Determinants of pharmacists' confidence to participate in antimicrobial stewardship: A confirmatory factor analysis.

AIM: Pharmacists are essential members of hospital antimicrobial stewardship (AMS) teams. A lack of self-perceived confidence can limit pharmacists' involvement and contributions. Pharmacists working in AMS have reported a lack of confidence. There is currently a lack of validated measures to assess pharmacists' self-perceived confidence when working in AMS and contributors to this confidence. This study aimed to identify variables contributing to pharmacist self-perceived confidence and validate an AMS hospital pharmacist survey tool using confirmatory factor analysis (CFA). METHODS: Responses from a survey of Australian and French hospital pharmacists were used to undertake CFA and path analysis on factors related to pharmacists' self-perceived confidence. It was hypothesized that pharmacists' self-perceived confidence would be impacted by time working in AMS, perceived importance of AMS programmes, perceived barriers to participating in AMS and current participation. RESULTS: CFA demonstrated a good model fit between the factors. Items included in the model loaded well to their respective factors with acceptable reliability. Path analysis demonstrated that time working in AMS had a significant impact on pharmacists' self-perceived confidence, while perceived barriers had a negatively significant relationship. Pharmacy participation in AMS and perceived importance of AMS programmes had a non-significant impact. CONCLUSION: Findings demonstrated that the survey tool showed good validity and identified factors that can impact pharmacists' self-perceived confidence when working in hospital AMS programmes. Having a validated survey tool can identify factors that can reduce pharmacists' self-perceived confidence. Strategies can then be developed to address these factors and subsequently improve pharmacists' self-perceived confidence.

A qualitative study on asthma management experiences of Turkish community pharmacists.

INTRODUCTION: Asthma is seen in more than 4 million people in Turkey. Numerous studies have shown the beneficial effects of pharmacist interventions on medication adherence and therapeutic outcomes. The aim of this study was to gain insight into the current situation by examining the experiences of Turkish community pharmacists in relation to the counseling and referral of asthma patients, the responsibilities of pharmacists and the recommendations made by pharmacists to improve asthma management. METHODS: In this qualitative study, the constructivist-interpretivist paradigm was adopted. To conduct qualitative interviews, a semi-structured interview guide was devised to gather insights from the pharmacists. The interviews were coded verbatim. Subsequently, various themes and sub-themes were developed based on the aim and objectives of the study. RESULTS: A total of 14 pharmacists engaged in semi-structured interviews conducted between June and August 2023. The wealth of information gathered during these interviews facilitated a meticulous thematic analysis, yielding four overarching themes: 1) Patient-related difficulties, 2) Communication with physicians, 3) Desired traits and responsibilities of pharmacists, 4) Pharmacists' expectations. Pharmacists placed significant emphasis on their challenges in allocating time to patients, primarily due to high workloads and limited collaboration with physicians. CONCLUSION: Considering the workload and time limitations faced by pharmacists, a collaborative model involving pharmacists and physicians is seen as essential. Enhancing the collaboration between pharmacists and physicians, especially for chronic diseases, holds the potential to enhance public health outcomes while alleviating the workload of pharmacists.

Exploring a role for community pharmacists in the identification of alcohol-related liver disease: a qualitative interview study with professionals, patients, and the public.

AIMS: To explore the views and attitudes of professionals, patients and the public to a role for community pharmacists in the identification of alcohol-related liver disease (ArLD). METHODS: Semi-structured interviews were conducted with a purposive sample of patients with ArLD, members of the public, pharmacy staff, and clinicians managing patients with ArLD across the Wessex region of south England. The interviews explored experiences of alcohol, ArLD and health advice in pharmacies and elicited views of what a pharmacist role in identifying ArLD could entail and factors influencing this. Transcripts were analysed using reflexive thematic analysis. RESULTS: Twenty-six participants were interviewed and three themes were generated: (i) acknowledging, seeking help and engaging with a hidden problem; (ii) professional roles, boundaries and attributes; (iii) communication, relationships, collaboration and support. Participants reported key challenges to identifying people at-risk of ArLD. Offering testing for ArLD was perceived to motivate engagement but there were concerns about pharmacists performing this. A role was mostly seen to be finding people at-risk and engaging them with further care such as referral to liver services. This was perceived to require developing interprofessional collaborations, remuneration and training for pharmacy staff, and community-based liver testing. CONCLUSIONS: Professionals, patient and public participants recognized a role for pharmacists in the identification of ArLD. This was envisaged to incorporate educating pharmacy users about ArLD risk, and identifying and directly engaging those at-risk with liver and support services through development of interprofessional collaborations. The findings of this study support and can inform future work to develop this role.

