Role Of Community Pharmacies Research Articles

How do people use community pharmacies to manage sleep problems? A cross-sectional survey of pharmacy customers in England, UK

Abstract Introduction Insomnia and sleep problems have become increasingly common in the UK population, with research indicating a rise in the prevalence of sleep issues and the use of hypnotic medications1. Poor sleep can severely affect overall health and has been linked to cardiovascular disease, type 2 diabetes, and other conditions2. Community pharmacies are ideally positioned to advise people about sleep, but there is limited information about how people currently utilise them for sleep problems. Aim To understand how people use community pharmacies to manage problems with sleep Methods A researcher-administered questionnaire with customers at 16 community pharmacies in the East Midlands from the 6th to 25th of March 2023. People aged 18 and older were approached to take part. Survey questions included demographic information, general pharmacy use, and specific questions related to health-seeking advice for sleep problems. Responses were recorded using the Qualtrics survey platform and descriptive statistics derived using MS Excel. Ethical approval was given by the School of Pharmacy Research Ethics Committee at the University of Nottingham (2017-017er). Results 13,127 customers were approached to take part, and 4,985 consented and completed the questionnaire (response rate = 38.0%). Two thirds of participants were female (66.3%), half were above the age of 50 years (51.1%), and the majority identified as white ethnicity (79.8%). Just under one-third of participants reported purchasing a medicine, herbal remedy, or other product to help with sleep in the past (28.2%), of which 81.8% had purchased from a community pharmacy. The most common medicines purchased were anti-histamines (43.7%), followed by herbal remedies (34.1%). Only 19.1% of participants had previously sought advice for a sleep problem, of which 64.9% had sought advice from a GP/other healthcare professional, and 29.2% had sought advice from a community pharmacy. The most common advice received from a community pharmacy was to use a medicine (32.2%), with the second most common being sleep hygiene/lifestyle advice (22.8%). The most common advice received from a GP was also to use a medicine (36.4%). Discussion / Conclusion A significant proportion of survey participants reported purchasing a medicine, herbal remedy, or other product to help with sleep from a community pharmacy, highlighting the significant role of pharmacies in managing sleep issues. However, considerably fewer customers had sought advice for their sleep problem, identifying a potential gap in care. Current national guidelines do not recommend medication as first-line treatment for insomnia, emphasising sleep hygiene and behavioural therapy, with no role for sedative anti-histamines3. Despite this, our survey indicated the most common advice focused on medicines. This suggests an opportunity for enhancing the education of healthcare professionals and improving public awareness of managing sleep problems. Whilst this survey involved a large number of participants, we recognise it may not be fully representative of the wider UK population or practice. Further analysis of this survey and interviews with customers and pharmacists would help understand how the role of community pharmacies in managing sleep could be further developed to improve care.

A survey of community pharmacists’ and healthcare advisors’ views and experiences on the provision of a Test and Treat Service for uncomplicated lower urinary tract infection in a retail pharmacy chain in Ireland

