Training Of Pharmacy Staff Research Articles

Exploring a role for community pharmacists in the identification of alcohol-related liver disease: a qualitative interview study with professionals, patients, and the public.

To explore the views and attitudes of professionals, patients and the public to a role for community pharmacists in the identification of alcohol-related liver disease (ArLD). Semi-structured interviews were conducted with a purposive sample of patients with ArLD, members of the public, pharmacy staff, and clinicians managing patients with ArLD across the Wessex region of south England. The interviews explored experiences of alcohol, ArLD and health advice in pharmacies and elicited views of what a pharmacist role in identifying ArLD could entail and factors influencing this. Transcripts were analysed using reflexive thematic analysis. Twenty-six participants were interviewed and three themes were generated: (i) acknowledging, seeking help and engaging with a hidden problem; (ii) professional roles, boundaries and attributes; (iii) communication, relationships, collaboration and support. Participants reported key challenges to identifying people at-risk of ArLD. Offering testing for ArLD was perceived to motivate engagement but there were concerns about pharmacists performing this. A role was mostly seen to be finding people at-risk and engaging them with further care such as referral to liver services. This was perceived to require developing interprofessional collaborations, remuneration and training for pharmacy staff, and community-based liver testing. Professionals, patient and public participants recognized a role for pharmacists in the identification of ArLD. This was envisaged to incorporate educating pharmacy users about ArLD risk, and identifying and directly engaging those at-risk with liver and support services through development of interprofessional collaborations. The findings of this study support and can inform future work to develop this role.

Analysis of the Risks Associated with the Functions of a Pharmacy Cleaner in Pharmaceutical Compounding

INTRODUCTION. Pharmacy compounding involves certain risks that are directly related to the process of extemporaneous preparation and the actions of its participants. However, the role of pharmacy cleaners, whose actions can influence the quality of compounded medicinal products, has not been studied yet.AIM. This study aimed to analyse the risks to the quality of compounded medicinal products associated with the functions of a pharmacy cleaner in pharmaceutical compounding of non-sterile dosage forms.MATERIALS AND METHODS. The study used failure modes and effects analysis (FMEA) in accordance with the relevant Russian State Standard, as well as open brainstorming discussion. The study examined the functions of a pharmacy cleaner in pharmaceutical compounding of non-sterile dosage forms. The results were assessed by statistically processing the study data and assigning each potential failure mode a certain category.RESULTS. The risk analysis identified 45 potential failure modes for the functions of a pharmacy cleaner. Of these, 12 failure modes (26.7%) had a high level of criticality, 14 failure modes (31.1%) had a medium level of criticality, and 19 failure modes (42.2%) had a low level of criticality. Not all potential failure modes had valid documented regulatory provisions for the risk assessment and the development of prevention-type controls.CONCLUSIONS. The analysis of the functions of a pharmacy cleaner highlighted the potential risks to the quality of extemporaneous medicinal products prepared by compounding pharmacies. The study identified a lack of valid regulatory documentation. The authors suggested using the study results to amend the regulatory documents and standard operating procedures (SOPs) guiding the work of a pharmacy cleaner, to develop illustrative educational materials, and to conduct on-the-job training for pharmacy staff.

Exploration of the effects of an innovative mentalization-based training on patient-centered communication skills of pharmacy staff: A video-observation study

ObjectiveTo explore whether a mentalization-based communication training for pharmacy staff impacts their ability to elicit and recognize patients’ implicit and explicit medication related needs and concerns. MethodsA single-arm intervention pilot study was conducted, in which pre-post video-recordings of pharmacy counter-conversations on dispensed-medication (N = 50 and N = 34, respectively; pharmacy staff: N = 22) were coded. Outcome measures included: detecting needs and concerns, and implicitly and explicitly eliciting and recognizing them. Descriptive statistics and a multi-level logistic regression were conducted. Excerpts of videos with needs or concerns were analyzed thematically on mentalizing attitude aspects. ResultsIndications show that patients more often express their concerns in an explicit way post-measurement, just as pharmacy staffs’ explicit recognition and elicitation of needs and concerns. This was not seen for patients’ needs. No statistically significant differences were found for determinants for detecting needs or concerns (i.e., measurement-, professional-type, or interaction). Differences in mentalizing attitude were observed between pre-post-measurements, e.g., more attention for patients. ConclusionThis mentalizing training shows the potential of mentalizing to improve pharmacy staff members’ explicit elicitation and recognition of patients’ medication-related needs and concerns. Practice ImplicationsThe training seems promising for improving patient-oriented communication skills in pharmacy staff. Future studies should confirm this result.