Surveillance of antimicrobial awareness among patients visiting community pharmacies.

OBJECTIVE: Although antimicrobial resistance (AMR) measures have been progressing, cases of patients requesting their doctors to prescribe antimicrobial agents and patients mistakenly believing that these agents are effective against viruses occasionally occur. In the AMR action plan (2023-2027) in Japan, one of the primary goals are public awareness and education. However, public understanding of AMR and antimicrobial agents has been reported to be at an unsatisfactory level. Here, we conducted a surveillance of antimicrobial awareness among patients visiting community pharmacies. MATERIAL AND METHODS: A questionnaire survey was conducted among patients visiting nine pharmacies in Hachioji, Tokyo, Japan. A total of 1887 active questionnaires were collected. The relationship between answers was analyzed using logistic regression analysis. RESULTS: Of the patients, 72% were unaware of AMR, and 68% believed that antimicrobials are effective against viruses. In addition, 28% of the patients answered that they did not take antimicrobial agents as prescribed by their physicians. Seventeen percent of the patients had never received appropriate instruction of antimicrobial use from pharmacists. Analysis of the relationship between answers showed that patients with correct knowledge were 1.65 times more likely to take antimicrobial agents as prescribed by their physicians (P < 0.01). Furthermore, the factors that led to the inappropriate behaviors of patients were associated with preliminary antimicrobial prescriptions from physicians (odds ratio, 3.18; 95% CI, 2.12-4.76) (P < 0.01). CONCLUSION: This study strongly suggests that physician and pharmacist interventions regarding the appropriate use of antimicrobial agents are important to improve awareness of antimicrobial agents.

Patterns of self-medication and intention to seek pharmacist guidance among older adults during the COVID-19 pandemic in Macao: a cross-sectional study.

INTRODUCTION: Self-medication was remarkably popular during the COVID-19 pandemic. In older populations, the risk of self-medication is higher. Pharmacists are well positioned to provide public health education and disease prevention. This study aims to explore the self-medication patterns and intention to seek pharmacist guidance among older adults in Macao. METHODS: A face-to-face cross-sectional survey was subsequently performed in March-April 2023 among older adults in Macao. The questionnaire was designed based on the Theory of Planned Behavior (TPB) framework. Multiple logistic regression was used to analyze predictors of self-medication behavior and multiple linear regression analysis to determine whether the TPB construct was the predictor of older adults' intention to seek guidance from pharmacists. RESULTS: A total of 412 participants completed the questionnaire. The self-medication rate among older adults in Macao was 64.2%. The most commonly used types of medications were over-the-counter and traditional Chinese medicine, mainly from government anti-pandemic packages. The majority of individuals engaged in self-medication to treat COVID-19 symptoms or prevent COVID-19 infection. The prevalent reasons for self-medication were the perceived non-seriousness of the illness. 85 years old or older and university degree were significantly associated with self-medication behavior. Older adults had moderate intention to seek pharmacist guidance on medication use. The average scores (standard deviation) were 3.43 (1.10) for Attitude, 2.69 (0.99) for Subjective Norm, 3.56 (1.04) for Perceived Behavioral Control, and 3.07 (1.43) for Intention. Attitude, Subjective Norm, and Perceived Behavioral Control were all strong predictors of intention, which explained 53% of the variance in intention. In demographic factors, age was identified as a significant predictor of intentions. CONCLUSIONS: Self-medication was widely practiced in Macao during the COVID-19 pandemic. To better control the risks associated with self-medication, the role of pharmacists is paramount. Enhancing the recognition and trust of pharmacists within society, modifying pharmacy management models, and strengthening pharmacists' self-perception of their profession are all pivotal directions areas to further enhance their role.

Knowledge, attitudes, and practices of primary healthcare practitioners regarding pharmacist clinics: a cross-sectional study in Shanghai.

