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Belachew EA, Shibe BS, Tefera AM, Wondm SA. Community pharmacy professionals' knowledge, attitude, and practice toward nutrition and lifestyle counseling in Gondar City, Ethiopia. SAGE Open Med 2024; 12:20503121241256569. [PMID: 38826823 PMCID: PMC11143820 DOI: 10.1177/20503121241256569] [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: 01/14/2024] [Accepted: 04/26/2024] [Indexed: 06/04/2024] Open
Abstract
Background Community pharmacy professionals play a vital role in health care, have a greater impact on public health programs, and play a critical role in patient counseling for both non-pharmacological and pharmacological management. This study aimed to evaluate the knowledge, attitude, and practice of community pharmacy professionals toward nutrition and lifestyle counseling in Gondar City, Ethiopia. Methods A cross-sectional survey was undertaken in Northwestern Ethiopia from May to June 2021. Face-to-face structured interviews were performed to collect data using a specially created questionnaire. Descriptive, independent t-test, and one-way ANOVA analyses were used. A significant difference was defined as a p-value of less than 0.05. Results This survey drew 100 community pharmacy professional from a pool of 105 participants, with a 95.2% response rate. More than a third of the participants (n = 43, 43%) defined medical nutrition therapy as the use of food to prevent disease, and almost half of the participants (n = 51, 51%) viewed therapeutic nutrition to be part of their job responsibilities. More than half (64%) believe that patients should be provided a combination of nutritional and pharmacological treatments in the majority of cases. The majority of participants (75%) gave patients counseling on drug-food interactions. Conclusion The majority of community pharmacy professionals said they knew a lot about medical nutrition therapy and were enthusiastic about nutrition evaluation and medical nutrition therapy, they see these tasks as part of their job, and they practiced dietary counseling that was limited to pregnancy and chronic diseases.
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Affiliation(s)
- Eyayaw Ashete Belachew
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Biniam Siyum Shibe
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Aschalew Mulatu Tefera
- Pharmacognosy Unit, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Samuel Agegnew Wondm
- Clinical Pharmacy Unit, Department of Pharmacy, College of Medicine and Health Sciences, Debre Markos University, Debre Markos, Ethiopia
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Jairoun AA, Al-Hemyari SS, Shahwan M, Jairoun SA, Alorfi NM, Zyoud SH, Suliman AA, Shahwan MK, Alnuaimi G, Shahwan M, Al-Qirim T, El-Dahiyat F. Current Perspectives, Practices, and Barriers Faced by Community Pharmacists Regarding Pharmaceutical Care Services for Diabetes Mellitus in the United Arab Emirates. J Multidiscip Healthc 2024; 17:2563-2576. [PMID: 38803617 PMCID: PMC11129742 DOI: 10.2147/jmdh.s447450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 03/04/2024] [Indexed: 05/29/2024] Open
Abstract
Background Providing accurate and sufficient information is a crucial requirement for delivering effective diabetes care, making it essential for community pharmacists to possess adequate knowledge of diabetes mellitus (DM) and its management. Objective To investigate community pharmacists' level of expertise and engagement in providing counseling and health promotion services for individuals with DM in the United Arab Emirates (UAE). Methods A cross-sectional study design was used. The community Pharmacies were chosen via random sampling and researchers then conducted face-to-face interviews with them using the structured questionnaire. The questionnaire included demographic data, 14 questions on the knowledge and 9 questions about the practice concerning pharmaceutical care for Diabetes Mellitus. Results The average age ± SD was 31 ± 6.3. Of the total 516 community pharmacists recruited in the study, 37.2% (n=192) were male and 62.8% (n=324) were female. The average knowledge score about DM prevention and management was 9.7 with a 95% confidence interval (CI) [9.5, 9.9] and the average practice score about DM prevention and management was 7.1 with a 95% confidence interval (CI) [6.9, 7.2]. Better knowledge scores were observed in chief pharmacists (OR 1.29; 95% CI 1.08-1.56), pharmacists with 6-10 Years of experience (OR 6.92; 95% CI 3.43-8.86), pharmacist with > 10 years of experience (OR 1.99; 95% CI 1.67-2.36), when the number of patients the pharmacist serve is 5-10 (OR 1.27; 95% CI 1.06-1.53) and being trained on DM prevention and management (OR 2.18; 95% CI 1.92-2.47). Similarly, better practice scores were observed in older participants (OR1.02; 95% CI 1.001-1.03), chain pharmacies (OR 1.42; 95% CI 1.20-1.68), chief pharmacists (OR 1.56; 95% CI 1.18-2.06), when the number of patients the pharmacists serve was 5-10 (OR 12.26; 95% CI 7.26-16.19), when the number of patients the pharmacists serve was 11-20 (OR 4.23; 95% CI 3.54-5.06) and being trained on DM prevention and management (OR 1.33; 95% CI 1.11-1.59). The most commonly reported barriers to providing counseling and health promotion services for diabetes mellitus (DM) in community pharmacies include a lack of coordination with other healthcare professionals (77%) and insufficient knowledge or clinical skills (68.7%). Conclusion Our study revealed that community pharmacy staff members displayed a noteworthy level of involvement in providing pharmaceutical care services for patients with diabetes mellitus. Based on these findings, it is recommended to enhance pharmacy education by incorporating more advanced, evidence-based training and curricula focusing on disease management and appropriate therapies, particularly for diabetes.
