INNOVATIONS in pharmacy (Iip - E-Journal)
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Pharmacists' Roles and Factors Affecting Patient Care in Korea
Get PDFObjectives: This study was conducted to explore Korean community pharmacists' perceptions of their roles in providing care to patients after the implementation of the Separation of Prescribing and Dispensing Act (SPD Act) and to investigate pharmacists' perceptions about factors that impact their patient care.
Methods: Eight community pharmacists participated in semi-structured, face-to-face, in-depth interviews in Korea. A snowball sampling technique was used to obtain participants. Interviews were audio-recorded and transcribed. Interviews were analyzed using a summative content analysis procedure.
Key findings: Participants' perceptions of their roles centered on dispensing prescriptions, educating and counseling patients, and helping patients with OTC products. Participants perceived time constraints due to prescription volume and patient expectations as factors influencing their provision of patient care.
Conclusion: This study suggests that the SPD Act was successful in changing pharmacists' roles in the Korean health care system. None of the participants perceived their role to include prescribing, while all of the participants indicated that their primary role was to dispense medications. Future research should examine the pervasiveness of the themes identified in this study across Korean community pharmacy practice in order to generalize the impact of the SPD Act.
Type: Original Researc
An Advanced Registered Nurse Practitioner-Community Pharmacist Team-Based Approach to Managing Hypertension in a Rural Community Pharmacy
Get PDFPurpose: To evaluate the implementation of an Advanced Registered Nurse Practitioner (ARNP) – community pharmacist team-based collaborative model for managing hypertension in a rural, Midwestern, community pharmacy and family medicine clinic using the core functions of the patient centered medical home model (PCMH).
Methods: Thirteen patients with uncontrolled hypertension, 5 of who were newly diagnosed, were referred to the pharmacist by the ARNP. The pharmacist rechecked the patient’s blood pressure (BP) every 2 weeks after referral and made drug therapy change recommendations to the ARNP if the patient was not below goal.
Results: Following the intervention, the average SBP and DBP decreased 24 mmHg and 12mmHg, respectively. The pharmacists made 21 recommendations (dose increase (11), add a medication (6), change a medication (2), and addition of an adherence tool (2)), 100% of which were accepted by the ARNP.
Conclusion: A team-based approach to managing hypertension in a rural community pharmacy and family medicine clinic was an effective way to lower blood pressure. In addition, the core functions of the PCMH model can be delivered in a small family medicine practice. Creating specific expectations for each member of the team prior to referring patients improved the efficiency of the intervention.
Type: Original Researc
Rules of Engagement: The Why, What, and How of Professional Engagement for Pharmacy
Get PDFThe development of student pharmacists must include inspiring within them a sense of engagement in their profession. This paper provides the rationale for and the potential implications of this concept, as well as an overview of experiences with professional engagement in student pharmacists at one college of pharmacy. Curricular-based experiences and research will be discussed, including the insights gained and suggestions for developing and encouraging professional engagement. Lastly, this article provides future direction for furthering professional engagement on both the conceptual and curricular level.
Type: Idea Pape
Identifying Community Pharmacists' Readiness to Participate in Transitions of Care
Get PDFObjective: To determine the readiness of community pharmacists to participate in transitions of care and to identify barriers related to participation.
Methods: A questionnaire was developed to identify community pharmacists’ willingness, attitudes, and barriers to participating in transitions of care programs. The questionnaire was piloted with community pharmacists prior to implementation. The questionnaire was distributed to a population of chain, supermarket/grocery, and independent community pharmacists (n=200). Descriptive statistics, correlations, and chi square tests were used to analyze demographic trends and final results.
Results: Of the 200 questionnaires distributed, 147 pharmacists responded (73.5%). Community pharmacists agreed transitions of care services have the potential to improve patients’ understanding of medications (97.3%), decrease medication-related errors (95.9%), and enhance relationships with patients (96.6%). The largest pharmacist perceived barriers included time (69.7%), communication/lack of patient data (14.6%), and lack of physician acceptance (6.7%). Of the respondents who indicated time as the greatest barrier to participation, 76.9% of pharmacists were still willing to participate in transitions of care given the opportunity. Willingness to participate in transitions of care did not differ by gender (p=0.139), years in practice (p=0.133), or degree of education (p=0.382).
Conclusion: Community pharmacists are in a unique position to widely impact patient health outcomes and decrease hospital readmission rates through improved care coordination. This research demonstrates community pharmacists’ readiness and willingness to participate in transitions of care. Awareness of perceived barriers can allow stakeholders to address these areas when designing and implementing transitions of care programs with pharmacists.
Type: Original Researc
Faculty Mentor Perspectives of a Formal Mentoring Program for Student Pharmacists: A Qualitative Study
Get PDFObjective: To describe pharmacy faculty perspectives on participating in a formal mentoring program for student pharmacists.
