Perception of Polish pharmacy students on simulation exercise in pharmaceutical care for diabetes-a pilot study.

BACKGROUND: The transformation of a pharmacist's role from that of a drug dispenser to an advisor and patient educator, partially accelerated by the COVID-19 pandemic, requires a thorough change in the pharmacy curriculum. Preparation for the provision of modern pharmaceutical services requires the use of the most advanced teaching methods, such as pharmaceutical simulation. Knowledge alone does not guarantee students' readiness and motivation to take on new challenges in their professional work, but it seems crucial that graduates of medical faculties have the ability to practically apply their knowledge, including in new and nonstandard situations. Therefore, in our study, we proposed an intervention using a simulation method (peer role play) in teaching pharmaceutical care, and we assessed its impact on students' levels of self-perceived confidence and self-efficacy in accordance with Bandura's theory. The aim of the study was to verify whether the introduction of these types of classes could be a useful element of pharmacy curriculum renewal. METHODS: The questionnaire-based study was conducted during pharmaceutical care peer role-playing classes in a simulation environment with a debriefing session among 85 final-year pharmacy students at Poznan University of Medical Sciences, Poland. The questionnaire consisted of two surveys: the General Self-Efficacy Scale (GSE) and a pre-post self-assessment and self-efficacy questionnaire. RESULTS: There was a positive correlation between the GSE score and self-efficacy (R = 0.52, p < 0.0001). A statistically significant increase in the post-self-assessment of all the skills and competencies included in the survey in the field of pharmaceutical care of a patient with diabetes compared to the pre-values was also observed (p < 0.001). Additionally, the students' self-efficacy in terms of communicating with patients was greater following the class than before the class (p < 0.001). CONCLUSIONS: The peer role-play active teaching method was found to be a cost-effective method allowing for an increase in the self-assessment and self-efficacy of pharmacy students in diabetic patient pharmaceutical care. However, further in-depth research is needed to fully confirm the effectiveness of simulation exercises for teaching pharmacy undergraduates.

Evaluation of medication safety assessment tools for pharmacist-led medication reviews: the Eastern European pilot project.

Background: Pharmacist-led medication reviews (MR) are one of the key methods to support medication safety in polypharmacy patients. The aims of this study were to pilot MRs in Eastern European community pharmacies, describe medication use in polypharmacy patients, and evaluate the usability of medication safety assessment tools. Methods: The MR pilot was undertaken in Estonia, Latvia, Poland, Hungary, Romania, and Bulgaria. Patients who used at least five medicines were directed to the service by their GPs. Data on drug-related problems (DRPs) and adherence were collected by pharmacists through structured patient interviews. Databases for identification of potential drug-drug interactions (pDDIs) and adverse drug reactions (ADRs) named Inxbase/Riskbase, as well as an integrated tool comprising potentially inappropriate medicines (PIMs) lists EU(7)-PIM and EURO-FORTA, were applied retroactively to the MR pilot data to investigate possibilities for their use and to describe medication use and potential risks in the study population. Results: A total of 318 patients were included in the study, 250 of them elderly (≥65 years). One hundred and eighty (56.6%) participants had a total of 504 pDDIs based on Inxbase analysis. On average, there were 1.6 pDDIs per participant. Twenty-five (5.0%) of the 504 pDDIs were in a high-risk category. A total of 279 (87.7%) participants had a potential ADR in at least one of 10 Riskbase categories. One hundred and fifty-four (20.8%) of the potential ADRs were in a high-risk category. Twenty-seven pDDIs and 68 ADRs documented as DRPs during the service were not included in the databases. Using the integrated EU(7)-PIM/EURO-FORTA PIM list, a total of 816 PIMs were found in 240 (96%) of the 250 elderly participants (on average 3.4 PIMs per elderly participant). Seventy-one (29.6%) of the participants were using high-risk PIMs. Twenty-one percent of high-risk PIMs and 13.8% of medium-risk PIMs were documented as DRPs by the pharmacists during the pilot. Conclusion: Medication safety assessment tools can be useful in guiding decision-making during MRs; however, these tools cannot replace patient interviews and monitoring. Tools that include a thorough explanation of the potential risks and are easy to use are more beneficial for MRs.

