Patient-pharmacist Relationships Research Articles

Patients’ perceptions of community pharmacists’ role: A cross-sectional study in Lebanon

Introduction Recognizing, fostering, and maintaining a favorable public image is crucial for developing strong connections between patients and pharmacists, ultimately enhancing the pharmacist’s influence on healthcare results. Consequently, this research seeks to evaluate how the community perceives the role of pharmacists in Lebanon. Methods A cross-sectional study was conducted among the Lebanese residents over 2 months. One-way analysis of variance assessed the relationship between the perception score and the general characteristics of the study sample. A multivariate analysis was performed using linear regression models to evaluate the combined effect of predictors on the perception score. Results The study comprised exclusively Lebanese participants, with a slightly higher proportion of males (53.4%) than females (46.6%) and a diverse age distribution, ranging from 18 to 65 years old, with 9.1% being 65 years or older. After adjusting for covariates, females scored 0.25 points lower than males (CI (−0.65, 0.15); p = .217), while individuals aged 40–49 and 50–65 had perception scores of 0.18 and 0.55 points lower than those aged 18–29, respectively (CI (−0.83, 0.48); p = .595 and CI (−1.29, 0.20); p = .153, respectively). Participants from Nabatiyeh had a perception score increase of 0.82 compared to those in Beirut (CI (0.15–1.49); p < .017), and those working in non-medical fields scored 0.90 points lower than others (CI (−1.49, −0.32); p = .002). Individuals with at least one comorbidity scored 0.83 points lower (CI (−1.44, −0.21); p = .008), while patients with public insurance and those with a treatment duration of 6 months had perception scores 0.57 and 0.66 points lower, respectively, compared to their counterparts (CI (−1.12, −0.03); p = .039 and CI (−1.29, −0.03); p = .040). Conclusion Findings stress the significance of tailored healthcare and consistent patient-pharmacist relationships, especially for managing complex conditions, underscoring the importance of understanding these dynamics to bolster trust and appreciation for community pharmacists in Lebanon.

Patient-pharmacist relationship dynamics: a mediation analysis of patient characteristics and reported outcomes.

While previous research underscores the independent effect of the pharmacist-patient relationship on patient outcomes, it did not delve further into the patient-pharmacist relationship dynamics and their effects on reported outcomes. Therefore, this study aimed to assess whether patient-pharmacist relationship aspects mediate the association between patient personal and health characteristics, on the one hand, and adherence to medication and quality of life, on the other hand (QOL). An online cross-sectional study was conducted between April 11 and 27, 2023. It enrolled 865 adults from all Lebanese governorates and used validated scales to measure the various concepts. The mean age was 32.52 ± 14.56 years, and 68.8% were female. Also, 79.3% reported having no chronic disease, and 57.7% indicated that getting nonprescription medications was the main reason for visiting a community pharmacy. The average routine intake of medications per day was 0.87 ± 1.78. Our key findings reveal a compelling association between worse health status and both increased medication non-adherence and reduced QOL. Sociodemographic factors were found to be correlated with QOL. Despite the considerable impact of demographic factors on patient expectations, our study challenges the expected mediation role of the pharmacist-patient relationship and counseling time on medication adherence. Nevertheless, patient expectations partially mediated the relationship between sociodemographic characteristics and QOL. This study sheds light on the intricate dynamics between patient characteristics, health status, medication adherence, and QOL within the context of the patient-pharmacist relationships.

Recognition of Community Pharmacists' Behaviors Related to Information Sharing: A Cross-Sectional Study.

