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1.
J Res Pharm Pract ; 8(3): 112-122, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31728341

RESUMEN

Objective: In the United Kingdom (UK), cardiovascular disease (CVD) is the second main cause of death (27.4%) and the leading cause of death in Greece, accounting for 48% incidences. Pharmacists, the most accessible health-care professionals, can have a key role in all stages of CVD prevention. This study aimed to explore the current and future role of pharmacists in CVD prevention, focusing on two European countries, the United Kingdom and Greece. Methods: Semi-structured interviews were conducted with 40 community pharmacists; 20 in the UK and 20 in Greece. All interviews were audio-recorded, transcribed, and analyzed thematically. Findings: Five main themes were identified: current pharmacists' role, future pharmacists' role, communication, resources and tools, and knowledge. Whereas pharmacists in the UK use a patient-centered approach, Greek pharmacists use a paternalistic approach. Nevertheless, the majority found it difficult to initiate a consultation. Both the UK and Greek pharmacists primarily focus on secondary CVD prevention, while dispensing prescribed medications, which is their main current role. Greek pharmacists recognized a potential role in primary prevention and early screening of CVD through the initiation of CVD prevention services with a weight management program being proposed. Barriers identified for a role in CVD prevention included: high workload in Greece and reimbursement issues and interprofessional relations in the UK. Conclusion: Pharmacists in both countries perceive having a potential role in CVD prevention based on their accessibility and customer relations. The challenges include a closer working relationship with other clinicians, communication/consultation skills training, and developing a sustainable funding model for the service.

2.
Pharmacy (Basel) ; 7(4)2019 Nov 16.
Artículo en Inglés | MEDLINE | ID: mdl-31744140

RESUMEN

Continuing Education (CE) or Continuing Professional Development (CPD) are used by pharmacists globally to maintain up-to-date knowledge and skills throughout their careers. The primary aim of this study was to identify the formats or models used by pharmacists for CE and CPD globally. The secondary aim was to identify preferences of pharmacists, in relation to the variety of formats or models used to fulfil mandatory requirements, in order to support future planning of lifelong learning events. A systematic review was performed using PubMed, Science Direct, and Web of Science covering a time period from 1995 until March 2018. Searches were conducted in English, with studies on undergraduate studies being excluded. Eighteen papers from an initial search of 4561 were included from 2004 to 2014. All studies focused on pharmacists. Three studies identified face-to-face learning as a preference, with six studies identifying a positive impact of interactive learning. All four identified studies focusing on online provision were linked to CE. One study highlighted the benefits of blended learning. Two studies identified concluded that no one size fits all. A clear structure of event was highlighted in three studies. Three studies highlighted the relevance of topics to practice, and two studies showed the need for opportunities to apply knowledge. Due to the variety of formats and no consistent model, no perfect model or activity has been identified. However, CPD showed increased practice outcomes versus CE. Although an increasing amount of technology is being utilized, face-to-face learning is still preferred. Interactive, multiple-format learning should be used where possible, to reflect preferences of different learners. There is a need for a structured approach to the planning and learning event itself to support CE and CPD.

3.
Int J Clin Pract ; : e13437, 2019 Oct 17.
Artículo en Inglés | MEDLINE | ID: mdl-31621983

RESUMEN

BACKGROUND: Problems related to poor adherence and inhaler technique (IT) are historically reported in the literature. Most common methods used for adherence and IT assessment are reported to be either inaccurate or subjective. Few electronic monitoring devices (EMDs) that provide an objective measure of both adherence and IT while patients use inhalers at home now exist. Therefore, this study aimed to examine adherence level and IT among respiratory patients in community care using such an EMD for the first time in England. METHODS: A prospective, multicentre, observational cohort study was conducted. Patients with chronic obstructive pulmonary disease (COPD) or asthma were recruited from independent community pharmacies within West and South London. Patients were provided with a dry-powder inhaler (DPI) mounted with an EMD to use for 1 month. Adherence was also assessed using pharmacy dispensing data, inhaler dose counter and self-reporting. RESULTS: Data were available for 48 patients. Only eight patients used their inhaler in the correct manner at the correct interval as identified by the chosen EMD. The median actual adherence rate, as measured by the EMD, was 42.7%. This was significantly different from the median dose counter adherence (100%), medication refill adherence (MRA) (100%), proportions of days covered (PDC) (97.8%) and self-reported adherence (P < .001, each). Within a 1-month period, there were 2188 files showing attempted use of the DPI, of which 840 had IT errors. The median technique error rate (TER) was 30.1%. Most common errors recorded were as follows: multiple inhalations, drug priming without inhalation and failure to prime the device correctly. CONCLUSION: The current study demonstrates that measures such as dose counter, prescription refill and self-reporting showed a high level of adherence among the observed patients. However, the objective data provided by the EMD showed a significantly lower actual adherence rate, reflecting how adherence remains variable and problematic among patients in the community.

