ORCID Profile
0000-0003-0040-4753
Current Organisations
PainChek Ltd
,
Curtin University
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Publisher: Springer Science and Business Media LLC
Date: 05-02-2010
Abstract: The majority of patients using antihypertensive medications fail to achieve their recommended target blood pressure. Poor daily adherence with medication regimens and a lack of persistence with medication use are two of the major reasons for failure to reach target blood pressure. There is no single intervention to improve adherence with antihypertensives that is consistently effective. Community pharmacists are in an ideal position to promote adherence to chronic medications. This study aims to test a specific intervention package that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications - Hypertension Adherence Program in Pharmacy (HAPPY). The HAPPY trial is a multi-centre prospective randomised controlled trial. Fifty-six pharmacies have been recruited from three Australian states. To identify potential patients, a software application (MedeMine CVD) extracted data from a community pharmacy dispensing software system (FRED Dispense ® ). The pharmacies have been randomised to either 'Pharmacist Care Group' (PCG) or 'Usual Care Group' (UCG). To check for 'Hawthorne effect' in the UCG, a third group of patients 'Hidden Control Group' (HCG) will be identified in the UCG pharmacies, which will be made known to the pharmacists at the end of six months. Each study group requires 182 patients. Data will be collected at baseline, three and six months in the PCG and at baseline and six months in the UCG. Changes in patient adherence and persistence at the end of six months will be measured using the self-reported Morisky score, the Tool for Adherence Behaviour Screening and medication refill data. To our knowledge, this is the first research testing a comprehensive package of evidence-based interventions that could be integrated into the community pharmacy workflow to enable pharmacists to improve patient adherence and/or persistence with antihypertensive medications. The unique features of the HAPPY trial include the use of MedeMine CVD to identify patients who could potentially benefit from the service, control for the 'Hawthorne effect' in the UCG and the offer of the intervention package at the end of six months to patients in the UCG, a strategy that is expected to improve retention. Australian New Zealand Clinical Trial Registry ACTRN12609000705280
Publisher: Public Library of Science (PLoS)
Date: 07-04-2014
Publisher: Informa UK Limited
Date: 07-2018
DOI: 10.2147/CIA.S168024
Publisher: Springer Singapore
Date: 2019
Publisher: Springer Science and Business Media LLC
Date: 03-04-2013
DOI: 10.1007/S11096-013-9766-Z
Abstract: Community pharmacies and hospitals are the two main professional areas for pharmacists. There is currently a lack of comparison of pharmacists working in these two distinct settings in relation to an expanded prescribing role. To compare the attitudes of hospital and community pharmacists regarding an expanded prescribing role. Australian pharmacists. A self-administered postal survey was used to collect the data. Data analysis was performed using SPSS(®) v19. Kendall's tau-c test was used to compare the mean values between categorical variables (i.e. hospital or community pharmacists) and continuous variables measuring attitudes on a Likert scale (i.e. reasons in favour and barriers of pharmacist prescribing, preferred therapeutic areas of prescribing and prescribing models). A Chi square test was used to analyse categorical variables (i.e. demographics). The opinion of hospital and community pharmacists regarding an expanded prescribing role. A response rate of 40.4% was achieved (1,049/2,592). Where significant differences were located, community pharmacists were more supportive of all proffered potential reasons in favour of pharmacist prescribing (p < 0.05) whereas hospital pharmacists were more in agreement with all suggested barriers to such a role (p < 0.05). In a supplementary (collaborative) prescribing model, hospital pharmacists were more confident than community pharmacists in prescribing for heart failure (p < 0.001) and anticoagulant therapies (p = 0.004). In an independent prescribing model hospital pharmacists were more supportive of prescribing anticoagulant therapies (p = 0.002). Significant differences were found between the two groups in relation to their support for independent prescribing (p = 0.020) and extension of the emergency supply 3 days rule to 30 days (p = 0.011). This study suggests that there are differences between hospital and community pharmacists in what they regard as potential reasons in favour of an expanded pharmacist prescribing role, perceived barriers to such a role and whether to prescribe independently of doctors. Hospital pharmacists' attitudinal differences in terms of support for certain therapeutic areas of prescribing reflects probably their existing active role in clinical decision making processes in patients who are often seriously ill.
