1
|
Gonçalves JR, Sleath BL, Cerdeira M, Cavaco AM. Older people, medication usage and long-term care pharmacists: a retrospective cohort study. Eur J Hosp Pharm 2023:ejhpharm-2023-003908. [PMID: 37758319 DOI: 10.1136/ejhpharm-2023-003908] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/12/2023] [Indexed: 10/03/2023] Open
Abstract
OBJECTIVE To investigate the impact of the presence of a pharmacist on medication usage in long-term care facilities. METHODS The study followed a retrospective cohort design, with a sample of patients aged ≥65 years admitted to three long-term care facilities over 30 months. Data on age, gender, type of stay, the presence or absence of a pharmacist and pharmacotherapeutic profile at admission and discharge were obtained for study patients. Variations in the number of medicines, anticholinergic burden and potentially inappropriate medications at admission and discharge were assessed as outcome variables. Anticholinergic burden and potentially inappropriate medications were assessed using the Anticholinergic Cognitive Burden scale and the EU(7)-PIM List, respectively. One-sample t-tests were used to compare the mean values of the outcome variables. A four-way ANOVA was used to test the association between background and outcome variables. Partial eta squared (η2) was used to measure the effect size. RESULTS A total of 1366 patients were studied. All outcome variables showed a statistically significant increase at discharge compared with admission. The presence of a pharmacist was statistically significant in improving the number of medicines (p<0.001) and the anticholinergic burden score (p<0.001), while no statistically significant value was reached on potentially inappropriate medications (p=0.642). Small effect size values were obtained for the impact of the pharmacist on the number of medicines and anticholinergic burden scores (η2=0.021 and η2=0.011, respectively). CONCLUSION These findings suggest that the presence of a long-term care pharmacist can positively impact the use of medication associated with poor health outcomes. An integrated interprofessional approach is needed to address potentially inappropriate medications, anticholinergic burden and polypharmacy in long-term care settings, particularly at the time of discharge.
Collapse
Affiliation(s)
| | - Betsy L Sleath
- UNC Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA
| | - Mariana Cerdeira
- Pharmacy Services, Residências Montepio - Serviços de Saúde S.A, Lisbon, Portugal
| | | |
Collapse
|
2
|
Harnett JE, Desselle SP, Fernandes MB, Yao D, Modun D, Hallit S, Dabbous M, Wahab MSA, Cavaco AM, Magalhães M, Faller EM, Flores JM, Gabriel JRDS, Othman N, Anantachoti P, Sriboonruang T, Sriviriyanupap W, Alnezary F, Alahmadi Y, Fallatah SB, Fadil HA, Ung COL. Defining and supporting a professional role for pharmacists associated with traditional and complementary medicines: a cross-country survey of pharmacists. Front Pharmacol 2023; 14:1215475. [PMID: 37654614 PMCID: PMC10467277 DOI: 10.3389/fphar.2023.1215475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Accepted: 07/24/2023] [Indexed: 09/02/2023] Open
Abstract
Introduction: An estimated 80% of the world's population use traditional and complementary medicine (T&CM) products as part of their healthcare, with many accessed through pharmacy. This cross-cultural study posed a set of professional practice responsibilities and actions to pharmacists related to T&CM products, with a view toward developing consensus, safeguarding, and promoting the health of the public. Methods: Data were collected from 2,810 pharmacists across nine countries during 2022 via a cross-sectional online survey reported in accordance with the guidelines of STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) and the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Results: Of the 2,810 participants from nine countries, 2,341 completed all sections of the survey. Of these, most agreed (69%) that T&CM product use was common in the community they served, but most did not have adequate training to support consumer needs. Over 75% acknowledged that there were known and unknown safety risks associated with T&CM use. Of 18 professional responsibilities posed, 92% agreed that pharmacists should be able to inform consumers about potential risks, including T&CM side effects and drug-herb interactions. The provision of accurate scientific information on the effectiveness of T&CM products, skills to guide consumers in making informed decisions, and communication with other healthcare professionals to support appropriate and safe T&CM product use were all ranked with high levels of agreement. In order to effectively fulfill these responsibilities, pharmacists agreed that regulatory reforms, development of T&CM education and training, and access to quality products supported by high-quality evidence were needed. Conclusion: General agreement from across nine countries on eighteen professional responsibilities and several stakeholder actions serve as a foundation for the discussion and development of international T&CM guidelines for pharmacists.
