Describing the consumer profile of different types of community pharmacy in Aotearoa New Zealand.

Introduction Aotearoa New Zealand has a range of community pharmacies; independent, corporate, hybrid, and mail-order, each with differing service delivery models. Corporate and hybrid pharmacies do not charge the NZ$5.00 co-payment on standard prescriptions; however, prescription co-payments were universally removed from 1July 2023. Aim This research aims to describe the consumer profiles of Aotearoa New Zealand's different types of community pharmacies prior to the removal of the prescription co-payment. Methods A nationwide retrospective observational study linked 1-year of dispensing data (1 March 2022-28 February 2023) from the Pharmaceutical Collection to patient enrolment data using a National Health Index (NHI) number to identify the demographic details of people who use the different pharmacy types. People were assigned to a particular type of pharmacy if they collected at least 70% of their prescriptions from there; if they did not meet this threshold, they were defined as mixed users. Results Independent pharmacies had an older customer base and fewer Asian users compared to other pharmacy types. Hybrid pharmacies served a greater proportion of Pacific peoples and those from areas of high deprivation. Maori made up relatively equal proportions of users across all pharmacy types. Areas without major cities had fewer corporate pharmacies and only four hybrid pharmacies were identified outside of Auckland. Discussion There appears to be differences in the consumer profiles of the different pharmacy types. These results will serve as a comparison to how removing prescription co-payments shifts patients' behaviour.

Exploring the Important Determinants Shaping Treatment Preferences: Qualitative Insights into Breast Cancer Patient Experiences and Perspectives in New Zealand.

Purpose: Despite the importance of acknowledging patient preferences in treatment decision-making, little is known about the treatment preferences and the factors underlying those preferences of breast cancer patients. This study aims explore patient experience and perspective regarding treatment preferences and identify the important determinants that shape these preferences in the context of New Zealand. Patients and Methods: Semi-structured online interviews comprised of six focus group discussions and five individual interviews were performed with 26 breast cancer patients. The interviews were recorded, transcribed, and analyzed using the reflexive thematic analysis approach. Results: Four main themes were derived: (1) positive treatment outcomes; (2) the negative impact of treatment-related side effects on quality of life; (3) treatment accessibility, availability, and timeliness; (4) cost of treatment. Patients revealed a strong preference towards treatments that yield longer survival, achieve remission, and prevent cancer recurrence. Additionally, patients favored treatments with minimal side effects that had minimal impact on their quality of life. There was a notable preference for treatments that were easily accessible and available in a timely manner. However, patients faced challenging decisions in balancing the costs of treatments with their benefits, leading to a consistent preference for treatments supported by government funding or medical insurance to alleviate financial burdens. Conclusion: Our study reveals that breast cancer patients in New Zealand have different perceptions and preferences regarding cancer treatment. Patients frequently find themselves making trade-offs among various attributes of a treatment, aligning these decisions with their personal values and beliefs. By considering these preferences and trade-offs in future studies that measure patient preferences, healthcare professionals can enhance their support for patients in making informed choices that align with their values and priorities. Additionally, healthcare policymakers can develop patient-centered policies that cater to the unique needs and preferences of breast cancer patients.

Understanding Patient Preferences Regarding the Important Determinants of Breast Cancer Treatment: A Narrative Scoping Review.

Objective: Conventionally, optimal treatment strategies for breast cancer have been largely determined by physicians, with a scant understanding of patients' treatment values and preferences. Incorporating patient preferences in the decision-making process for breast cancer treatment is gaining recognition and can potentially improve treatment outcomes and compliance. This scoping review aims to synthesize evidence on the key determinants that are most valued by breast cancer patients when deciding on their treatment options. Methods: We searched three electronic databases (PubMed/MEDLINE, SCOPUS, and CINAHL Plus) utilizing a systematic scoping review method. Two reviewers independently screened, applied inclusion criteria, reviewed, and synthesized findings. A mixed-method narrative approach combining the inductive thematic analysis and content analysis methodologies was used to synthesize and summarize the findings. Results: The review included 22 studies, leading to the conceptualization of 5 overarching themes and 17 sub-themes. Among these, the most frequently cited theme was treatment benefits, followed by treatment-related process, treatment-related risk, quality of life, and cost of treatment. Women with breast cancer highly value treatments that offer good effectiveness, prolong survival, prevent recurrence, and maintain quality of life. Patient concerns include treatment-related side effects, safety, the risk of secondary cancer, and direct or indirect out-of-pocket costs. Additionally, patients also consider treatment duration, mode of administration, physician recommendation, and treatment availability and accessibility when deciding on their preferred treatment. Conclusion: The evidence synthesized in this review offers insights into refining breast cancer treatment strategies to align more closely with patient values. Recognizing and integrating patient perspectives in breast cancer care could potentially lead to improved treatment outcomes, enhanced patient compliance, and more personalized care. Healthcare professionals are encouraged to incorporate these key determinants in their treatment decision-making processes, aiming to deliver a patient-centered care that aligns with the unique preferences and values of each patient.

