Pharmacists' roles are evolving from that of compounders and dispensers of medicines to that of experts on medicines within multidisciplinary health care teams. In the developing country context, the pharmacy is often the most accessible or even the sole point of access to health care advice and services.
Because of their knowledge of medicines and clinical therapeutics, pharmacists are suitably placed for task shifting in health care and could be further trained to undertake functions such as clinical management and laboratory diagnostics. Indeed, pharmacists have been shown to be willing, competent, and cost-effective providers of what the professional literature calls "pharmaceutical care interventions"; however, internationally, there is an underuse of pharmacists for patient care and public health efforts. A coordinated and multifaceted effort to advance workforce planning, training and education is needed in order to prepare an adequate number of well-trained pharmacists for such roles.
Acknowledging that health care needs can vary across geography and culture, an international group of key stakeholders in pharmacy education and global health has reached unanimous agreement that pharmacy education must be quality-driven and directed towards societal health care needs, the services required to meet those needs, the competences necessary to provide these services and the education needed to ensure those competences. Using that framework, this commentary describes the Pharmacy Education Taskforce of the World Health Organization, United Nations Educational, Scientific and Cultural Organization and the International Pharmaceutical Federation Global Pharmacy and the Education Action Plan 2008–2010, including the foundation, domains, objectives and outcome measures, and includes several examples of current activities within this scope.
Pharmacy support-staff (pharmacy technicians, dispensers and Medicines
Counter Assistants) support the delivery of pharmaceutical and retail
functions of the pharmacy. Workflow is supervised and at times dependent
upon the pharmacist’s presence. Policy makers and pharmacy’s representative
bodies are seeking to extend the community pharmacist's role including
requiring the pharmacist to undertake private consultations away from the
dispensary and shop floor areas. However, support-staff voices are seldom
heard and little is known about the impact such policies have on them.
The objective of this study is to explore the impact and consequences of the
English Medicine Use Review (MUR) service on pharmacy support-staff.
Ten weeks of ethnographic-oriented observations in two English community
pharmacies and interviews with 5 pharmacists and 12 support-staff. A
thematic approach was used to analyse the data.
Despite viewing MURs as a worthwhile activity, interviews with support-staff
revealed that some felt frustrated when they were left to explain to
patients why the pharmacist was not available when carrying out an MUR.
Dependency on the pharmacist to complete professional and accuracy checks on
prescriptions grieved dispensing staff because dispensing workflow was
disrupted and they could not get their work done. Medicines Counter
Assistants were observed to have less dependency when selling medicines but
some still reported concerns over of customers and patients waiting for the
pharmacist. A range of tacit and ad hoc strategies were consequently found
to be deployed to handle situations when the pharmacist was absent
performing an MUR.
Consideration should be given to support-staff and pharmacists’ existing work
obligations when developing new pharmacy extended roles that require private
consultations with patients. Understanding organisational culture and
providing adequate resourcing for new services are needed to avoid
improvisations or enactments by pharmacy support-staff and to allow
successful innovation and policy implementation.
Pharmacists' Aides; Pharmacists; Workflow; Community Pharmacy Services; Drug Utilization Review; Professional Practice; United Kingdom
To understand the contribution of the Medicines Use Review consultation to counseling practice in community pharmacies.
Qualitative study involving ten weeks of observations in two community pharmacies and interviews with patients and pharmacy staff.
‘Traditional’ counseling on prescription medicines involved the unilateral transfer of information from pharmacist to patient. Over-the-counter discussions were initiated by patients and offered more scope for patient participation. The recently introduced MUR service offers new opportunities for pharmacists’ role development in counseling patients about their medicines use. However, the study findings revealed that MUR consultations were brief encounters dominated by closed questions, enabling quick and easy completion of the MUR form. Interactions resembled counseling when handing out prescription medicines. Patients rarely asked questions and indeterminate issues were often circumvented by the pharmacist when they did. MURs did little to increase patients’ knowledge and rarely affected medicine use, although some felt reassured about their medicines. Pragmatic constraints of workload and pharmacy organisation undermined pharmacists’ capacity to implement the MUR service effectively.
Pharmacists failed to fully realise the opportunity offered by MURs being constrained by situational pressures.
Pharmacist consultation skills need to be reviewed if MURs are to realise their intended aims.