4.
Pharmacy (Basel) ; 7(3)2019 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-31266192

RESUMEN

This study aimed to identify and determine the confidence level of community pharmacists in providing different interventions during asthma-targeted medicine use reviews (MURs). A self-administered questionnaire was posted to 487 pharmacies accredited to provide the service, across Greater London, Southampton, Cornwall, Sheffield and Norwich. A total of 122 responses were obtained, giving a response rate of 25% (122/487). Around half of the community pharmacists (51.6%) were providing more than 60 asthma-targeted MURs annually with inhaler technique being the most offered intervention and stepping up/down therapy being the least. The majority of community pharmacists (94.3%) were confident in providing inhaler technique advice, followed by smoking cessation (91%). However, confidence was less with relevant vaccination (61.5%) and stepping up/down patients' therapy (56.6%). Confidence level can vary between community pharmacists regarding different interventions provided during respiratory MURs. The results stress the need to promote community pharmacists' confidence in providing interventions such as stepping up/down therapy during asthma-targeted MURs. Additional research in this field is highly recommended in order to evaluate community pharmacists' confidence level on a national scale and to determine the factors influencing it. The study also suggests that provision of different interventions during respiratory MURs can be related to how community pharmacists perceive their role.

5.
Pharmacy (Basel) ; 7(3)2019 Jul 03.
Artículo en Inglés | MEDLINE | ID: mdl-31277208

RESUMEN

Obesity constitutes one of the main modifiable risks of developing cardiovascular disease. In the UK, in 2016, 30% of the adult population were obese (30% of females and 29% of males). Community pharmacies are ideally situated to offer weight management (WM) services, enabling individuals to control and lose their excess weight. This study aimed at exploring the views of the pharmacy-led WM service providers in England. Semi-structured interviews were conducted with 15 trained community pharmacists and pharmacy staff-11 (73.3%) from Kent, three (20%) from Kingston and Richmond and one (6.7%) from Hackney and City-offering the WM service, either owning or working in independent pharmacies or for pharmacy chains. All interviews were audio-recorded, transcribed and anonymised. The analysis was conducted using thematic analysis. Three themes emerged: training and support, barriers and approach. Interestingly, service providers (SP) stated that obesity is a tough topic to talk about: they found it difficult to start a conversation about it, even if they had received training to facilitate this role. Additionally, several barriers for running such a service were identified, such as lack of time, too much work pressure and too little advertising, which could potentially lead to poor sustainability of the service. SPs can effectively intervene in an individual's weight through the WM service that they offer. It is clear that further training should be provided in order for SPs to feel more comfortable in approaching and communicating with people and to increase the public's awareness of the pharmacy-led WM service, so as to ensure the service's sustainability.

6.
Res Social Adm Pharm ; 15(4): 425-439, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30917894

RESUMEN

BACKGROUND: There are an increasing number of older housebound patients who are not seen by the pharmacists responsible for the provision of their medications. This growing population is increasingly dependent on time-limited carers for their medication support. OBJECTIVES: To evaluate the findings of pharmacist led holistic domiciliary medicine use reviews (dMUR) targeted at this group of housebound patients, in terms of required medication support and the identification of unmet social care needs. METHODS: Patients were identified in the London Borough of Richmond (UK) who were predominantly housebound and taking multiple medications. Twelve community pharmacists visited patients and carried out interviews as part of a structured holistic dMUR, which included understanding the patients' living conditions. RESULTS: Altogether 133 patients completed the dMUR with the pharmacist. Patients had a mean age of 81.7 years (range 49-98 years) and took an average of 9.4 different medications, 3 of which being high risk. Nearly 40% had difficulties taking their medications, including a lack of dexterity or difficulty swallowing. Over a quarter (26.8%) of diabetic patients lacked monitoring. Patients were identified with a risk of falling (14.3%) and inadequate social care (11.3%). Continence, dehydration, hygiene and nutrition issues were found, often caused by mobility problems or a lack of suitable toilet facilities. A need for home modifications such as hand rails to prevent falls was also identified. CONCLUSIONS: This study highlighted the varied difficulties facing housebound patients identified during the pharmacists' visits, including a lack of social care provision and fall hazards. Domiciliary visits by pharmacists may be able to help identify the diverse care needs of isolated housebound patients helping to integrate their care requirements.


