Views Of Pharmacists Research Articles

Medication dispensing errors in Palestinian community pharmacy practice: a formal consensus using the Delphi technique.

Background Medication dispensing errors (MDEs) are frequent in community pharmacy practice. A definition of MDEs and scenarios representing MDE situations in Palestinian community pharmacy practice were not previously approached using formal consensus techniques. Objective This study was conducted to achieve consensus on a definition of MDEs and a wide range of scenarios that should or should not be considered as MDEs in Palestinian community pharmacy practice by a panel of community pharmacists. Setting Community pharmacy practice in Palestine. Method This was a descriptive study using the Delphi technique. A panel of fifty community pharmacists was recruited from different geographical locations of the West Bank of Palestine. A three round Delphi technique was followed to achieve consensus on a proposed definition of MDEs and 83 different scenarios representing potential MDEs using a nine-point scale. Main outcome measure Agreement or disagreement of a panel of community pharmacists on a proposed definition of MDEs and a series of scenarios representing potential MDEs. Results In the first Delphi round, views of key contact community pharmacists on MDEs were explored and situations representing potential MDEs were collected. In the second Delphi round, consensus was achieved to accept the proposed definition and to include 49 (59%) of the 83 proposed scenarios as MDEs. In the third Delphi round, consensus was achieved to include further 13 (15.7%) scenarios as MDEs, exclude 9 (10.8%) scenarios and the rest of 12 (14.5%) scenarios were considered equivocal based on the opinions of the panelists. Conclusion Consensus on a definition of MDEs and scenarios representing MDE situations in Palestinian community pharmacy practice was achieved using a formal consensus technique. The use of consensual definitions and scenarios representing MDE situations in community pharmacy practice might minimize methodological variations and their significant effects on the number and rate of MDEs reported in different studies.

Knowledge, attitudes and barriers towards breast cancer health education among community pharmacists

Objectives The goal of this study was to evaluate knowledge, attitudes and perceived barriers among community pharmacists towards breast cancer health promotion. Methods A structured questionnaire was administered to 1000 registered community pharmacists in northern, central and southern regions in Jordan. Key findings Mean score for knowledge of breast cancer among community pharmacists was 8.51 ± 3.04 points out of 15 points, classifying the overall knowledge as acceptable. Five hundred (50%) pharmacists had poor knowledge, while the other half had acceptable level of knowledge for breast cancer. Mean score for pharmacists’ knowledge of breast cancer screening was 3.83 ± 1.61 out of 7 points. Six hundred pharmacists (60%) had poor knowledge, while 400 pharmacists (40%) had satisfactory knowledge of screening guidelines. Pharmacists showed favourable attitude towards involvement in breast cancer education with an average score of 19.8 ± 4.35 out of 28 points. Lack of time was perceived by most pharmacists (63.9%) as a major barrier. Other highly recognised barriers were lack of privacy (57.1%) and lack of proper educational skills (56.2%). Age had no relationship with level of knowledge or attitude among pharmacists; however, a significant correlation exists between pharmacists’ attitude and knowledge of breast cancer. Conclusions Knowledge of breast cancer and its screening were modest among community pharmacists in Jordan. However, views of community pharmacists towards breast cancer health promotion and awareness were positive. Efforts to improve knowledge of community pharmacists in order to be effective educators of the public about breast cancer are highly advocated.

Funding for change: New Zealand pharmacists' views on, and experiences of, the community pharmacy services agreement.

To explore pharmacist's views on the shift in ethos, funding and service delivery model introduced through the New Zealand's Community Pharmacy Services Agreement (CPSA). A purposive sampling approach drew pharmacists from a matrix who were then contacted via telephone and invited to be interviewed. Semistructured interviews were conducted face-to-face with community pharmacists (n = 17) across urban and rural New Zealand. An interview schedule exploring 12 subject areas was used to facilitate discussion and determine pharmacist's views and understanding of the CPSA. The interviews were recorded and transcribed verbatim and a general inductive approach was taken to identifying emergent themes. Key themes that emerged were: pharmacists supported the philosophy behind the CPSA, pharmacists understanding of the CPSA, implementing CPSA-related services, perceived impact on patient outcomes and future sustainability of the CPSA. Overall, pharmacists supported the alignment of funding with patient-centred services, but pharmacy owners reported difficulty understanding the funding model, resulting in uncertainty over income. Several pharmacists believed the quality of care offered had not changed, while others found their attitudes towards care had evolved. All pharmacists communicated an increase in their workload and many perceived the sustainability of the CPSA to be linked to its ability to financially sustain community pharmacies. The majority of pharmacists believed in the philosophy of the CPSA, but expressed concerns over funding, workload and benefits for patients. Future research is required to determine generalisability of these findings, investigate patient perspectives and assess the effect of the CPSA on patient outcomes.