Collapse
Affiliation(s)
- Joanna E. Harnett
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Shane P. Desselle
- Touro University California College of Pharmacy, Vallejo, CA, United States
| | - Marcília Baticy Fernandes
- Departamento de Ciências da Saúde, Ambiente e Tecnologias, Universidade de Santiago, Assomada, Cabo Verde
| | - Dongning Yao
- School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Darko Modun
- Department of Pharmacy, University of Split School of Medicine, Split, Croatia
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon
- Applied Science Research Center, Applied Science Private University, Amman, Jordan
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Mariam Dabbous
- School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Mohd Shahezwan Abd Wahab
- Faculty of Pharmacy, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Selangor, Malaysia
- Non-Destructive Biomedical and Pharmaceutical Research Centre, Smart Manufacturing Research Institute, Universiti Teknologi MARA (UiTM) Cawangan Selangor, Selangor, Malaysia
| | - Afonso Miguel Cavaco
- Universidade de Lisboa, Faculdade de Farmácia, Departamento de Farmácia Farmacologia e Tecnologias em Saúde, Lisboa, Portugal
| | - Maria Magalhães
- Universidade de Lisboa, Faculdade de Farmácia, Departamento de Farmácia Farmacologia e Tecnologias em Saúde, Lisboa, Portugal
| | - Erwin Martinez Faller
- Pharmacy Department, School of Allied Health Sciences, San Pedro College, Davao City, Philippines
| | | | | | - Noordin Othman
- Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
- School of Pharmacy, Management and Science University, University Drive, Off Persiaran Olahraga, Selangor, Malaysia
| | - Puree Anantachoti
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | - Tatta Sriboonruang
- Faculty of Pharmaceutical Sciences, Chulalongkorn University, Bangkok, Thailand
| | | | - Faris Alnezary
- Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Yaser Alahmadi
- Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Saad Bakur Fallatah
- Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Haifa Abdulrahman Fadil
- Clinical and Hospital Pharmacy Department, College of Pharmacy, Taibah University, Al-Madinah Al-Munawwarah, Saudi Arabia
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao, China
| |
Collapse
|
3
|
Correia AR, Costa M, Monteiro J, Cavaco P, Falcão F, Cavaco AM. Clinical Communication Within Hospital Pharmacy Practice: Exploring Pharmaceutical Oncological Consultations. Health Commun 2023; 38:480-489. [PMID: 34289767 DOI: 10.1080/10410236.2021.1956069] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This exploratory study aimed to identify communication trends typical of pharmacists' clinical communication in the context of hospital consultations. A cross-sectional design was used to investigate the pharmacist-patient exchange, applying the Roter Interaction Analysis System (RIAS). Communication variables and RIAS composites were assessed, including therapeutic information complexity, estimated through the ad-hoc score CTICS (Cancer Therapy Information Complexity Score). The study comprised 13 consultations of cancer patients with one female pharmacist, of which 6 included a patient family member, lasting on average 22.74 minutes and presenting repeated or overlapping consultation phases. The pharmacist's talk dominance reached 53.49%, slightly higher in dyadic consultations (U = 6.0, p = .032), and with an overall predominance of closed-ended questioning (W = 81.0, p = .013). Patients' questioning on biomedical issues was higher in dyadic consultations. The level of the pharmacist's rapport-building with the relative was higher when the patient's age was ≥80 years. Several strong correlations, both positive and negative, were found between composites, including between patient positive rapport-building and relative lifestyle/psychosocial information giving (Rho = -0.971, p = .001). Pharmaceutical consultations seem to be lengthier than other hospital practitioners' interviews, indicating a lack of clear organization and flow, thus challenging their efficiency regarding therapy management. Still, several positive communication features were found regarding the pharmaceutical care of older cancer patients. Further studies are needed, involving larger samples and other hospital consultation settings.
