Determining patient preferences of community pharmacy attributes: A systematic review.
TL;DR: A relationship with a respectful, friendly, competent pharmacist represents important pharmacist-related attributes in the process of pharmacy selection, including cost, convenience, and wait times.
Abstract: Objective Patient selection of community pharmacy is based on a multitude of factors. With increasing competition and rapidly changing face of pharmacy, identification of these factors is critical for patient satisfaction and financial success. This systematic review summarizes patient preferences for different attributes of community pharmacy. Data sources Systematic review of peer-reviewed studies conducted on U.S. population, published from 2005 to 2018 in EBSCO, PubMed, and EMBASE, was conducted to identify attributes of community pharmacy that determine patient patronage. Study selection Studies conducted between 2005 and 2018 on U.S. population that examined attributes in choosing a pharmacy were eligible for this systematic review. Data extraction Data were independently extracted, assessed, and evaluated by 2 reviewers. Any disagreements were resolved by the third reviewer. Data obtained included year, setting, number of patients, data collection and evaluation methods, and relevant results and outcomes. Results Of the 713 papers identified, 10 articles met the inclusion criteria and were included in this systematic review. Majority of the studies used surveys to examine key attributes that influence patients’ selection of a pharmacy. Pharmacist traits like friendly, helpful, trustworthy, professional, competent, caring, knowledgeable, responsive, and approachable are critical attributes that influence a patient’s selection of pharmacy. Convenience (i.e., location, hours of operation, wait time, stock availability) also influenced patients’ selection of pharmacy. Cost and contract with insurance were other important factors. Availability of auto-refills appeared consistently in the studies. Medication safety (detecting drug interactions) quality metrics also appeared high among patients’ preferences. Conclusion The results of this review found that a relationship with a respectful, friendly, competent pharmacist represents important pharmacist-related attributes in the process of pharmacy selection. Important pharmacy-related attributes include cost, convenience, and wait times. Availability of auto-refill service was also a frequently reported attribute in this review.
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02 Apr 2020
TL;DR: A narrative review explores the current challenges pharmacists face with MTM delivery, summarizes potential solutions for addressing challenges, and seeks to incite further debate, service reconfiguration, and ultimately service improvement of pharmacist-provided MTM services.
Abstract: Medication therapy management (MTM) services have evolved as a means for pharmacists and other providers to assist patients and caregivers in improving therapeutic outcomes and reducing health care expenditures. More than a decade has passed since the Medicare Modernization Act of 2003 provided pharmacists with the opportunity to deliver MTM services to Medicare beneficiaries. MTM continues to offer pharmacists the opportunity to use their knowledge; yet, pharmacists have reported challenges with service delivery. Identifying the challenges that affect MTM services in pharmacy practice is necessary in order to seek improvement to MTM delivery. This narrative review explores the current challenges pharmacists face with MTM delivery, summarizes potential solutions for addressing challenges, and seeks to incite further debate, service reconfiguration, and ultimately service improvement of pharmacist-provided MTM services.
42 citations
TL;DR: Grossman et al. as discussed by the authors conducted a prospective cohort study at eight clinical sites and pharmacies in California and Washington State from July 2018 to March 2020 to estimate effectiveness and acceptability of medication abortion with mifepristone dispensed by pharmacists.
14 citations
TL;DR: While the public in the Middle East has a good understanding of the basic duties of a community pharmacist, there is lack of awareness of advanced pharmaceutical services and decision makers in Middle Eastern countries should set strategies to improve community pharmacy professional image and competence beyond medication dispensing.
