Pharmacy Participants Research Articles

Identifying Factors of User Acceptance of a Drone-Based Medication Delivery: User-Centered Design Approach.

The use of drones in the health care sector is increasingly being discussed against the background of the aging population and the growing shortage of skilled workers. In particular, the use of drones to provide medication in rural areas could bring advantages for the care of people with and without a need for care. However, there are hardly any data available that focus on the interaction between humans and drones. This study aims to disclose and analyze factors associated with user acceptance of drone-based medication delivery to derive practice-relevant guidance points for participatory technology development (for apps and drones). A controlled mixed methods study was conducted that supports the technical development process of an app design for drone-assisted drug delivery based on a participatory research design. For the quantitative analysis, established and standardized survey instruments to capture technology acceptance, such as the System Usability Scale; Technology Usage Inventory (TUI); and the Motivation, Engagement, and Thriving in User Experience model, were used. To avoid possible biasing effects from a continuous user development (eg, response shifts and learning effects), an ad hoc group was formed at each of the 3 iterative development steps and was subsequently compared with the consisting core group, which went through all 3 iterations. The study found a positive correlation between the usability of a pharmacy drone app and participants' willingness to use it (r=0.833). Participants' perception of usefulness positively influenced their willingness to use the app (r=0.487; TUI). Skepticism had a negative impact on perceived usability and willingness to use it (r=-0.542; System Usability Scale and r=-0.446; TUI). The study found that usefulness, skepticism, and curiosity explained most of the intention to use the app (F3,17=21.12; P<.001; R2=0.788; adjusted R2=0.751). The core group showed higher ratings on the intention to use the pharmacy drone app than the ad hoc groups. Results of the 2-tailed t tests showed a higher rating on usability for the third iteration of the core group compared with the first iteration. With the help of the participatory design, important aspects of acceptance could be revealed by the people involved in relation to drone-assisted drug delivery. For example, the length of time spent using the technology is an important factor for the intention to use the app. Technology-specific factors such as user-friendliness or curiosity are directly related to the use acceptance of the drone app. Results of this study showed that the more participants perceived their own competence in handling the app, the more they were willing to use the technology and the more they rated the app as usable.

Longer-term outcomes of medicine and pharmacy students at Cardiff University after undergraduate therapeutics and prescribing interprofessional education

Background: Studies have reported students’ satisfaction with and learning from undergraduate interprofessional education (IPE). However, there is insufficient research reporting on any longer-term effects of IPE. The objective is to assess the longer-term impact of learning by 3rd/4th year medical and pharmacy students 12-24 months after a therapeutics/prescribing IPE session. Methods: Semi-structured interview transcriptions were explored inductively using thematical analysis, and deductively by using the Modified Kirkpatrick’s evaluation model. Exactly 34 interviews were conducted. Results: Inductively, six themes were identified: preparedness; students as learners and teachers; knowledge/skills development; application of learning; session value; and suggestions for change. Deductively, participants found the session enjoyable and interesting (level 1), had modified attitudes of peers (level 2a), acquired knowledge and skills (level 2b), and, those in employment, provided examples of behavioural change (level 3). No organisational change (level 4) or improved patient outcomes (level 5) were reported. Conclusion: Both medical and pharmacy participants were able to recall a therapeutic/prescribing IPE session that took place 12-24 months earlier. Participants emphasised the usefulness of interacting with peers, increasing their understanding of each others’ roles, improving communication skills and applying learning within practice. Those developing IPE should consider early consistent delivery, utilise multidisciplinary faculty members and ensure an appropriate student knowledge gap.

