Community Pharmacy Intervention Research Articles

Intensive community pharmacy intervention had little impact on triptan consumption: A randomized controlled trial

Objective. To evaluate the impact of an intensive pharmaceutical care campaign targeting inappropriate use of triptans. Design. Randomized controlled trial. Setting. 22 community pharmacies in the County of Funen, Denmark. Subjects. A total of 1123 triptan users at intervention pharmacies and 1340 at control pharmacies. Intervention. Intervention pharmacy staff received information on migraine and other types of headache, detection of inappropriate triptan use and other drug-related problems, and techniques for establishing a dialogue with patients. Intervention consisted of a folder and a structured dialogue with the pharmacy staff. The folder included questions aimed at detecting overuse and inappropriate triptan use. Main outcome measures. Change in average triptan consumption in doses per month measured by means of a prescription database with information on all purchases of reimbursed drugs at the level of the individual patient. Results. Overall, intervention had no statistically significant short-term impact on patients’ consumption of triptans either among incident users (intervention/control ratio 1.02; 95% confidence interval 0.95 to 1.12), or among prevalent users (1.02; 0.97 to 1.08). No effects were observed after 6 and 9 months, apart from a possible borderline effect after 9 months among prevalent users with intermediate triptan consumption (0.93; 0.87 to 1.00). Conclusion. The pharmaceutical care campaign did not reduce the use of triptans.

Smoking Cessation Program Using Nicotine Patches Linking Hospital to the Community

Objective: To compare the quit rates achieved by participants in a smoking cessation program, initiated in hospital using nicotine patches and continued in either the community pharmacy or hospital setting, with quit rates in a minimal intervention group.Setting: The medical and surgical units at The Queen Elizabeth Hospital (TQEH), a major teaching hospital located in the western suburbs of Adelaide, South Australia.Participants: Inpatients aged over 18 years who smoked 10 or more cigarettes per day. Of 306 smokers screened, 102 were enrolled.Study Procedures: Participants were randomised to either the minimal intervention arm (n = 33), the hospital‐based program (n = 35), or the community pharmacy‐based program (n = 34). The minimal intervention group received written materials and advice about quitting. The two intervention arms started with a consultation with the research pharmacist and participants were commenced on nicotine patches and were followed after discharge with weekly counselling visits with either the researcher in an outpatient clinic or a community‐based pharmacist. Patches were supplied for $15.00 per week for up to 16 weeks. Exhaled carbon monoxide measurements to confirm abstinence were performed whenever possible. Continuous and point prevalence of abstinence from smoking were assessed 3, 6 and 12 months after enrolment.Results: There was a statistically significant difference in the point prevalence of abstinence between groups at 12 months with 38%, 24% and 4.6% abstinence in the hospital, community pharmacy and minimal intervention arms respectively (X2 = 7 .145, df = 2, p = 0.031 ). The differences seen in continuous abstinence at 12 months (24%, 19% and 4.6% respectively) did not reach statistical significance.Conclusion: A hospital‐based smoking cessation program initiated with nicotine patches was equally effective whether continued by hospital‐ or community‐based pharmacists and was superior to minimal intervention without nicotine patches.