ORCID Profile
0000-0002-3230-889X
Current Organisation
James Cook University
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Publisher: Oxford University Press (OUP)
Date: 15-11-2021
DOI: 10.1093/IJPP/RIAB072
Abstract: To synthesise stakeholder (consumer, pharmacist and health professional) perspectives of expanded pharmacy practice in rural and remote community pharmacy. Comparison of perspectives of stakeholder groups identified by four studies has highlighted the expected outcomes and anticipated barriers to expanded pharmacy practice. Aligning the studies has identified priority areas of health for which pharmacists may be able to provide expanded service delivery. Expanded pharmacy services are supported by consumers, pharmacists and health professionals and are expected to improve health outcomes for rural and remote populations. Barriers will need to be overcome for expanded services to be sustainable in the future. The pharmacy profession will need to undertake a paradigm shift to professional practice and work towards this should begin to reduce the health inequality for rural populations.
Publisher: Therapeutic Guidelines Limited
Date: 03-12-2018
Publisher: Wiley
Date: 06-2021
DOI: 10.1111/AJR.12739
Abstract: To explore pharmacist and stakeholder perspectives of pharmacists providing expanded services in rural community pharmacies. A descriptive qualitative study with an ethnographic lens of rural culture collected data via in‐depth semi‐structured interviews with stakeholder representatives and rural and remote pharmacists. Regional, rural and remote practice settings as defined by the Modified Monash Model MM3‐MM7. Twelve rural or remote pharmacists and eight stakeholder representatives from various government and professional organisations participated in the study. Macro‐, meso‐ and micro‐level perspectives of pharmacists providing expanded pharmacy services in rural community pharmacies. At the macro‐level, both pharmacists and stakeholders agreed that governance is needed to clarify the terms used to describe expanded practice as a first step to developing an expanded practice framework. The meso‐level revealed that pharmacist participants expected expanded practice to improve rural pharmacist recruitment and retention through improved professional satisfaction. The importance of effective collaboration and coordination with other health care providers in a community was described by pharmacists and stakeholders to ensure success of expanded services. All participants agreed that sustainability of these services relied on appropriate remuneration. At the micro‐level, expanded pharmacy services are expected to save consumers’ time and money as patients are redirected into appropriate health care settings. Enablers and barriers across policy, health professional, consumer and community levels need to be addressed in order to design and develop sustainable expanded pharmacy services to improve health service provision in rural and remote communities.
Publisher: Springer Science and Business Media LLC
Date: 14-06-2021
DOI: 10.1186/S40814-021-00856-6
Abstract: Ear disease is a major cause of preventable hearing loss and is very common in rural communities, estimated to affect 1.3 million Australians. Rural community pharmacists are well placed to provide improved ear health care to people who are unable to easily access a general practitioner (GP). The purpose of this study is to apply an ear health intervention to the rural community-pharmacy setting in Queensland, Australia, to improve the management of ear disease. The aims are the following: (1) to evaluate the feasibility, potential effectiveness and acceptability of a community pharmacy-based intervention for ear health, (2) to evaluate the use of otoscopy and tympanometry by pharmacists in managing ear complaints in community pharmacy and (3) to evaluate the extended role of rural pharmacists in managing ear complaints, with the potential to expand nationally to improve minor ailment management in rural communities. This is a longitudinal pre- and post-test study of a community-pharmacy-based intervention with a single cohort of up to 200 patients from two rural community pharmacies. Usual care practices pertaining to the management of ear complaints will be recorded prior to the intervention for 8 weeks. The intervention will then be piloted for 6 weeks, followed by a 12 month impact study. Patients aged 13 years presenting to the pharmacies with an ear complaint will be invited to participate. Trained pharmacists will conduct an examination including a brief history, hearing screening, otoscopy and tympanometry assessments. Patients will be referred to a general practitioner (GP) if required, according to the study protocol. Patients will complete a satisfaction survey and receive a follow-up phone call at 7 days to explore outcomes including prescribed medications and referrals. Pharmacists and GPs will complete pre- and post- intervention interviews. Patient, pharmacist and GP data will be analysed using descriptive statistics and thematic analysis for the qualitative data. This study will demonstrate the implementation of a screening and referring ear health intervention in rural community pharmacy. Feasibility, potential effectiveness and acceptability of the intervention will be assessed. Australian and New Zealand Clinical Trial Registry Number: ACTRN12620001297910 .