Asunto(s)
Servicios Comunitarios de Farmacia , Personas Imposibilitadas/estadística & datos numéricos , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Londres , Masculino , Persona de Mediana Edad , Polifarmacia
7.
BMC Public Health ; 19(1): 138, 2019 Jan 31.
Artículo en Inglés | MEDLINE | ID: mdl-30704425

RESUMEN

BACKGROUND: Preventing type 2 diabetes (T2DM) is one of the biggest health challenges currently facing the UK, with the NHS spending £14 billion each year on treating the disease and associated symptoms. AIMS: The aim of this study was to determine the public's awareness about the symptoms, risk factors and lifestyle choices, commonly associated with T2DM. This study also aimed to determine whether the level of awareness varies if the questions are asked in different languages, primarily those spoken by ethnic minorities. METHODS: This was a cross sectional, multisite study conducted in London, UK, involving 399 participants, who were non-diabetic, aged between 25 and 74 years old and living in one of four selected London boroughs. Descriptive statistics, Chi square and Fisher's Exact Tests were used to highlight and summarise the key findings of this study. RESULTS: A response rate of 23.7% (n = 399/1683) for the English questionnaire was achieved. Overall, 59.4% (n = 237/399) of the cohort were able to identify a minimum of three T2DM symptoms and thus, were considered to have adequate or good awareness. Whereas, 60.6% (n = 242/399) were able to identify a minimum of six T2DM risk factors and were considered to have adequate or good awareness. More participants could correctly identify that obesity was a risk factor of T2DM when they were asked the question in their spoken language, rather than English (p < 0.01). When participants were asked about their current lifestyle choices, there were high levels of inactivity, smoking and alcohol consumption reported. CONCLUSION: Despite approximately half of participants demonstrating adequate or good awareness about the symptoms, risk factors and lifestyle choices commonly associated with T2DM, yet the study still highlights gaps in awareness among the remaining proportion of participants. Future prevention interventions should be tailored to address these existing gaps in awareness.


Asunto(s)
Barreras de Comunicación , Diabetes Mellitus Tipo 2 , Conocimientos, Actitudes y Práctica en Salud , Adulto , Anciano , Estudios Transversales , Femenino , Humanos , Londres , Masculino , Persona de Mediana Edad , Factores de Riesgo , Encuestas y Cuestionarios
8.
BMC Health Serv Res ; 19(1): 5, 2019 Jan 05.
Artículo en Inglés | MEDLINE | ID: mdl-30611264

RESUMEN

BACKGROUND: Community pharmacists' (CPs') interventions have a positive impact on managing respiratory patients. However, methods used by CPs to assess patients' inhaler technique and adherence are subjective. New technologies to objectively assess inhaler technique and adherence were introduced to address such a gap. This study aimed to explore CPs' perceptions towards the management of respiratory patients regarding inhaler technique and adherence. In addition, it explored the views of CPs and their need of technologies to objectively assess inhaler technique and adherence. CPs were probed with a new technology called Inhaler Compliance Assessment (INCA) device, designed to objectively monitor both inhaler technique and adherence of patients using a dry powder inhaler, as an example. METHODS: A qualitative study employing semi-structured interviews was conducted. A convenience and snowballing sampling strategy was employed to recruit CPs working in independent community pharmacies within West and South London. Twenty-three pharmacists were interviewed between August and November 2015. Data was analysed thematically using the framework methodology and coded using NVivo10 software. RESULTS: Analysis revealed five main themes: services and limitations of patient support, the need and acceptability of new technologies to support respiratory patients, fragmented primary care, the need to promote the clinical role of CPs, and professional identity. Patient support was patchy and affected by several barriers related to pharmacists and patients. In addition, lack of communications with different healthcare professionals in primary care and inaccessibility to clinical records were identified as problematic issues. Some CPs perceived their clinical role to be lacking within the patient care pathway. Interestingly, CPs showed positive a attitude towards the use of technologies, such as the INCA technology to support patients and were willing to provide new services. However, remuneration appeared to be a major driver for willingness to offer new services or promote existing services. CONCLUSION: The current study highlighted some measures that can augment CPs' clinical practice while managing patients, such as having accessibility to patients' medical records and the use of technologies such as the INCA technology to promote objective counselling of patients.


Asunto(s)
Actitud del Personal de Salud , Conocimientos, Actitudes y Práctica en Salud , Enfermedades Pulmonares/tratamiento farmacológico , Comunicación , Servicios Comunitarios de Farmacia/organización & administración , Femenino , Humanos , Londres , Masculino , Cumplimiento de la Medicación , Nebulizadores y Vaporizadores , Percepción , Farmacias/organización & administración , Farmacéuticos/organización & administración , Atención Primaria de Salud/organización & administración , Práctica Profesional , Rol Profesional , Relaciones Profesional-Paciente , Investigación Cualitativa
9.
Int J Pharm Pract ; 27(3): 295-302, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30648772