Abstract Introduction The use of Point of Care Testing (POCT) as an aid to guide antibiotic prescribing has been highlighted in Ireland’s second One Health National Action Plan on Antimicrobial Resistance 2021-2025 (iNAP2).[1] The role of community pharmacy is expanding with the introduction of antimicrobial stewardship (AMS) POCT strategies. Uncomplicated urinary tract infections (UTIs) are frequent and burdensome in the community. With antibiotic resistance on the rise amongst uropathogens, AMS efforts to reduce inappropriate antibiotic prescribing for urinary symptoms are paramount. Aim To evaluate community pharmacy staff views and experiences on the provision of a Cystitis Test-and-Treat Service for uncomplicated UTIs, while identifying opportunities for service improvement and expansion. Methods An electronic survey on Microsoft® Forms was distributed within a large retail pharmacy chain in Ireland during November 2021, with two reminders issued. Pharmacists and Healthcare advisors over the age of 18, working in 88 pharmacies that provided the Velieve Cystitis Test-and-Treat Service were eligible to participate. The survey was subdivided into participant demographics, local UTI information, views and experiences of participants on the Cystitis Test-and-Treat Service, the patient information leaflet and the training completed by pharmacy staff providing the service and included open-ended and closed-ended or Likert-scale questions. The survey was developed based on the literature and was revised following the contributions of pharmacy chain pharmacists and its Research Governance Committee who have a working knowledge of Service. Data were analysed using Microsoft® Excel and IBM® SPSS® statistics version 28.0. Qualitative data from the open-ended survey questions were analysed using thematic analysis. Results A total of 43 pharmacy staff (18 pharmacists and 25 healthcare advisors) participated in the study (overall participation rate of 10.2%). The majority of participants were female (83.7%) and most pharmacies were located in a town/suburb area (55.8%). The majority of participants (76.7%) estimated that service users with symptoms suggestive of UTI present to the pharmacy first, before visiting their GP. Participants believed that the Cystitis Test-and-Treat Service improved service user satisfaction in symptom management, reduced antimicrobial prescribing, alongside reduced general practitioner workload. High acceptability was attributed to the speed and convenience of the service, while time cost and time required explaining the service were identified as barriers. The associated smartphone application was identified as a service weakness. Participants recommended extended training on service user eligibility with perhaps training videos to improve overall confidence. While the low response rate and small sample size is a limitation of this study, the inclusion of participants from two differing pharmacy roles strengths the findings. Conclusion This study highlights that POCT are feasible AMS initiatives that enhance management of uncomplicated UTI and could be incorporated into community pharmacy practice. The perceived ‘poor public awareness of the service’ reported by the participants, suggests the need for increased promotion and advertising.

A qualitative exploration of the barriers and enablers to supporting informal and familial carers within community pharmacies.

There are approximately 5.3 million informal carers in the United Kingdom, many of whom support family in their health despite being unpaid and often unsupported. Many visit pharmacies to collect medicines and look for advice. This work explores informal carer support within community pharmacies (CP). Semi-structured video interviews exploring perspectives on the role of CP in supporting carers were conducted in autumn 2022. The study received institutional ethical approval. Interviews were audio-recorded, transcribed verbatim, and analysed using a reflexive thematic approach. In total 25 interviews were conducted with 13 carers and 12 pharmacy staff. Three themes were identified:-What support do carers need through CP?-medicines management, navigating services, and carers health and wellbeing.-Barriers to CP better supporting carers-relationships with CP, carer needs, identification as a 'carer'.-Enablers to CP better supporting carers-support is a team effort, and CP as a community 'hub'. There is a trusted relationships between carers and pharmacy staff which can contribute to establishing pharmacies as a safe space of support, this includes medicines-specific support and navigating services, but also carer health and wellbeing support. Pharmacy staff may need to reconsider approaches to identifying and supporting carers and not just treating them as an extension of supporting a patient. In making this support accessible, relationships with pharmacy staff are important, as well as embracing CP as a 'community hub', although pharmacy staff may need training and information to facilitate them in this role.

Vaccination equity and the role of community pharmacy in the United States: A qualitative study

ObjectivesTo identify strategies community pharmacists utilized to support equitable vaccination in their communities. Study DesignQualitative, descriptive design. MethodsKey informant interviews were conducted virtually via teleconference using a mix of purposeful and snowball sampling of Pennsylvania community pharmacy personnel who participated in COVID-19 vaccination efforts. Interviews were conducted from March until August 2022 when thematic saturation was reached. A qualitative, inductive thematic data analysis was utilized to identify major themes and strategies that emerged from the data. ResultsPharmacists utilized three philosophies: (1) prioritizing trust, (2) meeting people where they are at, and (3) building capacity within their teams and communities to create “safe spaces” for people to receive vaccinations. Nine discrete strategies used in practice exemplify how respondents implemented these philosophies: (1) Build Community Partnerships; (2) Establish Trust to Build Credibility; (3) Address Transportation Issues; (4) Provide Patient Education and Address Health Literacy Barriers; (5) Address Language Barriers; (6) Create a Safe and Accessible Space for Those with Individualized Needs; (7) Provide Patient-Centered and Culturally-Sensitive Care; (8) Train Staff on Health Equity and Patient Engagement; and (9) Advocate for Community Pharmacy Policy and Payment Reform. Definitions for these philosophies and key examples that illustrate how each strategy was employed in practice are provided. ConclusionThe findings highlight unique strategies respondent community-based pharmacy teams use to contribute to equitable vaccination efforts in communities and further emphasizes the importance of their role in public health initiatives.

