BACKGROUND: Even though the effectiveness of community pharmacists in helping customers to reduce weight has been evident, few pharmacists provided weight management services (WMS). To drive community pharmacist WMS provision, factors affecting their intention and WMS provision were important to be investigated. OBJECTIVE: The present study aimed to explore relationships among pharmacist authority, perceived customer obstruction, WMS performance support, obstacles, and facilitators with intention to provide WMS and WMS rovision using structural equation modeling (WMS. METHOD: Self-administered questionnaires were utilized to collect data from 302 Thai community pharmacists from December 2022 to March 2023. Structural equation modeling (SEM) was used to explore the influencing factors on pharmacist WMS intention and WMS provision. RESULTS: Pharmacist authority (r = 0.35), WMS performance support (r = 0.24), and facilitators (r = 0.22) were significantly correlated with community pharmacist WMS provision. Pharmacist authority (r = 0.50), facilitators (r = 0.46), and WMS performance support (r = 0.42) were significantly correlated with community pharmacist intention to provide WMS e structural equation model (SEM), pharmacist authority (ß = 0.34) and intention (ß = 0.16) significantly influenced WMS provision (R2 = 0.20). Authority (ß = 0.49) and WMS performance support (ß = 0.28) significantly influenced pharmacist intention to WMS (R2 = 0.42). The model from empirical data indicated a good fit with the hypothetical model (p-value = 0.000, Comparatively Fit Index = 0.9, and Tucker-Lewis Index = 0.878). CONCLUSION: Pharmacist authority had direct effects with both their intention to provide WMS and WMS provision. WMS performance support had a direct effect on intention to provide WMS and an indirect effect on WMS provision. Facilitators also had significant correlations with intention to provide WMS and WMS provision.
Background: Obesity is one of the health problems which could cause health impacts, as well as economic and social impacts. Community pharmacists are accessible primary health care providers who can play a role in counselling on diet and exercise to control weight and correcting medication misuse for weight control. Literature has shown the effectiveness of weight management services (WMS) provided by community pharmacists, but the percentages of this service provision were low. Objective: To systematically review contributing factors for community pharmacists intention to provide weight management services. Results: The systematic review included 3,884 participants from 24 studies. There were four major dimensions of weight management service in community pharmacies: 1) patient recruitment, 2) problem identification and referral, 3) counselling, and 4) monitoring. Pharmacists indicated difficulty in starting a conversation about weight with patients. Most pharmacists performed diet and weight-loss product counselling, but few pharmacists monitored patients progress and adherence to WMS because of the follow-up difficulty. They recommended the use of mobile applications and social media to facilitate monitoring. Pharmacists viewed that those weight-loss products needed to be better regulated. Therefore, it should be pharmacists responsibility to correct the irrational use of these products. Pharmacists authority, inadequate pharmacist staff, lack of patient awareness, patients demand, and private counselling areas were the barriers to weight management service. Knowledge and training, accreditation, time for pharmacists to study, reimbursement, multidisciplinary collaboration, and health resource support could motivate pharmacists to provide WMS. To start WMS, pharmacists reported the need for knowledge about diet, lifestyle modification, weight-loss products, and improving patient engagement in weight management programs. (AU)
Humans , Body Weight , Pharmaceutical Services , Obesity , Pharmacies
Background: The people who use complementary medicines (CMs) believe that these medicines are safe and harmless. They could easily access CMs like herbal or traditional medicines in community pharmacies. Therefore, community pharmacists are important professionals in advising the safe choices of CMs and providing evidence-based information for customers to decrease adverse effects of CMs. Objectives: To systematically review knowledge, attitude, and practices of community pharmacists about CMs, and the factors associated with CM practices of dispensing, recommending and counseling patients, and answering the patients queries. Method: An electronic search was performed with four databases: PubMed, Scopus, SpringerLink and ScienceDirect, from 1990 to 19th May 2022. The inclusion criteria were studies 1) about knowledge, attitude, and/or practices of community pharmacists about CMs, 2) written in English, 3) conducted with quantitative methods, and 4) able to retrieve full text. (AU)