With the recent shift in community pharmacist services toward in-person services and the growing need for centralized and continuous medication management/monitoring, pharmacist-patient information sharing is crucial. This study investigated the pharmacist-patient gap in the recognition of pharmacists' behaviors regarding information sharing and assessed the potential impact of such recognition on patient trust and willingness to self-disclose. This cross-sectional study included 600 patients (aged 21-85 years) using pharmacy services (surveyed online in December 2020) and 591 community pharmacists with ≥1 year of experience (surveyed from September to November 2021). Both groups responded to items on the recognition of pharmacists' behaviors regarding information sharing. There were patient-specific items on trust in community pharmacists and willingness to self-disclose. For all items on the recognition of pharmacists' behaviors, patients' scores were significantly lower (4-5) than pharmacists' own scores (≥5), revealing a notable perception gap. Patients' recognition had a positive, direct effect on trust and willingness, and trust had a positive, direct effect on willingness. Patients' recognition and trust positively influenced their willingness to self-disclose. Pharmacist communication with clear intent is important to bridge the gaps in pharmacist-patient recognition and foster effective patient-pharmacist relationships.

Investigation of predictors influencing patient-pharmacist relationship establishment

BackgroundA strong patient-pharmacist relationship is tied to patients’ trust and confidence in pharmacists and pharmacy services. While past research has described patient-pharmacist relationship archetypes (i.e., “customer,” “client,” “partner”) with potential to help pharmacists initially understand patients’ preferences and expectations of care and services, little is known about potential factors that underlie these preferences and expectations. ObjectivesThis study was aimed to [1] compare the prevalence of the current and desired patient-pharmacist relationships archetypes reported by patients and [2] identify the sociodemographic, health, and medication use and procurement factors predictive of the archetypes representing patients’ current relationship with outpatient pharmacists. MethodsData from 1521 patients were collected via the 2021 National Consumer Survey on Medication Experience and Pharmacists' Role. Patient-pharmacist relationship distribution across patients’ sociodemographic characteristics was explored using crosstabulations. Multinomial logistic regression was also used to investigate the association between patient sociodemographic characteristics and the current patient-pharmacist archetype relationships. ResultsThe mean age of the patients was 53.9 years and 57.3% were married. Thirty-two percent of the patients reported currently having a “Customer” relationship, while 17.9% and 15.2% reported having a “Client” and “Partner” archetype relationship, respectively. “Client” (25.2%) and “Partner” (20.2%) relationships were the most commonly preferred archetypal relationships. The odds ratios (OR) of having “Client” or “Partner” relationships increased with the number of patients’ health conditions and medications. Patients who visited independently owned and clinic pharmacies had a higher OR of building professional relationships with a pharmacist. ConclusionThe qualities of a patient-pharmacist relationship may be associated with key patient characteristics. Pharmacists can build relationships with patients informed by a continuum of patient preferences, expectations, and needs to optimize health outcomes.

Influence of patient-pharmacist relationship on willingness to accept pharmacist-provided services

BackgroundWillingness to accept various pharmacist-provided services such as health promotion and medication management is still considered low. Evidence suggests that patient experience and socio-demographics partially explain patient willingness to use pharmacy services. However, the influence of a patient's relationship with their pharmacist may provide additional explanatory power. ObjectivesThe aims of the study were to [1] explore the willingness to accept pharmacy services across patients’ relationship with pharmacists and [2] evaluate the association between the patient-pharmacist relationship and patients' willingness to accept pharmacist-provided services. MethodsA total of 1521 respondents' data on the types of patient-pharmacist relationships and willingness to accept dispensing, drug information, medication management, and health promotional services were collected from the 2021 National Consumer Survey on Medication Experience and Pharmacists' Role. Willingness scores across the groups were evaluated using chi-square and analysis of variance. Binary logistic regression was used to investigate the associations between patient-pharmacist relationships and willingness to accept pharmacist-provided services. ResultsMore respondents were "definitely willing" to accept dispensing services (68.5%) and drug information (68.3%), while 56.5% and 50.1% were "definitely willing" to accept health promotion and medication management services, respectively. While respondents with "customer" and "client" archetype relationships were definitely willing to accept the 4 categories of pharmacy services, the highest proportion of respondents definitely willing to accept the services was observed among those with "partner" archetype relationships. Willingness scores increased significantly across the archetype relationships. Respondents with a "partner" archetype relationship had the highest and most significant odds ratio of accepting all the categories of pharmacist-provided services. ConclusionWillingness to accept services from pharmacists increased as the level of the patient-pharmacist relationship grew. Patients in "partner" archetype relationship were significantly more likely to accept all categories of pharmacist-provided services. Pharmacists are encouraged to embrace the patient-pharmacist relationship continuum to optimize patient care.