The role of community pharmacy in addressing health inequalities

The role of community pharmacy in addressing health inequalities

Role of community pharmacy and pharmacists in self care in Sweden

BackgroundSelf care is an important concept, which is increasingly being applied by policy makers on a large scale. It is associated with improved health literacy and technological advances. Community pharmacy practitioners are easily accessible for self care counselling, purchase of non-prescription products and for referrals to other healthcare providers. ObjectiveTo describe self care policies and strategies in Swedish healthcare authorities, pharmaceutical organizations and community pharmacy. MethodsA search was conducted to retrieve self care policy documents and strategies in Swedish healthcare authorities, pharmaceutical organizations and community pharmacy on respective websites, as well as personal contacts with key persons in pharmaceutical organizations and community pharmacy practice. ResultsA new law on self care was adopted by the Swedish Parliament becoming effective in 2023. The law defines self care as a healthcare measure that has been assessed by a treating licenced healthcare practitioner to be possible to be performed by the patient him/herself. The law includes a wide range of measures. According to a Government Commission that followed Sweden's the National Pharmaceutical Strategy's Action Plan in 2018, the Medical Products Agency (MPA) was assigned to establish requirements of qualifications in self care counselling. In its report in late 2022, the MPA stated that self care counselling by community pharmacy practitioners plays an important role in society. The new requirements are expected to become effective in mid-2023. None of the four community pharmacy chains operating 97% of Sweden's community pharmacies have developed any specific self care policies, although self care counselling and sales of non-prescription products, as well as provision of some primary healthcare services, constitute important components of their operations. Furthermore, all Swedish pharmacies offer several digital self care solutions, supporting people to manage their own health. Neither the Swedish Pharmacy Association, representing most pharmacies, nor the Swedish Pharmacists Association, the trade union, have developed any self care policies. However, the Swedish Association of the Pharmaceutical Industry is promulgating Swedish self care reform using a systematic review of self care and which medicines should be over-the-counter. ConclusionsSelf care is not currently established as a core pillar of a Swedish national health strategy. There are further opportunities to enable pharmacists to fulfil their potential in supporting individual wellbeing and promoting self care interventions. A new system needs to be created which fully integrates the promotion of everyday wellbeing, self care for self-treatable conditions and the management of long-term conditions.

The Role of Community Pharmacies in Providing Access to HIV Post-exposure Prophylaxis (PEP).

HIV affects an estimated 1.2 million individuals in the United States and is disproportionately concentrated among African Americans, Latinos, and people of multiple races. Post-exposure prophylaxis (PEP) substantially decreases HIV transmission when started within 72h after exposure, but problems of accessibility have hindered its widespread usage in communities at risk for HIV infection. Pharmacy-initiated PEP access was first permitted in New York City in 2017, allowing pharmacists to provide a 7-day supply of PEP without a prescription for consumers at high risk for HIV infection. It was expected that the broad reach and accessibility of community pharmacies would increase timely access to PEP for all individuals, especially those who already face significant barriers to accessing the healthcare system. Since then, eleven other states have followed suit and expanded the scope of outpatient pharmacy practice in order to increase the availability of HIV PEP but prescribing laws in over 75% of the US have not been changed. Much of the existing literature on HIV prevention focuses on PrEP access barriers with limited information on PEP access in the US. In this paper, we review the current status of pharmacist-initiated PEP in the US as part of the End the HIV Epidemic (EHE) initiative.