Cost-Effectiveness of Pharmacist Prescribing for Managing Hypertension in the United States.

Importance: Pharmacist-led interventions can significantly improve blood pressure (BP) control. The long-term cost-effectiveness of pharmacist-prescribing interventions implemented on a large scale in the US remains unclear. Objective: To estimate the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve BP control in the US. Design, Setting, and Participants: This economic evaluation included a 5-state Markov model based on the pharmacist-prescribing intervention used in The Alberta Clinical Trial in Optimizing Hypertension (or RxACTION) (2009 to 2013). In the trial, control group patients received an active intervention, including a BP wallet card, education, and usual care. Data were analyzed from January to June 2023. Main Outcomes and Measures: Cardiovascular (CV) events, end-stage kidney disease events, life years, quality-adjusted life years (QALYs), lifetime costs, and lifetime incremental cost-effectiveness ratio (ICER). CV risk was calculated using Framingham risk equations. Costs were based on the reimbursement rate for level 1 encounters, medication costs from published literature, and event costs from national surveys and pricing data sets. Quality of life was determined using a published catalog of EQ-5D utility values. One-way sensitivity analyses were used to assess alternative reimbursement values, a reduced time horizon of 5 years, alternative assumptions for BP reduction, and the assumption of no benefit to the intervention after 10 years. The model was expanded to the US population to estimate population-level cost and health impacts. Results: Assumed demographics were mean (SD) age, 64 (12.5) years, 121 (49%) male, and a mean (SD) baseline BP of 150/84 (13.9/11.5) mm Hg. Over a 30-year time horizon, the pharmacist-prescribing intervention yielded 2100 fewer cases of CV disease and 8 fewer cases of kidney disease per 10 000 patients. The intervention was also associated with 0.34 (2.5th-97.5th percentiles, 0.23-0.45) additional life years and 0.62 (2.5th-97.5th percentiles, 0.53-0.73) additional QALYs. The cost savings were $10 162 (2.5th-97.5th percentiles, $6636-$13 581) per person due to fewer CV events with the pharmacist-prescribing intervention, even after the cost of the visits and medication adjustments. The intervention continued to produce benefits in more conservative analyses despite increased costs as the ICER ranged from $2093 to $24 076. At the population level, a 50% intervention uptake was associated with a $1.137 trillion in cost savings and would save an estimated 30.2 million life years over 30 years. Conclusion and Relevance: These findings suggest that a pharmacist-prescribing intervention to improve BP control may provide high economic value. The necessary tools and resources are readily available to implement pharmacist-prescribing interventions across the US; however, reimbursement limitations remain a barrier.

A systematic review of economic evaluations of pharmacist services.

BACKGROUND: Challenges to the provision of health care are occurring internationally and are expected to increase in the future, further increasing health spending. As pharmacist roles are evolving and expanding internationally to provide individualised pharmaceutical care it is important to assess the cost-effectiveness of these services. OBJECTIVES: To systematically synthesise the international literature regarding published economic evaluations of pharmacy services to assess their cost-effectiveness and clinical outcomes. METHODS: A systematic review of economic evaluations of pharmacy services was conducted in MEDLINE, EMBASE, PubMed, Scopus, Web of Science, CINAHL, IPA and online journals with search functions likely to publish economic evaluations of pharmacy services. Data were extracted regarding the interventions, the time horizon, the outcomes and the incremental cost-effectiveness ratio. Studies' quality of reporting was assessed using the Consolidated Health Economic Evaluation Reporting Standard (CHEERS) statement. RESULTS: Seventy-five studies were included in the systematic review, including 67 cost-effectiveness analyses, 6 cost-benefit analyses and 2 cost-consequence analyses. Of these, 57 were either dominant or cost-effective using a willingness-to-pay threshold of NZ$46 645 per QALY. A further 11 studies' cost-effectiveness were unable to be evaluated. Interventions considered to be most cost-effective included pharmacist medication reviews, pharmacist adherence strategies and pharmacist management of type 2 diabetes mellitus, hypertension and warfarin/INR monitoring. The quality of reporting of studies differed with no studies reporting all 28 items of the CHEERS statement. CONCLUSIONS: There is strong economic evidence to support investment in extended pharmacist services, particularly those focussed on long-term chronic health conditions.