Advanced Level Practice Education: UK Critical Care Pharmacists' Opinions in 2015.

National UK standards for critical care highlight the need for clinical pharmacists to practice at an advanced level and above. The aim of this research paper was to describe the views of UK critical care pharmacists on the current provision of Advanced Level Practice (ALP) education and accreditation. It sought to identify whether there is a need for a national or regional training programme. A questionnaire was delivered electronically targeting UK critical care pharmacists. Whilst the response rate was low at 40% (166/411); the views expressed were representative of UK practitioners with the majority of responders meeting the national specifications for clinical pharmacist staffing in critical care areas. The responses highlighted work-based learning as the main resource for developing ALP and a lack of suitable training packages. The vast majority of pharmacists identified that a national or regional training programme was required for ALP. The results also identified the main barriers to undertaking ALP accreditation were lack of time, uncertainty regarding the process and its professional benefits and a lack of education and training opportunities. In conclusion, the responses clearly indicated that, for the necessary progression of critical care pharmacists to ALP, a national or regional training programme is required.

"Basically you wait for an 'in''': community pharmacist views on their role in weight management in New Zealand.

INTRODUCTION Obesity is now widely regarded as the main contributor to poor health globally, overtaking tobacco as the leading potentially modifiable risk to health. Community pharmacists are delivering an increasing number of extended services and are potentially well placed to contribute to obesity management strategies. No studies to date have investigated the views of community pharmacists in New Zealand about their role in weight management. AIM To explore the views of community pharmacists in one region of New Zealand about their role in weight management, including the perceived barriers and facilitators to their involvement. METHODS Qualitative, face-to-face, semi-structured interviews were undertaken with 11 community pharmacists from the Greater Wellington region. Interviews were transcribed verbatim and analysed thematically using an inductive approach. RESULTS Four key themes were identified from data analysis. These were: (i) perceptions of obesity; (ii) perceptions of weight management treatment options; (iii) the unique position of the community pharmacist; and (iv) barriers to involvement. The main barriers described included: (i) a lack of time and remuneration; (ii) the absence of an appropriate space within the pharmacy to discuss weight-related matters; (iii) and a lack of awareness of who to contact for specialist support. DISCUSSION Community pharmacists in Greater Wellington believe that they have a distinct role in their local community and can contribute to a multidisciplinary approach to reduce levels of obesity. Further work is required to determine the most appropriate role for community pharmacy in weight management and the training needs for pharmacy staff to optimally fulfil this role.

Exploring factors underlying the attitude of community pharmacists to generic substitution: a nationwide study from Poland.

Background Generic uptake will increasingly be promoted by governments in the face of increasing healthcare costs and global economic uncertainties. Objective The purpose of this study was to investigate attitudes towards generic substitution among community pharmacists, with a focus on the perception of the efficacy, knowledge of the generics characteristics, as well as the willingness to recommend generic substitution. Setting Community pharmacies in Poland. Method The survey was conducted in 2013 by telephone interviews with 802 holders of an MSc degree in pharmacy working as community pharmacists. Stratified sampling was implemented to make the study representative in geographic terms. Main outcome measure Pharmacists’ attitudes towards generics drugs. Results The study showed that only 40 % of pharmacists always inform patients about their right to choose a generic substitute. It was also shown that the less time a pharmacist has been practising, the less likely they are to invite consumers to choose between generic and innovator products. The likelihood of informing was not affected by pharmacist’s sex or age, or by pharmacy location or status (chain vs. independent pharmacy) (p > 0.05). Pharmacists varied in their approach to their statutory obligation to inform about a generic; a more or less equal share of respondents were either in favour or against it. Approximately 60 % pharmacists were shown to be familiar with the definition of a generic medicine. Pharmacists with shorter time of practice proved to know more about generics. However, more than 30 % respondents failed to choose the correct statement on generic versus reference medicine dosage. The majority of respondents (67 %) believed there are no differences in efficacy between generics and innovator drugs, whereas 31 % claimed that original brands could be more effective. A significant correlation was demonstrated between the views of pharmacists on the therapeutic efficacy and their willingness to substitute for generics whenever permitted by a physician. Conclusion It is important to address all concerns pharmacists may have over generics, for example by implementing comprehensive awareness-raising campaigns. Also, pharmacotherapy monitoring systems (i.e. provided in a framework of pharmaceutical care) could be considered to identify any safety or quality concerns that may arise.Electronic supplementary materialThe online version of this article (doi:10.1007/s11096-015-0227-8) contains supplementary material, which is available to authorized users.