Evaluation of a training program to support the implementation of a community pharmacist-led support service for people living with severe and persistent mental illness

BackgroundWith appropriate training, community pharmacists can support people living with severe and persistent mental illness (SPMI) by identifying and managing medication-related issues and physical health concerns. The Bridging the Gap between Physical and Mental Illness in Community Pharmacy (PharMIbridge) randomized controlled trial (RCT) tested the impact of an individualized, pharmacist-led support service for people living with SPMI. Objective(s)To evaluate the impact of the PharMIbridge training program on pharmacy participants’ knowledge and confidence, as well as stigma and attitudes, in relation to supporting, and providing services to, people living with SPMI; compared to Mental Health First Aid (MHFA) training alone. MethodsPharmacy staff (n = 140) from 55 community pharmacies across 4 RCT regions attended face-to-face training. Both intervention group (IG) and comparator group (CG) participants received MHFA training while IG participants received additional PharMIbridge training, involving role-plays and mental health consumer educators (MHCEs). A questionnaire including validated instruments was administered at baseline, after training and after 12 months. Comparative analyses included paired t tests and mixed between/within analysis of variance (ANOVA). ResultsPre and post-training surveys were completed by 136 participants, most of which were pharmacists. Both IG and CG participants had significant reductions in stigma (P < 0.001) post-training. IG participants’ confidence and knowledge regarding metabolic monitoring significantly improved compared to CG (P < 0.001). IG participants were significantly more confident and comfortable in providing medication counseling, compared to CG participants (P < 0.05). ConclusionMHFA training reduced participants’ stigma toward mental health. However, the purpose-designed PharMIbridge training program provided pharmacists with additional knowledge and skills to confidently support the physical health care needs of people living with SPMI. The inclusion of role-plays and MHCEs allowed pharmacists to self-reflect and practice skills in safe, supportive environments. Future studies should continue to involve MHCEs in pharmacy training and explore whether these improvements are sustainable.

What are the research priorities for optimising the safe and effective use of opioids in Australian general practice?

Persistent high rates of prescription opioid use and harms remain a concern in Australia, Europe and North America. Research priority setting can inform the research agenda, strategic responses and evidence-based interventions. The objective of this study was to establish research priorities related to the safe and effective use of prescription opioids in general practice. Consumers, clinicians and policy makers were invited to participate in a structured consensus workshop in May 2021. A modified nominal group technique was used to explore research priorities for the safe and effective use of opioids in Australian general practice. Research priorities were identified, consolidated and prioritised using a structured process. Seventeen consumer, medical, pharmacy, nursing, allied health and policy participants generated 26 consolidated priorities across three domains: (i) consumer-focused priorities; (ii) clinician and practice-focused priorities; and (iii) system and policy-focused priorities. The highest ranked research priorities in each of the domains were consumer characteristics that influence opioid prescribing and outcomes, opioid deprescribing strategies, and system-level barriers to prescribing alternatives to opioids, in the consumer, clinician and practice, and system and policy domains, respectively. The priorities reflect opportunities for research priority setting within Australian general practice. The priorities provide a map for future qualitative and quantitative research that will inform safe and effective opioid prescribing.

Active vaccine safety surveillance of seasonal influenza vaccination via a scalable, integrated system in Western Australian pharmacies: a prospective cohort study

ObjectivesWe integrated an established participant-centred active vaccine safety surveillance system with a cloud-based pharmacy immunisation-recording program in order to measure adverse events following immunisation (AEFI) reported via the new surveillance...

A Delphi study to explore and gain consensus regarding the most important barriers and facilitators affecting physiotherapist and pharmacist non-medical prescribing.

Non-medical prescribing was introduced into the United Kingdom to improve patient care, but early research indicated a third of Allied Health Professionals may not use their prescribing qualification. A previous literature review, highlighting factors influencing prescribing, identified only papers with nursing and pharmacy participants. This investigation explored consensus on factors affecting physiotherapist and pharmacist non-medical prescribers. A three round Delphi study was conducted with pharmacist and physiotherapist prescribers. Round One comprised information gathering on facilitators and barriers to prescribing participants had experienced, and underwent content analysis. This was followed by two sequential consensus seeking rounds with participants asked to rate the importance of statements to themselves. Consensus criteria were determined a priori, including median, interquartile range, percentage agreement and Kendall's Coefficient of Concordance (W). Statements reaching consensus were ranked for importance in Round Three and analysed to produce top ten ranks for all participants and for each professional group. Participants, recruited October 2018, comprised 24 pharmacists and 18 physiotherapists. In Round One, content analysis of 172 statements regarding prescribing influences revealed 24 themes. 127 statements were included in Round Two for importance rating (barriers = 68, facilitators = 59). After Round Two, 29 statements reached consensus (barriers = 1, facilitators = 28), with no further statements reaching consensus following Round Three. The highest ranked statement in Round Three overall was: "Being able to prescribe to patients is more effective and really useful working [in my area]". Medical support and improved patient care factors appeared the most important. Differences were noted between physiotherapist and pharmacist prescribers regarding the top ten ranked statements, for example team working which pharmacists ranked higher than physiotherapists. Differences may be explained by the variety of practice areas and relative newness of physiotherapy prescribing. Barriers appear to be post or person specific, whereas facilitators appear universal.

