ORCID Profile
0000-0002-5406-2296
Current Organisation
University of Nottingham
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Publisher: Elsevier BV
Date: 12-2011
DOI: 10.5688/AJPE7510194
Publisher: Hindawi Limited
Date: 17-01-2008
DOI: 10.1111/J.1365-2710.2008.00869.X
Abstract: Pharmacist prescribing is a relatively new initiative in the extension of prescribing responsibilities to non-medical healthcare professionals. Pharmacist supplementary prescribing was introduced in 2003 and allowed prescribing in accordance with a clinical management plan agreed with a medical practitioner and patient to improve patient access to medicines and better utilize the skills of healthcare professionals. The objective of this research was to examine the volume, cost and trends in pharmacist prescribing in community and primary care using Prescription Analysis and Cost (PACT) data and to suggest possible reasons for the trends. Using PACT data at national, chapter and subchapter level for 2004-2006 the volume, costs and trends for pharmacist prescribing were obtained. Supplemental data and statistical analysis from other sources, relating to prescribing of in idual drugs, were also utilized. The total number of items prescribed by pharmacists in community and primary care increased from 2706 in 2004 to 31 052 in 2006. In 2006, pharmacist prescribing represented only 0.004% of all prescribing in the community and primary care setting. Cardiovascular medicines were the most frequently prescribed therapeutic class followed by central nervous system, respiratory, endocrine and gastrointestinal medicines. Pharmacist prescribing is increasing but represents an extremely small proportion of primary care prescribing. PACT data between 2004 and 2006 reflects pharmacist supplementary prescribing alone and has been in the anticipated therapeutic areas of drugs which treat chronic conditions such as hypertension.
Publisher: Elsevier BV
Date: 02-2014
DOI: 10.5688/AJPE7814
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/SH12069
Abstract: Background Chlamydia (Chlamydia trachomatis) is the most commonly notified sexually transmissible infection in Australia. Increasing the number of people aged 16–25 years being tested for chlamydia has become a key objective. The strategy recommends that chlamydia screening sites should be easy to access. Community pharmacies are conveniently located and easily accessible. This review aimed to determine the different types of pharmacy-based chlamydia screening interventions, describe their uptake rates, and understand issues around the acceptability of and barriers to testing. Methods: Seven electronic databases were searched for peer-reviewed articles published up to 30 October 2011 for studies that reported chlamydia screening interventions from community pharmacies, or had qualitative evidence on acceptability or barriers linked with interventions. Results: Of the 163 publications identified, 12 met the inclusion criteria. Nine reported chlamydia screening interventions in a pharmacy setting, whereas three focussed on perspectives on chlamydia screening. Pharmacists could offer a chlamydia test to consumers attending the pharmacy for a sexual health-related consultation, or consumers could request a chlamydia test as part of a population-based intervention. Participating consumers said pharmacies were accessible and convenient, and pharmacists were competent when offering a chlamydia test. Pharmacists reported selectively offering tests to women they thought would be most at risk, undermining the principles of opportunistic interventions. Conclusion: Chlamydia screening from community pharmacies is feasible, and can provide an accessible, convenient venue to get a test. Professional implementation support, alongside resources, education and training programs, and incentives may overcome the issue of pharmacists selectively offering the test.
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.SAPHARM.2016.10.004
Abstract: This study describes the perspective of patients, nurses, pharmacists, doctors and policy makers to identify the level of collaboration and the areas for improvement to achieve inter-professional collaboration between doctors, nurses, pharmacists and policy makers in a primary care clinic. Patients (n = 20), Nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) from a primary care were in idually interviewed using a semi-structured topic guide. Purposive s ling was used. Interviews were transcribed verbatim and analysed using thematic analysis informed by constant comparison. Patients, doctors, nurses, pharmacists and policy makers were eager for pharmacists to be more proactive in creating health awareness and conducting osteoporosis screening at the primary care clinic via inter-professional collaboration. These findings were further examined using the D'Amour's structural model of collaboration which encompasses four main themes: shared goals and visions, internalization, formalization and governance. This model supports our data which highlights a lack of understanding of the pharmacists' role among the doctors, nurses, policy makers and pharmacists themselves. There is also a lack of governance and formalization, that fosters consensus, leadership, protocol and information exchange. Nonetheless, the stakeholders trust that pharmacists have sufficient knowledge to contribute to the screening of osteoporosis. Our primary care clinic can be described as developing towards an inter-professional collaboration in managing osteoporosis but is still in its early stages. Inter-professional collaboration in osteoporosis management at the primary care level is beginning to be practised. Efforts extending to awareness and acceptance towards the pharmacists' role will be crucial for a successful change.
