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Publisher: Elsevier BV
Date: 03-2015
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.SAPHARM.2019.07.001
Abstract: Community pharmacies provide enhanced (within current scope of practice) and extended (requiring additional credentialing) services, for disease state management and primary care. To quantify the prevalence and characteristics of extended and enhanced professional services offered by community pharmacies in Western Australia (WA), their frequency of remuneration, facilitators, barriers and factors influencing their provision. A questionnaire was mailed to a random s le of 421/628 (67.0%) community pharmacies in WA. Data collected included demographic information, provision of extended and enhanced pharmacy services and whether remuneration was received. Facilitators and barriers for offering these services used Likert scale responses to proffered questions. Data were entered into SPSS and descriptive statistics were reported. Logistic regression analyses investigated any factors (pharmacist and pharmacy characteristics) associated with the provision of influenza vaccination, or any of nine selected enhanced services. The response rate was 205/417 (49.2%). Only one-half or less of respondents provided any extended services. Pharmacist-administered influenza vaccinations (94/205, 45.0%) and Home Medicines Reviews (105/205, 52.0%) were the most prevalent. Remuneration for extended services was received by > 60% of respondents. Of 18 enhanced services >80% of pharmacies provided blood pressure monitoring and needle and syringe programs. Over half of the pharmacies (113/205, 55.1%) were banner (franchise) group members. Belonging to a banner group, having a private consultation area and space for a patient to lie down were positively associated with the provision of influenza vaccination and the selected enhanced services. Facilitators for the provision of services included enhancing patient relationships and the role of pharmacists. Major barriers were time constraints and inadequate remuneration. Extended services were limited in scope and provision whilst enhanced services were not uniformly available. Pharmacy organisations should look to increase their scope and provision, including improved government and third-party funding.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2013
DOI: 10.1002/CHP.21198
Abstract: Current mental health policy in Australia recognizes that ongoing mental health workforce development is crucial to mental health care reform. Community pharmacy staff are well placed to assist people with mental illness living in the community however, staff require the knowledge and skills to do this competently and effectively. This article presents the systematic planning and development process and content of an education and training program for community pharmacy staff, using a program planning approach called intervention mapping. The intervention mapping framework was used to guide development of an online continuing education program. Interviews with mental health consumers and carers (n = 285) and key stakeholders (n = 15), and a survey of pharmacy staff (n = 504) informed the needs assessment. Program objectives were identified specifying required attitudes, knowledge, skills, and confidence. These objectives were aligned with an education technique and delivery strategy. This was followed by development of an education program and comprehensive evaluation plan. The program was piloted face to face with 24 participants and then translated into an online program comprising eight 30-minute modules for pharmacists, 4 of which were also used for support staff. The evaluation plan provided for online participants (n ≅ 500) to be randomized into intervention (immediate access) or control groups (delayed training access). It included pre- and posttraining questionnaires and a reflective learning questionnaire for pharmacy staff and telephone interviews post pharmacy visit for consumers and carers. An online education program was developed to address mental health knowledge, attitudes, confidence, and skills required by pharmacy staff to work effectively with mental health consumers and carers. Intervention mapping provides a systematic and rigorous approach that can be used to develop a quality continuing education program for the health workforce.
Publisher: Springer Science and Business Media LLC
Date: 11-2019
DOI: 10.1007/S11096-019-00930-3
Abstract: Background Antipsychotic polypharmacy ("polypharmacy") is the concurrent prescribing of more than one antipsychotic. It is widely practised, as reported in the literature, and is known to increase the risk of adverse outcomes for patients. Objective To quantify the prevalence and magnitude of polypharmacy in patients with schizophrenia or schizoaffective disorder and identify potential factors contributing to this practice. Setting Armadale Mental Health Service (a public inpatient and outpatient psychiatric facility in Perth, Western Australia). Method A retrospective, cross-sectional study was conducted, evaluating the medical records of adult (18-64 years old) patients fulfilling the established inclusion criteria in the period between August and December 2016. Data collected included the number and doses of antipsychotic(s) prescribed and documented rationale for polypharmacy. Defined daily doses and proportions of maximum licensed daily doses were calculated for all regularly prescribed antipsychotics and were evaluated as measures of antipsychotic load. Main Outcome Measure The percentage prevalence of antipsychotic polypharmacy defined daily antipsychotic doses and proportions of maximum licensed daily doses. Results Seventy-seven patients were assessed, with a polypharmacy prevalence of 39.0%. Total defined daily doses ranged from 0.9 to 5.9 and maximum licensed daily doses from 0.4 to 2.3. Documented rationales for polypharmacy included poor symptom control, patient's preference, hesitancy to amend other prescribers' management plans, off-label antipsychotic indications and medication cross-titration. Conclusion Antipsychotic polypharmacy occurred in more than one-third of patients. In idual antipsychotics were typically prescribed at doses within the licensed range, however, the total proportion of combined maximum licensed doses and combined daily defined doses often exceeded 100%. Due to suboptimal documentation, prescribing rationale was unclear in the majority of cases. The magnitude of polypharmacy aims to foster a greater appreciation of the prescribed antipsychotic load, increasing clinician self-awareness of prescribing practices and facilitating future opportunities to optimise prescribing.
Publisher: Springer Science and Business Media LLC
Date: 30-08-2016
Publisher: Hindawi Limited
Date: 30-05-2013
DOI: 10.1002/DA.22132
Abstract: This study examined the feasibility and preliminary effectiveness of d-cycloserine (DCS)-augmented cognitive behavioral therapy (CBT) for children and adolescents with difficult-to-treat Obsessive Compulsive Disorder, in a double-blind randomized controlled pilot trial (RCT). Seventeen children and adolescents (aged 8-18 years) with a primary diagnosis of OCD, which was deemed difficult-to-treat, were randomly assigned to either nine sessions of CBT including five sessions of DCS-augmented exposure and response prevention (ERP) [ERP + DCS] or nine sessions of CBT including five sessions of placebo-augmented ERP [ERP + PBO]. Weight-dependent DCS or placebo doses (25 or 50 mg) were taken 1 hour before ERP sessions. At posttreatment, both groups showed significant improvements with 94% of the entire s le classified as responders. However, a greater improvement in the ERP + DCS relative to the ERP + PBO condition was observed at 1-month follow-up on clinician-rated obsessional severity and diagnostic severity, and parent ratings of OCD severity. There were no changes across time or condition from 1- to 3-month follow-up. In this preliminary study, DCS-augmented ERP produced significant improvements in OCD severity from posttreatment to 1-month follow-up, relative to a placebo control condition, in severe and difficult-to-treat pediatric OCD. The significant effect on obsessional severity suggests that DCS augmentation might be associated with enhanced modification of obsessional thoughts during ERP, and warrants further investigation.
Publisher: Elsevier BV
Date: 05-2023
Publisher: Wiley
Date: 11-03-2015
DOI: 10.1111/HEX.12179
Publisher: Springer Science and Business Media LLC
Date: 10-01-2014
DOI: 10.1007/S10597-012-9580-4
Abstract: Development of a mental health education package for community pharmacy staff should be informed by mental health consumers/carers' needs, expectations and experiences, and staff knowledge, skills and attitudes. This review (1) explored research on community pharmacy practice and service provision for mental health consumers/carers, and (2) identified validated methods for assessing staff knowledge, skills and attitudes about mental illness to inform the development of a training questionnaire. A literature scan using key words knowledge, skills, attitudes, and beliefs combined with community pharmacy, pharmacist, and pharmacy support staff, and mental illness, depression, anxiety was conducted. A small number of studies were found that used reliable methods to assess pharmacists' training needs regarding mental illness and treatment options. There was little published specifically in relation to depression and anxiety in community pharmacy practice. No studies assessed the training needs of pharmacy support staff. A systematic analysis of pharmacy staff learning needs is warranted.
Publisher: Oxford University Press (OUP)
Date: 08-03-2012
DOI: 10.1111/J.2042-7174.2012.00193.X
Abstract: It is well established that rural areas have compromised access to health services, including medication services. This paper reviews the practice developments for rural health professionals in relation to medication processes, with a focus on regulatory provisions in Queensland, Australia, and a view to identifying opportunities for enhanced pharmacy involvement. Literature referring to ‘medication/medicine’, ‘rural/remote’, ‘Australia’ and ‘pharmacy harmacist harmaceutical’ was identified via EBSCOhost, Ovid, Informit, Pubmed, Embase and The Cochrane Library. Australian Government reports and conference proceedings were sourced from relevant websites. Legislative and policy documents reviewed include drugs and poisons legislation, the National Medicines Policy and the Australian Pharmaceutical Advisory Council guidelines. The following developments enhance access to medication services in rural Queensland: (1) endorsement of various non-medical prescribers, (2) authorisation of registered nurses, midwives, paramedics and Indigenous health workers to supply medications in sites without pharmacists, (3) skill-mixing of nursing staff in rural areas to ease medication administration tasks, (4) establishment of pharmacist-mediated medication review services, (5) electronic transfer of medical orders or prescriptions and (6) enhanced transfer of medication information between metropolitan and rural, and public and private facilities. This review identified a ide between medication access and medication management services. Initiatives aiming to improve supply of (access to) medications focus on scopes of practice and endorsements for non-pharmacist rural healthcare providers. Medication management remains the domain of pharmacists, and is less well addressed by current initiatives. Pharmacists' involvement in rural communities could be enhanced through tele-pharmacy, outreach support and sessional support.
Publisher: Wiley
Date: 03-2012
DOI: 10.1002/J.2055-2335.2012.TB00131.X
Abstract: Inadequate or inaccurate transfer of medication information can challenge optimal medication management. Studies of medication information transfer typically involve the hospital–community interface in urban settings. There is little research on medication information transfer between community health services, between hospitals (rural and metropolitan) and rural community settings. To explore medication information transfer issues faced by rural healthcare providers and their perspectives on initiatives to optimise the process. Semi‐structured interviews were conducted with 49 health professionals in 4 towns in rural Queensland on issues surrounding medication supply and management. Interviews were recorded, transcribed verbatim and analysed thematically. Some of the issues identified included: discrepancies in medication records, lack of a coordinated system to communicate medication or prescription information between health professionals, and inadequate communication between secondary/tertiary facilities and rural primary care providers. According to the participants, the root causes of these challenges related to workforce issues and inefficiencies in communication and networking systems. Key issues were identified relating to medication information transfer between healthcare providers and between healthcare settings, which impacted on optimal medication management for rural patients.