Inhaler use technique course: an effective postgraduate training solution for pharmacists to enhance therapeutic outcomes as part of patient education.

BACKGROUND: Patients with asthma and chronic obstructive pulmonary disease could benefit from education on using inhalers provided by pharmacists. However, pharmacists may have limited competencies, indicating the necessity to implement appropriate postgraduate courses. The study aimed to evaluate an inhaler use course for pharmacists, including its impact on participants' knowledge and satisfaction. METHODS: The study involved 261 pharmacists from community pharmacies and was conducted between September 2019 and March 2021. A pre-post analysis of their knowledge of the topic was applied. Additionally, at the beginning of the course, participants were asked about their educational needs, and at the end, they completed a satisfaction survey. The preferred learning formats indicated by participants were interactive workshops and lectures. RESULTS: As a result of the course, both their actual and self-assessed level of knowledge significantly increased. The percentage of correct answers in the test before the training was 24.4%, while after, it was 84.3% (p < 0.0001). Before the course, their average self-assessed level of knowledge was 52.0%, and after the training, it increased to 90.0% (p < 0.0001). Almost all respondents stated that the course met their expectations. They estimated their satisfaction at 94.0% and the usefulness of the provided information at 98.0%. CONCLUSIONS: Improved preparation of pharmacists resulting from their participation in the course can contribute to providing more professional advice to patients, thereby positively influencing the pharmaceutical care process in community pharmacies.

Multidimensional Interventions on Supporting Disease Management for Hospitalized Patients with Heart Failure: The Role of Clinical and Community Pharmacists.

BACKGROUND: existing trials on the role of clinical pharmacists in managing chronic disease patients have focused on variety of interventions, including preparing patients for the transition from hospital to home. However, little quantitative evidence is available regarding the effect of multidimensional interventions on supporting disease management for hospitalized patients with heart failure (HF). The present paper reviews the effects of inpatient, discharge and/or after-discharge interventions performed on hospitalized HF patients by multidisciplinary teams, including pharmacists. METHODS: articles were identified through search engines in three electronic databases following the PRISMA Protocol. Randomized controlled trials (RCTs) or non-randomized intervention studies conducted in the period 1992-2022 were included. In all studies, baseline characteristics of patients as well as study end-points were described in relation to a control group i.e., usual care and a group of subjects that received care from a clinical and/or community pharmacist, as well as other health professionals (Intervention). Study outcomes included all-cause hospital 30-day re-admission or emergency room (ER) visits, all-cause hospitalization within >30 days after discharge, specific-cause hospitalization rates, medication adherence and mortality. The secondary outcomes included adverse events and quality of life. Quality assessment was carried out using RoB 2 Risk of Bias Tool. Publication bias across studies was determined using the funnel plot and Egger's regression test. RESULTS: a total of 34 protocols were included in the review, while the data from 33 trials were included in further quantitative analyses. The heterogeneity between studies was high. Pharmacist-led interventions, usually performed within interprofessional care teams, reduced the rates of 30-day all-cause hospital re-admission (odds ratio, OR = 0.78; 95% CI 0.62-0.98; p = 0.03) and all-cause hospitalization >30 days after discharge (OR = 0.73; 95% CI 0.63-0.86; p = 0.0001). Subjects hospitalized primarily due to heart failure demonstrated reduced risk of hospital admission within longer periods, i.e., from 60 to 365 days after discharge (OR = 0.64; 95% CI 0.51-0.81; p = 0.0002). The rate of all-cause hospitalization was reduced by multidimensional interventions taken by pharmacists: reviews of medicine lists and/or their reconciliation at discharge (OR = 0.63; 95% CI 0.43-0.91; p = 0.014), as well as interventions that were based mainly on patient education and counseling (OR = 0.65; 95% CI 0.49-0.88; p = 0.0047). In conclusion, given that HF patients often have complex treatment regimens and multiple comorbid conditions, our findings highlight the need for greater involvement from skilled clinical and community pharmacists in disease management.