O.28.4 - A communication training for pharmacy staff to improve the conversation about medication switches: Presenter(s): Marcia Vervloet, Nivel Netherlands Institute For Health Services Research, Netherlands

O.28.4 - A communication training for pharmacy staff to improve the conversation about medication switches: Presenter(s): Marcia Vervloet, Nivel Netherlands Institute For Health Services Research, Netherlands

Access to safer injection equipment among people who inject drugs utilizing medical services in an urban hospital in the United States

Injection drug use carries significant risks for injury and infection, particularly when injection supplies are reused or shared. Syringe service programs and pharmacy nonprescription sale of syringes minimize this risk by promoting access to supplies. This study aimed to characterize how individuals accessing medical care obtain supplies and the impact of perceived barriers to accessing safer injection supplies. One hundred and twenty participants reporting past seven-day injection drug use were recruited from a large urban academic medical center. Participants completed a survey about their injection drug use practices, access to injection supplies, as well as barriers to accessing supplies. Most participants (68%) reported obtaining syringes from multiple sources over the past 3 months, most commonly syringe service programs (78%) or a pharmacy (68%). Few (3%) reported obtaining supplies from medical settings. Participants who found syringes easy to obtain were less likely to report reusing a syringe >10 times (25% vs. 81%, p < .001). More participants were comfortable obtaining syringes through syringe service programs (89%) than nonprescription sale of syringes (60%, p = .001). Perceiving syringe service programs as not convenient or not comfortable reduced the odds of obtaining syringes there by 90% (p < .001) and 88% (p < .003), respectively. Perceiving pharmacies as not comfortable or not affordable reduced the odds of obtaining syringes there by 82% (p < .001) and 75% (p < .002), respectively. Even in regions with legalized syringe service programs and nonprescription sale of syringes, barriers to accessing safer injection supplies remain, and may be partially addressed by expanding syringe service program hours and locations, addressing cost of nonprescription sale of syringes, pharmacy staff training, and expansion of injection supply distribution in medical settings.

STOP— a training intervention to optimise treatment for smoking cessation in community pharmacies: cluster randomised controlled trial

BackgroundCommunity pharmacies serve people with high levels of tobacco-related illness, but throughput in NHS Stop Smoking Services in pharmacies remains relatively low. We investigated the effectiveness of a complex intervention to increase service uptake and retention.MethodsWe randomised 60 pharmacies in England and Wales to the STOP intervention or usual practice in a pragmatic, parallel-group, controlled trial over 11 months. Smokers were blind to the allocation. The intervention was theory-based consultation skills training for pharmacy staff with environmental prompts (badges, calendars and behavioural cues). The primary outcome was the number of smokers attending an initial consultation and setting a quit date.ResultsThe intervention made no significant difference in setting a quit date, retention or quit rate. A total of 631 adult smokers (service users) enrolled and set a quit date in intervention pharmacies compared to 641 in usual practice pharmacies, a rate ratio of 0.75 (95% CI 0.46 to 1.23) adjusted for site and number of prescriptions. A total of 432 (68%) service users were retained at 4 weeks in intervention and 500 (78%) in usual practice pharmacies (odds ratio 0.80, 0.41 to 1.55). A total of 265 (42%) service users quit smoking at 4 weeks in intervention and 276 (43%) in usual practice pharmacies (0.96, 0.65 to 1.43). The pharmacy staff were positive about the intervention with 90% (56/62) stating that it had improved their skills. Sixty-eight per cent would strongly recommend the training to others although there was no difference in self-efficacy for service delivery between arms. Seventy of 131 (53%) service users did not complete the 6-month follow-up assessment. However, 55/61 (90%) service users who completed follow-up were satisfied or very satisfied with the service. All usual practice arm service users (n = 33) and all but one in the intervention arm (n = 27) would recommend the service to smokers.ConclusionsWe found high levels of retention and acceptable quit rates in the NHS pharmacy stop smoking service. Despite pharmacy staff providing positive feedback on the STOP intervention, it made no difference to service throughput. Thus, other factors may currently limit service capacity to help smokers to quit.Trial registrationISRCTN, ISRCTN16351033. Retrospectively registered.

