Social Pharmacy and Clinical Pharmacy:Joining Forces

This commentary seeks to define the areas of social pharmacy and clinical pharmacy to uncover what they have in common and what still sets them apart. Common threats and challenges of the two areas are reviewed in order to understand the forces in play. Forces that still keep clinical and social pharmacy apart are university structures, research traditions, and the management of pharmacy services. There are key (but shrinking) differences between clinical and social pharmacy which entail the levels of study within pharmaceutical sciences, the location in which the research is carried out, the choice of research designs and methods, and the theoretical foundations. Common strengths and opportunities are important to know in order to join forces. Finding common ground can be developed in two areas: participating together in multi-disciplinary research, and uniting in a dialogue with internal and external key players in putting forth what is needed for the profession of pharmacy. At the end the question is posed, “What’s in a name?” and we argue that it is important to emphasize what unifies the families of clinical pharmacy and social pharmacy for the benefit of both fields, pharmacy in general, and society at large

The use of herbal medicines, food supplements, and OTCs - design and testing of a questionnaire

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenBackground: Epidemiologic studies show that open-ended questionnaire items are unreliable measures of the use of drugs and related substances. It is also important to avoid questions regarding the distant past. These issues were kept in mind when designing a questionnaire on the use of herbal medicines, food supplements, and over-the-counter drugs (OTCs). The objectives of this study were to pre-test the questionnaire and measure the prevalence of use in the last two weeks. Methods: A questionnaire was constructed almost entirely with closed-ended responses. A pre-test was carried out in two phases. Respondents were patrons of the Icelandic Heart Association's clinic. In the utilization study a sample was taken from all 18 079 participants of the MONICA Reykjavík research study and the Descendant Study of the Icelandic Heart Association. The random sample was stratified according to age and sex (N=350). A chi-squared test was used to compare rates. Results: The questionnaire was changed little after pre-testing. The main changes related to wording of questions. In the utilization study, 220 individuals responded (62.9%). The prevalence of herbal use was 46.8%, 75.9% for vitamins, minerals, and micronutrients, and 69.5% for OTCs. Garlic was the most commonly used herbal and food-supplement (14.5%). Codliver oil held a superior position in the group of vitamins, minerals, and micronutrients (59.1%). Vitamin C was the most used single vitamin (20,9%). Calcium was by far the most used mineral (11,4%). Pain relievers were the most common OTCs (38.6%). Conclusions: The format of the questionnaire was satisfactory. The prevalence of use of all groups of substances was high compared to foreign studies. Response bias may make the use seem higher than is true. As the sample was very small, this study should be viewed as a test of a specific method for measuring the use of these substances.Tilgangur: Faraldsfræðilegar rannsóknir sýna að opnar spurningar í spurningalistum eru varasamar við mælingu á notkun lyfja og skyldra efna. Mikilvægt er einnig að varast að spyrja langt aftur í tímann. Þessi atriði voru höfð í huga við hönnun spurningalista um notkun náttúruefna, fæðubótarefna og lausasölulyfja. Markmið rannsóknarinnar var að prófa spurningalistann ásamt því að mæla algengi notkunar síðustu tvær vikur. Efniviður og aðferðir: Nýr spurningalisti var hannaður og nær allir svarmöguleikar hafðir lokaðir. Forprófun á spurningalistanum fór fram í tveim fösum. Þátttakendur voru úr hópi fólks sem kom í skoðun hjá Hjartavernd. Í þriðja fasa var tekið úrtak af 18.079 þátttakendum úr Reykjavíkurrannsókn MONICA og Afkomendarannsókn Hjartaverndar. Tekið var lagskipt slembiúrtak með tilliti til aldurs og kyns (N=350). Við samanburð á tíðnitölum var notað kí-kvaðrat próf. Niðurstöður: Spurningalistanum var lítillega breytt eftir forprófun. Aðallega var um orðalagsbreytingar að ræða í spurningunum. Í notkunarrannsókninni svöruðu 220 einstaklingar listanum (62,9% svarhlutfall). Algengi notkunar náttúruefna var 46,8%; 75,9% fyrir vítamín, stein- og snefilefni, og 69,5% fyrir lausasölulyf. Hvítlaukur var algengasta náttúru- og fæðubótarefnið (14,5%). Lýsi hafði yfirburði í flokki vítamína, stein- og snefilefna (59,1%). C-vítamín var mest notað af stökum vítamínum (20,9%). Kalk var langmest notaða steinefnið (11,4%). Verkjalyf voru algengustu lausasölulyfin (38,6%). Ályktanir: Form spurningalistans þótti þægilegt í forprófun. Algengi notkunar allra flokkanna er mikið miðað við erlendar rannsóknir. Svarbjagi gæti verið til staðar þannig að notkun virðist algengari hjá Íslendingum en raunin er. Þar sem úrtak var mjög lítið skal litið á þessa rannsókn sem prófun ákveðinnar aðferðar við mælingu notkunar þessara efna og lyfja

Introducing Pharmaceutical Care to Primary Care in Iceland—An Action Research Study