What do pharmacy users think of free pharmacy services? Investigating pharmacy users' perceptions, attitudes and willingness to pay for free healthcare from pharmacies.

Background: Evidence exists of pharmacists providing free or partially subsidised clinical services in order to meet patient healthcare needs. Little is known about how patients perceive the quality and importance of such unfunded services to their healthcare. Objectives: To explore pharmacy user perspectives about unfunded services such as their valuation, why they chose to access these services from the pharmacy as well as their willingness to pay should pharmacies need to start charging for the provision of such services owing to budgetary constraints. Methods: This study was nested in a larger nationwide study where 51 pharmacies were recruited across fourteen locations across New Zealand . Semi-structured interviews were conducted with patients who had accessed unfunded services in community pharmacies. Patients were followed up to identify their percieved health outcomes resulting from accessing the unfunded service. Results: A total of 253 patient interviews were conducted on-site across 51 pharmacies in New Zealand. Two main themes were identified pertaining to (1) patient-provider relationship and (2) Willingness to pay. A total of fifteen different considerations were found to influence pharmacy users' decisions to access health services from the pharmacy. It was found that 62.8% of patients were willing to pay for unfunded services and the majority paying NZD$10. Conclusion: Patients positively rate these services and largely deem them important for their healthcare. Willingness to pay for services were also variable between patients and were dependant on the type of service accessed.

Messaging preferences for the role of pharmacists in pharmacy education recruitment material.

INTRODUCTION: Applications to pharmacy programs are declining worldwide. Previous research suggests that positioning of recruitment material according to prospective students' preferences may increase interest in the profession and entry-to-practice programs. The aim of this study was to determine messaging preferences for the role of the pharmacist. METHODS: This was a best-worst choice survey conducted at one institution in one country. Participants included prospective students, current pharmacy students, and others representing the general public. Thirteen statements (plus one control) describing the role of the pharmacist were extracted from pharmacy program websites. Survey participants completed the best-worst choice analysis, and a conditional logit model was used to estimate statement preference coefficients. RESULTS: A total of 150 complete survey responses were collected. The top ranked statement was, "Pharmacists are health care professionals who are experts in medicines" and the least ranked statement was the control statement, "Pharmacists are experts in dispensing medications and counting tablets." No differences were observed between the different groups of survey respondents. Other highly ranked statements spoke to the expertise of the pharmacist and promoted a well-defined role. Catchy statements, such as "Pharmacists are medicines superheroes," were not ranked highly. CONCLUSIONS: This study found that current and prospective pharmacy students preferred descriptive and explicit messages that align with pharmacists' professional identity for promotion of the pharmacist's role.

Impact of Promotional Videos on Public Perception of Pharmacy Services.

Background: Promotional videos are an effective means of marketing products or services in this era of social media. However, little is known if such videos can be a useful tool to promote pharmacy services. Objective: To assess the impact of promotional videos on public awareness of the health services provided by New Zealand pharmacists. Methods: This experimental study used an online questionnaire and promotional videos developed by the Pharmaceutical Society of New Zealand as an intervention to assess the public's perspectives about pharmacy services before and after the intervention. The survey was sent out to 1 127 randomly selected members of the public aged 18 and above from all over New Zealand. Data were analysed using descriptive statistics and thematic analysis. Results: A total of 313 participants completed the survey. The majority (95.8%) had not heard of the promotional videos before. However, 84.3% found the videos informative and nearly three-quarters (74.1%) reported a change in their perception of pharmacy services after watching the video. Similarly, 63.2% reported that they or a family member would be more likely to visit a pharmacy in the future after watching the promotional video. Less than half (40%) of the participants reported that the videos were too long and only 11.5% found them boring. Conclusion: The PSNZ videos were found to be an effective tool for educating New Zealanders on different pharmacy services and the pharmacy profession, however, there is a need to choose the advertising platform carefully so as to enhance the coverage.