Perception of Pharmacists about Nuclear Pharmacy Services in Saudi Arabia

International Journal of Pharmacology and Clinical Sciences,2021,10,2,80-88.DOI:10.5530/ijpcs.2021.10.12Published:September 2021Type:Research ArticleAuthors:Yousef Ahmed Alomi, Ali Taer Al-Asmri, Mohammed Abdulaziz Ayoub Asiri, and Abdulaziz Saleh Alnabbah Author(s) affiliations:Yousef Ahmed Alomi*, Bsc. Pharm, Msc. Clin pharm, BCPS, BCNSP, Critical Care Clinical Pharmacists, TPN Clinical Pharmacist, Freelancer Business Planner, Content Editor, and Data Analyst, Riyadh, SAUDI ARABIA. Ali Taer Al-Asmri, BSc.Pharm, Al-Dawaa Medical Services Co. LTD, Abha, SAUDI ARABIA. Mohammed Abdulaziz Ayoub Asiri, BSc. Pharm, Dr. Sulaiman Alhabib Medical Group, Riyadh, SAUDI ARABIA. Abdulaziz Saleh Alnabbah, Bsc. Pharm, Riyadh, SAUDI ARABIA. Abstract:Goal: In this study, we aimed to explore the nuclear pharmacy perception in the Kingdom of Saudi Arabia. Methods: This is a 4-month cross-sectional study including all pharmacists and pharmacy interns in the Kingdom of Saudi Arabia. Students were excluded from this study. We distributed the electronic survey to the participants which consisted of two parts. The first part collected demographic information, and the second part collected information of perception of pharmacists about nuclear pharmacy services and reasons preventing nuclear pharmacy services. The responses were obtained through the Survey Monkey system and analyzed via Microsoft Excel and Statistical Package of Social Science (SPSS) software. Results: A total of 235 pharmacists responded to this survey. Of them, 142 (63.96%) were male and 80 (36.04%) were female responders, with statistically significant differences between them (p<0.001). Most of the responders were in the age group of 24–30 years (115 (48.94%)) followed by those in the age group of 31–35 years (57 (24.26%)), with statistically significant differences between all age groups (p<0.001). About two-thirds of the pharmacists had obtained Bachelor’s degree (149 (63.40%)) and Diploma in Pharmacy (75 (31.91%)), with statistically significant differences between the degrees (p<0.001). The total average score for the element “pharmacist perception of nuclear pharmacy services” was 3.54. We obtained high scores for the element “nuclear pharmacy required to complete the drug therapy for cancer patients” (3.77) followed by the element “nuclear pharmacy should be mandatory” (3.75). The score for the element “under-working in nuclear pharmacy in the healthcare institutions” (3.74). The total average score for the element “barriers prevent the implementation of nuclear pharmacy services” was 3.54 with high score obtained for the element “lack of periodic training of pharmacy staff about nuclear pharmacy” (3.81). The most recommendations/suggestions for facilitating the implementation of nuclear pharmacy was implemented nuclear pharmacy residency program (170 (72.65%)). Moreover, set up the therapeutic protocol or guidelines for nuclear pharmacy (147 (62.82%)). Conclusion: The perception of pharmacists about nuclear pharmacy services was acceptable. The nuclear pharmacy system demands workforces, nuclear management guidelines, and implementation of nuclear pharmacy residency program. We highly recommend to resolve all nuclear pharmacy challenges in order to improve healthcare services in Saudi Arabia. Keywords:Attitude, Nuclear, Perception, Pharmacist, Pharmacy, Saudi ArabiaView:PDF (312.44 KB) PDFClick here to download the PDF file. Images The recommendations/suggestions for facilitating the implementation of nuclear pharmacy.