Publisher: Wiley
Date: 31-08-2015
DOI: 10.1111/HEX.12401
Publisher: Elsevier BV
Date: 05-2018
DOI: 10.1016/J.SAPHARM.2017.06.002
Abstract: Community pharmacists play a significant role in the provision of non-prescription medicines. There is evidence that women self-medicate and use non-prescription medicines whilst breastfeeding. Studies have demonstrated that breastfeeding women are likely to seek advice from pharmacists, presenting a unique opportunity for pharmacists to provide on-going support of these women especially in relation to the appropriate use of non-prescription medicines. This study aimed to explore community pharmacists' attitudes and perspectives towards the use of non-prescription medicines during breastfeeding. This exploratory study was conducted through semi-structured interviews with 30 community pharmacists in Western Australia, between July and September 2013. Transcribed data were analysed using descriptive and qualitative approaches. NVivo Four major themes emerged. Despite the positive attitudes and favourable perceived knowledge level, participants often found themselves in a dilemma when required to make clinical recommendations especially in situations where there was a therapeutic need for treatment but clear guidelines or evidence to suggest safety of the medicines or treatment in lactation was absent. Despite the popularity of complementary medicines, participants felt more confident in providing advice in relation to conventional over complementary medicines. Whilst medication safety is within the field of expertise of pharmacists, the absence of information and safety data was seen as a major challenge and barrier to enable pharmacists to confidently provide evidence-based recommendations. This study has enhanced our understanding of the attitudes and perspectives of community pharmacists towards the use of non-prescription, including complementary medicines, during breastfeeding. Future studies are warranted to confirm the safety of commonly used or requested medicines in breastfeeding. University training and continuing education for pharmacists should include the latest information available regarding the use of both conventional and complementary medicines throughout lactation.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Wiley
Date: 26-06-2016
DOI: 10.1111/JICD.12225
Abstract: There is a lack of appropriate, commercially-available topical corticosteroid formulations for use in oral lichen planus (OLP) and oral lichenoid reaction. Current therapy includes crushing a dexamethasone tablet and mixing it with water for use as a mouth rinse. This formulation is unpleasant esthetically and to use in the mouth, as it is a bitter and gritty suspension, resulting in poor compliance. Thus, the present study was designed to formulate and pilot an effective, esthetically-pleasing formulation. A single-blinded, cross-over trial was designed with two treatment arms. Patients were monitored for 7 weeks. Quantitative and qualitative data was assessed using VAS, numeric pain scales, the Treatment Satisfaction Questionnaire for Medication-9, and thematic analysis to determine primary patient-reported outcomes, including satisfaction, compliance, quality of life, and symptom relief. Nine patients completed the pilot trial. Data analysis revealed the new compounded formulation to be superior to existing therapy due to its convenience, positive contribution to compliance, patient-perceived faster onset of action, and improved symptom relief. Topical dexamethasone is useful in the treatment of OLP. When carefully formulated into a compounded mouth rinse, it improves patient outcomes.
Publisher: Informa UK Limited
Date: 04-2018
DOI: 10.2147/IPRP.S140431
Publisher: Springer Science and Business Media LLC
Date: 05-07-2009
DOI: 10.1007/S11096-009-9309-9
Abstract: To explore the usefulness and implementation of practice standards in community pharmacy practice regarding contemporary core services. Community pharmacies in South East Queensland, Australia. During August and September 2006 semi-structured interviews with community pharmacists explored practice processes and procedures and the utilisation of endorsed standards and guidelines. Thematic content analysis of the interviews, inductive analysis and continual comparison of categories and concepts enabled common and distinct themes to be clarified. Usefulness and integration of practice standards in the provision of core pharmacy services, utilisation of support staff, record keeping and overall risk management processes in community pharmacy. Seventeen community pharmacists participated, representing a wide range of demographics, experience and pharmacy types. Staff utilisation and record keeping practices were analysed as well as two core services, namely: (1) the supply of over-the-counter medicines, and (2) the dispensing of prescriptions. The procedures followed concerning the supply of over-the-counter medicines varied. The majority of participants did not regard this as a pharmacist's immediate role, but rather relied on support staff to identify when the supply required a pharmacist's intervention. Whilst all participants involved dispensary assistants in the dispensing process, the delegation of procedures differed. Most participants did not clearly differentiate between pharmacists' and dispensary assistants' activities. Dispensing processes and the involvement of pharmacists in the provision of patient advice varied. Pharmacist intervention record keeping was uncommon and records of 'near misses' were not routinely kept by any of the participants. A lack of integration of practice standards indicated a need to review the standards for relevance. Additionally, pharmacists need to re-evaluate workflow models and the delegation of tasks in the light of new roles and responsibilities.
Publisher: Springer Science and Business Media LLC
Date: 13-11-2013
Abstract: Main concerns for lactating women about medications include the safety of their breastfed infants and the potential effects of medication on quantity and quality of breast milk. While medicine treatments include conventional and complementary medicines, most studies to date have focused on evaluating the safety aspect of conventional medicines. Despite increasing popularity of herbal medicines, there are currently limited data available on the pattern of use and safety of these medicines during breastfeeding. This study aimed to identify the pattern of use of herbal medicines during breastfeeding in Perth, Western Australia, and to identify aspects which require further clinical research. This study was conducted using a self-administered questionnaire validated through two pilot studies. Participants were 18 years or older, breastfeeding or had breastfed in the past 12 months. Participants were recruited from various community and health centres, and through advertising in newspapers. Simple descriptive statistics were used to summarise the demographic profile and attitudes of respondents, using the SPSS statistical software. A total of 304 questionnaires from eligible participants were returned (27.2% response rate) and analysed. Amongst the respondents, 59.9% took at least one herb for medicinal purposes during breastfeeding, whilst 24.3% reported the use of at least one herb to increase breast milk supply. Most commonly used herbs were fenugreek (18.4%), ginger (11.8%), dong quai (7.9%), chamomile (7.2%), garlic (6.6%) and blessed thistle (5.9%). The majority of participants (70.1%) believed that there was a lack of information resources, whilst 43.4% perceived herbal medicines to be safer than conventional medicines. Only 28.6% of users notified their doctor of their decision to use herbal medicine(s) during breastfeeding 71.6% had previously refused or avoided conventional medicine treatments due to concerns regarding safety of their breastfed infants. The use of herbal medicines is common amongst breastfeeding women, while information supporting their safety and efficacy is lacking. This study has demonstrated the need for further research into commonly used herbal medicines. Evidence-based information should be available to breastfeeding women who wish to consider use of all medicines, including complementary medicines, to avoid unnecessary cessation of breastfeeding or compromising of pharmacotherapy.
Publisher: Wiley
Date: 18-07-2018
Abstract: Reviewing pharmacist diabetes intervention studies revealed a lack of structured process in providing diabetes care, leading to varied results from increased to minimal improvements. The aim of this study was to determine the effectiveness of the Simpler tool, a structured clinical guidelines tool, in the delivery of diabetes care. The primary outcome was significant improvement in HbA1c. Secondary outcomes were improved lipid profiles and blood pressure (BP). A 6-month parallel multicenter two-arm, single-blind randomized controlled trial involving 14 pharmacists at seven primary care clinics was conducted in Johor, Malaysia. Pharmacists without prior specialized diabetes training were trained to use the tool. Patients were randomized within each center to either Simpler care (SC), receiving care from pharmacists who used the tool (n =55), or usual care (UC), receiving usual care and dispensing services (n = 69). Compared with UC, SC significantly reduced HbA1c (mean reduction 1.59% [95% confidence interval {CI} -2.2, -0.9] vs 0.25% [95% CI -0.62, 0.11], respectively P ≤ 0.001), and significantly improved systolic BP (-6.28 mmHg [95% CI -10.5, 2.0] vs 0.26 mmHg [95% CI -3.74, 0.43], respectively P = 0.005). A significantly higher proportion of patients in the SC than UC arm reached the Malaysian guideline treatment goals for HbA1c (14.3% vs 1.5% P = 0.020), systolic BP (80% vs 42% P = 0.001), and low-density lipoprotein cholesterol (60.5% vs 40.4% P = 0.046). Using the Simpler tool facilitated the delivery of comprehensive evidence-based diabetes management and significantly improved clinical outcomes. The Simpler tool supported pharmacists in providing enhanced structured diabetes care.
Publisher: Springer Science and Business Media LLC
Date: 22-07-2011
DOI: 10.1007/S11096-011-9540-Z
Abstract: To obtain community pharmacists' opinions of their role in administering Pharmacy (S2) and Pharmacist Only (S3) Medicines in a medical emergency. These medicines can only be sold in a pharmacy and are not available for self-selection by patients. Whilst qualified pharmacy assistants can supply S2 medicines, pharmacists must be directly involved in the supply of S3 medicines. Community pharmacies in South East Queensland, Australia. A survey of 151 Gold Coast and Toowoomba community pharmacists was conducted during October 2009. Pharmacists were asked their opinions as to whether the administration of S2 and S3 medicines should fall within their scope of practice, whether they had administered S2 and S3 medicines in a medical emergency in the past and if clarification of this role was required. The study achieved a 30% (n = 45) response rate and demonstrated similar results regarding whether pharmacists should administer salbutamol (22/44), adrenaline (23/42), glyceryl trinitrate (22/43) and aspirin (18/36) in a medical emergency. The majority (36/43) believed that role clarification was required. Pharmacists were more likely to administer an S3 medicine in a medical emergency when they considered potential outcomes first, had no easy access to a doctor and the patient could not administer the medicine they carried with them themselves (40/45). Community pharmacists have direct access to S2 and S3 medicines that could be required in the management of a variety of medical emergencies. This study demonstrates that some pharmacists have administered S2 and S3 medicines in an emergency situation. However, there are currently no clear guidelines for pharmacists when faced with a medical emergency other than to act within their professional competence. To promote patient safety through the appropriate use of S2 and S3 medicines in the event of a medical emergency, additional training of pharmacists on the administration of these readily accessible medicines is needed. Clarification of the role of pharmacists in an emergency situation is required.