Publisher: Informa UK Limited
Date: 06-2017
DOI: 10.2147/JMDH.S140989
Publisher: Elsevier BV
Date: 02-2020
Publisher: MDPI AG
Date: 15-06-2021
Abstract: Unaddressed hearing loss affects an estimated 466 million people worldwide, costing over $750 billion globally, with rural communities being particularly disadvantaged, due to the greater inequity in access to healthcare services. This mixed-methods study aimed to use the PRECEDE-PROCEED model to develop and pilot a rural community pharmacy-based ear health service, LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Program). The PRECEDE process involved an assessment of the predisposing, reinforcing and enabling constructs to support practice change through a scoping review, stakeholder surveys and interviews and consultation with governing bodies and regulatory authorities. The PROCEED segment structured the evaluation of the service pilot and informed planned implementation, process, impact and outcome evaluation. The pilot study conducted in February 2021 included 20 participants, with the most common ear complaints presented being pain, pressure or blockage. All these participants reported high levels of satisfaction with the service, would recommend the service to others and would attend the pharmacy first before seeing a GP for future ear complaints. The PRECEDE-PROCEED model provides a comprehensive model to guide the design of the LISTEN UP program, an innovative model, expanding services offered by rural community pharmacies, with preliminary results demonstrating high consumer satisfaction.
Publisher: Wiley
Date: 26-10-2021
DOI: 10.1002/JPPR.1688
Publisher: Informa UK Limited
Date: 04-2018
DOI: 10.2147/JMDH.S156161
Publisher: MDPI AG
Date: 16-01-2023
Abstract: Infertility impacts millions of people of reproductive age worldwide, with approximately 10–15% of couples affected. When infertility is present, there are many potential barriers to treatment, leading to inequity of access. Assisted reproductive technologies (ART) are the mainstay of medical treatment for infertility and include procedures such as in vitro fertilisation. This scoping review aims to explore the barriers to accessing assisted reproductive technologies to highlight a potential role for the pharmacist in addressing these barriers. Five databases, including CINAHL, Emcare, Medline, Scopus, and Web of Science, were searched using keywords that resulted in 19 studies that explored barriers to initially accessing or continuing ART. Studies identified more than one barrier to accessing ART, with the most mentioned barrier being the geographic location of the patient, with others themed as psychological, financial, minority groups, educational level, and the age of the patient. Recommendations were made to address barriers to accessing ART, which included changes to government regulations to increase health education and promotion of infertility. Pharmacists’ accessibility, even in geographically remote locations, places them in an ideal position to address many of the challenges experienced by people accessing infertility treatment to improve outcomes for these people.
Publisher: Informa UK Limited
Date: 03-2022
DOI: 10.2147/JMDH.S360654
Publisher: MDPI AG
Date: 20-04-2023
Abstract: Rural and remote populations are predisposed to poorer health outcomes, largely associated with limited access to health services and health professionals. This disparity provides an opportunity for health professionals to work collaboratively in interdisciplinary teams to deliver improved health outcomes for rural and remote communities. This study aims to explore exercise physiologist and podiatrist perceptions of interprofessional practice opportunities with pharmacists. Role theory provided a framework for this qualitative study. Interviews were conducted, recorded, transcribed, and thematically analysed according to the constructs of role theory (role identity, role sufficiency, role overload, role conflict, and role ambiguity). The perceptions of participants varied, largely due to the lack of understanding of the role and scope of the practice of a pharmacist. Participants acknowledged and adopted a flexible approach to the way in which they delivered health services to meet the needs of the community. They also described a more “generalist” approach to care, owing to the high prevalence of disease and disease complexity, along with a lack of staffing and resources. The potential for increased interprofessional collaboration was supported and identified as a strategy to manage significant workloads and provide improved patient healthcare. The application of role theory to this qualitative study provides insight into perceptions of interprofessional practice that may inform future development of remote practice models of care.
