Objective: This study aimed to measure the outcomes of a harmonised, structured pharmaceutical care programme provided to elderly patients: (greater than or equal to 65 years of age) by community pharmacists in a multicentre international study performed in 7 European countries. Design and setting: The study was a randomised, controlled. longitudinal, clinical trial with repeated measures performed over an Is-month period. A total of 104 intervention and 86 control pharmacy sites participated in the research and 1290 intervention patients and 1164 control patients were recruited into the study. Main outcome measures and results: A general decline in health-related quality of lift: over time was observed in the pooled data; however, significant improvements were achieved in patients involved in the pharmaceutical care programme in some countries. Intervention patients reported better control of their medical conditions as a result of the study and cost savings associated with pharmaceutical care provision were observed in most countries. The new structured service was well accepted by intervention patients and patient satisfaction with the services improved during the study. The pharmacists involved in providing pharmaceutical care had a positive opinion on the new approach, as did the majority of general practitioners surveyed. The positive effects appear to have been achieved via social and psychosocial aspects of the intervention, such as the increased support provided by community pharmacists, rather than via biomedical mechanisms. Conclusions: This study is the first large-scale, multicentre study to investigate the effects of pharmaceutical care provision by community pharmacists to elderly patients. Future research methodology and implementation will be informed by the experience gained from this challenging trial.

Improving the well-being of elderly patients via community pharmacy-based provision of pharmaceutical care: a multicentre study in seven European countries.

Background There is a need to describe how role theory has been used by researchers to describe various phenomena in pharmacy so as to identify gaps in knowledge and future research priorities. Objective The primary purpose of this article is to review how role theory has been used in the community pharmacy literature. Secondary objectives are to (1) examine the use of role theory over the evolution of the profession of pharmacy, (2) determine what role theory perspectives have been used, (3) explore the implications of role theory for patient-pharmacist interactions, and (4) explore implications for future pharmacy research using role theory. Methods A literature search of Web of Knowledge and International Pharmaceutical Abstracts was conducted. Articles were included if they examined some aspect of role theory in community pharmacy and were categorized based on their role theory perspective and “era” of pharmacy in which they were published. Results Thirty research articles were identified spanning from 1956 to 2004 with the majority (19 studies) using mail surveys. Articles used functionalist (9 studies), organizational (7), functional and organization (4), cognitive (10), and symbolic interactionist (1) perspectives to role theory. The number of articles using role theory has been increasing over time. The functional and symbolic interactionist perspectives provide rich descriptions of the multiple pharmacy roles and allow for a clearer understanding of the barriers affecting actors' experience. Using an organization perspective, role stressors such as role conflict, ambiguity, and overload were found to impact pharmacists' worklife. Cognitive role theory research has clearly shown that pharmacists' and patients' expectations for the encounter shape interaction. Conclusions The use of role theory informs both researchers and practitioners about the practice of pharmacy and patient interactions. Still, there is much work to be done in role theory and pharmacy research. Experimental designs, longitudinal studies, and qualitative research methodologies may warrant greater use and attention. Role change should be identified as a priority, and research is needed to elucidate what interventions change patients' and pharmacists' expectations of the patient-pharmacist interaction.

Role theory: literature review and implications for patient-pharmacist interactions.

Background:A patient-centered approach is increasingly recognized as an important component in the evaluation of healthcare services.Objective:To assess patient satisfaction with, attitudes toward, and expectations of or experience with community pharmacy in genera), and to evaluate the effect of the community pharmacy–led medications management service on these factors.Methods:Postal questionnaire surveys were completed at baseline and after 12 months (follow-up) as part of a randomized controlled trial of the service. The setting was 9 primary care organizations in England. Patients with coronary heart disease were recruited from general practice registers and randomly allocated to the intervention (pharmacy-led medications management service) or control group.Results:Survey response rates at baseline and follow-up were 88.4% (1232/1394) and 80.1% (1085/1355), respectively. The respondents indicated that they wanted pharmacists to provide dispensing, medications review, advice on medications and health,...