The role of active learning methods in teaching pharmaceutical care - Scoping review.

Background: The pharmacists in a community pharmacies have already provided, or will provide in the near future advanced pharmaceutical care services. This requires modifying the approach to teaching pharmacy students as well as adapting the curriculum to the changing professional realities. It has been proven that in the field of medical and related sciences, learners-centered active teaching methods allow to achieve learning outcomes effectively, especially in the field of practical skills. Objectives: As the pharmaceutical services are only being introduced in many European countries, the question arises as to what active learning methods to use to prepare pharmacy graduates for this. Thus the review of worldwide literature occurred to be helpful in identifying what active learning methods are being used specifically in teaching aspects of pharmaceutical care. Methods: Three electronic databases: Pubmed, Scopus and Web of Science were searched using the keywords "active learning" and "pharmaceutical care". Results: On the basis of the publications included in the review, 7 methods were distinguished. Case-study, role play and simulation exercises turned out to be the most popular. It was also possible to make preliminary conclusions on how to properly match the method to the learning outcomes. Moreover, a weak point of many studies was the lack of structured methods of assessing the skills acquired by the students. Conclusions: In conclusion, the curriculum renewal in pharmacy is necessary and requires taking many aspects into account, from the types of tasks assigned to pharmacists, through the selection of appropriate teaching methods, to the verification of assessment methods.

Polish Patients' Needs and Opinions about the Implementation of Pharmaceutical Care in Diabetes.

The study aimed to get to know patients' opinions on implementing pharmaceutical care for diabetic patients in a community pharmacy to prevent and effectively and holistically approach the treatment of people with diabetes. It was based on an authorial survey form and conducted from August to October 2021 in a community pharmacy in Poznan, Poland. A total of 131 pharmacy patients over 18 years were included in the study. Results showed that the vast majority of patients confirmed their interest in pharmaceutical care in diabetes conducted by pharmacists. Moreover, 79.4% of respondents would like to benefit from medicines use review, while 87.0% confirmed an interest in the 'New Drug' service, with diabetic patients being particularly interested in this (p = 0.2447). Most respondents were also interested in education on how to use a glucose meter, administer insulin and use a lancing device. In addition, the study showed patients' insufficient knowledge about risk factors and prevention of diabetes with the need for patient education. As the source of funding, 91.7% of diabetic patients indicated the National Health Fund. Given that such a service has not been implemented in Poland yet, this study may support established teams at the Supreme Pharmaceutical Chamber or the Ministry of Health in introducing such new services.

Interdisciplinary Cooperation between Pharmacists and Nurses-Experiences and Expectations.

BACKGROUND: Getting to know the experience gained so far between professions such as pharmacists and nurses allows for introducing changes aimed at better cooperation, and that can improve the quality of patient care. The aim was to obtain the nurses' opinions on the ongoing cooperation with pharmacists and to analyze the possibilities of cooperation between these groups. METHODS: The survey was conducted from January to March 2021 among 124 nurses in Poland. The link to the electronic questionnaire was sent by e-mails sourced from online social groups for nurses. Before completing the questionnaire, each participant was informed about the anonymous research and the purpose of the data obtained. RESULTS: In total, 80.6% of the respondents confirmed that the pharmacist is a reliable advisor in the field of general information about a drug and 60.9% in the field of clinical information about the drug, and 54.8% of the nurses agreed that a pharmacist should carry out such practices as measuring blood pressure or glucose in a community pharmacy, with 70.1% agreeing that a pharmacist should provide pharmaceutical care in a community pharmacy in the future and the most convinced of this were people with a master's degree. Of the respondents, 74.1% indicated that pharmacist advice should be fully reimbursed by the National Health Fund or another insurance institution. CONCLUSIONS: The study showed that the nursing community appreciates the role of pharmacists and has a positive attitude towards cooperation with this professional group. What is more is that it indicates willingness for interdisciplinary cooperation.