Collapse
Affiliation(s)
| | | | | | - Patrícia Cavaco
- Pharmacy Department, Hospital de S. Francisco Xavier, Centro Hospitalar de Lisboa Ocidental EPE
| | - Fátima Falcão
- Faculty of Pharmacy, University of Lisbon
- Pharmacy Department, Hospital de S. Francisco Xavier, Centro Hospitalar de Lisboa Ocidental EPE
| | | |
Collapse
|
4
|
Cavaco AM, Ribeiro J, Nørgaard LS. Exploring the use of cognitive enhancement substances among Portuguese university students. Exploratory Research in Clinical and Social Pharmacy 2022; 5:100097. [PMID: 35478516 PMCID: PMC9032074 DOI: 10.1016/j.rcsop.2021.100097] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 11/25/2022] Open
Abstract
Background Prescription drug use and the consumption of substances to enhance college students' cognitive performance, described as pharmacological cognitive enhancement (PCE), is a known phenomenon potentially impacting individuals' health. University and college students are two specific subpopulations noted to use PCE (up to 17%, on average). To our knowledge, no data have been published on the use of PCE drugs among university students at a national level in Portugal and the factors that might be associated with this usage. Objective The main objective was to estimate the prevalence of PCE use by Portuguese university students and to identify the PCE substances commonly used by university students, i.e., those classified as prescription drugs and other legal and nonprescribed substances, including food supplements. Methods The study followed a cross-sectional exploratory, descriptive design and pursued a convenience sample of students from Portuguese public and private universities (22 higher education institutions). Results From a sample of 745 university students, 32% indicated the use of prescribed and nonprescribed substances. The most consumed substances were food supplements with CNS stimulants being the most frequent prescription-only drugs but not necessarily accessed through a medical prescription. A significant statistical association was found between substance consumption and the field of study. Health science students reported more food supplements and drug intake, allegedly under prescribed regimens, compared to humanities and exact sciences students. The study discusses the need to better understand the competitive societies that produce and support young students' outputs and the perceived ‘need’ for performance-enhancing substances. Conclusions One-third of the university students aimed to improve their performance by pharmacological cognitive enhancement, with a preference for food supplements dispensed in pharmacies. PCE substance consumption in higher education is thus non-negligible. The study suggests the need to improve regulations on potential inequalities in academic rankings and success and an observant attitude concerning implications that negatively affect health in the long run.
Collapse
|
5
|
Sepp K, Cavaco AM, Raal A, Volmer D. Profession Driven Improvement of the Quality of Pharmacy Practice-Implementation of Community Pharmacy Services Quality Guidelines in Estonia. Healthcare (Basel) 2021; 9:804. [PMID: 34206788 PMCID: PMC8308008 DOI: 10.3390/healthcare9070804] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/18/2021] [Accepted: 06/24/2021] [Indexed: 11/24/2022] Open
Abstract
Constant improvement of the quality of community pharmacy services is important in the development of contemporary patient care. A national and voluntary Community Pharmacy Services Quality Guidelines (CPSQG) was developed to formulate the principles of contemporary pharmacy services, including quality criteria for service provision. The purpose of this study was to identify the implementation of the CPSQG as a profession-driven initiative towards improving and harmonizing community pharmacy services in Estonia. Three cross-sectional electronic surveys were conducted among community pharmacies in Estonia in 2014 (N = 478 pharmacies), 2016 (N = 493), and 2019 (N = 494), and the CPSQG indicators were used for evaluation of the service quality. In this study, the aggregated data, collected in three study years were used to identify the implementation of guidelines into practice. For data analysis, the One-Way ANOVA test and Post-hoc multiple comparisons were used. The results demonstrated slow implementation of the CPSQG, but guidelines-based evaluation enabled a detailed overview of the community pharmacy activities and provided services. In order to develop community pharmacy services more efficiently, the use of implementation science principles, continuous introduction of the CPSQG to the pharmacists, and more active involvement of the state could be considered in the future.