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Affiliation(s)
- Ammar Abdulrahman Jairoun
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinang, 11500, Malaysia
- Health and Safety Department, Dubai Municipality, Dubai, United Arab Emirates
| | - Sabaa Saleh Al-Hemyari
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia (USM), Pulau Pinang, 11500, Malaysia
- Pharmacy Department, Emirates Health Services, Dubai, United Arab Emirates
| | - Moyad Shahwan
- College of Pharmacy and Health Sciences, Ajman University, Ajman, 346, United Arab Emirates
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Sumaya Abdulrahman Jairoun
- Department of Clinical Pharmacy & Pharmacotherapeutics, Dubai Pharmacy College for Girls, Al Mizhar Dubai, United Arab Emirates
| | - Nasser M Alorfi
- Pharmacology and Toxicology Department, College of Pharmacy, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Sa’ed H Zyoud
- Department of Clinical and Community Pharmacy, College of Medicine and Health Sciences, An-Najah National University, Nablus, 44839, Palestine
- Clinical Research Centre, An-Najah National University Hospital, Nablus, 44839, Palestine
| | - Abdulhaq A Suliman
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
- College of Dentistry, Ajman University, Ajman, United Arab Emirates
| | - Manar Khalil Shahwan
- College of Pharmacy and Health Sciences, Ajman University, Ajman, 346, United Arab Emirates
- Centre of Medical and Bio-Allied Health Sciences Research, Ajman University, Ajman, United Arab Emirates
| | - Ghala Alnuaimi
- College of Pharmacy and Health Sciences, Ajman University, Ajman, 346, United Arab Emirates
| | - Monzer Shahwan
- Diabetes Clinic, AL-Swity Center for Dermatology and Chronic Diseases, Ramallah, 972, Palestine
| | - Tariq Al-Qirim
- Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, 11733, Jordan
| | - Faris El-Dahiyat
- Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al Ain, 64141, United Arab Emirates
- AAU Health and Biomedical Research Center, Al Ain University, Abu Dhabi, 112612, United Arab Emirates
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Bogale Kassie A, Mengie Ayele T, Mekonnen Agidew M. Assessment of Dispensing Malpractice in Community Drug Retail Outlets in South Gondar Zone, Northwest Ethiopia: A Simulated Patient Experience. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2023; 12:171-183. [PMID: 37522068 PMCID: PMC10386832 DOI: 10.2147/iprp.s416830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 07/18/2023] [Indexed: 08/01/2023] Open
Abstract
Background Pharmacy professionals in community drug retail outlets, as the most accessible personnel for the community, are engaged in consultation and responding to health problems in addition to filling prescriptions. In doing so, different dispensing malpractices are observed and much is not known on the issue in Ethiopia. Objective The study aimed at assessing dispensing malpractice at pharmacies, drug stores and drug vendors in South Gondar zone. Methodology A cross-sectional study design with a descriptive approach was applied from April 1 to June 30. The data was collected using the simulated patient method. Seven prescription-only medicines and a diarrheal case were requested during visit. All drug retail outlets in South Gondar zone that were in service during data collection were visited. Results Almost all prescription-only medications were dispensed without prescription at all community drug retail outlets. Of all the dispensaries, 19 (82.6%) provided a partial dosage regimen of amoxicillin. Presence of fever and pregnancy status were asked about by dispensers in only 8% and 20% of visits for diarrhea, respectively. Medication history was also rarely requested. Medication was dispensed in 80% of visits for diarrhea, all of which included antimicrobials. Oral rehydration salt was considered in only two (10%) dispensaries. Conclusion Dispensing medications without a prescription is common in community drug retail outlets in South Gondar zone in Amhara Regional State. Our findings also showed that detailed assessments of patients' signs and symptoms are not performed properly by the dispensers to understand the diarrheal case. Training of pharmacy professionals and strict regulatory control are needed.
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Affiliation(s)
- Achenef Bogale Kassie
- Department of Pharmacy, College of Health Sciences, Debre Tabore University, Debre Tabore, Amhara Regional State, Ethiopia
| | - Teklie Mengie Ayele
- Department of Pharmacy, College of Health Sciences, Debre Tabore University, Debre Tabore, Amhara Regional State, Ethiopia
| | - Melaku Mekonnen Agidew
- Department of Biomedical Science, College of Health Sciences, Debre Tabore University, Debre Tabore, Amhara Regional State, Ethiopia
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Loh P, Lee JW, Karuppannan M, Chua SS. Practice of pharmaceutical care by community pharmacists in response to self-medication request for a cough: a simulated client study. BMC Health Serv Res 2023; 23:657. [PMID: 37340333 DOI: 10.1186/s12913-023-09642-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 06/03/2023] [Indexed: 06/22/2023] Open
Abstract
BACKGROUND Community pharmacy practice worldwide has been shifting from product-focused to patient-oriented. However, due to the absence of separation between prescribing and dispensing in Malaysia, community pharmacists may have limited roles in the provision of pharmaceutical care to patients with chronic diseases. Therefore, the main functions of community pharmacists in Malaysia are related to self-medication requests for minor ailments and the supply of non-prescription medications. The objective of this study was to determine the practice of pharmaceutical care by community pharmacists within the Klang Valley, Malaysia in response to self-medication requests for a cough. METHODS This study utilised a simulated client method. A research assistant, acting as a simulated client, visited community pharmacies in the Klang Valley, Malaysia to consult the pharmacists on the treatment of a cough experienced by his father. Upon leaving the pharmacy premise, the simulated client entered the pharmacist's responses in a data collection form which was structured based on pharmacy mnemonics for the response to symptoms, OBRA'90 on counselling elements, the five practice principles of pharmaceutical care by the American Pharmacists Association and literature review. Visits to the community pharmacies were conducted from September to October 2018. RESULTS The simulated client visited a total of 100 community pharmacies. None of these community pharmacists practised adequate patients' data collection, with only a low proportion who practised all the components studied under medication information evaluation (13%), formulating a drug therapy plan (15%) and monitoring and modifying the plan (3%). Of the 100 community pharmacists, 98 recommended treatment but none of them provided all the counselling elements studied in implementing the drug therapy plan. CONCLUSION The present study showed that community pharmacists within the Klang Valley, Malaysia were not providing adequate pharmaceutical care services to patients seeking self-medication for a cough. Such practice may compromise patient safety if inappropriate medicines or advice are given.
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Affiliation(s)
- Pengyeow Loh
- School of Pharmacy, Faculty of Health & Medical Sciences, Taylor's University, 1, Jalan Taylors, Subang Jaya, Selangor, 47500, Malaysia.
