Is the pharmacy profession innovative enough?: meeting the needs of Australian residents with chronic conditions and their carers using the nominal group technique

Background Community pharmacies are ideally located as a source of support for people with chronic conditions. Yet, we have limited insight into what innovative pharmacy services would support this consumer group to manage their condition/s. The aim of this study was to identify what innovations people with chronic conditions and their carers want from their ideal community pharmacy, and compare with what pharmacists and pharmacy support staff think consumers want. Methods We elicited ideas using the nominal group technique. Participants included people with chronic conditions, unpaid carers, pharmacists and pharmacy support staff, in four regions of Australia. Themes were identified via thematic analysis using the constant comparison method. Results Fifteen consumer/carer, four pharmacist and two pharmacy support staff groups were conducted. Two overarching themes were identified: extended scope of practice for the pharmacist and new or improved pharmacy services. The most innovative role for Australian pharmacists was medication continuance, within a limited time-frame. Consumers and carers wanted improved access to pharmacists, but this did not necessarily align with a faster or automated dispensing service. Other ideas included streamlined access to prescriptions via medication reminders, electronic prescriptions and a chronic illness card. Conclusions This study provides further support for extending the pharmacist’s role in medication continuance, particularly as it represents the consumer’s voice. How this is done, or the methods used, needs to optimise patient safety. A range of innovative strategies were proposed and Australian community pharmacies should advocate for and implement innovative approaches to improve access and ensure continuity of care

Positioning pharmacists’ roles in primary health care: a discourse analysis of the compensation plan in Alberta, Canada

Abstract Background A comprehensive Compensation Plan for pharmacy services delivered by community pharmacists was implemented in Alberta, Canada in July 2012. Services covered by the Compensation Plan include care planning services, prescribing services such as adapting prescriptions, and administering a drug or publicly-funded vaccine by injection. Understanding how the Compensation Plan was framed and communicated provides insight into the roles of pharmacists and the potential influence of language on the implementation of services covered by the Compensation Plan by Albertan pharmacists. The objective of this study is to examine the positioning of pharmacists’ roles in documents used to communicate the Compensation Plan to Albertan pharmacists and other audiences. Methods Publicly available documents related to the Compensation Plan, such as news releases or reports, published between January 2012 and December 2015 were obtained from websites such as the Government of Alberta, Alberta Blue Cross, the Alberta College of Pharmacists, the Alberta Pharmacists’ Association, and the Blueprint for Pharmacy. Searches of the Canadian Newsstand database and Google identified additional documents. Discourse analysis was performed using social positioning theory to explore how pharmacists’ roles were constructed in communications about the Compensation Plan. Results In total, 65 publicly available documents were included in the analysis. The Compensation Plan was put forward as a framework for payment for professional services and formal legitimization of pharmacists’ changing professional roles. The discourse associated with the Compensation Plan positioned pharmacists’ roles as: (1) expanding to include services such as medication management for chronic diseases, (2) contributing to primary health care by providing access to services such as prescription renewals and immunizations, and (3) collaborating with other health care team members. Pharmacists’ changing roles were positioned in alignment with the aims of primary health care. Conclusions Social positioning theory provides a useful lens to examine the dynamic and evolving roles of pharmacists. This study provides insight into how communications regarding the Compensation Plan in Alberta, Canada positioned pharmacists’ changing roles in the broader context of changes to primary health care delivery. Our findings may be useful for other jurisdictions considering implementation of remunerated clinical services provided by pharmacists

‘Making the invisible visible’ through alcohol screening and brief intervention in community pharmacies: an Australian feasibility study

Background: Screening and brief interventions (SBI) for alcohol related problems have been shown to be effective in health settings such as general practice or emergency departments. Recent data from the United Kingdom and New Zealand suggest that SBI can be delivered through community pharmacies, but this approach has not been tested in Australia. This study assesses the feasibility of delivering alcohol SBI via community pharmacists. Method: We recruited five pharmacies and developed an SBI training package to be delivered by pharmacy staff, who screened consumers and delivered the brief intervention where appropriate. Consumers also completed a questionnaire on the process. At three months consumers were telephoned to enable ‘retention’ to be quantified. After completing recruitment, a semi-structured interview was conducted with pharmacists on the process of delivering the intervention, potential improvements and sustainability. Results: Fifty consumer participants were screened, ten from each pharmacy. There were 28 (57 %) men and 21 (43 %) women with one not responding. Most (67 %) were aged 25-55 years. Their AUDIT scores had a range of 0 to 39 (mean 10.9, SD 9.8) with 11 categorised as ‘hazardous (8-15)’, four as ‘harmful (16-19)’ and eight as ‘probably dependent (20+)’ consumers of alcohol. Reactions to the process of SBI were generally favourable: for example 75 % agreed that it was either appropriate or very appropriate being asked about their alcohol consumption. With respect to follow-up interviews, 23 (46 %) agreed that they could be contacted, including five from the highest AUDIT category. Subsequently 11 (48 %) were contactable at three months. Three of the five non-low risk drinkers had reduced their level of risk over the three months. Ten pharmacists participated in semi-structured telephone interviews. Overall these pharmacists were positive about the intervention and five main themes emerged from the interviews: 1) flexibility applied in recruitment of participants, 2) easiness in use of AUDIT score to facilitate discussions, 3) perceived positive intervention impact, 4) enhanced role of community pharmacists and 5) facilitators and challenges experienced. Conclusions: Pharmacy-based SBI appears to be acceptable to consumers and feasible for pharmacy staff to deliver. Challenges remain in translating this potential into actual services

