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1.  Pharmacy Students' Perceptions of Tobacco Sales in Pharmacies and Suggested Strategies for Promoting Tobacco-Free Experiential Sites 
Objective
The objectives of this report were to estimate the extent to which pharmacy student perceptions are aligned with the 2003 resolution of the American Association of Colleges of Pharmacy (AACP) addressing the use of experiential sites that sell cigarettes and other tobacco products.
Methods
Pharmacy students participating in a national tobacco cessation training program completed posttraining survey instruments and indicated their opinion about tobacco sales in pharmacies. Responses were examined with respect to students' sex and tobacco use status.
Results
Of 3,064 students, 3.5% were in favor of tobacco sales in pharmacies. Opinions varied by students' sex (p < 0.001) and tobacco use status (p < 0.001); in logistic regression analyses, males (OR = 2.62; 95% CI, 1.77, 3.89) and current tobacco users (OR = 2.31; 95% CI, 1.41, 3.76) were most likely to be in favor of tobacco sales.
Conclusion
Few pharmacy students are in favor of tobacco sales in pharmacies. Given the overall lack of support, and acting in accordance with the 2003 AACP resolution, pharmacy schools are encouraged to use only experiential sites that do not sell tobacco products. Suggested strategies for moving toward this goal are presented.
PMCID: PMC1636987  PMID: 17136194
tobacco; pharmacies; pharmacy education; experiential sites; community pharmacy
2.  Role of community pharmacies in prevention of AIDS among injecting drug misusers: findings of a survey in England and Wales. 
BMJ : British Medical Journal  1989;299(6707):1076-1079.
OBJECTIVE--To determine the current and potential roles of community pharmacists in the prevention of AIDS among misusers of injected drugs. DESIGN--Cross sectional postal survey of a one in four random sample of registered pharmacies in England and Wales. SETTING--Project conducted in the addiction research unit of the Institute of Psychiatry, London. SUBJECTS--2469 Community pharmacies in the 15 regional health authorities in England and Wales. MAIN OUTCOME MEASURES--Willingness of pharmacists to sell injecting equipment to known or suspected misusers of drugs; pharmacists' attitudes to syringe exchange schemes, keeping a "sharps" box for use by misusers of drugs, and offering face to face advice and leaflets; and opinions of community pharmacists on their role in AIDS prevention and drug misuse. RESULTS--1946 Questionnaires were returned, representing a response rate of 79%. This fell short of the target of one in four pharmacies in each family practitioner committee area in England and Wales, and total numbers of respondents were therefore weighted in inverse proportion to the response rate in each area. The findings disclosed a substantial demand for injecting equipment by drug misusers. After weighting of numbers of respondents an estimated 676 of 2434 pharmacies were currently selling injecting equipment and 65 of 2415 (3%) were participating in local syringe exchange schemes; only 94 of 2410 pharmacies (4%) had a sharps box for used equipment. There was a high degree of concern among pharmacists about particular consequences of drug misusers visiting their premises, along with a widespread acceptance that the community pharmacist had an important part to play. CONCLUSIONS--Promoting the participation of community pharmacists in the prevention of AIDS among misusers of injected drugs is a viable policy, but several problems would need to be overcome before it was implemented.
PMCID: PMC1837978  PMID: 2511969
3.  Individual and neighborhood-level factors associated with non-prescription counseling in pharmacies participating in the New York State Expanded Syringe Access Program (ESAP) 
Objective
To determine the individual- and neighborhood-level predictors of frequent non-prescription in-pharmacy counseling.
Design
Cross-sectional survey
Setting
130 pharmacies registered in the Expanded Syringe Access Program (ESAP) in New York City.
Participants
477 pharmacists, non-pharmacist owner/managers, and technicians/clerks.
Main outcome measures
Frequent counseling on medical conditions, health insurance, and other products.
Results
Technicians were less likely than pharmacists to provide frequent counseling on medical conditions or health insurance. In terms of neighborhood-level characteristics, pharmacies in areas of high employment disability were less likely to provide frequent health insurance counseling and pharmacies in areas with higher deprivation were more likely to provide counseling on other products.
Conclusion
ESAP pharmacy staff is a frequent source of non-prescription counseling for their patients/customers in disadvantaged neighborhoods of NYC. These findings suggest that ESAP pharmacy staff may be amenable to providing relevant counseling services to injection drug using syringe customers and warrants further investigation.
doi:10.1331/JAPhA.2010.09202
PMCID: PMC3575749  PMID: 20833615
Expanded Syringe Access Program; in-pharmacy counseling; injection drug users; expanded services; New York City
4.  Telephone survey of Alaskan pharmacists' nonprescription needle-selling practices 
Objectives
To determine the availability of nonprescription needles and syringes (NS) through pharmacy sales and to assess the impact of pharmacy policies and municipal paraphernalia laws on pharmacists' selling practices.