| | - Jason W Lee
- School of Pharmacy, Faculty of Health & Medical Sciences, Taylor's University, 1, Jalan Taylors, Subang Jaya, Selangor, 47500, Malaysia
| | - Mahmathi Karuppannan
- Department of Clinical Pharmacy, Faculty of Pharmacy, Universiti Teknologi MARA Selangor Branch, Puncak Alam Campus, Bandar Puncak Alam, Selangor, 42300, Malaysia
| | - Siew Siang Chua
- School of Pharmacy, Faculty of Health & Medical Sciences, Taylor's University, 1, Jalan Taylors, Subang Jaya, Selangor, 47500, Malaysia
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Aziz MM, Rasool MF, Alanazi M, Alharby TN, Alanazi J, Huwaimel B. Evaluating the Counseling Standards and Ability of Pharmacy Staff to Detect Antibiotic-Drugs Interactions: A Simulated Client Study from Pakistan. Antibiotics (Basel) 2023; 12:antibiotics12050931. [PMID: 37237834 DOI: 10.3390/antibiotics12050931] [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: 03/16/2023] [Revised: 04/29/2023] [Accepted: 05/16/2023] [Indexed: 05/28/2023] Open
Abstract
Effective and safe medication use can be maximized by providing medication counseling, which aims to optimize therapeutic results. This approach improves the effectiveness of antibacterial treatment, reduces treatment expenses, and mitigates the emergence of antimicrobial resistance. No research from Pakistan has been previously documented. The purpose of this research was to evaluate both the quality of antibiotic counseling provided and the level of understanding exhibited by pharmacy employees with regard to interactions involving antibiotic medications. Using a simulated client method, two scenarios were used to assess 562 pharmacies that were systematically selected. Scenario 1 focused the counseling for use of prescribed medicines with non-prescribed antibiotics. Scenario2 indicated counseling provision for prescribed antibiotics that have possible antibiotic-drug interactions. The evaluation of counseling skills was also conducted. The analysis involved the use of descriptive statistics and chi-square tests. Only 34.1% of simulated clients received medication counseling directly; 45% received it on request. About 31.2% of clients were referred to a physician without counseling. The most frequently provided information was therapy dose (81.6%) and duration (57.4%). More than half (54.0%) of clients were asked about disease duration, but drug storage was ignored. Insufficient information was provided about side effects (1.1%) and antibiotic-drug interactions (1.4%). Most (54.3%) clients were instructed about dietary or lifestyle modifications. Only 1.9% of clients received information about drug administration route. No information was provided about other medication during therapy, effect of medicine withdrawal, and compliance to medication. The current level of antibiotic counseling within Pakistani community pharmacies is inadequate and requires the attention of medical authorities. Professional training of staff could improve counseling.
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Affiliation(s)
- Muhammad Majid Aziz
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University Multan, Multan 60000, Pakistan
| | - Muhammad Fawad Rasool
- Department of Pharmacy Practice, Faculty of Pharmacy, Bahauddin Zakariya University Multan, Multan 60000, Pakistan
| | - Muteb Alanazi
- Department of Clinical Pharmacy, College of Pharmacy, University of Ha'il, Hail 81442, Saudi Arabia
| | - Tareq Nafea Alharby
- Department of Clinical Pharmacy, College of Pharmacy, University of Ha'il, Hail 81442, Saudi Arabia
| | - Jowaher Alanazi
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Ha'il, Hail 81442, Saudi Arabia
| | - Bader Huwaimel
- Department of Pharmaceutical Chemistry, College of Pharmacy, University of Ha'il, Hail 81442, Saudi Arabia
- Medical and Diagnostic Research Center, University of Ha'il, Hail 55473, Saudi Arabia
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Loh P, Chua SS, Karuppannan M. The extent and barriers in providing pharmaceutical care services by community pharmacists in Malaysia: a cross-sectional study. BMC Health Serv Res 2021; 21:822. [PMID: 34399749 PMCID: PMC8365940 DOI: 10.1186/s12913-021-06820-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 07/23/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Since the introduction of pharmaceutical care concept by Hepler and Strand in 1990, community pharmacists worldwide have been realigning their roles from being product-focused to patient-orientated to improve patient's quality of life. The objectives of this study were to determine the type of services, with emphasis on the extent of pharmaceutical care services provided by community pharmacists and the barriers in providing such services in Malaysia. METHODS A cross-sectional observational study was conducted using an online questionnaire. Community pharmacists in Malaysia were invited to participate in the study via emails. The questionnaire was structured based on the Malaysian Community Pharmacy Benchmarking Guidelines, the five practice principles of pharmaceutical care by the American Pharmacists Association and other studies. The online questionnaire was opened for 6 months, from April to September 2018. A reminder to participate was sent via email to the community pharmacists every fortnight. RESULTS A total of 420 community pharmacists responded to the online questionnaire. Besides essential services such as treatment for minor illness, medicine dispensing and counselling, most of the respondents were providing health screening and monitoring (99.5%), selection and recommendation of health supplements (90.5%), patient medication review (68.8%), weight management (52.4%) and counselling on smoking cessation (51.0%). More than half (53.3%) of the respondents reported that they were providing pharmaceutical care services to patients with chronic diseases. Based on the practice principles of pharmaceutical care, the respondents were involved in patients' data collection (23.3%), medical information evaluation (18.6%), formulating a drug therapy plan (9.3%), implementing a drug therapy plan (4.5%), and monitoring and modifying the plan (18.3%). Lack of separation between prescribing and dispensing was perceived as the main barrier to the implementation of pharmaceutical care services by a majority of the respondents (84.0%). CONCLUSIONS The present study found that pharmaceutical care services provided by community pharmacists in Malaysia were inadequate compared to international practice principles. Areas that need improvement included collaboration with patients' other health care providers; more proactive management of patient's medicine regimen; having proper patient monitoring and follow-up mechanisms, and documentation.
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Affiliation(s)
- Pengyeow Loh
- School of Pharmacy, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia.
| | - Siew Siang Chua
- School of Pharmacy, Faculty of Health & Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia
| | - Mahmathi Karuppannan
- Department of Pharmacy Practice, Faculty of Pharmacy, Universiti Teknologi MARA Cawangan Selangor, Puncak Alam Campus, Bandar Puncak Alam, Selangor, Malaysia
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Belachew SA, Muluneh NY, Erku DA, Netere AK. A cross sectional study on beliefs and roles of community pharmacy professionals in preventing and managing metabolic syndrome in an Ethiopian setting. PLoS One 2020; 15:e0244211. [PMID: 33347490 PMCID: PMC7751855 DOI: 10.1371/journal.pone.0244211] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 12/06/2020] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION Metabolic syndrome (MetS) is a group of cardiovascular risk factors, and its prevalence is becoming alarmingly high in Ethiopia. Studies uncovered as community pharmacy professionals (CPPs) have not yet well integrated into public health programs and priorities. In low income setting like Ethiopia, evidence regarding the roles CPPs in preventing and management of MetS is dearth. OBJECTIVE The study was aimed to assess community pharmacy professionals'(CPPs) opinions about metabolic syndrome, describe their perception level towards the effectiveness of the main interventions and explore their extent of involvement in counseling patients with the metabolic syndrome in Gondar town, Northwestern Ethiopia. METHOD A descriptive, cross-sectional study was conducted among pharmacists and druggists working in community medication retail outlets (CMROs) in Gondar town, northwestern Ethiopia from April 1 to May 31, 2019. Data were collected using a self-administered pre-tested questionnaire. Descriptive statistics was used to summarize different variables, and presented in tables and figure. An independent t-test and one way ANOVA (Analysis of Variance) were used to compare mean scores. A 5% level of significance was used. RESULT Out of the 75 CPPs approached, 65(40 pharmacists and 25 druggists) completed the survey giving a response rate of 86.7%. Smoking cessation practice was identified to be low. There were a statistically significant difference (t = 2.144, P = 0.036) in the involvement towards counseling patients between CPPs who claimed to work in pharmacy (mean = 3.96 out of 5 points Likert scale) and drug stores (mean = 3.80 out of 5 points Likert scale). CONCLUSION The study concluded that the overall involvement of professionals in counseling patients, opinion about metabolic syndrome, and perception towards the effectiveness of the intervention was found to be more or less positive. However, the provision of services, such as monitoring therapy, selling equipment for home blood pressure and glucose monitoring and documenting patient care services needs to be encouraged. Given proper education and training, the current study hope that community pharmacists could be an important front-line contributors to contain this emerging epidemic in Gondar town as well as in the entire nation.