Abstract: Background Over the last few years, pharmacy practice in the Arab regions of the Middle East has started to change and develop. There have been small but promising steps to recognize the importance of extending community pharmacists’ roles to meet the expanding public healthcare demands. Objectives This systematic review aims to identify, synthesize and assess the quality of the literature in the Middle East concerning public attitudes on community pharmacist role and services and in relation to public perceptions on strategies to improve pharmacy services and the image of community pharmacist. Methods A systematic search of 11 electronic databases was conducted to identify all published relevant studies from inception till January 2020. Data was extracted using a designed and tested tool. Studies were assessed for quality using Crowe Critical Appraisal Tool. Results The final study results included 36 studies of which 31 adopted a cross-sectional-survey-based design. Included studies were published between 2004 and 2019. Most studies were done in Saudi Arabia (n = 11) or the United Arab Emirates (UAE) (n = 10). We identified four overarching themes across included studies 1) Use of Community Pharmacies; 2) Attitudes towards Community Pharmacist role; 3) Attitudes towards Current Community Pharmacy Services and 4) Strategies to Improve Community Pharmacy Practice. The most common reason for visiting a community pharmacy was to purchase a prescription or over-the counter-medication. The most common factors that affected patients’ choice of a particular pharmacy included convenient pharmacy location, availability of a good range of products or medicines, friendliness of the pharmacy staff and convenient pharmacy opening hours. There was a general public perception of community pharmacist as a business oriented person. Expectations of pharmacist duties included treatment of minor health ailments, consultation on over-the-counter medications and parapharmaceutical products, and accuracy checking of dispensed medications. Overall satisfaction with community pharmacy varied between the studies and ranged from 33% to 67.1%. Most commonly reported recommendations to improve pharmacy practice were provision of diagnostic, screening and monitoring services, keeping patient records in the pharmacy, advice on minor illness and provision of a private area for consultation. Seven articles were considered of low quality and 13 articles were considered of high quality. Conclusions While the public in the Middle East has a good understanding of the basic duties of a community pharmacist, there is lack of awareness of advanced pharmaceutical services. Decision makers in Middle Eastern countries should set strategies to improve community pharmacist professional image and competence beyond medication dispensing.
11 citations
TL;DR: Preference measurements showed that “frequency of telephone follow-up to monitor ADRs” had the most critical impact on decisions, followed by “mode of drug delivery,” which need to take into account to improve their design to increase uptake and patient loyalty.
Abstract: Objectives: To survey, analyze, and ascertain the preferences for specialty pharmacy services among patients requiring complex care and to provide evidence to support specialty pharmacy service decision-making in China. Methods: To identify essential service attributes and levels, a review of the literature, discussions with specialty pharmacy managers and a pilot questionnaire were conducted. A D-efficient fractional factorial design was used to generate the discrete-choice experiment (DCE) questionnaire. A face-to-face survey of patients with chronic illness and their families or friends was conducted at three specialty pharmacies in Chengdu and Qingdao, China. A mixed logit model was used for estimation. Results: Six relevant attributes were identified and incorporated into the DCE questionnaire. A total of 417 participants completed the survey (mean age 43 years, 45.1% males), and 32.1% had lung cancer. The conditional relative importance showed that the most critical attribute was "frequency of telephone follow-up to monitor adverse drug reactions (ADRs), "followed by "mode of drug delivery," "provider of medication guidance services," and "availability of medical insurance consultation"; the least important attribute was "business hours." A 1 min increase in time spent led to a 0.73% decrease in the probability that a service profile would be chosen. Negative preferences were noted for ADR monitoring by telephone follow-up once a year (β = -0.23, p < 0.001) and business hours [8:30-20:00 (Monday to Friday), 8:30-17:30 (weekend)] (β = -0.12, p < 0.001). Compared with women, men had a higher preference for service monitoring ADRs once every 3 months. Conclusions: Preference measurements showed that "frequency of telephone follow-up to monitor ADRs" had the most critical impact on decisions, followed by "mode of drug delivery." Specialty pharmacies in China need to take these findings into account to improve their design to increase uptake and patient loyalty.
4 citations
TL;DR: Policymakers can utilize these findings to provide targeted professional development opportunities for the practicing community pharmacists in order to improve the overall service and care for patients.