Pharmacist’s Perception of Forensic Pharmacy Services

International Journal of Pharmacology and Clinical Sciences,2021,10,3,120-128.DOI:10.5530/ijpcs.2021.10.17Published:September 2021Type:Research ArticleAuthors:Yousef Ahmed Alomi, Samiyah Ibrahim Qassadi, Mawadah Mohsen Aqeeli, and Rehab Sultan Najmi Author(s) affiliations:Yousef Ahmed Alomi*, Bsc. Pharm, Msc. Clin pharm, BCPS, BCNSP, DiBA, CDE Critical Care Clinical Pharmacists, TPN Clinical, Pharmacist, Freelancer Business Planner, Content Editor and Data Analyst, P.O.BOX 100, Riyadh 11392, Riyadh, SAUDI ARABIA. Samiyah Ibrahim Qassadi, Pharm D, Jazan University, Jazan, SAUDI ARABIA. Mawadah Mohsen Aqeeli, Pharm D, Ministery of Heath, Abha, SAUDI ARABIA. Rehab Sultan Najmi, Bsc. Pharm,King Khalid University Abha, SAUDI ARABIA. Abstract:Goal: To illuminate the pharmacist perception of forensic pharmacy in Saudi Arabia. Methods: It is cross-sectional of convenient sampling and planned number of the subject with power eighty. An electronic survey was dispersed to the pharmacist and pharmacy intern, excluding pharmacy students and other healthcare professionals. The survey entailed of demographic data, pharmacist’s perception of forensic pharmacy, and barriers preventing implementation of forensic pharmacy. Survey monkey, Microsoft Excel, and Statistical Package of Social Science (SPSS) were used in this study. Results: The total number of responding pharmacists was 402. Of those, 198 (49.75%) were male, while 200 (50.25%) were female, with statistical significance between them (p<0.001). Almost three-quarters of the pharmacists had bachelor’s degrees 303 (75.56%), with statistically momentous among all pharmaceutical degrees (p<0.001). The total average scores of pharmacist perception of forensic pharmacy services were (3.93). The high scores element was under-working in forensic pharmacy in the healthcare institutions (4.15). On the contrary, the lowest score medical staff feel like their mistakes are held against them when an event is stated (3.35). The total average scores of barriers prevent the implementation of forensic pharmacy services were (3.41) with high scores element was lack of periodic training of pharmacy staff about forensic pharmacy (4.13). At the same time, the lowest score aspect of forensic pharmacy was the pharmacist shred in forensic sciences is too trivial to work (1.88). The most suggestions for facilitating forensic pharmacy implementation were implementing an electronic forensic pharmacy 306 (77.86%) and raise the number of forensic pharmacist staff by 319 (81.17%). Conclusion: The pharmacist had a positive insight of forensic pharmacy. However, various barriers are requisite to eliminate to start the implementation of forensic pharmacy services. Therefore, education and training are indispensable elements for establishing forensic pharmacy services in the Kingdom of Saudi Arabia. Keywords:Forensic, Perception, Pharmacist, Pharmacy, Saudi ArabiaView:PDF (340.83 KB) PDFClick here to download the PDF file. Images The recommendations/suggestions for facilitating the implementation of Forensic pharmacy

Exploring satisfaction level among outpatients regarding pharmacy facilities and services in the Kingdom of Saudi Arabia; a large regional analysis.

BackgroundEvaluation of patients`satisfaction towards pharmacy services is of utmost importance to ensure the quality of care. It helps in identifying domains requiring improvements to provide high quality pharmacy services to ensure the provision of enhanced pharmaceutical care. The current study aims to ascertain the extent of satisfaction towards pharmacy services among patients attending outpatient pharmacies in Kingdom of Saudi Arabia.MethodsA hospital-based cross-sectional study involving 746 patients attending outpatient pharmacies of various public hospitals was conducted from 01 January to 15 February 2020. Information on socio-demographic profile of the study subjects along with their satisfaction towards outpatient pharmacy was extracted by using a 23-items questionnaire. These questions were divided into two domains including 7 questions related to the pharmacy facilities (questions from 1F to 7F) and 8 questions for pharmacy services (questions from 1S to 8S), where F and S denotes facilities and services, respectively. The cumulative satisfaction score was estimated by a 5-item Likert scale with a maximum score of 5 for each item. The relationship between demographics and satisfaction scores was evaluated by using appropriate statistics.ResultsThere were 746 patients with male preponderance (58.8%). The overall satisfaction score was 2.97 ± 0.65. Satisfaction towards pharmacy services scored lower (mean score: 3.91 ± 0.77) than pharmacy facilities (mean score: 4.03 ± 0.66). Items related to patient`s counseling (3F, 2S, 3S, 6S) scored least during the analysis. Older patients (p = 0.006), male gender (p<0.001), Saudi nationality (0.035), patients attending primary care centers (p = 0.02), and patients with chronic illnesses were significantly associated with lower satisfaction score.ConclusionThis study reported that the satisfaction level of patients attending outpatient pharmacies was low and differed among various socio-demographic groups. Approximately one-half of the patients were not satisfied with outpatient pharmacy services. These findings underscore the dire need for managerial interventions including the hiring of trained professionals, onsite training of pharmacy staff, initiation of clinical or patient centered pharmacy services, evaluation of patient`s response towards the services and appropriate controlling measures, irrespective to the type of hospitals.

