Community Pharmacists In England Research Articles

Pharmacists' perspectives on recommending herbal medicines for acute infections: a qualitative study.

Community pharmacists have an essential role in antimicrobial stewardship by providing self-care advice for self-limiting infections. To explore community pharmacists' perceptions and experiences of advising patients on management of acute respiratory tract infections (RTIs) and urinary tract infections (UTIs), and to explore issues regarding use of over-the-counter (OTC) medicines, including herbal medicines. A qualitative study using semi-structured interviews with community pharmacists in England. Qualitative interviews with community pharmacists were carried out face to face and by telephone between November 2019 and March 2020. Data were collected through in-depth, semi-structured interviews, recorded and transcribed. A reflexive thematic analysis was undertaken. In total, 18 community pharmacists were interviewed. Three main themes were identified. Theme 1 was self-management recommendations. Community pharmacists considered patients' preferences when recommending self-management strategies. Some believed that conventional OTC medications had quicker and stronger effects, while others preferred herbal OTCs as a more natural approach, particularly for less severe symptoms. Theme 2 was factors influencing pharmacists' recommendations for acute infections. This included pharmacists' perceptions of patient preferences, nature or severity of illness, research evidence, training, commercial pressures, and patient concerns about medication cost. Theme 3 was pharmacist-patient communication. Pharmacists sometimes experienced challenges with language barriers and patients' expectations of receiving antibiotics. Pharmacists emphasised the importance of being trusted by their patients. There was widespread acceptance of their role in self-management advice for acute illness and interest in the role of herbal medicines, but pharmacists did not feel confident in recommending these. Pharmacists are central to the management of self-limiting infections. There is a need to educate the public about appropriate use of antibiotics and provide training and support for pharmacists on self-management strategies including herbal medicine.

Are Community Pharmacists Ready to Deliver Pharmacogenomics Testing Services?

This study assesses the readiness and willingness of community pharmacists in England to deliver the pharmacogenomic (PG) testing service. A survey covering demographics and four key themes including awareness and training, general views and experience, barriers, willingness, and confidence was distributed to community pharmacies in the boroughs of Croydon and Sutton in South London. A total of 51 pharmacists responded to the survey. The study revealed that most respondents had a limited familiarity or understanding of pharmacogenomics (n = 32, 63%). Moreover, on average, around 60% of participants were unable to accurately identify drugs that currently have or could have potentials for PG testing. They indicated that their pharmacogenomic education and training is inadequate, with only 2/51 pharmacists reported receiving relevant training. Time constraints, shortage of staff and lack of knowledge were identified as barriers that could hinder the implementation of PG. Over 60% of respondents expressed willingness to provide PG testing service after receiving adequate training. The study found that currently not all community pharmacists are prepared to provide PG testing services, with newly qualified pharmacists appearing to have an upper hand when it comes to understanding the subject. Therefore, consistent, and uniform training is required to allow community pharmacists with all years of experience to equally contribute to the implementation of PG testing.

Clinical checking in practice: qualitative perspectives from community pharmacists.

Community pharmacists (CPs) are the last healthcare professional to check the clinical appropriateness of prescribed medicines before being dispensed to patients. This process is known as 'clinical checking' and is intended to ensure the prescribed medications are safe and effective. This study aims to explore how CPs carry out clinical checking in practice, and the main factors affecting their clinical decisions. The study was qualitative in nature, and data were collected by means of semi-structured interviews. The interview questions aimed to explore how CPs carry out clinical checking in practice. A purposive sampling strategy was employed to recruit a sample representative of CPs in England. Interview transcripts were subjected to thematic template analysis. Twelve CPs of various professional backgrounds participated in the interviews. The analysis yielded three overarching themes, namely: pharmacists' perception of the clinical checking process; clinical checking as a naturalistic decision-making process and barriers to effective clinical checking. Interviewees described being faced with a trade-off between examining each prescription thoroughly and maintaining the throughput of prescriptions, due to the highly pressurised environment they work within. A number of factors inform this trade-off: (1) assuming the safety of repeat medicines; (2) lacking access to sufficient clinical information and (3) working under challenging circumstances (such as a lack of resources). Clinical checking is a complex, variable and experience-driven process which is heavily influenced by the surrounding environment and information accessibility. Further research should investigate the cognitive process involved in clinical checking and explore the practicalities and potential benefits of the recommendations identified in this study.