Publisher: Springer Science and Business Media LLC
Date: 18-06-2022
DOI: 10.1186/S12913-022-08156-2
Abstract: Ordering of computed tomography (CT) scans needs to consideration of diagnostic utility as well as resource utilisation and radiation exposure. Several factors influence ordering decisions, including evidence-based clinical decision support tools to rule out serious disease. The aim of this qualitative study was to explore factors influencing Emergency Department (ED) doctors’ decisions to order CT of the head or cervical spine. In-depth semi-structured interviews were conducted with purposively selected ED doctors from two affiliated public hospitals. An interview tool with 10 questions, including three hypothetical scenarios, was developed and validated to guide discussions. Interviews were audio recorded, transcribed verbatim, and compared with field notes. Transcribed data were imported into NVivo Release 1.3 to facilitate coding and thematic analysis. In total 21 doctors participated in semi-structured interviews between February and December 2020 mean interview duration was 35 min. Data saturation was reached. Participants ranged from first-year interns to experienced consultants. Five overarching emerging themes were: 1) health system and local context, 2) work structure and support, 3) professional practices and responsibility, 4) reliable patient information, and 5) holistic patient-centred care. Mapping of themes and sub-themes against a behaviour change model provided a basis for future interventions. CT ordering is complex and multifaceted. Multiple factors are considered by ED doctors during decisions to order CT scans for head or c-spine injuries. Increased education on the use of clinical decision support tools and an overall strategy to improve awareness of low-value care is needed. Strategies to reduce low-yield CT ordering will need to be sustainable, sophisticated and supportive to achieve lasting change.
Publisher: Wiley
Date: 27-07-2022
DOI: 10.1002/JPPR.1160
Publisher: Springer Science and Business Media LLC
Date: 11-07-2021
Publisher: SAGE Publications
Date: 23-09-2014
Abstract: The stigma of mental illness can be a barrier to effective medication management in the community pharmacy setting. This article explored mental health consumers’ or caregivers’ experiences of stigma in Australian community pharmacies. Semi-structured interviews and focus groups were conducted with a purposive s le of consumers or caregivers ( n = 74). Interview transcripts were analysed using a general inductive approach. Stigma presented a barrier to effective mental health management. Self-stigma impeded consumers’ community pharmacy engagement. Positive relationships with knowledgeable staff are fundamental to reducing stigma. Findings provide insight into the stigma of mental illness in community pharmacies.
Publisher: Springer Science and Business Media LLC
Date: 15-05-2019
DOI: 10.1007/S11096-019-00815-5
Abstract: Background Ethical reasoning informs decision making and professional judgement, is guided by codes of ethics and conduct, and requires navigation through a regulatory framework. Ethical reasoning should evolve throughout the pharmacy internship year and prepare interns for independent practice. Objective To explore the ethical reasoning and processes of Australian pharmacists and pharmacy interns. Setting Queensland community pharmacists and interns. Method A survey to determine use of resources to guide ethical decisions, management of ethical dilemmas, and exposure to potential practice privacy breaches. Participants were recruited at pharmacy intern training events, a pharmacist education session and through telephone contact of randomised community pharmacies. Main outcome measure Comparison between pharmacist and intern responses using 5-point Likert scales, listings and prioritising. Results In total 218 completed surveys were analysed: 121 pharmacy interns and 97 pharmacists. The Code of Ethics was identified as the resource most frequently consulted when faced with ethical dilemmas. Interns were more likely to consult legislation and regulatory authorities whereas pharmacists with colleagues. Responses to ethical vignette scenarios and exposure to privacy breaches varied between interns and pharmacists, with some scenarios revealing significant differences. Most participants had been exposed to a variety of potential privacy breaches in practice. Conclusion Interns focussed on legislation and guidelines when presented with hypothetical ethical dilemmas. In contrast to this positivist approach, pharmacists reported using a social constructionist approach with peers as a reference. Pharmacists avoided ethical scenario options that required complex management. Interns reported more exposure to potential practice privacy breaches.
Publisher: Springer Science and Business Media LLC
Date: 25-10-2023
Publisher: Springer Science and Business Media LLC
Date: 26-04-2016
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/AH14081
Abstract: Objective Many of Australia’s rural hospitals operate without an on-site pharmacist. In some, community pharmacists have sessional contracts to provide medication management services to inpatients. This paper discusses the funding arrangements of identified sessional employment models to raise awareness of options for other rural hospitals. Methods Semistructured one-on-one interviews were conducted with rural pharmacists with experience in a sessional employment role (n = 8) or who were seeking sessional arrangements (n = 4). Participants were identified via publicity and referrals. Interviews were conducted via telephone or Skype for ~40–55 min each, recorded and analysed descriptively. Results A shortage of state funding and reliance on federal funding was reported. Pharmacists accredited to provide medication reviews claimed remuneration via these federal schemes however, restrictive criteria limited their scope of services. Funds pooling to subsidise remuneration for the pharmacists was evident and arrangements with local community pharmacies provided business frameworks to support sessional services. Conclusion Participants were unaware of each other’s models of practice, highlighting the need to share information and these findings. Several similarities existed, namely, pooling funds and use of federal medication review remuneration. Findings highlighted the need for a stable remuneration pathway and business model to enable wider implementation of sessional pharmacist models. What is known about the topic? Many rural hospitals lack an optimal workforce to provide comprehensive health services, including pharmaceutical services. One solution to address medication management shortfalls is employment of a local community pharmacist or consultant pharmacist on a sessional basis in the hospital. There is no known research into remuneration options for pharmacists providing sessional hospital services. What does this paper add? Viability of services and financial sustainability are paramount in rural healthcare. This paper describes and compares the mechanisms initiated independently by hospitals or pharmacists to meet the medication needs of rural hospital patients. Awareness of the funding arrangements provides options for health service providers to extend services to other rural communities. What are the implications for practitioners? Rural practitioners who identify unmet service needs may be inspired to explore funding arrangements successfully implemented by our participants. Innovative use of existing funding schemes has potential to create employment options for rural practitioners and increase provision of services in rural areas.
Publisher: Research Square Platform LLC
Date: 19-03-2021
DOI: 10.21203/RS.3.RS-323832/V1
Abstract: Background: Insulin is a high-risk medicine, associated with hospital medication errors. Pharmacists play an important role in the monitoring of patients on insulin. Objective: To analyse interventions made by hospital pharmacists that were associated with insulin prescribing for inpatients with diabetes. Method: Retrospective audit of pharmacist interventions for adult inpatients for an 8-month period, 1 June 2019 to 31 January 2020. Pharmacist interventions recorded in the electronic medication management system by inpatient unit and dedicated high-risk medicine pharmacists were extracted, screened, and analysed. Results: Of 3,975 pharmacist interventions 3,356 (84.43%) were recorded by high-risk medicine pharmacists and 619 (15.57%) by inpatient unit pharmacists. July and August 2019 had the highest numbers of interventions with 628 and 643 (15.80% and 16.18%) respectively. Most of the interventions, namely 3,410 (85.79%) were classified as medicine optimisation interventions and 565 (14.21%) as prescribing errors . In the medicine optimisation intervention category, 2,985 (75.09%) were due to insulin not charted for ongoing administration. Conclusion: This study provides insights into pharmacist interventions for inpatients on insulin, showing that high-risk medicine pharmacists recorded most interventions. The classification of the insulin interventions into medicine optimisation and prescribing errors provides useful information for the training of prescribers in insulin management.
Publisher: Oxford University Press (OUP)
Date: 07-04-2013
DOI: 10.1111/IJPP.12034
Abstract: Personally Controlled Electronic Health Records (PCEHRs) were introduced for Australian health consumers in July 2012. This study aimed to determine, in the months prior to the launch, community pharmacists’ perceptions about practical and professional aspects relating to integration of the PCEHR into pharmacy practice, with a view to informing practice guidelines and training. Semi-structured interviews with 25 pharmacy owners and/or managers from 24 community pharmacies in Perth, Western Australia, were undertaken during March–April 2012. Participants were given a standardised briefing about the PCEHR before exploratory questioning regarding the expected integration, benefits and challenges of the system in pharmacy practice. Despite some awareness of the impending introduction of PCEHRs via the lay media, pharmacists were almost unanimously uninformed about the intended rollout, design and functionality of the system for health consumers and practitioners. Participants expressed concerns regarding patients’ control over their data management, time associated with staff training, technical upgrades and resource allocation. Obstacles included pharmacists’ inability to legitimately access patient data outside consultations. Pharmacists expected flexibility to record clinical activities and health services. Priorities identified for the profession were remuneration, medico-legal guidelines and boundaries, and clarification of roles and responsibilities. Despite being unaware of details surrounding integration of PCEHRs in practice, community pharmacists provided insights into their expectations and concerns and the perceived benefits relating to implementation of the system. Training priorities and practice guidelines should address ethical data management and optimal use of electronic health records for clinical services.
Publisher: Informa UK Limited
Date: 26-11-2016
DOI: 10.3109/09638237.2015.1101418
Abstract: Australian general practitioners primarily treat mental health problems by prescribing medication dispensed by community pharmacists. Pharmacists therefore have regular interactions with mental health consumers and carers. This narrative review explored the potential role of community pharmacy in mental health services. Medline, CINAHL, ProQuest, Emerald, PsycINFO, Science Direct, PubMed, Web of Knowledge and IPA were utilised. The Cochrane Library as well as grey literature and "lay" search engines such as GoogleScholar were also searched. Four systematic reviews and ten community pharmacy randomised controlled trials were identified. Various relevant reviews outlining the impact of community pharmacy based disease state or medicines management services were also identified. International studies involving professional service interventions for mental health consumers could be contextualised for the Australian setting. Australian studies of pharmacy professional services for chronic physical health conditions provided further guidance for the expansion of community pharmacy mental health professional services.