Collapse
Affiliation(s)
- Kristiina Sepp
- Institute of Pharmacy, Faculty of Medicine, University of Tartu, 50411 Tartu, Estonia; (A.M.C.); (A.R.); (D.V.)
| | - Afonso Miguel Cavaco
- Institute of Pharmacy, Faculty of Medicine, University of Tartu, 50411 Tartu, Estonia; (A.M.C.); (A.R.); (D.V.)
- Department of Social Pharmacy, Faculty of Pharmacy, University of Lisbon, 1649-004 Lisboa, Portugal
| | - Ain Raal
- Institute of Pharmacy, Faculty of Medicine, University of Tartu, 50411 Tartu, Estonia; (A.M.C.); (A.R.); (D.V.)
| | - Daisy Volmer
- Institute of Pharmacy, Faculty of Medicine, University of Tartu, 50411 Tartu, Estonia; (A.M.C.); (A.R.); (D.V.)
| |
Collapse
|
6
|
Guerreiro MP, Strawbridge J, Cavaco AM, Félix IB, Marques MM, Cadogan C. Development of a European competency framework for health and other professionals to support behaviour change in persons self-managing chronic disease. BMC Med Educ 2021; 21:287. [PMID: 34016108 PMCID: PMC8136137 DOI: 10.1186/s12909-021-02720-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 04/29/2021] [Indexed: 05/07/2023]
Abstract
BACKGROUND Healthcare and other professionals are expected to support behaviour change in people living with chronic disease. However, effective behaviour change interventions are largely absent in routine encounters. The Train4Health project, a European strategic partnership for higher education, sought to address this problem. The primary aim of this study, which is part of an early work package, was to develop an interprofessional competency framework for health and other professions to support behaviour change for the self-management of chronic disease at a European level. A secondary aim was to derive a set of behaviour change techniques (BCTs) from an established taxonomy to link with framework competencies. METHODS The study comprised two interlinked parts. Part 1 involved a two-round e-Delphi study with an interprofessional panel of 48 experts across 12 European countries to develop the behaviour change competency framework. Preparatory work included drafting a list of competency statements based on seven existing frameworks. Part 2 involved an expert panel of six behavioural psychologists deriving a set of BCTs to link with framework competencies. Their feedback was based on preparatory work, which focused on seven high priority chronic diseases for self-management, identified through European projects on self-management and identifying five relevant target behaviours from key clinical guidelines. A literature search yielded 29 effective BCTs for the target behaviours in the selected chronic diseases. RESULTS Twenty-seven competency statements, were presented in Round 1 to the Delphi panel. Consensus was achieved for all statements. Based on comments, two statements were removed, one was added, and 14 were modified. All 15 statements subjected to Round 2 were consensus-approved, yielding a total of 12 foundational competencies for behaviour change in self-management of chronic disease and 14 behaviour change competencies. Four behaviour change competencies related to BCTs. Behavioural psychologists' feedback led to a core set of 21 BCTs deemed applicable to the five target behaviours across the seven chronic diseases. CONCLUSIONS A behaviour change competency framework comprising 26 statements for European health and other professionals to support self-management of chronic disease was developed, linked with a core set of 21 BCTs from an established taxonomy.
Collapse
Affiliation(s)
- Mara Pereira Guerreiro
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal.