Counseling; Medicines Use Reviews; Patient centred; Patient–pharmacist communication; Pharmacy practice
The increasing trend towards deregulation of more medicines to over the counter status has implications for the primary health care team as well as for consumers and patients. Better information for patients could improve the safety of over the counter medicines, but better systems need to be devised for reporting adverse reactions. "Collaborative care" could bring financial benefits. Doctors, nurses, and pharmacists need to discuss how they will respond to self medication practices, and ways of rewarding pharmacists for advising patients need to be found. Improved communication between doctors and pharmacists and the involvement of nurses could bring health care professionals into a new and more constructive interaction with each other and with the patient--or the changes required could split the professions as they each try to keep control of medicines.
Pharmacists are not yet fully integrated into the primary health care team and their skills could be better used to help patients with their long term medicines. The government is encouraging the setting up of medicines management services. Community pharmacists are well placed to help patients who have cardiovascular disease or who are at risk of this: they have an opportunity to identify at-risk patients, they can identify under treated patients at the point of dispensing, and they can provide education and advice on lifestyle and diet. They are also involved in smoking cessation services. Practice based pharmacists can improve patient care through medication review clinics.
Patient non-adherence to medicines represents a significant waste of health resource and lost opportunity for health gain. Medicine management services are a key health policy strategy to encourage patients to take medicines as they are prescribed. One such service is the English Medicines Use Review (MUR) which is an NHS-funded community pharmacy service involving a patient-pharmacist consultation aiming to improve patients’ knowledge of medicines and their use. To date the evidence for MURs to improve patient health outcomes is equivocal and GPs are reported to be sceptical about the value of the service. This paper presents the patient’s perspective of the MUR service and focuses on the importance of GP-pharmacist collaboration for patient care. Suggestions on how MURs may have value to GPs through the delivery of increased patient benefit are discussed.
A qualitative study involving ten weeks of ethnographic observations in two English community pharmacies. Observations were made of all pharmacy activities including patient-pharmacist MUR consultations. Subsequent interviews with these patients were conducted to explore their experience of the service. Interviews with the pharmacy staff were conducted after the period of observations. A thematic approach was used to analyse the data.
Fifty-four patients agreed to have their MUR observed of which thirty-four were interviewed. Seventeen pharmacy staff were also interviewed. Patients reported positive views about MURs. However, there was little evidence suggesting that pharmacists and GPs were working collaboratively or communicating outcomes resulting from MURs. MURs were conducted in isolation from other aspects of patient care. Patients considered GPs to have authority over medicines making a few wary that MURs had the potential to cause tensions between these professionals and possibly adversely affect their own relationship with their doctor.
This study reveals the potential for effective GP-pharmacist collaboration to improve the capacity of the MUR service to support patient medicine taking. Closer collaboration between GPs and pharmacists could potentially improve patients’ use of medicines and associated health care outcomes. The current lack of such collaboration constitutes a missed opportunity for pharmacists and GPs to work together with patients to improve effective prescribing and optimise patient use of medicines.
Adherence; Community pharmacy; Cooperative behaviour; General practitioners; Medicines Use Reviews; Patients; Pharmacists
A survey was undertaken to document the primary health care role of the pharmacist in London, Ont. Of particular interest was the volume of primary contacts, the type of problem handled and the advice given by the pharmacist. The contribution of pharmacists in primary health care was found to be large, with neighbourhood pharmacies being the most active. Eighty percent of all problems were handled by recommending an over-the-counter drug. The pharmacist appears to be comfortable in this function, although a conflict may exist between his professional and merchant roles.