Perinatal Women’s Views of Pharmacist-Delivered Perinatal Depression Screening: A Qualitative Study

Internationally, 20% of women experience perinatal depression (PND). Healthcare providers including general practitioners and midwives are critical in providing PND screening and support; however, the current workforce is unable to meet growing demands for PND care. As accessible and trusted primary healthcare professionals, pharmacists could provide PND care to complement existing services, thereby contributing to early detection and intervention. This study aimed to explore perinatal women's views of community pharmacist-delivered PND screening and care, with a focus on their attitudes towards and acceptability of PND screening implementation in community pharmacy. Semi-structured interviews with women (n = 41) were undertaken, whereby interview data were transcribed verbatim and then inductively and thematically analysed. Five overarching themes emerged; "patient experience with existing PND support and screening services"; "familiarity with pharmacists' roles"; "pharmacist visibility in PND screening care"; "patient-pharmacist relationships" and "factors influencing service accessibility". Themes and subthemes were mapped to the Consolidated Framework for Implementation Research. Findings highlight participants' generally positive attitudes towards community pharmacist-delivered PND screening and care, and the potential acceptability of such services provided pharmacists are trained and referral pathways are established. Addressing perceived barriers and facilitators would allow community pharmacist-delivered PND screening and care to support existing PND care models.

Understanding factors that could influence patient acceptability of the use of the PINCER intervention in primary care: A qualitative exploration using the Theoretical Framework of Acceptability.

IntroductionMedication errors are an important cause of morbidity and mortality. The pharmacist-led IT-based intervention to reduce clinically important medication errors (PINCER) intervention was shown to reduce medication errors when tested in a cluster randomised controlled trial and when implemented across one region of England. Now that it has been rolled out nationally, and to enhance findings from evaluations with staff and stakeholders, this paper is the first to report patients’ perceived acceptability on the use of PINCER in primary care and proposes suggestions on how delivery of PINCER related care could be delivered in a way that is acceptable and not unnecessarily burdensome.MethodsA total of 46 participants living with long-term health conditions who had experience of medication reviews and/or monitoring were recruited through patient participant groups and social media. Semi-structured, qualitative interviews and focus groups were conducted face-to-face or via telephone. A thematic analysis was conducted and findings mapped to the constructs of the Theoretical Framework of Acceptability (TFA).ResultsTwo themes were identified and interpreted within the most relevant TFA construct: Perceptions on the purpose and components of PINCER (Affective Attitude and Intervention Coherence) and Perceived patient implications (Burden and Self-efficacy). Overall perceptions on PINCER were positive with participants showing good understanding of the components. Access to medication reviews, which PINCER related care can involve, was reported to be limited and a lack of consistency in practitioners delivering reviews was considered challenging, as was lack of communication between primary care and other health-care providers. Patients thought it would be helpful if medication reviews and prescription renewal times were synchronised. Remote medication review consultations were more convenient for some but viewed as a barrier to communication by others. It was acknowledged that some patients may be more resistant to change and more willing to accept changes initiated by general practitioners.ConclusionsParticipants found the concept of PINCER acceptable; however, acceptability could be improved if awareness on the role of primary care pharmacists is raised and patient-pharmacist relationships enhanced. Being transparent with communication and delivering streamlined and consistent but flexible PINCER related care is recommended.