DEVELOPMENT OF QUALITY INDICATORS FOR PHARMACEUTICAL CARE PERFORMANCE ASSESSMENT IN NIGERIAN COMMUNITY PHARMACIES: A DELPHI PANEL

Objective: This study aimed to develop quality indicators for assessing pharmaceutical care performance in the Nigerian community pharmacies.&#x0D; Methods: We searched for existing quality indicators through an extensive literature review. The identified quality indicators consisted of thirty-four items in 10 core components. The Delphi method was used to arrive at a consensus on quality indicators for assessing pharmaceutical care performance in the Nigerian community pharmacies by surveying a panel of experts. There were 3 rounds of the Delphi panel conducted by consulting a panel of 10 experts in pharmaceutical care practice. A mean score&gt;3.5, median&gt;3.5, an absolute value between the median and mode&lt;1.00 was used to establish consensus on the quality indicators for assessing pharmaceutical care performance in the Nigerian community pharmacies.&#x0D; Results: Ten studies met the inclusion criteria. A list of 33 quality indicators comprising of 10 core components emerged from the extensive literature review. They included quality management, documentation of care, communication with the patient, management of clinical risk in pharmacy, compounding, dispensing and patient care, follow-up of pharmacotherapy counselling, drug inventory and stocking, training of pharmaceutical staff. At the end of the round three votings, 24 statements of the quality indicator reached consensus in nine core components: quality management (5), continuity of care (1), communication with patients (3), clinical risk management (5), dispensing (1), follow-up of pharmacotherapy (3), counselling (1), logistics (3), training of pharmacy staff (2).&#x0D; Conclusion: This study developed a set of 24 quality indicators for assessing pharmaceutical care performance in community pharmacies in Nigeria.

Support and perceived barriers to implementing pre-exposure prophylaxis screening and dispensing in pharmacies: Examining concordance between pharmacy technicians and pharmacists

ObjectivesRecent legislation to expand pre-exposure prophylaxis (PrEP) screening and dispensing in pharmacies may significantly improve PrEP access for people at a high risk of human immunodeficiency virus (HIV) transmission. Studies have shown that pharmacists show wide support for PrEP expansion in pharmacies. However, pharmacy technicians are often the first point of contact for patients in pharmacies and are required to implement many of the tasks to ensure patients of a pharmacy receive adequate services. The purpose of this study was to assess pharmacists’ and pharmacy technicians’ perspectives regarding the implementation of PrEP screening and dispensing. MethodsWe qualitatively examined whether pharmacy technicians’ (n = 6) support and perceived barriers to screening and dispensing PrEP in pharmacies were concordant with those of pharmacists (n = 7). Pharmacy staff were recruited from high-risk HIV neighborhoods in Atlanta, GA using AIDSVu (Atlanta, GA). Two independent coders used MAXQDA (Berlin, Germany) and performed thematic data analysis and unitization to determine agreement. ResultsPharmacists and pharmacy technicians expressed strong willingness and support for screening and dispensing PrEP in pharmacies. Both groups expressed concerns about the time and the resources needed to perform PrEP screening and dispensing. Technicians, however, also reported concerns about privacy for patients, the need for community support and awareness of pharmacy-based PrEP screening, and recommended scheduling of PrEP screening activities during a limited part of the day to facilitate screening. Pharmacists reported fewer barriers but reported a need for more training of pharmacy staff to assist with PrEP screening and dispensing implementation. ConclusionPharmacy technicians discussed more barriers compared with pharmacists who were largely centered around practical considerations (i.e., logistics and workflow) that may affect the success of PrEP screening and dispensing. Given technicians’ pivotal role in the pharmacy, implementation of pharmacy-based PrEP services should address technicians’ perceived barriers in addition to those of pharmacists.