BACKGROUND: Pharmacist clinics offer professional pharmaceutical services that can improve public health outcomes. However, primary healthcare staff in China face various barriers and challenges in implementing such clinics. To identify existing problems and provide recommendations for the implementation of pharmacist clinics, this study aims to assess the knowledge, attitudes, and practices of pharmacist clinics among primary healthcare providers. METHODS: A cross-sectional survey based on the Knowledge-Attitude-Practice (KAP) model, was conducted in community health centers (CHCs) and private hospitals in Shanghai, China in May, 2023. Descriptive analytics and the Pareto principle were used to multiple-answer questions. Chi-square test, Fisher's exact test, and binary logistic regression models were employed to identify factors associated with the knowledge, attitudes, and practices of pharmacist clinics. RESULTS: A total of 223 primary practitioners participated in the survey. Our study revealed that most of them had limited knowledge (60.1%, n = 134) but a positive attitude (82.9%, n = 185) towards pharmacist clinics, with only 17.0% (n = 38) having implemented them. The primary goal of pharmacist clinics was to provide comprehensive medication guidance (31.5%, n = 200), with medication education (26.3%, n = 202) being the primary service, and special populations (24.5%, n = 153) identified as key recipients. Logistic regression analysis revealed that education, age, occupation, position, work seniority, and institution significantly influenced their perceptions. Practitioners with bachelor's degrees, for instance, were more likely than those with less education to recognize the importance of pharmacist clinics in medication guidance (aOR: 7.130, 95%CI: 1.809-28.099, p-value = 0.005) and prescription reviews (aOR: 4.675, 95% CI: 1.548-14.112, p-value = 0.006). Additionally, practitioners expressed positive attitudes but low confidence, with only 33.3% (n = 74) feeling confident in implementation. The confidence levels of male practitioners surpassed those of female practitioners (p-value = 0.037), and practitioners from community health centers (CHCs) exhibited higher confidence compared to their counterparts in private hospitals (p-value = 0.008). Joint physician-pharmacist clinics (36.8%, n = 82) through collaboration with medical institutions (52.0%, n = 116) emerged as the favored modality. Daily sessions were preferred (38.5%, n = 86), and both registration and pharmacy service fees were considered appropriate for payment (42.2%, n = 94). The primary challenge identified was high outpatient workload (30.9%, n = 69). CONCLUSIONS: Although primary healthcare practitioners held positive attitudes towards pharmacist clinics, limited knowledge, low confidence, and high workload contributed to the scarcity of their implementation. Practitioners with diverse sociodemographic characteristics, such as education, age, and institution, showed varying perceptions and practices regarding pharmacist clinics.

The juggling act of pharmacists in Sweden: a qualitative study on balancing healthcare professionalism and retail employment.

BACKGROUND: Community pharmacies in Sweden merge a state-funded professional community service with a retail business. While previous research has recognized its challenges, less attention has been paid to the potential conflict of interest it could result in regarding the work of pharmacists. This study aims to increase understanding of how pharmacists in Sweden combine their healthcare ambitions and obligations with those concerning being employees in a retail business. METHODS: Semi-structured interviews were conducted with 28 pharmacists employed by pharmacy chains in Sweden. The data were thematically analysed. RESULTS: In the analysis, three themes were formulated: Different interests, The conflict between professional work & business work, and Strategies to manage the conflicts. The analysis of the data reveals that pharmacists in Sweden experience a conflict of interest. They grapple with balancing being healthcare professionals with a focus on patient care and being valued retail employees that also focus on financial results. This conflict manifests in various situations, such as time management, communication focus, preferred behaviours, and different tasks. The different strategies applied by individual pharmacists to manage the work are results of job crafting. Pharmacists employ strategies such as compromise, mandate stretching, avoidance, and acceptance to manage the conflict. However, these strategies lead to compromises in their work. CONCLUSION: This study aimed to understand how pharmacists combine their healthcare ambitions and obligations with those of being employees in a retail business. The study demonstrated that Swedish community pharmacists need to perform a juggling act to be both professional healthcare workers and viewed as valuable retail employees. In situations when the conflict of interest occurs, the pharmacists use different strategies when determining how to prioritize between the professional work and the business work. The conflict of interest in the pharmacists' work need to be taken into consideration when discussing pharmacists practices, the profession, or role it's in the healthcare system.

Readiness of and barriers for community pharmacy professionals in providing and implementing vaccination services.

BACKGROUND: Community pharmacy professionals are essential for healthcare delivery, particularly for administering vaccination services. However, there is a lack of substantial evidence documenting their role in vaccination within Ethiopia. OBJECTIVES: This study aimed to assess community pharmacy professionals' readiness to provide vaccination services, identify barriers hindering the implementation of these services, and determine factors influencing the provision of vaccination services by community pharmacy professionals. METHODS: A cross-sectional study was conducted among community pharmacy professionals in Debre Markos and Injibara Town from April 15 to May 13, 2024. The data were collected using a structured questionnaire, and descriptive statistics were used to analyze the findings. RESULTS: The study revealed that a significant majority of community pharmacy professionals perceived that they had adequate vaccine knowledge and were easily accessible to the community. However, barriers such as lack of regulation, time constraints, workload concerns, patient trust issues, and infrastructure challenges hinder the implementation of vaccination services. Factors influencing the provision of vaccination services included the need for enhanced education and training, financial reimbursement, patient demand, infrastructure improvements, collaboration with other healthcare providers, and pharmacists' special interest in vaccination. CONCLUSIONS: Community pharmacy professionals exhibit readiness to provide vaccination services. However, significant barriers such as regulatory constraints, time pressures, workload concerns, patient trust issues, and infrastructure challenges hinder their full participation. Addressing these barriers and leveraging pharmacists' expertise is essential for optimizing service delivery and improving public health outcomes. Advocating for policy changes, developing comprehensive training programs, establishing clear guidelines, investing in infrastructure improvements, conducting public awareness campaigns, and fostering collaboration with other healthcare providers are recommended to facilitate the provision and implementation of vaccination services by community pharmacy professionals in Ethiopia.