BACKGROUND: There have been calls for greater collaboration between general practitioners (GPs) and community pharmacists in primary care. AIM: To explore barriers between the two professions in relation to closer interprofessional working and the extension of prescribing rights to pharmacists. DESIGN OF STUDY: Qualitative study. SETTING: Three locality areas of a health and social services board in Northern Ireland. METHOD: GPs and community pharmacists participated in uniprofessional focus groups; data were analysed using interpretative phenomenology. RESULTS: Twenty-two GPs (distributed over five focus groups) and 31 pharmacists (distributed over six focus groups) participated in the study. The 'shopkeeper' image of community pharmacy emerged as the superordinate theme, with subthemes of access, hierarchy and awareness. The shopkeeper image and conflict between business and health care permeated the GPs' discussions and accounted for their concerns regarding the extension of prescribing rights to community pharmacists and involvement inextended services. Community pharmacists felt such views influenced their position in the hierarchy of healthcare professionals. Although GPs had little problem in accessing pharmacists, they considered that patients experienced difficulties owing to the limited opening hours of pharmacies. Conversely, pharmacists reported great difficulty in accessing GPs, largely owing to the gatekeeper role of receptionists. GPs reported being unaware of the training and activities of community pharmacists and participating pharmacists also felt that GPs had no appreciation of their role in health care. CONCLUSION: A number of important barriers between GPs and community pharmacists have been identified, which must be overcome if interprofessional liaison between the two professions is to be fully realised.
Expanded pharmacist prescribing is a new professional practice area for pharmacists. Currently, Australian pharmacists’ prescribing role is limited to over-the-counter medications. This review aims to identify Australian studies involving the area of expanded pharmacist prescribing. Australian studies exploring the issues of pharmacist prescribing were identified and considered in the context of its implementation internationally. Australian studies have mainly focused on the attitudes of community and hospital pharmacists towards such an expansion. Studies evaluating the views of Australian consumers and pharmacy clients were also considered. The available Australian literature indicated support from pharmacists and pharmacy clients for an expanded pharmacist prescribing role, with preference for doctors retaining a primary role in diagnosis. Australian pharmacists and pharmacy client’s views were also in agreement in terms of other key issues surrounding expanded pharmacist prescribing. These included the nature of an expanded prescribing model, the need for additional training for pharmacists and the potential for pharmacy clients gaining improved medication access, which could be achieved within an expanded role that pharmacists could provide. Current evidence from studies conducted in Australia provides valuable insight to relevant policymakers on the issue of pharmacist prescribing in order to move the agenda of pharmacist prescribing forwards.
Pharmacist prescribing; Australia; pharmacy clients; Australian pharmacy; non-medical prescribing
Benefits of engaging community pharmacists in providing wider primary care are internationally acknowledged; in Hong Kong, however, strategies for harnessing their potential contributions are yet to be launched. Here, community pharmacist and Chinese medicine retailers are responsible for providing western and Chinese over-the-counter (OTC) medications. Patterns of OTC uses reflect the characteristics of populations who rely on community pharmacists and Chinese medicine retailers as their main point of contact with the healthcare system. Analyzing the data from a Hong Kong survey (n = 33,263) on self medication and medical consultation patterns, we propose, in this article, an extended role for community pharmacists and Chinese medicine retailers, which entails aspects as follows: (1) referring patients to other medical services where appropriate; (2) providing health education and preventative services; (3) safeguarding the use of Chinese herbal medicines.
Many drugs previously restricted to prescription only status are being reclassified as pharmacy only status and hence are becoming available over the counter to patients. A general practitioner should make enquiries about a patient's self-medication practices before deciding on treatment for the patient. Over-the-counter medicines are considered safe and their increased use indicates that patients are taking greater responsibility for their own health and possibly taking some of the financial burden of drug treatment from the National Health Service. The retention of their restriction to pharmacy only sale provides some additional protection for patients and promotes the role of pharmacists in the care of patients. However, having more drugs available for self-treatment may encourage patients to believe that there is a drug treatment for every ailment. Increasing the range of drugs available over the counter increases the risks of interactions and adverse reactions and of self-treatment being undertaken when medical aid should have been sought. For general practitioners to recommend positively use of over-the-counter preparations may involve some medicolegal risks, and the potential savings to the NHS may prove illusory. Education for patients and better communication between general practitioners and community pharmacists are required to allow easier availability of modern medicines to patients in order to bring the benefits anticipated.
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.
community pharmacy; health professions; interprofessional education
Generic medicines can generate larger savings to health care budgets when
their use is supported by incentives on both the supply-side and the
demand-side. Pharmacists’'remuneration is one factor influencing the
dispensing of generic medicines.