Views of English Pharmacists on Providing Public Health Services.

Locally-commissioned pharmacy public health services have developed in England over the last 20 years. Few studies have sought pharmacist views on commissioning and provision of public health services in general. This study sought views of community pharmacists (n = 778) in 16 areas of England on services provided, decisions about services, support, promotion and future developments, using a postal questionnaire with two reminders. Response rate was 26.5% (206). Funded public health services provided most frequently were: emergency contraception (71%), smoking cessation (62%), and supervised drug consumption (58%). Blood pressure monitoring was provided by 61% and was considered to be one of the services pharmacists perceived as being most valued by customers, but was not National Health Services (NHS)-funded. Motivation for providing public health services was professional not financial, particularly from those working in independent pharmacies. Only 35% were personally involved in deciding which services to deliver, and fewer than 20% based decisions on local public health reports. Pharmacists had positive attitudes towards providing public health services, but mixed views on support for services and their promotion. Most thought services would increase in future, but were concerned about commissioning. Both national and local support is needed to ensure future commissioning of pharmacy public health services.

Do no harm: the role of community pharmacists in regulating public access to prescription drugs in Saudi Arabia.

Pharmacists have a crucial role to ensure regulated public access to prescription drugs. The study aimed to investigate the views of community pharmacists practising in Saudi Arabia on their role in the unauthorised supply of prescription drugs, consider the possible contributory factors and report pharmacists' suggested strategies to regulate supply. One hundred community pharmacists were invited to participate in an interview-based survey, including questions on demographic characteristics, and the unauthorised supply of prescription drugs. Descriptive statistics were conducted, and associations between categorical responses tested; a P value of ≤0.05 was considered significant. Responses to open questions were analysed thematically. In Saudi Arabia, there is widespread unregulated supply of prescription drugs; pharmacists are under pressure from patients to provide prescription drugs for a wide range of clinical conditions. There are safety and appropriateness concerns when drugs are provided based on patient demand rather than clinical need. Pharmacists do not maintain patient records with information on drugs supplied and associated actions. While most pharmacists supply prescription drugs without the necessary prescriber authorisation, they also this may jeopardise patients safety. While we have many concerns about this practice its present form, we believe pharmacists should have certain prescribing privileges within their areas of competence. A legal framework is needed to guarantee proper pharmacists' training, support, mentorship and access to the tools required to provide safe pharmacy practice.

Employing the nominal group technique to explore the views of pharmacists, pharmacy assistants and women on community pharmacy weight management services and educational resources†

The objectives of this study were to investigate how pharmacists, pharmacy assistants and women feel about community pharmacy involvement in weight management, and to identify what pharmacists, pharmacy assistants and women want in weight management educational resources. Three homogenous and one heterogeneous nominal group (NG) sessions of up to 120-min duration were conducted with nine women, ten pharmacists and eight pharmacy assistants. The NG technique was used to conduct each session to determine the most important issues that should be considered surrounding community pharmacy weight management services and development of any educational resources. The heterogeneous NG session was used to finalise what women, pharmacists and pharmacy assistants want in educational resources. Overall, pharmacists, pharmacy assistants and women believe that pharmacy staff have an important role in the management of overweight and obesity because of their accessibility, trust and the availability of products in pharmacy. Regarding the most suitable healthcare professional(s) to treat overweight and obesity, the majority of participants believed that no one member of the healthcare team was most suitable and that overweight and obesity needs to be treated by a multidisciplinary team. The importance of having weight management educational resources for pharmacy staff and women that come from trustworthy resources without financial gain or commercialisation was also emphasised. Pharmacists, pharmacy assistants and women feel that community pharmacies have a definite role to play in weight management. Pharmacy-specific weight management educational resources that are readily available to pharmacy staff and women are highly desirable.