Reducing the burden of knee osteoarthritis through community pharmacy: Protocol for a randomised controlled trial of the Knee Care for Arthritis through Pharmacy Service.

INTRODUCTION: Knee osteoarthritis (OA) negatively impacts the health outcomes and equity, social and employment participation, and socio-economic wellbeing of those affected. Little community-based support is offered to people with knee OA in Aotearoa New Zealand. Identifying Maori and non-Maori with knee OA in community pharmacy and providing co-ordinated, evidence- and community-based care may be a scalable, sustainable, equitable, effective and cost-effective approach to improve health and wellbeing. AIM: Assess whether the Knee Care for Arthritis through Pharmacy Service (KneeCAPS) intervention improves knee-related physical function and pain (co-primary outcomes). Secondary aims assess impacts on health-related quality of life, employment participation, medication use, secondary health care utilisation, and relative effectiveness for Maori. METHODS AND ANALYSIS: A pragmatic randomised controlled trial will compare the KneeCAPS intervention to the Pharmaceutical Society of New Zealand Arthritis Fact Sheet and usual care (active control) at 12 months for Maori and non-Maori who have knee OA. Participants will be recruited in community pharmacies. Knee-related physical function will be measured using the function subscale of the Short Form of the Western Ontario and McMaster Universities Osteoarthritis Index. Knee-related pain will be measured using an 11-point numeric pain rating scale. Primary outcome analyses will be conducted on an intention-to-treat basis using linear mixed models. Parallel within-trial health economic analysis and process evaluation will also be conducted. ETHICS AND TRIAL DISSEMINATION: Ethical approval was obtained from the Central Health and Ethics Committee (2022-EXP-11725). The trial is registered with ANZCTR (ACTRN12622000469718). Findings will be submitted for publication and shared with participants.

Pharmacists' Satisfaction with Work and Working Conditions in New Zealand-An Updated Survey and a Comparison to Canada.

BACKGROUND: As roles have evolved over time, changes in workplace environments have created higher patient expectations creating stressful conditions for pharmacists. AIM: To evaluate pharmacists' perceptions of their working conditions, work dissatisfaction, and psychological distress; determine their predictors in New Zealand (NZ); and compare results with Canadian studies and historic NZ data. METHODS: A cross-sectional online survey was distributed to registered pharmacists in NZ. The survey included demographics, work satisfaction, psychological distress, and perceptions of their working conditions (six statements with agreement rated on a 5-point Likert scale). Comparisons were made with surveys from Canada and NZ. Chi-square, t-tests, and non-parametric statistics were used to make comparisons. RESULTS: The response rate was 24.7% (694/2815) with 73.1% practicing in a community pharmacy (45.8% independent, 27.3% chains). Pharmacists disagreed on having adequate time for breaks and tasks, while the majority contemplated leaving the profession and/or not repeating their careers again if given the choice. Working longer hours and processing more prescriptions per day were predictive factors for poorer job satisfaction. More NZ pharmacists perceived their work environment to be conducive to safe and effective primary care (57% vs. 47%, p < 0.001) and reported that they had enough staff (45% vs. 32%, p = 0.002) as compared to Canadian pharmacists. Pharmacists' job satisfaction and psychological distress have not improved compared to the assessment 20 years prior. CONCLUSIONS: NZ pharmacists perceive working conditions to be sub-optimal yet had higher satisfaction than their Canadian counterparts. Work dissatisfaction and psychological distress are high and have not improved over the last two decades.

Impact of removing prescription co-payments on the use of costly health services: a pragmatic randomised controlled trial.