The aim of this article is to provide an overview of different pharmacist
remuneration systems for generic medicines in Europe, with a view to
exploring how pharmacist remuneration systems can contribute to generic
Data were obtained from a literature review, a Master thesis in
Pharmaceutical Care at the Catholic University of Leuven and a mailing sent
to all members of the Pharmaceutical Group of the European Union with a
request for information about the local remuneration systems of community
pharmacists and the possible existence of reports on discounting
Pharmacists remuneration in most European countries consists of the
combination of a fixed fee per item and a certain percentage of the
acquisition cost or the delivery price of the medicines. This percentage
component can be fixed, regressive or capped for very high-cost medicines
and acts as a disincentive for dispensing generic medicines. Discounting for
generic medicines is common practice in several European countries but
information on this practice tends to be confidential. Nevertheless, data
for Belgium, France, the Netherlands and United Kingdom indicated that
discounting percentages varied from 10% to 70% of the wholesale selling
Pharmacists can play an important role in the development of a generic
medicines market. Pharmacists should not be financially penalized for
dispensing generic medicines. Therefore, their remuneration should move
towards a fee-for-performance remuneration instead of a price-dependent
reimbursement which is currently used in many European countries. Such a
fee-for-performance remuneration system provides a stimulus for generic
medicines dispensing as pharmacists are not penalized for dispensing them
but also needs to account for the loss of income to pharmacists from
prohibiting discounting practices.
Drugs, Generic; Drug Substitution; Fees, Pharmaceutical; Pharmacists; Europe
In the last decades, the provision of pharmaceutical care by community pharmacists has developed in OECD countries. These developments involved significant changes in professional practices and organization of primary care. In France, they have recently been encouraged by a new legal framework and favored by an increasing demand for health care (increase in the number of patients with chronic diseases) and reductions in services being offered (reduction in the number of general practitioners and huge regional disparities).
Objectives: This study aimed to investigate final-year pharmacy students' opinions on 1/expanding the scope of pharmacists' practices and 2/the potential barriers for the implementation of pharmaceutical care. We discussed these in the light of the experiences of pharmacists in Quebec, and other countries in Europe (United Kingdom and the Netherlands).
All final-year students in pharmaceutical studies, preparing to become community pharmacists, at the University Paris-Descartes in Paris during 2010 (n = 146) were recruited. All of them were interviewed by means of a questionnaire describing nine "professional" practices by pharmacists, arranged in four dimensions: (1) screening and chronic disease management, (2) medication surveillance, (3) pharmacy-prescribed medication and (4) participation in health care networks. Respondents were asked (1) how positively they view the extension of their current practices, using a 5 point Likert scale and (2) their perception of potential professional, technical, organizational and/or financial obstacles to developing these practices.
143 (97.9%) students completed the questionnaire. Most of practices studied received a greater than 80% approval rating, although only a third of respondents were in favor of the sales of over-the-counter (OTC) drugs. The most significant perceived barriers were working time, remuneration and organizational problems, specifically the need to create a physical location for consultations to respect patients' privacy within a pharmacy.
Despite remaining barriers to cross, this study showed that future French pharmacists were keen to develop their role in patient care, beyond the traditional role of dispensing. However, the willingness of doctors and patients to consent should be investigated and also rigorous studies to support or refute the positive impact of pharmaceutical care on the quality of care should be carried out.
To compare practice settings and activities of pharmacists with bachelor of science (BS) in pharmacy and doctor of pharmacy (PharmD) degrees.
Data from the 2009 National Pharmacist Workforce Survey instrument were analyzed. Multivariate regression was used to examine the association of the PharmD degree with time spent in dispensing and patient care.
The survey response rate by pharmacists was 52%, and 562 usable responses met our inclusion criteria. Sixty-three percent of BS and 39% of PharmD pharmacists were employed in community pharmacies, compared with 21% of BS and 38% of PharmD pharmacists employed in hospital pharmacy settings. Practicing in a community setting had the strongest influence on time spent in dispensing and time spent in patient care. Among respondents with PharmD degrees, a residency was associated with less time in dispensing and more time in patient care.
Time spent in dispensing and patient care were influenced more by practice setting than by educational degree and residency training.
degrees; graduates; pharmacist; workforce
Strong working relationships between pharmacists and physicians are needed to optimize patient care. Understanding attitudes and barriers to collaboration between pharmacists and physicians may help with delivery of primary health care services. The objective of this study was to capture the opinions of family physicians and community pharmacists in Newfoundland and Labrador (NL) regarding collaborative practice.
