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Manon SM, Phuong JM, Moles RJ, Kelly A, Center JR, Luckie K, White C, Carter SR. The role of community pharmacists in delivering interventions for osteoporosis: A systematic review. J Am Pharm Assoc (2003) 2022; 62:1741-1749.e10. [DOI: 10.1016/j.japh.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 06/21/2022] [Accepted: 06/28/2022] [Indexed: 11/30/2022]
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Toh LS, Lai PSM, Othman S, Shah A, Dang CPL, Low BY, Wong KT, Anderson C. Exploring the current and future role of the pharmacists in osteoporosis screening and management in Malaysia. Int J Clin Pharm 2018; 40:450-457. [PMID: 29380234 DOI: 10.1007/s11096-018-0597-9] [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: 08/17/2017] [Accepted: 01/19/2018] [Indexed: 10/18/2022]
Abstract
Background Several studies have found that pharmacists can assist in screening and prevention of osteoporosis by referring patients for bone mineral density scans and counselling on lifestyle changes. In Malaysia, screening osteoporosis in all elderly women is not mandatory due to its cost. One approach to address this gap is to develop a pharmacist-led osteoporosis screening and prevention program. However, there is a paucity of data on the perspectives of Malaysian pharmacists in this area. Objective To explore the perspective of stakeholders (policy makers, doctors, pharmacists, nurses and patients) towards the role of pharmacists in osteoporosis screening and management. Setting A primary care clinic located within a teaching hospital in Kuala Lumpur, Malaysia. Method Patients (n = 20), nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) were individually interviewed using a semi-structured topic guide. Purposive sampling was used. Interviews were transcribed verbatim and analysed using thematic analysis. Main outcome measure Perspective of stakeholders on the current and future role of pharmacists. Results All participants perceived pharmacists to be suppliers of medication, although there was some recognition of roles in providing medication advice. Nonetheless, these stakeholders were eager for pharmacists to expand their non-dispensing roles towards counselling, creating awareness and screening of osteoporosis. Interviewed pharmacists referred to their current role as 'robotic dispensers' and unanimously agreed to spread out to osteoporosis management role. Conclusion Under stakeholders there is a willingness to expand the role of pharmacists in Malaysia to non-dispensing roles, particularly in osteoporosis screening and management.
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Affiliation(s)
- L S Toh
- Division of Pharmacy, School of Medicine, University of Tasmania, Sandy Bay Campus, Pharmacy Building Churchill Avenue, Tasmania, 7005, Australia. .,School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia.
| | - P S M Lai
- University of Malaya Primary Care Research Group (UMPCRG), Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - S Othman
- University of Malaya Primary Care Research Group (UMPCRG), Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - A Shah
- Division of Pharmacy, School of Medicine, University of Tasmania, Sandy Bay Campus, Pharmacy Building Churchill Avenue, Tasmania, 7005, Australia
| | - C P L Dang
- Division of Pharmacy, School of Medicine, University of Tasmania, Sandy Bay Campus, Pharmacy Building Churchill Avenue, Tasmania, 7005, Australia
| | - B Y Low
- School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - K T Wong
- School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - C Anderson
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, Nottingham, NG7 2RD, UK
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Community osteoporosis screening services for the prevention of osteoporotic fractures in population health. INT J EVID-BASED HEA 2017; 15:43-52. [DOI: 10.1097/xeb.0000000000000104] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Toh LS, Lai PSM, Othman S, Wong KT, Low BY, Anderson C. An analysis of inter-professional collaboration in osteoporosis screening at a primary care level using the D'Amour model. Res Social Adm Pharm 2016; 13:1142-1150. [PMID: 27780658 DOI: 10.1016/j.sapharm.2016.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 10/07/2016] [Accepted: 10/10/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES This study describes the perspective of patients, nurses, pharmacists, doctors and policy makers to identify the level of collaboration and the areas for improvement to achieve inter-professional collaboration between doctors, nurses, pharmacists and policy makers in a primary care clinic. METHODS Patients (n = 20), Nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) from a primary care were individually interviewed using a semi-structured topic guide. Purposive sampling was used. Interviews were transcribed verbatim and analysed using thematic analysis informed by constant comparison. RESULTS Patients, doctors, nurses, pharmacists and policy makers were eager for pharmacists to be more proactive in creating health awareness and conducting osteoporosis screening at the primary care clinic via inter-professional collaboration. These findings were further examined using the D'Amour's structural model of collaboration which encompasses four main themes: shared goals and visions, internalization, formalization and governance. This model supports our data which highlights a lack of understanding of the pharmacists' role among the doctors, nurses, policy makers and pharmacists themselves. There is also a lack of governance and formalization, that fosters consensus, leadership, protocol and information exchange. Nonetheless, the stakeholders trust that pharmacists have sufficient knowledge to contribute to the screening of osteoporosis. Our primary care clinic can be described as developing towards an inter-professional collaboration in managing osteoporosis but is still in its early stages. CONCLUSIONS Inter-professional collaboration in osteoporosis management at the primary care level is beginning to be practised. Efforts extending to awareness and acceptance towards the pharmacists' role will be crucial for a successful change.