Publisher: Informa UK Limited
Date: 10-2018
Publisher: Cambridge University Press (CUP)
Date: 2021
DOI: 10.1017/S1463423621000487
Abstract: In Australia, around 3.6 million people suffer from hearing loss, more than 1.3 million with preventable hearing conditions. Ear diseases are prevalent in Indigenous populations, particularly children and are associated with poor educational outcomes and subsequent high rates of unemployment and incarceration. In Australia, rural and remote communities have rates of middle ear perforations five times the rate that the World Health Organisation regards to be a significant public health problem. Barriers to accessing ear health services have been identified including gaps in testing during the ‘early years’ and difficulty in accessing these services. Reducing the risk of hearing loss through improved ear health care can directly impact the ability to learn and develop. Collaboration between community, health providers and government is crucial to ensure necessary support for change. An opportunity presents for rural community pharmacists, who are both qualified and accessible to provide an ear health programme and thus improve health outcomes for both Indigenous and non-Indigenous Australians in their communities. The aim of this study was to identify published evidence of pharmacists’ involvement in ear health care interventions to inform the development of ear health services able to be delivered in rural community pharmacy in Australia. The search strategy was applied to the following electronic databases: MEDLINE, Scopus, CINAHL, Emcare, Cochrane, Google Scholar and Google. Study selection articles were included if they described an ear health intervention in a community pharmacy setting. The interventions reported in the articles were evaluated for their inclusion of effectiveness, whether the service was sustainable, and the inclusion of enablers and barriers to the provision of ear care. The articles were also thematically analysed using the Deadly Ears Deadly Kids Deadly Communities Framework . A total 8427 articles were identified and evaluated against inclusion and exclusion criteria, with eleven eligible articles suitable for inclusion in the review. The articles included were conducted in Australia ( n = 4), England ( n = 4), United States of America ( n = 2) and Brazil ( n = 1). The ear health interventions identified included hearing screening ( n = 3), otoscopy pilot studies ( n = 2), audiometry services ( n = 1), specific education for undergraduate pharmacy students ( n = 2) and a pharmacy-based clinic ( n = 3). Effectiveness and sustainability were not formally reported in any of the included articles. Positive outcomes, funding availability, consumer access to community pharmacy, cost savings for consumers and improved connection to health providers were identified as enablers. Difficulty in attracting funding was the most commonly reported barrier. Improving ear health of both Indigenous and non-Indigenous peoples through services provided in community pharmacy presents as an important opportunity for rural pharmacists. Pharmacists are accessible and thus well placed to improve ear healthcare and resultant quality of life for these vulnerable populations. This review has identified factors required to effectively develop ear health models of care in community pharmacy including a pharmacist training program, continuous funding to ensure sustainability and support from pharmacy stakeholders and the community.
Publisher: Informa UK Limited
Date: 12-2020
DOI: 10.2147/JMDH.S279243
Publisher: Informa UK Limited
Date: 03-2020
DOI: 10.2147/JMDH.S236488
Publisher: Wiley
Date: 04-2019
DOI: 10.1111/AJR.12490
Abstract: This two-phase study aimed to explore the influence of a university rural curriculum and clinical placements on pharmacists' choice to practise in a rural or remote area. A sequential mixed-methods approach involved the design of both a questionnaire and semistructured in-depth interviews to collect quantitative and qualitative data. Regional, rural and remote practice areas according to the Pharmacy Access/Remoteness Index of Australia classifications. Ninety-two pharmacists from varied areas of practice, working in rural and remote locations across Australia, participated in the study. University curriculum and clinical placements during the degree and their influence on the current rural workforce. In the survey s le, two-thirds of the current rural pharmacy workforce's choice of practice location was significantly influenced by positive rural placement experiences. Rural practice was, however, not included in the curriculum for 50% of the rural workforce in the s le, although graduates from regional universities experienced up to 80% more exposure to rural curricula. In this s le, rural origin was also not found to be a significant determinant of rural practice, while rural lifestyle, family commitments, remuneration, career opportunities and other contractual agreements have had a greater influence than university education. Although the positive influence of rural placements has been identified, there is still a way to go in terms of the development of a meaningful rural curriculum. This highlights that universities have a role to play in addressing this issue to produce graduates who are better prepared for the opportunities and challenges of rural pharmacy practice.