Humans , History, 20th Century , History, 21st Century , Complementary Homeopathic Drugs , Health Knowledge, Attitudes, Practice , Pharmacists , Drug-Related Side Effects and Adverse Reactions , Products Commerce
BACKGROUND: Turnover is an important issue in all healthcare professions including pharmacy practice settings. A high turnover rate of pharmacists, not only has negative financial impact, but also reduces quality of care and patient safety. The high turnover also increases workload and job stress which can increase job errors and decrease job efficiency and performance in pharmacy practices. OBJECTIVES: To systematically review the extent of pharmacists' turnover and their intention to leave their jobs or the pharmacy profession. METHODS: An electronic search was performed from database inception to December 19, 2020 using the following 6 databases; PubMed, Scopus, ScienceDirect, ProQuest, ERIC, and ERIC-EBSCO. Articles were included if they were relevant to reports of pharmacist turnover or turnover intention. Only research studies were included, but not editorials, letters, or review articles. RESULTS: Twenty-eight studies were contained within this systematic review. Using the QualSyst assessment tool to assess the included article qualities, all studies demonstrated good quality with quality assessment score of 0.75. Fifteen studies (53.6%) were conducted from the US, 3 studies (10.7%) from Taiwan, 2 studies (7.1%) from the UK, and the remaining studies from Lithuania, Australia, New Zealand, Malaysia, Saudi Arabia, and Jamaica. The turnover of the pharmacists from their jobs ranged from 8.6 to 17%, and the turnover from the pharmacy profession was in the range of 6-9%. The turnover intention of the pharmacists in their jobs was from 13% to 61.2%, and the turnover intention in the pharmacy profession was 6.5%-18.8%. Hospital pharmacists had significantly higher turnover intentions than community ones. The turnover intention rates of both hospital and community pharmacists have gradually increased over time in both European countries and Asian countries. CONCLUSION: Based on the included articles, pharmacists' turnover rate appeared to increase over time. However, based on the heterogeneity of studies, further research is warranted to confirm this and to help to identify the potential causes of turnover intention since intention was related to behavior.
Pharmaceutical Services , Pharmacies , Humans , Intention , Job Satisfaction , Pharmacists
BACKGROUND: Adverse drug event (ADE) reporting is a significant process to increase consumer care and consumer safety associated with the use of medicines. An in-depth investigation into low ADE reporting by consumers and community pharmacists was undertaken to uncover interventions to improve reporting. METHOD: In-depth interviewing of the three parties; consumers, pharmacists and employees of the Pharmacovigilance Center in Thailand, was used to collect the data. They were interviewed about ADE reporting experiences and contributing factors and problems of ADE reporting. Thematic analysis was used to interpret the results. RESULT: The HPVC received few ADE reports from consumers. Most community pharmacists received ADE reports from consumers; however, the Pharmacovigilance Center received few ADE reports from community pharmacists. ADE reporting of community pharmacists and consumers were influenced by many factors which were categorized into four themes which were (1) "Cognition" (awareness, attitude and responsibility); (2) "Reporting process" (complication, competency, information deficiency, feedback, and resource); (3) "Inducer" (service orientation, acquaintanceship, motivation, severity level, regulatory and reward); and (4) "Obstacle" (doubt, belief and prosecution). CONCLUSION: Health professionals should motivate consumers to report ADEs. Building social responsibility and benefits and increasing knowledge of reporting process, channels, and system to both community pharmacists and consumers were recommended. Providing rewards and making community pharmacists feel comfortable to report ADEs by simplifying the ADE form and providing training, guidelines, and an ADR assessment tool can drive them to report ADEs. Feedback to consumers by confirming whether it was ADE and feedback to pharmacists that the Pharmacovigilance Center received their reports and their reports were utilized were also important.