Patients’ opinions on participation in patient-centered outcomes research in community pharmacies: A qualitative study

BackgroundPatient-centered outcomes research (PCOR) often brings patient voices, thoughts, and opinions into the research process, allowing patients to have a say in the research process from project inception to dissemination of results. Community pharmacy teams are well-situated to engage patients in their own health and in research, given their trusting relationships with patients and access in communities. ObjectiveTo gather patients’ opinions on participation in PCOR at their local community pharmacy. MethodsFour regional focus groups representing western, central, northeastern, and southeastern Pennsylvania were conducted. A single community pharmacy in each region recruited patients to participate in each focus group. A focus group discussion guide was developed and reviewed by a Stakeholder Advisory Board that consisted patients, pharmacists, and researchers. Questions focused on patients’ relationships with their pharmacy and pharmacist, perceptions of research occurring at their local pharmacy, and patient engagement methods. Focus group sessions were audio-recorded, transcribed verbatim, and independently coded by 2 investigators. Coding discrepancies were reconciled through discussion, and a qualitative inductive thematic analysis was conducted by the research team. ResultsA total of 44 patients participated in one of 4 focus groups. Patients provided insights into what would make them more likely to participate in PCOR at their local community pharmacy. Four themes emerged from the discussions: (1) Understanding the impact to one’s health or community affects participation; (2) Patients prefer to schedule research activities at times outside of prescription pick-up or drop-off; (3) Trusted relationships can be leveraged for recruitment; and (4) Face-to-face engagement is preferred for participant recruitment. ConclusionPatients want to engage in research in a way that is respectful of their time and matters to them. Strong patient-pharmacist relationships are essential for patient engagement in and acceptance of PCOR opportunities in community pharmacies. Community pharmacies may be rich locations to engage patients in PCOR.

Factors impeding the supply of over-the-counter medications according to evidence-based practice: A mixed-methods study.

ObjectiveDespite the positive attitudes pharmacists have toward evidence-based practices (EBPs), its application in community pharmacies in Saudi Arabia is lacking. Therefore, this study aimed to explore and assess EBPs by community pharmacists in Saudi Arabia when they dispense over-the-counter (OTC) medications for three minor ailments: diarrhea, cough, and the common cold.Research design and methodsWe used a mixed-methods approach consisting of two study parts. The first was a quantitative investigation that used mystery shoppers. Four researchers, posing as mystery shoppers, visited 214 randomly selected pharmacies in the Riyadh region of Saudi Arabia. They used 14 questions from a standardized checklist to examine EBPs by community pharmacists. The qualitative part of the study entailed three focus-group discussions with 13 pharmacists from different community practice settings and explored factors that affected the application of EBPs when supplying OTC medications from the pharmacists’ point of view.ResultsThe analysis indicated that 40% of pharmacists dispensed OTC medications according to EBPs. Logistic regression analysis showed that one question, "Describe your symptoms", predicted the correct supply of OTC medications (p = 0.021). The qualitative section of the study identified nine factors that affected EBP. Some of these factors facilitated EBP, such as established patient-pharmacist relationships, some acted as barriers such as conflicts between available evidence, while other factors could either facilitate or hinder EBPs, such as the health literacy of the patient.ConclusionGiven that dispensing OTC medication is a core function of pharmacists, this study uncovered low adherence to EBPs by community pharmacists in Saudi Arabia when dispensing OTC medication for three minor ailments: diarrhea, cough, and the common cold. Furthermore, this study identified a number of explanatory factors for this low adherence. Targeting these factors could help change the behavior of pharmacists and decrease undesirable outcomes.

Formation of a statewide community pharmacy practice-based research network: Pharmacist opinions on research participation and engagement

ObjectiveTo gather the insights and opinions of pharmacist stakeholders to inform the creation of a community pharmacy practice-based research network (PBRN) in Pennsylvania. DesignA stakeholder advisory board of pharmacists, patients, and researchers was established to guide this research. This was a qualitative study using a semistructured interview guide. Setting and participantsCommunity pharmacists from the Pennsylvania Pharmacist Care Network. Outcome measuresThemes were identified that describe pharmacist insights and opinions on research participation and preferences for engagement in the PBRN. ResultsA total of 16 pharmacists participated in the study. The pharmacists believed that participating in research would help demonstrate their value and commitment to improving patients’ health. Enhancing patient-pharmacist relationships and driving innovation were additional benefits that were reported. The pharmacists believed that they could effectively leverage their relationships with patients to engage them in research opportunities. The pharmacists reported that they would like to share research ideas and successful research practices with other members of the PBRN. ConclusionGathering pharmacists’ opinions on participating in research was an important step in developing a community pharmacy PBRN that meets stakeholder needs. The results of this study can help others who seek to form community pharmacy PBRNs that facilitate stakeholder-driven research.