Publisher: Wiley
Date: 15-11-2018
DOI: 10.1111/AJR.12462
Abstract: The objective of this review was to scope the impact of university rural curriculum and rural clinical placements on students' intentions to practise rurally and rural pharmacists' choice of rural practice. The scoping review used Arskey and O'Malley's methodological framework, searching the following databases: MEDLINE, CINAHL, Informit and Scopus. This scoping review followed PRISMA for article reporting. Studies were selected from those conducted in Australia, USA, Canada and Africa. Pharmacy undergraduate students, interns, registered and academic pharmacists were included. The pharmacy curriculum at universities and placements undertaken, specifically in rural and remote settings, were evaluated to determine their influence on intention to practise as a rural pharmacist. The search strategy generated 294 records, 31 of which were included in the scoping review. Key findings were mapped to two domains, which broadly included the impact of rural placements and curriculum on intention to practise rurally. Some universities have attempted to introduce a rural curriculum, but reported resources as a barrier and the lack of resulting evidence of students' intention to practise rurally. Although results indicate rural placements have had a positive influence on students' intention to work rurally, this intention has been measured immediately after exposure to rural practice and might not reflect future intentions. This review highlights significant gaps in the impact particularly of a rural curriculum and rural clinical placements in relation to the current rural pharmacist workforce. A greater understanding of this topic may guide recommendations for future strategies to address rural pharmacy workforce maldistribution.
Publisher: MDPI AG
Date: 02-09-2020
Abstract: Pharmaceutical care is a concept which has moved the pharmacy profession from their primary focus on the product to optimising drug therapy for the in idual patient. Expanded pharmacy practice beyond pharmaceutical care will further challenge the role perceptions that other health professionals have about pharmacists. Role theory as a philosophical perspective was used to explore rural and remote health professionals’ beliefs on pharmacists expanding their clinical role by conducting twenty-three semi-structured interviews. Five role theory categories described the data, role ambiguity, role conflict, role overload, role identity and role insufficiency. The health professionals interviewed were found to be uncertain about the boundaries between the traditional roles of the pharmacist compared to that of the expanded roles. A perceived lack of accountability by pharmacists was seen as a major contributor to role conflict, which in turn was found to impact the ability of pharmacists and other health professionals to work collaboratively. Perspectives of other health professionals on pharmacists adopting expanded practice models has highlighted significant concerns with role conflict and role identity. Acknowledging and developing clear strategies to address these concerns is essential to ensure that expanded pharmacy practice can be effectively integrated to improve access to health services and thus health outcomes for rural Australians.
Publisher: MDPI AG
Date: 12-01-2022
Abstract: Aim: The aim of this study is to explore pharmacist perspectives of the implementation of a community pharmacy-based ear health service in rural communities. Method: A community pharmacy-based health service model was designed and developed to provide an accessible ear care service (LISTEN UP—Locally Integrated Screening and Testing Ear aNd aUral Program) and pharmacist’s perspectives of the implementation of LISTEN UP were explored. Thematic analysis was conducted and data coded according to the Consolidated Framework for Implementation Research. Results: A total of 20 interviews were conducted with 10 pharmacists, averaging 30 min. Visualistion of the ear canal was reported as the greatest advantage of the service, whilst the time required for documentation reported as a complexity. The number of pharmacists working at one time and the availability of a private consultation room were identified as the two limiting factors for execution. On reflection, the need for government funding for service viability and sustainability was highlighted. Discussion/Conclusion: Expanded pharmacy practice is emerging for the Australian pharmacy profession. Rural community pharmacists are recognised as integral members of healthcare teams, providing accessible medication supply and health advice to seven million people in Australia who call rural and remote regions home. However, there are no structured models supporting them to provide expanded services to improve health outcomes in their communities. This study provides lessons learnt to guide future design and development of expanded models of pharmacy practice.