- Centro de Investigação Interdisciplinar Egas Moniz (CiiEM), Instituto Universitário Egas Moniz, Monte de Caparica, Portugal.
| | - Judith Strawbridge
- Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular Sciences, Dublin, Ireland
| | | | - Isa Brito Félix
- Nursing Research, Innovation and Development Centre of Lisbon (CIDNUR), Nursing School of Lisbon, Lisbon, Portugal
| | - Marta Moreira Marques
- ADAPT SFI Research Centre & Trinity Centre for Practice and Healthcare Innovation, Trinity College Dublin, Dublin, Ireland
- Comprehensive Health Research Centre (CHRC), NOVA Medical School, Lisbon, Portugal
| | - Cathal Cadogan
- Trinity College Dublin, School of Pharmacy and Pharmaceutical Sciences, Dublin, Ireland
| |
Collapse
|
7
|
Sánchez-Pozo A, Cavaco AM, Blasi P, Reynoso MO, Quirino-Barreda CT, Johnson PA, Moscoso FT, Rodrigues de Castilho S, Fegadolli C, Zarwar SS, Atkinson J. The COPHELA (Cooperation in Quality Assurance for Pharmacy Education and Training between Europe and Latin America) Project. Pharmacy 2020; 8:pharmacy8010029. [PMID: 32143432 PMCID: PMC7151694 DOI: 10.3390/pharmacy8010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 02/23/2020] [Accepted: 02/26/2020] [Indexed: 11/30/2022] Open
Abstract
COPHELA (Cooperation in Quality Assurance for Pharmacy Education and Training between Europe and Latin America), a collaborative project between the European Union (EU) and Latin America, will produce on-line courses for the master degree in pharmacy. The program runs from 2019 through 2021. It is funded by the Erasmus+ program of the Education, Audio-visual and Culture Executive Agency (EACEA) of the European Commission. The partners are EU and Latin American universities. These are accompanied by associated partners from EU and Latin American universities, as well as from governmental and non-governmental organizations, such as pharmacy chambers and educational associations. The project is coordinated by the University of Granada, Spain (first author of this paper). It will produce distance learning master degree courses in a dozen fields of specialized pharmaceutical science education and practice, ranging from patient care to industrial pharmacy. This paper describes the design of the project and is intended to evoke constructive comments. It also represents a call for the recruitment of additional associated partners.
Collapse
Affiliation(s)
- Antonio Sánchez-Pozo
- Facultad de Farmacia, Campus Cartuja, Universidad de Granada-UGR, 18701 Granada, Spain;
| | - Afonso Miguel Cavaco
- Social Pharmacy Department, Faculdade de Farmacia, Universidade de Lisboa – FFUL-Lisboa, 1649-003 Lisbon, Portugal;
| | - Paolo Blasi
- Dipartimento di Farmacia e Biotecnologie, Alma Mater Studiorum – Università di Bologna, 40127 Bologna, Italy;
| | - Mariana Ortiz Reynoso
- Facultad de Farmacia, Universidad Autónoma del Estado de México – UAEM, Toluca 50000, Mexico;
| | | | | | - Fernando Torres Moscoso
- Escuela de Química y Farmacia, Facultad de Medicina, Universidad Andrés Bello – UNAB, Santiago de Chile 8370146, Chile;
| | | | - Claudia Fegadolli
- Faculdade de Farmacia, Universidade Federal de São Paulo – UNIFESP, São Paulo 04021-001, Brazil;
| | - Sergio Slan Zarwar
- Departamento de Gestão do Ambiente Educacional, Racine Qualificação e Assessoria – Rua Padre Chico 93, Pompéia IR, São Paulo CEP 05008-010, Brazil;
| | - Jeffrey Atkinson
- Université de Lorraine-UL, 12 rue de Versigny, 54600 Villers, France
- Correspondence:
| | | |
Collapse
|
8
|
Cavaco AM, Mourato M, Ferreira S, Yeğenoğlu S. Assessing Medical Prescription Forms as a Communication Tool in Trans-European Health Care. J Res Pharm Pract 2018; 7:22-29. [PMID: 29755995 PMCID: PMC5934983 DOI: 10.4103/jrpp.jrpp_17_61] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE The objective of the study was to compare the medical prescription forms in European Union (EU) countries, evaluating their convergence toward the implementation of cross-border care, as proposed by the existing EU health-care directives. It also aims to assess how the existing EU prescription models fulfill higher standards of medication prescribing quality and patient safety. METHODS Prescription forms from all EU countries were purposively collected. The prescription fields and other content elements were qualitatively and quantitatively analyzed. Forms were statistically compared with each other and a theoretical EU cross-border prescription form, using hierarchical cluster analysis and nonparametric testing. FINDINGS None of the EU countries' prescriptions include all the elements required by the cross-border legislation (CBL), with most countries having seven or less mandatory elements. Cluster analysis revealed that countries with similar prescription forms are geographically nearer. Important elements from the EU directive to assure patient safety are also absent such as the International Classification of Diseases, the patient's ID according to the European Health Insurance Card, and the patient's contact. However, Western and Nordic countries showed higher standardization when compared to the CBL and model. CONCLUSION Political action is still needed to harmonize medical prescription forms between countries, serving the common goal of trans-European health care and to increase EU patients' safety using medications and other prescribed treatments.