The impact of mobile health monitoring on the evolution of patient-pharmacist relationships

PurposeIncreasingly popular mobile health technology is creating a new paradigm for the delivery of care to patients involving a role of the pharmacist. This study aims to propose a renewed patient–pharmacist relationship in this environment and present an empirical case study investigating the influence of key variables, including the consumer’s attitude toward personalized monitoring performed by the pharmacist, on the intention to adopt a mobile health app. Other drivers identified were ease of use and perceived usefulness of the app, individual and health-related factors (perceived vulnerability and severity of health condition, social norms and innovativeness with technology) and quality of relationship with the pharmacist.Design/methodology/approachA self-administered online survey was completed by 356 Canadian mobile device owners of more than 40 of age. Analyses were performed using structural equation modeling.FindingsThe main factor driving adoption intentions was perceived usefulness followed by the respondent’s innovativeness with technology and perceived vulnerability of his/her health condition. Attitude toward personalized monitoring depends primarily on the relationship with the pharmacist. No relationship was found between adoption intentions and attitude toward personalized monitoring.Originality/valueThis research features a multidisciplinary approach by using variables from relational marketing, information technology and health and inclusion of the pharmacist (vs physician) as a health consultant, offering relevant marketing avenues for pharmacists.

"Being in Control of My Asthma Myself" Patient Experience of Asthma Management: A Qualitative Interpretive Description.

Asthma control can be achieved with effective and safe medication use; however, many patients are not controlled. Patients’ perceptions of asthma, asthma treatment, and pharmacist roles can impact patient outcomes. The purpose of this study was to explore patients’ experiences and patient–pharmacist relationships in asthma care. Qualitative Interpretive Description method guided the study. Semi-structured individual interviews were conducted with 11 patients recruited from personal contacts, pharmacies, and asthma clinics. Categories and themes were identified using inductive constant comparison. Themes indicated patients had a personalized common sense approach to asthma management, “go-to” health care provider, and prioritized patient–pharmacist relationships. Patients described their illness experiences and asthma control based on personal markers similar to the common sense model of self-regulation. Patients chose a family physician, asthma specialist, respiratory therapist, or pharmacist as an expert resource for asthma management. Patient perceived pharmacists’ roles as information provider, adviser, or care provider. Pharmacists who develop a collaborative relationship with their asthma patients are better positioned to provide tailored education and self-management support. Inviting patients to share their perspective could increase patient engagement and uptake of personalised asthma action plans to achieve asthma control.

Bulletin: Patient–pharmacist relationships key to home BP monitoring success; Development of MAT drugs for opioid use disorder; Valsartan guidance from FDA; Antibiotics currently overprescribed in urgent care; Pharmacists eligible for up to $70K through NIH student loan repayment program

Bulletin: Patient–pharmacist relationships key to home BP monitoring success; Development of MAT drugs for opioid use disorder; Valsartan guidance from FDA; Antibiotics currently overprescribed in urgent care; Pharmacists eligible for up to $70K through NIH student loan repayment program

Patient preferences for objective quality metrics during community pharmacy selection: A discrete choice experiment.