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Affiliation(s)
- L S Toh
- Division of Pharmacy, School of Medicine, University of Tasmania, Sandy Bay Campus, Pharmacy Building, Churchill Avenue, 7005, Australia
| | - P S M Lai
- Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - S Othman
- Department of Primary Care Medicine, University of Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, 50603, Kuala Lumpur, Malaysia
| | - K T Wong
- School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - B Y Low
- School of Pharmacy, University of Nottingham, Jalan Broga, 43500, Semenyih, Selangor, Malaysia
| | - C Anderson
- Division of Pharmacy Practice and Policy, School of Pharmacy, University of Nottingham, NG7 2RD, UK.
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Nik J, Lai PSM, Ng CJ, Emmerton L. A qualitative study of community pharmacists' opinions on the provision of osteoporosis disease state management services in Malaysia. BMC Health Serv Res 2016; 16:448. [PMID: 27577560 PMCID: PMC5006277 DOI: 10.1186/s12913-016-1686-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 08/17/2016] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists' opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services. METHODS Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach. RESULTS Nineteen community pharmacists with 1-23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists' knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists' reimbursement for osteoporosis care. CONCLUSIONS The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was performed by community pharmacists. Development and trial of collaborative osteoporosis disease state management services in community pharmacy could be facilitated by training, support and remuneration.
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Affiliation(s)
- Jah Nik
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603 Malaysia
| | - Pauline Siew Mei Lai
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603 Malaysia
| | - Chirk Jenn Ng
- Department of Primary Care Medicine, University Malaya Primary Care Research Group (UMPCRG), Faculty of Medicine, University of Malaya, Kuala Lumpur, 50603 Malaysia
| | - Lynne Emmerton
- School of Pharmacy, Curtin University, GPO Box U1987, Perth, WA 6845 Australia
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Fuller JM, Wong KK, Grunstein R, Krass I, Patel J, Saini B. A comparison of screening methods for sleep disorders in Australian community pharmacies: a randomized controlled trial. PLoS One 2014; 9:e101003. [PMID: 24978952 PMCID: PMC4076224 DOI: 10.1371/journal.pone.0101003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Accepted: 05/27/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Community pharmacies may potentially assist in screening for chronic conditions such as sleep disorders, which remain both under-diagnosed and untreated. We aimed to compare a subjective risk-assessment-only questionnaire (RAO) for common sleep disorder screening against the same risk-assessment questionnaire plus a nasal flow monitor as an objective marker of possible underlying obstructive sleep apnea (OSA) (RA+) in a community pharmacy setting. The primary outcome was the number of participants identified in RAO or RA+ group who were likely to have and consequently be diagnosed with OSA. Further outcomes included the number of participants identified as being at risk for, referred for, taking-up referral for, and then diagnosed with OSA, insomnia, and/or restless legs syndrome (RLS) in either group. METHODS In a cluster-randomized trial, participants were recruited through 23 community pharmacies. Using validated instruments, 325 (RAO = 152, RA+ = 173) participants were screened for OSA, insomnia, and RLS. FINDINGS 218 (67%) participants were at risk of OSA, insomnia or RLS and these participants were referred to their primary physician. The proportion of screened participants identified as being at risk of OSA was significantly higher in the RA+ group (36% in RAO vs. 66% in RA+, OR 3.4, 95% CI (1.8-6.5), p<0.001). A 12-month follow-up was completed in 125 RAO and 155 RA+ participants. Actual referral uptake was 34% RAO, 26% RA+, OR 4.4, 95% CI (1.4-19.2), p = 0.31. The OSA diagnosis rate was higher in the RA+ arm (p = 0.01). To yield a single additional confirmed OSA diagnosis, 16 people would need to be screened using the RA+ protocol. CONCLUSIONS These results demonstrate that utilising either screening method is feasible in identifying individuals in the community pharmacy setting who are likely to have OSA, insomnia and/or RLS. Secondly, adding an objective marker of OSA to a questionnaire-based prediction tool resulted in more confirmed OSA diagnoses. TRIAL REGISTRATION ACTR.org.au ACTRN12608000628347.