Publisher: Japanese Pharmacological Society
Date: 2010
DOI: 10.1254/JPHS.10109FP
Abstract: This study was conducted to determine the rate of P-glycoprotein (P-gp)-mediated efflux of digoxin analogues and metabolites and to assess the effects of macrolide antibiotics on this efflux. Bidirectional transport studies were conducted using our Caco-2 sub clone with high P-gp expression (CLEFF9). HPLC methods were employed to measure drug transport. All digoxin metabolites were P-gp substrates, although digoxin had the greatest efflux ratio. Erythromycin had no effect on the transport of digoxin, maintaining a basolateral to apical efflux ratio of 14.8, although it did reduce the efflux ratio of dihydrodigoxin and digoxigenin by 34% and 43%, respectively. Azithromycin also had little effect on the transport of digoxin or any of its metabolites. In contrast, clarithromycin and roxithromycin almost eliminated basolateral targeted efflux. Using paclitaxel as a known P-gp substrate, erythromycin demonstrated only partial P-gp inhibitory capacity, maintaining an efflux ratio over 100. In contrast, clarithromycin and roxithromycin were 10-fold greater P-gp inhibitors. Clarithromycin and roxithromycin are likely to exhibit drug interactions with digoxin via inhibition of efflux mechanisms. Azithromycin appears to have little influence on P-gp-mediated digoxin absorption or excretion and would be the safest macrolide to use concurrently with oral digoxin.
Publisher: Public Library of Science (PLoS)
Date: 21-06-2013
Publisher: Informa UK Limited
Date: 06-2014
DOI: 10.2147/TCRM.S61687
Publisher: Hindawi Limited
Date: 19-06-2014
DOI: 10.1111/JCPT.12185
Abstract: About half of all patients taking antihypertensives discontinue treatment by 12 months. There is potential for substantial health gains at both in idual and population levels through improved treatment adherence. The objective was to evaluate a community pharmacist intervention to improve adherence with antihypertensive medicines with a view to improving blood pressure (BP) control. prospective, non-blinded, cluster-randomized, controlled trial. adults with primary hypertension who obtained antihypertensives in the previous 6 months. Patients with poor refill adherence were preferentially identified with the help of a purpose-built software application. package comprising BP monitor training on BP self-monitoring motivational interviewing medication use review prescription refill reminders. six months. change in proportion self-reporting medication adherence. Secondary outcome: BP changes. Participants (n = 395 intervention - 207 control - 188) had a mean age of 66.7 years 51.1% were males. The proportion of adherent participants increased in both groups but was not significantly different between groups [57·2% to 63·6% (control) vs. 60·0% to 73·5% (intervention), P = 0·23]. The mean reduction in systolic BP was significantly greater in the intervention group (10·0 mmHg vs. 4·6 mmHg P = 0·05). The proportion of patients who were non-adherent at baseline and adherent at 6 months was 22·6% (95%CI 5·1-40·0%) higher in the intervention group (61·8% vs. 39·2%, P = 0·007). Among participants with baseline BP above target, reduction of systolic BP was significantly greater in the intervention group [by 7·2 mmHg (95%CI 1·6-12·8 mmHg) (P = 0·01)]. Among participants non-adherent at baseline and above target BP, the proportion reporting adherence at 6 months was significantly greater in the intervention group [56·8% vs. 35·9%, P = 0·039). This community pharmacist intervention resulted in improved adherence to antihypertensive medication and reduced systolic BP.