OBJECTIVES: To determine whether exempting people (with high health needs and living in areas of high deprivation) from a $5 prescription charge reduces hospital use. DESIGN: Two-group parallel prospective randomised controlled trial. SETTING: People living in the community in various regions of New Zealand. PARTICIPANTS: One thousand sixty one people who lived in areas of high socioeconomic deprivation, and either took medicines for diabetes, took antipsychotic medicines, or had chronic obstructive pulmonary disease (COPD). Of the 1053 who completed the study, just under half (49%) were Maori. INTERVENTIONS: Participants were individually randomized (1-1 ratio) to either be exempted from the standard $5 charge per prescription item for one year (2019-2020) (n = 591) or usual care (n = 469). Those in the intervention group did not pay the standard NZ$5 charge, and pharmacies billed the study for these. Participants continued to pay any other costs for prescription medicines. Those in the control group continued to pay all prescription charges for the year although they may have received one-off assistance from other agencies. MAIN OUTCOME MEASURES: The primary outcome was length of stay (hospital bed-days). Secondary outcomes presented in this paper included: all-cause hospitalisations, hospitalisations for diabetes/mental health problems/COPD, deaths, and emergency department visits. RESULTS: The trial was under-powered because the recruitment target was not met. There was no statistically significant reduction in the primary outcome, hospital bed-days (IRR = 0.68, CI: 0.54 to 1.05). Participants in the intervention group were significantly less likely to be hospitalised during the study year than those in the control group (OR = 0.70, CI: 0.54 to 0.90). There were statistically significant reductions in the number of hospital admissions for mental health problems (IRR = 0.39, CI: 0.17 to 0.92), the number of admissions for COPD (IRR = 0.37, CI: 0.16 to 0.85), and length of stay for COPD (IRR 0.20, CI: 0.07 to 0.60). Apart from all-cause mortality and diabetes length of stay, all measures were better for the intervention group than the control group. CONCLUSIONS: Eliminating a small co-payment appears to have had a substantial effect on patients' risk of being hospitalised. Given the small amount of revenue gathered from the charges, and the comparative large costs of hospitalisations, the results suggest that these charges are likely to increase the overall cost of healthcare, as well as exacerbate ethnic inequalities. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12618001486213 registered on 04/09/2018.

Do entry year pharmacy students have similar personal characteristics? Comparing personalities, professional goals, and role perceptions.

BACKGROUND: Schools and faculties of pharmacy are responsible for selecting students to admit into the profession. Despite many similarities, admission processes, pharmacists' training, and scope of practice are different across jurisdictions. Students that are selected for admission may then differ in a number of ways, including by personality traits and other individual difference measures. OBJECTIVE: To compare the trait characteristics between students entering a New Zealand (NZ-University of Otago) and Canadian ((University of Waterloo) pharmacy programme and to compare their professional goals and role perceptions. METHODS: Incoming first year students at each university were invited to take an online questionnaire that included personality characteristics and potential predictors of involvement in pharmacists' roles: (1) the Big Five Inventory (openness, conscientiousness, extraversion, agreeableness, neuroticism); (2) the Achievement Goals Questionnaire-Revised; (3) the Rational Experiential Inventory; and (4) Counsellor Role Orientation. Statistical tests were conducted to determine if there were differences between entry level pharmacy students from NZ and Canada. RESULTS: 184 students (97/150 Otago, 87/118 Waterloo) completed the survey. On average, Waterloo students scored higher on agreeableness (M = 80 vs. 76, p = 0.06), conscientiousness (M = 70 vs. 68, p = 0.30), mastery-approach (M = 93 vs.90, p = 0.06), and faith-in-intuition (M = 67 vs. 61, p = 0.03) compared to Otago pharmacy students who were higher for openness M = 70 vs. 66, p = 0.09). An item measuring reliance on physicians for medicine advice was endorsed more by Otago pharmacy students (M = 35 vs. M = 15, p < 0.001). Items on time pressure (e.g., "It takes too much time to for a pharmacist to talk with a patient about the medication they receive") were higher for Otago students (M = 41 vs. M = 38, p = 0.26). Higher scores for pharmacist restriction ("There should be legal restrictions on what pharmacists can tell patients") were also seen among Otago students (M = 26 vs. M = 12, p < 0.001). There were important differences between entry level pharmacy students and practicing pharmacists in both jurisdictions. DISCUSSION: While entry-level pharmacy students had similar personality profiles, differences were observed in role expectations and in experiential learning orientation. This highlights differing societal views on the role of pharmacists in each respective country. Pharmacy schools should study their student bodies when designing their curricula and electives, helping ensure graduates feel like they have the training to do what they need to do. Future work will determine if these personality and learning goals influence students' preparation for practice.

Knee osteoarthritis and the knowledgeable, trustworthy pharmacist: Patient and pharmacist perceptions of community pharmacy-based education and support.