Publisher: Elsevier BV
Date: 04-2011
Publisher: Elsevier BV
Date: 08-2018
DOI: 10.1016/J.SAPHARM.2017.09.004
Abstract: Various factors influence decision making in over-the-counter (OTC) medicine consultations, yet limited studies have focused, in-depth, on the thought process of pharmacy staff. This includes pharmacy students as pharmacists-in-training. To explore the factors that influence pharmacy students' decisions in relation to OTC consultations and choice of OTC medicine/s. Semi-structured interviews using the critical incident technique were undertaken with ten pharmacy students in Australia, who also worked as part-time pharmacy staff. Nine key themes were identified to influence pharmacy student decision making in OTC consultations, including customer response, confidence and scope of practice. Product requests were reported as more challenging due to customer expectations and experiences in other pharmacies, states or countries. Although negative customer response influenced some students to supply medicines in contradiction of evidence, an overarching concern for safety meant that a medicine was only supplied if unlikely to cause harm. Students reported developing confidence in OTC decision making more from real-life practice than university training greater confidence was identified for inquiries more frequently experienced in the pharmacy. Students perceived that customers had assumptions around support staff, and were happier to talk to students than assistants. This study further identified that OTC decision making is a complex process for pharmacy students. Additional opportunities for experiential learning within this area are suggested, such as work-based placements or in-class activities such as role-plays with simulated patients.
Publisher: Informa UK Limited
Date: 09-2014
DOI: 10.2147/PPA.S65718
Publisher: Springer Science and Business Media LLC
Date: 29-01-2018
DOI: 10.1007/S11096-018-0597-9
Abstract: Background Several studies have found that pharmacists can assist in screening and prevention of osteoporosis by referring patients for bone mineral density scans and counselling on lifestyle changes. In Malaysia, screening osteoporosis in all elderly women is not mandatory due to its cost. One approach to address this gap is to develop a pharmacist-led osteoporosis screening and prevention program. However, there is a paucity of data on the perspectives of Malaysian pharmacists in this area. Objective To explore the perspective of stakeholders (policy makers, doctors, pharmacists, nurses and patients) towards the role of pharmacists in osteoporosis screening and management. Setting A primary care clinic located within a teaching hospital in Kuala Lumpur, Malaysia. Method Patients (n = 20), nurses (n = 10), pharmacists (n = 11), doctors (n = 10) and policy makers (n = 5) were in idually interviewed using a semi-structured topic guide. Purposive s ling was used. Interviews were transcribed verbatim and analysed using thematic analysis. Main outcome measure Perspective of stakeholders on the current and future role of pharmacists. Results All participants perceived pharmacists to be suppliers of medication, although there was some recognition of roles in providing medication advice. Nonetheless, these stakeholders were eager for pharmacists to expand their non-dispensing roles towards counselling, creating awareness and screening of osteoporosis. Interviewed pharmacists referred to their current role as 'robotic dispensers' and unanimously agreed to spread out to osteoporosis management role. Conclusion Under stakeholders there is a willingness to expand the role of pharmacists in Malaysia to non-dispensing roles, particularly in osteoporosis screening and management.