Publisher: IEEE
Date: 2013
Publisher: Springer Science and Business Media LLC
Date: 07-06-2012
Publisher: Springer Science and Business Media LLC
Date: 19-04-2022
DOI: 10.1007/S11096-022-01409-4
Abstract: Integration of clinical pharmacists into multidisciplinary Mental Health Hospital-in-the-Home teams is increasing but little is known about the medication safety contribution these pharmacists make. To evaluate whether clinical pharmacist involvement in a Mental Health Hospital-in-the-Home service improved medication safety key performance indicators. Medical records were retrospectively reviewed of all patients admitted to 2 Western Australian Mental Health Hospital-in-the-Home services from September to November 2015. was a 16-bed service incorporating a clinical pharmacist as part of its multidisciplinary team. was a similarly structured 18-bed service but without clinical pharmacist involvement. The primary outcome measure was completion of medication safety key performance indicators obtained from the Western Australian Government Pharmaceutical Review Policy and mental health-specific best practice guidelines. Key performance indicators from Site 1 (n = 75 records), which incorporated a clinical pharmacist, demonstrated significantly ( p 0.001) higher rates of completion of medication reconciliation [65 (87%) versus 17 (29%)], accurate adverse drug reaction list [73 (97%) versus 34 (58%)], accurate discharge medication list [51 (74%) versus 18 (45%)], accurate medication profile [74 (99%) versus 40 (68%)] and medication chart review [74 (99%) versus 0 (0%)] than Site 2 (n = 59). Integrating a clinical pharmacist into a Mental Health Hospital-in-the-Home program significantly improved achievement of medication safety key performance indicators.
Publisher: JMIR Publications Inc.
Date: 29-12-2015
DOI: 10.2196/JMIR.4345
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.PEC.2011.04.037
Abstract: Changes in health care provision have led to an emphasis on providing end of life care within the home. community pharmacists are well positioned to provide services to community-based palliative care patients and carers. A multiple qualitative case study design was adopted. A total of 16 focus groups and 19 interviews with pharmacists, nurses, general practitioners and carers were undertaken across metropolitan and regional settings in Western Australia, New South Wales, Queensland and Victoria. Data were analysed thematically using a framework that allowed similarities and differences across stakeholder groups and locations to be examined and compared. Three main themes emerged: effective communication challenges to effective communication and: towards best practice, which comprised two themes: community pharmacists' skills and community pharmacists' needs. A key component of the provision of palliative care was having effective communication skills. Although community pharmacists saw an opportunity to provide interpersonal support, they suggested that they would need to develop more effective communication skills to fulfil this role. There is clear need for continuing professional development in this area - particularly in communicating effectively and managing strong emotions. Community pharmacists are willing to support palliative care patients and carers but need education, support and resources.
Publisher: Wiley
Date: 12-02-2007
Publisher: Informa UK Limited
Date: 06-2018
DOI: 10.2147/JPR.S158793
Publisher: AMPCo
Date: 05-2012
DOI: 10.5694/MJA12.10484
Publisher: SAGE Publications
Date: 30-04-2013
DOI: 10.1345/APH.1R556
Abstract: Proton pump inhibitors (PPIs) are a class of medications indicated for the treatment of gastric acid–related diseases. Hypomagnesemia is a rare but serious adverse effect of PPIs. To address the association between the use of different PPIs and hypomagnesemia by examining the frequency of occurrence of hypomagnesemia among the reported adverse drug reactions from the Food and Drug Administration (FDA) Adverse Event Reporting System database. We conducted a cross-sectional study of PPI-associated adverse effect cases reported to the FDA between November 1, 1997, and April 1, 2012. Logistic regression was used to examine the association of sex, age, and different PPIs with hypomagnesemia. χ 2 Analysis was conducted to investigate the association of PPI-associated hypomagnesemia with hypocalcemia and hypokalemia. Among 66,102 subjects identified as experiencing 1 or more adverse effects while taking a PPI, 1.0% (n = 693) were reported to have hypomagnesemia. The mean (SD) age of PPI users presenting with hypomagnesemia was 64.4 (12.9) years. Results from logistic regression indicated that, compared with esomeprazole, all other PPIs had a higher rate of hypomagnesemia, with pantoprazole having the highest rate (OR 4.3 95% CI 3.3–5.7 p 0.001). The risk of female subjects having hypomagnesemia (OR 0.83 95% CI 0.71–0.97 p = 0.016) was significantly lower than that of males. Elderly subjects (age years) were at increased risk of PPI-associated hypomagnesemia (OR 1.5 95% CI 1.2–1.7 p 0.001). χ 2 Analysis showed strong association between hypomagnesemia and both hypocalcemia (p 0.001) and hypokalemia (p 0.001). All PPIs were associated with hypomagnesemia, with esomeprazole having the lowest risk and pantoprazole having the highest risk. The risk of PPI-associated hypomagnesemia was higher in males and the elderly population. Hypocalcemia and hypokalemia commonly coexisted with PPI-associated hypomagnesemia.