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Affiliation(s)
- Joanne M. Fuller
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
- The Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, NSW, Australia
- * E-mail:
| | - Keith K. Wong
- The Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, NSW, Australia
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
- The Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Ronald Grunstein
- The Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, NSW, Australia
- Royal Prince Alfred Hospital, Sydney, NSW, Australia
- The Woolcock Institute of Medical Research, The University of Sydney, Sydney, NSW, Australia
| | - Ines Krass
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Jayshree Patel
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
| | - Bandana Saini
- Faculty of Pharmacy, The University of Sydney, Sydney, NSW, Australia
- The Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, NSW, Australia
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Stuurman-Bieze AGG, Hiddink EG, van Boven JFM, Vegter S. Proactive pharmaceutical care interventions decrease patients' nonadherence to osteoporosis medication. Osteoporos Int 2014; 25:1807-12. [PMID: 24570297 DOI: 10.1007/s00198-014-2659-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2014] [Accepted: 02/13/2014] [Indexed: 11/25/2022]
Abstract
UNLABELLED Using a protocolled intervention program, pharmacists can decrease nonadherence to osteoporosis medication, by continuous monitoring and tailored counseling sessions, starting at treatment initiation. In the usual care group, 32.8% of patients initiating osteoporosis medication discontinued or were nonadherent, compared to 19.0% of patients in the intervention group. PURPOSE While community pharmacies have been shown to offer a promising platform for osteoporosis management in patients with osteoporosis, more research is needed to determine pharmacists' effects on improving adherence. The aim of this study was to determine the effects of a community pharmacists' intervention program on the 1-year discontinuation and nonadherence rates of patients initiating osteoporosis medication. METHODS This intervention study included 937 patients, recruited from 13 Dutch community pharmacies, initiating osteoporosis medication. The intervention group (N = 495), received the Medication Monitoring and Optimization (MeMO) intervention, comprising of continuous monitoring of patients' adherence to their osteoporosis medication and tailored counseling sessions with nonadherent patients. Results were compared to an internal (n = 442) reference group, receiving usual pharmacy care. Primary study outcomes were therapy discontinuation and nonadherence; results were adjusted for potential confounders using Cox proportional hazard analysis. Secondary outcome was patients' satisfaction. RESULTS In the usual care group, 32.8% of patients initiating osteoporosis medication discontinued or were nonadherent, compared to 19.0% of patients in the intervention group (P < 0.001). Ninety-three percent of the respondents were satisfied with the pharmacies' services provided. Notably, 31% mentioned that the pharmacy was the only place where they received information on various aspects of administration and acting of their medication. CONCLUSION Pharmacists can decrease nonadherence and discontinuation with osteoporosis medication by providing tailored counseling sessions and continuous monitoring of drug use. Pharmaceutical care programs, such as MeMO, contribute to more optimal use of osteoporosis medication.
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Ayorinde AA, Porteous T, Sharma P. Screening for major diseases in community pharmacies: a systematic review. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2013; 21:349-61. [PMID: 23683090 DOI: 10.1111/ijpp.12041] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Accepted: 03/26/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVES The aim of this systematic review was to assess the published evidence about the feasibility and acceptability of community pharmacy-based screening for major diseases. METHOD Studies published between January 1990 and August 2012 involving community pharmacy-based screening interventions, published in the English language, were identified from electronic databases. Reference lists of included studies were also searched. KEY FINDINGS Fifty studies (one randomised controlled trial, two cluster randomised studies, five non-randomised comparative studies and 42 uncontrolled studies) were included. The quality of most of these was assessed as poor. Screening was mostly opportunistic and screening tools included questionnaires or risk assessment forms, medical equipment to make physiological measurements, or a combination of both. Few studies assessed the accuracy of pharmacy-based screening tools. More than half of the screening interventions included an element of patient education. The proportion of screened individuals, identified with disease risk factors or the disease itself, ranged from 4% to 89%. Only 10 studies reported any economic information. Where assessed, patient satisfaction with pharmacy-based screening was high, but individuals who screened positive often did not follow pharmacist advice to seek further medical help. CONCLUSION Available evidence suggests that screening for some diseases in community pharmacies is feasible. More studies are needed to compare effectiveness and cost-effectiveness of pharmacy-based screening with screening by other providers. Strategies to improve screening participants' adherence to pharmacist advice also need to be explored. This systematic review will help to inform future studies wishing to develop community pharmacy-based screening interventions.