Development, implementation, and assessment of a comprehensive, integrated, and multimodal interprofessional education (CIM-IPE) program

Abstract Objective The 2016 ACPE Standard 11 mandates the inclusion of interprofessional education (IPE) in pharmacy programs. However, challenges exist in the standardized design, delivery, and assessment of an IPE curriculum. We developed and implemented a c omprehensive, vertically and horizontally i ntegrated, m ultimodal IPE curriculum (CIM-IPE) and assessed for student, program, and institutional outcomes. Methods We established an IPE collaboration, created an institutional infrastructure, and operationalized the curriculum incorporating pharmacy, nursing, and medical students using a five-pronged approach built around 1) a didactic component, 2) high fidelity simulation with manikins with content-emphasis, 3) hospital simulation with manikins with process emphasis, 4) interprofessional case conferences, and 5) a Hotspotting IPE-elective. The 2016 Interprofessional Education Collaborative competencies and ACPE Standard 11 were used to assess outcomes, classifying developmental stages as initial, developing, developed, and proficient. Results In seven IPE events distributed across the P1 through P3 years of the CNUCOP Pharmacy curriculum, a high total number of pharmacy, nursing and medical school participants (N = 1799) were repeatedly engaged. Overall assessment data show a high success rate of the integrated CIM-IPE program with mean performance scores of 98 (SD = 13, N = 117) and 95 (SD = 5, N = 67) for the interprofessional case conferences, 100 (SD = 2, N = 117), 95 (SD = 4, N = 67), and 95 (SD = 5, N = 67) for the three simulation based IPE events. Conclusion Our curricular and assessment strategies for CIM-IPE outline a stepwise development and implementation blueprint for an inclusive and comprehensive IPE program that is readily transferable to other colleges and schools of pharmacy and other health care professional programs.

The Help for Hay Fever community pharmacy-based pilot randomised controlled trial for intermittent allergic rhinitis

Management of intermittent allergic rhinitis (IAR) is suboptimal in the UK. An Australian community pharmacy-based intervention has been shown to help patients better self-manage their IAR. We conducted a pilot cluster RCT in 12 Scottish community pharmacies to assess transferability of the Australian intervention. Trained staff in intervention pharmacies delivered the intervention to eligible customers (n = 60). Non-intervention pharmacy participants (n = 65) received usual care. Outcome measures included effect size of change in the mini-Rhinoconjunctivitis Quality of Life Questionnaire (miniRQLQ) between baseline, 1-week and 6-week follow-up. Trial procedures were well received by pharmacy staff, and customer satisfaction with the intervention was high. The standardised effect size for miniRQLQ total score was −0.46 (95% CI, −1.05, 0.13) for all participants and −0.14 (95% CI,−0.86, 0.57) in the complete case analysis, suggesting a small overall treatment effect in the intervention group. A full-scale RCT is warranted to fully evaluate the effectiveness of this service.

Inter-professional prescription safety workshop for non-medical prescribing and pharmacy students: A cross-sectional study.