Qualitative interview study exploring the early identification and referral of patients with suspected head and neck cancer by community pharmacists in England

ObjectiveTo explore pharmacists’ perceptions of, and attitudes towards, the early identification and referral of patients with signs and symptoms indicating potential diagnosis of head and neck cancer (HNC) in community...

Evaluation of the England Community Pharmacy Quality Scheme (2018–2019 and 2019–2020) in reducing harm from NSAIDs in older patients

IntroductionNon-steroidal anti-inflammatory drugs (NSAIDs) are widely used for their analgesic and anti-inflammatory action, but the gastrointestinal (GI) adverse effects are a known cause of preventable harm. A medication safety audit...

A retrospective evaluation of the effectiveness of a targeted medicines use review service in improving asthma and COPD control provided by community pharmacists in England

Abstract Objective Medicines Use Reviews (MUR) may benefit asthma and chronic obstructive pulmonary disease (COPD) control. The present study evaluates the effect of respiratory-targeted MUR-plus (MUR+) services delivered by community pharmacists on disease control. Methods A retrospective analysis of MUR+ data in the PharmOutcomes database was conducted. All patients receiving respiratory-targeted MUR+ in Milton Keynes were included. Changes in asthma control test (ACT) and COPD assessment test (CAT) scores were analysed. Key findings A total of 191 asthma and 81 COPD patients received MUR+. Asthma and COPD control improved as shown by the increase in mean ACT [+1.2 (95% CI, 0.6–1.8)] and decrease in mean CAT [−0.2 (95% CI, −1.4 to 1.0)]. Baseline ACT, smoking cessation, absence of change in drug therapy, patient education, healthcare professional referral, device training and baseline ACT score ≤19 were associated with change in ACT, but only smoking cessation was related to CAT change. A multivariable regression model comprising the aforementioned variables explained 19% of the variance in ACT change (P < 0.001). Only baseline ACT was associated with ACT change (beta = −0.34, P < 0.01). Baseline CAT, absence of change in drug therapy, smoking cessation and baseline CAT score >20 accounted for 12% of the variance in changes in CAT (P = 0.046). No variable was significantly associated with CAT change. Conclusions Respiratory-targeted MUR+ service by community pharmacists was associated with improvements in asthma control among patients with poorer baseline ACT, but not in patients with COPD. Several potentially modifiable factors such as education were associated with changes in control.

Specialist clinical skills training for 10,000 community pharmacists to be provided in England

Community pharmacists in England will be offered funded clinical skills training, including history-taking and identification for a range of serious conditions, as part of a £2m programme expected to start in December 2022. Health Education England (HEE) says it is looking for providers to deliver training for up to 10,000 pharmacists, with a mix of […]

Community pharmacists administer almost 3 million flu jabs in 2020–2021

Community pharmacists in England have recorded administering 2.6 million flu vaccines as part of the NHS advanced service in 2020–2021 — over 1 million more than were administered by community pharmacy during the previous flu season. According to statistics published by the Pharmaceutical Services Negotiating Committee (PSNC), pharmacies using Sonar and PharmOutcomes administered a total […]

RPS to offer free clinical consultation skills training to community pharmacists in England

RPS to offer free clinical consultation skills training to community pharmacists in England

The use of social media as a tool to educate United Kingdom undergraduate pharmacy students about public health