RESUMEN

OBJECTIVE: Increased demands from healthcare services have led to new roles for healthcare professionals (HCPs). Simulation based learning (SBL) can offer multidisciplinary HCPs and students a format to train for such emerging roles. The aim of this work was to adapt existing nursing SBL to involve pharmacy students and evaluate perceptions and effectiveness of SBL when used for interprofessional education (IPE). METHODS: Settings were a simulated hospital ward and a general practitioner (GP) practice. Participants were pharmacy and nursing students. Evaluation was by questionnaires and interviews. Ethical approval was obtained from the University Ethics Committee. KEY FINDINGS: A total of 440 students participated. The majority of respondents (317/330;96%) found the sessions useful. All elements were highly rated: briefing (315/340;93%), setting (301/321;94%), scenario (325/338;96%), feedback (303/327;93%), interaction with the "patient" (328/338;97%), interactions with other HCP trainee (293/329;89%). The majority (304/327;93%) agreed that they felt the sessions had enhanced their skills. Significant (p ≤ 0.05) enhancement in communication confidence was perceived by the students. Students gained understanding of each other's roles, and appreciated practicing communication and teamwork. CONCLUSIONS: Students recognised the importance, usefulness and need for IPE. SBL has the potential to support a variety of HCPs to facilitate uptake of new roles and working in multidisciplinary teams.


Asunto(s)
Educación en Enfermería/métodos , Educación en Farmacia/métodos , Comunicación Interdisciplinaria , Prácticas Interdisciplinarias/métodos , Entrenamiento Simulado/métodos , Medicina General , Humanos , Aprendizaje , Servicio de Farmacia en Hospital , Evaluación de Programas y Proyectos de Salud , Estudiantes de Enfermería/psicología , Estudiantes de Enfermería/estadística & datos numéricos , Estudiantes de Farmacia/psicología , Estudiantes de Farmacia/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Lugar de Trabajo
10.
Cont Lens Anterior Eye ; 42(2): 190-195, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30442512

RESUMEN

Contact lenses (CLs) designed to deliver medication gradually to the eye are being developed and investigated for the use in ocular drug delivery. The aim of the current research is to determine patients' acceptance of the use of lenses for ocular drug delivery. In addition, the study aimed to seek the views and perceptions of healthcare professionals (HCPs) on CLs as a method of ocular drug delivery and whether it will be prescribed to treat ocular conditions. This was a cross-sectional survey targeted at patients and HCPs. Two separate questionnaires were created with open-closed ended and multiple response questions, gauging the perceptions and acceptance of CLs as drug delivery tool. The patients' survey was distributed in John Radcliffe (JR), Oxford and Moorfields eye hospital (MEH), London, UK. The HCPs' questionnaire was manually distributed and was also devised on Survey Monkey and sent by email to ophthalmologists, optometrists, opticians, GPs and hospital and community pharmacists. The data were analysed using SPSS statistical software and Excel. Over 60% (92/151) of patients would accept the use of CLs for their ocular treatment with the highest acceptance being reported by patients in the age group of 30-49 years old. The most frequently used conventional treatment formulation was eye drops as indicated by 87% (131/151) of the responses. More than half of eye drop users (57%, 75/131) indicated that they would accept using CLs expecting them to reduce the frequency of application of the medicine and be less time consuming. Interestingly, half of HCPs were not aware of CLs as an ocular drug delivery method; nevertheless, a total of 65 HCPs out of the 112 surveyed stated that they would prescribe/dispense CLs to treat ocular disease.

11.
Int J Pharm Pract ; 27(1): 88-95, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29732649

RESUMEN

OBJECTIVES: Investigating public perceptions of community pharmacists (CP) in public health and their use of social media (SM) and mobile health applications (MH apps) in that regard. METHODS: Two surveys were created. One sought public perceptions of SM and the other of MH apps for health advice. Both included a section on perceptions of the role of CPs in public health. A convenience sampling strategy, based on proximity, was used.The study population was the public (n = 8 500 000) living in Greater London. The general public were recruited face-to-face in public spaces. A minimum sample (95% confidence interval/5% margin of error) of 385 was needed. Ethical approval was obtained from the university ethics committee. Responses were analysed in SPSS. KEY FINDINGS: About 820/1800 (45.6%) completed one/both surveys. Respondents seek health advice primarily from GPs, followed by digital mediums and then CPs. Under 35s use digital mediums more frequently (P = 0.039). Those who had used SM (41.7%) or MH apps (61.8%) for health information did not confirm its accuracy with a healthcare professional (HCP). Of those that did (MH apps = 39.2%; SM = 58.3%), the HCP disagreed with the information on MH apps and SM on 19.6% and 36.7% of occasions, respectively. Nevertheless, 64.5% stated that if a SM page was maintained by an HCP they would use it. CONCLUSIONS: The public are using digital mediums for health advice instead of speaking to an HCP. If CPs want to have an impact on public health they must start imbedding digital mediums into their services.