BACKGROUND: Under-reporting of adverse drug reactions (ADRs) is the main problem of spontaneous ADR reporting systems, especially reporting from community pharmacists. However, community pharmacists cannot report ADRs if patients do not report them. OBJECTIVE: To investigate factors that can influence patients' intention to report ADRs to community pharmacists and to develop a structural model of influencing factors to report ADRs from patients. METHOD: Self-administered questionnaire via a Google form was used. The study samples were people living in all regions of Thailand. Structural equation modeling (SEM) was used to determine the influencing factors to intention to report ADRs to community pharmacists. RESULTS: A total of 2774 responses were collected. All Pearson correlations among variables were statistically significant. The correlation between intention to report ADR and instrumental attitude was highest. Perceived behavior control had the lowest correlation with intention to report ADRs. The structural equation model was an adequate fit for the data. Intention to report ADRs to community pharmacists was significantly influenced by instrumental attitude, injunctive norm, descriptive norm and self-efficacy. CONCLUSION: Positive attitude of ADR reporting, self-efficacy and their reference person such as physicians, community pharmacists, their families and friends could encourage and motivate their intention to report ADRs to community pharmacists.
Drug-Related Side Effects and Adverse Reactions , Pharmacists , Adverse Drug Reaction Reporting Systems , Humans , Intention , Latent Class Analysis
Background: The people who use complementary medicines (CMs) believe that these medicines are safe and harmless. They could easily access CMs like herbal or traditional medicines in community pharmacies. Therefore, community pharmacists are important professionals in advising the safe choices of CMs and providing evidence-based information for customers to decrease adverse effects of CMs. Objectives: To systematically review knowledge, attitude, and practices of community pharmacists about CMs, and the factors associated with CM practices of dispensing, recommending and counseling patients, and answering the patients' queries. Method: An electronic search was performed with four databases: PubMed, Scopus, SpringerLink and ScienceDirect, from 1990 to 19th May 2022. The inclusion criteria were studies 1) about knowledge, attitude, and/or practices of community pharmacists about CMs, 2) written in English, 3) conducted with quantitative methods, and 4) able to retrieve full text. Results: Twenty-three studies were included in this systematic review. Some studies showed that less than half of the pharmacists asked or counselled about CMs to their patients and answered the patients' queries about CMs. Only 20% of the pharmacists did report CM side-effects. Training or education about CMs was a common factor associated with the CM practice of dispensing, recommending, counseling, and answering the patients' queries about CMs. CMs recommended most by community pharmacists were vitamins & minerals, food or dietary supplements, fish oil and probiotics. The most common dispensed CMs were vitamins & minerals, herbs, food or dietary supplements, fish oil and essential oils. Lacks of reliable information sources and scientific evidence were common barriers for the CM practices. Being less expensive than conventional medicines motivated the pharmacists to recommend and discuss about CMs. The community pharmacists that participated in included studies suggested strengthening CM trainings and highlight the pharmacist role in CM therapy. Conclusion: A high percentage of community pharmacists did dispense CMs to their patients, while a low percentage of the pharmacists did report CM side effects. Pharmacists were most comfortable recommending and responding the patients' CM queries. Training or education about CMs associated with CM dispensing, recommending, discussing, and answering the patients' queries about CMs was recommended.
Background: Pharmacist turnover can negatively impact not only on work efficiency, organizational performance, work productivity and customer satisfaction, but also on the quality of pharmaceutical services and patient safety. Turnover intention is a core antecedent of turnover. Turnover intention of the pharmacists is affected by many factors related to their organization or job. Objective: To elaborate the factors affecting the pharmacists turnover intention and their associations. Studies related to any factors affecting pharmacists turnover intention in all pharmacy settings were included. The QualSyst assessment tool was used for assessing the quality of the included studies. Result: For this systematic review, 3,822 studies were identified. Of these studies, 20 studies were included. Thirty factors were explored and a model for pharmacists turnover intention was produced. Organizational