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Hasan S, Sulieman H, Stewart K, Chapman CB, Hasan MY, Kong DCM. Assessing patient satisfaction with community pharmacy in the UAE using a newly-validated tool. Res Social Adm Pharm 2012; 9:841-50. [PMID: 23116921 DOI: 10.1016/j.sapharm.2012.10.002] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Revised: 10/05/2012] [Accepted: 10/05/2012] [Indexed: 11/16/2022]
Abstract
BACKGROUND Patient satisfaction has become an integral component of the quality of healthcare services. It has been used for the purpose of performance assessment, reimbursement, and quality management of health service delivery. It has been suggested that patient satisfaction could be a predictor of health-related behavior. OBJECTIVES To develop and validate a tool for use within the Arabic context to assess patient satisfaction. To assess patient satisfaction with current community pharmacy services in the UAE using the validated tool. METHODS A systematic process was used to develop an assessment tool that could be used within the Arabic context and establish its validity and reliability. Survey participants assessed their satisfaction with the services based on a 5-point Likert-type scale: Poor = 1, Fair = 2, Good = 3, Very good = 4, Excellent = 5. The anonymous questionnaire was distributed over a 5-month period to eligible participants in public places such as malls and shopping markets, in various emirates across the UAE. Those who were 21 years or older, taking at least one scheduled (regular) medication and having adequate Arabic or English language proficiency were included. RESULTS The instrument comprised four dimensions: Information, Relationship, Accessibility and Availability. Participants required more information about medications and self-management (Mean = 2.49 ± 1.19). Measures of competence, i.e., care, interest, time, confidence and trust, could also be improved (Mean = 3.05 ± 1.07). Accessibility scores measuring physical, geographical and financial items were lowest (Mean = 2.80 ± 1.33). Overall scores on availability of medications indicated relative satisfaction with this dimension (Mean = 3.51 ± 0.7). CONCLUSIONS This study is the first to use a patient satisfaction tool specifically developed for the Arabic context. Patient satisfaction scores in all dimensions were significantly lower than published data, suggesting patients have unmet expectations of community pharmacy services in the UAE. Stakeholders could utilize this information to help in the design and delivery of improved services that could lead to increased demand.
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Affiliation(s)
- Sanah Hasan
- Department of Pharmacy Practice and Pharmacotherapeutics, College of Pharmacy, Sharjah University, Sharjah, United Arab Emirates; Centre for Medicine Use and Safety, Monash University (Parkville Campus), 381 Royal Parade, Parkville, Victoria 3052, Australia
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Brown D, Portlock J, Rutter P. Review of services provided by pharmacies that promote healthy living. Int J Clin Pharm 2012; 34:399-409. [PMID: 22527479 DOI: 10.1007/s11096-012-9634-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2011] [Accepted: 03/29/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND The recognition that community pharmacies have the potential to make a greater contribution to promoting public health has led to a new concept, called the Healthy Living Pharmacy (HLP). These are designed to meet public health needs through a tiered commissioning framework delivering health and well being services through community pharmacy, tailored to local requirements for tackling health inequalities. AIM To search the literature for quality evidence to support the inclusion of services in the HLP portfolio and suggest areas where more evidence is required. METHOD A systematic review of the research literature covering the period January 1990-August 2011 inclusive, using MEDLINE, EMBASE, Pharmline, NHS Evidence and the Cochrane databases. On-line searching of the grey literature (e.g. conference proceedings) was also carried out. Standard methods of assessing quality were employed. RESULTS A total of 377 papers were included. Over time, there was a marked increase in frequency of publications reflecting a growing pharmacy interest in the public healthcare agenda; over a third (35 %) of papers appeared in the last three-year study period. The body of research had a wide geographical basis; contributions were as follows: UK (51.5 %), US (20.4 %), Australia/New Zealand (9.8 %), Europe (7.7 %) and Canada (7.2 %). The topics of contraception, cardiovascular disease prevention, diabetes and smoking cessation accounted for 40 % of included papers. The literature supports the introduction of specific community pharmacy services, targeted at customer groups, both with and without pre-existing diseases. Good evidence exists for smoking cessation, cardiovascular disease prevention, hypertension and diabetes. Some good evidence exists for interventions on asthma and heart failure. The evidence supporting weight management, sexual health, osteoporosis detection, substance abuse and chronic obstructive pulmonary disease is weak and needs development. CONCLUSION There is strong evidence for the role of community pharmacy in a range of services, not only aimed at improving general health, but also maintaining the health of those with existing disease. In other areas, the evidence is less strong and further research is required to justify their inclusion in a HLP portfolio.
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Affiliation(s)
- David Brown
- University of Portsmouth, Portsmouth, Hampshire, UK.