Publisher: Hindawi Limited
Date: 2016
DOI: 10.1155/2016/5897452
Abstract: Background . We conducted a review of current diabetes intervention studies in type 2 diabetes and identified opportunities for pharmacists to deliver quality diabetes care. Methods . A search on randomised controlled trials (RCT) on diabetes management by healthcare professionals including pharmacists published between 2010 and 2015 was conducted. Results and Discussion . Diabetes management includes multifactorial intervention which includes seven factors as outlined in diabetes guidelines, namely, glycaemic, cholesterol and blood pressure control, medication, lifestyle, education, and cardiovascular risk factors. Most studies do not provide evidence that the intervention methods used included all seven factors with exception of three RCT which indicated HbA1c (glycated hemoglobin) reduction range of 0.5% to 1.8%. The varied HbA1C reduction suggests a lack of standardised and consistent approach to diabetes care. Furthermore, the duration of most studies was from one month to two years therefore long term outcomes could not be established. Conclusion . Although pharmacists’ contribution towards improving clinical outcomes of diabetes patients was well documented, the methods used to deliver structured, consistent evidence-based care were not clearly stipulated. Therefore, approaches to achieving long term continuity of care are uncertain. An intervention strategy that encompass all seven evidence-based factors will be useful.
Publisher: Elsevier BV
Date: 11-2018
DOI: 10.1016/J.SAPHARM.2017.12.001
Abstract: Easy access to effective over-the-counter (OTC) treatments allows self-management of some conditions, however inappropriate or incorrect supply or use of OTC medicines can cause harm. Pharmacy personnel should support consumers in their health-seeking behaviour by utilising effective communication skills underpinned by clinical knowledge. To identify interventions targeted towards improving communication between consumers and pharmacy personnel during OTC consultations in the community pharmacy setting. Systematic review and narrative analysis. Databases searched were MEDLINE, EMBASE, Psycinfo, Cochrane Central Register and Cochrane Database of Systematic Reviews for literature published between 2000 and 30 October 2014, as well as reference lists of included articles. The search was re-run on 18 January 2016 and 25 September 2017 to maximise the currency. Two reviewers independently screened retrieved articles for inclusion, assessed study quality and extracted data. Full publications of intervention studies were included. Participants were community pharmacy personnel and/or consumers involved in OTC consultations. Interventions which aimed to improve communication during OTC consultations in the community pharmacy setting were included if they involved a direct measurable communication outcome. Studies reporting attitudes and measures not quantifiable were excluded. The protocol was published on Prospero Database of Systematic Reviews. Of 4978 records identified, 11 studies met inclusion criteria. Interventions evaluated were: face-to-face training sessions (n = 10) role-plays (n = 9) a software decision making program (n = 1) and simulated patient (SP) visits followed by immediate feedback (n = 1). Outcomes were measured using: SP methodology (n = 10) and a survey (n = 1), with most (n = 10) reporting a level of improvement in some communication behaviours. Empirical evaluation of interventions using active learning techniques such as face-to-face training with role-play can improve some communication skills. However interventions that are not fully described limit the ability for replication and/or generalisability. This review identified interventions targeting pharmacy personnel. Future interventions to improve communication should consider the consumer's role in OTC consultations.
Publisher: Springer Science and Business Media LLC
Date: 07-02-2015
Publisher: Informa UK Limited
Date: 04-07-2018
DOI: 10.1080/09638237.2017.1340618
Abstract: Mental illness is a worldwide health priority. As medication is commonly used to treat mental illness, community pharmacy staff is well placed to assist consumers. To evaluate the effectiveness of a multifaceted, community pharmacy medication support service for mental health consumers. Pharmacists and pharmacy support staff in three Australian states were trained to deliver a flexible, goal-oriented medication support service for adults with mental illness over 3-6 months. Consumer-related outcome measures included perceptions of illness and health-related quality of life, medication beliefs, treatment satisfaction and medication adherence. Fifty-five of 100 trained pharmacies completed the intervention with 295 of the 418 recruited consumers (70.6% completion rate) 51.2% of consumers received two or more follow-ups. Significant improvements were reported by consumers for overall perceptions of illness (p < 0.001), the mental health domain of quality of life (p < 0.001), concerns about medication (p = 0.001) and global satisfaction with medication (p < 0.001). Consumers also reported an increase in medication adherence (p = 0.005). A community pharmacy mental health medication support service that is goal-oriented, flexible and in idualised, improved consumer outcomes across various measures. While further research into the cost-effectiveness and sustainability of such a service is warranted, this intervention could easily be adapted to other contexts.
Publisher: Oxford University Press (OUP)
Date: 25-04-2015
DOI: 10.1111/IJPP.12114
Abstract: The study aims to explore within the community pharmacy practice context the views of mental health stakeholders on: (1) current and past experiences of privacy, confidentiality and support and (2) expectations and needs in relation to privacy and confidentiality. In-depth interviews and focus groups were conducted in three states in Australia, namely Queensland, the northern region of New South Wales and Western Australia, between December 2011 and March 2012. There were 98 participants consisting of consumers and carers (n = 74), health professionals (n = 13) and representatives from consumer organisations (n = 11). Participants highlighted a need for improved staff awareness. Consumers indicated a desire to receive information in a way that respects their privacy and confidentiality, in an appropriate space. Areas identified that require improved protection of privacy and confidentiality during pharmacy interactions were the number of staff having access to sensitive information, workflow models causing information exposure and pharmacies' layout not facilitating private discussions. Challenges experienced by carers created feelings of isolation which could impact on care. This study explored mental health stakeholders' experiences and expectations regarding privacy and confidentiality in the Australian community pharmacy context. A need for better pharmacy staff training about the importance of privacy and confidentiality and strategies to enhance compliance with national pharmacy practice requirements was identified. Findings provided insight into privacy and confidentiality needs and will assist in the development of pharmacy staff training material to better support consumers with sensitive conditions.
Publisher: Oxford University Press (OUP)
Date: 16-03-2017
DOI: 10.1111/IJPP.12356
Abstract: To identify the health management information needs of Australian mental health consumers and carers and explore the role of community pharmacy in meeting those needs. Interviews and focus groups were conducted with a purposive convenience s le of 74 mental health consumers and carers across three Australian states, representing metropolitan, rural and remote settings, including those with culturally and linguistically erse backgrounds. Recruitment and interviews continued until data saturation was reached. Interviews and group discussions were digitally recorded and transcribed verbatim, and data were managed using NVivo® software. A ‘coding framework’ or set of themes was created, and all transcripts were coded accordingly. Thematic analysis was informed by a general inductive approach. Participants had unmet needs for information from community pharmacy. They expressed the requirement for receiving easy-to-understand, relevant medication information about mental health management from community pharmacy staff, communicated in a respectful way, with clear and comprehensive medication labelling, while respecting consumer privacy. The information needs of mental health consumers and carers remain largely unmet within Australian community pharmacy. This was particularly evident regarding the provision of information about adverse effects of medicines. The overall perceived lack of information is experienced as disempowering. Australian community pharmacy is well placed to respond to the unmet demand for information needs of mental health consumers and carers. While many community pharmacies are embracing the principles of patient-centred care, there is an opportunity to optimise the quality of care provided to mental health consumers and carers.
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1016/J.SAPHARM.2019.06.015
Abstract: Careful planning is important for successful implementation and ongoing provision of enhanced and extended pharmacy services. To explore the factors that contributed to the successful implementation and ongoing provision of enhanced and extended services in Western Australian community pharmacies. In-depth semi-structured telephone interviews were conducted with purposively selected pharmacists from various practice settings. Interviews explored experiences and perspectives on the provision of enhanced and extended professional services and continued until saturation was achieved. Analysis focused on prior investigation before implementation of services, perceptions of the impact of the services and factors to be considered. The COM-B (Capability, Opportunity, Motivation and Behaviour) model was applied post hoc to the thematic analysis to explore whether there was an overlap between themes and the model. In total 26 pharmacists (16 males, 10 females) participated in semi-structured interviews during October 2017 and February 2018. They classified as 20 community, 13 accredited and 7 specialist pharmacists and 11 pharmacist immunisers (some classified as more than one). Interview duration was 55 min (minimum 22, maximum 91 min). Responses regarding prior investigation/research conducted varied in approach followed and level of enquiry. Opinions about services were overall positive such as enhanced collaboration with other healthcare professionals, positive patient outcomes, increased staff satisfaction and acceptance of pharmacists as primary care providers. New services did not always provide direct financial benefit. Three major themes emerged as factors that impacted on provision of services: 1) pharmacist characteristics, 2) local needs, structures and support, and 3) an enabling practice framework. Pharmacists who were successful in the implementation and maintenance of new professional services were familiar with local needs. Both pharmacy and pharmacist aspects should be considered during implementation and maintenance of new professional services. An enabling practice framework is crucial in facilitating new pharmacy services.
Publisher: MDPI AG
Date: 28-09-2023
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.SAPHARM.2012.03.004
Abstract: Requests for supply of the emergency contraceptive pill (ECP) through community pharmacies require consideration of a range of factors and the application of professional judgment. Pharmacists should therefore be able to follow a structured reasoning process. The research involved an assessment of history taking and counseling by pharmacy staff through mystery patient emergency contraception product requests. Two challenging ECP request case scenarios were developed with assessment tools. Mystery patients were trained to present the scenarios to pharmacies. A project information package and expression of interest form was posted to 135 pharmacies in the Gold Coast, Australia 23 (17%) pharmacies agreed to participate. Pharmacy staff was exposed to 1 of 2 scenarios during December 2010. Staff interactions were recorded, analyzed, and rated to evaluate the management of ECP requests. The results identified practice gaps among pharmacy staff with respect to information gathering and the provision of advice. Ongoing training is required to enhance the skills, competence, and confidence of pharmacy staff in managing complicated requests for nonprescription medicines, such as the ECP. The impact of time pressures and financial burdens on the provision of pharmaceutical services needs to be acknowledged.