Deploying and Maintaining Standards of New Pharmacy Services Provision in Poland-Introducing the National Pharmacist Competencies Assessment Tool: Pre-Registration Exam-Results of the Pilot Project.

Despite the functioning of the Bologna Declaration, the knowledge and skills of graduates educated in different countries may differ significantly. Therefore, this article aims to present the differences in results of the final exam in pharmacy among Polish pharmacy students. This exam was modeled on the British national exam supervised by the General Pharmaceutical Council. The exam was conducted in three cities in Poland, among a total of 175 final-year students (a full sample of those eligible was 451 with 276 refusals (38.58% response rate)). Taking the exam was voluntary and anonymous. The results indicate that none of the Polish students achieved the 70% mark required to pass the Great Britain exam. Significant differences in test results were noticed between cities. Students achieved the best average exam result in Bydgoszcz (46.35%), then in Warsaw (38.81%) and Lódz (38.35%). The pharmaceutical education system in Poland requires complete changes that will prepare future pharmacists for clinical work.

Polish Pharmacy Students' Attitudes toward Undergraduate Teaching and Practical Implementation of Pharmaceutical Care-A Cross Sectional Study.

It is necessary to monitor and adapt pharmacy curricula to make graduates ready to effectively meet the health needs of the society. Therefore, the aim of the study was to obtain Polish final year pharmacy students' opinions on the activities related to pharmaceutical care (PC) andtheir perception of PC. Two questionnaires were used: one evaluating a PC regarding classes and in practice (n = 64), and the other on the assessment of existing educational solutions in the field of professional counseling (n = 118). Statistical analysis showed that the students agreed that there are not enough hours of a PC classes, since these are necessary to enable them to provide PC services in the future (R = 0.05, p = 0.0007). In previous classes, teachers' knowledge was rated the highest on a five-point scale (4.74), and role play (3.92) and the duration of the classes (3.77) were rated the lowest. Although the students were aware of the role of a PC in the work of a pharmacist, they indicated that more extensive use of active learning methods would better prepare them for the profession. Therefore, pharmacy students' self-efficacy survey and a curriculum renewal would be recommended in Poland.

Assessment of Pharmacists' Willingness to Conduct Medication Use Reviews in Poland.

INTRODUCTION: Pharmacists play an important role in healthcare. Their functions are evolving and, in many countries, they actively participate in interdisciplinary patient treatment. One of the most common services provided by pharmacists as part of pharmaceutical care in community pharmacies involves medication reviews. OBJECTIVE: The objective of this study was to evaluate the readiness of pharmacists to conduct medication reviews in community pharmacies. MATERIALS AND METHODS: This study comprises 493 pharmacists from community pharmacies in Poland. A questionnaire (developed for the purposes of this study) was used. It consisted of eight questions regarding readiness to conduct medication reviews, along with personal data. RESULTS: A total of 63.9% of the pharmacists were ready to conduct medication reviews, and 23.1% already had experience in this area. Participants were of the opinion that this service should be funded by the Ministry of Health or a third-party public payer, and overall was valued by the participants at PLN 169.04 (SD = 280.77) net per patient. CONCLUSIONS: Pharmacists in Poland have expressed their readiness to conduct medical reviews. Implementation of this service in community pharmacies in Poland can have a significant impact on optimising patient health outcomes.

The Influence of the Pharmacists' Training on the Quality and Comprehensiveness of Professional Advice Given in the Field of Inhalation Techniques in Community Pharmacies in Poland.