Abstract: This study aimed to evaluate the current practice of community pharmacists from patients’ and pharmacists’ perspectives in Saudi Arabia. This paper presents the pharmacist’s perspective. A cross-sectional self-administered online survey was designed to collect responses from community pharmacists in Saudi Arabia from February to April 2021. The questionnaire consisted of several statements related to best practice in community pharmacy. Pharmacists’ responses to each statement were scored using a 5-point Likert scale. Higher scores represented a greater extent to which they adhered to best practice in the community pharmacy setting and vice versa. Data of 164 participants were included in the analysis. The minimum median score was related to the statement: Pharmacist explains the main side effects. The maximum median score was related to the statement: Pharmacist explains dosage regimen. Pharmacists aged 30 years or above and non-Saudi pharmacists had significantly higher median scores compared with pharmacists less than 30 years of age (p = 0.016) and Saudi pharmacists, respectively (p = 0.001). A gap between best practice and current practice of community pharmacists was observed. Policymakers can utilize these findings to provide targeted professional development opportunities for the practicing community pharmacists in order to improve the overall service and care for patients.
3 citations
References
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TL;DR: 49.6 million Americans speak a language other than English at home, yet many patients who need medical interpreters have no access to them, and language barriers can have deleterious effects.
Abstract: 49.6 million Americans speak a language other than English at home. Yet many patients who need medical interpreters have no access to them. Dr. Glenn Flores writes that language barriers can have deleterious effects.
475 citations
TL;DR: A unified, transdisciplinary EBP model would address historical shortcomings by redefining the contents of each model circle, clarifying the practitioner's expertise and competencies, emphasizing shared decision making, and adding both environmental and organizational contexts.
Abstract: In 1996, Haynes and colleagues introduced a conceptual model depicting how research could be integrated into the clinical practice of medicine (Haynes et al. 1996). This vanguard “three circles” model has been adapted by the major health disciplines, all of which endorse the policy of evidence-based practice (EBP). Indeed, the Institute of Medicine (IOM) has named EBP as a core competence for health professionals (Greiner and Knebel 2003). The IOM's guidance aims to speed up the glacial rate at which medical discoveries are translated into practice and to increase the delivery of recommended health care (IOM 2001). The endorsement of EBP accords also with the National Institute of Health (NIH)'s Roadmap initiative to break down disciplinary silos and accelerate the transfer between research and practice (Zerhouni 2005). Just as the research teams of the future will be interdisciplinary, the practice teams of the future will be interprofessional (Grumbach and Bodenheimer 2004; Zerhouni 2005).
The challenges associated with translational science and interprofessional practice are substantial and call for more unified practice models, a common language, and unifying goals (Stokols 2006; Stokols et al. 2008). Because the training of practitioners in the health professions differs, their vocabulary, conceptual frameworks, and research methods often differ as well, thereby impeding cross-disciplinary translation. A recent review of interprofessional health education (IPHE) highlights these challenges and confirms that although a handful of studies support IPHE, this area is still in its infancy (Reeves et al. 2008). Although interdisciplinary groups like the United States Preventive Services Task Force (USPSTF), the Cochrane Collaboration, and the Campbell Collaboration have offered successful and influential systematic reviews and practice guidelines, these organizations serve as “producers” of evidence-based materials and rarely serve as EBP “consumers,” that is, frontline practitioners or policymakers engaged in clinical decision making who might benefit from translational and transdisciplinary dissemination and training. Readers are directed elsewhere for more information about these important collaboratives or the EBP guidelines (e.g., http://www.cochrane.org; http://www.ahrq.gov/clinic/uspstfix.htm; Guyatt and Rennie 2007).
The coauthors of this article hail from medicine, nursing, psychology, social work, and public health and also have formed the Council on Evidence-Based Behavioral Practice supported by NIH's Office of Behavioral and Social Sciences Research (OBSSR). In this article we examine the history and evolution of evidence-based practice policies in our respective professions in order to produce a shared EBP conceptual model and process that uses the unique strengths from each profession and addresses the common criticisms of evidence-based practices; for example, the evidence is too narrowly defined; the role and value of practitioners and their expertise are unclear; resources and/or contextual factors are ignored; and not enough attention is paid to the client's preferences. In each discipline-specific section we present a brief history of EBP, a conceptual model, and a discussion of the EBP process, including what constitutes legitimate “data” or “evidence.” We conclude by offering a harmonized, transdisciplinary model of evidence-based practice that specifies a common language and an enriched process for clinical and/or policy decision making surpassing that of a single disciplinary approach. We hope that this enhanced, hybrid model will support a collaborative dissemination and implementation of evidence-based health practices at the individual, community, and population levels.