BACKGROUND: Osteoarthritis (OA) clinical guidelines recommend self-management education, but education is often not included in primary care consultations. OBJECTIVE: To explore pharmacists' and patients' perceptions of a pharmacist-led model of service delivery for knee OA that was integrated within pharmacies' day-to-day workflow. METHODS: Cross-sectional qualitative design using Thematic Analysis. Community pharmacies were recruited in New Zealand and Australia. Pharmacy patients were screened for knee OA and offered tailored explanations, self-management information and referral for further support. Pharmacist focus groups and patient 1:1 interviews explored perceptions of the service delivery model. RESULTS: Nineteen pharmacists and 12 patients with knee OA participated. Pharmacist and patient data were analysed separately, with themes compared and contrasted to derive three meta-themes. Meta-theme 1: 'Welcome Engagement' included two pharmacist themes ('putting my broad skill set to use' and 'we're here and happy to help') and two patient themes ('information delivered well' and 'a welcome offer of help'). Meta-theme 2: 'The Knowledgeable and Trustworthy Pharmacist' included two pharmacist themes ('professional knowledge to help all sorts of patients' and 'managing time to help my patients') and one patient theme ('the accessible professional who I know and trust'). Meta-theme 3: 'The Opportunity for More Support' included one pharmacist theme ('this is not the end of the story') and one patient theme ('more help is available'). CONCLUSION: Community pharmacists are well-positioned to provide information and support to people with knee OA. Pharmacists appreciate the opportunity to better use their skills and accessibility for OA care, and patients welcome this engagement.

Investigating the provision, nature and associated costs of unfunded pharmacy services: A nationwide study.

BACKGROUND: There is increasing evidence of pharmacists providing free or partially subsidised patient-focused services in order to meet healthcare needs. Limited information exists about the types of unfunded services and their value. OBJECTIVES: (1) Identify the types of unfunded services provided nationally in New Zealand (NZ) and (2) Determine the costs associated with service provision. METHODS: A continuous observation time-motion study was conducted across New Zealand to characterise the provision of unfunded pharmacy services and the labour costs associated with their provision. The time-motion study spanned one business day (between seven to eight hours) in each participating pharmacy. The primary investigator (YA) spent one business day in each participating pharmacy (n = 51) and recorded details about the patient-focused services that were provided. Details included the type of service provided, approximate duration of the service and out-of-pocket costs borne by the patient. RESULTS: A total of 660 observations of unfunded services were recorded across the 51 pharmacies where 360 observation hours were carried out. Twenty-three types of unfunded services were identified, where minor ailments accounted for over half of the total observations. Labour costs associated with service provision were variable. CONCLUSION: Pharmacies across New Zealand are providing patient-focused services for which no funding is being provided.

Feasibility of a randomised controlled trial of two types of written information for people with knee osteoarthritis.

Objective: Test the feasibility of conducting an individually randomised controlled trial recruiting people with knee osteoarthritis (OA) in community pharmacies and evaluate the impacts of a novel information booklet. Design: People with knee OA were identified by pharmacy staff using clinical criteria and randomised to receive a novel information booklet (intervention) or the currently available written OA resource (active control). Mixed-methods process evaluation assessed participant recruitment, retention, and experience. Participant-reported outcome measures, assessing OA illness perceptions, OA knowledge, fear of movement, and pain when walking at baseline and 4-weeks, were analysed using linear regression models (adjusted for baseline). Results: Of 72 eligible people, 64 were randomised to intervention (n â€‹= â€‹33) or control (n â€‹= â€‹31). The randomisation sequence was followed correctly and no protocol deviations identified. Mean recruitment rate was 2.7 participants per pharmacy per week. One-in-five participants had no educational qualifications and one-in-four had not received a knee OA diagnosis prior to the trial. Three meta-themes emerged from pharmacist and participant qualitative analysis: 'pleased to be asked'; 'easy process'; and 'successful process'. Three participants were lost to follow-up. At 4 weeks, intervention arm Knee Osteoarthritis Knowledge Scale scores improved (mean difference â€‹= â€‹3.6, 95%CI 0.7 to 6.5). Brief Illness Perceptions Questionnaire scores were similar between groups (mean difference 0.4, 95%CI -3.7 to 4.5). Conclusion: It is feasible to conduct an individually randomised trial in community pharmacy, a potentially effective setting to initiate accessible OA care. A novel information booklet improved OA knowledge, but is unlikely to affect illness perceptions on its own.