Pharmacy-based pre-exposure prophylaxis support among pharmacists and men who have sex with men

ObjectiveTo understand the perceptions and support for pharmacy-based pre-exposure prophylaxis (PrEP) delivery among pharmacists and men who have sex with men (MSM). DesignA qualitative study from April 2017 to December 2018. Setting and participantsThe researchers used purposive sampling to identify MSM participants and AIDSVu to identify pharmacists in high–human immunodeficiency virus (HIV) zip codes in the metropolitan Atlanta area. Eight MSM and 6 pharmacists consented to participate in the study. Outcome measuresPerceptions and support for PrEP delivery in pharmacies. ResultsBoth MSM and pharmacists expressed strong support for in-pharmacy PrEP screening and dissemination. MSM reported that pharmacies were more convenient and accessible compared with physician’s offices. However, they also noted that privacy and training of pharmacy staff were important for them to consider being screened for PrEP in a pharmacy. Pharmacists also believed training was important and felt comfortable counseling on HIV prevention for their current patients. ConclusionThese data support early evidence that pharmacies are a promising venue to improve PrEP access for MSM. To implement PrEP screening in pharmacies, proper training of pharmacy staff and a designated space to ensure privacy are critical. Future studies should test the feasibility of screening for PrEP in pharmacies for black MSM.

Consumer perspectives on pharmacy staff roles in providing oral health services in Australia.

Australian and international findings report pharmacy staff are motivated to expand and undertake new roles in public health and expressed a strong interest in providing oral healthcare services to the community. We sought to describe consumer experiences within primary oral healthcare, and views about pharmacy staff roles and boundaries in providing oral health services as perceived by a sample of consumers living within metropolitan Australia. Sampling occurred purposively to enable diverse perspectives on the topic. Socioeconomic status, as defined by the Socio-Economic Index for Areas, was used as the primary criteria to stratify focus group recruitment. Thematic, in-depth analysis of focus group discussions was carried out. In all, 34 participants took part in six focus groups, held in metropolitan settings in Queensland, Australia. Findings show that consumers supported pharmacy staff performing non-invasive oral health services including providing oral health education and advice, reviewing medications and recommending evidence-based medications. As services became more invasive (i.e., oral screening and fluoride application), questions and concerns were raised around the appropriateness of the community pharmacy setting and the level of training of pharmacy staff to provide these services. This study identifies the need to support greater integration of oral healthcare roles by community pharmacy staff. Future innovative and collaborative research involving additional stakeholder groups are necessary to explore, develop and test the feasibility and effectiveness of pharmacy-led oral healthcare models.

Sécurisation de la dispensation individuelle et nominative suite à l’implantation d’un automate de dispensation nominative : cartographie des risques a priori au sein d’une pharmacie à usage intérieur

With a view to reinforcing the security of the drug distribution process, the hospital pharmacy has decided to automate the patient-specific unit dose distribution system which, up to now was performed manually, through the acquisition of a unit dose dispensing system: the ACCED S 300 (ECODEX®). The aim of this work is to realize a cartography of risks, focused on the dispensing stage, prior to the implementation of the automated system. A multidisciplinary group applied the preliminary risk analysis (PRA) technique. The study was limited to the dispensing stage of unit doses within the hospital pharmacy. This analysis revealed 122accident scenarii, including 18with an initial unacceptable criticality (14.8% of scenarii). In total, 140risk management actions were proposed. These actions include: acquisition of equipment, communication and training of pharmacy staff, communication with services, human resources management and organization of working hours, writing and updating quality documents, programming the software and interfaces linked with the robot. The implementation of risk management actions should reduce the risk and contribute to avoiding the most critical scenarii. This will require the availability of human and financial resources and the implication of management.