322 citations
TL;DR: The paper provides an overview of the approach and discusses issues that arise when using discrete choice experiments to assess individuals’ preferences for health and healthcare.
Abstract: To investigate the impact of health policies on individual well-being, estimate the value to society of new interventions or policies, or predict demand for healthcare, we need information about individuals’ preferences. Economists usually use market-based data to analyze preferences, but such data are limited in the healthcare context. Discrete choice experiments are a potentially valuable tool for elicitation and analysis of preferences and thus, for economic analysis of health and health programs. This paper reviews the use of discrete choice experiments to measure consumers’ preferences for health and healthcare. The paper provides an overview of the approach and discusses issues that arise when using discrete choice experiments to assess individuals’ preferences for health and healthcare.
201 citations
TL;DR: SEM must be thrust into the daily vocabulary and routine practice of health behavior researchers by allowing for the specification of complex, theory-driven models that can be tested with empirical data.
Abstract: Objective: To introduce the state of the art of structural equation modeling (SEM). Method: This primer is organized in a manner allowing readers to review any one of 5 freestanding sections. Results: SEM maintains several advantages over regression and other multivariate techniques. Through a 2-step modeling process, SEM strengthens research by allowing for the specification of complex, theory-driven models that can be tested with empirical data. Although use of SEM alone is not a magic solution, new software developments provide users with unparalleled flexibility for improving research. Conclusion: SEM must be thrust into the daily vocabulary and routine practice of health behavior researchers.
128 citations
TL;DR: It is found that the majority of pharmacies do not offer accommodations that facilitate access to prescription medications, including home-delivery, with considerable variation by pharmacy type and across counties.
Abstract: Importance
Despite their increasingly important role in health care delivery, little is known about the availability, and characteristics, of community pharmacies in the United States.
Objectives
(1) To examine trends in the availability of community pharmacies and pharmacy characteristics (24-hour, drive-up, home delivery, e-prescribing, and multilingual staffing) associated with access to prescription medications in the U.S. between 2007 and 2015; and (2) to determine whether and how these patterns varied by pharmacy type (retail chains, independents, mass retailers, food stores, government and clinic-based) and across counties.
Methods
Retrospective analysis using annual data from the National Council for Prescription Drug Programs. Pharmacy locations were mapped and linked to the several publically-available data to derive information on county-level population demographics, including annual estimates of total population, percent of population that is non-English speaking, percent with an ambulatory disability and percent aged ≥65 years. The key outcomes were availability of pharmacies (total number and per-capita) and pharmacy characteristics overall, by pharmacy type, and across counties.
Results
The number of community pharmacies increased by 6.3% from 63,752 (2007) to 67,753 (2015). Retail chain and independent pharmacies persistently accounted for 40% and 35% of all pharmacies, respectively, while the remainder were comprised of mass retailer (12%), food store, (10%), clinic-based (3%) or government (<1%) pharmacies. With the exception of e-prescribing, there was no substantial change in pharmacy characteristics over time. While the number of pharmacies per 10,000 people (2.11) did not change between 2007 and 2015 at the national-level, it varied substantially across counties ranging from 0 to 13.6 per-capita in 2015. We also found that the majority of pharmacies do not offer accommodations that facilitate access to prescription medications, including home-delivery, with considerable variation by pharmacy type and across counties. For example, the provision of home-delivery services ranged from less than <1% of mass retailers to 67% of independent stores and was not associated with county demographics, including ambulatory disability population and percent of the population aged ≥65 years.
Conclusions
Despite modest growth of pharmacies in the U.S., the availability of pharmacies, and pharmacy characteristics associated with access to prescription medications, vary substantially across local areas. Policy efforts aimed at improving access to prescription medications should ensure the availability of pharmacies and their accommodations align with local population needs.
123 citations