Establishment, Implementation, and Consolidation of Clinical Pharmacy Services in Community Pharmacies: Perceptions of a Group of Pharmacists.

When pharmacists incorporate clinical practice into their routine, barriers and facilitators influence the implementation of patient care services. Three focus groups were conducted with 11 pharmacists who were working for the Farmácia Popular do Brasil program on the establishment, implementation, and consolidation of clinical pharmacy services. The perception of the pharmacists in Brazil about the program was that it facilitated access to health care and medication. The distance between neighboring cities made it difficult for patients to return for services. Lack of staff training created a lack of communication skills and knowledge. The pharmacists wanted to have increased technical support, skill development opportunities, and monitoring of researchers who assessed progress of the service. Pharmacists overcame many of their insecurities and felt more proactive and committed to quality service. Positive experiences in service implementations have shown that it is possible to develop a model of clinical services in community pharmacies.

Pharmaceutical care program for elderly patients with uncontrolled hypertension.

OBJECTIVE: To evaluate the effect of a pilot pharmaceutical care program developed for elderly patients with uncontrolled hypertension. METHODS: Nonrandomized single intervention pre/posttest blood pressure study in a community pharmacy in Aracaju, Brazil. This study enrolled elderly patients diagnosed with essential hypertension and uncontrolled blood pressure. Monthly visits were scheduled during a 10-month period. Pharmaceutical interventions were focused on health education and monitoring of drug-related problems. Primary outcomes included target blood pressure control, reduction in blood pressure, pulse pressure, medication adherence, and reduction of anthropometric indices. RESULTS: 35 of 51 patients completed the study. After 10 months of intervention, 57.2% of elderly patients achieved blood pressure control (P = 0.000) and the mean reduction was 26.6 mm Hg (P < 0.0001) for systolic blood pressure, 10.4 mm Hg (P < 0.0001) for diastolic blood pressure, and 15.7 mm Hg (P < 0.0001) for pulse pressure. Medication adherence also improved (P = 0.0000); however, anthropometric indices remained unchanged. CONCLUSION: The pharmaceutical care program improved outcomes by reducing and controlling blood pressure and improving medication adherence among elderly patients with uncontrolled hypertension.

Assessment of Community Pharmacists' Counseling Practices With Simulated Patients Who Have Minor Illness: A Pilot Study.

STATEMENT: A community pharmacist (CP) must provide counseling to consumers of nonprescription medicines and promote responsible self-medication. Previous studies indicate no available statistics on the proportion of pharmacies that provide cognitive services in Brazil. Furthermore, few studies have explored CPs' performance regarding patient-centred cognitive services in community pharmacies. Thus, quality improvement initiatives are needed for the responsible provision of self-medication to fully integrate Brazilian CPs into patient-centred cognitive services. Consequently, the present study's aim was to assess CPs' performance in the management of cases with minor symptoms using nonprescription medicines.

Developing communication skills in pharmacy: a systematic review of the use of simulated patient methods.

OBJECTIVE: To review the literature relating to the use of simulated patient methods to enhance communication skills of pharmacists. METHODOLOGY: We searched Embase, Lilacs, Medline, Scielo, and Scopus databases between 1980 and 2008, using "communication skills", "patient counseling" and "pharmacist" as keywords. This search was then further refined by using "simulated patients", "pseudo-customer", "standardized patients", and "mystery shoppers" as additional keywords. RESULTS: The initial search identified 241 published studies. Once further refined, 15 studies met inclusion criteria. CONCLUSION: The majority of studies had an assessment focus aimed at documenting counseling behavior of practicing pharmacists, rather than an educational focus aimed at equipping pharmacists with effective communication skills. In instances where simulated patient methods were used for educational purposes, little regard was given to the role of performance and corrective feedback in shaping communication behavior of pharmacists. The majority of studies failed to describe the competencies and skills being investigated in relation to communication in the practice of pharmacy. PRACTICE IMPLICATIONS: Simulated patient methods provide pharmacy educators with a tool for implementing communication skills in the practice of pharmacy and will serve as a basis for implementing communication skills development programs at the College of Pharmacy of the Federal University of Sergipe in Brazil.