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Affiliation(s)
- Sewunet Admasu Belachew
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia
- * E-mail:
| | - Niguse Yigzaw Muluneh
- Department of Psychiatry, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia
| | - Daniel Asfaw Erku
- Centre for Applied Health Economics, School of Medicine & Menzies Health Institute Queensland, Griffith University, Queensland, Australia
| | - Adeladlew Kassie Netere
- Department of Clinical Pharmacy, School of Pharmacy, University of Gondar-College of Medicine and Health Sciences, Gondar, Ethiopia
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Bahta M, Tesfamariam S, Weldemariam DG, Yemane H, Tesfamariam EH, Alem T, Russom M. Dispensing of antibiotics without prescription and associated factors in drug retail outlets of Eritrea: A simulated client method. PLoS One 2020; 15:e0228013. [PMID: 31978180 PMCID: PMC6980490 DOI: 10.1371/journal.pone.0228013] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 01/06/2020] [Indexed: 11/18/2022] Open
Abstract
Dispensing antibiotics without prescription is irrational and can hasten the emergence and spread of antibiotic resistance. This study aims at determining the extent of this practice and its determinants in all drug retail outlets of Eritrea. A cross-sectional simulated client method was used to conduct the study. Data was collected between July and August 2019, entered and analyzed using Statistical Package for Social Science version 22. Descriptive analysis was performed using mean (standard deviation), median (interquartile range), frequency, percentage, as appropriate, for independent variables. Logistic regression, at bivariate and multivariate levels, along with odds ratio (95% confidence interval) was used to determine the association between the dispensing of antibiotics without prescription and independent variables. P-values less than 0.05 were considered as statistically significant. The extent of dispensing antibiotics without prescription was found to be 87.6% with the most frequently dispensed antibiotics being ciprofloxacin (47.8%) and co-trimoxazole (37.5%). Furthermore, 12.4% of the drug retail outlet attendants did not dispense antibiotics because they preferred a referral to health facilities (52.6%), were following administrative restrictions not to sell antibiotics (42.1%), or did not have the necessary antibiotics (31.6%). Private community pharmacies (AOR = 7.68, 95% CI: 1.67, 35.37; p = 0.009) and private drug shops (AOR = 10.65, 95% CI: 1.96, 57.93; p = 0.006) were more likely to dispense antibiotics compared to the governmental community pharmacies. Dispensing antibiotics without prescription was more likely to occur in the Maekel (central) region (AOR = 3.76, 95% CI: 1.19, 11.92; p = 0.024) compared to the remaining regions combined. In conclusion, the sales of antibiotics without prescription in the drug retail outlets of Eritrea is alarming which requires immediate attention from policymakers.
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Affiliation(s)
- Merhawi Bahta
- Department of Medical Sciences, Pharmacy Unit, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | | | | | | | - Eyasu H. Tesfamariam
- Department of Statistics, Biostatistics and Epidemiology Unit, College of Science, Eritrean Institute of Technology, Mai Nefhi, Eritrea
| | - Tesfamariam Alem
- Department of Medical Sciences, Pharmacy Unit, Orotta College of Medicine and Health Sciences, Asmara, Eritrea
| | - Mulugeta Russom
- Eritrean Pharmacovigilance Center, National Medicines and Food Administration, Asmara, Eritrea
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Björnsdottir I, Granas AG, Bradley A, Norris P. A systematic review of the use of simulated patient methodology in pharmacy practice research from 2006 to 2016. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2019; 28:13-25. [PMID: 31397533 DOI: 10.1111/ijpp.12570] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Accepted: 07/09/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Simulated patient (SP) methodology (mystery shopping) is used increasingly to assess quality of pharmacy services, and evaluate impact of interventions. Our objective was to review papers reporting on the use of SP methodology in pharmacy practice research 2006-2016 in community pharmacies worldwide. METHODS We searched EMBASE and MEDLINE for papers reporting on the use of mystery shopping in pharmacy settings, using a wide range of terms for SPs, based on previous review. We removed irrelevant papers, duplicates, papers not written in English, and review papers and reviewed remaining papers. Two reviewers carried out data abstraction, using the same tool as the previous review and inserting data into Excel, focusing on how the SP methodology is used. KEY FINDINGS A total of 148 papers from 52 countries from all regions of the world were included in the review. A wide range of terms described the method, and simulated patient was the most common (49 papers). Most studies were cross-sectional (124), and most investigated only community pharmacies (115). The most common aim was to evaluate some aspect of pharmacists' or other staff's advice and counselling (94). Number of visits is 2-7785. Many papers did not cover details, such as number of visits planned, and carried out, scenario used, training and background of SPs, and ethical approval for the study. CONCLUSIONS The use of SP methodology has increased substantially in the field of pharmacy over the past decade. This is a useful method in a wide range of countries and settings. Greater detail is required in reporting.