Two parallel surveys were offered to all community pharmacists and family physicians in NL. Surveys assessed the following: attitudes and experience with collaborative practice, preferred communication methods, perceived role of pharmacists, areas for more collaboration and barriers to collaborative practice. Results for both groups were analyzed separately, with comparisons between groups to compare responses with similar questions.
Survey response rates were 78.6% and 7.1% for pharmacists and physicians, respectively. Both groups overwhelmingly agreed that collaborative practice could result in improved patient outcomes and agreed that major barriers were lack of time and compensation and the need to deal with multiple pharmacists/physicians. Physicians indicated they would like more collaboration for insurance approvals and patient counselling, while pharmacists want to assist with identifying and managing patients’ drug-related problems. Both groups want more collaboration to improve patient adherence.
Both groups agree that collaborative practice can positively affect patient outcomes and would like more collaboration opportunities. However, physicians and pharmacists disagree about the areas where they would like to collaborate to deliver care. Changes to reimbursement models and infrastructure are needed to facilitate enhanced collaboration between pharmacists and physicians in the community setting.
Self-care, including self-medication with over-the-counter (OTC) drugs, facilitates the public’s increased willingness to assume greater responsibility for their own health. Direct consultation with pharmacists provides efficient professional guidance for safe and appropriate OTC use.
The purpose of this study was to characterize patient perceptions of pharmacists and use of nonprescription therapy in an ambulatory care population in Qatar.
Patients having prescriptions filled at one organization’s private medical clinics during two distinct two-week periods were invited to participate in a short verbal questionnaire. Awareness of pharmacist roles in guiding OTC drug selection was assessed, as were patient preferences for OTC indications. Attitudes towards pharmacist and nurse drug knowledge and comfort with direct dispensing were also evaluated.
Five hundred seventy patients participated representing 29 countries. Most respondents were men (92.1%) with mean age of 38.3 years. Almost 1 in 7 did not know medical complaints could be assessed by a pharmacist (15.3%) and 1 in 5 (21.9%) were unaware pharmacists could directly supply OTC therapy. The majority (85.3%) would be interested in this service. In general, respondents were more comfortable with medication and related advice supplied by pharmacists as opposed to nursing professionals.
Patients were familiar with the roles of pharmacists as they pertain to self-medication with OTC therapy and described the desire to use such a service within this Qatar ambulatory health care setting.
patient; self-medication; over-the-counter; pharmacist; Qatar
Background: No randomised studies have addressed whether self-management for asthma can be successfully delivered by community pharmacists. Most randomised trials of asthma self-management have recruited participants from secondary care; there is uncertainty regarding its effectiveness in primary care. A randomised controlled study was undertaken to determine whether a community pharmacist could improve asthma control using self-management advice for individuals recruited during attendance at a community pharmacy.
Methods: Twenty four adults attending a community pharmacy in Tower Hamlets, east London for routine asthma medication were randomised into two groups: the intervention group received self-management advice from the pharmacist with weekly telephone follow up for 3 months and the control group received no input from the pharmacist. Participants self-completed the North of England asthma symptom scale at baseline and 3 months later.
Results: The groups were well matched at baseline for demographic characteristics and mean (SD) symptom scores (26.3 (4.8) and 27.8 (3.7) in the intervention and control groups, respectively). Symptom scores improved in the intervention group and marginally worsened in the control group to 20.3 (4.2) and 28.1 (3.5), respectively (p<0.001; difference adjusted for baseline scores = 7.0 (95% CI 4.4 to 9.5).
Conclusions: A self-management programme delivered by a community pharmacist can improve asthma control in individuals recruited at a community pharmacy. Further studies should attempt to confirm these findings using larger samples and a wider range of outcome measures.
Today, the use of herbal medicine for primary healthcare has increased considerably. Since local pharmacists graduate with little knowledge on herbal medicine, the majority are ill-equipped to provide pharmaceutical advice.
To develop and evaluate a herbal medicine formulary to aid healthcare professionals (HCPs) in the prescribing, dispensing and counselling responsibilities.
Settings and Design
Methods and Material
Monographs on all herbal substances available locally were compiled into a formulary. The formulary was then distributed to all, 216, local pharmacies. Subsequently, a questionnaire was distributed to 55 pharmacists and 10 general practitioners (GPs).