Asunto(s)
Servicios Comunitarios de Farmacia/organización & administración , Comunicación en Salud , Conducta en la Búsqueda de Información , Farmacéuticos/psicología , Relaciones Profesional-Paciente , Adulto , Anciano , Servicios Comunitarios de Farmacia/estadística & datos numéricos , Femenino , Necesidades y Demandas de Servicios de Salud/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Aplicaciones Móviles/estadística & datos numéricos , Rol Profesional , Medios de Comunicación Sociales/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Telemedicina/estadística & datos numéricos , Reino Unido , Adulto Joven
12.
Can J Diabetes ; 43(1): 27-33, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30026045

RESUMEN

OBJECTIVE: Intensive self-monitoring of blood glucose levels by patients with diabetes achieves optimal glucose control, hence reducing the likelihood of complications. METHODS: This is a prospective, cross-sectional study targeting adults with diabetes through community pharmacies and patient groups in Central and West London over a period of 10 weeks. RESULTS: In all, 195 adults with diabetes were included in the analysis of the results. When monitoring adherence was examined, 43.4% (n=33/76) of participants with type 1 diabetes reported that their health care professionals had asked them to monitor their blood glucose levels between 3 and 4 times per day; however, 10% of this group was not following their health-care professionals' directions. Participants with type 2 diabetes were asked the same question; 42.9% (n=51/119) were asked to monitor their blood glucose between 3 and 4 times a day, but only 2.5% (n=3/119) were following their health-care professionals' directions. When questioned about their reasons for poor adherence, the cohort indicated that it was due to the painful (29.2%, n=57/195), uncomfortable (33.8%, n=66/195) or inconvenient (36.9%, n=72/195) nature of testing. In addition, 75.3% (n=147/195) of the participants expressed their desire for a noninvasive monitoring device, and 74.3% (n=145/195) said they would be satisfied to use one of the preselected advanced technologies to monitor their blood glucose levels. CONCLUSIONS: The favoured advanced technology, selected by 49.7% (n=97/195) of participants, was the wristband. Statistical significance was seen between the type of diabetes and the device selected; patients with type 1 diabetes preferred contact lenses (p<0.05) and tattoos (p<0.0001), whereas participants with type 2 diabetes preferred earlobe sensors (p<0.0001) and saliva analyzers (p<0.0001). Participants' gender, age and ethnicity also influenced device selection.


Asunto(s)
Glucemia/metabolismo , Diabetes Mellitus Tipo 1/sangre , Diabetes Mellitus Tipo 2/sangre , Invenciones , Participación del Paciente , Percepción , Adulto , Automonitorización de la Glucosa Sanguínea/psicología , Automonitorización de la Glucosa Sanguínea/tendencias , Estudios Transversales , Diabetes Mellitus Tipo 1/epidemiología , Diabetes Mellitus Tipo 1/psicología , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/psicología , Femenino , Humanos , Londres/epidemiología , Masculino , Persona de Mediana Edad , Participación del Paciente/psicología , Estudios Prospectivos , Encuestas y Cuestionarios , Adulto Joven
13.
Int J Pharm Pract ; 27(1): 71-79, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-29949210

RESUMEN

OBJECTIVES: The Healthy Living Pharmacy framework, introduced in England in 2008, provides a tailored approach to the implementation of pharmacy services locally, facilitated by qualified 'Health Champions' (HCs). The study aimed to evaluate the perceived value of the 1-day level 2 HC training by assessing knowledge and confidence of HC pre- and post-training, and changes in practice. The views of additional stakeholders on factors that either obstructed or facilitated pharmacy engagement are also explored. METHODS: This study used a mixed method approach. Pre- and post-training surveys evaluating HC pre-existing knowledge and understanding of their role were used. Additionally, qualitative semi-structured interviews were undertaken with four key groups: participating pharmacists, non-participating pharmacists, Local Pharmaceutical Committee leads and Public Health Leads from Public Health England. KEY FINDINGS: A total of 354 pre-training evaluation surveys were completed on the training day (100%), compared to 54 post-evaluation postal surveys with a 19% (n = 54/282) response rate. The post-evaluation of the training indicated that 83% (n = 45) of qualified HC were actively implementing their new role, with observed increased confidence and service provision. From the 22 interviews conducted two major themes emerged including: Training and Impact. Training had a positive impact on staff knowledge and confidence plus service delivery. CONCLUSION: An immediate impact was observed in increasing HC knowledge and confidence, service delivery and awareness of facilities for patient sign-posting. There was no statistical evidence to support a positive effect stemming from training on services. However, it was identified that time and further training were needed to both provide and assess value within local public health.


