Preparing community pharmacists for a role in mental health: An evaluation of accredited Australian pharmacy programs

Background: Australian community pharmacists are well placed to provide medication-related support and contribute to optimization of outcomes for mental health consumers and their caregivers. However, little is known about the actual competencies of community pharmacists to provide this care. To determine how graduates are being prepared to competently assist mental health consumers and their caregivers, an exploration of the mental health content of university pharmacy programs that set the foundation for pharmacists' professional roles is needed. Aim: To investigate the mental health content of accredited Australian pharmacy qualifying programs. Method: A review of publically available online profile information for accredited degree programs was conducted, and program coordinators from the 18 accredited pharmacy degree programs providers in Australia were surveyed. Results: Mental health education is embedded in core subjects such as pharmacology, pharmacotherapy, and pharmacy practice. Multiple options are employed to deliver mental health teaching, including lectures, workshops, and experiential learning. However, while education is intended to align with pharmacists' expected level of professional competencies, there is a lack of national standardized outcome-based competency criteria for new graduates and wide-ranging inter-program variations were evident. Conclusion: A lack of standardized content in pharmacy qualifying programs that underpin pharmacists' mental health knowledge and skills might result in variations to practice competencies. Further work is needed to determine how variations impact the way pharmacists deliver care to mental health consumers and their caregivers

Mental health consumer and caregiver perceptions of stigma in Australian community pharmacies

Background: The stigma of mental illness can be a barrier to effective medication management in the community pharmacy setting. This article explored mental health consumers’ or caregivers’ experiences of stigma in Australian community pharmacies. Materials: Semi-structured interviews and focus groups were conducted with a purposive sample of consumers or caregivers (n = 74). Interview transcripts were analysed using a general inductive approach. Discussion: Stigma presented a barrier to effective mental health management. Self-stigma impeded consumers’ community pharmacy engagement. Positive relationships with knowledgeable staff are fundamental to reducing stigma. Conclusions: Findings provide insight into the stigma of mental illness in community pharmacies

Review of Community Pharmacy Staff Educational Needs for Supporting Mental Health Consumers and Carers

Development of a mental health education package for community pharmacy staff should be informed by mental health consumers/carers’ needs, expectations and experiences, and staff knowledge, skills and attitudes. This review (1) explored research on community pharmacy practice and service provision for mental health consumers/carers, and (2) identified validated methods for assessing staff knowledge, skills and attitudes about mental illness to inform the development of a training questionnaire. A literature scan using key words knowledge, skills, attitudes, and beliefs combined with community pharmacy, pharmacist, and pharmacy support staff, and mental illness, depression, anxiety was conducted. A small number of studies were found that used reliable methods to assess pharmacists’ training needs regarding mental illness and treatment options. There was little published specifically in relation to depression and anxiety in community pharmacy practice. No studies assessed the training needs of pharmacy support staff. A systematic analysis of pharmacy staff learning needs is warranted

What's the attraction? Social connectedness as a driver of recreational drug use

Background: Licit and illicit drugs are commonly used for recreational purposes, with users viewing them as a relatively safe and acceptable leisure activity. This study proposes key drivers for better understanding the attractions of recreational drugs and factors that underwrite their popularity. Method: In-depth interviews were conducted with key informants whose roles were to share their experiences and to act as field observers of the complex scenarios and contexts that constitute the recreational drug scene in Gold Coast Region of Australia. Data were analyzed using a grounded theory approach. Results: Recreational drug use takes place in complex social settings and entails extensive codes and practices. Two ascribed benefits underpinned recreational drug use: (1) improved social connectedness and (2) enhanced performance. This paper reports on the relationship between recreational drug use and social connectedness. Discussion and conclusions: Enhanced social connectedness seems to contribute to the attractiveness and acts as a potent force underpinning recreational drug use. This research suggests that harm mitigation strategies must speak to a wider audience as well as address the social attraction of drugs because focusing on younger populations and antisocial features does not seem to reflect reality for recreational users

What's the attraction? The role of performance enhancement as a driver of recreational drug use