Innovative medical devices and hospital decision making: a study comparing the views of hospital pharmacists and physicians.

Objectives Many university hospitals have developed local health technology assessment processes to guide informed decisions about new medical devices. However, little is known about stakeholders' perceptions and assessment of innovative devices. Herein, we investigated the perceptions regarding innovative medical devices of their chief users (physicians and surgeons), as well as those of hospital pharmacists, because they are responsible for the purchase and management of sterile medical devices. We noted the evaluation criteria used to assess and select new medical devices and suggestions for improving local health technology assessment processes indicated by the interviewees. Methods We randomly selected 18 physicians and surgeons (nine each) and 18 hospital pharmacists from 18 French university hospitals. Semistructured interviews were conducted between October 2012 and August 2013. Responses were coded separately by two researchers. Results Physicians and surgeons frequently described innovative medical devices as 'new', 'safe' and 'effective', whereas hospital pharmacists focused more on economic considerations and considered real innovative devices to be those for which no equivalent could be found on the market. No significant difference in evaluation criteria was found between these groups of professionals. Finally, hospital pharmacists considered the management of conflicts of interests in local health technology assessment processes to be an issue, whereas physicians and surgeons did not. Conclusions The present study highlights differences in perceptions related to professional affiliation. The findings suggest several ways in which current practices for local health technology assessment in French university hospitals could be improved and studied. What is known about the topic? Hospitals are faced with ever-growing demands for innovative and costly medical devices. To help hospital management deal with technology acquisition issues, hospital-based health technology assessment has been developed to support decisions. However, little is known about the different perceptions of innovative medical devices among practitioners and how different perceptions may affect decision making. What does this paper add? This paper compares and understands the perceptions of two groups of health professionals concerning innovative devices in the university hospital environment. What are the implications for practitioners? Such a comparison of viewpoints could facilitate improvements in current practices and decision-making processes in local health technology assessment for these medical products.

Exploring attitudes and opinions of pharmacists toward delivering prescribing error feedback: A qualitative case study using focus group interviews.

Prescribing error (PE) rates have been extensively reported in the literature. Various interventions at reducing PEs have been studied with some success, yet PEs continue to be a challenge for the health care system. Prescriber feedback has been proposed as one mechanism to reduce PEs in seminal studies. Pharmacists are viewed as an integral safety net in intercepting PEs and have been suggested as best placed to deliver feedback. However, there is very limited literature considering pharmacists; attitudes, views and opinions on facilitating PE feedback. To explore the attitudes and views of hospital pharmacists in delivering feedback on PEs to prescribers. Twenty-four pharmacists were recruited for one of four focus groups in a large district general hospital in the Northwest of England to explore the views of pharmacists to delivering feedback on PEs. Focus groups were transcribed verbatim and analyzed using a thematic framework approach to identify current practices, beliefs and attitudes of pharmacists toward delivering PE feedback. Transcripts were independently analyzed by the research team. Pharmacists' views on providing feedback on PEs were organized into eight major themes; Delivery of feedback, impact of feedback, prescription error, work environment, feedback facilitator, working relationships, education and training, and system improvements. Pharmacists recognized that timely feedback on PEs was essential for prescribers to learn from their mistakes and to reduce PEs. However, delivery of feedback appeared to be inconsistent, influenced by time pressures, workload, rapport and PE severity and prescriber availability. Pharmacists reported that ward-based pharmacists in particular, were suitable to facilitate PE feedback, but expressed concern that the process may adversely affect prescriber-pharmacist rapport. Pharmacists reported limited training on delivery of feedback with formalized training required for improved consistency, and quality, of constructive feedback. PE feedback should be delivered to prescribers with ward-based pharmacists best suited to the role. Both direct and indirect benefits of PE feedback were reported, although potential barriers to delivering PE feedback were also identified. Pharmacists reported additional anxieties that feedback could create tensions and compromise working relationships with prescribers. PE feedback could be considered an extension of a pharmacist's role and pharmacists welcomed formalization of feedback, but were cognizant of the potential impact on their workload and expressed the need for training in the delivery of feedback.

Pharmacists' medicines-related interventions for people with intellectual disabilities: a narrative review.

