Translating research into a relevant education activity to fulfil pharmacists' continuing professional development requirements.

Background: In New Zealand (NZ), provision of culturally safe care by pharmacists is mandated, including an expectation of understanding issues relevant to Maori, the Indigenous people of NZ, yet there are few pharmacy-specific resources to support attainment. Objectives: To: i) test whether a research-informed education activity (short video summarising research findings plus reflective exercises) meets NZ pharmacists' annual continuing professional development requirements including those relating to culturally safe care ii) identify suggested improvements to the education activity; and iii) identify individual pharmacists' proposed actions in response to reflection prompted by the education activity. Methods: Previous research was utilised to develop an education activity (short, animated research summary video and reflective questions). Participants (NZ-registered pharmacists or intern pharmacists) were asked to watch the video and respond to questions online related to perceived relevance and usefulness of the video to informing practice and meeting CPD requirements. Simple descriptive analysis (quantitative data) and general inductive thematic analysis (qualitative data) were applied to the research data. Results: Thirty-three people participated from Nov-Dec 2022. Most participants said the video was relevant/very relevant to practice (91%), that the reflective exercise was very or extremely useful (100%) and that it met their CPD requirements as relevant to cultural safety (100%). Conclusion: The education activity appeared to be an appropriate and relevant for CPD and was seen to be concise and exposed ideas in a logical and succinct manner with the potential to benefit the populations receiving care from these providers.

Designing for health equity: A mixed method study exploring community experiences and perceptions of pharmacists' role in minor ailment care.

BACKGROUND: Minor ailments are self-limiting, easily diagnosable and treatable conditions. Funded pharmacist minor ailments services (PMAS) have been posited to improve medicines access equity and, despite ethnic minorities across the globe experiencing reduced access to medicines and health care, PMAS internationally have not explicitly centered ethnic equity in service design or outcome measurement. OBJECTIVE: To explore Maori experiences of minor ailments care and perceptions of the pharmacists' role. METHODS: This mixed methods study collected data through facilitated wananga (collaborative knowledge-sharing group discussions). Eligible participants (Maori, 18 years plus, obtained medicine from pharmacy in last 3 years) were recruited through local pharmacist networks using convenience sampling. Wananga included qualitative data collection through discussion using a topic guide and a quantitative questionnaire. Indigenous theory was applied within a general inductive approach to thematic development to analyze qualitative data. Quantitative data was reported using simple descriptive statistics. RESULTS: Thirteen wananga (3 in-person, 10 online) were conducted from September 2021-February 2022 with 62 participants from seven New Zealand regions. The minor ailments that participants were most likely to seek treatment from pharmacy first, instead of a doctor, were eczema (87.2%), coughs and colds (85.7%), headlice (85.7%), insect bites (83.9%), and hayfever (83.9%). Four themes were generated from the qualitative data: designing the right environment for minor ailment care; clinically and culturally safe care; moving from stigmatizing to strengths-based services; the benefits of PMAS. Participant-informed ideas for PMAS service development centered on Maori aspirations included: developing clinically and culturally safe pharmacy environments, enabling medicine supply outside of the physical pharmacy setting, avoiding stigmatizing language when promoting PMAS availability, and collaborative practice with other health providers. CONCLUSION: This study provides important recommendations when developing PMAS to increase the likelihood of delivering equitable care, and has international application across multiple pharmacy and health service settings.

Maori, pharmacists, and medicines adherence - A mixed methods study exploring indigenous experiences of taking medicines 'as prescribed' and mechanisms of support.

Background: Medicines are the most common medical intervention and medicines adherence is associated with improved clinical outcomes. Understanding drivers and experiences of medicines adherence is important for optimising medicines use. Maori (Indigenous people of Aotearoa New Zealand) experience inequities in access to medicines yet little evidence exists regarding Maori and medicines adherence, or the role of pharmacists in supporting medicines adherence for Maori. Objectives: To explore Maori experiences of medicines adherence and non-adherence, and pharmacists' role in supporting adherence. Methods: This was a convergent parallel mixed methods study. Facilitated wananga (collaborative knowledge-sharing group discussions) were undertaken either online or in-person with eligible participants, using convenience and snowball sampling to recruit. Participants were eligible if they were Maori, 18 years or older, and had recently obtained medicine from a pharmacy. Wananga involved semi-structured interviewing and questionnaire completion. General inductive coding and thematic analysis and descriptive statistical analysis were used respectively, and findings were situated in social, cultural and political Maori contexts. Results: Thirteen wananga were conducted with 62 participants (71% female, median age range 35-44) from September 2021 to February 2022. Four themes were identified: The aspirations of hauora Maori (Maori wellbeing) - medicines as a component of holistic wellbeing; whanaungatanga (relationships); knowledge; and whanau (family and support network) advocacy and problem solving. Forgetting to take medicines was the most frequently identified reason for non-adherence, followed by not having medicines on hand, adverse effects, and lack of symptoms of health conditions. Participants identified that proactive pharmacist support, including developing caring therapeutic relationships, sharing knowledge, acknowledging medicines as just one component of holistic wellbeing, and giving adherence tips to support routine medicine taking were positive ways that pharmacists could support medicines adherence. Conclusions: Factors contributing to medicines adherence were diverse and participants identified numerous practical solutions that pharmacists, health service providers and policymakers could employ to support Maori medicines adherence.