Patients select healthcare providers and facilities based on a complex array of factors. Pharmacy-level quality metrics have been discussed as a way to help direct patients towards high-quality pharmacies. Limited research has been conducted on the potential impact of quality metrics on the pharmacy selection process. This study aimed to measure the relative strength of patient preferences for community pharmacy attributes and to describe associations between patient sociodemographic and health characteristics and pharmacy preferences. This study elicited preferences for pharmacy attributes using a discrete choice experiment presenting a scenario in which participants had moved to a new location and needed to select a pharmacy. Six attributes were selected based on published literature, expert opinion, and pilot testing feedback. Attributes were relationship-based (hours of operation, staff friendliness/courtesy, pharmacist communication, pharmacist willingness to establish a personal relationship) or competence-based (overall quality and a drug-drug interaction (DDI) specific quality metric). Participants responded to blocks of 10 random and 2 fixed choice tasks assigned by Sawtooth v9.2. Data were analyzed using conditional logit, and Hierarchical Bayes estimates of individual-level utilities were used to compare preferences across demographic subgroups. Study participants expressed the strongest preferences for competence-based pharmacy attributes, including DDI-specific and overall quality measures (Attribute Importance Values: 40.3% and 31.3%, respectively). Women ascribed higher utility to 5-star DDI and overall quality ratings than men. Rural respondents and those with inadequate health literacy expressed stronger preferences for patient-pharmacist relationships than those in suburban areas and with adequate health literacy, respectively. Respondents exhibited strong preferences for pharmacies with higher competence-based quality ratings, suggesting that they may perceive medication safety to be a key role of community pharmacists. Future research on patient expectations of and preferences for community pharmacies can inform ways to effectively encourage patient engagement with pharmacists to improve health outcomes.

Community pharmacists' attitudes and opinions towards supplying clozapine.

Background Clozapine is very effective for treatment-resistant schizophrenia, but its use has been limited due to the risk of agranulocytosis. From July 2015, clozapine has been accessible from Australian community pharmacies following regulatory changes, but pharmacists' attitudes towards these changes remain unknown. Objective To explore pharmacists' perspectives and experiences in supplying clozapine. Setting Australian community pharmacists. Methods A cross-sectional study with a mixed methods approach involving two phases. An online survey containing Likert-type and open-response questions was distributed to community pharmacists (n = 134) via ClopineCentral™ (clozapine monitoring system). Participants were then invited to participate in semi-structured telephone interviews (n = 12) regarding clozapine supply. Quantitative data were statistically analysed, while qualitative responses were thematically content-analysed. Main outcome measures Pharmacists' responses to surveys and interviews. Results Community pharmacists were supportive towards supplying clozapine as it increased access for consumers. Better patient-pharmacist relationships and holistic care approach were identified to benefit both consumers and pharmacists. Pharmacists reported to be confident (89.6%), have adequate support (73.1%), knowledge (86.6%) and skills (93.3%) in dispensing clozapine. Training and support received facilitated pharmacists' roles, whereas administrative issues, especially in obtaining valid haematology results, posed challenges. Educational and technical improvements were suggested to improve service provision. Conclusion Community pharmacists welcomed the regulatory changes positively and were confident in supporting consumers taking clozapine. Despite challenges present, benefits and facilitators identified supported the feasibility of this service in community pharmacies. Future research should explore other aspects of clozapine supply, such as attitudes of other stakeholders, to improve current supply systems.

SCREENING OF DRUG RELATED PROBLEMS IN HIV PATIENTS RECEIVING ANTI RETROVIRAL THERAPY

Aim: The main aim of the study is prospective screening of drug related problems in ART receiving patients at RIMS Kadapa. Objectives: The key objectives of the study include To identify various drug related problems using various domains as per PCNE (Pharmaceutical care network Europe). To identify the most common ART regimen causing DRP. Methodology: A prospective observational study conducted for a period of six months november2015-april 2016. The data was collected by using Patient Data Collection Form, PCNE classification V5.01, Drug interaction form, ADR form. The collected data was analysed for age and gender distribution, distribution of patients based on co morbidities, patients with and without DRPs based on type of ART regimen used, distribution of problems, causes for different problems, interventions suggested for different problems then outcome of interventions were calculated. Results: A total of 125 patients 104 members experienced DRPs with ART regimens, which accounts 63(60.57%) males and 41(39.42%) females. Out of 104 patients 59 members experienced DRPs with ZLN regimen. In those patients the main DRPs were adverse drug reactions, drug use problems and drug interactions. The main causes for those problems were Pharmacokinetic problems incl. Ageing/ deterioration in organ function and interactions (C1.4), manifest side effect no other cause (C1.8) as per PCNE scheme V5.01. The various interventions suggested for those problems were Patient (medication) counselling (I2.1), Instructions for use changed to......(I3.4), new drug started(I3.6). the outcomes for suggested interventions were problems( Rashes, muscle pain, vomiting, nausea, headache, cough, abdominal pain.....etc.) totally solved(O1.0) and problems (Neutropenia, anaemia, hyper pigmentation of skin & nails, ear impairment, severe anaemia, finger paralysis, blurred vision.....etc.) were partially solved(O2.0). Conclusion: Our study concludes adverse drug reactions with ART are high in problems domain as per PCNE, which can be decreased by identifying DRPs in early stages of drug therapy, prescribing other drugs cautiously in HIV patients. Majority of DRPs can be decreased by improving patient-physician relationships and patient-pharmacist relationships. For better outcomes patient counselling can be considered as a better interventional tool which will improve adherence and decrease DRPs in HIV patients. Keywords: Pharmaceutical Care Network Europe, Drug related problems, Anti retro viral therapyÂ