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Affiliation(s)
| | | | - Amanda Bradley
- Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Pauline Norris
- School of Pharmacy, University of Otago, Dunedin, New Zealand
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Smith H, Whyte S, Chan HF, Kyle G, Lau ETL, Nissen LM, Torgler B, Dulleck U. Pharmacist Compliance With Therapeutic Guidelines on Diagnosis and Treatment Provision. JAMA Netw Open 2019; 2:e197168. [PMID: 31314116 PMCID: PMC6647553 DOI: 10.1001/jamanetworkopen.2019.7168] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
IMPORTANCE Misuse and overselling of over-the-counter pharmaceuticals poses a major burden on both private and public health expenditures. OBJECTIVE To seek evidence on whether over-the-counter medication dispensing behavior complies or conflicts with the protocols indicated in practice standards and guidelines of a national professional pharmacy organization. DESIGN, SETTING, AND PARTICIPANTS This quality improvement study was undertaken in 205 pharmacies in the wider Brisbane, Australia, area. Two standardized patient (SP) scenarios were developed to evaluate noncompliant behavior. Data collection for scenario 1 was conducted between November 23 and December 9, 2016. Data collection for scenario 2 was conducted between September 1 and 28, 2017. A 2-sample test of proportions and a probit regression model were used to evaluate the likelihood of noncompliant treatments and overtreatments in each case scenario. Statistical analysis was performed from January 30 to June 21, 2018, and revised in May 2019. MAIN OUTCOMES AND MEASURES Outcomes were the observed likelihood of noncompliant treatments and overtreatments. Noncompliance is defined as treatments not complying with practice standards and guidelines set by the professional pharmacy society. Noncompliant treatments include undertreatment (patient did not receive necessary treatment) and overtreatments (patient was supplied with more than sufficient treatments) in both scenarios. RESULTS In scenario 1, 9 trained female SPs visited 89 pharmacies to request emergency hormonal contraception from pharmacy staff. In 45 cases, SPs reported having unprotected intercourse within the last 24 hours (case 1A), and in 44 cases, SPs reported having unprotected intercourse more than 72 hours ago (case 1B), which is past the efficacy threshold of over-the-counter emergency hormonal contraception. In scenario 2, 11 SPs (5 male and 6 female) visited 150 pharmacies (154 visits in total) to request treatment for family members or a partner with symptoms indicating bacterial conjunctivitis (case 2A; n = 73) or viral conjunctivitis (case 2B; n = 81). In scenario 1-dispensing emergency hormonal contraception when physician referral is recommended-21 of 44 pharmacists (47.7%) in case 1B violated the recommendation by selling the over-the-counter medication. With the inclusion of both no physician referral and emergency hormonal contraception sold, this rate increased to 79.5% (35 of 44 pharmacists). In scenario 2-1 case each of bacterial and viral conjunctivitis-overtreatment occurred in 55 of 154 cases (35.7%). In both scenarios, 140 of 243 pharmacies (57.6%) followed dispensing behavior compliant with the protocol, while 76 of 243 pharmacies (31.3%) involved some form of overtreatment or overselling of medication. Some evidence of an association between sex of SP and pharmacist was also found. CONCLUSIONS AND RELEVANCE Although the market for dispensing over-the-counter medication in Australia is regulated, relatively high rates of overtreatment and some cases of undertreatment were observed in this study. Given the unintended adverse effects, including overuse of antibiotics and corticosteroids, these observations suggest the advisability of regulatory intervention ensuring compliance with professional protocols.
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Affiliation(s)
- Harriet Smith
- School of Economics and Finance, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Stephen Whyte
- School of Economics and Finance, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Behavioural Economics, Society and Technology, Brisbane, Queensland, Australia
| | - Ho Fai Chan
- School of Economics and Finance, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Behavioural Economics, Society and Technology, Brisbane, Queensland, Australia
| | - Gregory Kyle
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Esther T. L. Lau
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Lisa M. Nissen
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Benno Torgler
- School of Economics and Finance, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Behavioural Economics, Society and Technology, Brisbane, Queensland, Australia
- Center for Research in Economics, Management and the Arts, Zürich, Switzerland
| | - Uwe Dulleck
- School of Economics and Finance, Queensland University of Technology, Brisbane, Queensland, Australia
- Centre for Behavioural Economics, Society and Technology, Brisbane, Queensland, Australia
- Crawford School of Public Policy, Australian National University, Canberra, Australian Capital Territory, Australia
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Sinopoulou V, Gordon M, Rutter P. A systematic review of community pharmacies' staff diagnostic assessment and performance in patient consultations. Res Social Adm Pharm 2018; 15:1068-1079. [PMID: 30342907 DOI: 10.1016/j.sapharm.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 10/02/2018] [Accepted: 10/09/2018] [Indexed: 01/26/2023]
Abstract
BACKGROUND Increases in patients seeking advice at pharmacies has led to pharmacy staff engaging in diagnostic behaviours. Approaches to diagnosis include using mnemonics and clinical reasoning. OBJECTIVES The primary aim of this review was to assess the degree to which the criteria researchers use to evaluate diagnostic performance in pharmacy consultations, in studies that have simulated patients or vignettes, conform with a clinical reasoning and a mnemonic framework. A secondary aim of the review was to characterize staff performance in the studies, based on the authors' comments of their results. METHODS MEDLINE, EMBASE and Web of Science were searched between October 2016 and April 2017. Only peer-reviewed studies assessing pharmacy staff's diagnostic performance using simulated patients or vignettes were eligible for inclusion. Data were extracted about how each study's criteria conformed with clinical reasoning and mnemonic frameworks. A scoring system between 0 and 4 was devised to determine the degree to which studies aligned to these two approaches. Risk of bias was assessed using the NHI Study Quality Assessment Tools. The review was registered in PROSPERO with identification number CRD42017054827. RESULTS Sixty-eight studies (55 cross-sectional, 11 educational interventions and 2 RCTs) with sample sizes between 10 and 2700 were included in the review. Most studies were of poor or fair quality. Performance of pharmacy staff was overwhelmingly reported as poor by study authors. This was the case regardless of geography, scenario used, or assessment framework adopted. Scrutiny on how authors arrived at these conclusions revealed that mnemonic criteria were employed to assess pharmacy staff's diagnostic performance rather than a clinical reasoning approach. CONCLUSIONS Potentially important aspects of the decision-making process, such as clinical reasoning, were left unexplored. The number and geographic distribution of the included studies is a strength of this review; however, a validated tool was not employed.