Patient Evaluation of a Community Pharmacy Medications Management Service

Objectives We aimed to determine the perception of Maltese consumers of the community pharmacist and of the services offered from community pharmacies.



Method  A self-administered questionnaire was developed and psychometrically evaluated. Fifty community pharmacies were chosen by stratified random sampling and the questionnaire was distributed to 500 consumers, 10 from each pharmacy, selected by convenience sampling. Descriptive statistics were undertaken.



Key findings  The majority of the consumers were very or fairly satisfied with various pharmacist characteristics, such as pharmacist efficiency when dealing with requests (95%), provision of instructions on how to take medications (94%), pharmacist discretion (91%), professional pharmacist–consumer relationship (90%), provision of explanations on how medications work (86%) and pharmacist knowledge and ability to answer questions (81%). They were least satisfied with the privacy in the pharmacy (69%). Consumers were in favour of the evolution of pharmacist professional services, namely the community pharmacist liaising with primary and secondary care-based physicians (91%), provision of diagnostic testing (87%) and extended opening hours (83%).



Conclusions  Maltese consumers have a positive overall perception of community pharmacists and of the services offered from community pharmacies. They were in favour of the development of extended professional services.

/pdf/consumer-perception-of-the-community-pharmacist-and-2z600av2y3.pdf

Consumer perception of the community pharmacist and community pharmacy services in Malta

Objective To explore the awareness of Medicare Part D enrollees regarding medication therapy management (MTM) and to examine their expectations and perceptions of pharmacists in providing MTM. Methods The Internet-based survey consisted of questions on respondent demographics, prescription-related be- havlor, awareness of MTM, and expectation and perception of pharmacists in usual roles and as MTM providers. Four open- ended questions examined expectations, trust, source of MTM information, and perceived benefit from MTM. Results The sample of 504 Medicare Part D enrollees from California (mean age 72 years) used an average of 4.3 prescriptions per day. Awareness of MTM was low in this cohort (93% unaware). Trust in the pharmacist was centered on dispensing prescriptions. Expectation of pharmacists also revolved around product (>60%). Approximately 70% of respondents did not believe they needed MTM; however, 58% believed pharmacists were good candidates to provide MTM. Willingness to pay for MTM services was also low (31%). Conclusion Medicare Part D enrollees' expectation and perception of pharmacists revolves around the dispensing function. The public, payers, and policy makers need to be educated to recognize and use pharmacists as cost-effective providers of MTM.

https://www.japha.org/article/S1544-3191(15)31142-0/pdf

Perceptions of Medicare Part D enrollees about pharmacists and their role as providers of medication therapy management

Objective: To explore the relationships between patients' satisfaction and (1) the level of pharmaceutical care services received, (2) patients' perceptions of the personal attention paid to them by the pharmacist, and (3) patients' perceptions of the pharmacist's ability to help them manage their asthma and prevent asthma-related problems. Design: Exploratory study using mail or telephone survey methods. Patients or Other Participants: Asthma patients (n = 250) enrolled in one of two Florida managed care organizations. Main Outcome Measures: Predictor variables were level of pharmaceutical care and patients' perceptions of personal attention and their pharmacist's ability to help them control their asthma. Outcome variable was patients' overall satisfaction with the care they received from their pharmacist. Results: The direct causal effects of level of care (standardized regression coefficient, (3 = 0.07) and patients' perception of pharmacists' ability to help (p = 0.01) on satisfaction were nonsignificant. Only personal attention had a significant direct path coefficient to patient satisfaction ((3 = 0.63). Although the level of care was associated with patient satisfaction (r= 0.32), its direct effect was not significant because of its joint association (r = 0.27) with personal attention. Patients' satisfaction was associated with the level of pharmaceutical care and their perception of the pharmacist's ability to help them with their asthma. However, personal attention from the pharmacist was most influential. Conclusion: Patients may be less able to judge the technical quality of the care they receive, but they do judge their social interaction with the pharmacist. Pharmacy professionals must increase patients' awareness of the value of pharmaceutical care services and make it important to their judgment of satisfaction.

Feng Wang

Papers

Patients’ Satisfaction and Their Perception of the Pharmacist