commitment, job satisfaction, career commitment, job stress, perceived organizational support, and work climate were frequently found as drivers to pharmacist turnover intention. Some of 24 other factors had both direct and indirect effects on pharmacist turnover intention via organizational commitment, job satisfaction, career commitment, job stress, and perceived organizational support. Many studies have reported that organizational commitment and job satisfaction had significant influence on pharmacist turnover intention in all settings. Job stress and work climate had direct and indirect effects on turnover intention of hospital pharmacists. Career commitment and perceived organizational support had direct and indirect effects on community pharmacist turnover intention (AU)
Humans , Pharmacists , Personnel Turnover , Intention , Job Satisfaction , Workload
Background: Pharmacist turnover can negatively impact not only on work efficiency, organizational performance, work productivity and customer satisfaction, but also on the quality of pharmaceutical services and patient safety. Turnover intention is a core antecedent of turnover. Turnover intention of the pharmacists is affected by many factors related to their organization or job. Objective: To elaborate the factors affecting the pharmacists' turnover intention and their associations. Studies related to any factors affecting pharmacists' turnover intention in all pharmacy settings were included. The QualSyst assessment tool was used for assessing the quality of the included studies. Result: For this systematic review, 3,822 studies were identified. Of these studies,20 studies were included. Thirty factors were explored and a model for pharmacists' turnover intention was produced. Organizational commitment, job satisfaction, career commitment, job stress, perceived organizational support, and work climate were frequently found as drivers to pharmacist turnover intention. Some of 24 other factors had both direct and indirect effects on pharmacist turnover intention via organizational commitment, job satisfaction, career commitment, job stress, and perceived organizational support. Many studies have reported that organizational commitment and job satisfaction had significant influence on pharmacist turnover intention in all settings. Job stress and work climate had direct and indirect effects on turnover intention of hospital pharmacists. Career commitment and perceived organizational support had direct and indirect effects on community pharmacist turnover intention. Conclusion: The factors driving the turnover intention of the pharmacists in different pharmacy practices were different. It indicated that the further interventions should be different to improve the pharmacists' retention in each pharmacy practice setting. Our systematic review is beneficial to guide human resource management in pharmacy and useful for guiding the conceptual framework of future research studies.
OBJECTIVES: Medication monitoring is important for safe and effective medication use; however, no attitudinal measure exists for a health care provider's medication monitoring attitude. The objectives of this study were to (1) create a measure of a community pharmacist medication monitoring attitude; (2) test concurrent validity using a validated measure of medication monitoring behaviours; and (3) report community pharmacist attitudes towards medication monitoring. METHODS: A mixed methods item development process was employed to generate Likert-type items from qualitative interviews. Following item review and piloting, a four-contact survey, including 20 6-point Likert-type items and the four-item Behavioral Pharmaceutical Care Scale monitoring domain, was mailed to 599 randomly sampled US community pharmacists from the state of Iowa. Exploratory factor analysis, Pearson's correlation and descriptive statistics were used to address study objectives. KEY FINDINGS: There were 254 (42.4%) returned and usable surveys. Factor analysis yielded two domains, a seven-item, positively worded internal (α = 0.819) and an eight-item, negatively worded external domain (α = 0.811). Both domains were positively correlated with the monitoring domain of the Behavioral Pharmaceutical Care Scale supporting convergent validity. Overall, respondents had a positive internal monitoring attitude with a mean of 4.62 (0.68), although many practiced in an environment less conducive to monitoring, as evident by a mean of 3.13 (0.88). Pharmacists were more oriented towards medication side effect and effectiveness monitoring than nonadherence monitoring. CONCLUSIONS: The mixed methods item development process created a reliable and valid measure of a pharmacist's medication monitoring attitude. While pharmacists had an overall positive medication monitoring attitude, improvements are needed to bolster adherence monitoring and make pharmacy environments more conducive to monitoring.