Background and purposeThe role of community pharmacists in England now includes public health service delivery, which is deemed to be an essential pharmacy service. This study aimed to evaluate pharmacy students' perceptions of social media as a learning tool and to investigate if workplace skills could be imbedded into a course assignment. Educational activity and settingFinal year Kingston University MPharm students (N = 120) were divided into 10 groups for a course assignment. They had to deliver an offline and online public health campaign on an assigned topic. Following the campaign, students delivered an oral presentation and created a poster to showcase their campaign content and strategy. FindingsOver half (51.3%) preferred the self-directed learning aspect of the assignment while 28.2% preferred the delivery of the campaign and use of social media. Students noted that they had developed team working, communication and creativity skills. Most (93.6%) agreed that social media was an effective tool when learning about public health. Students achieved higher scores for their social media pages than they did for their oral presentation. SummaryA blended learning approach proved to be an effective way to teach final year pharmacy students about public health topics. Social media was noted as an effective tool to learn about public health. A public health assignment is an effective way to support pharmacy students to learn how to use this medium appropriately to support healthy lifestyles.

The mental health literacy of British community pharmacists

PurposeThe purpose of this paper is to examine the mental health literacy (MHL) of British community pharmacists.Design/methodology/approachA survey instrument was sent by facsimile to a random sample of community pharmacists in England, Scotland and Wales. The survey instrument contained items concerning recognition of the symptoms of depression, bipolar disorder or schizophrenia, the helpfulness of a range of interventions, mental health stigma and the degree of comfort providing pharmaceutical care to people with mental health problems.FindingsAmong community pharmacists (n=329) symptom recognition was high for depression but lower for bipolar disorder and schizophrenia. Pharmacists showed a preference for evidence-based interventions and support for psychological therapies and physical activity for all three mental health problems. Pharmacists expressed less comfort providing pharmacy services to people with bipolar disorder, schizophrenia and depression than cardiovascular disease. Mental health stigma was higher for schizophrenia and bipolar disorder than depression, with many pharmacists holding misperceptions about schizophrenia and bipolar disorder.Practical implicationsThe study findings indicate the need for enhanced mental health content in the undergraduate pharmacy curriculum which should challenge misperceptions of mental illness.Originality/valueThis is the first study to investigate the MHL of British community pharmacists.

How do community pharmacists conceptualise and operationalise self-care support of long-term conditions (LTCs)? An English cross-sectional survey.

To explore community pharmacists' contributions to self-care support of long-term conditions by; investigating their conceptual understanding of self-care principles; identifying self-care support activities they considered important and their engagement in them; and examining barriers and enablers. A questionnaire was developed using existing literature and qualitative interviews, piloted and distributed online to a random sample of 10 000 community pharmacists in England between August and November 2014. The questionnaire contained sections addressing the above objectives. Data were analysed using descriptive statistics; free text comments were analysed using content analysis. A total of 609 responses were received; 334 completed all sections of the survey. Responses to statements exploring conceptual understanding showed that respondents were more likely to agree with self-care principles about patients taking responsibility and being more actively involved in their health and care; they agreed less with self-care principles promoting patient autonomy and independence. Respondents considered medicines-related self-care support activities as a lead role for community pharmacy, which they said they engaged in regularly. Whilst many agreed that other self-care support activities such as supporting self-monitoring and collaborative care planning were important, they indicated only limited engagement. Respondents identified access to patient records and availability of private consultation rooms as their main barriers and enablers, respectively; working relationship with GPs and skill-mix in community pharmacy were viewed as both barriers and enablers. Community pharmacists in this study conceptualised and operationalised self-care support of long-term conditions (LTCs) from a narrow, medicines-focussed perspective, rather than from a multifaceted, patient-focussed perspective. A concerted and coherent strategy that builds on the strengths, and tackles the identified barriers is needed if community pharmacy is to improve contributions to self-care support of LTCs.