Publisher: Springer Science and Business Media LLC
Date: 04-08-2010
DOI: 10.1007/S11096-010-9400-2
Abstract: To evaluate the views of Australian pharmacists on expanded pharmacist prescribing roles and identify important drivers and barriers to its implementation. Setting Pharmacists in Australia. Data were collected using a self-administered questionnaire distributed nationally to a random s le of pharmacists either directly, or in the case of one state, via community pharmacies. One-way ANOVA and ϰ(2) testing were used to identify significant associations. Factor analysis was conducted to pool variables and the derived factors were subjected to regression analysis. Perceptions of Australian pharmacists on expanded prescribing and the relationships between variables derived. A total of 2592 questionnaires were distributed and a response rate of 40.4% was achieved (n = 1049). Of the respondents 83.9% strongly agreed/agreed to an expanded prescribing role for pharmacists and 97.1% reported they would need further training. Of the respondents 896 agreed that pharmacists should engage in supplementary, independent prescribing or both. Of these 69.1% preferred only supplementary prescribing, 3.3% independent prescribing and 27.4% both models. Both models were found to be positive predictors of expanding pharmaceutical services through prescribing (P < 0.001) with supplementary prescribing showing a stronger association (β = 0.52 vs. β = 0.18). Pharmacists' opinion based on their current perceptions of their clients was an important predictor in expanding pharmaceutical services through prescribing (P = 0.005). Inadequate training in patient assessment, diagnosis and monitoring were the strongest barriers to expanded pharmacist prescribing (P < 0.001). The majority of Australian pharmacists supported an expanded pharmacist prescribing role. Support for supplementary was stronger than independent prescribing. Pharmacists acknowledged that they would need further training to perform such roles.
Publisher: JCFCorp SG PTE LTD
Date: 26-05-2021
DOI: 10.18549/PHARMPRACT.2021.2.2295
Abstract: Background: Managing minor ailments in community pharmacy is an evolving pharmacy service in developing countries. Defined scopes of practice for pharmacy staff are essential for the safe management of minor ailments. Limited research exists regarding the perceptions of Indonesian pharmacists’ and pharmacy technicians’ scopes of practice in providing minor ailments management services. Objective: To evaluate pharmacists’ and pharmacy technicians’ understanding of their scopes of practice, perceived competency and factors influencing the delivery of minor ailments services in Indonesian community pharmacies. Methods: Cross-sectional surveys were conducted during January-February 2020 of pharmacists and pharmacy technicians attending seminars conducted by relevant Indonesian Associations in Central Java, Indonesia. Percentage of common responses (PCR) described similarity of perceived scopes of practice for pharmacists and pharmacy technicians. Univariate and multivariate analyses identified associations of scopes of practice with pharmacy characteristics. Results: A total of 185 pharmacists and 142 pharmacy technicians participated. Pharmacy technicians performed minor ailment consultations, however, if considered beyond their scope of practice, they referred the patient to the pharmacist (T=120/142, 84.5%). Vaginal thrush, bacterial conjunctivitis, gastro-oesophageal reflux disease, and acute pain were minor ailments perceived only within a pharmacist’s scope (PCR above 60%). Of 34 minor ailments, 11 showed PCR values between 40-60% overlapping pharmacists and pharmacy technicians perceived scopes of practice (allergy/rash, back pain, cold sores, dermatitis, diarrhoea, eczema, hayfever, haemorrhoids, rheumatism, sore throat, and superficial wounds). Back pain, cold sores, dermatitis, and sore throat associated pharmacists’ scope of practice with years of practice experience (p-value .05). Pharmacy technicians perceived their scopes of practice to be wider than perceived by pharmacists. Conclusions: Discordance between pharmacists’ and pharmacy technicians’ perceived scopes of minor ailments management highlights the need for clearly defined scopes of practice for each professional group. Each professional group must practise within their competence to ensure safe pharmacy practices.