Design
Telephone survey of all pharmacies in Alaska's four largest cities.
Setting
Anchorage, Fairbanks, Juneau, and Ketchikan, Alaska.
Subjects
A single pharmacist from each pharmacy represented in the cities' phone books.
Main Outcome Measures
Reports of (1) pharmacies' policies and individual pharmacists' procedures regarding the nonprescription sale of NS, (2) pharmacists' selling practices, and (3) identification of conditions that may affect pharmacists' decisions to sell nonprescription NS.
Results
Response rate of 86% (37/43); 77% of pharmacists reported selling at least one nonprescription NS in the last month. Store policy was related to selling practices; however, there was no difference in selling practices between a city with a paraphernalia law and cities without such laws. Logistic regression revealed pharmacists were more likely to sell NS if they worked in chain pharmacies and estimated that a high number of other local pharmacists sell nonprescription NS.
Conclusion
NS are available through nonprescription sales in Alaskan pharmacies. The majority of pharmacies have store policies that permit pharmacists to sell nonprescription NS, either in all cases or at their discretion. Municipal paraphernalia laws do not determine the selling practices of individual pharmacists.
doi:10.1007/BF02350967
PMCID: PMC3456607  PMID: 10741847
5.  Prospective Student Pharmacist Interest in a Rural Pharmacy Curriculum 
Objective. To determine prospective student pharmacists’ interest in a rural pharmacy health curriculum.
Methods. All applicants who were selected to interview for fall 2011 enrollment at the UNC Eshelman School of Pharmacy were invited to participate in a Web-based survey. Questions addressed participants’ willingness to participate in a rural health pharmacy curriculum, interest in practicing in a rural area, and beliefs regarding patient access to healthcare in rural areas.
Results. Of the 250 prospective student pharmacists invited to participate, 91% completed the survey instrument. Respondents agreed that populations living in rural areas may have different health needs, and students were generally interested in a rural pharmacy health curriculum.
Conclusions. An online survey of prospective student pharmacists was an effective way to assess their interest in a rural pharmacy program being considered by the study institution. Location of the rural program at a satellite campus and availability of housing were identified as factors that could limit enrollment.
doi:10.5688/ajpe766105
PMCID: PMC3425920  PMID: 22919081
Rural health; pharmacy curriculum; underserved; manpower; survey
6.  Tobacco sales in pharmacies: time to quit 
Tobacco Control  2006;15(1):35-38.
Objective
To assess the pharmacy profession's perceptions of tobacco sales in US pharmacies and explore whether a policy prohibiting sales of tobacco in pharmacies would alter adult consumer shopping behaviour.
Subjects and design
In California, surveys were administered to 1168 licensed pharmacists and 1518 pharmacy students, and telephone interviews were conducted with 988 adult consumers.
Results
Most (58.1%) licensed pharmacists were strongly against sales of tobacco in pharmacies, 23.6% were against it, 16.7% were neutral, 1.2% were in favour of it, and 0.4% were strongly in favour of it. Pharmacists who were current tobacco users were more likely to be in favour of tobacco sales in pharmacies than were pharmacists who were current non‐users (p < 0.005). Similar statistics were observed for pharmacy students. Most consumers (72.3%) disagreed with the statement, “I am in favour of tobacco products being sold in drugstores”; 82.6% stated that if the drugstore where they most commonly shopped were to stop selling tobacco products, they would shop there just as often, 14.2% would shop there more often, and 3.2% would shop there less often.
Conclusion
Little professional or public support exists for tobacco sales in pharmacies.
doi:10.1136/tc.2005.012278
PMCID: PMC2563615  PMID: 16436403
health professional; pharmacist; pharmacy; tobacco sales
7.  The Ethics of Dietary Supplements and Natural Health Products in Pharmacy Practice: A Systematic Documentary Analysis 
Aims and Objectives
Many natural health products (NHPs) and dietary supplements (DS) are purchased in pharmacies and it has been argued that pharmacists are in the best position to provide patients with evidence-based information about them. This study was designed to identify how the pharmacist’s role with respect to NHPs/DS is portrayed in the literature.
Method
A systematic search was conducted in a variety of health databases to identify all literature that pertained to both pharmacy and NHPs/DS. Of the 786 articles identified, 665 were broad-coded and 259 were subjected to in-depth qualitative content analysis for emergent themes.
Key Findings
Overwhelmingly, support for the sale of NHPs/DS in pharmacies is strong. Additionally, a role for pharmacists in NHP/DS counselling is underscored. But another recurrent theme is that pharmacists are ill-equipped to counsel patients about these products that are available on their shelves. This situation has led some to question the ethics of pharmacists selling NHPs/DS and to highlight the existence of an ethical conflict stemming from the profit-motive associated with NHP/DS sales.