Methods: This qualitative study used ten, 45 to 60 minute semi-structured interviews conducted in November and December, 2012 with faculty mentors sampled randomly by strata of on-site off-site positions at a single public university college of pharmacy. Interviews were recorded and transcribed. Transcripts were coded using an inductively created consensus code list. The research team iteratively grouped codes into themes, developed summaries, and identified representative quotes.
Results: Analysis of interviews produced three main themes. Mentor interaction was described as having an investigative or responsive orientation, which influenced mentor actions and perspectives for the relationship with the student mentee. Program structure and concerns included a perceived absence of clear program objectives. Mentor response to feedback focused on 3 feedback sources: administrators, peers, and students.
Conclusions: Overall, faculty mentors in this program had different approaches to, expectations for, and experiences in their formal mentoring program participation. These differences are initial descriptions of mentor approaches toward mentoring interactions by faculty in a formal mentoring program. Colleges of pharmacy leaders and administrators may benefit from more clearly specifying and communicating program objectives in order to achieve results for mentees, mentors, and the organization.
Type: Original Researc
Efficacy and Satisfaction of a Smoking Cessation Telephone Counseling Service Provided by Pharmacy Students
Get PDFObjective: This was a prospective, research survey assessing patient satisfaction and efficacy of the smoking cessation telephone counseling service provided by pharmacy students at the University of Illinois Hospital.
Methods: From September 2012 through May 2013, 82 patients received telephone counseling post hospital discharge and were followed up at 30 days for a telephone survey. Primary outcomes included improvement in stages of change, motivation and confidence levels in quitting tobacco, as well as patient satisfaction of the service. Secondary outcomes included self-reported continuous and point prevalence abstinence rates at 30 days.
Results: Eighteen patients completed the survey. There was no significant difference before and after the service with regards to the stage of change (p = 0.14), motivation levels (p = 0.80) nor confidence levels (p = 0.89) to quit tobacco. Majority of patients felt the duration of the call was just nice (83.3%), but having only one call was too little (77.8%). Overall satisfaction of the service was 83.1%. Self-reported continuous and point prevalence abstinence rates at 30 days were 16.7% and 22.2%, respectively.
Conclusion: Although there was no statistically significant improvement in the stages of change, motivation and confidence levels to quit smoking, patients were highly satisfied with the telephone counseling service provided by pharmacy students.
Type: Clinical Experienc
Mentoring Residency Candidates: Avoiding Misinformation and Employing Best Practices
Get PDFType: Commentar
Patient Assessment Skills Pertinent to Practicing Pharmacists
Get PDFObjectives: To describe pharmacists’ opinions regarding which patient assessment skills are necessary to understand and/or perform to provide optimal patient care in pharmacy practice.
Methods: An online questionnaire was distributed to pharmacists licensed in North Carolina (n=14,167), as identified by the Board of Pharmacy. The 80 patient assessment items in the questionnaire were derived from a course text book and faculty experience. Participants indicated whether they “need to understand and be able to perform”, “need to understand only”, or “not need to understand or be able to perform” each item in their current practice setting. Descriptive statistics were used to describe background demographics and perceived need for each item. Post-hoc chi-square analyses were performed to determine differences in need based on practice setting and Pharm.D. degree completion.
Results: Of 1036 responses received, 770 were used in data analysis; incomplete questionnaires and non-practicing pharmacist responses were excluded. Fifty-nine percent of respondents held a Pharm.D. degree. Participants identified their practice site(s) as inpatient (29%), outpatient (16%), community/retail (50%), long term care (5%), and other (8%). The top five patient assessment items respondents identified as important to understand and perform included automatic blood pressure measurement (63%), point of care testing (57%), manual blood pressure measurement (53%), heart rate measurement (52%), and peak flow meter use (47%). Post-hoc analyses showed a significant difference among those with a Pharm.D. versus those without for the response “need to understand and be able to perform” for 20 patient assessment items; a significant difference was also noted among practice settings for 29 items.
Conclusions: The top items pharmacists identified they need to both understand and perform could be applied in various practice settings. The study results may guide which patient assessment items should be included in pharmacy education and training.
Type: Original Researc
Lesson Learned in the Growth and Maturation Stages of a Community Pharmacy Practice-Based Research Network: Experiences of the Medication Safety Research Network of Indiana (Rx-SafeNet)
Get PDFCommunity pharmacy practice-based research networks (CP PBRNs) are a relatively new arena for pharmacists. While some lessons may be gleaned from primary care PBRNs, the experiences of CP PBRNs have much to offer the profession in terms of organization and practice. In 2012, we reported on our early experiences developing the Medication Safety Research Network of Indiana (RxSafeNet) after establishing the Network in 2010. Over the past 3 years, our CP PBRN of approximately 180 members has managed further growth by revisiting policies and procedures, maintaining CP PBRN member relationships, and preparing for financial sustainability. We look forward to furthering our CP PBRN projects in the coming years and collaborating with other CP PBRNs to enhance medication safety in Indiana and beyond.
Type: Original Researc