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Mazza D, Assifi AR, Hussainy SY, Bateson D, Johnston S, Tomnay J, Kasza J, Church J, Grzeskowiak LE, Nissen L, Cameron ST. Expanding community pharmacists' scope of practice in relation to contraceptive counselling and referral: a protocol for a pragmatic, stepped-wedge, cluster randomised trial (ALLIANCE). BMJ Open 2023; 13:e073154. [PMID: 37652588 PMCID: PMC10476139 DOI: 10.1136/bmjopen-2023-073154] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 08/21/2023] [Indexed: 09/02/2023] Open
Abstract
INTRODUCTION Improving access to effective contraception has the potential to reduce unintended pregnancy and abortion rates. Community pharmacists could play an expanded role in contraceptive counselling and referral to contraceptive prescribers particularly when women are already attending community pharmacy to obtain emergency contraceptive pills (ECPs) or to have medical abortion (MA) medicines dispensed. The ALLIANCE trial aims to compare the subsequent uptake of effective contraception (hormonal or intrauterine) in women seeking ECP or MA medicines, who receive the ALLIANCE community pharmacy-based intervention with those who do not receive the intervention. METHODS AND ANALYSIS ALLIANCE is a stepped-wedge pragmatic cluster randomised trial in Australian community pharmacies. The ALLIANCE intervention involves community pharmacists delivering structured, patient-centred, effectiveness-based contraceptive counselling (and a referral to a contraceptive prescriber where appropriate) to women seeking either ECPs or to have MA medicines dispensed. Women participants will be recruited by participating pharmacists. A total of 37 pharmacies and 1554 participants will be recruited. Pharmacies commence in the control phase and are randomised to transition to the intervention phase at different time points (steps). The primary outcome is the self-reported use of effective contraception at 4 months; secondary outcomes include use of effective contraception and the rate of pregnancies or induced abortions at 12 months. A process and economic evaluation of the trial will also be undertaken. ETHICS AND DISSEMINATION Ethical approval has been obtained from the Monash University Human Research Ethics Committee (#34563). An explanatory statement will be provided and written consent will be obtained from all participants (pharmacy owner, pharmacist and women) before their commencement in the trial. Dissemination will occur through a knowledge exchange workshop, peer-reviewed journal publications, presentations, social media and conferences. TRIAL REGISTRATION NUMBER ACTRN12622001024730.
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Affiliation(s)
- Danielle Mazza
- SPHERE NHMRC Centre of Research Excellence, Department General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anisa Rojanapenkul Assifi
- SPHERE NHMRC Centre of Research Excellence, Department General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Safeera Yasmeen Hussainy
- SPHERE NHMRC Centre of Research Excellence, Department General Practice, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Pharmacy Department, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
| | - Deborah Bateson
- The Daffodil Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | | | - Jane Tomnay
- Centre for Excellence in Rural Sexual Health, University of Melbourne, Shepparton, Victoria, Australia
| | - Jessica Kasza
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jody Church
- Centre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Luke E Grzeskowiak
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- SAHMRI Women and Kids, South Australian Health and Medical Research Institute Limited, Adelaide, South Australia, Australia
| | - Lisa Nissen
- Centre for the Business & Economics of Health, The University of Queensland, Brisbane, Queensland, Australia
| | - Sharon Tracey Cameron
- Obstetrics and Gynaecology, University of Edinburgh, Edinburgh, UK
- Sexual and Reproductive Health, NHS Lothian, Edinburgh, UK
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Buckingham P, Amos N, Hussainy SY, Mazza D. Scoping review of pharmacy-based initiatives for preventing unintended pregnancy: protocol. BMJ Open 2020; 10:e033002. [PMID: 32014873 PMCID: PMC7044843 DOI: 10.1136/bmjopen-2019-033002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Revised: 11/24/2019] [Accepted: 01/03/2020] [Indexed: 11/08/2022] Open
Abstract
INTRODUCTION Due to a high global incidence of unintended pregnancy, finding novel ways to increase the accessibility of contraceptive products and information is critical. One proposed strategy is to use the accessibility of community pharmacies and expand the role of pharmacists to deliver these services. This protocol reports the methods of a proposed scoping review of pharmacy-based initiatives for preventing unintended pregnancy. We intend to identify the range of interventions employed by pharmacists worldwide and their outcomes and aim to infer the value of task sharing for reducing certain access and equity barriers to contraception. METHODS AND ANALYSIS This protocol was developed with guidance from the Joanna Briggs Institute Methodology for Scoping Reviews. Reporting is compliant with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocols. The scoping review will be reported according to the PRISMA Extension for Scoping Reviews. Seven electronic databases (PubMed, Ovid Medline, Embase, Cochrane Library, Scopus and Cumulative Index to Nursing and Allied Health Literature) were systematically searched for relevant literature published in English from 2000, on 22 August 2019. Two authors will individually screen articles for eligibility in Covidence and data will be charted and reported using a tool developed for the purpose of this review. ETHICS AND DISSEMINATION Findings will be disseminated in publications and presentations with relevant stakeholders. Ethical approval is not required as we will be using data from publicly available literature sources. We will map available evidence across the breadth of studies that have been conducted and identify the effectiveness and acceptability of interventions.