BACKGROUND: Following the example of other countries, it is very important to educate patients on the correct use of inhalers by properly trained healthcare professionals, including pharmacists. OBJECTIVES: The aim of the study was to assess the quality and comprehensiveness of professional advice given by pharmacists on the use of inhalers, which was determined by the pharmacists' level of training. METHODS: The study was conducted from June 2019 to March 2020. 150 pharmacists from Poznan and Warsaw (Poland) were involved. Before the study began, the professional education of 240 pharmacists was conducted in Warsaw to implement standard operating procedures. The study used the model of a mystery shopper. RESULTS: The conversation with a trained pharmacist lasted on average 5.5 min, with an untrained one-3.0 min (p < 0.0001). Placebo inhalers were used more often by trained pharmacists during patients' education (p < 0.0001). Moreover, 10.3% of untrained pharmacists did not provide any education. Additionally, untrained employees' quality of advice was assessed on an average of 3.5 points, while trained ones-7.6 points (p < 0.0001). CONCLUSIONS: This study has shown that there is a need for professional training among pharmacists in Poland, which translates into better patient education in the field of inhalation techniques.

Factors Facilitating and Hindering Development of a Medication Use Review Service in Eastern Europe and Iran-Cross-Sectional Exploratory Study.

Polypharmacy is a common issue in patients with chronic diseases. Eastern-European countries and Iran are exploring possibilities for implementing the Medication Use Review (MUR) as a measure for optimizing medication use and ensuring medication safety in polypharmacy patients. The aim of this study was to gain insights into the development of the community pharmacy sector and map facilitators and barriers of MUR in Eastern Europe and Iran. The representatives of the framework countries received a questionnaire on community pharmacy sector indicators, current and future developments of pharmacies, and factors encouraging and hindering MUR. To answer the questionnaire, all representatives performed document analysis, literature review, and qualitative interviews with key stakeholders. The socio-ecological model was used for inductive thematic analysis of the identified factors. Current community pharmacist competencies in framework countries were more related to traditional pharmacy services. Main facilitators of MUR were increase in polypharmacy and pharmaceutical waste, and access to patients' electronic list of medications by pharmacists. Main barriers included the service being unfamiliar, lack of funding and private consultation areas. Pharmacists in the framework countries are well-placed to provide MUR, however, the service needs more introduction and barriers mostly on organizational and public policy levels must be addressed.

Cooperation Between Pharmacists and Physicians - Whether It Was Before and is It Still Ongoing During the Pandemic?

Nowadays, it is very important to put an emphasis on widely understood teamwork. This is of great importance for achieving and maintaining success in all areas, especially in medicine. This kind of unity has many advantages, including unique ideas that are very helpful in a competitive environment, improve performance and knowledge, and create stronger supportive work relationships. Patient's health can be improved by using comprehensive treatment. This provides an urgent need for multidisciplinary partnership in the medical community. Optimal pharmacological treatment is crucial to achieving treatment goals. To ensure excellent quality of medical care, interprofessional cooperation between physicians and pharmacists and/or other medical professionals is necessary. Their complementary knowledge and experience can lead to improved health outcomes and can also reduce treatment costs. There are also many barriers and difficulties in legal systems that would allow for more effective inter-professional cooperation. The COVID-19 pandemic contributed to emphasizing the role of the pharmacist, increasing powers, and at the same time to teamwork, sometimes forced by the situation. The purpose of this publication is to view the literature on the cooperation of physicians and pharmacists in the provision of medical services for patients. Professional cooperation has been well known in many countries for years, as it is a key medium supporting optimized patient care. Analyzing the challenges and approaches can lead to better and improved health care.

Pharmacists' Preparedness to Patients Education at the Time of Pandemic-A Cross-Sectional Study with an Example of SARS-CoV-2 Outbreak in Poland.