Introduction: Despite the risks involved, the use of drugs for recreational purposes is prevalent and generally well accepted. However, there is sparse research to explore the drivers of this phenomenon. Method: Semi-structured interviews were conducted with lay field observers of the recreational drug scene. The data were analyzed using ground theory to provide a framework for understanding motivators underpinning recreational drug use. Two ascribed benefits underpinned recreational drug use: 1) improved social connectedness and 2) enhanced performance. This paper reports on the relationship between drug use and performance enhancement. Results: Recreational drugs were used with the aim of enhancing performance in a number of ways, including to improve endurance, appearance, confidence, and personality. The majority of participants reported that drug taking offers personal and social benefits that outweighed the risks. Discussion and conclusions: In contrast to much of the literature, this study found that people perceived recreational drug use to have a range of positive effects that they wanted to take advantage of. This important finding adds to our understanding of the "pulling power" of drugs. Ultimately, the study highlights a need to rethink the preoccupation in drug strategies with negative physical, mental, and social outcomes as this would seem to be disconnected from actual experience and may result in a credibility gap for prevention education

Provision of pharmaceutical care in patients with limited English proficiency: Preliminary findings

Objective: Overcoming language and cultural barriers is becoming ever challenging for pharmacists as the patient population grows more ethnically diverse. To evaluate the current practices used by the pharmacists for communicating with patients with limited English proficiency (LEP) and to assess pharmacists’ knowledge of, attitude toward, and satisfaction with accessing available services for supporting LEPs patients within their current practice settings. Methods: Semi-structured interviews were conducted with five pharmacists employed in pharmacies representing multiple practice settings Queensland, Australia. Thematic analysis was primarily informed by the general inductive approach. NVivo software (QSR International Pty Ltd.) was used to manage the data. Findings: Three interlinked themes emerged from the analysis of interview data: (1) Barriers to the provision of pharmaceutical care, (2) Strategies employed in dealing with LEP patients, and (3) Lack of knowledge about existing services. Pharmacists recognized their lack of skills in communicating with LEP patients to have potential negative consequences for the patient and discussed these in terms of uncertainty around eliciting patient information and the patient’s understanding of their instructions and or advice. Current strategies were inconsistent and challenging for LEP patient care. While the use of informal interpreters was common, a significant degree of uncertainty surrounded their actual competency in conveying the core message. Conclusion: The present study highlights a significant gap in the provision of pharmaceutical care in patients with LEP. Strategies are needed to facilitate quality use of medicines among this patient group

Community pharmacy experiential placement: comparison of preceptor and student perspectives in an Australian postgraduate pharmacy programme

Background: Community Pharmacy Placements are an integral component of the pharmacy curriculum. Their success relies heavily on the willingness and capability of pharmacists to precept.Aims: To explore community pharmacy preceptors' perceptions about factors that assist them facilitate student learning, and the corresponding pharmacy students' perception of their experiential learning.Method: Preceptors (n=75) and their preceptees (n=83) were asked to complete anonymous surveys immediately following the placement. Descriptive statistics were conducted on surveys returned [53 preceptors, 51 students].Results: Preceptors positively rated support from the University and their teams. Students rated their experiential placement as productive. Preceptors indicated difficulty preceptoring in busy and complex situations.Conclusion: Placements are valuable for preceptees. Preceptors are supported through information provided by the University, however guidance could be provided around managing students in complex and difficult situations. Quality pharmacy preceptor guidance should ensure continuation of positive learning experiences for students

Yes to recreational drugs and complementary medicines but no to life-saving medications: beliefs underpinning treatment decisions among PLHIV

Despite the life-preserving benefits of antiretroviral therapy (ART), some people living with HIV (PLHIV) delay, decline or diverge from recommended treatment while paradoxically being willing to use potentially dangerous substances, such as recreational drugs (RD) and complementary medicines (CM). During 2016 and 2017, interviews were conducted with 40 PLHIV, in Australia to understand drivers underpinning treatment decisions. While many believed ART to be effective, they expressed concerns about long-term effects, frustration over perceived lack of autonomy in treatment decisions and financial, emotional and physical burdens of HIV care. In contrast, they ascribed a sense of self-control over the use of RD and CM, along with multiple professed benefits. The perceived burden of ART emerged as a motivator for deviating from recommended treatment, while positive views towards RD and CM appear to justify use. This study may serve as guidance for the development of future strategies to address barriers to treatment uptake and adherence and subsequently health outcomes for PLHIV in Australia and elsewhere