People with intellectual disabilities (ID) have complex pharmaceutical care needs due to a high prevalence of multimorbidity, a notable degree of polypharmacy and a high risk of adverse drug reactions. Despite this, people with ID often experience significant health disparities compared to the general population. In most developed countries, increasing emphasis on deinstitutionalisation and community integration also means greater utilisation of primary health care services where general practitioners, pharmacists and carers may lack appropriate information about the pharmaceutical needs of this population. Aim of the review To explore what type of pharmaceutical care interventions were being undertaken for people with ID and how pharmacists' contributed to the care of people with ID as part of multidisciplinary teams. Systematic searches of the following electronic databases were carried out; CINAHL, Pubmed, Medline, Embase, Cochrane library, Science Direct and International Pharmaceutical Abstracts. Results were limited to the period 1994-2014 using search terms 'learning disabilities', 'intellectual disabilities', 'mental retardation', 'developmental disabilities', 'learning difficulties' and 'pharmacist intervention', 'pharmaceutical care', 'primary care', 'pharmacy' "pharmacists" "pharmacy technicians". Agreement on studies to be included was arrived at by consensus and by using a pre-determined set of inclusion criteria. Due to the heterogeneous nature of the study aims, methods and presentation of study outcomes found, a narrative review was considered appropriate. In total, after removal of duplicates, 70 abstracts were identified and screened from the initial search. After screening and consensus agreement, eight articles which met the inclusion criteria were included in the review and were analysed under the following three themes; pharmacist interventions, pharmacists collaboration in provision of care, qualitative studies relating to patient, carers, and pharmacist views on care of people with ID. The limited evidence available in the literature suggests that pharmacists can make positive interventions in relation to the quality of the medication use process, in collaboration with other healthcare professionals, carers and patients with ID. However, further research will be required to increase the evidence base with regard to the benefits of providing pharmaceutical care to patients with intellectual disability and to inform future policy and planning.

Adherence counseling during patient contacts in swiss community pharmacies.

PurposeNumerous studies showed the effectiveness of pharmaceutical care in improving medication adherence in primary care patients. However, in daily pharmacy practice, the provision of pharmaceutical care appears to be limited. We aimed at quantifying the content of counseling by community pharmacy staff during patient contacts, especially adherence counseling, and at investigating pharmacist views about their practice of adherence counseling.Patients and methodsA Master’s student in Pharmacy observed patient contacts at selected community pharmacies in the region of Basel, Switzerland. Content of counseling was manually ticked on a checklist with predefined themes (administration, dose, effect, and adherence). Pharmacists working in the pharmacy were interviewed on triggers, topics, and barriers in adherence counseling.ResultsIn 20 community pharmacies and during a total of 148.1 hours, 1,866 patient contacts were observed. During the 1,476 patient contacts including the dispensing of one or more medications, counseling was provided to 799 (54.1%) patients; with 735 (49.8%) patients counseled about administration, 362 (24.5%) about dose, 267 (18.1%) about effect, and 99 (6.7%) about adherence. Significantly more patients received counseling when they obtained prescribed versus over-the-counter medication (P=0.002), a new prescription versus a repeat prescription (P<0.001), or when they were served by a pharmacist versus by another staff member (P<0.001). Of the 33 interviewed pharmacists, all except one reported actively approaching patients for adherence counseling. Triggers included medication-related and patient-related factors. The pharmacists named predominantly product-centered topics of adherence counseling. The most cited barriers were rejection of counseling by the patient and lack of time.ConclusionHalf of the patients receiving one or more medications were counseled, and only 6.7% of all contacts included adherence counseling. Future studies should clarify how barriers to adherence counseling at the community pharmacy can be overcome.

A qualitative assessment of community pharmacists views about the non‐prescription sale of citalopram for the management of premature ejaculation in eastern region, Alahsa, Saudi Arabia

Objectives This study assessed the community pharmacist views about the non-prescription request for citalopram by male customers seeking assistance for premature ejaculation. Methods This was a qualitative study conducted in summer June 2012 until August 2012, in community pharmacy setting eastern province, Al Ahsa, Saudi Arabia. A structured interview guide was used and study sample was drawn from the community pharmacist practicing in the region. The entire interview was recorded and was transcribed by the researcher in to themes. Key findings Overall, it is found that non-prescription sale over the counters is a frequent practice. Patients requesting citalopram for premature ejaculation are mainly within the age group of 25–50 years. Lidocaine spray was reported to be another medication given either alone or in combination with citalopram for same purpose. Conclusion These findings may be worrying for the drug regulatory authorities and might reflect a failure in implementing the safe use of medicines in the community. Citalopram is a prescribed medication and conditions such as premature ejaculation need to be examined by qualified personnel for appropriate treatment, rather than seeking pharmacist assistance to resolve the abnormality.