Although pharmacy employees' involvement in patient education has great potential, the extent to which they actually provide cognitive services seems inadequate. Given the overburdening of the healthcare system and limited access to medical services due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic outbreak, this study aimed to evaluate the preparedness of Polish pharmacy employees for patient education on the new threat. The study was conducted using the mystery shopper method. Two interviewers phoned 90 randomly chosen community pharmacies throughout Poland and presented some inquiries on the SARS-CoV-2. Pharmacists devoted more time to patients than pharmacy technicians (2:22 vs. 1:54), and the information they provided was significantly more comprehensive (p = 0.006). The majority of respondents provided an evidence-based recommendation on prevention, symptoms, and management of SARS-CoV-2; however, the scope of advice significantly varied. Community pharmacy staff often expressed their concern about the lack of time to address patients' questions adequately. No statistically significant differences were found in recommendations provided by chain and non-chain pharmacy staff. Obtained results seem to confirm the possibility of involving pharmacists in public health activities during a pandemic. Nevertheless, providing proper working conditions and adequate just-in-time learning solutions is crucial.

Screening Services in a Community Pharmacy in Poznan (Poland) to Increase Early Detection of Hypertension.

BACKGROUND: Community pharmacies in many countries around the world provide healthcare services for patients. Pharmacists trained as medication experts provide a wide range of patient care services related to medication therapy, patient education, disease prevention, and health promotion. Professional training, expertise, and skills qualify pharmacists to engage in health screenings. These screening programs performed by community pharmacists can help to identify risk factors, facilitate early detection of common diseases, and assist physicians with making effective diagnoses. OBJECTIVES: In this study, we created and tested a novel model to provide professional monitoring and counseling on blood pressure by community pharmacists. The aims of the study were to identify the prevalence of elevated blood pressure among patients visiting a community pharmacy and describe the demographic characteristics of patients with hypertension (sex, age, education, body weight, and hypertension risk factors). METHODS: The research project was conducted in an accredited community pharmacy in Poznan, Poland, from January to April 2019. A total of 118 anonymous patients (30.5% men and 69.5% women) participated in this study. To qualify for this study, participants had to be older than 18 years of age and have no previous diagnosis of hypertension or other cardiovascular disease. RESULTS: Based on the blood pressure screenings, 61.9% of patients were qualified for the standard consultation (SC: normal blood pressure), 21.2% for the intensive consultation (IC: normal blood pressure and hypertension risk factor), 16.9% patients with elevated blood pressure for the high-risk consultation (HRC: referred to a physician), and 3.4% received a diagnosis of hypertension. We qualified 35.6% with a high-pressure value (greater than 140/90 mmHg). CONCLUSIONS: The novel model for blood pressure control screening and counseling implemented in a generally accessible community pharmacy may help with early detection of hypertension problems, lead to initiation of effective patient counseling by a community pharmacist, and result in early referral of the patient to a physician.

As the twig is bent, so is the tree inclined: a survey of student attitudes toward interprofessional collaboration supported with the curricula analysis.

Pharmaceutical care was legally introduced as an interprofessional service in Poland in 2009. However, a collaboration between physicians and pharmacists remains incidental. Proper education at the undergraduate level is necessary to shape the attitudes of students toward establishing interprofessional relations. The aim of the study was to assess the perception of physician-pharmacist collaboration among final-year medical and pharmacy students through questionnaires with both closed-ended and open-ended questions. The study also includes an analysis of medicine and pharmacy curricula in terms of promoting interprofessional collaboration between the two fields. The statistical analysis of data obtained from 502 respondents revealed significant differences between the perceived areas for such collaboration. Moreover, the division of roles and responsibilities during the pharmacotherapy process between both professions seems to be unclear. Importantly, only 10.14% of the respondents evaluated these professional relations as 'good' or 'very good'. Also, 66.87% of the students emphasized the importance of educational interventions to improve interprofessional collaboration between pharmacists and physicians. Although 70% of medical and 87% of pharmacy students wish to establish such collaboration in the future, only 15% and 35%, respectively feel adequately prepared for the task. Understanding similarities and differences in this field appears to be the key to designing effective educational solutions for promoting interprofessional attitudes among healthcare undergraduates.

PHARMACEUTICAL CARE FORM APPLICATION IN ELDERLY PATIENTS RESEARCH.