Statistical analysis used
Descriptive statistical analysis.
A total of 177 herbal monographs have been compiled and 612 herbal products listed. Thirty HCPs participated in the questionnaire. The formulary was found to be useful by all participants with 19 claiming to use it frequently and 7 quite frequently. Participants (n = 30) agree that the information contained within the formulary was found to be useful (26), the formulary helped them learn which HMPs are present in the local market (29), the formulary is user friendly (27), information included is up-to-date and well referenced (29) and that there is the need for a formulary of this kind in Malta (28).
The formulary was found to be a useful tool for HCPs leading to high quality, evidence-based prescribing together with enhanced monitoring and improved patient care.
Formulary; Healthcare; Herbal medicine; Pharmacist; Usefulness
Pharmacists, with expertise in optimizing drug therapy outcomes, are valuable components of the healthcare team and are becoming increasingly involved in public health efforts. Pharmacists and pharmacy technicians in diverse community pharmacy settings can implement a variety of asthma interventions when they are brief, supported by appropriate tools, and integrated into the workflow. The Asthma Friendly Pharmacy (AFP) model addresses the challenges of providing patient-focused care in a community pharmacy setting by offering education to pharmacists and pharmacy technicians on asthma-related pharmaceutical care services, such as identifying or resolving medication-related problems; educating patients about asthma and medication-related concepts; improving communication and strengthening relationships between pharmacists, patients, and other healthcare providers; and establishing higher expectations for the pharmacist’s role in patient care and public health efforts. This article describes the feasibility of the model in an urban community pharmacy setting and documents the interventions and communication activities promoted through the AFP model.
Asthma; Community pharmacy; Pharmacists; Pharmaceutical care; Collaboration; Communication
Collaborative working relationships (CWRs) between community pharmacists and physicians may foster the provision of medication therapy management services, disease state management, and other patient care activities; however, pharmacists have expressed difficulty in developing such relationships. Additional work is needed to understand the specific pharmacist-physician exchanges that effectively contribute to the development of CWR. Data from successful pairs of community pharmacists and physicians may provide further insights into these exchange variables and expand research on models of professional collaboration.
To describe the professional exchanges that occurred between community pharmacists and physicians engaged in successful CWRs, using a published conceptual model and tool for quantifying the extent of collaboration.
A national pool of experts in community pharmacy practice identified community pharmacists engaged in CWRs with physicians. Five pairs of community pharmacists and physician colleagues participated in individual semistructured interviews, and 4 of these pairs completed the Pharmacist-Physician Collaborative Index (PPCI). Main outcome measures include quantitative (ie, scores on the PPCI) and qualitative information about professional exchanges within 3 domains found previously to influence relationship development: relationship initiation, trustworthiness, and role specification.
On the PPCI, participants scored similarly on trustworthiness; however, physicians scored higher on relationship initiation and role specification. The qualitative interviews revealed that when initiating relationships, it was important for many pharmacists to establish open communication through face-to-face visits with physicians. Furthermore, physicians were able to recognize in these pharmacists a commitment for improved patient care. Trustworthiness was established by pharmacists making consistent contributions to care that improved patient outcomes over time. Open discussions regarding professional roles and an acknowledgment of professional norms (ie, physicians as decision makers) were essential.
The findings support and extend the literature on pharmacist-physician CWRs by examining the exchange domains of relationship initiation, trustworthiness, and role specification qualitatively and quantitatively among pairs of practitioners. Relationships appeared to develop in a manner consistent with a published model for CWRs, including the pharmacist as relationship initiator, the importance of communication during early stages of the relationship, and an emphasis on high-quality pharmacist contributions.
Pharmacists; Physicians; Collaborative working relationships; Pharmacist-physician collaborative index; Community
To define the role and education of the traditional pharmacist who supports the needs of the veterinarian (hereafter referred to as veterinary pharmacist) and a pharmacist who practices solely in veterinary pharmacy (here after referred to as veterinary pharmacy specialist).
The Delphi technique involving 7 panels of 143 experts was employed to reach consensus on the definition of the roles and education of the veterinary pharmacist and veterinary pharmacy specialist.