Publisher: OMICS Publishing Group
Date: 05-2011
DOI: 10.4066/AMJ.2011.694
Publisher: Elsevier BV
Date: 03-2012
DOI: 10.1016/J.DIABRES.2011.11.004
Abstract: To explore how clinical and demographic variables impact on the management of diabetes mellitus in general practice. A structured vignette survey was conducted in Australia. This included nine vignettes chosen at random from 128 developed around seven clinical variables. Respondents were asked to recommend a change in treatment and make specific recommendations. A random s le of general practitioners (GPs) were recruited. Two diabetologists involved in the development of national guidelines also participated. 125 (13.8%) GPs participated. Statistical analyses were used to generate outcome measures. GPs recommended a change in treatment for most (81.1%) cases were less likely to prescribe a statin (68.5% GPs vs. 76.3% diabetologists), less likely to treat hypertension (66.7% vs.89%) and less likely to refer for lifestyle modification (82.3% vs. 96.5%). Significant disagreement occurred around prescribing or changing oral hypoglycaemics. No GP characteristics showed significant impact. The proportion of GPs who agreed with diabetiologists on dose and choice of drugs was 35.7% for statins, 49.6% for antihypertensives and 39.6% for oral hypoglycaemics. There were significant differences between diabetologists and GPs on the management of diabetes. The survey suggests significant under-dosing by GPs. These findings warrant further investigation.
Publisher: SAGE Publications
Date: 28-02-2014
Publisher: Wiley
Date: 06-05-2008
Publisher: Springer International Publishing
Date: 2022
Publisher: Wiley
Date: 05-04-2019
Abstract: To quantify the impact of cognitive impairment on pain assessment and management practices in the ED. A retrospective, cross-sectional study of patient records was conducted for all elderly patients (65 years or older) who presented to the ED of a large Western Australian tertiary hospital with a fracture because of a fall between 6 February and 14 December 2015. Of 327 records identified, 318 were suitable for data extraction. Of these, 120 patients had a cognitive impairment. Primary outcome measures were the method and frequency of pain assessment, and the delay to the administration of a pain intervention after pain was first assessed for patients with and without a cognitive impairment. Patients with a cognitive impairment were less likely to have their pain assessed with a standardised pain assessment tool (55% vs 91.4%, P < 0.001), and 9.4 times more likely to have their pain assessed using ad hoc assessments only (95% confidence interval 4.6-19.1). The median time between ED presentation and a patient's first pain assessment was longer for patients with cognitive impairment (28 vs 17 min P < 0.001), as was the time between repeat assessments (81 vs 62 min P < 0.004). The median times to receive a pain intervention following pain assessment were 51 and 50 min for cognitively intact and impaired patients, respectively (P = 0.209, after adjustment for the first pain score). Pain is inadequately and inappropriately assessed for elderly patients with a cognitive impairment in the ED, resulting in delays in initiation of pain management.
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.PEC.2011.04.027
Abstract: To evaluate the capacity and effectiveness of trained community pharmacists in delivering the Diabetes Medication Assistance Service (DMAS) via (1) number and types of self-management support interventions (SMSIs) (2) number of goals set and attained by patients and (3) patient outcomes (glycaemic control, medication adherence and satisfaction). Pharmacists (n=109) from 90 community pharmacies in Australia were trained and credentialed to deliver the DMAS. The training focused on developing pharmacists' knowledge and skills in supporting patients' diabetes self-management. A total of 387 patients completed the trial. The mean number of SMSIs per patient was 35 (SD ±31) and the majority (87%) had at least one documented goal that was fully or partially attained. There were significant health benefits for patients including improved glycaemic control and a reduced risk of non-adherence to medications. Over 90% of DMAS patients reported improvements in their knowledge about diabetes self-management. The DMAS provides self management support in the community pharmacy for people with T2DM which may result in improved clinical outcomes. Given appropriate training in diabetes care and behavior change strategies, community pharmacists can offer programs which provide self-management support to their patients with T2DM and improve their health outcomes.