Many patients, especially elderly, very often don't inform family physicians about drugs prescribed by other specialist and use a number of preparations to self-medicate. These actions may supply negative consequences in recovery process and can be significantly reduced through the implementation of a well-run pharmaceutical care (PC) in the community pharmacy. Therefore, it is necessary to design proper PC documentation, which allows for comprehensive gathering information needed to carry out the analysis of relevant factors impacting on the prescribed pharmacotherapy effectiveness. The aim of this study was to develop the proper documentation to conduct PC in community pharmacy and verification of its correctness in the group of elderly patients, who is receiving treatment from family physician and additionally at least two specialized doctors. Also an assessment of PC implementation validity as a specialized service was presented. A study was carried out from January 2014 to June 2015. The research covered 54 elderly (41.0% men and 59.0% women) in Jarocin (Poland). Pharmacist was filling in the designed PC form, which subsequently was analyzed mainly for pharmacotherapy problems. The study indicated that 48.1% of patients were counselled by at least 3 specialists; 66.7% of patients were treated by cardiologist and 55.6% by the ophthalmologist; 75.9% of participants had hypertension. 42.6% of the patients used 10 or more pharmaceuticals and 24.1% took 8 or 9 drugs. Moreover, 20.4% of participants used drugs irregularly and 7.4% of them took too low doses of medications. Additionally, during the pharmacotherapy analysis, very significant and significant drug-drug interactions were noticed (1.1% and 18.4%, respectively). Very significant drug-food interactions occurred in 1.4% cases and significant in 3.3% cases. Total number of detected interactions were 553. The substantial analysis of participants' data allowed for 48 patients selection for pharmaceutical counselling. Six patients were involved into the group where PC process was reasonable. These patients often used 10 or more drugs (p = 0.0026), discontinued using medication without doctor consulting (p = 0.0201) and did not follow up the prescribed pharmacotherapy (p = 0.0351). This study provides new data about implementation of PC in Poland. The designed PC documentation may be helpful for proper analysis of the patient's pharmacotherapy to avoid drug problems and to improve elderly patients' quality of life. This project may contribute to PC implementation in Polish community pharmacy.

PHYSICIANS' VALUATION OF INDIVIDUAL MEDICATION MANAGEMENT SYSTEM (IMMS) IMPLEMENTATION IN POZNAN (POLAND) COMMUNITY PHARMACIES.

The reason of growing Pharmaceutical Care (PC) popularity in Poland and all over the world in recent years is connected with a new idea which separates pharmacists from a stereotype of drug store, dealing only with issuing medicines in adequate doses. There is an intention of emphasizing their qualifications and maximizing the use of them. One of the essential part of PC is preparing Individual Medication Management System (IMMS) which may provide individualized pharmacotherapy for patient. The aim of the study was to assess the physicians' opinion about implementation of IMMS in Polish community pharmacies and to evaluate physician-pharmacist cooperation. A cross sectional study was carried out from April 2013 to December 2013 by a pharmacist (authors' of the study). The survey covered 103 physicians (35.9% men and 64.1% women) providing medical services in Poznan. The respondents obtained an anonymous questionnaire with a brief information about IMMS. The results of the study confirmed that 90.3% of physicians would recommend IMMS to their patients. They believed that 72.8% of the patients would be interested in this service. According to 74.8% of doctors, especially with a specialization in cardiology, family medicine, and without specialty, IMMS might contribute to the PC development (p < 0.0001). The respondents (56.3%) confirmed their collaboration with at least 1 pharmacist and 79.6% declared the possibility of the cooperation by using IMMS. This study provides new data about implementation of IMMS in Poland. This innovatory service could be the chance both for patient and physicians to increase the safety and effectiveness of pharmacotherapy and for pharmacists who are intended to highlight their role as a part of health care system. The physicians' positive opinion provide the opportunity to implement IMMS in Polish community pharmacies.

Individual medication management system (IMMS) implementation in pharmacists' opinion.