Asunto(s)
Servicios Comunitarios de Farmacia/organización & administración , Educación en Farmacia/estadística & datos numéricos , Promoción de la Salud/organización & administración , Farmacéuticos/estadística & datos numéricos , Rol Profesional , Competencia Clínica/estadística & datos numéricos , Humanos , Londres , Farmacias/organización & administración , Farmacias/estadística & datos numéricos , Farmacéuticos/organización & administración , Farmacéuticos/psicología , Encuestas y Cuestionarios/estadística & datos numéricos
14.
Res Social Adm Pharm ; 15(1): 23-30, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-29501431

RESUMEN

BACKGROUND: A number of barriers prevent community pharmacists (CPs) from impacting public health (PH) outcomes. Social media (SM) and mobile health apps (MH apps) may offer ways to help the public make positive health decisions. OBJECTIVES: To evaluate CP perceptions of their role in PH and the use of SM and MH apps in this regard. METHODS: This was a mixed method study using a cross-sectional survey and follow-up interviews. The survey covered: CPs role in PH; CP use of SM; CP use of MH apps; non-identifiable demographic information. Following ethical approval and piloting, responses were collected on paper and online. The study population was CPs in Greater London, UK (n = 2931). A minimum sample size of 340 was calculated (95% confidence interval/5% margin of error). To achieve this, 596 surveys were distributed. Responses (n = 257) were analysed using descriptive statistics. Twenty-five respondents were willing to take part in follow-up one-to-one interviews. Twenty interviews were completed as data saturation was achieved after the 14th. Interviews were transcribed and analysed using framework methodology as described by Ritchie and Spencer in 1994. RESULTS: Survey response rate was 43%. Respondents represented English CPs in terms of age but males and non-whites were over-represented. The majority of CPs accessed SM and MH apps for personal use but did not recommend these in a professional capacity due to lack of awareness and confidentiality/liability concerns. Most would promote an SM health page (78.6%) or MH app (83.7%) if maintained by healthcare professionals (HCPs). Under 35s were more positive about these tools in PH. Two interview themes emerged: The role of CPs in PH; Concerns and opportunities for the use of technology in PH. CONCLUSIONS: Most CPs, particularly those under 30, were positive about the use of SM and MH apps in PH. Training on the use of such tools among the pharmacy team, and an awareness of the availability of evidence-based apps will ensure their wider adoption.


Asunto(s)
Servicios Comunitarios de Farmacia , Aplicaciones Móviles , Farmacéuticos/psicología , Rol Profesional , Medios de Comunicación Sociales , Adulto , Anciano , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Persona de Mediana Edad , Percepción , Salud Pública , Encuestas y Cuestionarios , Telemedicina , Reino Unido , Adulto Joven
15.
BMC Health Serv Res ; 18(1): 763, 2018 Oct 10.
Artículo en Inglés | MEDLINE | ID: mdl-30305085

RESUMEN

BACKGROUND: Medication problems among patients with long-term conditions (LTCs) are well documented. Measures to support LTC management include: medicine optimisation services by community pharmacists such as the Medicine Use Review (MUR) service in England, implementation of shared decision making (SDM), and the availability of rapid access clinics in primary care. This study aimed to investigate the experience of patients with LTCs about SDM including medication counselling and their awareness of community pharmacy medication review services. METHODS: A mixed research method with a purposive sampling strategy to recruit patients was used. The quantitative phase involved two surveys, each requiring a sample size of 319. The first was related to SDM experience and the second to medication counselling at discharge. Patients were recruited from medical wards at St. George's and Croydon University Hospitals.The qualitative phase involved semi-structured interviews with 18 respiratory patients attending a community rapid access clinic. Interviews were audio-recorded and transcribed verbatim. Thematic analysis using inductive/deductive approaches was employed. Survey results were analysed using descriptive statistics. RESULTS: The response rate for surveys 1 and 2 survey was 79% (n = 357/450) and 68.5% (240/350) respectively. Survey 1 showed that although 70% of patients had changes made to their medications, only 40% were consulted about them and two-thirds (62.2%) wanted to be involved in SDM. In survey 2, 37.5% of patients thought that medication counselling could be improved. Most patients (88.8%) were interested in receiving the MUR service; however 83% were not aware of it. The majority (57.9%) were interested in receiving their discharge medications from community pharmacies. The interviews generated three themes; lack of patient-centered care and SDM, minimal medication counselling provided and lack of awareness about the MUR service. CONCLUSION: Although patients wanted to take part in SDM, yet SDM and medication counselling are not optimally provided. Patients were interested in the MUR service; however there was lack of awareness and referral for this service. The results propose community pharmacy as a new care pathway for medication supply and counselling post discharge. This promotes a change of health policy whereby community-based services are used to enhance the performance of acute hospitals.