The veterinary pharmacy specialist's role included dispensing medications, complying with regulations, advocating for quality therapeutic practices, and providing consultative services, research, and education. The perceived role of the veterinary pharmacist was viewed as being somewhat narrower. Compared to veterinary pharmacists, a more in-depth education in veterinary medicine was viewed as essential to the role development of veterinary pharmacy specialists.
The authors hope their research will promote widespread awareness of the emerging field of veterinary pharmacy and encourage schools to offer increased access to clinically relevant professional training programs.
veterinary pharmacy; Delphi; role; education; research method; curriculum
Headache, or cephalalgia, is one of the 20 most disabling diseases in the
world and affects a large portion of the world's population. People
generally use over-the-counter medications to treat headaches and other
minor symptoms. A pharmacist should help patients choose the most effective,
safe, and convenient pharmacotherapeutic option.
To assess the counselling skills of community pharmacists for headache management by using the simulated patient approach.
A cross-sectional study was conducted from March 2010 to July 2010. Data were
obtained from a convenience sample consisting of one pharmacist from each of
the 24 participating community pharmacies. In order to evaluate the
pharmacists' counselling skills, a simulated patient role played a
standardized headache case requesting self-medication. The interactions of
the simulated patient with the pharmacists were audiovisually recorded using
a hidden micro camera, and these recordings were analysed using a validated
Of the 24 evaluated pharmacists, 19 (79.1%) were women. Information was
spontaneously provided by 15 (62.5%) pharmacists. At least one question was
asked by the pharmacist to assess the signs and symptoms. Most pharmacists
(n=17, 70.8%) recommended sodium dipyrone, either alone or in combination
with other drugs. The most discussed items in the simulation visits were
contraindications (n=17, 70.8%), indications (n=10, 41.6%), and drug
administration times (n=8, 33.3%). None of the pharmacists recommended any
non-pharmacological therapeutic alternatives. The overall impressions of the
pharmacists' professional counselling skills ranged from poor to
This study showed that the pharmacists' counselling skills and the
guidance provided by the pharmacists to the simulated patient were
insufficient for the satisfactory management of headache.
Headache; Community Pharmacy Services; Professional Practice; Pharmacists; Patient Simulation; Brazil
In general the health of methadone clients has been found to be poorer than that of the general population. In New Zealand specialist drug services are not funded to provide primary healthcare services. Many health conditions could potentially be managed by community pharmacists who have frequent contact with this client group. This study sought to explore the health problems suffered by methadone clients, who they sought help from, and the potential for greater involvement of pharmacists.
Self-completion questionnaire of methadone maintenance clients managed in specialist care in Auckland, New Zealand.
The most common health problem experienced by these clients in the past three months was sweating (70.0%), and more than half of the respondents also reported experiencing headache, fatigue and depression. The least frequently experienced conditions were hay fever (12.9%) and abscesses (12.1%). Respondents indicated that the top three choices from whom they would seek help were GP (56.7%), the client's partner (31.6%) and community pharmacists (27.9%). Barriers to seeking help from pharmacists included issues around cost, perceptions of pharmacist knowledge and skills, privacy and confidentiality.
Methadone clients in this study indicated that they suffered a number of general health problems, and in many cases were likely to seek help from a GP or their own partner, before seeking help from pharmacists. However, for over one quarter of respondents the pharmacist was in the top three from whom they would seek advice. Any barriers towards consulting pharmacists, in the main seem to be resolvable.
Community pharmacists play a significant role in patient/disease management and perception by patients is increasingly important. A self-administered questionnaire was developed consisted of sociodemographic part and 15 questions. Patients have a positive overall perception of community pharmacists that is comparable to most studies in Europe. Community pharmacists’ beyond dispensing drugs play a significant role in patient and disease management. This role of the pharmacist is performed through pharmaceutical care. Patient’s opinion is increasingly considered to be a useful component in the determination of care outcomes and consumer satisfaction is an integral component of the quality of primary health care. For the purpose of this study we developed self-administered questionnaire consisted of sociodemographic part, and 15 questions. Survey has been conducted in 10 pharmacies. Results are presented in tables and figures and descriptive statistics has been used. We found that patients in Bosnia and Herzegovina have a positive overall perception of community pharmacists and of the services offered from community pharmacies that is comparable to most studies in Europe, but there is still room for improvement of relationships and pharmaceutical services.
patients perception; community pharmacists.