Impact of a blended learning program on community pharmacists' barriers, knowledge, and counseling practice with regard to preconception, pregnancy and lactation.

BACKGROUND: Community pharmacists acknowledge to have an important role in providing pharmaceutical care during preconception, pregnancy and lactation. However, pharmacists' knowledge and counseling regarding this topic is still insufficient. Hence, educational initiatives are urgently needed. OBJECTIVES: To assess the impact of a blended learning program ('intervention') on community pharmacists' barriers, knowledge, and counseling practice with regard to preconception, pregnancy and lactation. METHODS: A pre-post study was performed in collaboration with 40 randomly selected pharmacies belonging to a large pharmacy chain in Belgium. All pharmacists employed in these pharmacies were eligible to participate in a blended learning program consisting of an e-learning and an on-site training day. Data were collected using online surveys, mystery shopping visits and pharmacy records. Pharmacy conversations were assessed on information gathering, dispensed product, and case-specific information. A retention knowledge test was completed 3-6 months after the intervention. RESULTS: In total, 60 pharmacists completed the post-intervention surveys (response rate: 95%). The total number of barriers decreased after the intervention, while organizational barriers such as lack of privacy (73%) and lack of time (67%) became more prevalent. Pharmacists' short and long-term knowledge improved after the intervention (p ≤ 0.001), although knowledge declined again over time (p ≤ 0.001). During counseling, pharmacists more often spontaneously provided information about folic acid when dispensing a pregnancy test, and more often suggested the correct dose/dosage for the dispensed OTC-product against pregnancy-related nausea. However, poor information gathering, dosing errors and incomplete information were still observed. CONCLUSION: The blended learning decreased pharmacists' barriers and improved their short- and long-term knowledge, while counseling practice only partially improved. Hence, the blended learning was insufficient to enhance pharmacists' information gathering competences and to fully implement pharmaceutical care services with regard to preconception, pregnancy and lactation.

Community pharmacists' attitudes, barriers, knowledge and counseling practice with regard to preconception, pregnancy and lactation.

BACKGROUND: Although preferably avoided, pregnant and lactating women often use medicines, including potentially inappropriate products. Pregnant women also commonly search for online information on medication. This underscores the need for appropriate counseling by healthcare professionals, including community pharmacists. However, little is known about pharmacists' perceptions and barriers towards this role, nor about their knowledge and counseling practice. OBJECTIVES: To explore licensed pharmacists' attitudes, barriers, knowledge and counseling practice regarding pharmaceutical care during preconception, pregnancy and lactation. METHODS: All pharmacists employed in 40 randomly selected pharmacies of a Belgian pharmacy chain ('Surplus Network') were asked to complete an online survey between September 2018-February 2019. The survey assessed pharmacists' attitudes and current practice regarding their role, as well as barriers and knowledge. Additionally, the 40 pharmacies were visited twice in December 2017 by simulated patients. The scenarios included a request for a pregnancy test and for an over-the-counter (OTC) product to treat pregnancy-related nausea. RESULTS: All 63 invited pharmacists completed the survey. For all attitude-related statements, at least 80% agreed that pharmacists should take up the presented roles. However, for only 1 in 5 statements did at least 80% report currently taking up these roles for all or most patients. Most commonly reported barriers related to difficulties identifying the woman's status (71%) and lack of education (67%). The median score for the knowledge test was 23/45 (range: 6-36). The mystery shopping showed inadequate questioning and insufficient counseling. Only in 10% of cases was folic acid intake spontaneously discussed; in 39% of cases, incorrect advice about the dispensed OTC-product was given. CONCLUSION: Pharmacists acknowledged having an important role during preconception, pregnancy and lactation, but currently do not provide pharmaceutical care in this area to most patients. Educational programs are urgently needed to improve licensed pharmacists' knowledge and counseling regarding this topic.

Impact of training on pharmacists' counseling of patients starting antidepressant therapy.

