Effect of a Smoking Cessation Education Program on the Knowledge, Attitude, and Self-Efficacy of Community Pharmacists in Japan: A Quasi-Experimental Study.

Background: Supporting smoking cessation at pharmacies can be challenging owing to difficulties in recruiting smokers to participate in cessation programs, insufficient communication skills among pharmacists, and lack of knowledge and self-efficacy in successfully quitting smoking in Japan. Objective: This study evaluates the effectiveness of a smoking cessation training program on community pharmacists' knowledge, attitude, and self-efficacy in supporting smoking cessation. Methods: The study, conducted in Japanese pharmacies with 100 community pharmacists, employed a quasi-experimental design. Two online training programs were implemented. Participants completed a web-based survey assessing their knowledge, attitude, and self-efficacy in supporting smoking cessation before, immediately after, and 1 year after the training program. A two-way analysis of variance with a mixed model was used to examine score changes at each time point. Results: Total knowledge scores significantly increased between baseline and immediately after training and baseline and 1 year after training. The total attitude scores between baseline and immediately after training differed significantly. However, no differences were noted between baseline and 1 year after training. Total self-efficacy scores significantly increased at baseline, immediately after training, and between baseline and 1 year after training. Despite no significant interactions between the programs, there was a partial interaction effect on knowledge, with only the customized program having items whose knowledge levels improved after 1 year. Conclusion and Relevance: The training program improved community pharmacists' knowledge, attitude, and self-efficacy regarding smoking cessation support. The customized program must be reinforced to improve support performance and maintain attitude.

Utilization and Issues Related to Discharge Medication Summaries from Hospital Pharmacies to Community Pharmacies.

In 2020, the Japan Community Healthcare Organization (JCHO) Hoshigaoka Medical Center started providing information to community pharmacies about patients admitted to the acute care ward using discharge medication summaries (the summaries). We conducted an online self-recording survey of 149 pharmacies belonging to the Hirakata City Pharmacists Association to clarify the usability of the summaries, any related issues, and to further discuss future collaboration between hospitals and pharmacies. 46 pharmacies have received the summaries in the past, of which 44 pharmacies answered that they have utilized the summaries with patient instruction and prescription queries of doctors. However, two pharmacies responded they did not utilize the summaries, and the reasons were (a) the information was not timely and (b) patients whom the discharge medical summary was sent for did not come to the pharmacy. There were some requests regarding the summaries such as, "I would like to know what kind of information hospital pharmacists want from community pharmacists." Preference for sharing information other than the summaries (e.g., online tools) with hospital pharmacists was related to whether the pharmacy was providing home pharmaceutical visit services. The survey revealed that, in addition to the usability of the summaries, there are also events that prevent them from being utilized. Some of the challenges include the timing of sending the summaries, the accurate identification of the family pharmacy and the communication of follow-up after discharge from hospital. Collaborating with pharmacies providing home pharmaceutical visit services would be beneficial in creating new system of bidirectional information sharing.

A qualitative study on the process of dietitians working in pharmacies to practice dietary habit improvement support in their daily work

Background: Recently in Japan, there have been some cases of pharmacies staffed with dietitians in an effort to improve their health support functions. However, there have been few reports on the effects of these efforts, and it has been pointed out that dietitians may not be fully exercising their professional abilities. We conducted a before-and-after comparison study in 2022 to confirm the effectiveness of collaboration between pharmacy dietitians and pharmacists in supporting patients with type 2 diabetes. Objective: This study aimed to investigate the process by which dietitians who participated in our research project became accustomed to providing continuous dietary counseling as a matter of habit. Methods: Semi-structured interviews were conducted with three dietitians and two pharmacists. The main questions asked were about 1) the nature of their work before they began providing the interventions, 2) the aspects they paid attention to while providing the interventions, 3) what they felt they had changed during the intervention period, and4) what they considered obstacles to providing nutritional guidance in their pharmacies. Results: The responses of the participants regarding the nature of their work before they began providing interventions were mostly related to their “work as a dispensing clerk.” The dietitians also indicated their desire for more continuous dietary support. The responses of the participants regarding what they felt had changed during the intervention period included numerous references to having an “opportunity for trial and error” and obtaining the “cooperation of staff.” In the responses regarding what the participants considered obstacles, the dietitians mentioned “recognition by patients” and “an environment in which they can consult with patients.”... (AU)

A pilot study of Pharmacist-Dietician Collaborative support and Advice (PDCA) for patients with type 2 diabetes in community pharmacy: A single-arm, pre-post study

Background: In Japan, there is a pressing need to improve community health care to cope with the rapid aging of the population. In this context, there have been private-sector-led approaches to enhance community dietary support by employing dietitians in pharmacies. Objectives: To evaluate the effects of collaboration between dietitians and pharmacists working in pharmacies to support patients with type 2 diabetes. Methods: A single group pre- and post-comparative study was conducted on patients with type 2 diabetes mellitus. The intervention period was 6 months. During the intervention period, the dietitians provided dietary support to the patients after first providing them with medication guidance. The contents of these instructions were shared with the pharmacists. The contents of the instructions were recorded, and confirmed in monthly meetings with the principal investigator. The primary endpoint was the Hemoglobin A1c(HbA1c) level, and the secondary endpoints were high-density lipoprotein-cholesterol (HDL-c), low-density lipoproteincholesterol (LDL-c), Triglyceride (TG), degree of dietary self-management, degree of unbalanced diet and satisfaction with pharmacy services. Results: Eight patients completed the intervention period. The first patient’s intervention started in March 2021, and all patients’ interventions were completed by December 2021. The primary endpoint, the mean (SD) HbA1c, was 7.26 (0.96) at baseline and decreased to 6.63 (0.79) after 6 months (p=0.028, r=0.72). Also, the HDL-c increased from 55.00 (14.81) to 63.14 (10.11) (p=0.110, r=0.51) and the Diabetes Mellitus Dietary Self Efficacy Scale score increased from 51.67 (8.31) to 60.17 (8.45) (p=0.025, r=0.79) and the patient satisfaction score increased 24.0 (4.0) to 26.1 (3.3) (p=0.161, r=0.51). Moderate decreases were also observed in LDL-c (p=0.235, r=0.47) and TG (p=0.368, r=0.37). (AU)