Publisher: MDPI AG
Date: 07-09-2015
Publisher: MDPI AG
Date: 30-05-2022
Abstract: A unique approach was introduced to integrate pharmacy students into a multicentre patient-centred research project predicting medication related harm (MRH) post-discharge. A training framework was developed to prepare students for research participation and integration. The framework aligned research project tasks with the pharmacists’ national competency standards framework. The framework was piloted on four research placement students from two local universities during three hospital placements, from October 2020 to August 2021. Following their initial orientation and training, students collected data from 38 patients and were involved in patient screening processes, interviewing, data collection and analysis. Patients’ MRH risk scores correlated with re-admission rates with 16/38 (42%) of patients re-admitted within eight weeks following discharge. Their participation in the research enabled students to obtain skills in (1) literature searching, (2) maintaining patient confidentiality, (3) interviewing patients, (4) obtaining data from medical records, (5) communicating with patients and clinicians, and (6) the use of clinical information to predict MRH risk.
Publisher: MDPI AG
Date: 08-09-2015
Publisher: Springer Science and Business Media LLC
Date: 26-10-2018
DOI: 10.1007/S11096-018-0738-1
Abstract: Background Pharmacist-administered vaccination services have been available in various countries for several years. In 2014, Western Australian (WA) legislation was introduced to allow pharmacist immunisers to administer the influenza vaccine to consumers 18 years and older. Objective To determine consumer satisfaction with pharmacist-administered influenza vaccination services in WA and identify factors associated with opinions to extend the service to include other vaccines. Setting Thirteen WA community pharmacies. Method In 2015, 133 pharmacies in WA offered pharmacist-administered influenza vaccinations. Of the 133 pharmacies, a purposive s le of 10% (13) were invited to participate in this 2016 study. Following vaccination, consumers were given a questionnaire and asked to evaluate the service and if they would support expansion of the service to include other vaccinations. Main outcome measure Consumer satisfaction with aspects of the service using a 5-point Likert scale. Results A total of 434 (66.8%) questionnaires were completed at the 13 pharmacies and returned. The majority of consumers (99.5%) were satisfied with the service overall, and 97.2% advised they would receive a vaccination from a community pharmacist in the future. Over 60% would like vaccinations to expand to other conditions. Women and those who would again have their influenza vaccine from the pharmacist were particularly supportive of this expansion. Conclusion Consumer satisfaction with pharmacist-administered vaccinations was high. Consumers found the service convenient, comfortable and professional. The majority of respondents supported expansion of pharmacist-administered vaccination services to a wider range of vaccines.
Publisher: Elsevier BV
Date: 03-2023
Publisher: MDPI AG
Date: 26-04-2021
Abstract: Community pharmacies are well positioned to participate in harm-minimisation services to reduce harms caused by both licit and illicit substances. Considering developments in pharmacist practices and the introduction of new professional pharmacy services, we identified a need to explore the contemporary role of community pharmacy in harm minimisation. Semi-structured interviews were undertaken to explore the opinions of stakeholders, pharmacy staff, and clients about the role of community pharmacy in harm minimisation, including provision of current services, experiences, and expectations. Participants (n = 28) included 5 stakeholders, 9 consumers, and 14 staff members from seven community pharmacies. Three over-arching themes were identified across the three participants groups: (i) scope and provision, (ii) complexity, and (iii) importance of person-centred advice and support in relation to community pharmacy harm minimisation services. Community pharmacies are valuable healthcare destinations for delivery of harm minimisation services, with scope for service expansion. Further education, support, and remuneration are needed, as well as linkage to other sector providers, in order to ensure that pharmacists and pharmacy staff are well equipped to provide a range of harm minimisation services.
Publisher: Springer Science and Business Media LLC
Date: 16-03-2019
DOI: 10.1007/S11096-019-00807-5
Abstract: Background The need for greater collaboration between pharmacists and general practitioners in Australia facilitated the development of the practice pharmacist role. Practice pharmacists work from within general practices to provide services to patients and health professionals to improve the quality use of medications. Objective To explore the perceptions of Australian accredited pharmacists and pharmacists already working in general practices about current roles, facilitators and barriers, and remuneration expectations of practice pharmacists. Setting This study was conducted Australia wide. Method This was a two-stage study. The first stage involved a quantitative online questionnaire of accredited pharmacists whilst the second stage involved semistructured interviews with pharmacists working in general practice. Main outcome measure Pharmacists' opinions on expected and current roles, barriers and facilitators, remuneration expectations and training requirements for practice pharmacist. Results A total of 65 accredited pharmacists completed the online survey and 20 practice pharmacists participated in interviews. The primary practice pharmacist roles identified included medication reviews, verifying the appropriateness of prescriptions, counselling and promoting adherence and providing education to other allied health professionals in the practice. The major facilitator identified was enhanced communication. Remuneration expectations and current working relationships were identified as main barriers. Conclusion The implementation of an appropriate funding model and a defined scope of role are critical to the successful implementation of the role of practice pharmacists.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.SAPHARM.2017.03.005
Abstract: The scope of community pharmacy practice has expanded over the years. Pharmacists are now involved in the provision of a range of professional services. Pharmacists have regular contact with breastfeeding women, and are perceived as easily accessible, trusted health advisors. There is limited information on factors needed to be considered when implementing breastfeeding-related services in pharmacies to meet the needs of this population group. This study aimed to explore community pharmacists' perspectives on the implementation of breastfeeding-related services, the factors to consider and the required implementation strategies in community pharmacies. The study involved semi-structured interviews with 30 community pharmacists practising in Western Australian. Interviews were audio-recorded and transcribed verbatim to facilitate analysis. NVivo Participants' perceptions about their role in providing breastfeeding-related services in community pharmacies were generally favourable. Participants reported receiving regular enquiries from the public about the use of various medicines during breastfeeding, in particular non-prescription medicines. Most of their knowledge regarding the use of medicines in breastfeeding and breastfeeding in general was a culmination of day-to-day work experience, self-directed continuing professional development, personal or close-contact breastfeeding experience, and university training. Multifaceted efforts including public and professional education, research and development, and government initiatives were identified as essential to facilitate quality use of medicines in breastfeeding, and to increase pharmacists' support of breastfeeding women. Based on the needs and demand, appropriate training and continuing development is warranted so that pharmacists are well-equipped with knowledge regarding the use of medicines in breastfeeding, and breastfeeding in general. There appear to be opportunities for pharmacists to expand their professional services and contribute towards improved care and support of breastfeeding women at primary care level.
Publisher: Wiley
Date: 09-2010
DOI: 10.1002/J.2055-2335.2010.TB00540.X
Abstract: A comprehensive hospital discharge summary sent to the patient's general practitioner (GP) in a timely manner can ease patient transition between care settings. To investigate the quality of discharge summaries sent by a regional hospital to GPs and to evaluate GPs' satisfaction with the medication list contained in the discharge summary. A questionnaire was mailed to a s le of 80 Gold Coast GPs who had made more than five referrals to the Gold Coast Hospital during June 2009. 18 responses (23% response rate) were received from September to October 2009. The majority (67%) of GPs received discharge summaries from the hospital and they were mostly in an electronic format with attached medication lists. The reasons for changing medications were not well explained and the timeframe for receiving summaries was considered unsatisfactory. Overall, the majority of GPs were satisfied with the quality of the discharge summaries. GPs mostly received the discharge summaries and the majority received them electronically. The majority of GPs indicated that the medication lists were often attached to the discharge summaries and changes to medications recorded.
Publisher: Springer Science and Business Media LLC
Date: 12-03-2020
Publisher: Springer Science and Business Media LLC
Date: 30-10-2013
DOI: 10.1007/S40271-013-0032-1
Abstract: Trusting relationships between mental health consumers and health care providers are critical in the management and recovery process. Although community pharmacy staff are well placed to form relationships with mental health consumers and carers, little is known about the existence, nature or significance of consumer-staff relationships. The aim of this study was to explore mental health consumers' and carers' perceptions of community pharmacy services, and describe the nature of their relationships with pharmacy staff. Focus groups and semi-structured interviews were conducted with a convenience s le of 74 mental health consumers or carers who self-selected into the study. Thematic analysis was undertaken to explore participants' perspectives. Positive experiences of pharmacy services were perceived to encourage consumers' and carers' trust in pharmacists and promote relationship development. This was enhanced when participants felt that elements of patient-centred care were part of the pharmacy services provided. Although some participants perceived community pharmacy to have a limited role in mental health, those who had established relationships highlighted the current role of pharmacists in their care, and appeared to welcome further extensions of pharmacists' role in mental health. Trusting relationships between consumers and carers and community pharmacy staff were deemed to be important in mental health care and contributed to consumers' and carers' views of pharmacy as a safe health care space. Community pharmacy services that included core elements of patient-centred care appeared to facilitate relationship formation and associated benefits. Education and training is needed for community pharmacy staff to improve mental health knowledge and promote positive engagement with consumers and carers.
Publisher: Elsevier BV
Date: 09-2017
DOI: 10.1016/J.SAPHARM.2017.05.017
Abstract: Community pharmacists are in an ideal position to promote and provide mental health medication management services. However, formalised or structured pharmacy services to support consumers with mental health conditions are scarce. Australian mental health consumers indicated a need for targeted community pharmacy mental health services which presented an opportunity to develop an intervention that were integrated with remunerated professional services. The study aimed to pilot a mental health medication management intervention in Australian community pharmacies. Pharmacists worked in partnership with consumers, carers and mental health workers over three to six months to set and support achievement of in idual goals related to medicines use, physical health and mental wellbeing. This paper provides a comparison of community pharmacies that successfully delivered the intervention with those that did not and identifies facilitators and challenges to service implementation. One hundred pharmacies opted to pilot the delivery of the intervention in three Australian states (Queensland, Western Australia and northern New South Wales). Of those, 55 successfully delivered the intervention (completers) whilst 45 were unsuccessful (non-completers). A mixed methods approach, including quantitative pharmacy surveys and qualitative semi-structured interviews, was used to gather data from participating pharmacies. Following intervention development, 142 pharmacists and 21 pharmacy support staff attended training workshops, received resource kits and ongoing support from consumer and pharmacist mentors throughout intervention implementation. Baseline quantitative data was collected from each pharmacy on staff profile, volume of medicines dispensed, the range of professional services delivered and relationships with health professionals. At the completion of the study participants were invited to complete an online exit survey and take part in a semi-structured interview that explored their experiences of intervention implementation and delivery. Twenty-nine staff members from completer pharmacies returned exit surveys and interviews were conducted with 30 staff from completer and non-completer pharmacies. Descriptive analyses of quantitative data and thematic analyses of qualitative data were used to compare completers and non-completers. Baseline similarities included numbers of general and mental health prescriptions dispensed and established professional services. However, there was greater prevalence of diabetes management, opioid substitution services, and relationships with mental health services in completer pharmacies. Key facilitators for completers included pharmacy owner/manager support, staff buy-in and involvement, intervention flexibility, recruitment immediately following training, integration of intervention with existing services, changes to workflow, and regular consumer contact. Key barriers for both groups included lack of pharmacy owner/manager support or staff buy-in, time constraints, privacy limitations and pilot project associated paperwork. Insights into factors that underpinned successful intervention implementation and delivery should inform effective strategies for similar future studies and allocation of pharmacy mental health service delivery resources.