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Affiliation(s)
- Vassiliki Sinopoulou
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, United Kingdom.
| | - Morris Gordon
- School of Medicine, University of Central Lancashire, United Kingdom
| | - Paul Rutter
- School of Pharmacy and Biomedical Sciences, University of Central Lancashire, United Kingdom
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Assessment of community pharmacy professionals' knowledge and counseling skills achievement towards headache management: a cross-sectional and simulated-client based mixed study. J Headache Pain 2018; 19:96. [PMID: 30326826 PMCID: PMC6755542 DOI: 10.1186/s10194-018-0930-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Accepted: 10/05/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Headache is one of the most common disabling medical condition affecting over 40% of adults globally. Many patients with headache prefer to alleviate their symptom with a range of over-the-counter analgesics that are available in community medicine retail outlets (CMROs). However, data regarding how community pharmacists respond to headache presentation and their analgesic dispensing behaviors in Ethiopia is scarce. The present study aimed to assess the self-reported and actual practice of community pharmacists toward management of a headache in Gondar town, Ethiopia. METHODS A dual-phase mixed-methods research design, including pseudo-client visits (between April 1 and 30, 2018) followed by a questionnaire-based cross-sectional study (between May 1 and 20, 2018) was conducted among CMROs in Gondar town, Ethiopia. RESULTS Among the 60 pseudo-client visits, 95% of them dispensed medications. The overall counseling approach was found to be 42.6% which improved to 58.3% when the pseudo-clients demanded it. Duration (73.3%) and signs/symptoms (45%) of headache were asked before dispensing the medications. Dosing frequency (86.7%), indication (60%) and dosage form (35%) were the most discussed items. Ibuprofen (45%) and diclofenac (41.5%) were primarily added to paracetamol for better headache treatment. Effectiveness (61.7%) and cost (21.7%) were the main criteria to choose drugs. In the cross-sectional survey, 60 participants were requested and 51 of them agreed to participate (response rate of 85%). Of these participants, 64.7% agreed that managing headache symptomatically is challenging. Patient lack of confidence in dispensers (41.2%) and lack of updated medical information (31.4%) were reported as the primary barriers to counsel clients. CONCLUSION This study demonstrated the practical gaps in counseling practices and poor headache management of community pharmacies in Gondar city. National stakeholders in collaboration with academic organizations should be involved in continuous clinical training and education regarding proper counseling practices.
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Erku DA, Mersha AG. Involvement of community pharmacists in public health priorities: A multi-center descriptive survey in Ethiopia. PLoS One 2017; 12:e0180943. [PMID: 28704478 PMCID: PMC5509284 DOI: 10.1371/journal.pone.0180943] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Accepted: 06/10/2017] [Indexed: 11/27/2022] Open
Abstract
Located in the heart of the community and widely distributed geographically, community pharmacies provide a platform for a more proactive involvement in public health services. So far, little information has been gathered in Ethiopia on community pharmacists’ level of involvement in public health services. The aim of the present study was, therefore, to document the level of involvement of community pharmacy professionals in the provision of public health services and the barriers to such involvement. This study employed a self-administered questionnaire based survey, which asked participants to indicate their frequency and level of involvement in providing public health services and their perceived barriers in providing such services. Surveys were undertaken from May to July, 2016 with 472 community pharmacy professionals working in community pharmacies in six cities of Amhara regional state of Ethiopia: Debre Markos, Gondar, Dessie, Bahir Dar, Woldya and Debre Birhan. Among 472 community pharmacy professionals approached, 412 (233 pharmacists and 179 pharmacy technicians) completed the survey with a response rate of 87.3%. Most respondents reported as being either “not at all involved” or “little involved” in counselling on smoking cessation (79.3%), and screening for hypertension (86.9%), diabetes (89.5%), and dyslipidemia (88.9%). On the other hand, they reported a higher level of involvement in the management and screening of infectious diseases (72.8%) and counseling with partners when initiating treatment for sexually transmitted diseases (68.9%). Lack of knowledge or clinical skills and lack of personnel or resources were the most commonly reported barrier for expanding such services. This survey revealed a low level of involvement of community pharmacists in public health services. In order to better integrate community pharmacies into future public health programs and optimize the contribution of community pharmacy professionals, interventions should focus on overcoming the identified barriers.
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Affiliation(s)
- Daniel Asfaw Erku
- Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- * E-mail:
| | - Amanual Getnet Mersha
- Department of Gynecology and Obstetrics, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Hermansyah A, Sainsbury E, Krass I. Community pharmacy and emerging public health initiatives in developing Southeast Asian countries: a systematic review. HEALTH & SOCIAL CARE IN THE COMMUNITY 2016; 24:e11-e22. [PMID: 26427905 DOI: 10.1111/hsc.12289] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/30/2015] [Indexed: 06/05/2023]
Abstract
The development of health and healthcare systems in South-East Asia has influenced the practice of community pharmacy. Over the years, community pharmacy in the region has striven to expand services beyond dispensing to encompass more involvement in public health issues. Searches were conducted in Scopus, EMBASE, MEDLINE and PubMed for articles published between January 2000 and December 2014, with 21 studies in five countries meeting the inclusion criteria. The findings showed increasing interest in research into the delivery of pharmacy services and public health initiatives. Overall, the review found that provision of some health services in pharmacies was common; however, most public health initiatives appeared to be poorly implemented, had limited evidence and were not demonstrated to be sustainable across the sector. This indicates that the practice of community pharmacy in the region has not significantly changed over the past 14 years with respect to the scope and quality of pharmacy services provided, and fundamental policy changes are necessary to improve this situation.
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Affiliation(s)
- Andi Hermansyah
- Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
- Faculty of Pharmacy, Airlangga University, Surabaya, Indonesia
| | - Erica Sainsbury
- Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
| | - Ines Krass
- Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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Abdel Shaheed C, McFarlane B, Maher CG, Williams KA, Bergin J, Matthews A, McLachlan AJ. Investigating the Primary Care Management of Low Back Pain: A Simulated Patient Study. THE JOURNAL OF PAIN 2016; 17:27-35. [DOI: 10.1016/j.jpain.2015.09.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Revised: 09/20/2015] [Accepted: 09/24/2015] [Indexed: 12/22/2022]
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MacFarlane BV, Bergin JK, Reeves P, Matthews A. Australian pharmacies prevent potential adverse reactions in patients taking warfarin requesting over-the-counter analgesia. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2014; 23:167-72. [DOI: 10.1111/ijpp.12152] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2013] [Accepted: 09/09/2014] [Indexed: 11/26/2022]
Abstract
Abstract
Objective
The objective of this article was to assess if Australian pharmacy staff prevent potential adverse reactions in warfarin patients requesting over-the-counter (OTC) analgesia.
Methods
Mystery shoppers entered 170 pharmacies across Australia to request OTC analgesia for a hypothetical patient with a wrist injury who currently takes warfarin following a heart valve replacement. The request was made to the first pharmacist or non-pharmacist staff member to approach the mystery shopper. The interaction was audio-taped and assessed by a pharmacist. The OTC analgesic recommended was assessed for the potential to cause an adverse bleeding event. The quality of advice given with the OTC analgesic was assessed against determined criteria. Results were compared with scenarios of similar request type where the hypothetical patient was not taking warfarin.