Collapse
Affiliation(s)
- Afonso Miguel Cavaco
- Department of Social Pharmacy, University of Lisbon, Lisboa, Portugal,Address for correspondence: Dr. Afonso Miguel Cavaco, E-mail:
| | - Miguel Mourato
- Department of Social Pharmacy, University of Lisbon, Lisboa, Portugal
| | - Sofia Ferreira
- Department of Social Pharmacy, University of Lisbon, Lisboa, Portugal
| | - Selen Yeğenoğlu
- Department of Pharmacy Management, Hacettepe University, Ankara, Turkey
| |
Collapse
|
9
|
Cavaco AM, Arslan M, Şar S. Informing the homeopathic practice for Turkish pharmacists: reviewing the example of Portuguese community pharmacies. HOMEOPATHY 2017; 106:93-102. [PMID: 28552179 DOI: 10.1016/j.homp.2017.02.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2016] [Revised: 02/21/2017] [Accepted: 02/28/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Alternative and complementary therapy systems, such as homeopathy, have long been used around the world. Since 1995 homeopathy has been officially recognized in Europe as a system of medicine or a medical specialty. Portuguese community pharmacists have long-standing experience with homeopathic products. By contrast, healthcare professionals in Turkey are less experienced with homeopathic practice although there is a new regulatory setting in place. There are a limited number of studies addressing pharmacists' role within the homeopathic system. AIM To investigate the attitudes (knowledge, feelings and behaviour) of experienced Portuguese pharmacy practitioners who deal with homeopathy, and thus to inform Turkish pharmacy practice and policy on homeopathy-related success factors. METHODS A qualitative cross-sectional design was followed, using semi-structured and face-to-face individual interviews with purposively selected Portuguese pharmacists experienced with homeopathic medicines. Audio-recordings were transcribed verbatim and the transcriptions imported into QSR NVivo v10 software for qualitative coding and analysis. Using a thematic content approach, the extracted codes were grouped and indexed by recurrent themes through a reflective procedure and constant comparison. RESULTS & DISCUSSION Six general themes emerged, the most relevant being participants' feelings of gratitude for the ability to work in homeopathy; other themes were a helpful regulatory body, clear practice boundaries, scientific support and product quality assurance. Specialized homeopathic education was considered the most important factor for success. This was related to patients' positive perceptions and acceptance, suggesting an increase in public awareness through the pharmacy network. CONCLUSIONS Portuguese pharmacists' attitudes towards their homeopathic practices highlighted the key elements for success in a field that is usually distant from traditional pharmaceutical education and practice. The present findings provide guidance for Turkish pharmacists willing to expand their professional scope and to embrace complementary medicines.