Publisher: Elsevier BV
Date: 04-2015
DOI: 10.5688/AJPE79335
Publisher: Oxford University Press (OUP)
Date: 15-12-2016
Abstract: Background Lifestyle and dietary advice typically precedes or accompanies the prescription of statin medications. However, evidence for adherence to this advice is sparse. The objective was to compare saturated fat intake, exercise, alcohol consumption and smoking between statin users and non-users in Australia. Methods Data were analysed for 4614 participants aged ≥37 years in the Australian Diabetes, Obesity and Lifestyle study in 2011-2012. Statin use, smoking status and physical activity were self-reported. Saturated fat and alcohol intake were measured via a food frequency questionnaire. Multinomial logistic regression was used to compute adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for the associations between statin use and the four lifestyle factors. All models were adjusted for age, sex, education, number of general practitioner visits, body mass index, hypertension, diabetes and prior cardiovascular diseases. Results In total 1108 (24%) participants used a statin. Statin users were 29% less likely to be within the highest quartile versus the lowest quartile of daily saturated fat intake compared to non-users (OR 0.71, 95% CI 0.54-0.94). There were no statistically significant associations between statin use and smoking, physical activity or alcohol consumption. Conclusions Smoking status, alcohol consumption and exercise level did not differ between users and non-users of statins. However, statin users were less likely to consume high levels of saturated fat than non-users. We found no evidence that people took statins to compensate for a poor diet or lifestyle.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2008
Publisher: Springer Science and Business Media LLC
Date: 02-2020
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.5688/AJPE8011
Publisher: Elsevier BV
Date: 08-1970
DOI: 10.1016/J.SOCSCIMED.2015.10.012
Abstract: Discontents surrounding depression are many, and include concerns about a creeping appropriation of everyday kinds of misery ergent opinions on the diagnostic category(ies) and debates about causes and appropriate treatments. The somewhat mixed fortunes of antidepressants - including concerns about their efficacy, overuse and impacts on personhood - have contributed to a moral ambivalence around antidepressant use for people with mental health issues. Given this, we set out to critically examine how antidepressant users engage in the moral underpinnings of their use, especially how they ascribe legitimacy (or otherwise) to this usage. Using a modified constant comparative approach, we analyzed 107 narrative interviews (32 in UKa, 36 in UKb, 39 in Australia) collected in three research studies of experiences of depression in the UK (2003-4 UKa, and 2012 UKb) and in Australia (2010-11). We contend that with the precariousness of the legitimacy of the pharmaceutical treatment of depression, participants embark on their own legitimization work, often alone and while distressed. We posit that here, in iduals with depression may be particularly susceptible to moral uncertainty about their illness and pharmaceutical interventions, including concerns about shameful antidepressant use and deviance (e.g. conceiving medication as pseudo-illicit). We conclude that while people's experiences of antidepressants (including successful treatments) involve challenges to illegitimacy narratives, it is difficult for participants to escape the influence of underlying moral concerns, and the legitimacy quandary powerfully shapes antidepressant use.
Publisher: SAGE Publications
Date: 10-2008
DOI: 10.1258/JHSRP.2008.008004
Abstract: Supplementary prescribing (SP) by pharmacists and nurses in the UK represents a unique approach to improving patients’ access to medicines and better utilizing health care professionals’ skills. Study aims were to explore the views of stakeholders involved in SP policy, training and practice, focusing upon issues such as SP benefits, facilitators, challenges, safety and costs, thereby informing future practice and policy. Qualitative, semi-structured interviews were conducted with 43 purposively s led UK stakeholders, including pharmacist and nurse supplementary prescribers, doctors, patient groups representatives, academics and policy developers. Analysis of transcribed interviews was undertaken using a process of constant comparison and framework analysis, with coding of emergent themes. Stakeholders generally viewed SP positively and perceived benefits in terms of improved access to medicines and fewer delays, along with a range of facilitators and barriers to the implementation of this form of non-medical prescribing. Stakeholders’ views on the economic impact of SP varied, but safety concerns were not considered significant. Future challenges and implications for policy included SP being potentially superseded by independent nurse and pharmacist prescribing, and the need to improve awareness of SP. Several potential tensions emerged including nurses’ versus pharmacists’ existing skills and training needs, supplementary versus independent prescribing, SP theory versus practice and prescribers versus non-prescribing peers. SP appeared to be broadly welcomed by stakeholders and was perceived to offer patient benefits. Several years after its introduction in the UK, stakeholders still perceived several implementation barriers and challenges and these, together with various tensions identified, might affect the success of supplementary and other forms of non-medical prescribing.