Pharmacists' attitudes towards interprofessional collaboration to optimise medication use in older patients in Switzerland: a survey study.

BACKGROUND: Collaboration between physicians and pharmacists facilitates the conduct of medication optimisation efforts. In the context of deprescribing, pharmacists' roles are often described as making deprescribing recommendations to physicians. Little is known about factors associated with pharmacists' willingness to make deprescribing recommendations and their interprofessional collaboration with physicians in Swiss primary care settings. OBJECTIVE: To explore pharmacists' perspectives on medication optimisation and deprescribing in older adults, and their preferences for interprofessional collaboration in Swiss primary care settings. METHODS: In this cross-sectional study, a random sample of 1000 pharmacist members of the Swiss Pharmacists Association pharmaSuisse was invited to participate in a survey on medication optimisation, deprescribing, and interprofessional collaboration. The survey contained three case vignettes of multimorbid patients with polypharmacy aged ≥ 80 years old, with different levels of dependency in activities in daily living (ADL) and cardiovascular disease (CVD). For each case vignette, pharmacists were asked if and which medications they would deprescribe. We calculated proportions of pharmacists' willingness to deprescribe by case vignette and performed a multilevel logistic regression to assess associations between CVD, ADL, and willingness to deprescribe. RESULTS: One hundred thirty-eight (14%) pharmacists responded to the survey: 113 (82%) were female, their mean age was 44 years (SD = 11), and 66% (n = 77) reported having never received any specific training on how to conduct structured medication reviews. Eighty-three (72%) pharmacists reported to be confident in identifying deprescribing opportunities. All pharmacists were willing to deprescribe ≥ 1 medication in all vignettes. Patients with CVD were at lower odds of having medications deprescribed (OR = 0.27, 95%CI 0.21 to 0.36). Willingness to deprescribe was lower with higher dependency in ADL (medium versus low dependency: OR = 0.68, 95%CI 0.54 to 0.87, high versus low dependency: OR = 0.72, 95%CI 0.56 to 0.91). However, the effect of dependency in ADL on willingness to deprescribe was significantly modified by the history of CVD. One hundred five pharmacists (97%) reported to interact with physicians to clarify questions regarding prescriptions at least once a week and 88 (81%) wished to be more involved in deprescribing and medication review. CONCLUSION: Pharmacists were willing to make deprescribing suggestions for older patients with polypharmacy, but two-thirds reported having received no formal training on how to perform structured medication reviews. Pharmacists would like to be more involved in the process of medication review and deprescribing, which should be leveraged in the context of Swiss primary care settings.

Assessing the preparedness and future-readiness of Malaysian community pharmacists in Klang Valley regarding the use of medical marijuana.

BACKGROUND: This study investigated community pharmacists' level of knowledge and attitude towards medical marijuana and its association with sociodemographic characteristics. METHODS: A cross-sectional study was conducted from 21 February 2022 to 15 November 2022. Community pharmacists working in Klang Valley were given a self-administered questionnaire. This survey instrument facilitated the collection of information about their sociodemographic attributes, training background, and knowledge and attitude concerning medical marijuana. Through rigorous analysis of the accumulated data, discernible factors correlating with the levels of knowledge and attitudes surrounding medical marijuana were identified. RESULTS: The majority (n=149, 53.8%) of participants had low knowledge of medical marijuana. Participants with lower knowledge of medical marijuana tend to have a negative attitude toward medical marijuana. Besides that, male participants showed higher knowledge of medical marijuana than female participants. Furthermore, it was found that atheists had the most negative attitude among other religions toward medical marijuana. CONCLUSION: Most community pharmacists in Malaysia lack sufficient knowledge about medical marijuana. This indicates that Malaysian pharmacists are not future-ready and need to equip themselves with adequate knowledge of the indications and adverse effects of medical marijuana if it is to be legalised one day. Thus, there is a need for improved training and education of pharmacists around cannabis-based medicines.