Conclusion
This analysis raises concerns about the ethics of NHPs/DS being sold in pharmacies, and about pharmacists being expected to counsel about products of which they have little knowledge.
PMCID: PMC2918535  PMID: 20218027 CAMSID: cams1317
8.  Audit of Renal Drug Dosing: Comparison of 2 Methods and Evaluation of Pharmacists’ Knowledge, Attitudes, and Behaviour 
Background:
The renal dosing directive of the Winnipeg Regional Health Authority Pharmacy Program outlines an auditable pharmacy service whereby pharmacists are required to perform documentation (i.e., document their rationale) only if they do not adjust the dose of any medications listed in the directive.
Objective:
To compare the suitability of manual orders (hard copy) and reports from the pharmacy information system (computer-generated) for determining pharmacists’ compliance with the renal dosing directive; to measure compliance with the renal dosing directive; and to determine pharmacists’ opinions about audit programs.
Methods:
A retrospective audit was used to compare 400 manual orders with the corresponding orders in reports from the pharmacy information system, to determine compliance with the renal dosing directive. An e-mail survey was performed to gather pharmacists’ opinions about audit programs.
Results:
Of the 400 orders evaluated, 86 (22%) required consideration of a dose adjustment. Of these, 78 (91%) showed that dosing followed the guidelines for renal dysfunction in standard pharmacy references. Six (7%) of 86 manual orders and 8 (9%) of 86 pharmacy information system orders were not compliant with the renal dosing directive (i.e., no dosage adjustment and no documentation of rationale). Of 77 pharmacists approached, 34 (44%) completed the survey. Most respondents (31/34 [91%]) agreed that auditing is beneficial to patients, and the same number (31/34 [91%]) agreed that auditing provides important information to the pharmacy program. Only 17 (50%) were aware of medications listed in the renal dosing directive, and 14 (41%) felt that they had received sufficient education about pharmacy directives. Most respondents (29/34 [85%]) agreed that audits would reveal areas for improvement, and all (34/34 [100%]) would comply with any changes required to facilitate performance of an audit if such changes did not increase workload.
Conclusions:
Similar results were obtained with the 2 auditing methods used for this study (manual orders and reports from the pharmacy information system). However, pharmacists’ current use of electronic documentation limits the feasibility of pharmacy information system audits. Survey respondents claimed that they were not familiar with the renal dosing directive, but they did agree that auditing clinical services is beneficial.
PMCID: PMC3420850  PMID: 22919105
renal dose adjustments; pharmacists’ compliance; pharmacists’ behaviours and attitudes; ajustements posologiques chez les insuffisants rénaux; conformité de la part des pharmaciens; comportements et attitudes des pharmaciens
9.  Chlamydia testing in community pharmacies: evaluation of a feasibility pilot in south east London 
Quality & Safety in Health Care  2007;16(4):303-307.
Background and objective
Chlamydia trachomatis infection is a common sexually transmitted infection with serious sequelae. Excellent access to testing, treatment and contact tracing are an essential part of strategies to control it. With traditional sexual health services overstretched, community pharmacies are well placed to provide this service. They have the potential to improve access by offering chlamydia testing and treatment from high street venues with long opening hours. This study evaluated the feasibility and acceptability to users and pharmacists of this service in independent community pharmacies.
Method
A chlamydia testing and treatment service was offered in three community pharmacies in two inner London boroughs for a 3‐month pilot. Data on the feasibility and acceptability of the new service were collected via a survey of client experience, indepth semistructured interviews with clients and pharmacists, and structured evaluation reports completed by professional patients paid to visit the pharmacies.
Results
83 tests were taken with eight (9.5%) of these positive for C trachomatis. Of those tested, 94% (n = 73) were women and 71% (n = 56) were from ethnic minorities. 80 clients completed the questionnaires and 24 clients were interviewed. Most clients heard about the service from the pharmacist when requesting emergency contraception and 16% (n = 13) would not otherwise have been tested. Clients valued the speed and convenience of the service and the friendly, non‐judgmental approach of the pharmacist. Confidentiality when asking for the service at the counter was suboptimal, and the pharmacist trained to deliver the service was not always available to provide it.
Conclusions
Chlamydia testing and treatment in community pharmacies is feasible and acceptable to users. The service increases access among young women at high risk of sexually transmitted infection but not among young men.
doi:10.1136/qshc.2006.020883
PMCID: PMC2464947  PMID: 17693680
10.  Availability of Tobacco and Alcohol Products in Los Angeles Community Pharmacies 
Journal of Community Health  2012;37(1):113-118.