Publisher: Wiley
Date: 12-2019
DOI: 10.1002/JPPR.1619
Publisher: Oxford University Press (OUP)
Date: 30-06-2020
DOI: 10.1111/IJPP.12648
Abstract: Expanded pharmacy service delivery for rural and remote Australia has potential to address the rural health disparity. Pharmacists practising to their full scope are recognised as being most beneficial in rural and regional communities, where access to health professionals (HPs) is not comparable to those in metropolitan areas. However, research on HP perspectives on expanded pharmacy practice is limited. This study aims to determine rural and remote HP (doctors, nurses, allied health and other HPs) perspectives of expanded services to be delivered through community pharmacy. Australian rural and remote HPs participated in a questionnaire survey which explored views on expanded pharmacy services in their local communities. Potential expanded pharmacy services were provided, and participants were asked to indicate what expanded pharmacy would benefit their local community and their level of support for the services. Analysis of the data included frequency analyses and one-way ANOVA tests with post hoc Tukey’s HSD tests using IBM SPSS Statistic 25. Health professionals (N = 121) from rural and remote locations participated. Sexually transmitted disease testing, vaccinations, diabetes and asthma management were the most frequently chosen services that HPs agreed would improve the health of people in their community. Doctors chose the least number of services (mean = 1 services) compared with all other HPs (mean =& 5 services). Sixty-eight per cent of participants agreed/strongly agreed that providing these additional services would improve health, with participants (73%) agreeing/strongly agreeing that they would support the implementation of these additional services, not otherwise available in their community. Comparing professional groups, doctors were only half as supportive of expanded pharmacy services, when compared with all other HPs. This study confirms the importance of a collaborative, local model to deliver expanded pharmacy services for rural communities. Health professionals were found to largely support expanding pharmacy practice, agreeing about the improved access to health care that would be provided for people living in rural and remote Australia.
Publisher: BMJ
Date: 04-2022
DOI: 10.1136/BMJOPEN-2021-057011
Abstract: Ear disease in rural and remote communities is occurring at high rates, with limited access to health services and health providers contributing to the problem. Community pharmacists are well-placed to provide expanded services to improve ear health in rural communities. We aimed to evaluate the feasibility, accessibility and acceptability of a pharmacist-led intervention for ear disease in consumers presenting to community pharmacy. Prospective preintervention and postintervention mixed-methods study. An ethnographic lens of rural culture was applied to the descriptive qualitative component of the study. Two rural community pharmacies in Queensland, Australia. People aged 6 months or older, who present with an ear complaint to a participating community pharmacy. LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Programme) is a community pharmacy-based intervention to improve the management of ear health. Trained pharmacists conducted ear examinations using otoscopy and tympanometry on consumers following a LISTEN UP protocol. They made recommendations including no treatment, pharmacy only products or general practitioner (GP) referral. Consumers were contacted 7 days later for follow-up. 55 rural consumers participated in the study. The most commonly reported complaints were ‘blocked ear’ and ‘ear pain’. Pharmacists recommended over-the-counter products to two-thirds of the participants and referred one quarter to a GP. 90% (50/55) of the consumers were highly satisfied with the service and would recommend the service. All consumers described the service positively with particular reference to convenience, improved confidence and appreciation of the knowledge gained about their ear complaint. Pharmacists were motivated to upskill and manage workflow to incorporate the service and expected both consumers and GPs to be more accepting of future expanded services as a result of LISTEN UP. However, without funding to provide the service, during the study other remunerated pharmacy tasks took priority over providing LISTEN UP. Rural community pharmacists can provide an acceptable and accessible ear health service however, it is not feasible without a clear funding structure to provide resources including additional pharmacists, equipment and training. ACTRN12620001297910.
No related grants have been discovered for Selina Taylor.