Improving medication dispensing and counselling for patients with vision impairment: a qualitative study of pharmacist-reported barriers and facilitators.

BACKGROUND: People with vision impairment encounter many difficulties when it comes to medicines use. However, evidence indicates that there are major gaps in pharmaceutical care service provision worldwide and limited research on interventions to optimise medication use for this patient population. The Theoretical Domains Framework (TDF) provides a method for theoretically understanding individuals' behaviour and informing development of interventions. The aim of this research was to (a) identify the barriers and facilitators to the provision of medication dispensing and counselling services by pharmacists to patients with vision impairment, and (b) identify key TDF domains to be targeted in a future intervention. METHODS: Semi-structured interviews were conducted with pharmacists from different pharmacy practice settings/areas in Saudi Arabia. The 14-domain TDF was utilised as the theoretical lens through which pharmacists' behaviours were examined. Interviews were conducted in Arabic or English, either face-to-face or over the telephone based on the participant's preference. Following transcription, interviews conducted in Arabic were translated into English before analysis. Data analysis involved using the framework method and content analysis to identify important barriers and facilitators to the provision of dispensing and counselling services to those with vision impairment. Key TDF domains that could be targeted in a future intervention were then identified using a consensus-based approach. RESULTS: Twenty-six pharmacists were interviewed. Pharmacists' experience in pharmacy practice ranged from two to 28 years. A range of barriers and facilitators were highlighted as important in providing services to those with vision impairment. Eight domains were identified as 'key domains' including: 'Knowledge', 'Skills', 'Beliefs about capabilities', 'Goals', 'Memory, attention, and decision processes', 'Environmental context and resources', 'Social influences', and 'Behavioural regulation'. CONCLUSIONS: Barriers and facilitators identified by pharmacists will inform the development of an intervention to ensure its applicability to everyday practice. Future research will focus on the process of developing the proposed intervention through targeting key TDF domains to improve medication dispensing and counselling by pharmacists to patients with vision impairment.

Barriers to pharmaceutical care provision in the community and hospital pharmacies of Motta town, Northwest Ethiopia: a cross-sectional study.

BACKGROUND: Although pharmaceutical care has tangible positive importance in ensuring patient pharmacotherapy safety, its provision encounters several barriers. Therefore, this study investigated the obstacles pharmacy professionals faced while providing pharmaceutical care in Motta town, Northwest Ethiopia. METHODS: A cross-sectional study was conducted from July 30, 2022, to August 30, 2022, at all community and hospital pharmacies in Motta town, Northwest Ethiopia. The data were collected via a self-administered questionnaire and analyzed via SPSS version 26.0. Descriptive statistics and statistical analysis tests, such as the independent t-test, variance, and multiple linear regressions, were employed to analyze the data. RESULTS: The study had a 97.7% response rate. Among the 130 participants, 71 (54.6%) were females. The mean (± SD) total score of pharmaceutical care provision barriers was 85.06 (± 20.2). The highest and lowest mean subscale scores of pharmaceutical care provision barriers were related to lack of resources and skill, respectively. Among resource-related barriers, lack of time and money, lack of trained staff, and lack of private space for consultation scored higher than other barriers. Concerning vision/attitudinal barriers, patients and other healthcare workers' inappropriate attitudes toward pharmaceutical care obtained the highest scores. The lack of clinical education in pharmaceutical care, lack of communication, and lack of documentation skills of pharmacists scored higher than other barriers in the educational and skill-related barriers subscales. For the regulatory/environmental subscale, a lack of clinical practice guidelines and legal barriers scored higher than the other subscales did. Pharmaceutical care provision barriers were significantly associated with age (B = 14.008), years of practice (B = 13.009), and graduating institution (B=-16.773). CONCLUSIONS: Resource and attitudinal/vision-related barriers were reported to be the most common barriers to pharmaceutical care implementation. Stakeholders should work together to develop strategic solutions to overcome these barriers and thus achieve optimal pharmaceutical care provision. These strategies should include optimizing the number of trained pharmacy staff, time and financial problems should be resolved, communication and documentation skills should be improved, pharmacy layouts should incorporate private counseling rooms, policies that support the pharmacist's role in patient care should be developed, and effective training and continuing professional education programs should be offered.

The roles of French community pharmacists in palliative home care.