Outcomes of a randomized trial evaluating two approaches for promoting pharmacy-based referrals to the tobacco quitline

ObjectivesTo evaluate the long-term impact of 2 promising intervention approaches to engage pharmacy personnel (pharmacists, technicians) in referring patients who want to quit smoking to the tobacco quitline. DesignRandomized trial. SettingCommunity pharmacies in Connecticut (n = 32) and Washington (n = 32). InterventionTwo intervention approaches were evaluated: academic detailing (AD), which involved on-site training for pharmacy staff about the quitline, versus mailed quitline materials (MM). Main outcome measuresChanges in the overall percentage of quitline registrants who reported hearing about the quitline from any pharmacy during the 6-month baseline monitoring period versus the 12-month intervention period, and between-group comparisons of a) the number of quitline registrants who reported hearing about the quitline from one of the study pharmacies during the 12-month intervention period, and b) the number of quitline cards and brochures distributed to patients during the first 6 months of the intervention period. ResultsThe percentage of quitline callers who reported having heard about the quitline from a pharmacy increased significantly, from 2.2% during the baseline monitoring period to 3.8% during the 12-month intervention (P < 0.0001). In addition, comparisons controlled for seasonal effects also revealed significant increases in referrals. Across all 64 pharmacies, 10,013 quitline cards and 4755 brochures were distributed. The number of quitline cards distributed and the number registrants who reported hearing about the quitline from a pharmacy did not differ by intervention approach (AD vs. MM), although AD pharmacies distributed more quitline brochures (P = 0.022). ConclusionBrief cessation interventions are feasible in community pharmacies, and the 2 approaches evaluated for engaging pharmacy personnel were similarly effective and collectively led to meaningful increases in the number and proportion of all patients who called the quitline. Involvement of community pharmacy personnel in tobacco cessation presents a significant opportunity to promote quitline services by connecting patients with an effective publicly available resource.

A qualitative case study of ehealth and digital literacy experiences of pharmacy staff.

eHealth's many forms are benchmarked by the World Health Organization. Scotland is considered an advanced adopter of ehealth. The third global survey on ehealth includes pharmacy-related ehealth indicators. Advances in ehealth place an obligation on pharmacy staff to demonstrate proficiency, or digital literacy, in using ehealth technologies. The aim of this study was to provide an indepth exploration of the ehealth and digital literacy experiences of pharmacy staff in the North East of Scotland. A qualitative local case study approach was adopted for observational and interview activities in community and hospital pharmacies. Interview and observational data were collated and analysed using a framework approach. This study gained management approval from the local health board following ethical review by the sponsor university. Nineteen pharmacies and staff (n=94) participated including two hospitals. Most participants were female (n=82), aged 29 years and younger (n=34) with less than 5 years pharmacy experience (n=49). Participants identified their own digital literacy as basic. Most of the pharmacies had minimum levels of technology implemented (n=15). Four themes (technology, training, usability, processes) were inducted from the data, coded and modelled with illustrative quotes. Scotland is aspirational in seeking to support the developing role of pharmacy practice with ehealth, however, evidence to date shows most pharmacy staff work with minimum levels of technology. The self-reported lack of digital literacy and often mentioned lack of confidence in using IT suggest pharmacy staff need support and training. Informal work based digital literacy development of the pharmacy team is self-limiting. Usability of ehealth technology could be a key element of its' acceptability. There is potential to better engage with ehealth process efficiencies in both hospital and community pharmacy. As Scotland increasingly invests in ehealth pharmacy technology, it is important that it also invests in pharmacy staff training.

"These patients look lost" - Community pharmacy staff's identification and support of patients with limited health literacy.