Collapse
Affiliation(s)
- Afonso Miguel Cavaco
- Lisbon University, Faculty of Pharmacy, Department of Social Pharmacy, Lisbon, Portugal.
| | - Miray Arslan
- Ankara University, Faculty of Pharmacy, Department of Pharmacy Management, Ankara, Turkey.
| | - Sevgi Şar
- Ankara University, Faculty of Pharmacy, Department of Pharmacy Management, Ankara, Turkey.
| |
Collapse
|
10
|
Patrícia Antunes L, Gomes JJ, Cavaco AM. How pharmacist-patient communication determines pharmacy loyalty? Modeling relevant factors. Res Social Adm Pharm 2014; 11:560-70. [PMID: 25577547 DOI: 10.1016/j.sapharm.2014.11.003] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 11/12/2014] [Accepted: 11/13/2014] [Indexed: 11/24/2022]
Abstract
BACKGROUND Portuguese community pharmacies provide pharmaceutical services, such as therapeutic outcomes follow-up, supplemented by relevant point-of-care testing that require continuity of provision to be effective. OBJECTIVES To identify factors of technical and communication nature that during a patient interview contribute to patients' loyalty. METHODS A cross-sectional descriptive study, with a purposive sample of community pharmacies providing pharmaceutical care, was conducted. Patient interviews were taped and transcribed verbatim. Duration, segments and utterances were identified and time stamped, using a previously validated coding scheme. To identify predictors of loyalty, logistic regression analyses were performed. RESULTS From 59 interviews, participants' average age was 65.7 years and 42 (71.2%) were female; 45 (76.3%) interviews were classified as outcomes measurements and 14 (23.7%) as pharmaceutical consultations, with 33.2% of the patients booking a following appointment. The significant items to explain loyalty were associated with lifestyle and psychosocial exchange, age of the patient, and the presence of all interview segments (i.e. a complete consultation). CONCLUSION Contrary to common professional beliefs and practice orientation it would appear that pharmacists' technical skills are not the essential factors that promote patients' loyalty needed for continuity of care, at least in the same extent as the social and lifestyle-related content of the exchange. Pharmaceutical care education should focus on relational skills as much as on medication-related competencies.
Collapse
Affiliation(s)
| | - João José Gomes
- Department of Statistics and Operational Research, Faculty of Sciences, University of Lisbon, Campo Grande, 1749-016 Lisboa, Portugal
| | - Afonso Miguel Cavaco
- Faculty of Pharmacy, University of Lisbon, Research Institute for Medicines (iMed.ULisboa), Av. Prof. Gama Pinto, 1649-003 Lisboa, Portugal.
| |
Collapse
|
11
|
Cavaco AM, Krookas AA. Community pharmacies automation: any impact on counselling duration and job satisfaction? Int J Clin Pharm 2013; 36:325-35. [PMID: 24254258 DOI: 10.1007/s11096-013-9882-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2013] [Accepted: 11/09/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND One key indicator of the quality of health practitioners-patient interaction is the encounters' duration. Automation have been presented as beneficial to pharmacy staff work with patients and thus with a potential impact on pharmacists' and technicians' job satisfaction. OBJECTIVE To compare the interaction length between pharmacy staff and patients, as well as their job satisfaction, in community pharmacies with and without automation. SETTING Portuguese community pharmacies with and without automation. METHODS This cross-sectional study followed a quasi-experimental design, divided in two phases. In the first, paired community pharmacies with and without automation were purposively selected for a non-participant overt observation. The second phase comprised a job satisfaction questionnaire of both pharmacists and technical staff. Practitioners and patients demographic and interactional data, as well as job satisfaction, were statistically compared across automation. MAIN OUTCOME MEASURE Interaction length and job satisfaction. RESULTS Sixty-eight practitioners from 10 automated and non-automated pharmacies produced 721 registered interaction episodes. Automation had no significant influence in interaction duration, controlling for gender and professional categories, being significantly longer with older patients (p = 0.017). On average, staff working at the pharmacy counter had 45 % of free time from direct patient contact. The mean overall satisfaction in this sample was 5.52 (SD = 0.98) out of a maximum score of seven, with no significant differences with automation as well as between professional categories, only with a significant lower job satisfaction for younger pharmacists. CONCLUSION As with previous studies in other settings, duration of the interactions was not influenced by pharmacy automation, as well as practitioners' job satisfaction, while practitioners' time constrains seem to be a subjective perception.