Primary care provider perspectives on the role of community pharmacy in colorectal cancer screening: a qualitative study

BackgroundThe United States Preventive Services Task Force (USPSTF) lists 32 grade A or B recommended preventive services for non-pregnant United States (US) adults, including colorectal cancer screening (CRC). Little guidance is given on how to implement these services with consistency and fidelity in primary care. Given limited patient visit time and competing demands, primary care providers (PCPs) tend to prioritize a small subset of these recommendations. Completion rates of some of these services, including CRC screening, are suboptimal. Expanding delivery of preventive services to other healthcare providers, where possible, can improve access and uptake, particularly in medically underserved areas or populations. Fecal immunochemical testing (FIT) (at-home, stool-based testing) for CRC screening can be distributed and resulted without PCP involvement. Pharmacists have long delivered preventive services (e.g., influenza vaccination) and may be a good option for expanding CRC screening delivery using FIT, but it is not clear how PCPs would perceive this expansion.MethodsWe used semi-structured interviews with PCPs in North Carolina and Washington state to assess perceptions and recommendations for a potential pharmacy-based FIT distribution program (PharmFIT™). Transcripts were coded and analyzed using a hybrid inductive-deductive content analysis guided by the Consolidated Framework for Implementation Research (CFIR) to elucidate potential multi-level facilitators of and barriers to implementation of PharmFIT™.ResultsWe completed 30 interviews with PCPs in North Carolina (N = 12) and Washington state (N = 18). PCPs in both states were largely accepting of PharmFIT™, with several important considerations. First, PCPs felt that pharmacists should receive appropriate training for identifying patients eligible and due for FIT screening. Second, a clear understanding of responsibility for tracking tests, communication, and, particularly, follow-up of positive test results should be established and followed. Finally, clear electronic workflows should be established for relay of test result information between the pharmacy and the primary care clinic.ConclusionIf the conditions are met regarding pharmacist training, follow-up for positive FITs, and transfer of documentation, PCPs are likely to support PharmFIT™ as a way for their patients to obtain and complete CRC screening using FIT.

Publics' Knowledge, Perception and Practice on Management of Minor Ailment in Community Pharmacy in Malaysia.

Minor ailments can be defined as medical conditions that can be self-diagnosed, resolve on their own, and be self-managed with over-the-counter (OTC) medications. Nevertheless, minor ailment management was reported to consume much of the health care resources, which may burden the health care system as it increases patient waiting times and the doctors' workload. To evaluate the publics' knowledge, perceptions, and practice on the management of minor ailments in community pharmacies in Malaysia and factors that may influence it. A cross-sectional, self-administered survey was conducted between Dec 2020 and April 2021 among general population in Malaysia. The self-developed and validated survey form consisted of four sections included respondents' demographics, knowledge, perceptions and practices toward minor aliment management in community pharmacy and was distributed using Google Forms via social media platforms. Factors influencing good public practices and perceptions were modeled using binary logistic regression. A total of 562 respondents completed the survey. Majority (n = 354, 63.0%) have good knowledge (score of 9-10), good practice (n = 367, 65.3%) (score 18-30) and good perception score (n = 305, 54.3%) (score 41-60). Variables such as age, those with higher degree (master/PhD), and prior experience and frequency of using community pharmacy had significant influence on respondents' good perceptions, while age and frequency of visit were found to influence respondents' good practice on minor ailment management in community pharmacy. Public in Malaysia have good knowledge on management of minor ailments by community pharmacies. Nevertheless, the publics' perceptions and practice need to be further improved. More advocacy on community pharmacy's roles on minor ailment management among public is need to strengthen the Malaysia's healthcare system resources.