Asunto(s)
Servicios Comunitarios de Farmacia , Toma de Decisiones , Cumplimiento de la Medicación , Participación del Paciente , Adulto , Anciano , Actitud Frente a la Salud , Consejo , Inglaterra , Femenino , Humanos , Entrevistas como Asunto , Masculino , Persona de Mediana Edad , Enfermedades no Transmisibles/tratamiento farmacológico , Medicina Estatal , Encuestas y Cuestionarios , Adulto Joven
16.
Pharmacy (Basel) ; 6(3)2018 Aug 21.
Artículo en Inglés | MEDLINE | ID: mdl-30134511

RESUMEN

Five years after the introduction of the Prescribing Safety Assessment (PSA) in the UK, the role pharmacists play to help prepare medical students for this challenge is uncertain. Our study explored pharmacists' perceptions about their role in undergraduate medical training for the Prescribing Safety Assessment (PSA). One hundred and seventy-nine prospective participants from UK hospitals and education and training boards were emailed an interview schedule aimed at ascertaining their current involvement in undergraduate medical education, particularly the preparation for PSA. Responses received via email were thematically-analysed. A total of 27 hospital pharmacists and 3 pharmacists from local education and training boards participated in the interviews. Pharmacists were positive about their involvement in medical student training, recognising the added value they could provide in prescribing practice. However, respondents expressed concerns regarding resource availability and the need for formal educational practice mentoring. Despite a low response rate (17%), this research highlights the potential value of pharmacists' input into medical education and the need for a discussion on strategies to expand this role to maximise the benefits from having a pharmacist skill mix when teaching safe prescribing.

17.
BMC Public Health ; 18(1): 711, 2018 06 08.
Artículo en Inglés | MEDLINE | ID: mdl-29884154

RESUMEN

BACKGROUND: Antibiotic resistance (AR) continues to be a serious problem. Many factors contribute to AR, including inappropriate use of antibiotics, in which both healthcare professionals and patients play a contributing role. This study aimed to assess the awareness and knowledge of antibiotic usage and AR among the general public (in affluent and deprived areas) and community pharmacists' (CPs') in Greater London. METHODS: A cross-sectional survey involving members of the public was conducted between July 2014 and February 2015. Stage one involved members of the public (N = 384) residing in affluent areas of London. The second stage targeted public (N = 384) in deprived areas of London. In addition, CPs (N = 240) across the same areas were also surveyed. Data analysis was performed using Microsoft Excel and SPSS Software packages. RESULTS: Response rate: 36% (n = 139/384) and 57% (n = 220/384) and 25% (n = 60/240) of public residing in affluent areas, deprived areas and of CPs respectively was achieved. Definitive trends in knowledge of how antibiotics work could not be drawn to distinguish between affluent and deprived areas. However, public respondents residing in affluent areas possessed better understanding of AR and prudent use of antibiotics, and this was statistically significant in both cases (p < 0.05). Exposure to an antibiotic campaign (32% in affluent areas, 17% in deprived areas) did not raise public respondents' knowledge on AR and only partially raised their general knowledge on antibiotics usage. Only 20% of public residing in deprived areas received counselling from a CP, among them 74% had an antibiotic prescribed on at least one previous occasion. Those who received counselling displayed better knowledge about concordance/adherence with respect to antibiotic usage (p < 0.05) whereas exposure to an antibiotic campaign made no significant impact on knowledge about concordance/adherence. CONCLUSION: The study highlights that there has been no change in the status quo with respect to awareness of antibiotic usage and AR even after the implementation of several awareness campaigns in England. Those who benefited from CP counselling showed a significant better knowledge towards prudent antibiotic usage which stresses the importance of CPs' counselling on antibiotic prescription.


Asunto(s)
Actitud del Personal de Salud , Farmacorresistencia Microbiana , Conocimientos, Actitudes y Práctica en Salud , Farmacéuticos/psicología , Adulto , Antibacterianos/uso terapéutico , Estudios Transversales , Humanos , Londres , Persona de Mediana Edad , Características de la Residencia/estadística & datos numéricos , Factores Socioeconómicos , Encuestas y Cuestionarios
18.
Pharmacy (Basel) ; 6(2)2018 May 22.
Artículo en Inglés | MEDLINE | ID: mdl-29789461

RESUMEN

The prevalence of co-morbidities among patients with Chronic Obstructive Pulmonary Disease (COPD) is well documented in the literature. Therefore, this pilot study aimed to identify whether co-morbidities screening would enhance COPD case-finding. Smoking patients were approached at Croydon University Hospital and two local community pharmacies (CPs). Their co-morbidities, respiratory symptoms, smoking pack-years and exercise capacity were collected. Airflow limitation was determined using handheld spirometry (COPD-6) device. The prevalence of airflow limitation was 42% (n = 21/50). The main identified predictors of airflow limitation were: co-morbidities (OR = 9, CI: 1.04⁻77.81, p = 0.025), respiratory symptoms (OR = 33.54, CI: 1.06⁻11.77, p = 0.039) and smoking history of ≥20 pack-years (OR = 3.94, CI: 1.13⁻13.64, p = 0.029). CPs were the main location for case-finding. This study demonstrated the need to screen for co-morbidities for COPD case-finding within CPs.