Collapse
Affiliation(s)
- Afonso Miguel Cavaco
- iMed.UL, Faculty of Pharmacy, University of Lisbon, Av. Prof. Gama Pinto, 1649-003, Lisbon, Portugal,
| | | |
Collapse
|
12
|
Bachmann C, Abramovitch H, Barbu CG, Cavaco AM, Elorza RD, Haak R, Loureiro E, Ratajska A, Silverman J, Winterburn S, Rosenbaum M. A European consensus on learning objectives for a core communication curriculum in health care professions. Patient Educ Couns 2013. [PMID: 23199592 DOI: 10.1016/j.pec.2012.10.016] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To develop learning objectives for a core communication curriculum for all health care professions and to survey the acceptability and suitability of the curriculum for undergraduate European health care education. METHODS Learning objectives for a Health Professions Core Communication Curriculum (HPCCC) in undergraduate education were developed based on international literature and expert knowledge by an international group of communication experts representing different health care professions. A Delphi process technique was used to gather feedback and to provide a consensus from various health care disciplines within Europe. RESULTS 121 communication experts from 15 professional fields and 16 European countries participated in the consensus process. The overall acceptance of the core communication curriculum was high. 61 core communication objectives were rated on a five-point scale and found to be relevant for undergraduate education in health care professions. A thematic analysis revealed the benefits of the HPCCC. CONCLUSIONS AND PRACTICE IMPLICATIONS Based on a broad European expert consensus, the Health Professions Core Communication Curriculum can be used as a guide for teaching communication inter- and multi-professionally in undergraduate education in health care. It can serve for curriculum development and support the goals of the Bologna process.
Collapse
Affiliation(s)
- Cadja Bachmann
- Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Cavaco AM, Madeira F. European pharmacy students' experience with virtual patient technology. Am J Pharm Educ 2012; 76:106. [PMID: 22919082 PMCID: PMC3425921 DOI: 10.5688/ajpe766106] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2011] [Accepted: 02/13/2012] [Indexed: 05/12/2023]
Abstract
OBJECTIVE To describe how virtual patients are being used to simulate real-life clinical scenarios in undergraduate pharmacy education in Europe. METHODS One hundred ninety-four participants at the 2011 Congress of the European Pharmaceutical Students Association (EPSA) completed an exploratory cross-sectional survey instrument. RESULTS Of the 46 universities and 23 countries represented at the EPSA Congress, only 12 students from 6 universities in 6 different countries reported having experience with virtual patient technology. The students were satisfied with the virtual patient technology and considered it more useful as a teaching and learning tool than an assessment tool. Respondents who had not used virtual patient technology expressed support regarding its potential benefits in pharmacy education. French and Dutch students were significantly less interested in virtual patient technology than were their counterparts from other European countries. CONCLUSION The limited use of virtual patients in pharmacy education in Europe suggests the need for initiatives to increase the use of virtual patient technology and the benefits of computer-assisted learning in pharmacy education.
Collapse
|
14
|
Cavaco AM, Brito N, Lopes D. Immigrant pharmacists in Portugal: A qualitative exploration of their work-related attitudes. Res Social Adm Pharm 2012; 8:172-8. [DOI: 10.1016/j.sapharm.2010.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2010] [Revised: 10/14/2010] [Accepted: 10/14/2010] [Indexed: 10/18/2022]
|
15
|
Cavaco AM, Cabrita J. Comment: Community Pharmacy Services in Portugal. Ann Pharmacother 2007; 41:902; author reply 902-3. [PMID: 17456534 DOI: 10.1345/aph.1h129a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
|