Publisher: Wiley
Date: 22-06-2020
DOI: 10.1002/JPPR.1633
Publisher: SAGE Publications
Date: 03-01-2023
DOI: 10.1177/15910199221148551
Abstract: Flow erters (FDs) are neuroendovascular stents indicated for the management of unruptured intracranial aneurysms. Due to their composition, dual antiplatelet therapy (DAPT) is essential during the peri- and post-operative periods to prevent thromboembolic events. However, there is limited consensus within the scientific community regarding which antiplatelets to use and dosing following neuroendovascular treatment of aneurysms. A systematic search of four electronic databases was conducted during November 2020 that included studies published between January 2010 and November 2020. Eligibility for inclusion included primary research articles, published in the English language and use of flow- erting intracranial stents. Studies were excluded if they utilised combined therapies (e.g. FD with stent-assisted coiling), animal studies, clinical trial protocols and study population of less than 10 subjects. Eighteen studies were identified for inclusion with a total of 1312 patients with 1355 unruptured intracranial aneurysms treated with FDs. Of these, 13 studies primarily investigated the use of clopidogrel with aspirin with low rates of haemorrhagic and thromboembolic complications. A forest plot of nine of these studies showed average efficacy of 88% at 95% confidence interval (CI) (SD + 5%) with 63% heterogeneity. The large proportion of studies investigating clopidogrel and aspirin antiplatelet therapy presents a challenge in comparing antiplatelet regimens. Although prasugrel and ticagrelor have been identified as suitable alternatives to clopidogrel, these were based on studies with small cohort sizes. Glycoprotein IIb/IIIa inhibitors may be efficacious as rescue therapy for intra-procedural thrombosis. Further research is required to determine which antiplatelet is most suitable.
Publisher: Wiley
Date: 24-05-2012
DOI: 10.1111/J.1440-1584.2012.01269.X
Abstract: To identify the key issues reported by rural health-care providers in their provision of medication supply and related cognitive services, and in order to advise health workforce and role development and thus improve the quality use of medicines in rural communities. Exploratory semistructured interview research. A rural community comprising four towns in a rural health service district in Queensland, Australia. Forty-nine health-care providers (medical practitioners, pharmacists, nurses and others) with medication-related roles who serviced the study community, identified through databases and local contacts. Medication-related roles undertaken by the health-care providers, focusing on medication supply and cognitive services challenges in undertaking these roles. Medical and nursing providers reported challenges in ensuring continuity in supply of medications due to their existing medical workload demands. Local pharmacists were largely involved in medication supply, with limited capacity for extended cognitive roles. Participants identified a lack of support for their medication roles and the potential value of clinically focused pharmacists in medication management services. Medication supply may become more efficient with extended roles for certain health-care providers. The need for cognitive medication management services suggests potential for clinical pharmacists' role development in rural areas.
Publisher: Wiley
Date: 04-2020
DOI: 10.1002/JPPR.1634
Publisher: Ubiquity Press, Ltd.
Date: 12-08-2022
DOI: 10.5334/GH.1142
Publisher: JCFCorp SG PTE LTD
Date: 30-06-2019
Publisher: Springer Science and Business Media LLC
Date: 08-11-2016
Publisher: Springer Science and Business Media LLC
Date: 02-07-2014
Publisher: Elsevier BV
Date: 09-2012
DOI: 10.1016/J.SAPHARM.2011.11.001
Abstract: Rural settings challenge health care providers to provide optimal medication services in a manner that is timely and of high quality. Extending the roles of rural health care providers is often necessary to improve access to medication services however, there appears to be a lack of pharmacy-based involvement and support within the medication system. This article explores medication supply and management issues in rural settings, based on the governance perspectives of key informants on regulatory aspects, policy, and professional practice. The specific objectives were to (1) identify the key issues and existing facilitators and (2) explore the potential roles of pharmacy to improve medication supply and management services. Semi-structured interviews were conducted with representatives within regulatory or professional organizations. The participants were key informants who held leadership and/or managerial roles within their respective organizations and were recruited to provide insights from a governance perspective before data collection in the community. An interview guide, informed by the literature, assisted the flow of interviews, exploring topics, such as key issues, existing initiatives, and potential pharmacy-based facilitators, in relation to medication supply and management in rural settings. Issues identified that hindered the provision of optimal medication supply and management services in the rural areas centered on workforce, interprofessional communication, role structures, and funding opportunities. Legislative and electronic developments and support mechanisms aim to facilitate medication processes in rural areas. Potential initiatives to further enhance medication services and processes could explore extended roles for pharmacists and pharmacy support staff, as well as alternative service delivery models to enhance pharmacy workforce capacity. The study provided an overview of key issues with medication supply and management and highlighted the potential for increased pharmacy involvement to improve and support medication services in rural areas. The governance views of these key informants could be used to inform policy and practice related to rural medication services.
Publisher: Oxford University Press (OUP)
Date: 03-07-2013
DOI: 10.1111/IJPP.12051
Abstract: To explore pharmacy students' ethical behaviour and care towards patients in relation to the provision of emergency hormonal contraception (EHC). Three hundred and forty-seven pharmacy students were presented a hypothetical scenario involving refusal of EHC, based on religious or moral grounds, and asked to write responses as to how the patient should be managed 270 (77.8%) responded. Of all respondents, 90.4% referred the patient to another health professional to facilitate continuity of care, with referrals increasing as students progressed through the programme. Religion had no influence on referral, while female gender was related to increased referral. Gender difference, if continued into practice, has the potential to negatively impact on patient care.
Publisher: Oxford University Press (OUP)
Date: 18-05-2012
DOI: 10.1111/J.2042-7174.2012.00209.X
Abstract: To investigate community pharmacists' proposed actions in hypothetical medical emergency situations in South-East Queensland, Australia. A survey was posted to 151 Gold Coast and Toowoomba community pharmacies in October 2009. Pharmacists were asked to document their opinions regarding the pharmacist's role in medical emergencies and to respond to statements associated with two hypothetical medical emergency situations: an anaphylaxis and an asthma attack. Forty-five pharmacists responded to the survey (29.8%). In response to a hypothetical situation involving an asthma attack, 41 pharmacists (91.1%) agreed that they would assist the asthmatic person to administer salbutamol through a spacer, with 28 pharmacists (62.2%) confident in treating an asthma attack in the pharmacy. In comparison, only 21 pharmacists (21/38 55.3%) agreed to administer an adrenaline auto-injector (Epi-Pen) for a child experiencing an anaphylaxis, with nine respondents (9/38 23.7%) indicating that they would ask the mother for directions in a situation where they were unsure how to administer it. There were comments questioning whether indemnity insurance covers pharmacists for medicine administration, and 12 pharmacists (12/38 31.6%) indicated that if they were unsure about insurance cover they would ask the mother to administer the adrenaline. Pharmacists' responses to administering medications in hypothetical medical emergencies were variable. The cause of this variation is multi-factorial and likely to include familiarity with the medication, its safety profile and uncertainty about the pharmacist's role and responsibilities in these situations. Further clarification, training and guidelines are needed in order to address this.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/AH12190
Abstract: Objective. There are recognised health service inequities in rural communities, including the timely provision of medications, often due to shortages of qualified prescribers. The present paper explores the insights of rural healthcare providers into the prescribing and medication-initiation roles of health professionals for their rural community. Methods. Forty-nine healthcare providers (medical practitioners, pharmacists, nurses, occupational therapists, a dentist and an optometrist) from four neighbouring towns in a rural health service district in Queensland participated in face-to-face semistructured interviews. The interviews explored medication supply and management issues in the community, including the roles of health professionals to address these issues. The interviews, averaging 45 min in duration, were recorded, transcribed and qualitatively analysed for general trends and unique responses. Results. Participants recognised the potential for dentists, optometrists and nurse practitioners to reduce the prescribing workload of rural medical practitioners, and there was some support for a ‘continued dispensing’ model for pharmacists. Medication-initiation orders by endorsed registered nurses were also valued in providing timely medical treatment in rural hospitals. Conclusions. Rural communities have unique needs that require consideration of multidisciplinary support to assist medical practitioners in coping with prescription demands for timely medical treatment. What is known about the topic? Extension of prescribing rights to non-medical prescribers has been a topic of considerable debate in Australia for some decades. Several extended-prescribing or medication-initiation roles were established to supplement and support the medical workforce, particularly in rural areas, where health service inequalities and inefficiencies in prescribing and provision of medications are recognised. To date, workforce dynamics and legislative boundaries have restricted the eventual number of rurally located non-medical prescribers. What does this paper add? Little research has been conducted to investigate or evaluate the application of prescribing or medication-initiation roles in rural settings from a multidisciplinary approach. This paper provides the perspectives of rural healthcare providers on the prescribing and medication-initiation roles across health professions. Key findings from this rural-engagement exercise are considered valuable for policymakers and health service planners in optimisation of the prescribing or medication-initiation models. The qualitative methods also added richness and depth to the discussion about these roles. What are the implications for practitioners? According to the literature review and other media, extended prescribing roles are not universally accepted. However, some of the roles are being developed and implemented. Hence, it is important for health practitioners to embrace the roles and optimise their application. Specifically in rural settings, it is also important to recognise the value of multidisciplinary support and collaboration within the limited health workforce.