"Bomba hormonal": os riscos da contracepção de emergência na perspectiva dos balconistas de farmácias no Rio de Janeiro, Brasil

Resumo: A pesquisa objetivou conhecer a perspectiva dos balconistas de farmácias sobre a contracepção de emergência na Região Metropolitana do Rio de Janeiro, Brasil. O material empírico advém de pesquisa socioantropológica com vinte entrevistas semiestruturadas com balconistas dos sexos feminino (8) e masculino (12). Os entrevistados apresentam concepções negativas sobre a contracepção de emergência, enfatizando os riscos que ela pode provocar à saúde. O medicamento é considerado uma "bomba hormonal" que pode causar danos aos órgãos reprodutivos femininos e outros sistemas do corpo. Eles destacam os riscos do uso "descontrolado" ou "indiscriminado", especialmente por adolescentes e mulheres jovens. Por ser considerado "perigoso" aos corpos femininos, eles atribuem a responsabilidade de orientação e aconselhamento sobre o uso do método aos médicos ginecologistas e não aos farmacêuticos. Discute-se a necessidade de ampliação do debate público sobre contracepção de emergência no Brasil, incluindo-se os farmacêuticos e balconistas de farmácia, além dos profissionais de saúde e educadores

Factors that facilitate infant survival in a low socio-economic community in Lagos State, Nigeria

Infants are delicate, relying mostly on caregivers for their survival. Their survival is plagued by diseases, poverty, behavioural habits and cultural beliefs of the caregivers in the developing countries. For strategies to improve infant survival, the health seeking behaviour and home care practices of caregivers during infant illness episodes were studied. A total of 742 caregivers in 5 out of 11 health districts of Ajeromi/Ifelodun Local Government areas of Lagos State whose infants were ill four weeks preceding the survey were interviewed using a semi-structured questionnaire. Sixty-two (8.4%) of the interviewed lost their infants; 51.6% of children who died did so in hospitals, 35.5% at home and 12.9% at unspecified places. The notable causes of death were malaria (22.6%), acute respiratory infections (14.5%) and diarrhea (12.9%). Majority of the caregivers (60.0%) whose infants died did not seek external help until 24hrs or more after onset of illness signs. Infant's tendency to survive an illness episode was significantly dependent on full term delivery (

The Impact Of Community-Directed Administration Of Various Formulations Of Pre-Packaged Chloroquine In Umuahia South Local Government Area Of Abia State Nigeria

The high patronage of Patent Medicine Vendors (PMV's) to the detriment of Primary Health Centres (PHCs), the uncontrollable habit of home treatment and self-medication by rural dwellers, have necessitated the need to improve on the knowledge and awareness of malaria exhibited by these target groups. A community-directed intervention programme to effect prompt and adequate treatment of presumptive episodes of clinical malaria in a rural community (Ubakala, population 15,600) in Ummuahia South Local Government Area (L.G.A.) of Abia State, Nigeria has therefore been studied. The instruments of implementation were based on (a) training the rural dwellers, 3 Community Malaria Committees (CMC's) and the Patent Medicines Vendors (PMVs) in the community and (b) supplying the CMCs and PMVs with the essential antimalarial drug, chloroquine (CQ) packaged in various age-specific plastic bottles, compartmentalized polythene bags and blister packs. Of the 3,000 pre-packs delivered in 4 instalments from January to November 1998, 2503 were sold under a subsidized cost-recovery scheme. The progress of 510 patients was followed up 4 days after treatment and 250 mothers/carers of children under 6 years in each of the test and control (Olokoro, population: 11,800) communities were interviewed in-depth. Results showed a significant increase (

Glucose-6-Phosphate Dehydrogenase Deficiency (G6PD) and Uncomplicated Plasmodium Falciparum In Lagos

The protective role of Glucose-6-Phosphate deficiency (G6PD) in malaria has been an issue of considerable contention in malariology and population genetics. Most reports have proposed that heterozygous females have malaria resistance similar to or greater than hemizygous males. In view of this controversy, this study was undertaken to evaluate the protective role of G6PD in malaria using RANDOX (G6PD) quantitative technique backed up with questionnaire to highlight the frequency of self-reported malaria episodes by patients attending health facilities in Lagos. Malaria diagnosis was done using standard microscopy technique. A total of 100 blood samples slide positive for P.falciparum were used in the study with 66 symptomatic patients (Group A) and 34 asymptomatic (group B). The mean parasite density (MPD) was 613.34 + 1291.6 parasite/μL of blood ranging from 45 to 11,970 parasites/μL of blood. There were variations in G6PD activity (μ/g Hb). Patients with low or deficient G6PD (n = 28) had an MPD of 415.57 + 297.07 parasites/μL of blood. Those with normal G6PD activity (n = 71) had an MPD of 697.86 + 1516.92 parasites/μ/L of blood. This result demonstrated that patients with low G6PD activity had lower MPD which could possibly be protective though the difference was not statistically significant (F =0.539; P = 0.539). In addition, the relationship between G6PD activity (U/g Hb) and frequency of malaria occurrence showed a significant association for Group A (