BACKGROUND: The World Health Organization identifies pharmacists as a key resource in palliative care. However, the roles of these professionals in end-of-life care at home remain poorly understood, and community pharmacists themselves sometimes struggle to recognize their true role in this care. The aim of our study was to analyze community pharmacists' representations of their roles in palliative care at home in France. METHODS: The methodology was qualitative and based on semi-structured interviews with community pharmacists (n = 26). The analysis of the interviews was carried out using a qualitative content approach with thematic and lexical analysis. RESULTS: Three main elements of the community pharmacist's role were identified: drug expertise, care management, and psychosocial support for patients and their families. CONCLUSIONS: This study highlights a wide variety of roles adopted by French community pharmacists in palliative care at home. Some of these roles, which are in line with WHO recommendations on palliative care, have been little described to date. These roles of community pharmacists in home-based palliative care could be better recognized, and the players better integrated into end-of-life care systems at home, in order to improve such care. TRIAL REGISTRATION: This work was carried out within the framework of a call for projects from the Fondation de France and has received the approval of the University Clermont Auvergne Research Ethics Committee (no. IRB00011540-2021-60).

Knowledge, attitude, and practice of insulin among diabetic patients and pharmacists in Egypt: "cross-sectional observational study".

BACKGROUND: Diabetes recently has been identified as a growing epidemic. Although insulin's vital role in both types of diabetes, it is considered one of the harmful medications if used incorrectly. In Egypt, effective usage of insulin remains a challenge due to insufficient knowledge of insulin and diabetes management, leading to errors in insulin therapy. As pharmacists are experts in pharmacological knowledge, they are uniquely situated to assess adherence to treatment regimens, the effect of drug therapy, or potential alterations in drug therapy to meet patient goals. To provide effective patient education and counseling, community pharmacists in Egypt should be efficiently knowledgeable about diabetes and insulin. OBJECTIVE: To identify the knowledge, attitude, and practice of pharmacists and patients about insulin. To identify pharmacists' educational preparedness and confidence in counseling diabetic patients. METHODS: A descriptive, cross-sectional study was conducted with two knowledge, attitude, and practice surveys. This study was carried out from September 2016 to February 2023. Face-to-face interviews were conducted with patients, and a paper-based questionnaire was administered to pharmacists. The two questionnaires were adapted from previous studies. RESULTS: A total of 492 patients and 465 pharmacists participated in this study. The mean knowledge score of correct answers among patients and pharmacists was 10.67 ± 1.9 and 15 ± 3.6. Most of the patients and pharmacists had a positive attitude regarding insulin's role in improving health and to better control blood glucose. On the negative side, around half of the patients reported that they believe that regular use of insulin leads to addiction, while only 14.5% of the pharmacists believed that insulin could cause addiction. Self-confidence scores for pharmacists differed statistically with sex, years of experience, and pharmacist's direct exposure to diabetic patients. CONCLUSIONS: This study uncovers considerable deficiencies in patients' and pharmacists' knowledge about insulin therapy. This study also strongly recommends higher education and a more structured pharmacist training schedule.

Pharmacy work: Intrinsic motivation and extrinsic rewards across role and setting.

BACKGROUND: Pharmacists' and pharmacy technicians' stress and job turnover are at an all-time high. Both intrinsic motivations and extrinsic rewards play key roles in workplace satisfaction. Differences in workplace satisfaction have been identified when comparing chain pharmacies, independent pharmacies, and health systems work settings. OBJECTIVES: Cognitive evaluation theory was applied to explore the influence of intrinsic motivations and extrinsic rewards on both pharmacists' and pharmacy technicians' perceptions of motivations and rewards across various workplace settings. METHODS: A 92-item questionnaire was administered to 129 pharmacists and 111 pharmacy technicians. Participants were primarily recruited at a state pharmacy association annual meeting and via online forums. The questionnaire captured participant demographics including role and work setting (i.e., chain, independent, or health systems), demographic variables, and perceptions about work including autonomy, competence, relationships, pay satisfaction, and benefit satisfaction. RESULTS: A 2-way multivariate analysis of covariance was conducted to test hypothesized differences by role (pharmacist or pharmacy technician) and setting (chain, independent, or health systems). Results show pharmacy personnel in independent and hospital systems settings felt more positive about relationships, competence, pay satisfaction, and benefit satisfaction than those in chain settings. There were no role differences between pharmacists and pharmacy technicians on these outcomes. DISCUSSION: These findings highlight challenges of working in chain pharmacy environments. Results reveal that although pay does not differ across work settings, feelings about both the work and compensation satisfaction do vary across settings. Because role did not drive these relationships, this suggests a need to attend to working conditions for pharmacy personnel. CONCLUSION: Intrinsic motivation elements of competence and relationships are statistically different among employment settings. Relationships and feelings of competence are perceived more favorably in independent and health systems, rather than chain settings. More studies on intrinsic motivations of pharmacy employees within these settings are needed.