The availability of tobacco and alcohol products in community pharmacies contradicts the pharmacists’ Code of Ethics and presents challenges for a profession that is overwhelmingly not in favor of the sale of these products in its practice settings. The primary aim of this study was to estimate the proportion of pharmacies that sell tobacco products and/or alcoholic beverages and to characterize promotion of these products. The proportion of pharmacies that sell non-prescription nicotine replacement therapy (NRT) products as aids to smoking cessation also was estimated. Among 250 randomly-selected community pharmacies in Los Angeles, 32.8% sold cigarettes, and 26.0% sold alcohol products. Cigarettes were more likely to be available in traditional chain pharmacies and grocery stores than in independently-owned pharmacies (100% versus 10.8%; P < 0.001), and traditional chain drug stores and grocery stores were more likely to sell alcoholic beverages than were independently-owned pharmacies (87.5% vs. 5.4%; P < 0.001). Thirty-four (41.5%) of the 82 pharmacies that sold cigarettes and 47 (72.3%) of the 65 pharmacies that sold alcohol also displayed promotional materials for these products. NRT products were merchandised by 58% of pharmacies. Results of this study suggest that when given a choice, pharmacists choose not to sell tobacco or alcohol products.
doi:10.1007/s10900-011-9424-0
PMCID: PMC3394176  PMID: 21644021
Tobacco sales; Alcohol sales; Tobacco control; Pharmacies
11.  The Role of Pharmacists in Smoking Cessation in Poland 
In Poland, 38.0% of men and 25.6% of women smoke daily. One method for expanding access to smoking cessation services is through community-based pharmacists. Surveys were administered in 2007–2008 to (a) current smokers, (b) members of a pharmacy association, and (c) pharmacy students in their final year of training. Pharmacists were the highest ranked health professionals to whom Polish smokers reported they would turn for information about pharmacological support for smoking cessation. Most pharmacists (79%) reported their knowledge allowed them to provide basic smoking cessation information to their patients. Pharmacy students reported being more able to provide information about the health consequences of tobacco smoking than to help patients quit smoking (85% vs. 61%). In Poland, community-based pharmacists are positioned to provide smoking cessation interventions to all segments of the population. To extend and promote smoking cessation efforts, comprehensive tobacco cessation training should be a required component of the pharmacy school curriculum.
doi:10.1177/0163278709356190
PMCID: PMC2824766  PMID: 20042417
smoking cessation; pharmacists; health professionals; pharmaceutical care
12.  Availability and Perceived Value of Masters of Business Administration Degree Programs in Pharmaceutical Marketing and Management 
Objectives. To examine pharmacist-targeted master of business administration (MBA) degree programs and investigate pharmacists’ perceptions regarding them.
Methods. Specialized MBA programs in pharmaceutical marketing and management offered at US colleges and schools of pharmacy were identified in the literature and compared. Pharmacists’ perceptions of MBA programs were evaluated through a survey of clinical preceptors affiliated with a school of pharmacy.
Results. Seven US universities that offer an MBA program in pharmaceutical marketing and management were identified. Thirty-three percent of the 57 pharmacist preceptors who responded to the survey reported plans to pursue an MBA degree program. Respondents preferred MBA programs related to healthcare or pharmacy (66%) over general MBA programs (33%).
Conclusion. An MBA in pharmaceutical marketing and management could provide pharmacists with advanced knowledge of the operational and strategic business aspects of pharmacy practice and give pharmacy graduates an advantage in an increasingly competitive job market.
doi:10.5688/ajpe76464
PMCID: PMC3355284  PMID: 22611273
master of business administration (MBA); marketing; management; business; pharmaceutical industry; dual PharmD/MBA degree program
13.  What do pharmacists think about New York State's new nonprescription syringe sale program? Results of a survey 
Access to sterile syringes can prevent transmission of blood-borne diseases such as human immunodeficiency virus (HIV) and hepatitis B and C. We conducted a survey of attitudes of pharmacists to aid, in development of the Expanded. Syringe Access Demonstration Program (ESAP) in New York State. ESAP is an HIV prevention initiative that authorizes nonprescription sale of hypodermic needles and syringes by registered pharmacies in New York State beginning January 1, 2001. As part of planning for program implementation, the New York State Department of Health (NYSDOH), in collaboration with the New York State Education Department, conducted a mailed survey of all 4,392 licensed pharmacies in New York State during the summer of 2000. Some surveys (171) were returned as undeliverable. Of the 4,221 eligible respondents, 874 (20.7%) completed surveys were received, of which 574 (65.7%) indicated that their pharmacy would likely participate in ESAP. An additional 11.0% were not sure. Only 139 (15.9%) indicated that they would definitely not participate; 7.4% left this question blank. There were 608 responses to questions on safe disposal practices. Of these, 315 (51.8%) respondents indicated that their pharmacy sold sharps containers, and an additional 29 made them available at no cost. Only 133 (21.9%) respondents to this question did not offer sharps containers and were not interested in doing so. In all, 54 responses indicated that they accepted used hypodernmic needles and syringesfor disposal. Some (170, 28%) that did not accept shaprs for disposal were interested in doing so. More than half (382, 63.0%) did not wish to do so. NYSDOH considered respondent suggestions and minimized ESAP requirements. By March 31, 2001, only 3 months after ESAP became effective, more than half of all licensed pharmacies in New York State were registered for ESAP. Survey results provided useful information to NYSDOH and a good indication of likelihood of registration. The high level of pharmacy participation in ESAP may be reflective of NYSDOH attention to issues raised by pharmacists, as well as the direct effects of outreach to pharmacy chains regarding ESAP.