Key findings
Mystery shoppers enquiring about taking OTC analgesics concomitantly with warfarin had access to the pharmacist in 97.0% of cases. All 170 pharmacies recommended OTC analgesics that were less likely to cause adverse events when taken with warfarin. The advice given and the communication between pharmacy staff and mystery shoppers were of high quality.
Conclusion
Australian pharmacies support the quality use of medicines by patients taking warfarin by providing expeditious access to the pharmacist, appropriate recommendations of OTC analgesics, high standards of quality of advice and they communicate in a way to ensure ease of understanding by the consumer. The protocols used by pharmacy staff help prevent potentially serious adverse drug events.
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Affiliation(s)
| | - Jenny K Bergin
- The Australian College of Pharmacy, Canberra, ACT, Australia
| | - Peter Reeves
- The Australian College of Pharmacy, Canberra, ACT, Australia
| | - Andrew Matthews
- Pharmacy Transformation Group, The Pharmacy Guild of Australia, Canberra, ACT, Australia
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Salter SM, Delfante B, de Klerk S, Sanfilippo FM, Clifford RM. Pharmacists' response to anaphylaxis in the community (PRAC): a randomised, simulated patient study of pharmacist practice. BMJ Open 2014; 4:e005648. [PMID: 25009138 PMCID: PMC4091503 DOI: 10.1136/bmjopen-2014-005648] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 06/19/2014] [Accepted: 06/20/2014] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To evaluate how community pharmacists manage patients with anaphylaxis. DESIGN A randomised, cross-sectional, simulated patient study of community pharmacist practice. SETTING 300 metropolitan pharmacies located in Perth Australia, randomised to three groups of 100 pharmacies. Each group corresponded to a different epinephrine autoinjector: original EpiPen, new-look EpiPen or Anapen. PARTICIPANTS 300 pharmacies were visited with 271 simulated patient visits included in the final analysis (88=original EpiPen, 92=new-look EpiPen, 91=Anapen). OUTCOME MEASURES Primary anaphylaxis preparedness (readiness to treat acute anaphylaxis). Secondary anaphylaxis engagement (willingness to engage the patient in a discussion about their anaphylaxis). METHODS Simulated patients approached pharmacists, using a standardised scenario, for assistance with epinephrine autoinjector use and advice about the use of antihistamines in anaphylaxis. Scores for each outcome were obtained based on the number of predefined statements addressed by the pharmacist during the consultation (maximum score=5 for preparedness and 8 for engagement). RESULTS The mean anaphylaxis preparedness score was 2.39 points (SD 1.17). Scores for new-look EpiPen were significantly higher than for original EpiPen and Anapen (2.75 vs 2.38 points, p=0.027; 2.75 vs 2.03 points, p<0.001, respectively). Overall, 17.3% of pharmacists correctly demonstrated the epinephrine autoinjector. The mean anaphylaxis engagement score was 3.11 points (SD 1.73). Scores for new-look EpiPen were similar to original EpiPen and Anapen (3.11 vs 3.32 points; 3.11 vs 2.90 points, both p=0.42). Engagement was associated with preparedness. For each additional engagement point, preparedness increased by 7% (0.357 points; 95% CI 0.291 to 0.424; p<0.001). CONCLUSIONS Pharmacists demonstrated reasonable knowledge of anaphylaxis symptoms and emergency care, but had poor epinephrine autoinjector technique and rarely discussed anaphylaxis action plans. Pharmacists who had a more comprehensive discussion about anaphylaxis with patients, were more prepared for anaphylaxis emergencies. Future research should evaluate the nature and significance of errors in pharmacists' autoinjector technique.
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Affiliation(s)
- Sandra M Salter
- Pharmacy Program, Centre for Optimization of Medicines, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
| | - Brock Delfante
- Pharmacy Program, Centre for Optimization of Medicines, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
| | - Sarah de Klerk
- Pharmacy Program, Centre for Optimization of Medicines, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
| | - Frank M Sanfilippo
- School of Population Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Rhonda M Clifford
- Pharmacy Program, Centre for Optimization of Medicines, School of Medicine and Pharmacology, The University of Western Australia, Crawley, Western Australia, Australia
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Provision of smoking cessation services in Australian community pharmacies: a simulated patient study. Int J Clin Pharm 2014; 36:604-14. [PMID: 24718946 DOI: 10.1007/s11096-014-9944-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Accepted: 03/31/2014] [Indexed: 10/25/2022]
Abstract
BACKGROUND With the rising interest in expanding pharmacists' role in smoking cessation, it is pertinent that community pharmacists be equipped with up-to-date knowledge and competence to provide optimal therapeutic services that meet the demands of various presenting subsets of smokers. OBJECTIVE To investigate and evaluate responses to requests of quitting smoking from 'high risk' smokers seeking assistance and treatment within the pharmacy venue. SETTING Community pharmacies located within Sydney greater metropolitan area, New South Wales, Australia. METHOD A simulated patient methodology was utilised. Two scenarios were developed and enacted by two trained simulated patients in 100 randomly selected pharmacies. Scenario 1 involved a 28-year-old pregnant female who presents with a request for help in quitting smoking. Scenario 2 involved a 22-year-old female requesting a quit smoking product for her 55-year-old father who has cardiovascular problems. A standardised scoring key was designed to assess the performance of pharmacists during each encounter. MAIN OUTCOME MEASURE The primary outcome measure was the supply/non-supply of nicotine replacement products and the corresponding provision of counselling and advice to facilitate smoking cessation. RESULTS A product(s) was supplied in 42 % of the 100 encounters, while a product was adequately suggested pending doctor's referral in 45 %. In 13 % of the cases, a product was not supplied based on inappropriate notions of nicotine replacement therapy not being safe in the presented scenario. Pharmacists performed better in dispensing scores (counselling about product use) as compared to pre-dispensing scores (eliciting patient history). ANOVA followed by regression analysis indicated that the estimated age and gender of the pharmacist/staff were significant predictors affecting total scores. CONCLUSION Whilst pharmacists' counselling about smoking cessation aids seems satisfactory, further education is required to improve practice standards in terms of matching a patient's history and smoking status to an appropriate product.