Self-efficacy of community pharmacists and associated factors in counselling to support self-medication in Japan: A crosssectional study

Background: In 2016, the Ministry of Health, Labour and Welfare established the Health Support Pharmacy Certification System. The certification requirements include a track record of counseling regarding the use of over-the-counter drugs (OTC). Therefore, pharmacists must increase their self-efficacy for counseling. Objectives: To determine pharmacists’ self-efficacy for OTC counseling and related factors. Methods: A web-based survey was conducted. Multivariate analysis was conducted to test the relationship among the mean scores of self-efficacy for OTC counselling for 25 symptoms, pharmacist attributes, years of work, psychosocial factor, job satisfaction, and level of trust from the community and patients. Results: We received responses from 250 people. The overall self-efficacy was 5.8 (SD= 2.4) but varied depending on the symptoms. Self-efficacy was relatively high for allergic symptoms (6.9), cold/influenza (6.9), and constipation (7.1), but relatively low for contraceptive drugs (3.8), palpitation/shortness of breath (4.6), and abnormal taste/smell (4.2). In bivariate analysis, items related to self-efficacy included “age” (Spearman correlation= 0.276, P<0.001), “academic background” (-0.208, P=0.001), “number of years of work” (0.267, P<0.001), “level of trust from the community” (0.155, P=0.014), “level of trust from patients” (0.271, P<0.001), “job satisfaction” (0.236, P<0.001), “role clarity” (0.181, P=0.004), and “positive challenge at work” (0.271, P<0.001). Multivariate analysis indicated that the number of years of work (Standardizing Coefficient: 0.22), trust from patients (0.13), and positive challenge at work (0.25) had a positive effect on self-efficacy. (AU)

A Cross-sectional Study of Demonstrating Expertise and Job Satisfaction in Pharmacists and Dietitians Working in Community Pharmacies in Japan

Background: In Japan, there has been a private-sector initiative to register dietitians in pharmacies. There is not yet an adequate amount of data on the attitudes of dietitians in pharmacies regarding their work. Objectives: To assess the attitudes of pharmacists and dietitians working in community pharmacies in Japan about their work, and particularly about demonstrating expertise and overall job satisfaction. Methods: We administered a web-based questionnaire to pharmacists and dietitians working in pharmacy branches with registered dietitians at two pharmacy chains that agreed to cooperate. We used our own 7-item questionnaire and compared the scores for each item between pharmacists and dietitians. Results: A total of 61 persons (22 pharmacists and 39 dietitians) answered the questionnaire. The item with the highest mean score (standard deviation) for pharmacists was “I feel that I am helpful to patients,” at 3.50 (0.74), and for dietitians it was “I have colleagues at my workplace whom I can talk to when I have a problem,” at 3.51 (1.00). Conversely, the items with the lowest mean score (standard deviation) were “I am satisfied with my current job” for pharmacists, at 3.14 (0.83), and “I can grow sufficiently as a professional” for dietitians, at 2.41 (0.97). As a result of factor analysis, the seven-item question could be divided into two factors: “demonstrating expertise” and “overall job satisfaction.” The factor-score for “demonstrating expertise” was significantly lower for dietitians than for pharmacists (p<0.01), but there was no significant difference in overall job satisfaction between the two professions (p=0.36). Further research is needed to understand why dietitians find “demonstrating expertise” difficult in pharmacies. (AU)

Creation and validation of a semi-quantitative instrument to assess the confidence of pharmacists in medication consultation for patients with depression: The Pharmacists' Confidence scale about Medication Consultation for Depressive patients (PCMCD)

OBJECTIVES: To develop a semi-quantitative instrument to assess pharmacists' confidence in medication counseling for patients with depression, The Pharmacists' Confidence scale about Medication Consultation for Depressive patients (PCMCD), and investigated its validity. METHODS: Following discussions with practicing pharmacists, we developed a 12-item questionnaire to assess pharmacists' confidence in medication counseling for patients with depression. We launched web-based cross-sectional survey during November and December 2018 to 77 pharmacists employed at drug chain stores in Kansai area. Factor analysis was performed to evaluate the configuration concept validity. The least-squares method was used for factor extraction, and the resulting factors were subjected to direct oblimin rotation, with a factor loading cut-off of 0.4. To assess internal consistency, Cronbach's alpha values were calculated for each of the extracted factors (subscales). A multiple regression analysis was performed using simultaneous forced entry, with the scores obtained for each subscale as dependent variables and responder attributes as independent variables in order to investigate the factors associated with each subscale. RESULTS: During the factor analysis procedure, four questions were excluded by the cut-off rule. Eventually, a model with three subscales was identified, with a cumulative sum of squared loadings being 61.9%. The subscales were termed "relationship building," "comprehension of condition," and "information provision" based on the nature of the questions relevant for each of them. The Cronbach's alpha values for these subscales were 0.92, 0.73, and 0.72, respectively. The average inter-item correlation was 0.378. In addition, multiple regression analysis revealed that there were significant correlations between pharmacist career and both relationship building and information provision. CONCLUSIONS: The PCMCD model demonstrated a satisfactory construct validity and internal consistency. This model will provide an excellent tool for assessing pharmacists' confidence in depression care

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