19.
BMC Pregnancy Childbirth ; 18(1): 182, 2018 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-29801477

RESUMEN

BACKGROUND: The reported long-term effects of poor maternal nutrition and uptake of recommended supplements before and during pregnancy was the impetus behind this study. Our objectives were to investigate and understand women's expectations, knowledge, behaviour and information sources used regarding the use of nutrition and vitamin supplements before and during pregnancy. METHODS: A cross-sectional survey using a self-administered questionnaire was undertaken. A purposive sampling technique was used. Women attending the antenatal clinic at Croydon University Hospital during 2015 were invited to take part in the study. The data was analysed using descriptive statistics, paired sample T-tests and Chi-squared tests, with the level of significance set at 5% (p < 0.05). RESULTS: A total of 133 pregnant women completed the survey. Analysis of the results showed that women are currently using electronic resources (33%, n = 42) rather than healthcare professionals (19%, n = 25) as an information source before pregnancy. Women who sourced information through the internet were significantly more likely to take folic acid (p = 0.006) and vitamin D (p = 0.004) before pregnancy. Women preferred to receive information from the antenatal clinic (62%, n = 83), internet (46%, n = 61) and from mobile applications (27%, n = 36). Although women believed they had sufficient knowledge (60%, n = 80) and had received adequate advice (53%, n = 70) concerning the correct supplements to take, this was not demonstrated in their behaviour, with only a small number of women (37%, n = 49) taking a folic acid supplement before pregnancy. Women mistakenly perceived the timing of supplement advice as correct, with only a small number of women (18%, n = 23) considering the advice on supplements as too late. CONCLUSIONS: Despite the small sample size, this study demonstrated that women did not receive timely and/or accurate advice to enable them to take the recommended supplements at the optimal time. Women had the misconception that they understood the correct use of pregnancy supplements. This misunderstanding may be prevented by providing women intending to become pregnant with a structured, approved electronic source of information that improves their supplements uptake.


Asunto(s)
Información de Salud al Consumidor/estadística & datos numéricos , Suplementos Dietéticos/estadística & datos numéricos , Satisfacción del Paciente , Mujeres Embarazadas/psicología , Atención Prenatal/psicología , Adulto , Información de Salud al Consumidor/métodos , Estudios Transversales , Dieta/psicología , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Percepción , Atención Preconceptiva , Embarazo , Atención Prenatal/métodos , Encuestas y Cuestionarios , Adulto Joven
20.
Int J Pharm Pract ; 26(2): 183-190, 2018 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-28514043

RESUMEN

BACKGROUND: Pharmacy professionals have multiple opportunities to attend learning events run by a series of providers. However, there has never been a large-scale evaluation of events. Currently, formats of learning sessions differ by provider with no optimum model identified. Pharmacy Education South London was formed in April 2014 for the provision of education and training for pharmacy professionals in South London, running sessions multiple times across various locations. OBJECTIVE: The objective of this work was to identify factors that influence the perceived success of a face-to-face supplementary education and training event from the perspective of attendees. METHODS: Evaluation forms from 600 participants at training events followed by semi-structured individual interviews with 11 participants. KEY FINDINGS: Participants over 55 years were more likely to attend lecture style events versus those aged under 25 years who attended more workshops (P < 0.001); there was no correlation with gender. About 57.3% (n = 344) of participants agreed fully that the event increased their understanding of the topics, although only 38.5% (n = 231) stated that it would change their practice. Themes influencing an event fell into three broad themes: personal reasons affecting attendance, success factors for the session and application of learning, all with related subthemes. Subthemes included commitments, convenience, awareness, topic and personal relevance, content and delivery and reference, review and action. CONCLUSIONS: In publicising events, the topic, including the driver for the topic and the skills that will be obtained, the speaker and their experience plus how learning can be applied after the event should be included.


Asunto(s)
Educación Continua en Farmacia/métodos , Aprendizaje , Farmacéuticos , Técnicos de Farmacia/educación , Adulto , Factores de Edad , Femenino , Humanos , Londres , Masculino , Persona de Mediana Edad , Evaluación de Programas y Proyectos de Salud , Encuestas y Cuestionarios , Adulto Joven
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