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Affiliation(s)
- Philippa Buckingham
- General Practice, Monash University Faculty of Medicine Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Natalie Amos
- General Practice, Monash University Faculty of Medicine Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Safeera Yasmeen Hussainy
- General Practice, Monash University Faculty of Medicine Nursing and Health Sciences, Notting Hill, Victoria, Australia
| | - Danielle Mazza
- General Practice, Monash University Faculty of Medicine Nursing and Health Sciences, Notting Hill, Victoria, Australia
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Hussainy SY, Ghosh A, Taft A, Mazza D, Black KI, Clifford R, Gudka S, Mc Namara KP, Ryan K, Jackson JK. Protocol for ACCESS: a qualitative study exploring barriers and facilitators to accessing the emergency contraceptive pill from community pharmacies in Australia. BMJ Open 2015; 5:e010009. [PMID: 26656987 PMCID: PMC4679989 DOI: 10.1136/bmjopen-2015-010009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The rate of unplanned pregnancy in Australia remains high, which has contributed to Australia having one of the highest abortion rates of developed countries with an estimated 1 in 5 women having an abortion. The emergency contraceptive pill (ECP) offers a safe way of preventing unintended pregnancy after unprotected sex has occurred. While the ECP has been available over-the-counter in Australian pharmacies for over a decade, its use has not significantly increased. This paper presents a protocol for a qualitative study that aims to identify the barriers and facilitators to accessing the ECP from community pharmacies in Australia. METHODS AND ANALYSIS Data will be collected through one-on-one interviews that are semistructured and in-depth. Partnerships have been established with 2 pharmacy groups and 2 women's health organisations to aid with the recruitment of women and pharmacists for data collection purposes. Interview questions explore domains from the Theoretical Domains Framework in order to assess the factors aiding and/or hindering access to ECP from community pharmacies. Data collected will be analysed using deductive content analysis. The expected benefits of this study are that it will help develop evidence-based workforce interventions to strengthen the capacity and performance of community pharmacists as key ECP providers. ETHICS AND DISSEMINATION The findings will be disseminated to the research team and study partners, who will brainstorm ideas for interventions that would address barriers and facilitators to access identified from the interviews. Dissemination will also occur through presentations and peer-reviewed publications and the study participants will receive an executive summary of the findings. The study has been evaluated and approved by the Monash Human Research Ethics Committee.
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Affiliation(s)
| | - Ayesha Ghosh
- Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria, Australia
| | - Angela Taft
- Judith Lumley Centre, La Trobe University, Melbourne, Victoria, Australia
| | - Danielle Mazza
- Department of General Practice, Monash University, Melbourne, Victoria, Australia
| | - Kirsten Isla Black
- Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
| | - Rhonda Clifford
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Sajni Gudka
- School of Medicine and Pharmacology, University of Western Australia, Perth, Western Australia, Australia
| | - Kevin Peter Mc Namara
- Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria, Australia
- Deakin University and Flinders University, Melbourne, Victoria, Australia
| | - Kath Ryan
- School of Pharmacy, University of Reading, Reading, UK
| | - John Keith Jackson
- Centre for Medicine Use and Safety, Monash University, Melbourne, Victoria, Australia
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Gilmartin JFM, Marriott JL, Hussainy SY. Improving Australian care home medicine supply services: Evaluation of a quality improvement intervention. Australas J Ageing 2015; 35:E1-6. [DOI: 10.1111/ajag.12236] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Julia Fiona-Maree Gilmartin
- Centre for Medicine Use and Safety; Faculty of Pharmacy and Pharmaceutical Sciences; Monash University; Melbourne Victoria Australia
| | - Jennifer Lillian Marriott
- Centre for Medicine Use and Safety; Faculty of Pharmacy and Pharmaceutical Sciences; Monash University; Melbourne Victoria Australia
| | - Safeera Yasmeen Hussainy
- Centre for Medicine Use and Safety; Faculty of Pharmacy and Pharmaceutical Sciences; Monash University; Melbourne Victoria Australia
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Gilmartin JFM, Marriott JL, Hussainy SY. Towards improving dose administration aid supply: a quality improvement intervention aimed at reducing dispensing errors. Int J Clin Pharm 2013; 35:1152-60. [DOI: 10.1007/s11096-013-9839-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Accepted: 08/14/2013] [Indexed: 10/26/2022]
