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)

Text Analysis of Support Overview by Community Pharmacists to Prevent Self-interruption of Medication in Depressed Patients / 社会薬学

Depression requires continuous long-term treatment. However, many patients drop out from their treatment program. The purpose of this study is to investigate the current status of pharmacists’ support for depressed patients at higher risk of self-discontinuation of medication. This was a cross-sectional study of community pharmacists’ support for depressed patients using a web-based questionnaire. The survey items were 1) pharmacists’ basic attributes and 2) pharmacists’ support to prevent patients from dropping out of their treatment. Morphological analysis was performed using text mining to analyze the free responses, and the relationships between the extracted categories were examined using hierarchical cluster analysis. Free responses were obtained from 77 pharmacists. The morphological analysis extracted 26 categories from their responses, and the category with the highest frequency of occurrence was “explain” (44 times). The extracted categories were stratified into clusters 1 to 6 using hierarchical cluster analysis.

The Significance of Self-medication Support at Pharmacies and Drugstores -Consideration of Visit Encouragement Related to Cold-like Symptoms by Pharmacists and Drugstore Salespersons- / 日本プライマリ・ケア連合学会誌

Objective: We investigated cases of visit encouragement by pharmacists and drugstore salespersons, and confirmed the significance of self-medication support.Methods: We conducted a web survey for pharmacists working at community pharmacies and drugstores, and registered salespersons working at drugstores. The main survey items were the attributes of the respondents, whether they had experience in encouraging visits to the doctor during consultations for cold-like symptoms, and the type of encouragement (patient background, main complaints, and prognosis).Results: We obtained responses from 300 pharmacists working at community pharmacies, 57 pharmacists working at drugstores, and 56 registered salespersons. Of the respondents, 88% of the pharmacists at community pharmacies, and 100% of the pharmacists and registered salespersons at drugstores had experience in encouraging doctor visits. Of the 84 visit encouragement cases reviewed, the diseases that were often suspected were influenza, sinusitis, and gastroesophageal reflux disease. Cases of early symptoms of tuberculosis, mycoplasma pneumonia, and cerebral infarction, which were identified as a result of the doctor visits, were also included.Conclusion: Our study suggested that when customers with cold-like symptoms received accurate support from pharmacists and registered salespersons, they not only selected the correct OTC drugs for their symptoms, but they also received support that led to the early detection of serious diseases.

A Study about “YARIGAI” : What Makes Work Worth Doing for the Community Pharmacists Who Participated in a Workshop of the COMPASS Project / 社会薬学

Objective : By extracting and modeling the component factors that community pharmacists have for “YARIGAI”—a Japanese colloquial expression commonly defined as “something worthwhile doing”—and by re-defining “YARIGAI,” we sought to help improve the quality of work lives of community pharmacists. Methods : All of 139 employee pharmacists participated in a workshop of the COMPASS Project (May 2011) were surveyed using a self-administered questionnaire. Responses were collected on the scene. The seventeen, 6-point-scale questions focused on the “patient-pharmacist relationship,” which may be related to “YARIGAI.” Then “YARIGAI” factors were extracted using factor analysis, and modeled using covariance structure analysis. IBM SPSS (ver. 20) and Amos 5.0J were used for the analyses. Results : To the item “I feel ‘YARIGAI’ with pharmacy work,” 12.2% of the 139 respondents said, “Strongly agree”, followed by “Agree” (41.0%) and “Somewhat agree” (33.8%). A factor analysis extracted three factors related to “YARIGAI” (knowledge, patient counseling management, and sense of personal growth). After modeling (AGFI : 0.903, RMSEA : 0.048) with these factors as latent variables and items in them as observable variables, a positive correlation was indicated for all the following factor pairs : “knowledge” and “patient counseling management”, “knowledge” and “sense of personal growth”, and “sense of personal growth” and “patient counseling management” (standardized points of estimate : 0.71, 0.55, and 0.42, respectively). Standardized coefficients for all latent and observable variables were 0.7 or higher, showing a good fit. Conclusion : “YARIGAI” of pharmacists employed by community pharmacies can consist of “knowledge,” “patient counseling management,” and “sense of personal growth”. Our results suggest that the improvement of communication skills and knowledge can lead to improvement of “YARIGAI” of pharmacists working for community pharmacies.

The Relationship between the Awareness of Pharmacists Regarding Instructions on the Use of Inhaled Corticosteroids and the Instructions Conveyed / 医薬品情報学

<b>Objective: </b>To clarify the relationship between the awareness of pharmacists regarding instructions on the use of inhaled corticosteroids and the instructions conveyed.<br><b>Design: </b>Fact-finding-survey using self-administered questionnaires.<br><b>Methods: </b>The survey items consisted of age, years of clinical experience, number of prescriptions from asthmatics per month (“number of prescriptions”), items to concern when giving instructions (“items to concern”) time required to give instructions on inhaler usage (“time required”), and the pharmacists’ awareness regarding instructions on the inhaler usage (“awareness items”).  There were six awareness items for which responses were solicited on a four-grade scale.  Respondents were divided into two groups: a “high awareness” group giving responses of “completely agree” (or “completely disagree” for diametrically opposed items) and a “low awareness” group giving other responses.  T test was used to compare the average of age, years of clinical experience, number of prescriptions, concern degree, and time required between 2 groups.<br><b>Results: </b>This showed the higher consciousness that “instructions on inhaler usage are important issue relating to the patient’s asthma therapy” was significantly-high degree of concern and time required.  Also, the consciousness that “instructions on inhaler usage are a specialized activity performed by pharmacists” was related to age, years of clinical experience and level of concern degree.  Additionally, this suggested the pharmacists giving negative responses with respect to the notions that “the effect of instructions on inhaler usage is not worth the trouble” and “patients have insufficient desire to master of inhaler usage” had a higher degree of concern.<br><b>Conclusions: </b>For significance and importance of instructions on inhaler usage, there was confirmed to be relationship between pharmacists’ awareness and the information conveyed and time spent on the instructions.  This suggested that it was important to improve awareness of instructions on inhaler usage in both the clinical and educational setting.