This article reports on an evaluation of a prescribing workshop to increase ‘sharedlearning’ between registered practitioners undertaking a non-medicalprescribing (NMP) course (midwifery, nursing, physiotherapy, and podiatry) andundergraduate pharmacy students to increase awareness of, and understanding of theroles.&nbsp; The focus was on three domains ofsafe prescribing: Knowledge (of commonly prescribed medicines and theirsuitability for individual patients); Process (of legal requirements and supplyof medicines and associated patient information); and Relationships (betweenprescribers and pharmacists). A cross-sectional evaluation was utilized with6-point Likert-style items and a free text section, completed by 337participants.&nbsp; Participants reported positivelyabout the workshop content and their learning experience, although somedifferences between pharmacy and NMP participants were noted in the knowledgedomain. Quantitative analysis revealed significant differences (p&lt;0.001) oflow-to-moderate magnitude (partial-2=0.146) between NMP and Pharmacy studenton all 3 domains, with NMP students reporting slightly more positive outcomes(between 0.4 and 1.5 points higher) in all cases. However, both groups scoredpositively; with mean domain scores of 15.6 to 16.5 on scales with maximumscores of 18.

Comparison of patient satisfaction with pharmaceutical services of postal pharmacy and community pharmacy.

BackgroundThe growing drive in South Africa to contain medicine cost has seen the emergence of postal pharmacy as an alternative mechanism to dispense chronic medicines. Patient satisfaction with pharmaceutical services has received limited attention in South Africa.AimThe aim of this study was to compare the level of patient satisfaction with pharmaceutical services between postal and community pharmacies.SettingThe research was conducted in the eThekwini Municipality, KwaZulu- Natal Province, South Africa in July and August 2014.MethodsA cross-sectional quantitative study using a randomised, telephonic questionnaire survey was conducted. Selected land telephone numbers were called until a sample size of 250 community pharmacy participants and 125 postal pharmacy participants was obtained.ResultsNine hundred and five telephone calls were made to obtain a sampling frame of 375 (41.44%) respondents, 250 for community and 125 for postal. After adjusting overall satisfaction by removing financial satisfaction, there was no significant difference between satisfaction in the two groups (p = 0.471). Postal pharmacy participants reported a higher level of financial satisfaction (p = 0.001). Community pharmacy participants reported a higher level of satisfaction with counselling or explanation (p = 0.028) and less medicine wastage (p < 0.001).ConclusionsPatient satisfaction with pharmaceutical services provided by either community or postal pharmacy was not significantly different. However, community pharmacies tend to address patients’ specific concerns more effectively. With the move to National Health Insurance, policymakers need to ensure that they provide high-quality pharmaceutical services and are more inclusive of community pharmacies to deliver quality care.

A STUDY TO EXPLORE LEARNING STYLE PREFERENCES OF PHARMACY STUDENTS WITH REGARD TO PHARMACEUTICAL CALCULATIONS

Objective: Pharmaceutical calculations are an essential aspect of learning for pharmacy students in order to avoid drug dose errors and maintain patient safety in future practice. Learning styles influence how lecturers approach the teaching-learning process. So far no specific learning preference is believed to be most appropriate for the pharmacy curricular; however certain learning styles are favoured by students as they improve their understanding of course material, knowledge and performance.&#x0D; Methods: 148Master of pharmacy participants from the second and third year were given a questionnaire to complete during a compulsory Individual Readiness Assurance Test session. Participants were restricted to just one option.&#x0D; Results: Workshops with a tutor was the most selected (36%) followed by 25% of participants favouring formative assessments, 28% selected workbooks alone, 37% for whole-class lecturers and videos option was the least selected. Reasons for the most and least preferred learning styles were highlighted and separated into advantages and disadvantages using themes. In the knowledge test; 92% of participants selected “unsure” or “didn’t know” the answer, 29% had a partially correct answer and 19% selected incorrect answers.&#x0D; The overall order of ranking arose in regards to the most beneficial learning style which enhances performance. The responses revealed a variety of advantages and disadvantages which were reflected between year groups and similar to views obtained from recent literature. Students reflected a lack of understanding on extemporaneous preparation (EPs) terms used in pharmaceutical compounding practices, thus the university should consider addressing the lack of awareness and consider the best teaching-learning style in doing so.&#x0D; Conclusion: Overall the findings suggested that the sample students have similar views on the learning styles used to deliver pharmaceutical calculations on their academic performance to that expressed by the authors from recent published literature.