Even though pharmaceutical care is not a new concept in pharmacy, its introduction and development has proved to be challenging. In Iceland, general practitioners are not familiar with pharmaceutical care and additionally no such service is offered in pharmacies or primary care settings. Introducing pharmaceutical care in primary care in Iceland is making great efforts to follow other countries, which are bringing the pharmacist more into patient care. General practitioners are key stakeholders in this endeavor. The aim of this study was to introduce pharmacist-led pharmaceutical care into primary care clinics in Iceland in collaboration with general practitioners by presenting different setting structures. Action research provided the framework for this research. Data was collected from pharmaceutical care interventions, whereby the pharmaceutical care practitioner ensures that each of a patient’s medications is assessed to determine if it is appropriate, effective, safe, and that the patient can take medicine as expected. Sources of data included pharmaceutical care notes on patients, researcher’s notes, meetings, and interviews with general practitioners over the period of the study. The study ran from September 2013 to October 2015. Three separate semi-structured in-depth interviews were conducted with five general practitioners from one primary health care clinic in Iceland at different time points throughout the study. Pharmaceutical care was provided to elderly patients (n = 125) before and between general practitioners’ interviews. The study setting was a primary care clinic in the Reykjavik area and the patients’ homes. Results showed that the GPs’ knowledge about pharmacist competencies as healthcare providers and their potential in patient care increased. GPs would now like to have access to a pharmacist on a daily basis. Direct contact between the pharmacist and GPs is better when working in the same physical space. Pharmacist’s access to medical records is necessary for optimal service. Pharmacist-led clinical service was deemed most needed in dose dispensing polypharmacy patients. This research indicated that it was essential to introduce Icelandic GPs to the potential contribution of pharmacists in patient care and that action research was a useful methodology to promote and develop a relationship between those two health care providers in primary care in Iceland.Peer Reviewe

Providing emergency contraceptive pills in pharmacies

Neðst á síðunni er hægt að nálgast greinina í heild sinni með því að smella á hlekkinn View/OpenObjective: Use of the levonorgestrel emergency contraception (EC) pill has become more common after being made formally available in pharmacies without prescription. It was investigated how pharmacists in the capital area of Reykjavik supply EC to clients. Material and methods: A total of 46 pharmacists of all working ages and both genders were asked to answer a questionnaire concerning how they sold the emergency contraception pill over the counter (84.8% reply rate). Results: Four of five used <5 minutes to discuss emergency contraception with the client, but almost all enquired about time from intercourse. While only 20% asked about the woman s health, most considered concomitant drug use and potential interaction with levonorgestrel. Only about 50% pointed out that EC did not protect against sexually transmitted disease, (3/4) pointed out the need for permanent contraceptive use, 95% asked about previous EC use, but only 30% would provide EC again in the same menstrual cycle. One half of the pharmacists sold EC to men/teenage boys and wished to assist them with taking responsibility, while the others only sold the drug to the woman. Of those prepared to give the drug to the men, 55% asked to speak over the telephone with the woman to ensure correct prescription and information. Nearly a third would never or rarely provide consultation in private. Conclusions: Pharmacists agree mostly about main points in supplying EC, but not as regards provision to women through their male partners. Provisons for consultation can be improved. Key words: Key contraception, emergency contraception, pregnancy. Correspondence: Reynir Tomas Geirsson, [email protected]: Notkun neyðargetnaðarvarnar með levónorgestrel-töflum hefur orðið algeng eftir að bein afgreiðsla í apótekum var heimiluð. Kannað var hvernig lyfjafræðingar á höfuðborgarsvæðinu afgreiða neyðargetnaðarvörn. Efniviður og aðferðir: Alls voru 46 lyfjafræðingar af báðum kynjum og á öllum aldri beðnir um að svara spurningalista (svarhlutfall 84,8%) um hvernig þeir afgreiddu neyðargetnaðarvörn. Niðurstöður: Fjórir af fimm eyddu <5 mínútum í að ræða um neyðargetnaðarvörnina, en nær allir athuguðu tímalengd frá samförum. Fáir (20%) spurðu um heilsufarsvandamál, en lyfjanotkun og milliverkun við levónorgestrel var oftast könnuð. Tæpur helmingur benti á að neyðargetnaðarvörn dygði ekki gegn kynsjúkdómum, en 3/4 nefndu reglubundna getnaðarvörn. Nær allir (95%) spurðu um fyrri notkun neyðargetnaðarvarna. Aðeins 30% afgreiddu neyðargetnaðarvörn aftur í sama tíðahring. Helmingur lyfjafræðinganna vildi afgreiða karlmenn og aðstoða þá við að axla ábyrgð, en aðrir aðeins konuna sjálfa. Af þeim sem afgreiddu karlmenn sagðist helmingur (55%) ræða við konuna í síma til að tryggja rétta ávísun og upplýsingar. Nær þriðjungur ræddi sjaldan eða aldrei við skjólstæðinga í einrúmi. Ályktun: Lyfjafræðingar virðast sammála um meginatriði í afgreiðslu neyðargetnaðarvarnar, en þó ekki hvað varðar afhendingu til karla. Aðstaða til að ræða viðkvæm málefni við skjólstæðinga mætti víða vera betri

Online and Blended Learning Courses for Healthcare Professionals and Policymakers on Patients' Perspectives on Medicine:A Project Report

In order for healthcare professionals to better engage with patients, they need to understand and integrate the perspectives of patients into their daily work. In this project, we developed two courses for healthcare professionals on patients’ perspectives on medicine. One course was an online course that introduced the patients’ perspectives on medicine and explained its importance for healthcare and health policy. The second course was a blended learning course, consisting of online modules and face-to-face webinars, which specified how to explore patients’ perspectives in qualitative interviews, and how to develop implementation plans. Patients participated in the development, execution, and evaluation of both courses. Overall, more than 2000 healthcare professionals enrolled in the first course and, in just over a year, 191 participants completed the online course; 57 healthcare professionals registered in the second blended learning course and six participants completed both components of the course. The relevance of knowledge gained was positively evaluated. Participants especially appreciated the participation of patients. Based on the feedback, the second blended learning course was adapted to run online and both courses continue to be freely available to all interested healthcare professionals on the Coursera platform