doi:10.1093/jurban/78.4.679
PMCID: PMC3455869  PMID: 11796814
AIDS; HIV; Infection drug use; Pharmacy; Prevention; Substance abuse
14.  Roles and Responsibilities of Pharmacists with Respect to Natural Health Products: Key Informant Interviews 
Background
Although many pharmacies sell natural health products (NHPs), there is no clear definition as to the roles and responsibilities (if any) of pharmacists with respect to these products.
Objective
The purpose of this study was to explore pharmacy and stakeholder leaders’ perceptions of pharmacists’ professional NHP roles and responsibilities.
Methods
Semi-structured key informant interviews were conducted with pharmacy leaders (n= 17) and stakeholder (n=18) leaders representing consumers, complementary and alternative medicine practitioners, conventional healthcare practitioners, and industry across Canada.
Results
Overwhelmingly all participants believed a main NHP responsibility for pharmacists was safety monitoring. One challenge identified in the interviews was pharmacists’ general lack of NHP knowledge. Stakeholder leaders did not expect pharmacists to be experts on NHPs, rather that pharmacists should have a basic level of knowledge about NHPs. Many pharmacy leaders appeared to be unfamiliar with current pharmacy policies and guidelines concerning NHPs.
Conclusion
Participants described pharmacists’ professional roles and responsibilities for NHPs as similar to those for over-the-counter drugs. More awareness of existing NHP-related pharmacy policies is needed. Pharmacy owners/managers should provide additional training to ensure front-line pharmacists have appropriate knowledge of NHPs sold in the pharmacy.
doi:10.1016/j.sapharm.2009.02.004
PMCID: PMC2923149  PMID: 20188329 CAMSID: cams1316
natural health products; pharmacists; professional roles and responsibilities
15.  An Introductory Pharmacy Practice Experience Emphasizing Student-Administered Vaccinations 
Objective
To introduce a requirement for second-professional year (P2) and third-professional year (P3) students to administer vaccinations to adults in community pharmacy-based immunization clinics.
Design
Second-professional year students were trained to administer influenza, pneumococcal, and other vaccinations to adults following the American Pharmacists Association's standards. All P2 students in fall 2004 and all P2 and P3 students in fall 2005 were assigned to 2 community pharmacy-based immunization clinics in the metropolitan Denver area under the supervision of immunization-certified staff pharmacists. An evaluation of the experience was conducted using retrospective preceptor and student-based survey data.
Assessment
In 2004 and 2005, the students administered approximately 5,000 (30-50 immunizations per student) and 15,000 (60-70 per student) immunizations, respectively. Students and preceptors agreed that the requirement to administer vaccinations was an appropriate activity for students and that it increased the students' self-confidence. When asked to rate the value of the students' work administering adult immunizations in the fall 2004 semester, the mean score given by the P2 students' immunization-certified preceptors was 9.2 on a 10-point Likert scale (1 = no value and 10 = great value).
Conclusion
Consistent with accreditation standards for students to have direct patient care responsibilities in introductory pharmacy practice experience courses, a requirement for P2 and P3 students to administer vaccines to adult patients in community pharmacies was successfully introduced.
PMCID: PMC1847551  PMID: 17429503
immunization; vaccination; pharmacy student; introductory pharmacy practice experience; accreditation standards
16.  Exploring consumer and pharmacist views on the professional role of the pharmacist with respect to natural health products: a study of focus groups 
Background
Natural health products (NHPs) such as herbs, vitamins and homeopathic medicines, are currently available for sale in most Canadian pharmacies. However, most pharmacists report that they have limited knowledge about these products which have been regulated in Canada as a specific sub-category of drugs. In this paper, consumers' and practicing pharmacists' perceptions of pharmacists' professional responsibilities with respect to NHPs are examined.
Methods
A total of 16 focus groups were conducted with consumers (n = 50) and pharmacists (n = 47) from four different cities across Canada (Vancouver, Edmonton, Toronto, and Halifax).