Publisher: Informa UK Limited
Date: 08-2014
DOI: 10.2147/PPA.S66719
Publisher: JMIR Publications Inc.
Date: 14-06-2017
DOI: 10.2196/JMIR.7489
Publisher: Oxford University Press (OUP)
Date: 10-01-2014
DOI: 10.1111/IJPP.12014
Abstract: To explore pharmacists’ perceived needs on training required to undertake an expanded prescribing role taking account of their years of registration, current professional practice area and preferred prescribing model. A piloted self-administered questionnaire was distributed nationally to a random s le of pharmacists. Data were analysed using SPSS version18 software where data cross-tabulations, chi-squared and one-way analyses of variance were performed. A response rate of 40.4% (1049/2592) was achieved. Pathophysiology of conditions, principles of diagnosis, and patient assessment and monitoring were the most preferred training topics. There was no difference (P = 0.620) in pharmacists’ perceived needs for additional training with respect to the model of prescribing (i.e. supplementary or independent or both) and years of registration as pharmacists (P = 0.284). However, consultant pharmacists were less supportive of the need for additional training (P = 0.013). Pharmacists’ years of registration and professional practice influenced their training topic preferences. Supporters of an independent prescribing model only demonstrated a weaker preference for training in key therapeutic topics (P = 0.001). This study provides information on key areas for consideration when training pharmacists for an expanded prescribing role. Although most pharmacists preferred a supplementary model of prescribing where doctors retain their diagnostic role, their strongest training preferences were for topics that provided pharmacists with further skills in patient diagnosis, assessment and monitoring.
Publisher: JMIR Publications Inc.
Date: 13-02-2023
DOI: 10.2196/41992
Abstract: Infants are unable to self-report their pain, which, therefore, often goes underrecognized and undertreated. Adequate assessment of pain, including procedural pain, which has short- and long-term consequences, is critical for its management. The introduction of mobile health–based (mHealth) pain assessment tools could address current challenges and is an area requiring further research. The purpose of this study is to evaluate the accuracy and feasibility aspects of PainChek Infant and, therefore, assess its applicability in the intended setting. By observing infants just before, during, and after immunization, we evaluated the accuracy and precision at different cutoff scores of PainChek Infant, which is a point-of-care mHealth–based solution that uses artificial intelligence to detect pain and intensity based solely on facial expression. We used receiver operator characteristic analysis to assess interpretability and establish a cutoff score. Clinician comprehensibility was evaluated using a standardized questionnaire. Other feasibility aspects were evaluated based on comparison with currently available observational pain assessment tools for use in infants with procedural pain. Both PainChek Infant Standard and Adaptive modes demonstrated high accuracy (area under the curve 0.964 and 0.966, respectively). At a cutoff score of ≥2, accuracy and precision were 0.908 and 0.912 for Standard and 0.912 and 0.897 for Adaptive modes, respectively. Currently available data allowed evaluation of 16 of the 17 feasibility aspects, with only the cost of the outcome measurement instrument unable to be evaluated since it is yet to be determined. PainChek Infant performed well across feasibility aspects, including interpretability (cutoff score defined), ease of administration, completion time (3 seconds), and clinician comprehensibility. This work provides information on the feasibility of using PainChek Infant in clinical practice for procedural pain assessment and monitoring, and demonstrates the accuracy and precision of the tool at the defined cutoff score.