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Elias MN, Burden AM, Cadarette SM. The impact of pharmacist interventions on osteoporosis management: a systematic review. Osteoporos Int 2011; 22:2587-96. [PMID: 21720894 PMCID: PMC3169776 DOI: 10.1007/s00198-011-1661-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2010] [Accepted: 02/25/2011] [Indexed: 01/22/2023]
Abstract
UNLABELLED We completed a systematic review of the literature to examine the impact of pharmacist interventions in improving osteoporosis management. Results from randomized controlled trials suggest that pharmacist interventions may improve bone mineral density testing and calcium intake among patients at high risk for osteoporosis. INTRODUCTION Pharmacists play a key role in many healthcare systems by helping patients manage chronic diseases. We completed a systematic review of the literature to identify randomized controlled trials (RCTs) that have examined the impact of pharmacy interventions in narrowing two gaps in osteoporosis management: identifying at-risk individuals and improving adherence to therapy. METHODS We searched the electronic databases of EMBASE, HealthStar, International Pharmaceutical Abstracts, MEDLINE, and PubMed from database development to April 2010, examined grey literature, and completed manual searches of reference lists to identify English-language research that examined osteoporosis management interventions within pharmacy practice. Results from RCTs were abstracted and assessed for bias. RESULTS We identified 25 studies that examined pharmacist interventions in osteoporosis management: 16 cohort, 5 cross-sectional, 1 historical/ecological control, and 3 RCTs. RCT interventions included osteoporosis educational and counseling programs, screening by pharmacists based on risk factor assessment or bone mineral density testing, and physician contact or recommendations for patients to follow-up with a general practitioner. Results from the three RCTs suggest that pharmacist interventions may improve bone mineral density testing (targeted screening) and calcium intake among patients at high risk for osteoporosis. However, two of the three RCTs had high risk of bias, and no study examined the impact of pharmacist intervention on osteoporosis treatment adherence. CONCLUSIONS Data support the potential role for pharmacists to help reduce gaps in osteoporosis management through improved identification of high-risk patients. More research is needed to examine pharmacist interventions on osteoporosis treatment adherence.
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Affiliation(s)
- M. N. Elias
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON M5S 3M2 Canada
| | - A. M. Burden
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON M5S 3M2 Canada
| | - S. M. Cadarette
- Leslie Dan Faculty of Pharmacy, University of Toronto, 144 College Street, Toronto, ON M5S 3M2 Canada
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Patwardhan PD, Chewning BA. Tobacco users' perceptions of a brief tobacco cessation intervention in community pharmacies. J Am Pharm Assoc (2003) 2010; 50:568-74. [PMID: 20833613 PMCID: PMC3023976 DOI: 10.1331/japha.2010.09207] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To explore factors affecting tobacco users' perceived appropriateness of a brief and proactive tobacco cessation counseling program, ask, advise, and refer (AAR), at community pharmacies. DESIGN Inductive thematic analysis. SETTING Southern Wisconsin during fall 2008. PATIENTS 24 tobacco users who had recently received brief and proactive tobacco cessation counseling at a community pharmacy. INTERVENTION Semistructured telephone interviews conducted by primary author. MAIN OUTCOME MEASURES Perceptions of a brief and proactive tobacco cessation counseling program conducted at community pharmacies. RESULTS In conducting the thematic analysis, eight distinct themes were identified. Display of information and resources at pharmacies for use by tobacco users as needed was identified as the most predominant theme and was found to be most helpful by many respondents. Other themes identified in decreasing order of prevalence were: tobacco users' perceptions of the role of pharmacists in health care, tobacco users' belief that smoking could interact with a current medication or health condition, tobacco users' sensitivity toward their tobacco use behavior or being told what to do, nonconfrontational and friendly approach of pharmacists, tobacco users' readiness to quit at the time of AAR counseling, tobacco user initiation of tobacco use discussion, and tobacco users' belief that tobacco use is bad. CONCLUSION Overall, this qualitative investigation suggests that several factors might influence tobacco users' perceived appropriateness of AAR counseling at community pharmacies. AAR might be well received by tobacco users and pharmacy patrons as long as it is done in a professional and respectful manner.
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Affiliation(s)
- Pallavi D Patwardhan
- Schroeder Institute for Tobacco Research and Policy Studies, American Legacy Foundation, Washington, DC 20036, USA.
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Measurement of patient satisfaction with community pharmacy services: a review. ACTA ACUST UNITED AC 2009; 31:525-537. [DOI: 10.1007/s11096-009-9311-2] [Citation(s) in RCA: 79] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Accepted: 06/22/2009] [Indexed: 10/20/2022]
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