Role of community pharmacy and pharmacists in self-care in Brazil

Global healthcare systems, including the National Health System in Brazil – one of the largest public models in the world –, continue to evolve, as well as populations' health needs, currently shaped on individuals feeling a greater desire to manage their own health. Self-care practices are part of several public policies and clinical guidelines in Brazil including the National Policy on Complementary and Integrative Practices, the National AIDS Control Program, the National Policy for Women's Health, and the Guidelines for Care of People with Chronic Diseases. There are over 100,700 community pharmacies, in the country (89.2% privately owned) employing 234,300 pharmacists, representing an important delivery point for self-care, as they are the first point of access to care for most patients. Self-medication is a common practice in Brazil (prevalence rates of self-medication ranging from 16.1% to 35.0%), especially with non-prescription/over-the-counter medicinal products (65.0%). In fact, these products represent over 25% of volume marketed of medicines, summing revenues of USD 1.9 billion per year. Studies demonstrated a positive budget impact as important savings for the National Health System due to reductions of unnecessary medical appointments and loss of working days. In addition to minor ailments management, other self-care services provided by community pharmacies that are frequently sought by Brazilian citizens (20–25% of cases) are smoking cessation and weight management (costs per service ranging from around USD 5.00–12.00). However, pharmacy services are not yet as fully integrated in Brazil to the same extent as in other countries. Barriers such as standardization of processes (from services' design, implementation, and evaluation in practice), pharmacist remuneration for the provision of services and the amount to be charged for the service are still a matter of controversy. For more rapid and sustainable advances in these practices, communication among various stakeholders, professional practice and healthcare regulations, standardization of services and financing of self-care (both publicly and privately) are urgently needed. This paper provides an overview of some self-care services provided by community pharmacies in Brazil and call attention to the ongoing challenges to move the National Health system forward.

The role of community pharmacies in the HIV and HCV care continuum

IntroductionIn 2019, there were over 1.1 million people living with human immunodeficiency virus (HIV) and 2.4 million people living with hepatitis C virus (HCV) in the United States. One in seven (14%) are unaware of their HIV infection and almost half of all HCV infections are undiagnosed. People with unstable housing are disproportionately affected by HIV and HCV. The present study will evaluate interventions by community pharmacists that may reduce HIV and HCV transmission and promote linkage to care. MethodsThis study was conducted in an independent community pharmacy in Spokane, Washington. Eligible study participants were walk-in patients of the pharmacy, over the age of 18, and experiencing homelessness. Pharmacy patients were excluded if they had a history of HIV or HCV diagnosis, received a screening for HIV or HCV in the last six months or were unable to give informed consent. The intervention included administration of HIV and HCV point-of-care testing (POCT) using a blood sample, risk determination interview, comprehensive HIV and HCV education, and personalized post-test and risk mitigation counseling followed by referral to partnering health clinics. ResultsFifty participants were included in the final data analysis. Twenty-two participants (44%) had a reactive HCV POCT, and one participant had a reactive HIV POCT. Of the 94% of participants who reported illicit drug use, 74% reported injection drug use. Seventy-six percent (n = 38) qualified for PrEP. Pharmacist referrals were made for 28 participants and 71% were confirmed to have established care. ConclusionIndividuals experiencing homelessness are at an increased risk for acquiring HIV and HCV due to risky sexual behaviors and substance misuse. PrEP is underutilized in the U.S. and pharmacist involvement in the HIV and HCV care continuum may have a significant impact in improving linkage and retention in care of difficult to treat populations.

Antihypertensive medicine use differs between Ghana and Nigeria

BackgroundNon-communicable diseases are a growing burden in many African countries; cardiovascular disease is the main disease. Antihypertensive medicines (AHM) are a common treatment option but we know little about community use in most low- and medium-income countries (LMIC). We aimed to describe the use of antihypertensive medicines (AHM) in Ghana and Nigeria using a novel data source.MethodsWe used data from mPharma—a health and pharmaceutical company which distributes pharmaceuticals to hospital and retail pharmacies. We extracted data using the anatomical therapeutic chemical (ATC) classification codes and calculated use in defined daily doses and explored patterns by class, medicines, dose, and originator or generic product.ResultsAHM use differed between Ghana and Nigeria. The most used classes in Ghana were angiotensin receptor blockers (ARB) followed by calcium channel blockers (CCB) and angiotensin-converting-enzyme inhibitors (ACEi). The five most used products were 16 mg candesartan, 30 mg nifedipine, 10 mg lisinopril, 5 mg amlodipine and 50 mg losartan. In Nigeria ARB, CCB and diuretics were widely used; the top five products were 50 mg losartan, 10 mg lisinopril, 30 mg nifedipine, 40 mg furosemide, and 5 mg amlodipine. More originator products were used in Ghana than Nigeria.ConclusionThe differences between Ghana and Nigeria may result from a combination of medical, contextual and policy evidence and reflect factors related to clinical guidance (e.g. standard treatment guidelines), accessibility to prescribers and the role of community pharmacies, and structure of the health system and universal health coverage including funding for medicines. We show the feasibility of using novel data sources to gain insights on medicines use in the community.