Predictors of effective therapeutic relationships between pharmacists and patients with type 2 diabetes: Comparison between Arabic-speaking and Caucasian English-speaking patients.

The benefits of pharmacist-led interventions in achieving desired patient outcomes have been well established. Effective patient-pharmacist relationships are required to provide high-quality pharmacy care. Limited information is available about how Arabic-speaking migrants with diabetes, in Australia, perceive patient-pharmacist relationship and how these perspectives differ from the mainstream society (represented by Caucasian English-speaking people). To examine and compare the patient-pharmacist relationship, medication underuse and adherence levels among Arabic-speaking and Caucasian English-speaking patients with type 2 diabetes. A 98-item survey incorporating several previously-validated measurements was completed by Arabic-speaking migrants (ASMs) and Caucasian English-speaking patients (ESPs) with type 2 diabetes. Participants were recruited from various healthcare settings in the Melbourne metropolitan area and rural Victoria, Australia. This survey-based, cross-sectional study was designed to explore patients' perceptions of the patient-pharmacist relationship. A descriptive analysis of responses was undertaken, and binary logistic regression was used to explore patient-pharmacist relationships. A total of 701 participants were recruited; 392 ASMs and 309 ESPs. Of ASMs, 88.3% were non-adherent to their prescribed medication, compared with 45.1% of ESPs. The degree of relationship with community pharmacists differed significantly between ASMs and ESPs. Compared with ASMs, significantly more ESPs reported that they have thought about consulting a pharmacist when they had health problems (P=0.002). Compared with ESPs, significantly fewer ASMs reported always following pharmacist recommendations (32% versus 61.9% respectively). Arabic-speaking migrants had less-effective relationships with community pharmacists when having their prescriptions filled. Community pharmacists' expertise appeared to be underused. These minimal relationships represent missed opportunities to improve health outcomes.

Perceptions of pharmacists and patients on information provision and their influence on patient satisfaction in Japanese community pharmacies.

The provision of information is now considered a major area in pharmacist-patient interactions. However, few reports have simultaneously evaluated patient and pharmacist perceptions with regard to the pharmacist's information provision. The aims were to clarify the perceptions of pharmacists and patients regarding information provision and the level of influence of those perceptions on patient satisfaction. A cross-sectional survey with respect to information provision was conducted for patients and pharmacists in community pharmacies in Fukuoka Prefecture, Japan. In total, 407 patient-pharmacist pairs were included in a t-test and multilevel analysis. The levels of patient perception regarding information provision were significantly higher than the levels of pharmacist perception in all variables. The pharmacists' perceived level of information provision concerning medication effects had a negative and significant association with patient satisfaction, while the patients' perceived level of information provision by the pharmacist had a positive and significant association with patient satisfaction. Higher patient expectations regarding the level of information provision concerning medication side effects and older age of the pharmacist were adversely related to patient satisfaction. Both pharmacist and patient perceptions of the information provision by pharmacists personalized to the patient had positive associations with patient satisfaction. Pharmacist perceptions related to the information provision were not associated with patient satisfaction. The present study highlights accurate information provision, building good patient-pharmacist relationships, and improving pharmaceutical care in community pharmacy settings.