A Systematic Review of Independent and Chain Pharmacies Effects on Medication Adherence.

As the last step in the care pathway, pharmacies can significantly impact a patient's medication adherence and the success of treatment. The potential impact of patient's pharmacy choice on their medication adherence has yet to be established. This study aims to review the impact a pharmacies ownership model, either independent or chain, has on its users' medication adherence. As a generalisation, independent pharmacies offer a more personal service and chain pharmacies offer medications at lower prices. A keyword search of EMBASE and MEDLINE databases in March 2022 identified 410 studies, of which 5 were deemed to meet our inclusion criteria. The studies mostly took place in North America, measured medication adherence using pharmacy records over a 12-month period. This review was unable to substantiate a difference in the rate of medication adherence between the users of independent and chain pharmacies. However, those with a lower income, greater medication burden, and increased age appeared to use an independent pharmacy more than a chain pharmacy and to have greater medication adherence when doing so. Establishing the differences in service provision between types of pharmacies and why people choose a pharmacy to frequent should be a focus of future research.

Pharmacy postgraduate education transformation: pharmacist preferences for microcredentials.

OBJECTIVES: To explore micro-credentialing for postgraduate study in pharmacy practice. METHODS: An online survey of practicing or intern pharmacists in New Zealand was designed to identify learner preferences for education, determine interest and demand for microcredentials and elicit preferred 'willingness-to-pay' thresholds. KEY FINDINGS: A total of 430 responses were obtained. A stacked microcredential programme was preferred by 88% over traditional courses. Interest, skill development and career development were the top-ranked aspects. Participants favoured the lowest cost option ($300 NZD per microcredential). CONCLUSIONS: Pharmacists in New Zealand are supportive of microcredentials for postgraduate study as an alternative to traditional programmes.

Identifying New Zealand Public Preferences for Pharmacist Prescribers in Primary Care: A Discrete Choice Experiment.

BACKGROUND AND OBJECTIVE: Given increasing patient populations, general practitioner workforce constraints and the growing demand for health services in New Zealand (NZ), the development and provision of pharmacist prescribing services could be used to improve people's access to medicines. A discrete choice experiment (DCE) was utilised to determine NZ public preferences for pharmacist prescribing services in primary care in NZ. METHODS: A D-efficient DCE design generated 20 choice questions in four blocks of five questions with three labelled alternatives per choice question. The online DCE used a NZ general public online research panel administered by an external organisation (SurveyEngine). The DCE included six attributes with two attributes each with two levels (location of consultation and consultation type), three levels (type of service and operating hours) and four levels (waiting time and cost). RESULTS: Nine hundred and twenty-four respondents completed the survey with 4620 observations available for analyses. Respondents preferred pharmacist prescribing services with the following characteristics: optimisation of medicines and changes to only current medicine service types (relative to repeat prescribing); lower consultation costs, shorter waiting times, longer operating hours and consultation by appointment (relative to walk-in and wait clinic). CONCLUSIONS: Prescribing policy could incorporate these public preferences to help develop accessible and effective primary care prescribing services utilising the skills of pharmacist prescribers to improve and reduce inequities in access to medicines in NZ. These results suggest the NZ public see pharmacists as part of the primary care prescribing team and are willing to utilise them if these services are implemented.

Prevalence of joint-specific osteoarthritis and joint pain in British Columbia, Canada.

The objective is to determine the prevalence of self-reported physician-diagnosed osteoarthritis (OA) and musculoskeletal symptoms (pain, stiffness or discomfort) in specific joints among adults in British Columbia (BC), Canada. We carried out a cross-sectional mixed-mode survey in a random population sample of persons 18 years of age and older. Estimates were weighted to reflect the age and sex distribution of the population of BC. We obtained responses from 2,233 individuals. Overall, 18.4% (95% CI 16.8-20.1) of the adult population reported OA. Of those, more than 40% had OA in multiple sites. Prevalence ranged from 8.8% (95% CI 7.6-10.1) in the knee to 2.7% (2.1-3.5) in the foot. One-year prevalence of symptoms ranged from 49.1% (47.0-51.2) in the lower back to 23.3% (21.5-25.1) in the hip. Females reported more symptoms and OA than males in all joints. The most common site of self-reported physician-diagnosed OA in BC is the knee, but OA in the hands, hips, and feet is also common. Having OA in one joint is a strong predictor of OA in other joints.