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Gilmartin JFM, Hussainy SY, Marriott JL. Medicines in Australian nursing homes: a cross-sectional observational study of the accuracy and suitability of re-packing medicines into pharmacy-supplied dose administration aids. Res Social Adm Pharm 2013; 9:876-83. [PMID: 23499486 DOI: 10.1016/j.sapharm.2013.01.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [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: 11/08/2012] [Revised: 01/17/2013] [Accepted: 01/17/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND Though staff at Australian nursing homes (NHs) commonly administer medicines that have been re-packed into dose administration aids (DAAs) that organize medicines according to dose schedule, these pharmacy-supplied devices have not been extensively evaluated in the Australian setting. OBJECTIVE To audit the accuracy and suitability of re-packing medicines into DAAs (blister packs or sachets) for NHs and identify the proportion of DAAs with inaccurate or unsuitable medicine re-packing. METHODS Between January and June 2011, pharmacist researchers visited 49 randomly and purposively selected NHs from rural, regional, and metropolitan Victoria (Australia) to audit a sample of residents' newly prepared DAAs that contained all of their regularly re-packed medicines for 1 week. Over 1 or 2 days, the pharmacy-supplied DAAs were compared with the current prescriber-prepared NH medicine chart. Any occurrences of inaccurately re-packed medicines (discrepancies, with verification as necessary) or unsuitable medicine re-packing were recorded as DAA incidents and descriptive statistics was used to analyze the data. RESULTS Six hundred and eighty-four incidents occurring in 457 DAAs were detected from a total of 3959 DAAs audited for 1757 residents (incident rate of 11.5% of DAAs) from 49 participating NHs. Incidents were detected in 10.5% of blister packs and 14.5% of sachets. The top five incidents were unsuitable re-packing according to pharmaceutical guidelines (50.1%); added medicine (9.8%); incorrect quantity re-packed (5.4%); omitted medicine (5.3%); and damaged medicine (5.1%). CONCLUSIONS The incident rate of inaccurate or unsuitable medicine re-packing within DAAs supplied to NHs for use in medicine administration was higher than in previous research. Recommendations include using current findings in conjunction with further research to develop a quality improvement initiative to reduce DAA incident rates and improve NH standard of care.
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Hussainy SY, Styles K, Duncan G. A virtual practice environment to develop communication skills in pharmacy students. Am J Pharm Educ 2012; 76:202. [PMID: 23275667 PMCID: PMC3530064 DOI: 10.5688/ajpe7610202] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [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: 04/04/2012] [Accepted: 07/27/2012] [Indexed: 05/26/2023]
Abstract
OBJECTIVE To develop communication skills in second-year pharmacy students using a virtual practice environment (VPE) and to assess students' and tutors' (instructors') experiences. DESIGN A VPE capable of displaying life-sized photographic and video images and representing a pharmacy setting was constructed. Students viewed prescriptions and practiced role-playing with each other and explored the use of nonverbal communication in patient-pharmacist interactions. The VPE experiences were complemented with lectures, reflective journaling, language and learning support, and objective structured clinical examinations (OSCEs). ASSESSMENT Most students believed the VPE was a useful teaching resource (87%) and agreed that the video component enabled them to contextualize patient problems (73%). While 45% of students questioned the usefulness of watching the role plays between students after they were video recorded, most (90%) identified improvement in their own communication as a result of participating in the tutorials. Most tutors felt comfortable using the technology. Focus group participants found the modified tutorials more engaging and aesthetically positive than in their previous experience. CONCLUSION The VPE provided an effective context for communication skills development classes.
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Hussainy SY, Marriott JL, Nation RL. Assessing medication knowledge of Australian palliative cancer care patients and caregivers and their interactions with pharmacists. J Palliat Med 2010; 12:769. [PMID: 19719369 DOI: 10.1089/jpm.2009.0115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hussainy SY, Marriott JL, Beattie J, Nation RL, Dooley MJ. A palliative cancer care flexible education program for Australian community pharmacists. Am J Pharm Educ 2010; 74:24. [PMID: 20414437 PMCID: PMC2856413 DOI: 10.5688/aj740224] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [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: 06/16/2009] [Accepted: 07/26/2009] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To implement and evaluate a flexible palliative care education program for Australian community pharmacists. DESIGN After identifying pharmacists' education needs, the program content and format were developed. This included identifying expert writers to create modules, assigning education and palliative care specialists to review content, and designing Web hosting of materials. The program was comprised of 11 modules and 79 activities. ASSESSMENT An average of 28 responses was posted for each of the 20 noticeboard activities. Of the 60 pharmacists who began the program, 15 contributed to the discussion group, with an average of 3 posts each. Participants' responses to an online questionnaire indicated the program addressed their education needs and improved their knowledge and confidence in providing palliative cancer care. CONCLUSION A program that pharmacists could access at a time and place convenient to them via the Internet was developed. Pharmacists indicated the program positively impacted their practice.
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