Interprofessional service learning experiences among health professional students: A systematic search and review of learning outcomes

Abstract Interprofessional education and service learning offer inviting learning contexts for students from diverse professions to engage in learning about and improving communities. Given the growth of Interprofessional education (IPE) and its link to service learning, there is a need to establish where and how service-learning based IPE is effective. Using PRISMA guidelines, we systematically searched, identified, screened and assessed the eligibility of peer-reviewed publications from multiple bibliographic databases covering medical, education (general and medical), psychology, and social-behavioral science literature. This systematic review elicited 49 articles published since 1996, key characteristics of which are described in this paper. The findings provide evidence that a majority of Interprofessional service-learning experiences have been elective in nature, provide access to diverse populations and constitute unique learning experiences. Publications most frequently described medicine, nursing, and pharmacy participants. Substantive barriers to the development and implementation of service learning experiences include institutional support, extramural funding, and diverse programmatic requirements. Importantly, we concluded that there was not sufficient evidence to render a conclusion about the efficacy of service learning within an interprofessional context. The analysis noted multiple limitations with the existing body of research: namely, limited application of educational theory, a lack of rigor in evaluative methodology and little alignment with established interprofessional competencies.

Effectiveness and safety of early medication abortion provided in pharmacies by auxiliary nurse-midwives: A non-inferiority study in Nepal.

BackgroundExpanding access to medication abortion through pharmacies is a promising avenue to reach women with safe and convenient care, yet no pharmacy provision interventions have been evaluated. This observational non-inferiority study investigated the effectiveness and safety of mifepristone-misoprostol medication abortion provided at pharmacies, compared to government-certified public health facilities, by trained auxiliary nurse-midwives in Nepal.MethodsAuxiliary nurse-midwives were trained to provide medication abortion through twelve pharmacies and public facilities as part of a demonstration project in two districts. Eligible women were ≤63 days pregnant, aged 16–45, and had no medical contraindications. Between 2014–2015, participants (n = 605) obtained 200 mg mifepristone orally and 800 μg misoprostol sublingually or intravaginally 24 hours later, and followed-up 14–21 days later. The primary outcome was complete abortion without manual vacuum aspiration; the secondary outcome was complication requiring treatment. We assessed risk differences by facility type with multivariable logistic mixed-effects regression.ResultsOver 99% of enrolled women completed follow-up (n = 600). Complete abortions occurred in 588 (98·0%) cases, with ten incomplete abortions and two continuing pregnancies. 293/297 (98·7%) pharmacy participants and 295/303 (97·4%) public facility participants had complete abortions, with an adjusted risk difference falling within the pre-specified 5 percentage-point non-inferiority margin (1·5% [-0·8%, 3·8%]). No serious adverse events occurred. Five (1.7%) pharmacy and two (0.7%) public facility participants experienced a complication warranting treatment (aRD, 0.8% [-1.0%-2.7%]).ConclusionsEarly mifepristone-misoprostol abortion was as effective and safe when provided by trained auxiliary nurse-midwives at pharmacies as at government-certified health facilities. Findings support policy expanding provision through registered pharmacies by trained auxiliary nurse-midwives to improve access to safe care.

Is there a role for community pharmacists in promoting oral health?

The main aim of the present study was to investigate whether pharmacists recognised that they have a role in the promotion of oral health advice within the community. A cross sectional survey was conducted using a structured questionnaire which was distributed to randomly selected pharmacies (n = 1,500) in the London area. Six hundred and forty-five pharmacies (43%) responded to the initial invitation and 589 (39%) of pharmacy participants acknowledged that pharmacists should have a role in oral health promotion. Participants from 354 pharmacies (23.6%) subsequently agreed to complete the questionnaire. Of those pharmacies completing the questionnaire, 99.4% of the pharmacy participants recognised that there was a role for pharmacists in oral health promotion. Although 91.5% of the pharmacists reported a fairly high level of knowledge for most of the common oral conditions, they also indicated that they were interested in receiving further training on oral conditions through continuing professional development (CPD) courses. A number of the pharmacies (72.5%) expressed a willingness to incorporate oral health promotion within the NHS pharmacy contract. Pharmacies may be used effectively in oral health promotion by virtue of their frequent contact with members of public. As a result of their established role in promoting and improving the health within the community, it may possible to incorporate oral health within the existing NHS contract.