Could it be done safely? Pharmacists views on safety and clinical outcomes from the introduction of an advanced role for technicians.

There is ample evidence that pharmacists' interventions in patient care improve patient outcomes; however, community pharmacists do not necessarily have the time available to undertake these roles. One way to address this problem is to enable technicians to take on a greater role in the mechanical aspects of the dispensing process. This study aimed to investigate the opinions of New Zealand pharmacists regarding the potential introduction of an advanced technician's role into the New Zealand pharmacy setting. The survey was sent to all pharmacists registered with the New Zealand Pharmacy Council who had indicated a willingness to receive research-related requests (n = 2095). The full survey consisted of yes/no questions and five-point Likert scale questions regarding opinions. A number of the questions allowed respondents to make free-text comments. One of these questions focused on the separation of the clinical and mechanical aspects of the dispensing process. The free-text responses to this question were subjected to thematic analysis. Of 2095 surveys mailed out 736 were returned, yielding a return rate of 36%. Many of the respondents took the opportunity to make comments to individual questions in the overall survey and 400 pharmacists provided additional comments to the specific question regarding the separation of the clinical from the mechanical process of dispensing. The comments received centered on three key themes: Improvements to clinical outcomes, the impact, both positive and negative, on dispensing errors, and the need for quality procedures to minimize the safety risk. The pharmacists were of the opinion that the separation of clinical from mechanical parts of the dispensing process would increase the time available to spend interacting with patients. Coupled with more time dedicated to a clinical assessment of prescriptions they could appreciate this would improve clinical outcomes for the patients. Clear and stringent guidelines and standard operating procedures were proposed to ensure that safety standards do not change.

Provision of health /disease screening and medication monitoring /management in New Zealand community pharmacies

Background Access to health /disease screening (HDS) and medication monitoring /management (MM) services in New Zealand has traditionally been through general practitioners. While government and professional organisations are supportive of greater community pharmacy involvement, there has been little research on the extent of current provision or of the views of community pharmacists in this area. Aim To describe the characteristics and extent of HDS and MM services provided in New Zealand community pharmacies, and to document pharmacists’ opinions and perceived barriers in regard to the provision of these services. Methods A four-part questionnaire was developed to record: the types of HDS /MM services offered by community pharmacies; the opinions of respondent pharmacists regarding these services; the characteristics of community pharmacies offering the services; and the profiles of the respondent pharmacists. The questionnaire was distributed to 879 community pharmacies in New Zealand. Results There were 458 valid questionnaires returned, with a response rate of 52%. Over half (59%) of the responding pharmacies reported provision of HDS and /or MM services, although there were relatively few ‘high level’ services such as cardiovascular risk assessment and disease management. Most services were paid for by pharmacy customers, although some District Health Boards paid for services such as Medicines Use Review. Pharmacists cited lack of remuneration, lack of time and limited access to patient information as the main barriers to greater involvement. Conclusion At the time of this study (2007), community pharmacists in New Zealand were in the ‘early adoption’ phase concerning the provision of HDS and MM services.

Physicians' attitudes towards provision of primary care services in community pharmacy in the United Arab Emirates.

This study aims to explore physicians' views of pharmacists' roles in providing primary care services through community pharmacies in the United Arab Emirates (UAE). A qualitative approach involving semi-structured interviews conducted one-to-one or in group discussions was employed. The interviews explored participants' views of pharmacists' primary care services including screening and monitoring of disease, health advice, referral, lifestyle and preventive care, supply of printed information, counselling on medications, patient record keeping, and pharmacist intervention in chronic disease management. Data were analysed using the Framework approach. Fifty-three physicians participated; 27 were interviewed individually and 26 participated in five group discussions. Four major themes were identified: competence, business orientation, territorial control and service delivery. Participants were supportive of verbal counselling about medications, checking for drug dosing, interactions, duplications and errors, and keeping patient medication profiles. Physicians generally did not favour pharmacists' involvement in screening or monitoring of disease, providing information about diseases, diagnosis or long-term management of disease, or intervention directly with patients, mainly due to perceived lack of competence, territorial encroachment and business orientation of community pharmacy. Despite some reservations, participants showed support for pharmacist involvement in providing primary care services, provided certain quality and territorial issues were addressed. Understanding physicians' attitudes will facilitate interventions to enhance the contribution of community pharmacists to primary care in the UAE, and possibly in other regions with similar healthcare systems.

