This paper aims to describe users' views and experiences of a non-NHS, free of charge, community pharmacy-based cardiovascular risk assessment (CVRA) service at one Boots The Chemists pharmacy 2 to 4 weeks following the CVRA. Of the 25 participants who could recall their CVD risk value, 23 believed it was of use to be told of their individual risk. The majority had, at the time of interview, recommended the service to others with a further number stating that they would do, given the opportunity. Authors comment that a CVRA service which cannot trigger a direct referral appointment to a GP or is unable to register the outcome of an assessment in patient records may be of limited value. For further information click on this Abstracts link (PDF)
Provision of emergency hormonal contraception (EHC) is an ideal opportunity for offering Chlamydia screening (CS) to sexually active young women. In this study the authors audited 3 months of CS activity in community pharmacies in southeast London. This identified low rates of offers and uptake of CS in community pharmacies providing EHC to young women. This highlights the potential for significant improvement in CS uptake among this at-risk group in the pharmacy setting.For further information click on this Abstract link
Sampled members of the public were involved in one of five focus groups composed of mothers with young children, seniors and men. Focus group discussions revealed that participants were inclined to draw unfavourable comparisons between pharmacists and GPs. Importantly, participants' trust in GPs was greater than that in pharmacists. Participants considered pharmacists to be primarily involved in medicine supply, and awareness of the pharmacist's extended role was low. Participants were often reluctant to trust pharmacists to deliver unfamiliar services, particularly those perceived to be 'high risk'.
Numerous system-based factors were identified, which reinforce patient trust and confidence in GPs. By contrast, participants' exposure to community pharmacists was limited. Additionally, a good understanding of the GPs' level of training and role promoted confidence. The reviewers concluded that current UK initiatives, which aim to implement a range of pharmacist-led services, are undermined by lack of public trust. It seems improbable that the public will trust pharmacists to deliver unfamiliar services, which are perceived to be 'high risk', unless health systems change in a way that promotes trust in pharmacists. This may be achieved by increasing the quality and quantity of patient interactions with pharmacists and gaining GP support for extended pharmacy services. For further information click on Full text link (PDF)
Subsequent to reclassification of legal status, more than 90 prescription-only medicines have become available in the UK alone without a prescription. Similar changes are taking place internationally. Studies reporting factors associated with community pharmacists' decision making around adoption of these reclassified medicines into practice have been systematically reviewed. A total of 38 studies were included in the review. 28 factors associated with pharmacists' decision making were identified. Medicine and patient safety was consistently shown to be one of the key factors to pharmacists' decision making; however, the importance of evidence base and financial benefits of reclassification were less obvious. A paucity of high-quality studies limits generalisation of findings. For further information click on Abstract link
The population of the world is ageing. As a result, the incidence of chronic disease is projected to increase, there are predicted shortages in health care workforce and budget restraints; implications for future health care provision are serious. The current model of health care is not equipped to deal with these changes. Connected health care, via the use of health informatics, disease management and home telehealth technologies, has been suggested as an approach to ease the projected strain on future health care.
Evidence to date suggests a positive impact of the use of connected health care model; however, the majority of studies have overlooked the involvement of the community pharmacist. As the most common point of contact with primary health services for most of the population, the community pharmacist may be well placed to provide connected health care. The research to date is promising with improvements in outcomes for cardiovascular patients noted; however, further work is required to investigate the potential role the community pharmacist can play in the future of connected health care. For further information click on this Full text link (PDF)
According to a study published in The Lancet, pharmacist-led information technology intervention (PINCER) intervention is an effective method for reducing a range of medication errors in general practices with computerised clinical records. Medication errors are common in primary care and are associated with considerable risk of patient harm. The study was therefore conducted to evaluate whether PINCER was more effective than simple feedback in reducing the number of patients at risk of measures related to hazardous prescribing and inadequate blood-test monitoring of medicines 6 months after the intervention.
The researchers reported that at 6 months' follow-up, patients in the PINCER group were statistically significantly less likely to have been prescribed a non-selective NSAID if they had a history of peptic ulcer without gastro protection; a β blocker if they had asthma; or an ACE inhibitor or loop diuretic without appropriate monitoring. Additionally, PINCER has a 95% probability of being cost effective if the decision-maker's ceiling willingness to pay reaches £75 per error avoided at 6 months.
The researchers concluded that “because of the pressing need to reduce errors in healthcare, PINCER offers an effective method for reducing a range of medication errors in general practice. An essential prerequisite is the use of electronic health records, which effectively reduces errors. The PINCER intervention will be suitable for implementation in the increasing number of countries where clinical records are now computerised and where the roles of pharmacists to monitor proactively for clinically important medication errors can be extended. For further information click on this Abstract or Editorial
NICE COPD 2004 guidelines recommend COPD patients who smoke should be encouraged to stop at every opportunity; Inhaled corticosteroid should be used only among patients with moderate to severe COPD; Pharmacists should identify smokers and provide smoking cessation advice.
The community pharmacy contract requires pharmacists to review patients’ medications, creating an opportunity for reviewing the prescribing of inhaled corticosteroids in COPD. A self-completion questionnaire was sent to 2080 community pharmacists from the 2005 pharmacist census database. The survey explored the degree to which community pharmacists in North West England identify and provide advice to smokers and assess prescribed inhaled corticosteroids among COPD patients. Of the 1051 respondents, 37% mentioned COPD as a risk from smoking most or every time and 55% sometimes or rarely, and 20% routinely asked about smoking status when dispensing COPD medication.
Pharmacists with more than 20 years experience were more likely to have read the Guideline compared to pharmacists with 10 years or less. Pharmacists who had read the NICE Guideline were around twice as likely to mention COPD as a risk of smoking, ask about COPD if inhaled corticosteroids were dispensed and ask about smoking routinely if COPD medication was dispensed. The paper concludes that the NICE guidelines on COPD encourage community pharmacists to carry out smoking cessation and educational interventions. For further information click on this Abstract link (ScienceDirect)
The sale of over the counter (OTC) medicines from pharmacies represents an opportunity for people to self-medicate and manage their own symptoms. However, some OTC medicines have the potential for being used incorrectly or abused, and there have been increasing concerns about risks associated with some medicines. The primary aim of this study was to describe and understand current issues relating to OTC medicine addiction by investigating the experiences of individuals affected by OTC medicine addiction in the United Kingdom (UK), pharmacists and medicines counter assistants (MCAs), and key UK stakeholders. Additional aims involved exploring the role of the internet, pharmacy involvement, and different types of medicine use. For more information click on this Report link (PDF)
Drug selection and education or information were the most commonly identified warfarin-associated drug-related problems; most drug-related problems were of moderate clinical significance. 8 of 23 potentially serious warfarin drug interactions (34.8%) were identified in the medication review reports.
Pharmacists addressing drug selection and warfarin education drug-related problems during medication reviews may have contributed to the positive outcomes of the post-discharge service. Warfarin drug interactions were frequently identified; however, well-recognised potentially hazardous interactions were under-reported. Improved communication along the continuum of care would permit improved targeting of drug-related problem reporting, especially in relation to preventable drug interactions. For further information click on this Abstract link