Attitude of Health Personnel , Community Pharmacy Services/organization & administration , Drug Monitoring/methods , Pharmacists/organization & administration , Drug-Related Side Effects and Adverse Reactions/epidemiology , Factor Analysis, Statistical , Female , Humans , Iowa , Male , Medication Adherence , Pilot Projects , Reproducibility of Results , Surveys and Questionnaires
BACKGROUND: Student pharmacist mentoring programs have gained attention from colleges of pharmacy as a way to enhance the student experience. However, no evaluative models have been proposed or theoretical explanations described for use in improving formal mentoring programs in pharmacy or for guiding the construction of a literature base. OBJECTIVES: The objectives of this study were to investigate student expectations and preferences for formal mentoring programs and propose a model for evaluating formal mentoring programs in pharmacy education. METHODS: Five, 60-minute focus groups were conducted in September 2009. Participants were PharmD candidates in their first 3 years of professional education. Discussion was facilitated using a question guide. Following transcription, an initial iteration of the model was used to code the data. A consensus-forming process was used to derive themes and identify representative quotes. Elaboration and specification of the final proposed model is presented. RESULTS: In all, 28 students participated. Emergent constructs were identified from the data. Structures or inputs of the formal mentoring program included mentor and protégé characteristics and program structure. Mentoring processes included mentor functions, mentoring activities, and relationship development. Outcomes included both proximal outcomes in the form of mentor and protégé change, program satisfaction, and organizational learning; and distal outcomes comprised mentor, protégé, and organizational outcomes. CONCLUSIONS: This formal mentoring evaluation model was useful in guiding analysis of protégé experiences and preferences for a college-sponsored program. The model can be used to guide college administrators and researchers on future theory-based inquiry into protégé; mentor; and organizational structures, processes, and outcomes for formal mentoring programs.
Education, Pharmacy/organization & administration , Mentors , Adult , Female , Humans , Male , Organizational Culture , Program Evaluation , Schools, Pharmacy/organization & administration , Students, Pharmacy , Young Adult
OBJECTIVES: Characterize the skills and abilities required for department chairs, identify development needs, and then create AACP professional development programs for chairs. METHODS: A 30-question electronic survey was sent to AACP member department chairs related to aspects of chairing an academic department. RESULTS: The survey identified development needs in the leadership, management, and personal abilities required for effective performance as department chair. The information was used to prioritize topics for subsequent AACP development programs. Subsequent programs conducted at AACP Interim and Annual Meetings were well attended and generally received favorable reviews from participants. A list of development resources was placed on the AACP website. CONCLUSIONS: This ongoing initiative is part of an AACP strategy to identify and address the professional development needs of department chairs. Survey results may also inform faculty members and other academic leaders about the roles and responsibilities of department chairs.
Education, Pharmacy , Faculty/organization & administration , Staff Development/methods , Data Collection , Faculty/standards , Humans , Leadership , Professional Competence , United States , Workforce
OBJECTIVE: This multisite study compared the perceptions of three stakeholder groups regarding information technologies as barriers to and facilitators of clinical practice guidelines (CPGs). DESIGN: The study settings were 18 U.S. Veterans Affairs Medical Centers. A purposive sample of 322 individuals participated in 50 focus groups segmented by profession and included administrators, physicians, and nurses. Focus group participants were selected based on their knowledge of practice guidelines and involvement in facility-wide guideline implementation. MEASUREMENTS: Descriptive content analysis of 1,500 pages of focus group transcripts. RESULTS: Eighteen themes clustered into four domains. Stakeholders were similar in discussing themes in the computer function domain most frequently but divergent in other domains, with workplace factors more often discussed by administrators, system design issues discussed most by nurses, and personal concerns discussed by physicians and nurses. Physicians and nurses most often discussed barriers, whereas administrators focused most often on facilitation. Facilitators included guideline maintenance and charting formats. Barriers included resources, attitudes, time and workload, computer glitches, computer complaints, data retrieval, and order entry. Themes with dual designations included documentation, patient records, decision support, performance evaluation, CPG implementation, computer literacy, essential data, and computer accessibility. CONCLUSION: Stakeholders share many concerns regarding the relationships between information technologies and clinical guideline use. However, administrators, physicians, and nurses hold different opinions about specific facilitators and barriers. Health professionals' disparate perceptions could undermine guideline initiatives. Implementation plans should specifically incorporate actions to address these barriers and enhance the facilitative aspects of information technologies in clinical practice guideline use.