Summary of: Is there a role for community pharmacists in promoting oral health?

Aim The main aim of the present study was to investigate whether pharmacists recognised that they have a role in the promotion of oral health advice within the community. Methods A cross sectional survey was conducted using a structured questionnaire which was distributed to randomly selected pharmacies (n = 1,500) in the London area. Results Six hundred and forty-five pharmacies (43%) responded to the initial invitation and 589 (39%) of pharmacy participants acknowledged that pharmacists should have a role in oral health promotion. Participants from 354 pharmacies (23.6%) subsequently agreed to complete the questionnaire. Of those pharmacies completing the questionnaire, 99.4% of the pharmacy participants recognised that there was a role for pharmacists in oral health promotion. Although 91.5% of the pharmacists reported a fairly high level of knowledge for most of the common oral conditions, they also indicated that they were interested in receiving further training on oral conditions through continuing professional development (CPD) courses. A number of the pharmacies (72.5%) expressed a willingness to incorporate oral health promotion within the NHS pharmacy contract. Conclusion Pharmacies may be used effectively in oral health promotion by virtue of their frequent contact with members of public. As a result of their established role in promoting and improving the health within the community, it may possible to incorporate oral health within the existing NHS contract.

Examining preference of elderly for adding indication to the prescription label (Rx Label)

Rationale and aim To examine preference of the elderly for adding indication (medication use/purpose) to prescription label, reasons for their preference and its association with demographic characteristics. Methods A convenience sample of 143 patients of age 65 or older, who took at least one prescription medication every day were interviewed using a structured questionnaire. The data were analyzed for descriptive statistics, correlation for demographic characteristics with participant’s preference for adding indication to prescription label using the Chi-square and Fisher’s exact test. Regression analysis was conducted to predict participant’s preference. Results Participants were ethnically diverse, majority being female (60.8%), with average age of 76.9 yrs. Twenty nine percent participants had more than high school education. About 91% participants preferred adding indications to their prescription label for the reasons: “managing medication by category” (29%), “distinguishing medications” (69%), and “reducing confusion” (29%). Adult daycare centers and community pharmacy participants with lower than high school education showed higher preference for adding indication for reducing confusion and distinguishing medication, respectively. Whereas, Hispanic/Latino participants of adult daycare centers preferred for the reason, distinguishing medications (p&lt;0.05). Age, race/ethnicity and education were found to be good predictors of their preference. Conclusion The elderly showed higher preference for adding indication to the prescription label for improving their ability to distinguish medications and reduce confusion. Our results suggest a need for adopting recently released USP patient-centered prescription label standards, which also include adding indication to the Rx labels.

The impact of a short-term medical mission trip: Evaluation of pharmacy interventions and perceived clinical competence in an interprofessional setting

ObjectivesTo describe student pharmacists’ impact on an interprofessional team through documented interventions and to evaluate student health care professionals’ perceived competence concerning changes in therapeutic knowledge through participation in a medical mission trip. MethodsClinical interventions made by student pharmacists were prospectively collected during four clinic days. Intervention data included adult and pediatric dosing recommendations, medication recommendations, therapeutic substitution based on available formulary, and counseling. A pre-survey and a post-survey were anonymously administered to all pharmacy and physician assistant student participants. The survey consisted of questions based on a Likert scale that assessed perceived competence of medication knowledge and opinions regarding their participation in an interprofessional environment. ResultsStudent pharmacists made 624 interventions, including counseling of 420 patients, 78 dosing changes, 63 pediatric dosing calculations, 35 therapeutic substitutions, and 28 medication recommendations. A total of 25 student health care professionals completed the survey. Improvements were found in all questions pertaining to medication knowledge (p < 0.005). There was no difference with regard to opinions related to the medical mission trip’s effect on improving clinical skills (p = 0.414) and understanding of an interprofessional health care setting (p = 0.564) due to initial positive opinions in the pre-survey. ConclusionParticipation in the medical mission trip allowed student pharmacists to provide therapeutic interventions as a member of an interprofessional team. It also provides a unique opportunity for student health care professionals to practice clinical knowledge and improve perceived clinical competence in a direct patient care setting.