Role of Community Pharmacies in Chronic Disease Management

Role of Community Pharmacies in Chronic Disease Management

A qualitative evaluation of the attitudes, barriers, and facilitators relating to the provision of vaccine information by Irish community pharmacists

Abstract Introduction Community Pharmacists (CPs) can positively impact vaccination uptake. Vaccine hesitancy is not a binary belief but consists of a range of context-specific opinions. CPs are easily-accessible, trusted healthcare professionals responsible for improving patients’ wellbeing. CPs have a positive impact on reducing vaccine hesitancy and improving vaccine uptake. The importance of pharmacists’ role as vaccination educators is clear.(1) Despite the benefits of involvement in vaccine advocacy, CPs may be reluctant to communicate with vaccine-hesitant patients or may find counselling challenging. (2) Aim To examine factors influencing Irish CPs’ attitudes towards vaccine information provision and propose actions to remove barriers and promote facilitators to improve vaccination counselling. Methods Semi-structured interviews with a purposive sample of Irish CPs took place from October-November 2020. Topics covered included personal attitudes to vaccination, attitudes to pharmacists as vaccination educators, and barriers to counselling provision. Participants also completed a survey about their work environment and history of administering vaccines and beliefs about vaccination. Interview audio recordings were transcribed verbatim and thematic analysis used to identify themes. NVivo 12 was used to analyse interview data. Results Twelve pharmacists were interviewed. The majority of interviewees were female (n=10), supervising pharmacists (n=7), and received flu vaccines in at least three of the previous five years (n=7/10). Survey questions were not answered by two participants. All others agreed that vaccines are safe and effective. A single participant did not agree that vaccine counselling is a valuable use of a CPs time and that CPs should try to improve public vaccine uptake. Six themes were identified, with four relating to attitudes towards vaccine counselling; 1) vaccine value and confidence, 2) influence and duty, 3) knowledge, and 4) time and money, and two themes on actions to enhance counselling: 5) supporting resources, and 6) public awareness. Supporting materials would allow participants to be ‘very confident in going through…with them, going through risks, benefits, side-effects’ and would be ‘something tangible to show them’. In addition patients could take them home to help their deliberations. Having insufficient time was a barrier to vaccine counselling as they often were the only CP so they could not ‘start a conversation with someone about vaccine uptake if I can see that I have ten scripts waiting inside in the dispensary to be done.’ Conclusion Participants recognised the value of vaccination for improving patient wellbeing but willingness to promote immunisation was restricted by insufficient knowledge, time, and financial supports. Limited by its low number of participants, the diversity of CPs and overlapping themes strengthen the results of this study. Provision of accessible information repositories, training resources, counselling materials, and awareness campaigns may address deficits in knowledge and confidence. Removal of time and financial barriers may require reform of the role of community pharmacy in delivery of vaccine services in Ireland. References (1) Isenor JE, Edwards NT, Alia TA, Slayter KL, MacDougall DM, McNeil SA, et al. Impact of pharmacists as immunizers on vaccination rates: A systematic review and meta-analysis. Vaccine. 2016 Nov 11;34(47):5708–23. (2) Islam JY, Gruber JF, Lockhart A, Kunwar M, Wilson S, Smith SB, et al. Opportunities and Challenges of Adolescent and Adult Vaccination Administration Within Pharmacies in the United States. Biomed Inform Insights. 2017;9:1178222617692538.