Many countries of the world including Poland, are taking actions for improving the role of the pharmacist as a health care professional. One of those is implementation of pharmaceutical care (PC), as a documented specialist medical service, which also includes pharmacist interventions, such as preparing Individual Medication Management System (IMMS), to enhance patient's adherence. Because of the chance to monitor the dosage and to detect and prevent drug problems occurrence, IMMS is thought to be an opportunity for individualized, effective and safe patient's pharmacotherapy. The aim of the study was to define pharmacists' attitudes toward IMMS. The study included also the evaluation of pharmacist-physician cooperation to determine whether IMMS can improve partnership among health care professionals for proper patient's care. The survey was conducted in Poznan, between June 2011 and March 2012. An anonymous questionnaire was delivered personally to pharmacists. Each questionnaire was provided with a short information brochure attached and presentation of demos how to use IMMS. The survey covered 129 pharmacists (76.7% women and 23.3% men) where 48.8% had up to 5 years length of service as a pharmacist, 24.8% - 6-10 years, 14.9% - 11-20 years and 11.5% - 21 and more years. Most of the participants did not have specialization (80.6%) and only 5.4% had Ph.D. degree. Survey confirmed that 64.8% of pharmacists (p < 0.0001), mainly with the shortest length of service (p = 0.02268) and without specialty (p = 0.00244) didn't cooperate with physicians, but 68.8% of respondents emphasized that the range of cooperation could increase by IMMS application (p < 0.00001). About 50.0% of respondents' considered that patients would be interested in IMMS usage (p = 0.00079) and in 71.9% opinions, it would attach the patient to specific community pharmacy (p < 0.00001). This statement was confirmed by respondents with the shortest length of services (p = 0.00659). Proposed dosing system also improved patient's care serving by family or carers in pharmacists' opinion (p < 0.00001). A majority of pharmacists (85.3%) indicated also that IMMS would have a positive influence on PC implementation in Poland (p < 0.00001) and 69.0% of them confirmed that this service should be refunded by the National Health Fund (p < 0.00001). According to the scale of non-compliance, implementation of IMMS as a part of PC can be a chance both for patients and their physicians to increase the safety and effectiveness of therapy and for pharmacists, who are intended to highlight their role as a part of health care system.

Physicians' and patients' valuation of pharmaceutical care implementation in Poznan (Poland) community pharmacies.

Implementation of pharmaceutical care (PC) in Poland is of great importance to patients, who, on the one hand, often follow complex pharmacological treatment regimens recommended by several physicians of different specialties, and, on the other, take up the decision on self-treatment due to availability of OTC medications. The aim of the present study was to assess the opinion of both patients and physicians about implementation of PC service in Polish community pharmacies. A cross sectional study was carried out from September 2009 to September 2010 by a pharmacist (author of the study) on the basis of an anonymous questionnaire, where demand of physicians (n = 104) and patients (n = 202) for implementation of PC in a community pharmacy was assessed. The study was planned to determine the relationship between implementation of PC, cost and time of this service and patients' and physicians' socio-economic information. Responding patients (85.64%) and physicians (76.92%) unanimously confirmed the need for implementation of PC. Most people convinced of the service implementation were 88.89% of physicians under the age of 35 and all the respondents were over 65 years of age (p = 0.027), just as 93.33% with service lesser than 5 years and 73.68% of respondents working a maximum of 20 years (p = 0.023). Mainly according to 90.00% of physicians with specialty in internal medicine and 92.59% of physicians of the group "Others" (p = 0.012), PC should be implemented in pharmacies. Women more frequently than men reckoned that appointments with a pharmacist should last up to 15 min (p = 0.012). According to 77.78% of the youngest physicians and 83.33% of the oldest ones, appointments should last from 5 to 15 min (p = 0.049), and a similar opinion was shared by 80.77% of physicians without specialty and 77.78% of physicians of the group "Others" (p = 0.0009). According to patients, the mean cost of the visit should be USD 7. Physicians most often assessed the mean cost of the appointment at USD 14. This study provides new data about implementation of PC in Poland. The increased patients' and physicians' willingness to benefit from this service provides pharmacists with opportunities to develop PC in community pharmacies.