Results
In this paper, we illustrate the ways in which pharmacists' professional responsibilities are impacted by changing consumer needs. Many consumers in the study utilized a wide range of information resources that may or may not have included pharmacists. Nevertheless, the majority of consumers and pharmacists agreed that pharmacists should be knowledgeable about NHPs and felt that pharmacists should be able to manage drug-NHPs interactions as well as identify and evaluate the variety of information available to help consumers make informed decisions.
Conclusion
This paper demonstrates that consumers' expectations and behaviour significantly impact pharmacists' perceptions of their professional responsibilities with respect to NHPs.
doi:10.1186/1472-6882-8-40
PMCID: PMC2483265  PMID: 18625059
17.  New York City pharmacists' attitudes toward sale of needles/syringes to injection drug users before implementation of law expanding syringe access 
In May 2000, New York State passed legislation permitting the sale, purchase, and possession of up to 10 needles and syringes (hereafter “syringes”) without a prescription, intended to reduce blood-borne pathogen transmission among injection drug users (IDUs). To obtain baseline data on pharmacists' attitudes and practices related to human immunodeficiency virus (HIV) prevention and IDUs, a telephone survey was administered to 130 pharmacists systematically selected in New York City. Less than half of pharmacists were aware of the new law; 49.6% were willing to or supported providing nonprescription sales of syringes to IDUs. Pharmacists in support tended to be less likely to consider customer appearance “very important.” Managing and supervising pharmacists were more likely than staff pharmacists to support syringe sales to IDUs. Managing and supervising pharmacists who stocked packs of 10 syringes and personal sharps disposal containers, pharmacists who supported syringe exchange in the pharmacy, and pharmacists who were willing to sell syringes to diabetics without a prescription were more likely to support syringe sales to IDUs. Syringe disposal was a prominent concern among all pharmacists. Those not in support of syringe sales to IDUs tended to be more likely to believe the practice would increase drug use. These data suggest the need for initiatives to address concerns about syringe disposal and tailored continuing education classes for pharmacists on HIV and viral hepatitis prevention among IDUs.
doi:10.1007/BF02344038
PMCID: PMC3456774  PMID: 11194317
18.  Physician and Pharmacist Collaboration: The University of Hawai‘i at Hilo College of Pharmacy - JABSOM Experience 
Hawaii Medical Journal  2010;69(6 Supplement 3):42-44.
The purpose of this article is to describe the experiential program created at the newly formed University of Hawai‘i at Hilo College of Pharmacy (UHH CoP). The Introductory Pharmacy Practice Experience (IPPE) rotations were developed to prepare student pharmacists for their final year of Advanced Pharmacy Practice Experience (APPE) rotations by improving clinical skills and patient interactions. In partnership with the John A. Burns School of Medicine (JABSOM) Department of Family Practice, physician and pharmacist teams collaborate to deliver patient care for chronic diseases and elevate educational opportunities provided by UHH CoP. Another goal of the experiential program is to determine whether the investment of pharmacist faculty and adjunct physician/nurse preceptors prepares students for the final year of APPE rotations. A survey was administered to non-faculty pharmacist preceptors who taught the third IPPE rotation during the summer of 2009. Twenty-nine surveys were received from six facilities on O‘ahu and the Big Island. Initial survey results revealed an overall rating average of 3.72 (Likert scale: 1-lowest to 5-highest), an average of 4.14 for professionalism, an average of 3.41 for overall clinical skills, and an average of 3.45 for overall readiness for experiential rotations. Average ratings when compared with fourth-year students from several mainland colleges ranged from 1.7 to 2.2 (1-worse than, 2-same, 3-better). This data demonstrates that UHH CoP is investing faculty and preceptor resources wisely to enhance the preparation of students for APPE rotations.
PMCID: PMC3123145  PMID: 20540001
19.  A comprehensive system of pharmaceutical care for drug misusers 
This article outlines the evolution of a community pharmacy-based supervised consumption of methadone program in Grater Glasgow. The formalization of this program in 1994 promoted full patient compliance with the methadone regimen and reduced seepage of the drug to the illicit market. 184 of the area's 215 community pharmacies now dispense methadone for the treatment of opiate dependence. Of these, 173 have a supplementary contract with the local health board to supervise the consumption of methadone on their premises. In addition 15 of "methadone" pharmacists are involved in the provision of a pharmacy based needle exchange scheme. This has been shown to be the most efficient and cost effective method of delivering clean injecting equipment to injecting drug users in the Greater Glasgow area. Glasgow's pharmacists' have now been involved in the methadone and needle exchange programs for more than ten years. The support needed by pharmacists and the steps that have been put in place to provide this level of commitment are described. The development of the Glasgow pharmacy based services to drug users has had a major impact on practice elsewhere in the United Kingdom.
doi:10.1186/1477-7517-1-6
PMCID: PMC428584  PMID: 15169565
20.  Interventions performed by community pharmacists in one Canadian province: a cross-sectional study 
Purpose
Interventions made by pharmacists to resolve issues when filling a prescription ensure the quality, safety, and efficacy of medication therapy for patients. The purpose of this study was to provide a current estimate of the number and types of interventions performed by community pharmacists during processing of prescriptions. This baseline data will provide insight into the factors influencing current practice and areas where pharmacists can redefine and expand their role.