A survey of community pharmacists’ attitudes towards mental illness

Purpose – The purpose of this paper is to compare the pharmacy services provided to people taking psychotropic and cardiovascular medications and examine the association between pharmacists’ attitudes towards mental illness and provision of pharmacy services. The paper also considers pharmacists’ opinions of the pharmaceutical care needs of people with mental illness including their physical health. Design/methodology/approach – A survey instrument was sent by facsimile to a random sample of community pharmacists in England and Wales. Findings – Community pharmacists had generally positive attitudes towards mental illness but provided significantly fewer pharmacy services (and were less comfortable providing them) to patients taking psychotropic medications than to patients taking cardiovascular medications. Awareness of the higher prevalence of physical health conditions among people with severe mental illness was not high. Provision of pharmacy services was associated with pharmacists’ attitudes towards mental illness and comfort providing pharmaceutical care. Other factors that may contribute to these disparities in service provision are discussed. Practical implications – The study findings indicate the need for enhanced mental health education for pharmacy students to improve attitudes, knowledge and confidence in mental health and the inclusion of mental health in pharmacy advanced services. Originality/value – Few studies have examined the relationship between attitudes towards mental illness and provision of pharmacy services. This was the first study to examine the attitudes of British community pharmacists towards mental illness.

Seasonal influenza vaccination delivery through community pharmacists in England: evaluation of the London pilot

ObjectiveTo evaluate the effectiveness and cost of the pan-London pharmacy initiative, a programme that allows administration of seasonal influenza vaccination to eligible patients at pharmacies.DesignWe analysed 2013–2015 data on vaccination...

Delegation: a solution to the workload problem? Observations and interviews with community pharmacists in England.

This study aims to describe how pharmacists utilise and perceive delegation in the community setting. Non-participant observations and semi-structured interviews with a convenience sample of community pharmacists working in Kent between July and October 2011. Content analysis was undertaken to determine key themes and the point of theme saturation informed sample size. Findings from observations were also compared against those from interviews. Observations and interviews were undertaken with 11 pharmacists. Observations showed that delegation occurred in four different forms: assumed, active, partial and reverse. It was also employed to varying extents within the different pharmacies. Interviews revealed mixed views on delegation. Some pharmacists presented positive attitudes towards delegation while others were concerned about maintaining accountability for delegated tasks, particularly in terms of accuracy checking of dispensed medication. Other pharmacists noted the ability to delegate was not a skill they found inherently easy. Comparison of observation and interview data highlighted discrepancies between tasks pharmacists perceived they delegated and what they actually delegated. Effective delegation can potentially promote better management of workload to provide pharmacists with additional time to spend on cognitive pharmaceutical services. To do this, pharmacists' reluctance to delegate must be addressed. Lack of insight into own practice might be helped by self-reflection and feedback from staff. Also, a greater understanding of legal accountability in the context of delegation needs to be achieved. Finally, delegation is not just dependent on pharmacists, but also on support staff; ensuring staff are empowered and equipped to take on delegated roles is essential.

Community pharmacists' experience and perceptions of the New Medicines Service (NMS).

The New Medicines Service (NMS) is provided by community pharmacists in England to support patient adherence after the initiation of a new treatment. It is provided as part of the National Health Service (NHS) pharmacy contractual framework and involves a three-stage process: patient engagement, intervention and follow-up. The study aims to explore community pharmacists' experiences and perceptions of NMS within one area of the United Kingdom. In-depth semi-structured telephone interviews were conducted with 14 community pharmacists. Interviews were audio-recorded, independently transcribed and thematically analysed. Pharmacists gave a mixed response to the operationalisation, ranging from positive opportunities for improving adherence and enhancement of practice to difficulties in terms of its administration. Pharmacists generally welcomed opportunities to utilise their professional expertise to achieve better patient engagement and for pharmacy practice to develop as a patient resource. There was a perceived need for better publicity about the service. Different levels of collaborative working were reported. Some pharmacists were working closely with local general practices most were not. Collaboration with nurses in the management of long-term conditions was rarely reported but desired by pharmacists. Where relationships with general practitioners (GPs) and nurses were established, NMS was an opportunity for further collaboration; however, others reported a lack of feedback and recognition of their role. Community pharmacists perceived the NMS service as beneficial to patients by providing additional advice and reassurance, but perceptions of its operationalisation were mixed. Overall, our findings indicate that NMS provides an opportunity for patient benefit and the development of contemporary pharmacy practice, but better collaboration with GPs and practice nurses could enhance the service.

A qualitative study exploring community pharmacists' awareness of, and contribution to, self-care support in the management of long-term conditions in the United Kingdom.