Mansour uses health kiosks to bolster patient–pharmacist relationships

Mansour uses health kiosks to bolster patient–pharmacist relationships

CBO links more Rx fi lled to less medical spending

The use of medications can lower the costs of related medical services, according to a new report from the Congressional Budget Office (CBO) that represents a change in the agency’s estimating methodology. The use of medications can lower the costs of related medical services, according to a new report from the Congressional Budget Office (CBO) that represents a change in the agency’s estimating methodology. Based on a review of recent research, a 1% increase in the number of prescriptions filled by Medicare beneficiaries would cause Medicare spending on medical services to fall by roughly 0.2%, CBO announced November 29. ■CBO announced a change in its estimating methodology that linked more prescriptions filled to less spending on medical services.■CBO did not consider pharmacists’ clinical services. ■CBO announced a change in its estimating methodology that linked more prescriptions filled to less spending on medical services.■CBO did not consider pharmacists’ clinical services. When estimating the budgetary impact of future legislation or proposals that have a direct impact on Medicare prescription drug use, the agency will first estimate a proposal’s effect on prescription drug costs and then estimate the effect on the number of prescriptions filled and any resulting offsetting effect on spending for medical services. The new way of analyzing drug costs stopped short of suggesting any positive benefits of pharmacists’ clinical services. “APhA is pleased that CBO recognizes some of the benefits of paying for medications,” said Thomas E. Menighan, BSPharm, MBA, ScD (Hon), FAPhA, APhA Executive Vice President and CEO. “Now, we have to help them recognize the benefits of making sure those medicines are used effectively by patients. That’s a key component of our advocacy agenda for 2013.” “The CBO study is a step forward in recognition of the value of drug therapy in preventing, controlling, and treating disease,” J. Lyle Bootman, PhD, ScD, Dean of the University of Arizona College of Pharmacy, told Pharmacy Today. “However, this all assumes that all of the appropriate steps in the prescribing, distribution, and patient use of the medication actually occur. Pharmacists’ clinical services—which are not routinely provided due to reimbursement issues—can potentially increase the value of drug therapy beyond that recognized in the recent report.” Bootman is also Professor of Pharmacy, Medicine, and Public Health, as well as Founding Executive Director of the Center for Health Outcomes & Pharmacoeconomic Research, at the University of Arizona. He is a former APhA President. The National Community Pharmacists Association (NCPA) released a statement from NCPA CEO B. Douglas Hoey, BSPharm, MBA, that commended the new CBO analysis but called it the “tip of the iceberg in terms of the savings independent community pharmacists can produce for Medicare and other health plans.” Hoey noted that CBO focused only on the quantity of prescriptions filled, but not on the quality resulting from “strong patient-pharmacist relationships in helping patients take their medication appropriately” as demonstrated in private research. CBO explained the effects of prescription drug use on Medicare’s spending for health care services. “Most often, pharmaceuticals have the effect of improving or maintaining an individual’s health,” the agency wrote. “Taking an antibiotic may prevent a more severe infection, and adhering to a drug regimen for a chronic condition such as diabetes or high blood pressure may prevent complications. In either of those circumstances, taking the medication may avert hospital admissions and thus reduce the use of medical services.” Before the announcement, CBO didn’t include an offsetting effect on medical services in estimates involving changes to prescription drug policies, according to the report. For example, CBO didn’t include an offset for the 2003 law establishing Medicare Part D. “At the time, there was little evidence of a relationship between prescription drug use and spending for medical services,” the agency wrote. “However, a body of research has since developed that demonstrates a connection between prescription drug use and the use of medical services.” CBO analyzed recent research to determine whether and how to include the offsetting effect. To illustrate the offset, the CBO report applied the change in methodology to the budgetary impact of the gradual closing of the Part D doughnut hole under the 2010 health care reform law. Using the revised methodology, the agency estimated that the net cost of implementing the law’s provisions closing the coverage gap will be $51 billion, rather than the $86 billion estimated previously. (See page 57 for more information on the closing of the coverage gap.)