Examining equity in a void of evidence - Pharmacist minor ailments services and the role of systematic reviews.

Pharmacist minor ailment services (PMAS) are formalised services which remunerate pharmacists for delivering care and providing medicines used to treat minor ailments such as hayfever, musculoskeletal pain, head lice and constipation. PMAS have been postulated to improve medicines access equity yet there is little evidence to suggest that equitable health outcomes from PMAS have been achieved in those countries where these services have been initiated. Systematic reviews are regarded as the gold standard in assessing evidence of outcome effectiveness, including equity of outcomes. Our research team developed a systematic search strategy and review protocol to examine ethnic variation in PMAS outcomes. No results were returned, even with the inclusion of grey literature, and therefore the impact of PMAS on ethnic equity could not be examined. This commentary discusses the potential for PMAS to achieve medicines access equity and the role of empty reviews in identifying gaps in the literature and advocating for equity.

Exploring medicines information needs of mental health service users at a New Zealand hospital.

Providing effective medicines information to individuals can improve outcomes, yet little is known about what information mental health service users need and want about their medicines, and how best to deliver this. The aim of this study was to explore the medicines information needs of mental health service users. Adults (n=30) under the care of acute mental health services in a New Zealand hospital were invited to take part in semi-structured interviews or a focus group to explore preferences for medicines information. Interview data were analysed using an inductive thematic approach. Six key themes were identified: 1) personalisation of information, 2) adverse and beneficial effects, 3) relationships and trust, 4) informed choice, 5) use of reliable internet resources and 6) involvement of family and support people. Preferences on content, timing, provider and format of information delivery were highly individualised indicating the need for information to be personalised to the needs of the service user. A trusted relationship with their healthcare provider was essential . Making informed decisions reduced confusion or fear about medicines. Understanding medicines information needs of patients can help improve the education health professionals provide on medicines, thus potentially improving patient engagement and outcomes.

Q methodology: An underutilised tool in pharmacy practice research.

Pharmacy practice research is often concerned with opinions, perspectives, values, or a variety of other subjective domains, whether that be in regard to the experiences of patients, views of stakeholders about innovative pharmacy services, or culture in pharmacy practice. This article offers a brief introduction to Q methodology, which is a philosophical, conceptual, and technical framework well-suited to shed light on such subjective views. Q methodology combines qualitative and quantitative processes to uncover distinct viewpoints present about any given topic. While other textual analyses focus on identifying the constituent themes about a topic, Q methodology instead detects and interprets holistic and shared perspectives. The introduction covers key theoretical principles, as well as the logistics and procedures involved in completing a Q-methodological study. Example data from a study investigating views on pharmacist integration into general practice in New Zealand are presented to highlight the potential of Q methodology for pharmacy practice research.

Pharmacist integration into general practice in New Zealand.

Introduction Pharmacist integration into general practice is gaining momentum internationally, with benefits noted in reducing medication errors, improving chronic disease management and alleviating general practitioner workforce shortages. Little is known about how general practice pharmacists are working in New Zealand. Aim This study characterised the current landscape of pharmacist integration into general practice in New Zealand. Methods An online questionnaire was developed, piloted and distributed to all pharmacists in New Zealand. Results Thirty-six responses were analysed. Respondents were more likely to be female, have been pharmacists for at least 10 years and all but one held formal postgraduate clinical pharmacy qualifications. Seven pharmacists were working as pharmacist prescribers. Primary health organisations (PHOs) were the most common employer, with funding primarily derived from either PHOs or District Health Boards. Pharmacist integration into general practice appears to have progressed further in particular regions of New Zealand, with most respondents located in the North Island. Tasks performed by respondents included medication reviews, managing long-term conditions and medicines reconciliation. Increased job satisfaction compared with previous roles was reported by most respondents. Funding and a general lack of awareness about pharmacists' professional scope were seen as barriers to further expansion of the role. Discussion This study describes the characteristics of pharmacists currently working in general practices in New Zealand and provides insights into key requirements for the role. Understanding the way practice pharmacists are currently employed and funded can inform general practices considering employing pharmacists.