Publisher: Springer Science and Business Media LLC
Date: 13-05-2224
Publisher: Elsevier BV
Date: 07-2018
DOI: 10.1016/J.CPTL.2018.04.004
Abstract: To investigate the effectiveness of mentoring of pharmacy staff as they implemented a medication support service for mental health consumers. In particular, to show the relevance and applicability of Kram's four phases of mentoring to short-term mentoring relationships, the type of mentoring functions provided, and the value of utilising a pharmacist-consumer mentoring pair. 163 pharmacy staff (mentees) each participated in a one-day workshop prior to implementing the service and being mentored over a period of six months. Data were collected from mentees via pre- and post-training questionnaires, and from mentors in the form of diaries, field notes, and a focus group. Quantitative and qualitative analyses were employed. Kram's 4-phase model is relevant and applicable to short-term mentoring relationships. Mentoring functions increased after initiation, peaked during cultivation, and decreased during separation and redefinition. According to the mentors, both mentees and mentors benefitted from utilising a pair of mentors, each of whom had particular knowledge, experience, and perspectives to share. This study extends mentoring research by showing that Kram's four phases could be intentionally integrated into the planning and implementation of mentoring relationships moreover in short-term relationships. In addition, it has identified the particular mentoring functions that are sought and provided in different phases of relationships and that quantity of mentoring changes over the course of a relationship. Further, the study has found that mentees benefit from pairs of mentors (in this case a pharmacist and a consumer or carer) who provide different insights, knowledge and perspectives. In iduals and health-related organisations embarking on mentoring could use these findings as a guide to develop successful mentoring relationships, particularly when implementing a new service.
Publisher: MDPI AG
Date: 20-06-2019
Abstract: Background: Management of minor ailments through self-care and self-medication brings both benefits and risks that can be mitigated if consumers and pharmacy personnel engage in information exchange during over-the-counter (OTC) consultations. Objective: Explore the feasibility of interventions using situational cues to promote information exchange between pharmacy personnel and consumers, during OTC consultations. Methods: Intervention tools were developed prior to conducting the study, in two community pharmacies in Perth, Western Australia. The situational cues included two posters and in idual position badges. Data were collected from audio-recording OTC consultations, consumer questionnaires and interviews, and pharmacy personnel interviews. Results: Space required for posters and for researchers conducting interviews was challenging in the retail environment. Pharmacy personnel perceived that the badges positively impacted -consumers’ ability to identify the position of personnel they engaged with. Data collection methods were deemed practical and acceptable. Conclusions: The proposed interventions and evaluation methods were feasible. The use of posters and badges as situational cues to address the barriers to information exchange during OTC consultations was found to be practical, in a community pharmacy setting. There is potential to use situational cues to address other barriers identified to information exchange, to add to the effectiveness of the intervention. With growing emphasis on self-care and self-medication, effective interventions are necessary to promote information exchange to enhance appropriate management in community pharmacies.
Publisher: Bentham Science Publishers Ltd.
Date: 10-10-2018
DOI: 10.2174/1573399814666171215115239
Abstract: Studies on a structured method used by pharmacists to provide comprehensive, evidence-based diabetes care are lacking. The aim of this study was to prioritise, rank and construct validate indicators categorised as seven treatment factors utilised in the management of type 2 diabetes namely: Cholesterol, blood pressure and glycaemia control medication and lifestyle management cardiovascular risk management and patient education using the Delphi process. A Delphi questionnaire consisted of 29 Part 1 and nine Part 2 indicators which were incorporated into a tool called Simpler™. The indicators were mainly sourced from American, Australian and Malaysian diabetes management guidelines. Diabetes experts were asked to rank indicators in the order of importance in Part 1. In Part 2, indicators had to be chosen for inclusion into Simpler™ using a fivepoint Likert scale. The consensus level was pre-set at 60%. A three round Delphi process was used to validate all 38 indicators by 12 experts from Australia and Malaysia: five pharmacists, four doctors, two endocrinologists and a diabetes nurse. Consensus was reached for 93.1% (27/29) of the Part 1 indicators and all nine Part 2 indicators (100%). Five out of nine indicators in Part 2 questionnaire obtained consensus disagreement for inclusion into the Simpler ™ tool. The Simpler™ tool is the first structured diabetes multifactorial tool to address all seven evidence-based factors. The tool was refined and validated by multi-disciplinary health professionals from Australia and Malaysia. Pharmacists can use the Simpler™ tool to facilitate evidence-based comprehensive in idualised care among type 2 diabetes patients.
Publisher: Springer Science and Business Media LLC
Date: 22-12-2018
DOI: 10.1007/S11096-018-0774-X
Abstract: Background Practising pharmacists continuously develop their ethical reasoning skills, which evolve with practice experience and exposure to challenging scenarios. Considering the recent expansion of the roles of pharmacists and the paradigm shift in pharmacy practice, it is timely to explore community pharmacists' attitudes regarding the importance of ethics and their ethical reasoning. Objective To explore underlying factors influencing community pharmacists' and pharmacy students' ethical reasoning and attitudes towards pharmacy ethics, ethical reasoning processes and perceived current dilemmas. Setting Practising registered community pharmacists, pharmacists with provisional registration (interns) and final year pharmacy students in Australia. Method Two focus group discussions and two interviews were conducted with 16 Western Australian community pharmacists, interns and students. Participants were purposively selected for gender, background, practice setting, and practice experience. Main outcome measure Emerging themes embracing important influences on community pharmacists', interns' and students' ethical reasoning and perceived current ethical dilemmas and challenges. Results Two major themes embraced participants' ethical reasoning processes and conduct: (1) fundamental underpinning, from personal values and practice exposure, and (2) paradigm influenced, such as the changing healthcare landscape, expansion of roles, management of dilemmas, and competence. Increased frequency and complexity of ethical dilemmas related to role expansion. Rural pharmacists experienced unique ethical dilemmas in relation to practice isolation, privacy and confidentiality. Conclusion Changes in the community pharmacy practice environment has increasingly exposed pharmacists to more complex ethical dilemmas. Pharmacists practising in rural communities experience unique challenges. Structured and sound ethical reasoning skills are essential as pharmacists are faced with contemporary challenges.
Publisher: Elsevier BV
Date: 03-2022
DOI: 10.1016/J.SAPHARM.2021.03.014
Abstract: Antipsychotic polypharmacy ("polypharmacy") involves the concurrent prescribing of two or more antipsychotics for managing schizophrenia. It occurs frequently despite there being limited clinical evidence for this practice and an increased risk of adverse events. Little is understood about why it occurs outside of treatment guidelines, highlighting a current research gap. To explore the factors contributing to non-evidence based polypharmacy practice and possible strategies for addressing these factors. Three focus groups were conducted between June and August 2018 with doctors and nurses employed at a mental health unit of a Western Australian public hospital. Participants were asked about their perceptions of polypharmacy, why it occurred and what could limit its prevalence. Thematic inductive analysis was mapped to the Theoretical Domains Framework to identify key underlying themes and to establish potential enablers and barriers for practice change. Participants understood the risks of polypharmacy and perceived it to largely be perpetuated by external factors, out of which two key themes emerged: system-related issues (e.g.: communication failures whereby de-prescribing plans are not actioned) and patient-related issues (e.g.: misinformed views translating to medication-seeking behaviour). This led to the third theme: a disconnect between clinicians' knowledge and their practices (i.e.: being aware of Australian evidence-based guideline recommendations yet acknowledging polypharmacy still occurred due to the aforementioned issues). Strategies suggested to address these issues included developing medication management plans to bridge communication gaps and managing patients' medication expectations with education. Management of schizophrenia is complex, requiring consideration of many patient-related and systemic factors. Polypharmacy has a place in certain contexts, however, must be well considered and closely monitored to allow for early identification of opportunities to rationalise (i.e.: de-prescribe) therapy, where appropriate. Future research objectives will centre on implementing strategies identified from these focus groups to optimise patient outcomes.
Publisher: Springer Science and Business Media LLC
Date: 03-10-2022
DOI: 10.1186/S44201-022-00011-8
Abstract: The Cancer Urgent Assessment Clinic (CUAC) was an emergency department (ED) avoidance/unscheduled model of care implemented in response to the COVID-19 pandemic. The aim was to reduce the risk of COVID-19 exposure and infection by providing an alternative to ED for cancer patients while undergoing anticancer treatments. The clinic incorporated a telephone triage process and face-to-face appointments 8am to 8pm, 7 days per week. CUAC operated between 23 March '20 and 31 July '20, led by a nurse practitioner candidate, oncology registrars, cancer nurse specialists, and overseen by oncology consultants. Evaluation followed a mixed-methods approach through (1) analysis of CUAC patient data, (2) comparison of ED cancer patient presentation data from a previous period (23 March 2019–31 July 2019), and (3) a patient survey. In total, 400 patients were telephone triaged via CUAC, with 166 recorded as having avoided ED. There was a reduction in the number of cancer patient admissions to the ED short stay unit during the clinic period compared with the same time-period in 2019: 130 vs. 234, associated with 615 fewer hours. Patient satisfaction was positive particularly regarding ease of access, time to treatment, confidence in assessment and treatment of cancer-related concerns, and likelihood of presenting to hospital when unwell during the pandemic. While initially being implemented to reduce the risk of COVID-19 exposure, this evaluation demonstrated the CUAC model was an efficient and potentially cost-saving model of care for the management of cancer patients with mild to moderate severity of disease and treatment-related concerns.
Publisher: American Chemical Society (ACS)
Date: 22-11-2021
DOI: 10.1021/JACS.1C10927
Publisher: Wiley
Date: 12-2012
DOI: 10.1002/J.2055-2335.2012.TB00191.X
Abstract: An inpatient medication chart review at the Gold Coast Hospital identified shortcomings with the prescribing and monitoring of antiepileptic medications. To evaluate medication management of patients with epilepsy, seizure or convulsion to map their transition through the health system and to identify lifestyle behaviours that may lead to overt risks for seizure occurrence. A retrospective observational audit of adult patients (16 years and over) admitted to hospital with a diagnosis of epilepsy, seizure or convulsion from 1 to 31 January 2012. Majority of the 62 episodes of care investigated involved patients who were discharged directly from the ED (68%). Only 30% of all patients discharged from an inpatient unit received a discharge medication record from a pharmacist. Non‐adherence with antiepileptic medications, alcohol and/or recreational drug use and prescription medication misuse were identified as overt risks for seizure occurrence. Valuable insights were gained into the management of seizure patients. The role of the ED pharmacist was reviewed to focus on high‐risk seizure patients. An increase in the provision of discharge medication records and patient education on the overt risks for seizure occurrence is needed.