Awareness, Familiarity, and Pharmacist Trust: A Structural Equation Model Analysis.

Background: Trust in health care professionals is critical in the health care system and is needed for a patient to seek care, reveal sensitive information, and follow a specified treatment plan, among other things. Objective: To better understand trust in community pharmacists, this research develops a model of how patient awareness of the different community pharmacy roles (role awareness) and pharmacist familiarity influences pharmacist trust. Methods: A survey of pharmacy patients in Nova Scotia, Canada, occurred in November and December 2019, with quota sampling used to achieve representativeness by age, gender, and household income. A total of 640 usable surveys were obtained. Consistent partial least squares was deployed to test and refine the model. Results: Overall, the final model highlights that both role awareness and pharmacist familiarity influence patient assessments of pharmacist trust and explains 38.7% of its variance. Pharmacist familiarity has a stronger influence than role awareness on pharmacist trust. Results of the consistent partial least squares multigroup analysis found no statistically significant differences in the model based on patient gender. Conclusion: This research provides a means to capture interpersonal trust in community pharmacists and identifies 2 key determinants of such trust. This research also provides guidance on how to assess pharmacist trust, the value of patients knowing their pharmacist, and the value of patient awareness of the roles of the various professionals behind the counter. Such knowledge will help pharmacy managers, associations, and regulatory authorities develop evidence-informed plans to assess, rebuild, and sustain trust.

Demographic and psychological predictors of community pharmacists\u2019 cancer-related conversations with patients: a cross-sectional analysis and survey study

BackgroundThere is increasing interest in the role of community pharmacy in the early diagnosis and prevention of cancer. This study set out to examine how often community pharmacists (CPs) encourage patients to spot or respond to potential signs and symptoms of cancer, and how often they help people to make an informed decision about taking part in bowel cancer screening.MethodsData from 400 UK CPs, who completed the 2018 Cancer Research UK Healthcare Professional Tracker survey, were analysed. The primary outcomes were: ‘how often CPs encourage patients to spot or respond to potential signs and symptoms of cancer’ and ‘how often CPs encourage eligible people to make an informed decision to participate in bowel cancer screening’. Associations between behaviours and demographic and psychological variables (Capability, Opportunity and Motivation) were assessed using multivariate logistic regression.ResultsMost (n = 331, 82.8%) CPs reported occasionally, frequently or always encouraging patients to spot or respond to potential signs and symptoms of cancer, while only half (n = 203, 50.8%) reported occasionally, frequently or always helping people make an informed decision to participate in bowel cancer screening. Female sex (aOR: 3.20, 95%CI: 1.51, 6.81; p < 0.01) and increased Opportunity (aOR: 1.72, 95%CIs: 1.12, 2.64; p < 0.05) and Motivation (aOR: 1.76, 95%CIs: 1.37, 2.27; p < 0.001) were associated with encouraging patients to spot or respond to potential signs and symptoms of cancer; all three psychological variables were associated with helping people to make an informed decision to participate in bowel cancer screening (Capability: aOR: 1.39, 95%CIs: 1.26, 1.52, p < 0.001; Opportunity: aOR: 1.44, 95%CIs: 1.11, 1.87; p < 0.01; Motivation: aOR: 1.45, 95%CIs: 1.05, 2.00; p < 0.05).ConclusionsMost CPs encourage patients to spot or respond to potential cancer symptoms, while only half help them make an informed decision to participate in bowel cancer screening. A multifaceted approach, targeting multiple COM-B components, is required to change these behaviours.