Self-care support refers to activities aimed at educating, training and empowering patients with skills and ability to manage [and monitor] their long-term conditions (LTCs). While self-care support by health care professionals has emerged as a distinct concept in the management of LTCs, evidence of community pharmacy's contribution is sparse. The aim was to explore community pharmacy's contribution to self-care support of LTCs. The objectives were to explore how community pharmacists conceptualize self-care support of LTCs and how they operationalize the core elements of this in their practice. Semi-structured interviews were conducted with community pharmacists in England (n = 12) and Scotland (n = 12). A framework consisting of the core elements of self-care support (information and advice; skills training and support; technology; support networks; and collaborative care planning) was developed from the literature and was used to structure the interviews and analysis. Analysis was done thematically using the interpretative phenomenological analysis technique. The three main themes that emerged were conceptualization; operationalization of the core elements; and barriers to providing self-care support. Participants conceptualized self-care of LTCs as patients taking responsibility for their own health, performing activities that improved their LTCs and that enabled them to become more independent in managing their LTCs. Their views on self-care support did not reflect this conceptual understanding but was described primarily as providing patients with information and advice rather than actively supporting them. Participants' views of operationalizing the core elements of self-care support was found to be medicines focused, opportunistic and dependent on the services they provided, rather than being patient-centered and proactive. The barriers to providing self-care support of LTCs in community pharmacy were described as priority accorded to dispensing activities, the structure of the community pharmacy contract, lack of incentives to provide self-care support and patients' expectations and lack of awareness of community pharmacy's role in LTCs management. Community pharmacists' theoretical understanding of self-care was not reflected in the ways that they portrayed their contributions to self-care support. The current ways in which community pharmacy delivers its services for patient care may need to be re-configured in order to fit into the holistic self-care support paradigm.

Community pharmacists in England to get access to the summary care record

Community pharmacists in England to get access to the summary care record

Existing arrangements for monitoring community pharmacies in England: Can they have a role in the revalidation of pharmacists?

BackgroundMaintaining and regulating professional competence in health care is a growing concern. Tasked with developing a system of revalidation for pharmacy professionals, the pharmacy regulator in Great Britain commissioned a series of studies to evaluate existing sources of evidence as potential contributors to the revalidation process. ObjectivesTo explore the utility of existing regulatory inspections and service commissioners' contract monitoring processes in the community pharmacy sector as sources of evidence of the fitness to practice of pharmacists in England. MethodsThirteen semistructured telephone interviews conducted with representatives of the regulatory Inspectorate and community pharmacy commissioners. ResultsInterviewees described current processes for inspecting and monitoring community pharmacy premises and the services they provided. Their focus was primarily on the pharmacy and not on the pharmacist. Views were given as to how the roles of the Inspectorate and service commissioners might be developed to incorporate aspects of revalidation. Particular issues were raised in relation to the revalidation of self-employed locum and independent owner pharmacists. ConclusionsExisting inspection and contract monitoring processes have little utility in providing evidence of the fitness to practice of individual community pharmacists in England. However, there may be potential for the Inspectorate and service commissioners to develop a role in revalidation, particularly for locum pharmacists and/or independent pharmacy owners. Moreover, they may take a role in providing the infrastructure required to support the process of revalidation for community pharmacists. Current financial pressures and restructuring in the National Health Service, however, are obstacles to the development of revalidation processes.

Community pharmacists' perceptions of the skin conditions they encounter and how they view their role in dermatological care

To explore pharmacists' perceptions of the skin conditions they encounter, sources of postgraduate dermatological training and views of their role in the management of patients with skin problems. A self-completion questionnaire was sent to a random sample of 3500 community pharmacists in England and Wales. Seventy-eight per cent of pharmacists felt that patients sought their advice on problems about dry skin on a weekly basis. A total of 64.8% had undertaken postgraduate training in dermatology and the majority agreed that they played an important role in managing patients with skin problems. Pharmacists routinely encounter a small number of skin conditions and believe they can contribute towards the care of patients with skin diseases.