Publisher: Elsevier BV
Date: 03-2008
DOI: 10.1016/J.HEALTHPOL.2007.07.016
Abstract: Supplementary prescribing (SP) represents a recent development in non-medical prescribing in the UK, involving a tripartite agreement between independent medical prescriber, dependent prescriber and patient, enabling the dependent prescriber to prescribe in accordance with a patient-specific clinical management plan (CMP). The aim in this paper is to review, thematically, the literature on nurse and pharmacist SP, to inform further research, policy and education. A review of the nursing and pharmacy SP literature from 1997 to 2007 was undertaken using searches of electronic databases, grey literature and journal hand searches. Nurses and pharmacists were positive about SP but the medical profession were more critical and lacked awareness/understanding, according to the identified literature. SP was identified in many clinical settings but implementation barriers emerged from the empirical and anecdotal literature, including funding problems, delays in practicing and obtaining prescription pads, encumbering clinical management plans and access to records. Empirical studies were often methodological weaknesses and under-evaluation of safety, economic analysis and patients' experiences were identified in empirical studies. There was a perception that nurse and pharmacist independent prescribing may supersede supplementary prescribing. There is a need for additional research regarding SP and despite nurses' and pharmacists' enthusiasm, implementation issues, medical apathy and independent prescribing potentially undermine the success of SP.
Publisher: Elsevier BV
Date: 09-2019
Publisher: BMJ
Date: 2009
Publisher: Springer Science and Business Media LLC
Date: 25-11-2022
DOI: 10.1007/S11096-022-01493-6
Abstract: Opioids are commonly used for the management of chronic non-malignant pain in Pakistan but there is a lack of literature around precursors or motivators in the use of opioids. The study holistically explored factors contributing towards the unsafe use of opioids and identifies strategies to overcome them. Exploratory qualitative methods using interviews, focus groups and non-participant observational case studies were used. Interviews and focus groups were carried out face-to-face as well as virtually and observations were conducted in community pharmacies in Islamabad and Khyber Pukhtoon Khuwa province, Pakistan. Data were collected from 4 stakeholder groups pharmacy policy makers (n = 11), people with chronic non-malignant pain (n = 14), doctors (n = 31) and community pharmacists (n = 36) by purposive critical case s ling method. Data were analysed inductively using reflexive thematic analysis and then deductively mapped to a social ecological framework. Non-participant observations were analysed using a cross case synthesis using explanation building technique. Data from all three methods were triangulated to develop a logic model. Identified factors at macro (regulation), meso (social perceptions of pain and opioids) and micro levels (uncontrolled pain, self-medication, health literacy) and strategies are presented holistically and were used to develop a logic model for the prevention and mitigation of factors currently causing unsafe use of opioids. The study provides an in-depth view of factors contributing towards ersion of pharmaceutical opioids and can help guide national and international policy makers in their future initiatives to promote safe use of opioids in the management of chronic non-malignant pain in Pakistan.
Publisher: Springer Science and Business Media LLC
Date: 12-2008
Publisher: Springer Science and Business Media LLC
Date: 13-04-2017
Publisher: BMJ
Date: 12-2015
Publisher: SAGE Publications
Date: 13-01-2011
Abstract: Doctors have traditionally been viewed as the dominant healthcare profession, with the authority to prescribe medicines, but recent non-medical prescribing initiatives have been viewed as possible challenges to such dominance. Using the ex le of the introduction of supplementary prescribing in the UK, this study sought to explore whether such initiatives represent a challenge to medical authority. Ten case study sites in England involving primary and secondary care and a range of clinical areas were used to undertake a total of 77 observations of supplementary prescribing consultations and interviews with 28 patients, 11 doctors and nurse and pharmacist prescribers at each site. Supplementary prescribing was viewed positively by all participants but several doctors and patients appeared to lack awareness and understanding of supplementary prescribing. Continued medical authority was supported empirically in five areas: patients’ and supplementary prescribers’ perception of doctors as being hierarchically superior doctors legitimation of nurses’ and pharmacists’ prescribing initially doctors’ belief that they could control (particularly nurses’) access to prescribing training supplementary prescribers’ frequent recourse to use doctors’ advice, coupled with doctors’ encouragement of such ‘knock on door’ prescribing advice policies doctors’ denigration of most routine prescribing but claims that diagnosis was more skilled and key to medicine. Supplementary prescribing appeared to be successfully accomplished in practice in a range of clinical settings and was acceptable to all involved but did not ultimately challenge medical dominance. However, more recent nurse and pharmacist independent prescribing (involving diagnosis) may represent a more significant threat.