OBJECTIVE: To measure the impact of a one-day depression-related training program on pharmacists' counseling of unannounced "mystery shoppers" (MS) starting antidepressant therapy. METHODS: Clustered RCT pharmacies; intervention group pharmacists received communication skills training related to depression (n=21); control pharmacists did not (n=19). Eight months after training, the 40 community pharmacies were visited by MS with a first prescription for antidepressants. The pharmacy interactions were recorded and analyzed using the Roter Interaction Analysis System (RIAS). Mann-Whitney U tests were used to evaluate the impact of training on pharmacy interactions and MS evaluations of the pharmacists' skills and attitudes. RESULTS: Interactions of intervention group pharmacists were significantly longer and consisted of more education and counseling statements about lifestyle and psychosocial concerns. Intervention group pharmacists asked more questions about medical condition and therapeutic regimen, as well as socioemotional concerns. MS gave more socioemotional information to intervention group pharmacists and were more positive in their assessment of these pharmacists' skills and attitudes (p values<0.05). CONCLUSION: Pharmacist training in depression care can positively affect the quality of patient care. PRACTICE IMPLICATIONS: Postgraduate training in depression related services is a worthwhile approach to improve the quality of pharmaceutical care.

A depression training session with consumer educators to reduce stigmatizing views and improve pharmacists' depression care attitudes and practices.

OBJECTIVE: To measure the impact of a depression training day for pharmacists that included a 75-minute session with a consumer educator. DESIGN: The training day included interactive lectures on depression; the effects and side effects of and indications for the use of antidepressants; adherence issues; non-drug treatment options for depression; and basic skills in communication. Pharmacists also participated in a session with a consumer educator and in counseling exercises that included role playing. ASSESSMENT: The study used a randomized, clustered, comparative design to measure pharmacists' stigma, attitudes, and current practice related to the provision of pharmaceutical care to people with depression. Mean scores for depression-care practice after the training session were significantly higher in the intervention group than in the control group. Analysis of the changes between baseline and postintervention measures in both the control and intervention groups confirmed a significant difference in the change in both social distance and practice but no significant difference in the change in attitude between the 2 groups of pharmacists. CONCLUSION: A continuing-education depression training day for pharmacists that involve consumer educators may improve the care delivered in the community pharmacy to people with depression.

Pharmaceutical care for people with depression: Belgian pharmacists' attitudes and perceived barriers.

BACKGROUND: In the past three decades, the role of pharmacists has evolved toward working with other health professionals and the public in a patient-centered model of practice, which is called pharmaceutical care. This model has been implemented for most physical illnesses but in relation to mental health, pharmacists' role is still evolving. OBJECTIVE: The objective of this study was to evaluate pharmacists' attitudes, current practice, perceived barriers and training needs concerning pharmaceutical care for people with depression. SETTING: All pharmacists attending obligatory regional meetings of the Surplus Network (a Flemish community pharmacy chain) during April and May 2009. METHOD: Written survey consisting of questions on (1) pharmacists' attitude and current practice in depression care and pharmaceutical care for people with other illnesses; (2) potential barriers in providing pharmaceutical care for people with depression; and (3) training needs. Paired samples T tests and Wilcoxon-tests were used to analyze the data. MAIN OUTCOME MEASURE: Attitude and current practice in depression care versus care for other illnesses. RESULTS: Although the results show no difference in the attitude of pharmacists toward providing care for people with depression versus other illnesses (p = 0.315), pharmacists report to provide significantly less care to people with depression compared to people with other illnesses (p < 0.05). Perceived barriers toward providing depression care were the lack of information about the person and their treatment, the fact that depression is a difficult condition, the lack of education in mental health and the lack of time and privacy in the pharmacy. These, and the reported training needs, may limit the self-efficacy of pharmacists and hence influence current practice. CONCLUSION: In spite of pharmacists' positive attitude toward depression care, current practice displays actionable flaws. Barriers and training needs should be addressed in order to improve pharmaceutical care for people with depression.