A comparison of the provision of the My Choice Weight Management Programme via general practitioner practices and community pharmacies in the United Kingdom.

This study aimed to assess the effectiveness of a novel, community-based weight management programme delivered through general practitioner (GP) practices and community pharmacies in one city in the United Kingdom. This study used a non-randomized, retrospective, observational comparison of clinical data collected by participating GP practices and community pharmacies. Subjects were 451 overweight or obese men and women resident in areas of high socioeconomic deprivation (82% from black and minority ethnic groups, 86% women, mean age: 41.1 years, mean body mass index [BMI]: 34.5 kg m(-2)). Weight, waist circumference and BMI at baseline, after 12 weeks and after 9 months were measured. Costs of delivery were also analysed. Sixty-four per cent of participants lost weight after the first 12 weeks of the My Choice Weight Management Programme. There was considerable dropout. Mean percentage weight loss (last observation carried forward) was 1.9% at 12 weeks and 1.9% at final follow-up (9 months). There was no significant difference in weight loss between participants attending GP practices and those attending pharmacies at both 12 weeks and at final follow-up. Costs per participant were higher via community pharmacy which was attributable to better attendance at sessions among community pharmacy participants than among GP participants. The My Choice Weight Management Programme produced modest reductions in weight at 12 weeks and 9 months. Such programmes may not be sufficient to tackle the obesity epidemic.

The Effect of Proximity, Tall Man Lettering, and Time Pressure on Accurate Visual Perception of Drug Names

The aim of this study is to assess the effect of proximity and time pressure on accurate and effective visual search during medication selection from a computer screen. The presence of multiple similar objects in proximity to a target object increases the difficulty of a visual search. Visual similarity between drug names can also lead to selection error. The proximity of several similarly named drugs within a visual field could, therefore, adversely affect visual search. In Study 1, 60 nonpharmacy participants selected a target drug name from an array of mock drug packets shown on a computer screen, where one or four similarly named nontargets might be present. Of the participants, 30 completed the task with a time constraint, and the remainder did not. In Study 2, the same experiment was repeated with 28 pharmacy staff. In Study 1, the proximity of multiple similarly named nontargets within the specified visual field reduced selection accuracy and increased reaction times in the nonpharmacists. Time constraint also had an adverse effect. In Study 2, the pharmacy participants showed increased reaction times when multiple nontargets were present, but the time constraint had no effect. There was no effect of Tall Man lettering. The presence of multiple similarly named medications in close proximity to a target medication increases the difficulty of the visual search for the target. Tall Man lettering has no impact on this adverse effect. The widespread use of the alphabetical system in medication storage increases the risk of proximity-based errors in drug selection.

Effect of a tobacco cessation continuing professional education program on pharmacists' confidence, skills, and practice-change behaviors

ObjectiveTo evaluate the impact of a tobacco cessation training program on pharmacists' confidence, skills, and practice-change behaviors. DesignQuasiexperimental study. SettingWisconsin during 2002–2003. Participants25 community pharmacists. InterventionA continuing education training program was developed and implemented using home and live training components consisting of the national tobacco cessation guidelines, including the 5A's counseling process. The home study component included lectures and readings in CD-ROM format. Consistent with self-efficacy theory, the live training was based on exercises that included modeling, rehearsal, and feedback to learners. Main outcome measuresKnowledge assessment, pre- and postsurveys assessing confidence and skill levels, and service provision indicators. ResultsSelf-efficacy and perceived ability to counsel patients to quit using tobacco improved significantly after the combined program. No significant change in confidence or perceived skills occurred following home study alone, suggesting value in using a combination of teaching strategies (problem solving, modeling, rehearsal, and feedback). Of participants, 92% received a passing knowledge score and 75% attempted to implement a tobacco cessation service posttraining; more than 50% assisted patients up to 1 year posttraining. A relationship between self-efficacy and service provision was found when practice settings were considered. ConclusionThis program increased pharmacists' knowledge and self-efficacy to counsel patients on tobacco use. Further, the majority of pharmacy participants attempted to implement a tobacco cessation service.