Scenarios for 3D printing of personalized medicines - A case study

Background3D printing is a promising new technology for medicines' production. It employs additive manufacturing techniques, and is ideal for producing personalized medicines (e.g., patient-tailored dose, dosage form, drug release kinetics). ObjectiveTo investigate how 3D printing technologies can be implemented in a European pharmaceutical system, by suggesting different scenarios and assessing aspects that could affect its implementation. MethodQualitative, semi-structured interviews were conducted with key stakeholders (e.g., from ministry, authorities, research organizations, pharmacies) in the Netherlands to elicit perspectives on 3D printing of personalized medicines. The Netherlands were chosen since it has a strong tradition in compounding. Five general scenarios were investigated: placing the 3D printers in industry, community pharmacies, hospital pharmacies, compounding facilities, and in patients' homes. Content analysis was used, building on verbatim transcripts. ResultsFifteen stakeholders were interviewed. Regulatory, economic, ethical and organizational challenges were identified to varying degrees in the different scenarios. The industry and home scenarios were associated with the most challenges, hospital pharmacies and compounding facilities with the least. Other important aspects identified were the role of community pharmacies, and who should design the tablets to be printed. ConclusionAll potential scenarios for 3D printing of personalized medicines include challenges. These should be taken into account when pursuing the use of 3D printing of medicine.

Role of Community Pharmacy in Helping Patients and Public in the Society

The impact of community pharmacies are outstanding as they are able to work at the front row in providing healthcare services in towns, cities and villages. Constant rising disease cases in India suffer the community pharmacies to handle huge number of patients. This research article has described the role of community pharmacies in helping patients as well as financial condition. E-pharmacy Model has been helped the researchers to move the further procedure. Along with this secondary data collection method has adapted by the researchers to find out the proper relevant data and information to make this research more reliable. Keyword : — Community pharmacy, Patient satisfaction, Quality of service, India, Pharmacy education.

The role of community pharmacies during the COVID-19 pandemic

Emeritus Professor Alan Glasper, from the University of Southampton, discusses the role of community pharmacies in providing health care as an important adjunct to the NHS, especially during the pandemic

The role of pharmacy in the management of cardiometabolic risk, metabolic syndrome and related diseases in severe mental illness: a mixed-methods systematic literature review

BackgroundIndividuals with severe mental illness, e.g. schizophrenia have up to a 20% shortened life expectancy compared to the general population. Cardiovascular disease, due to cardiometabolic risk and metabolic syndrome, accounts for most of this excess mortality. A scoping search revealed that there has not been a review of published studies on the role of pharmacy in relation to cardiometabolic risk, metabolic syndrome and related diseases (e.g. type 2 diabetes) in individuals with severe mental illness.MethodsA mixed-methods systematic review was performed. Eleven databases were searched using a comprehensive search strategy to identify English-language studies where pharmacy was involved in an intervention for cardiometabolic risk, metabolic syndrome or related diseases in severe mental illness in any study setting from any country of origin. First, a mapping review was conducted. Then, implementation strategies used to implement the study intervention were classified using the Cochrane Effective Practice and Organisation of Care Taxonomy. Impact of the study intervention on the process (e.g. rate of diagnosis of metabolic syndrome) and clinical (e.g. diabetic control) outcomes were analysed where possible (statistical tests of significance obtained for quantitative outcome parameters reported). Quality assessment was undertaken using a modified Mixed Methods Appraisal Tool.ResultsA total of 33 studies were identified. Studies were heterogeneous for all characteristics. A total of 20 studies reported quantitative outcome data that allowed for detailed analysis of the impact of the study intervention. The relationship between the total number of implementation strategies used and impact on outcomes measured is unclear. Inclusion of face-to-face interaction in implementation of interventions appears to be important in having a statistically significantly positive impact on measured outcomes even when used on its own. Few studies included pharmacy staff in community or general practitioner practices (n = 2), clinical outcomes, follow up of individuals after implementation of interventions (n = 3). No studies included synthesis of qualitative data.ConclusionsOur findings indicate that implementation strategies involving face-to-face interaction of pharmacists with other members of the multidisciplinary team can improve process outcomes when used as the sole strategy. Further work is needed on clinical outcomes (e.g. cardiovascular risk reduction), role of community pharmacy and qualitative studies.Systematic review registrationPROSPERO CRD42018086411