Pharmacist and GP views on a medicine use review pilot project conducted in Italy

To obtain pharmacists’ and GPs’ views on a medicine use review (MUR) service provided in four Italian locations between October 2012 and January 2013. Method Nine focus groups involving 55 pharmacists who provided MURs to asthmatic patients were conducted in February 2013 and one with four GP opinion leaders, in November 2013. Four domains were explored: feedback from patients, practitioners’ views on MUR, limitations/barriers, expectations/future applications. University ethics approval was obtained. Discussions were audio-recorded, transcribed verbatim and analysed thematically. Results Pharmacists recognised MUR as a significant development for their profession and GPs were very positive about the service. Some pharmacists confirmed that the asthma MUR project was one of the most interesting projects in which they took part. GPs suggested that pharmacists should spend more time educating patients on when and how to use medicines optimally and about potential ADRs. One GP suggested providing MUR every time pharmacists sell OTC medications. Pharmacists identified information flow as a barrier and GPs identified red tape and bureaucracy. GPs suggested that information sharing is a must, and endorsed the need for a shared platform which both GPs and pharmacists can access. Pharmacists’ expectations were that MUR should extend to other therapeutic areas; GPs suggested various target groups including patients using at least three medications or complex regimens, those with multiple diseases, the elderly, or those with cognitive problems. GPs also recommended joint educational sessions. Conclusions Both health care professional groups gave a very positive evaluation of the MUR service provided. Both also recognised the extreme importance of information flow and data sharing. The idea of joint educational sessions needs to be explored further; it could be the starting point of a new and a much more integrated form of collaboration between these professions.

Professionalism within Pharmacy – the thoughts of Professional Leaders

To ascertain the thoughts of selected professional leaders on matters relating to pharmacist professionalism. These views will help build a picture of the professional status of pharmacy. Methods - Semi-structured interviews were conducted between July and November 2013 with representatives from eight UK pharmacy leadership bodies. The bodies were selected for their roles in pharmacy policy development, regulation and professional representation. The interviews were recorded and transcribed verbatim. Analysis by constant comparison identified a number of emerging themes. Results - The following emerging themes were identified from the interview data: Influence of the Pharmacy Landscape: Participants highlighted the role that pharmacy plays within the National Health Service and wider society and how future developments may affect the professional status currently afforded to pharmacists. Vocalising Pharmacy: Communication within the profession and also with those external to the profession, including other healthcare professionals and the general public, is important to ensure a high professional standing. The Impact of Commercialism: Professionalism and commercialism were generally seen to be antithetical and a rise in commercialism may adversely impact on external perceptions of the professionalism of pharmacy. Responsibility for Professionalism: The professional image of pharmacy is maintained by the individuals operating within it regardless of their scope of practice. It is the responsibility of all those individuals to ensure that they actively demonstrate ‘professional’ behaviours. The Journey to Professionalism: Acquiring a professional ethos is a continual process but there are stages in a pharmacist’s development that are considered particularly important. These include upbringing, undergraduate education and pre-registration training. Conclusions - Pharmacy’s professional status in the UK remains open to challenge and vital to retaining that status is the public perception of pharmacists. Future research examining pharmacy’s claims to professional status should focus on exploring the attitudes of the general public in addition to the views of pharmacists.

La mention « non substituable » de la prescription à la délivrance : comparaison des points de vue des médecins généralistes libéraux et des pharmaciens d’officine de la région Midi-Pyrénées

The "nonrefundable" term use leads to the princep's drug dispensing. The aim of our study was to compare the views of its use between general practitioners and community pharmacists. We conducted a descriptive study with similar questionnaires about "nonfundable" term use. A chi-2 test was used in order to detect a difference between the answers of general practitioners ant pharmacists. The general practitioners and pharmacists views of "nonrefundable" used was different (p<0.05). General practitioners majority used this term because of their patients demand. General practitioners are using the term "nonrefundable" because of their patients demand and they don't integrate this use in their therapeutics decision.