Attitude of Health Personnel , Attitude to Computers , Information Systems , Practice Guidelines as Topic , Adult , Female , Focus Groups , Guideline Adherence , Hospital Administrators , Hospitals, Veterans , Humans , Male , Middle Aged , Nurses , Physicians , United States
Provider knowledge is a potential barrier to adherence to clinical guidelines. The purpose of this study is to assess the impact of organizational, provider, and guideline factors on provider knowledge of a congestive heart failure (CHF) clinical practice guideline (CPG) in the Veterans Health Administration (VHA) health care system. We developed a survey to investigate institution-level factors influencing the effectiveness of guideline implementation, including characteristics of the guideline, providers, hospital culture and structure, and regional network. Survey participants were quality managers, primary care administrators, and other individuals involved in primary care CPG implementation at 143 VHA hospitals with ambulatory care clinics. Potential explanatory variables were grouped into 11 factors. Multivariate regression models assessed the association between these factors and reported levels of provider knowledge regarding the CHF guideline at the hospital level. Two hundred forty surveys from 126 of 143 (88%) VHA hospitals were returned. Provider knowledge of the CHF guideline was estimated as "great" or "very great" by 58% of respondents. Three predictor factors (dissemination approaches, use of technology in guideline implementation, and hospital culture) were independently associated (P < or = .05) with provider knowledge. Specific variables within these categories that were related to greater knowledge included physician belief that guidelines were applicable to their practice, distribution of guideline summaries, use of guideline storyboards in clinic areas, the use of technology (eg, electronic patient records) in CPG implementation, and establishment of implementation checkpoints and deadlines. Provider knowledge of guidelines is affected by factors at various organizational levels: dissemination approaches, use of technology, and hospital culture. Guideline implementation efforts that target multiple organizational levels may increase provider knowledge.
Ambulatory Care Facilities/standards , Guideline Adherence/statistics & numerical data , Heart Failure/therapy , Hospitals, Veterans/standards , Knowledge , Practice Guidelines as Topic , Practice Patterns, Physicians'/statistics & numerical data , Health Plan Implementation , Health Services Research , Hospitals, Veterans/organization & administration , Humans , Information Dissemination , Information Systems , Multivariate Analysis , Organizational Culture , United States , United States Department of Veterans Affairs
Older adults experiencing acute pain are often underassessed and undertreated. This review summarizes recommendations from an evidence-based practice guideline on acute pain management in older adults. Key areas highlighted are pain assessment and monitoring, patient education, pharmacologic management, and nonpharmacologic management.
Aged , Geriatric Nursing/methods , Pain Management , Pain Measurement/methods , Pain/diagnosis , Acute Disease , Aged/physiology , Aged/psychology , Analgesics/therapeutic use , Drug Monitoring/methods , Drug Monitoring/nursing , Drug Monitoring/standards , Evidence-Based Medicine , Family/psychology , Geriatric Assessment , Geriatric Nursing/standards , Humans , Nursing Assessment/methods , Nursing Assessment/standards , Pain Measurement/nursing , Pain Measurement/standards , Patient Education as Topic/methods , Patient Education as Topic/standards , Practice Guidelines as Topic , Relaxation Therapy/standards
OBJECTIVE: To evaluate whether prior pharmacy bargaining process strategies and pharmacy dependence on third parties affect the bargaining power of pharmacies in price negotiations with third parties. DESIGN: One-time survey. SETTING: Random sample of 900 independent and small chain pharmacies in nine states: Colorado, Connecticut, Georgia, Kentucky, Minnesota, Oklahoma, Oregon, Pennsylvania, and Wisconsin. PARTICIPANTS: Two hundred sixteen of the returned surveys contained sufficient responses for this analysis. INTERVENTIONS: Survey data on pharmacy bargaining power and prior pharmacy bargaining strategies, pharmacy dependence, and market characteristics were analyzed using multiple regression in a previously developed and modified provider/third party bargaining model. MAIN OUTCOME MEASURE: Pharmacy bargaining power. RESULTS: Pharmacy bargaining power varied across our sample. Pharmacy bargaining power was positively related to whether a pharmacy previously bargained with the third parties, negatively related to prior requests for contract changes, and negatively related to the pharmacy's dependence on third parties in total. CONCLUSION: Pharmacy bargaining power is related to the bargaining strategies employed by pharmacies during the previous year and the dependence of pharmacies on third party payers in total. With the prevalence of "take-it-or-leave-it" contracts from third parties, prior pharmacy bargaining behavior may affect the initial terms of the contracts that pharmacies are offered.
Labor Unions , Pharmacies/economics , Pharmacy Administration/economics , Algorithms , Drug Industry , Models, Economic , United States
