Portuguese Community Pharmacies Research Articles

Food drug interactions in an elderly population: Preliminary survey on a Portuguese community pharmacy

Food drug interactions in an elderly population: Preliminary survey on a Portuguese community pharmacy

Erro médico: Community pharmacists and physicians inter-professional work: insights from qualitative studies with multiple stakeholders

Objectives: To explore the opinions and experiences of a range of stakeholders on inter-professional working relationships between community pharmacists and physicians. Study design: Five qualitative studies. Setting: Primary care. Population and Methods: Thirty-one community pharmacists, eight medical and pharmacy leaders, 12 physicians and 21 patients took part in interviews and focus groups reflecting on medicines management services in Portuguese community pharmacy. Data pertaining to inter-professional work was subjected to thematic content analysis with the aid of NVIVO® software. Results: Generally, datasets offer evidence of immature inter-professional working relationships. Data analysis suggests a mismatch between the role pharmacists perceived for themselves and physicians’ perceptions. A second key theme in explaining barriers to inter-professional work is its perceived benefits. Once again, a mismatch was found between physicians, who gene-rally perceived little benefit for patients or for themselves, and pharmacists, who were keen to collaborate and anticipated be-nefits for patients. A third key theme was that of role encroachment. Analysis suggests that territorial behaviour was evident in both professions. More clinical roles were perceived as an invasion of physicians’ professional practice both by physicians and community pharmacists, but the latter showed unwillingness to compromise on these newly extended roles. Facilitators mentioned by participants included increasing awareness of the pharmacist’s role and services, adopting aspects such as joint training, and informal and formal inter-professional meetings. The use of protocols for collaboration and clinical data sharing were also identified as facilitators for inter-professional work. Conclusions: Inter-professional work between community pharmacists and physicians appears to be in an early stage of development. Multi-modal strategies combining top-down and bottom-up approaches seem necessary to advance inter-professional work to a collaboration level that can contribute to patient safety in the medication use process.

Acceptability of Community Pharmaceutical Care in Portugal: A Qualitative Study

In developed countries, community pharmacists are increasingly involved in clinical care. This study aimed to explore the acceptability to users of pharmaceutical care (drug therapy monitoring and management) provided in Portuguese community pharmacies, thereby informing future practice, policy and research. Qualitative semi-structured telephone interviews with a maximum variability sample of 21 service users. Interviews were audio-taped with permission of interviewees, transcribed verbatim and analysed using the 'framework approach' with the help of NVIVO(®) software. A perception of convenient access is one of the key themes associated with acceptability to users. Four factors are central in understanding this perception: shorter waiting time; flexibility of appointments; service organization; and proximity to home. Data analysis suggests that these factors have different weights. Another key theme underpinning user acceptability is the formation of a therapeutic relationship with the pharmacist. Patients' accounts provide evidence of a trusting and collaborative relationship where the pharmacist is seen as a health care provider. Recognition of interpersonal and technical skills were associated with the formation of this relationship. Although patients generally trusted the pharmacist's ability to help, patients were unable to voice clear expectations about the service, either in terms of the pharmacist's role or expected outcomes. Acceptability to patients is mainly determined by perceptions of convenient access and the development of a therapeutic relationship with the pharmacist. Patients' expectations concerning the service are not well developed, but not necessarily low.

Gauging Portuguese community pharmacy users’ perceptions

Objective: To assess perceptions related to facets of community pharmacy usage within the Portuguese general population. Methods: An ONSA (The Governmental Public Health Observatory) instrument was used, the ECOS (Em Casa Observamos Saude) sample. This consisted of a national representative sample of household units with telephone. General demographics and pharmacy users' perceptions related to five facets of community pharmacy usage were collected by telephone interviews. Main Results: Almost one-third (31.9%) of the participants were probable chronic drug users, hence in regular contact with the community pharmacy. Thirty-four percent preferred not to talk with the person who dispenses their prescribed drugs. Most users (47.6%) expressed opinions of pharmacists as being health care rather than business oriented, although one quarter of the sample was not sure. A large majority (73.7%) would like pharmacists to participate in their treatment decisions, but 55.1% did not seem able to distinguish between pharmacists and non-pharmacist technical staff, working at the pharmacy counter. Most significant predictors of users' dichotomous perceptions related to the usage facets surveyed were age, education and occupation. Being older, less literate and economically inactive increased the odds of inappropriate users' perceptions of the pharmacists. Conclusions: Results showed that erroneous concepts and behaviours exist within the Portuguese population in relation to the community pharmacists' role. This is a matter for pharmacy professional and educational bodies to take into account when developing intervention strategies, in particular when communicating with the general public.

Self-medication in a Portuguese urban population: a prevalence study.

To determine the prevalence of self-medication in a Portuguese urban population. To assess the feasibility of performing these studies in community pharmacies. A cross-sectional study was chosen to collect information about demography, use of health services and drug utilization in a sample of pharmacy user-purchasers in a pre-determined period of time. The proportion of pharmacies which participated in the study was 18.3% (11 from 60 invited) in Lisbon and 37.5% (15 of 40 invited) in Porto. Among the 3312 selected patients, only 2.6% (n = 114) refused to participate. The prevalence of self-medication was found to be 26.2%. The distribution of self-medication by gender was 28.4% for males and 25.2% for females. Use of self-medication was statistically significantly higher (p < 0.001) among individuals aged between 10 and 49 years. The main therapeutic groups used for self-medication, according to the ATC classification, were throat preparations, cough and cold preparations, stomatological preparations (antiinfectives and corticosteroides for local oral treatment), laxatives, analgesics, dermatological preparations, vitamins, mineral supplements and other alimentary tract and metabolism products. In the urban areas under study the overall prevalence of self-medication was 26.2%. Predictive factors for self-medication seem to be, a high level of education, professional status and length of waiting times for a medical consultation in cases of a severe health problem. Further research on this subject is needed to confirm the reproducibility of these results, since potential selection bias could have been introduced due to the method used for patient selection. Pharmacoepidemiologic research is feasible in Portuguese community pharmacies.