Publisher: Wiley
Date: 13-07-2012
DOI: 10.1111/J.1751-2980.2012.00606.X
Abstract: The aim of this study was to determine whether the presence of Helicobacter pylori (H. pylori) infection and multidrug resistance protein 1 (MDR1) C3435T polymorphism had an influence on P-glycoprotein (P-gp) expression in the upper gastrointestinal tract. A total of 76 patients who underwent upper gastroendoscopy at Sir Charles Gairdner Hospital in Western Australia from October 2010 to July 2011 were enrolled in the study. Antral and duodenal biopsies were collected for P-gp examination. Blood s les were taken and analyzed for MDR1 C3435T polymorphism. H. pylori infection status was confirmed by culture and polymerase chain reaction. A significant difference was found in P-gp expression between H. pylori-positive and H. pylori-negative patients (P = 0.028). For the MDR1 C3435T polymorphism, the TT genotype had a significantly lower P-gp expression compared with the CC genotype in antral specimens (P = 0.041). The homozygous TT genotype with H. pylori infection was also significantly different in P-gp expression compared with H. pylori-negative patients (P = 0.029). P-gp expression in the upper gastrointestinal tract is associated with H. pylori infection, and the TT genotype appeared to be associated with lower P-gp expression than the CC genotype in the stomach.
Publisher: Oxford University Press (OUP)
Date: 14-01-2011
DOI: 10.1111/J.2042-7174.2010.00077.X
Abstract: To examine the views of regular pharmacy clients on pharmacist prescribing and employ agency theory in considering the relationship between the stakeholders involved. Computer assisted telephone interviews were conducted with 400 pharmacy clients recruited around Australia. Potential respondents were identified using a random number generation function in Microsoft Excel. Data were analysed with SPSS version 17 using one-way analysis of variance, principal component analysis and linear regression. The relationships between the main stakeholders involved were explored using agency theory. A total of 1153 answered calls recruited 400 consenting pharmacy clients. Most respondents (71%) trusted pharmacists adopting an expanded role in prescribing, however the majority (66%) supported this only after a diagnosis had been made by a doctor. Those who accepted pharmacist diagnosing and prescribing preferred that this was limited to pain management and antibiotics. Most respondents (64%) considered that expanded pharmacist prescribing would improve their access to prescription medicines, although those over 65 years of age were less supportive than younger respondents. Factors which contributed positively to clients' perception of trust in an expanded prescribing role for pharmacists were identified, and improved access to medicines was found to be the strongest predictor (P & 0.0001). Most pharmacy clients trusted pharmacists adopting an expanded prescribing role, but preferred that this was limited to doctors performing the initial diagnosis. Agency theory would conceptualize the introduction of pharmacist prescribers, as disrupting the principal (patient) agent (doctor) relationship. Its introduction would best be facilitated by careful change management.
Publisher: Informa UK Limited
Date: 18-11-2014
DOI: 10.3109/13561820.2013.852523
Abstract: There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR.
Publisher: SAGE Publications
Date: 30-08-2201
DOI: 10.1345/APH.1Q138
Publisher: MDPI AG
Date: 22-08-2023
Abstract: Community pharmacy staff assist in the management of minor ailments. Agency Theory underpins relationships between health professionals and patients. This study explores pharmacists’ and pharmacy technicians’ perceived scopes of practice of minor ailment services in community pharmacies. Twelve one-on-one semi-structured interviews used an open-ended interview guide for each cohort of community pharmacists and pharmacy technicians, between June and July 2021. Purposive s ling selected a ersity of pharmacists and pharmacy technicians. Interviews were transcribed verbatim, thematically analysed assisted by NVivo version 20. Agency Theory aided the interpretation. Three main themes emerged: (1) inconsistencies in practice, (2) the lack of understanding of the scopes of practice of pharmacists and pharmacy technicians, and (3) provision of prescription-only medicines for some minor ailments or to fulfil patient requests. Several sub-themes included pharmacy staff involvement, education and training, provision of prescription-only medicines, and weak regulatory enforcement. Agency Theory indicated pharmacy patients (principals) delegated authority to pharmacists and pharmacy technicians (agents), which was confused by partial pharmacist absence. The lack of defined scopes of practice for pharmacists and pharmacy technicians disrupted established professional relationships. The scopes of practice and roles of the pharmacist and pharmacy technicians should be clearly defined, assisted by practice guidelines.
Publisher: Dustri-Verlgag Dr. Karl Feistle
Date: 09-2012
DOI: 10.5414/CP201720
No related grants have been discovered for Jeffery David Hughes.