Publisher: Springer Science and Business Media LLC
Date: 12-10-2018
Publisher: Springer Science and Business Media LLC
Date: 10-08-2014
Publisher: MDPI AG
Date: 24-10-2018
Abstract: (1) Background: Community pharmacy personnel help mitigate risks of self-care by consumers who seek over-the-counter (OTC) medicines or treatment of symptoms and/or conditions. Exchange of information facilitates the OTC consultation, but pharmacy personnel often report difficulties in engaging consumers in a dialogue. The aim of this study was to describe the development of a behaviour change intervention to enhance information exchange between pharmacy personnel and consumers during OTC consultations in community pharmacies. (2) Methods: The Behaviour Change Wheel methodological framework was used to link factors that influence consumer engagement with information exchange during OTC consultations with intervention functions to change behaviour. Options generated were rationalized and the final intervention strategy was derived. (3) Results: Education, persuasion, environmental restructuring, and modelling were determined to be potential intervention functions. The intervention incorporated placing situational cues in the form of posters in the community pharmacy modelling information exchange behaviour, persuading through highlighting the benefits of exchanging information and educating about its importance. (4) Conclusions: A systematic, theoretically underpinned approach was applied to develop candidate interventions to promote information exchange in OTC consultations. The feasibility and efficacy of the intervention strategy has since been tested and will be reported elsewhere.
Publisher: MDPI AG
Date: 06-12-2017
Publisher: Elsevier BV
Date: 02-2021
Publisher: Public Library of Science (PLoS)
Date: 11-06-2020
Publisher: Springer Science and Business Media LLC
Date: 27-06-2022
Publisher: Oxford University Press (OUP)
Date: 18-09-2019
DOI: 10.1111/IJPP.12580
Abstract: To investigate how community pharmacists view their responsibility for patient care in a scenario involving opioid use with significant risk of toxicity or misadventure. A case scenario was developed based on an Australian coronial inquiry involving a patient suffering fatal toxicity following misuse of opioids. Community pharmacists working in Brisbane, Queensland, were invited to take part in face-to-face semi-structured interviews at their place of work. Participants were asked how they would respond to the scenario in practice and their perceived responsibilities. Twenty-one pharmacists were interviewed. Participants identified similar actions in response to the case, and potential barriers and enablers. Participants differed with regard to how they described their perceived scope of practice and degree of responsibility in response to the case. Most participants described their scope of practice in terms of medication management with a focus on patient outcomes. Some participants described a narrower scope of practice that focused on either medicine supply or legal aspects. Participants who described a medication management focus differed in their views regarding their responsibility for patient outcomes in the case. Pharmacists in this study varied in terms of their perceived scope of practice and responsibility to patient outcomes in response to a case involving a patient at risk of opioid-related harm. Further work on pharmacist responsibility may reduce this variability.
Publisher: Springer New York
Date: 19-11-2016
Publisher: Wiley
Date: 09-2007
DOI: 10.1002/J.2055-2335.2007.TB00737.X
Abstract: Pharmacy state and territory legislation provides for the regulation of the profession throughout Australia by the pharmacy registering authorities. The Council of Pharmacy Registering Authorities (COPRA) was formed to harmonise these regulatory requirements and facilitate communication among pharmacy registering authorities. COPRA was recently renamed the Australian Pharmacy Council. The Council of Australian Governments (COAG) has made recommendations that will impact on the regulation of all health professionals in Australia. To compare the regulatory requirements and identify regulatory consistencies and differences between jurisdictions. A qualitative approach encompassing a survey and interview was used. All 8 pharmacy registering authorities were approached to participate via an invitation through the Australian Pharmacy Council in September 2006. Pharmacy registering authorities operate under erse legislative frameworks and requirements. There are different definitions for disciplinary processes and the extent to which the registering authorities are able to sanction practitioners. The jurisdictions have different requirements for pharmacy premises registration, the inspection of premises and the required equipment and resources to practise. Differences in pre‐registration programs, the assessment of pre‐registration pharmacists and initial and ongoing registration specifications were also identified. The Australian Pharmacy Council and the pharmacy registering authorities have made significant progress towards the harmonisation of pharmacy regulation. However, the regulation of the profession throughout Australia remains varied. COAG needs to focus on early reforms such as a national pharmacy register before addressing the complex issues of consistency in disciplinary outcomes, pre‐registration programs and annual pharmacist registration requirements.
Publisher: BMJ
Date: 09-2016
Publisher: SAGE Publications
Date: 30-09-2015
Publisher: Wiley
Date: 2021
DOI: 10.1002/CTI2.1260
Publisher: Springer Science and Business Media LLC
Date: 06-01-2021
DOI: 10.1186/S12910-020-00570-7
Abstract: There is a need for clearer guidance for pharmacists regarding their responsibilities when selling complementary medicines. A recently published ethical framework provides guidance regarding the specific responsibilities that pharmacists need to meet in order to fulfil their professional obligations and make a positive contribution to health outcomes when selling complementary medicines. Evaluate the acceptability and feasibility of a new ethical framework for the sale of complementary medicines in community pharmacy. Australian community pharmacists were invited to participate in online focus groups and interviews. Participants were recruited via multiple methods, including social media and the professional networks of pharmacy groups. Participants were provided the ethical framework prior to the discussion. Discussions were transcribed verbatim and analysed using thematic analysis. Seventeen community pharmacists participated in the study (11 in 4 focus groups and 6 in in idual interviews). There was good representation among participants in terms of gender, years of practice, pharmacy location and script volume. Participants differed in how proactive they were in relation to selling and providing advice on complementary medicines, how they interpreted evidence in relation to complementary medicines, and how they navigated their practice within the retail environment of community pharmacy. The majority of participants found the framework was acceptable for practice and was feasible for implementation with targeted support. Participants identified two important areas for targeted support in implementing the framework: improved access to evidence-based information resources on complementary medicines and independent evidence-based education and training on complementary medicine for pharmacists and pharmacy support staff. The ethical framework addresses an important gap in providing specific professional guidance to pharmacists when selling complementary medicines. The results of the study suggest that the framework may be acceptable to community pharmacists and be feasible to implement with targeted support.
Publisher: Emerald
Date: 02-09-2014
DOI: 10.1108/JMHTEP-09-2013-0030
Abstract: – The purpose of this paper is to explore the potential approaches to continuing education and training delivery for community pharmacists to equip them to support mental health consumers and carers with illnesses such as depression and anxiety. – Review of national and international literature about community pharmacists’ roles, beliefs and attitudes towards mental health, continuing education delivery for the workforce and training recommendations to equip pharmacy workforce. – Training involving consumer educators was effective in reducing stigma and negative attitudes. Interactive and contextually relevant training appeared to be more effective than didactic strategies. Narratives and role-plays (from the perspective of consumers, carers and health professionals) are effective in promoting more positive attitudes and reduce stigma. Flexible on-line delivery methods with video footage of expert and consumer narratives were preferable for a cost-effective programme accessible to a wide community pharmacy workforce. – There is a clear need for mental health education for community pharmacists and support staff in Australia. Training should target reducing stigma and negative attitudes, improving knowledge and building confidence and skills to improve pharmacy staff's perceived value of working with mental health consumers. The delivery mode should maximise uptake.
Publisher: Oxford University Press (OUP)
Date: 24-03-2021
DOI: 10.1093/IJPP/RIAA010
Abstract: Consensus is lacking regarding delivery of public health services in community pharmacy. The objective of this study was to explore pharmacists’ perspectives on public health initiatives in community practice. Australian community pharmacists were randomly s led to participate in face-to-face, semi-structured interviews to explore public health definitions and perceptions. Nine pharmacists participated early 2020, pre-COVID-19. Mean interview duration was 23 min. Results revealed little distinction between in idual and public health services. Barriers to service provision were lack of time, remuneration, training, standards and privacy. Enablers opposed barriers, namely accessibility, improved funding, education, standardised services and consulting rooms. Improved clarity is required regarding the role that community pharmacists can assume in provision of public health.
Publisher: Springer Science and Business Media LLC
Date: 06-2022
DOI: 10.1186/S12913-022-08119-7
Abstract: Active engagement in research by healthcare organisations and clinicians is associated with improvements in healthcare performance. Barriers to research engagement by clinician allied health (AH) professionals include competing priorities from high clinical workloads, lack of research skills and confidence, and lack of supportive research relationships. Collaboration with universities on joint clinical research projects is well recognised as a means of building health service research capacity. Research projects undertaken by students as part of their qualifying degree represent one such opportunity. However, there are few reports evaluating these collaborations from the health service perspective. A qualitative study using semi-structured interviews and thematic analysis to explore the experiences of AH professionals in the co-supervision of students completing research placements as part of their professional degree course. Fourteen health service employees from six allied health disciplines described collaborations on research projects with 24 students from four different universities. Student placements and projects varied widely in length of placement, extent of collaboration, supervision structure and study design. Three overarching themes were identified in the AH professional co-supervision experience: 1) Professional growth 2) Mismatch with expectations and 3) Focus on the student. Project outcomes were categorised from the health system perspective. These were 1) Healthcare performance improvements, including local increases in staff clinical practice knowledge and wider contributions to the evidence base 2) Research capacity gains within the health service, including research knowledge and skill development, collaborative linkages and opportunity for future research and 3) Staff-centred outcomes including increased job satisfaction. This study demonstrates the potential for AH professional supervision of students on research placements to contribute to healthcare performance improvements and research capacity gains within health services, alongside providing personal benefits for the AH professionals involved. Early consultation with a health service-employed research specialist may support health professional and student learning, team collaboration and project coordination for these student projects.
No related grants have been discovered for Laetitia Hattingh.