To date, routine use of health literacy assessment in clinical settings is limited. The objective of this study was to explore if community pharmacy staff can identify patients with limited health literacy, how they identify patients and how they support patients to improve medication use. In addition, perceived barriers in providing care for patients with limited health literacy were assessed. Structured face-to-face interviews with pharmacy staff were performed in 27 community pharmacies. Questions concerned pharmacy staff's experiences with limited health literacy during their work, e.g. recognition of patients, communication strategies and possible interventions for this patient group to improve medication use. Results from 74 interviews were included for analysis. Sixty-eight interviewees (92%) mentioned to identify patients with limited health literacy during their work, mostly based on intuition. Suggested strategies to improve medication use included tailored education and information, intensive support or use of aids such as a multidose drug dispensing system. Pharmacy staff indicated lack of time as a barrier to provide tailored pharmaceutical care. Most participants mentioned to recognize patients with limited health literacy merely on intuition or based on certain patient characteristics. Thus, an unknown number of patients with limited health literacy might be missed. This underlines the need to create more awareness of health literacy among pharmacy professionals. Moreover, training of pharmacy staff and use of aids to identify limited health literacy may help to identify more patients who need additional counselling.

Accreditation status of hospital pharmacies and their challenges of medication management: A case of south Iranian largest university.

Considering the importance of accreditation for hospital pharmacies, this study was to determine the challenges of medication management in hospital pharmacies affiliated with Shiraz University of Medical Sciences, Iran. The study was a mix-method research conducted in two qualitative and quantitative phases during the years 2014–2015 in Shiraz, Iran. National Accreditation Standard checklist for hospitals was used for data collection in the first phase, and Delphi method was applied in three rounds to achieve the most challenges of medication management and the related solutions. Results indicated a medium status of accreditation for all three dimensions in the above hospital pharmacies (3.53, 42.15 and 7, respectively). Lack of clinical pharmacists, nonparticipation of the pharmacy director in annual budgeting, lack of access to patient information, discontinuity of pharmaceutical care for patients discharged, defects in pharmacy staff training, lack of legislation in support of pharmacists and lack of adequate access to physicians' prescriptions, shortages in reporting medication errors, and lack of evidence related to microbial contamination are the most challenges extracted from the second phase. It seems that the studied hospital pharmacies encounter numerous problems regarding accreditation, pharmaceutical care as well as appropriate medication management and supply chain. Attempts to solve these problems can play an important role in improving the efficiency and effectiveness of pharmacies in Iran.

Trials and tribulations with electronic medication adherence monitoring in kidney transplantation.

Medication adherence in kidney transplantation is critical to prevent graft rejection. Testing interventions designed to support patients to take their prescribed medications following a kidney transplant require an accurate measure of medication adherence. In research, the available methods for measuring medication adherence include self-report, pill counts, prescription refill records, surrogate measures of medication adherence and medication bottles with a microchip-embedded cap to record bottle openings. Medication bottles with a microchip-embedded cap are currently regarded as the gold standard measure. This commentary outlines the challenges in measuring medication adherence using electronic medication monitoring of kidney transplant patients recruited from five sites. The challenges included obtaining unanimous stakeholder support for using this method, agreement on an index medication to measure, adequate preparation of the patient and training of pharmacy staff, and how to analyze data when periods of time were not recorded using the electronic adherence measure. Provision of this information will enable hospital and community pharmacists to implement approaches that promote the effective use of this adherence measure for optimal patient outcomes.

Privacy and confidentiality: perspectives of mental health consumers and carers in pharmacy settings.

The study aims to explore within the community pharmacy practice context the views of mental health stakeholders on: (1) current and past experiences of privacy, confidentiality and support; and (2) expectations and needs in relation to privacy and confidentiality. In-depth interviews and focus groups were conducted in three states in Australia, namely Queensland, the northern region of New South Wales and Western Australia, between December 2011 and March 2012. There were 98 participants consisting of consumers and carers (n = 74), health professionals (n = 13) and representatives from consumer organisations (n = 11). Participants highlighted a need for improved staff awareness. Consumers indicated a desire to receive information in a way that respects their privacy and confidentiality, in an appropriate space. Areas identified that require improved protection of privacy and confidentiality during pharmacy interactions were the number of staff having access to sensitive information, workflow models causing information exposure and pharmacies' layout not facilitating private discussions. Challenges experienced by carers created feelings of isolation which could impact on care. This study explored mental health stakeholders' experiences and expectations regarding privacy and confidentiality in the Australian community pharmacy context. A need for better pharmacy staff training about the importance of privacy and confidentiality and strategies to enhance compliance with national pharmacy practice requirements was identified. Findings provided insight into privacy and confidentiality needs and will assist in the development of pharmacy staff training material to better support consumers with sensitive conditions.