A narrative review of the well-being and burnout of U.S. community pharmacists.

OBJECTIVES: The purpose of this narrative review is to summarize the literature on well-being and burnout among community pharmacists in the U.S. and provide recommendations for future research. METHODS: Relevant literature was identified by searching PubMed for combinations of keywords such as "burnout" and "well-being" combined with "pharmacists." Titles and abstracts were reviewed for relevancy, and full text articles were reviewed when applicable. RESULTS: While burnout is defined by its 3 core symptoms of emotional exhaustion, depersonalization, and low personal accomplishment, well-being is more challenging to define and measure, which has led to it being less studied. Community pharmacists faced high rates of burnout, low quality of life (QOL), and extreme fatigue prior to the COVID-19 pandemic, a situation that has likely only worsened. Factors such as workload, the type of community pharmacy, the level of education or training of the pharmacist, and stress may be some of the contributors to high rates of burnout. Clinician burnout may be related to high rates of mental health disorders seen in pharmacists, may impact patient safety and satisfaction, and may affect productivity and costs to employers and the healthcare system overall. There has been no research into interventions or strategies to support well-being and reduce burnout among community pharmacists, but having a workplace that is perceived as supporting well-being may have some impact. Recommendations for future research include the following: (1) define well-being, (2) explore why various factors support well-being or contribute to burnout, (3) determine the impact of community pharmacists experiencing well-being or burnout, and (4) develop strategies to support well-being and reduce burnout that are specific to community pharmacy. CONCLUSION: There is a sparsity of evidence regarding community pharmacist well-being and burnout. Further research is needed to generate the evidence needed to support interventions that are specific to the unique work setting of community pharmacists.

Burnout assessment among pharmacist-academic detailers at the US Veterans Health Administration.

BACKGROUND: Burnout among clinical pharmacist practitioners has been well established, but not among those who perform academic detailing. OBJECTIVES: To measure burnout among clinical pharmacist practitioners who perform academic detailing (pharmacist-academic detailers) at the United States Veterans Health Administration and compare the findings using 2 validated burnout instruments for healthcare professionals. METHODS: A cross-sectional study design was performed to measure burnout in VHA pharmacist-academic detailers across all VA regions between April 2023 and May 2023. Burnout was measured using the Oldenburg Burnout Inventory (OLBI) and a validated single-item burnout measure (SIMB). OLBI has 2 domains (exhaustion and disengagement) and categorizes burnout into Low, Moderate, and High based on scores above or below 1 standard deviation (SD) of the mean. The validated SIMB categorized burnout as having a score of 3 or greater (range: 1-5). Interrater reliability testing between the OLBI and the SIMB at detecting burnout among pharmacist-academic detailers was performed using the kappa test. Correlation between the 2 burnout instruments was assessed using the Spearman rho test. RESULTS: A total of 50 pharmacist-academic detailers completed the burnout survey. A large proportion of respondents had Moderate levels of burnout for the total (72%) burnout score, disengagement (64%) domain, and exhaustion (74%) domain. In total, 86% of pharmacist-academic detailers reported having Moderate to High levels of burnout on the total OLBI score. On the SIMB, a total of 14 (28%) pharmacist-academic detailers reported having one or more symptoms of burnout. Interrater reliability was considered poor/slight agreement between the OLBI and SIMB. Correlation between the 2 burnout instruments was considered moderately correlated (rho = 0.67, P < 0.001). CONCLUSION: This study provides an empirical analysis of burnout among pharmacist-academic detailers; however, the ability to detect burnout among pharmacist-academic detailers may be impacted by the selection of burnout instrument used.

Student pharmacist perceptions toward community pharmacy practice.