Publisher: Bentham Science Publishers Ltd.
Date: 08-2012
Publisher: Springer Science and Business Media LLC
Date: 06-02-2023
DOI: 10.1007/S11096-022-01533-1
Abstract: In Thailand, the consumption of herbal medicines has been increasing. Adverse events (AEs) of herbal medicines have been identified through the spontaneous reporting system. However, the number of patients reporting AEs of herbal medicines remains limited. To explore the awareness and perceptions about the patient reporting system and to explore attitudes towards safety of herbal medicines, experiences, and intention to report AEs of herbal medicines. Semi-structured in-depth interviews were conducted with stakeholders (patients, community pharmacists, village health volunteers, and consumers who had experienced submitting a complaint about health products to the Consumers Foundation). Additionally, a focus group discussion was held with stakeholders (academics, herbal medicine manufacturers, healthcare professionals, policy maker who was responsible for promoting the use of herbal medicines, pharmacovigilance staff, patient, and representative from patient organisations). The data were audio recorded, transcribed verbatim and analysed using thematic analysis. Fifty participants were interviewed and the focus group discussion included 12 participants. Patients had positive attitudes towards the safety of herbal medicines. Lack of awareness of the patient reporting system was identified. Nevertheless, all stakeholders acknowledged the importance of the safety monitoring of herbal medicines and indicated a willingness to report AEs via the patient reporting system in the future. A simple reporting system, a variety of reporting channels, the provision of feedback, and providing rewards would motivate patients to report AEs. Although there is a lack of awareness, this provides a great opportunity to improve patient AE reporting system for herbal medicines in Thailand.
Publisher: International Pharmaceutical Federation (FIP)
Date: 07-04-2023
DOI: 10.46542/PE.2022.224.150154
Abstract: Competency-based education (CBE) is a viable educational approach to close a training gap between ever-changing health challenges and pharmacy and pharmaceutical education curricula. However, the implementation of CBE into initial professional education and training (IPET) for pharmacists is slow. Thus, the development of a handbook to guide academics, educators, and practitioners in implementing CBE would be beneficial. This paper describes the process of developing a handbook to support educators in implementing CBE principles in IPET for pharmacists and pharmaceutical scientists. The project involves three phases: (1) a systematic review, (2) a global survey, and (3) the development of a handbook. The handbook provides guidance and a stepwise approach to implementing CBE in pharmacy curricula, which is particularly useful in resource-limited settings where curriculum overhaul using CBE principles might be challenging.
Publisher: Public Library of Science (PLoS)
Date: 04-05-2015
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.5688/AJPE77221
Publisher: Springer Science and Business Media LLC
Date: 05-06-2009
Publisher: Elsevier BV
Date: 04-2010
DOI: 10.5688/AJ740356
Publisher: SAGE Publications
Date: 2010
DOI: 10.1258/JHSRP.2009.008157
Abstract: To review the literature on in idual community professionals’ caseload management (behaviours related to assessment, treatment and discharging of clients) to identify the main themes and concepts, and to synthesize the findings to inform practice, policy and research. Publications were systematically identified from electronic databases, hand searches of bibliographies, and contact with professional organizations. There were no restrictions on language, the nature of publications or publication year. Procedures were systematically applied for quality appraisal and data extraction. Qualitative and descriptive quantitative methods were used for data analysis and synthesis. Search criteria yielded 2048 papers of which 42 papers met the inclusion criteria. Thirty-five percent of these were based on research, the rest on professionals’ experiences. The papers covered 16 professional and 20 client populations, and their quality was generally poor. Analysis identified six broad themes: definitions of caseload management, caseload measurement and ‘tools’, models of caseload management practice, client- professional relationship, discharging and professional guidance. Six papers presented issues that related to but did not fit within these themes. Current caseload management tools and models of caseload management practice had a poor evidence base. Five papers described benefits of team-based approaches. Professional guidance for caseload management is limited in detail and relevance to daily practice. Although there is a considerable literature on caseload management, it is not possible to make summative conclusions. Policy-makers and professional bodies should encourage and support development of research evidence about the ways to achieve effective, efficient and equitable caseload management. Health and social care services considering implementing caseload management tools or models of practice should critically appraise their basis, and consider their potential advantages as well as disadvantages.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Claire Anderson.