Patients and methods
A cross-sectional study of community pharmacist interventions was completed. Participants included third-year pharmacy students and their pharmacist preceptor as a data collection team. The team identified all interventions on prescriptions during the hours worked together over a 7-day consecutive period. Full ethics approval was obtained.
Results
Nine student–pharmacist pairs submitted data from nine pharmacies in rural (n = 3) and urban (n = 6) centers. A total of 125 interventions were documented for 106 patients, with a mean intervention rate of 2.8%. The patients were 48% male, were mostly ≥18 years of age (94%), and 86% had either public or private insurance. Over three-quarters of the interventions (77%) were on new prescriptions. The top four types of problems requiring intervention were related to prescription insurance coverage (18%), drug product not available (16%), dosage too low (16%), and missing prescription information (15%). The prescriber was contacted for 69% of the interventions. Seventy-two percent of prescriptions were changed and by the end of the data collection period, 89% of the problems were resolved.
Conclusion
Community pharmacists are impacting the care of patients by identifying and resolving problems with prescriptions. Many of the issues identified in this study were related to correcting administrative or technical issues, potentially limiting the time pharmacists can spend on patient-focused activities.
doi:10.2147/TCRM.S37581
PMCID: PMC3520548  PMID: 23248573
pharmaceutical care; pharmacy; medications; Canada; prescriptions; drug-related problems
21.  Impact of Interprofessional Activities on Health Professions Students’ Knowledge of Community Pharmacists’ Role and Services 
Objectives. To determine the impact of health professions students’ participation in interprofessional activities on their knowledge of the roles of community pharmacists and community pharmacist-provided services.
Methods. Students at the Medical University of South Carolina were surveyed via a self-administered online survey tool to determine their participation in interprofessional activities as well as their knowledge of the role of community pharmacists and community pharmacist-provided services.
Results. Over 600 students completed the survey instrument. Nonpharmacy students who attended the university-sponsored Interprofessional Day were more knowledgeable of pharmacist-provided services. Previous interaction with a pharmacist increased nonpharmacy students’ awareness of the services that pharmacists provide.
Conclusion. Participation in interprofessional activities increased health professions students’ awareness of the role of pharmacists. Continued education among healthcare professions about the role of and services provided by pharmacists is needed to ensure that pharmacists have the greatest possible impact on patient care.
doi:10.5688/ajpe758152
PMCID: PMC3220333  PMID: 22102742
community pharmacy; health professions; interprofessional education
22.  Do community pharmacists have the attitudes and knowledge to support evidence based self-management of low back pain? 
Background
In many countries, community pharmacists can be consulted without appointment in a large number of convenient locations. They are in an ideal position to give advice to patients at the onset of low back pain and also reinforce advice given by other healthcare professionals. There is little specific information about the quality of care provided in the pharmacy for people with back pain. The main objectives of this survey were to determine the attitudes, knowledge and reported practice of English pharmacists advising people who present with acute or chronic low back pain.
Methods
A questionnaire was designed for anonymous self-completion by pharmacists attending continuing education sessions. Demographic questions were designed to allow comparison with a national pharmacy workforce survey. Attitudes were measured with the Back Beliefs Questionnaire (BBQ) and questions based on the Working Backs Scotland campaign. Questions about the treatment of back pain in the community pharmacy were written (or adapted) to reflect and characterise the nature of practice. In response to two clinical vignettes, respondents were asked to select proposals that they would recommend in practice.
Results
335 responses from community pharmacists were analysed. Middle aged pharmacists, women, pharmacy managers and locums were over-represented compared to registration and workforce data. The mean (SD) BBQ score for the pharmacists was 31.37 (5.75), which was slightly more positive than in similar surveys of other groups. Those who had suffered from back pain seem to demonstrate more confidence (fewer negative feelings, more advice opportunities and better advice provision) in their perception of advice given in the pharmacy. Awareness of written information that could help to support practice was low. Reponses to the clinical vignettes were generally in line with the evidence base. Pharmacists expressed some caution about recommending activity. Most respondents said they would benefit from more education about back pain.