BACKGROUND: Community pharmacy practice has incurred significant changes in scope of responsibility and workplace environment, particularly during the COVID-19 pandemic. The trends may impact how student pharmacists perceive community pharmacy practice and their future career opportunities. OBJECTIVE: To determine current perceptions that student pharmacists have toward community pharmacy practice. METHODS: A 15-item electronic, cross-sectional questionnaire was distributed to approximately 2200 student pharmacists from March to April 2023. To be included, respondents needed to be a current adult pharmacy student. The questionnaire included items about career interests, perceptions towards 12 different aspects of community pharmacy practice, and demographics. Data were analyzed primarily using descriptive statistics. A priori stratifications included interest to pursue community pharmacy according to class year and according to level of work experience. RESULTS: A total of 146 responses were included (response rate 6.6%). A total of 101 (69.2%) respondents were women, 108 (74.0%) were white, and the mean age was 24 years. Respondents represented all 4 pharmacy professional years, and 113 (77.4%) respondents reported current or previous work experience in community pharmacy. Most respondents were not interested in pursuing community pharmacy directly after graduation 77 (52.7%), nor as a long-term career 87 (59.6%). Student pharmacists found the most appealing aspects of community pharmacy practice to be salary/benefits, job availability and security, interactions with coworkers in the pharmacy, interactions with other medical professionals, relationships and interactions with patients, and teaching responsibilities. Student pharmacists found the work hours and schedule, business management responsibilities, navigating insurance-related tasks, and the pace of the work environment to be unappealing. CONCLUSIONS: Student pharmacists report a low interest in pursuing community pharmacy practice. Minimizing deterrents and enhancing the appealing aspects of community pharmacy as perceived by student pharmacists may help improve recruitment and retainment, as well as improve perceptions of the practice.

Pharmacists' awareness and confidence in performing Pharmacists' Patient Care Process-related activities.

BACKGROUND: The Pharmacists' Patient Care Process (PPCP) is a 5-step approach for patient-centered evidence-based pharmaceutical care. The PPCP was developed by the Joint Commission of Pharmacy Practitioners in 2014; however, little is known about PPCP terminology and process uptake across the profession. OBJECTIVES: This study aimed to explore practicing pharmacists' awareness of and confidence in performing PPCP-related activities in various practice settings. METHODS: This is a cross-sectional observational study of practicing pharmacists using a multiphase quantitative survey research design. A previously validated instrument, the PPCP Self-Efficacy Scale, was revised and distributed. The 28-item instrument addressed activities mapped to each of the 5 PPCP components (Collect, Assess, Plan, Implement, and Follow-Up). The survey was distributed via Qualtrics to an IQVIA pharmacist e-mail listserv in 2021 and to pharmacist state license rosters containing e-mail addresses in 2022. RESULTS: A total 853 practicing pharmacists completed the survey. Most participants identified as female (62.5%) and white (74.6%). Almost 60% of participants reported practicing for 16 or more years. Forty-four percent practiced in a community pharmacy setting, whereas 23.6% and 15.4% practiced in a health-system setting and ambulatory care setting, respectively. Sixty-two percent indicated they had no previous knowledge of the PPCP, and 12.5% were unsure. Overall participants had relatively high self-efficacy mean scores for each of the PPCP components. Participants working in an ambulatory care setting had the highest mean self-efficacy scores across all PPCP components (P < 0.05). Participants who were affiliated with a college or school of pharmacy (e.g., faculty, preceptor) had higher mean self-efficacy scores than participants who were not affiliated (P < 0.01). CONCLUSION: Most of practicing pharmacists are unaware of PPCP terminology. Their confidence in performing tasks associated with PPCP components is relatively high and varies based on PPCP component and practice setting.

An assessment of pharmacist perceptions and experiences with community health workers.

BACKGROUND: The American Public Health Association defines a community health worker (CHW) as "a trusted member of and/or has an unusually close understanding of the community served." Both CHWs and pharmacists have shown they are well-equipped to produce positive outcomes in chronic disease management, but there is still a gap in the literature regarding the CHW-pharmacist relationship. OBJECTIVE: The objective of this study was to assess and describe pharmacist perceptions and experiences with CHWs. METHODS: An online survey was distributed to pharmacists via state and national pharmacy organizations in the following states: Illinois, Indiana, Iowa, Minnesota, Nebraska, and Wisconsin. Descriptive statistics were used to summarize demographics and pharmacist experiences with CHWs. RESULTS: The survey received 241 responses and 212 (88.0%) met inclusion criteria. Of the 212 eligible respondents, the survey was sufficiently completed by 163 (76.9%). These 163 complete responses were included in the data analysis. Fifty-eight (35.6%) respondents reported working with a CHW and 105 (64.4%) reported never working with a CHW. Fifty-two (89.7%) respondents who previously worked with a CHW were strongly interested or interested in continuing to work with a CHW. Sixty-one (58.1%) respondents without experience were strongly interested or interested in working with a CHW. The reported improvements seen with the addition of a CHW to the healthcare team included: improved patient empowerment, improved clinical patient outcomes, decreased workload of other health care professionals, increased healthcare knowledge, increased healthcare utilization, and increased medication and/or treatment plan adherence. CONCLUSION: Pharmacists recognize the benefit of working with a CHW and their contributions to patient care and want to continue working collaboratively. Collaborative pharmacist-CHW relationships should be a priority for optimizing care through community pharmacies and will require a shift in the current structure of community pharmacy services.