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Chua SS, Lim KP, Lee HG. Utilisation of community pharmacists by the general public in Malaysia. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2012; 21:66-9. [PMID: 23301536 DOI: 10.1111/j.2042-7174.2012.00219.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 05/01/2012] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The study was conducted to assess how the general public in the Klang Valley, Malaysia, utilised community pharmacists. METHODS This was a prospective observational study which documented interactions between community pharmacists and their customers. A researcher was stationed in 10 participating community pharmacies around the Klang Valley to observe and record all the interactions, using a structured data-collection form. KEYS FINDINGS: Interactions between 1914 customers and the pharmacists of the 10 community pharmacies were recorded. A total of 2199 requests were made by these customers. The main types of request were for medications by brand name (32.2%), advice on minor health problems (25.9%) and for health supplements (11.7%). Only 65 prescriptions were received by the community pharmacies; that is, fewer than two prescriptions per pharmacy per day. The pharmacists provided counselling for only 54.4% of the requests where a medication or health supplement was dispensed. Counselling by pharmacist was significantly associated with the type of request (P < 0.001). CONCLUSIONS The main reason for the general public to visit a community pharmacy in Malaysia was to purchase a particular medication. Few prescriptions were filled at community pharmacies in Malaysia, indicating the under-utilisation of community pharmacists as a safety net for prescribed medications in primary care.
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Affiliation(s)
- Siew Siang Chua
- Department of Pharmacy, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia.
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Simulated caregivers: their feasibility in educating pharmacy staff to manage children's ailments. Int J Clin Pharm 2012; 34:587-95. [PMID: 22669734 DOI: 10.1007/s11096-012-9648-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2011] [Accepted: 04/21/2012] [Indexed: 10/28/2022]
Abstract
BACKGROUND Community pharmacy staff play a crucial role in the management of common childhood ailments. Simulated patient studies have not yet explored the management of children's cough/cold and fever, nor have many previous studies used simulated patient methods with focus on self-assessment as a training tool to shape future counselling behaviour. OBJECTIVES To assess and shape the counselling behavior of pharmacy staff when dealing with children's cough/cold and fever; investigate influential factors of counselling behavior; and explore participant perceptions of simulated patient methods as a training tool, with particular emphasis on self-assessment. SETTING Community pharmacies in the inner city region of metropolitan Sydney. METHOD Six simulated caregivers visited eight community pharmacies. After applying their scenario, the interaction was scored and immediate performance feedback was delivered in the form of self-assessment. Semi-structured interviews followed, focusing on participant perceptions of self-assessment. MAIN OUTCOME MEASURES Scores for each simulated patient interaction, and qualitative interviews responses from participants. RESULTS The highest mean percentage score achieved was for the symptom based request for a cough/cold remedy in a five year old (48 ± 14.3 %), while the lowest was the direct product request equivalent (22 ± 8.5 %). Qualitative results showed that simulated patient visits were viewed positively and self-assessment was highly regarded. CONCLUSION Using simulated caregivers in pharmacy to assess and improve children's cough/cold and fever management is feasible and acceptable. The opportunity to self-assess is particularly beneficial, allowing participants to demonstrate key psychology principles associated with behaviour change.
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Xu T, de Almeida Neto AC, Moles RJ. A systematic review of simulated-patient methods used in community pharmacy to assess the provision of non-prescription medicines. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2012; 20:307-19. [PMID: 22953770 DOI: 10.1111/j.2042-7174.2012.00201.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To explore the use of simulated-patient methods in community pharmacy for non-prescription medicines. METHODS The databases IPA (International Pharmaceutical Abstracts), EMBASE and MEDLINE were searched for articles published between 1990 and 2010 outlining studies using simulated-patient methods. KEY FINDINGS Thirty studies from 31 articles were reviewed. The majority used simulated-patient methods to purely assess counselling behaviour of pharmacy staff, rather than as an opportunity to provide educational feedback to improve counselling behaviour. CONCLUSIONS Few simulated-patient studies have incorporated performance feedback to encourage behavioural change and improve counselling skills. Studies that incorporated feedback did not provide sufficient detail, and few studies have explored participant perceptions. Additionally, very few studies have employed scenarios involving children's medicines. Future studies should test the feasibility of using the simulated-patient method, with appropriate performance feedback and describe participant perceptions of the value and acceptability of this training method.
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Affiliation(s)
- Tina Xu
- Faculty of Pharmacy, The University of Sydney, Sydney, New South Wales, Australia
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22
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How do pharmacists respond to complaints of acute insomnia? A simulated patient study. Int J Clin Pharm 2011; 33:237-45. [DOI: 10.1007/s11096-011-9482-5] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2010] [Accepted: 01/17/2011] [Indexed: 10/18/2022]
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Schneider CR, Everett AW, Geelhoed E, Padgett C, Ripley S, Murray K, Kendall PA, Clifford RM. Intern pharmacists as change agents to improve the practice of nonprescription medication supply: provision of salbutamol to patients with asthma. Ann Pharmacother 2010; 44:1319-26. [PMID: 20571101 DOI: 10.1345/aph.1p142] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Earlier work established an evidence practice gap during provision of nonprescription salbutamol (albuterol). Pharmacist interns are hypothesized to be in a position to improve professional practice in the community pharmacy setting. OBJECTIVE To explore the potential of intern pharmacists to improve the professional practice of community pharmacy staff in the provision of nonprescription salbutamol. METHODS Intern pharmacists (n = 157) delivered an asthma intervention in 136 pharmacies consisting of an educational activity to pharmacy staff and a health promotion campaign to consumers. Post-intervention, simulated patients presented to 100 intervention and 100 control community pharmacies with a request for salbutamol. The appropriate outcome was medical referral for poor asthma control and correction of poor inhaler technique. Incidence and quantity of patient assessment and counseling provided during the visit were also assessed. Logistic regression was used to determine the predictors of medical referral. RESULTS A doubling in the rate of medical referral was seen in the intervention group (19% vs 40%; p = 0.001). Assessment of reliever use frequency was the main predictor of medical referral (OR = 22.7; 95% CI 9.06 to 56.9). Correction of poor inhaler technique did not improve; however, a reduction in salbutamol supplied without patient assessment (23% vs 8%; p = 0.009) or counseling (75% vs 48%; p < 0.001) was noted. CONCLUSIONS A doubling in the rate of medical referral showed a clear improvement in professional practice during the provision of nonprescription salbutamol. The improved patient outcome in the intervention group was due to increased assessment of reliever use frequency. Identification of poor inhaler technique remained near zero in both groups, which suggests that intern pharmacists were able to improve the current practice of community pharmacies yet were unable to establish a new practice behavior. This study provides evidence that intern pharmacists can act as change agents to improve pharmacy practice.
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Affiliation(s)
- Carl R Schneider
- School of Biomedical, Biomolecular and Chemical Sciences, The University of Western Australia, Crawley, Australia.
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