Conclusion
Those sampled generally expressed positive attitudes about back pain and were able to offer evidence based advice. Pharmacists may benefit from training to increase their ability and confidence to offer support for self-care in back pain. Further research would be useful to clarify the representativeness of the sample.
doi:10.1186/1471-2474-8-10
PMCID: PMC1796877  PMID: 17266748
23.  Development and Implementation of a Curricular-wide Electronic Portfolio System in a School of Pharmacy 
The Feik School of Pharmacy collaborated with a commercial software development company to create a Web-based e-portfolio system to document student achievement of curricular outcomes and performance in pharmacy practice experiences. The multi-functional system also could be used for experiential site selection and assignment and continuing pharmacy education. The pharmacy school trained students, faculty members, and pharmacist preceptors to use the e-portfolio system. All pharmacy students uploaded the required number of documents and assessments to the program as evidence of achievement of each of the school's curricular outcomes and completion of pharmacy practice experiences.
doi:10.5688/ajpe75589
PMCID: PMC3142988  PMID: 21829263
portfolio; assessment; documentation; curricular outcomes
24.  Developing Preceptors through Virtual Communities and Networks: Experiences from a Pilot Project 
Background:
Supporting preceptors is critical to the expansion of experiential learning opportunities for the pharmacy profession. Informal learning opportunities within communities of practitioners are important for hospital preceptors. However, such communities may be limited by geographic separation of preceptors from peers, faculty members, and supports within the pharmacy services department.
Objective:
To use computer-mediated conferencing to create a sense of community among preceptors, specifically by using this medium to provide initial development of and continuing support for preceptors, and to examine preceptors’ satisfaction with this approach.
Methods:
Thirty-nine preceptors who had completed a day-long face-to-face preceptor development workshop and who were supervising students in 1 of 2 specific rotation blocks were invited to participate in the study. The pharmacists used computer-mediated conferencing to meet for virtual networking about specific topics. They met once before the student rotation to receive instructions about the technology and to discuss student orientation and scheduling, and 3 times during the student rotation for open discussion of specific topics. Evaluation and feedback were solicited by means of an electronic survey and virtual (i.e., computer-based) feedback sessions with an independent facilitator.
Results:
The response rate was 66% (26/39) for the electronic survey, but only 15% (6/39) for the virtual feedback sessions. All of the respondents were experienced preceptors, but for 92% (22/24), this was their first experience with computer-mediated conferencing. Overall, the sessions had a positive reception, and participants found it useful to share information and experiences with other preceptors. The main challenges were related to the technology, perceived lack of support for their participation in the sessions, and inconvenience related to the timing of sessions.
Conclusion:
Computer-mediated conferencing allowed preceptors to learn from and to support each other despite geographic distance. The participants felt that these sessions encouraged them to serve as preceptors regularly. Such encouragement could contribute to the retention of preceptors, which is important to the expansion of experiential learning.
PMCID: PMC3242573  PMID: 22479095
preceptorship; computer-mediated conferencing; students; préceptorat; téléconférence assistée par ordinateur; étudiants
25.  Survey of Canadian Pharmacists’ Responses to Warnings of Potential Interactions Between Ceftriaxone and Calcium in IV Solutions 
Background:
In 2007, because of a potential interaction between ceftriaxone and calcium-containing IV solutions, Roche Laboratories (manufacturer of Rocephin [ceftriaxone] in the United States) issued letters to health care professionals advising them of changes to the product monograph. Subsequently, warning letters were also issued by the US Food and Drug Administration (FDA) and Health Canada. The Health Canada recommendations and their implications for clinical practice generated debate in the Canadian hospital pharmacy community.
Objective:
To evaluate the response to the warnings among hospital pharmacists and their respective institutions.
Methods:
An anonymous, voluntary 10-question survey was distributed to members of the Pharmacy Specialty Networks of the Canadian Society of Hospital Pharmacists. Requests to participate were solicited via 2 e-mail messages. Responses were analyzed descriptively.
Results:
A total of 152 pharmacists participated in the survey. Forty-three respondents (28.3%) reported being very concerned and 86 (56.6%) reported being somewhat concerned about the Health Canada Notice to Hospitals. About half (77/152 [50.7%]) of the respondents felt that the Health Canada notice did not need to be strictly heeded. Two-thirds (98/145 [67.6%]) reported that their institutions had addressed the risk of an interaction through a change in policy regarding the administration of ceftriaxone. Eighty-eight (61.5%) of 143 participants indicated that their institution’s official position on the notice was that it represented a “relative contraindication” (i.e., the benefit may outweigh the risk).
Conclusions:
Warning letters issued by the manufacturer, the FDA, and Health Canada generated concern within the Canadian hospital pharmacy community. However, a large proportion of hospital pharmacy practitioners did not agree with strict adherence to the Health Canada notice.
PMCID: PMC2827021  PMID: 22478936
ceftriaxone; calcium; administration; precipitation; ceftriaxone; calcium; administration; précipitation

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