling for mental health-related medications compared to cardiac medications. Discussion Despite the volume of prescriptions that mental health-related medications represent in day-to-day practice, a significant portion of licensed pharmacists responding to our survey indicate that the emphasis on mental health in their training may have been inadequate.
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Affiliation(s)
- Courtney S Goodman
- MIRECC Pharmacy Fellow, W.G. (Bill) Hefner VA Medical Center, Salisbury, North Carolina,
| | - Tammy J Smith
- Clinical Pharmacy Specialist, Psychiatry, W.G. (Bill) Hefner VA Medical Center, Salisbury, North Carolina
| | - Joseph M LaMotte
- Clinical Pharmacy Specialist, Psychiatry, W.G. (Bill) Hefner VA Medical Center, Salisbury, North Carolina
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Silva SN, Lima MG, Ruas CM. Pharmaceutical interventions in mental health: A review of the literature to support evidence-informed policymaking. Res Social Adm Pharm 2017; 14:891-900. [PMID: 29195731 DOI: 10.1016/j.sapharm.2017.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 11/23/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND Pharmaceutical interventions may have an impact on different treatment aspects, such as therapy adherence, reducing the number of different medications in use and lowering treatment costs. OBJECTIVE Identify pharmaceutical interventions in the mental health field and their possible application in Brazilian public mental health services, considering the evidence-based model to establish implementation options. METHODS A structured search of the literature was performed in the Pubmed (Medline), Cochrane, PsycINFO and Lilacs databases to identify the main pharmaceutical intervention studies conducted in the mental health area. The articles selected were evaluated according to the quality of the evidence. The current laws and public database were researched to collect information on services and procedures provided by the Brazilian units, known as CAPS, and the number the pharmacists allocated to them. The proposal to synthesize the results of pharmaceutical interventions in Brazil was based on SUPPORT methodology items to prepare evidence-based policies. RESULTS A total of 1442 studies were identified, 18 of which were included. Several interventions are reported in the literature, educational interventions being frequently cited. However, there is a need for further studies with more methodological rigor. The number of pharmacists working in the CAPS is insufficient to cover all the services, since only 26.5% of CAPS employ pharmacists, who work an average of 29 (±11.1) hours a week. Three options were formulated to implement interventions in the Brazilian context that consider including pharmacists on the basic team of CAPS professionals and educational interventions through pharmacist training. CONCLUSIONS The present study could support the establishment of health policies, based on a synthesis of the evidence, contextualization of the current situation, given the absence of local evidence, and a discussion of the options available to implement pharmaceutical interventions in the Brazilian health system. Organizational changes in CAPS are needed to broaden pharmacist participation on the multidisciplinary team.
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Affiliation(s)
- Sarah Nascimento Silva
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil.
| | - Marina Guimarães Lima
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Cristina Mariano Ruas
- Department of Social Pharmacy, School of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, Brazil
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41
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Murphy AL. An opportunity for pharmacists and physicians to collaborate to prevent violence. CMAJ 2017; 189:E644. [PMID: 28461381 DOI: 10.1503/cmaj.732952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Affiliation(s)
- Andrea L Murphy
- Associate Professor, College of Pharmacy, Dalhousie University, Halifax, NS
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Fonseca J, Chang A, Chang F. Perceived Barriers and Facilitators to Providing Methadone Maintenance Treatment Among Rural Community Pharmacists in Southwestern Ontario. J Rural Health 2017; 34:23-30. [DOI: 10.1111/jrh.12264] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/16/2017] [Accepted: 07/19/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Joseph Fonseca
- Gateway Centre of Excellence in Rural Health; Seaforth Ontario Canada
- School of Pharmacy; University of Waterloo; Waterloo Ontario Canada
| | - Andrew Chang
- School of Pharmacy; University of Waterloo; Waterloo Ontario Canada
| | - Feng Chang
- Gateway Centre of Excellence in Rural Health; Seaforth Ontario Canada
- School of Pharmacy; University of Waterloo; Waterloo Ontario Canada
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Calogero S, Caley CF. Supporting patients with mental illness: Deconstructing barriers to community pharmacist access. J Am Pharm Assoc (2003) 2017; 57:248-255. [PMID: 28153705 DOI: 10.1016/j.japh.2016.12.066] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 11/10/2016] [Accepted: 12/13/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To discuss the barriers faced by individuals with mental health conditions attempting to access their community pharmacists and to propose solutions toward deconstructing those barriers. SUMMARY Given the prevalence of mental illness and the frequency at which psychotropic medications are dispensed, community pharmacists have a daily opportunity to engage patients with mental illness and be active participants in community-based mental health care. Yet multiple barriers affect patient access to community pharmacists. Some barriers, such as heavy dispensing workload, can be considered as "external" to the pharmacist. Other barriers, such as negative attitudes about mental illness, are considered to be "internal." Research about mental illness stigma in pharmacy often reports that community pharmacists are uncomfortable with, or have little time for, mental health patients. Patients also report experiencing stigma from pharmacists and pharmacy staff. Expanded efforts are needed by the pharmacy profession to deconstruct barriers that patients with mental illness are faced with in community pharmacy, especially related to stigma. Specifically, these efforts should include critically evaluating and addressing the quality of didactic and experiential opportunities in psychiatric pharmacotherapy for pharmacy students, transforming the physical layout of community pharmacies to offer true counseling privacy, educating community pharmacists and pharmacy staff about mental illness, and educating patients about what to expect from community pharmacists. CONCLUSION There are opportunities for community pharmacy to improve its impact on mental health treatment outcomes by resolving mental illness stigma and other barriers that prevent patients with mental illness from accessing their community pharmacist.
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Dolovich L, Tsuyuki RT. Pharmacy practice research produces findings that inform how pharmacists contribute to optimal drug therapy outcomes for Canadians. Can Pharm J (Ott) 2016; 149:261-263. [PMID: 27708670 DOI: 10.1177/1715163516663693] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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