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PubMedDate not supplied

[Dispensation of opioids by pharmacists in Tunisia].

This national survey aims to evaluate opioid availability and prescription by pharmacists in Tunisia and to examine pharmacists' attitude regarding Tunisian law. We surveyed a sample of 300 pharmacists randomly selected from the National Council of Pharmacists list and using the random table. This study started in September 1999 by sending to pharmacists a confidential questionnaire asking about the importance, the rate of sale and the availability of analgesics in their pharmacy. It also tried to determine pharmacists' opinions regarding Tunisian law. A total of 157 pharmacists out of 300 responded to the survey (52 per cent), 95 per cent were working in pharmacies and 15 per cent in hospitals. Analgesics were estimated to be important to very important in their work in 84 per cent and less important in 16 per cent of cases. They were given under advice with great importance in 85 per cent of cases and with less importance in 15 per cent of cases. Analgesic self-medication was frequent in 95 per cent of cases and rare in 4 per cent of cases. Analgesics of levels 1 and 2 were often to always available in 97 per cent of cases and rarely available in 1.5 per cent of cases. Some 84.7 per cent of pharmacists had opioid supplies and 8.9 per cent had no opioids in stock and 6.4 per cent hadn't given a response. 30 per cent of pharmacists think that the 7 days law for opioid prescription should be modified and 66 per cent think it should not, fearing illicit use, fraud and dependance. Pharmacists think that the minimal list of opioids to be stocked in a pharmacy is sufficient because of low demand.

Analgesics, Opioid↗
PubMed1992

Clinical privileges program for pharmacists.

A clinical privileges program for pharmacists is described. In 1985 and 1989 the Department of Veterans Affairs (VA) issued circulars defining policy on clinical privileges for pharmacists at its medical centers. Pharmacists at one large VA medical center responded by developing a clinical privileges program. Bylaws under which medical staff members are granted clinical privileges were used as a model for the pharmacist program. A pharmacist seeking privileges prepares an application detailing his or her background and the practice areas involved in the request; the applicant also drafts a quality assurance protocol. The application is reviewed by a pharmacist clinical privileges review board (PCPRB). The PCPRB uses the quality assurance plan to verify that adequate measures are in place to meet standards of care. If a question of patient safety arises, the board meets to review the pharmacist's activities. Each pharmacist who is granted privileges must have a physician sponsor. Since the first meeting of the PCPRB in 1990, clinical privileges have been requested by all 24 clinical pharmacy specialists at the center. No pharmacist has been denied privileges, although the board has required additional training or improved quality assurance protocols for many. Acceptance of the program by the medical staff has been good. A clinical privileges program at a VA medical center offers pharmacists the opportunity to practice pharmaceutical care.

Medical Staff Privileges↗
PubMed1981

Effect of exposure on physicians' attitudes toward clinical pharmacists.

The effect of exposure to clinical pharmacists on physicians' favorability toward clinical pharmacy was studied. Questionnaires were sent to 576 physicians belonging to a county medical society. The survey measured the extent to which physicians agreed that hospital pharmacists should: (1) maintain drug profiles, (2) monitor prescribing patterns of physicians to preempt adverse reactions, (3) counsel patients at bedside, (4) decide on the frequency of use and dosage forms of physician-prescribed drugs, and (5) independently choose the drug to be prescribed based in the physician's diagnosis. A Guttman scale of task favorability was computed and compared four respondent groups: (1) physicians unaware of clinical tasks being practiced in hospitals, (2) physicians aware of clinical services but not knowing the clinical pharmacists, (3) physicians knowing the pharmacists but not working with them, and (4) physicians working with clinical pharmacists. There were 180 usable responses. While all groups were unfavorable to pharmacists independently choosing drugs, the physicians in groups exposed to pharmacists were favorable toward pharmacists counseling patients (p less than 0.001) and deciding on frequency of use and dosage forms of physician-prescribed drugs (p less than 0.05). More than 90% of the physicians working with clinical pharmacists ranked their quality of work as good or excellent. Exposure was related to specialty, risk of malpractice claim, and participation in hospital meetings. Exposure had a positive effect on the favorability of physicians toward clinical pharmacists and their services.

Attitude of Health Personnel↗
PubMed2003

Pharmacists' attitudes toward and practices with adolescents.

BACKGROUND: Adolescents often face barriers to health care. As pharmacists' scope of practice expands, they may be in positions to decrease barriers to care for adolescents. OBJECTIVE: To describe pharmacists' attitudes toward and practices with adolescents. DESIGN: Cross-sectional self-administered survey of chief pharmacists at 1361 Indiana pharmacies. Survey items inquired about sociodemographic variables, adolescent-specific pharmacy practices, and training in adolescent health issues. SETTING: All active, licensed pharmacies in Indiana were surveyed. PARTICIPANTS: Nine hundred forty-eight surveys (70%) were returned. Sixty-five percent of responding pharmacists were male, 54% were younger than 45 years, and 58% had been practicing for more than 15 years; 47% practiced in areas with fewer than 30 000 people. MAIN OUTCOME MEASURES: Pharmacists' attitudes toward and practices with adolescents. RESULTS: The majority of pharmacists (94%) dispensed prescriptions for adolescents, but 57% felt inadequately trained in adolescent-specific issues. Forty-eight percent of pharmacies did not dispense emergency contraception. Pharmacists were more likely to report dispensing contraceptives directly to 17-year-olds than to 14-year-olds, and were more likely to report contacting a parent or provider before dispensing contraceptives to 14-year-olds. CONCLUSIONS: Adolescents often require pharmacy services, but many pharmacists feel inadequately trained in adolescent-specific issues. Confidentiality may not be maintained by all members of the health care team, and a prescription may be refused by the receiving pharmacist. Younger adolescents may face more barriers to care than older adolescents. Increasing pharmacists' knowledge and skills in adolescent issues, especially confidentiality, may decrease barriers to care and improve adolescent health outcomes.

Adolescent↗
PubMedDate not supplied

Community pharmacists as patient advocates: physician attitudes.

OBJECTIVES: To assess physician attitudes toward community pharmacists acting as patient advocates with respect to drug-related matters, and to correlate physician attitudes with physician characteristics and physician-pharmacist interactions. SETTING: State of Utah. PARTICIPANTS: Physicians in family practice, internal medicine, pediatrics, and psychiatry. INTERVENTIONS: Mail survey. MAIN OUTCOME MEASURES: Physician attitudes toward community pharmacists performing 15 patients advocacy activities, as well as physician-pharmacist interaction and respondent demographics. RESULTS: Favorable attitudes were identified for pharmacists monitoring drug use, counseling patients, advising physicians, contacting physicians to discuss patients' pharmacotherapy, and recording over-the-counter product use in patient profiles. Attitudes were less favorable toward pharmacists helping patients manage adverse drug reactions, suggesting drug regimen alterations, providing health screening services, selecting drugs by a protocol, discussing therapeutic equivalents with patients, and changing dosage forms to better suit patient needs. Physician age was negatively correlated with attitude toward a pharmacist aiding a physician in selecting a drug to be prescribed. The helpfulness of physician-pharmacist interactions was positively correlated with physician attitudes. CONCLUSION: From the physician's perspective, the most appropriate areas for expansion of the community pharmacist's role into patient advocacy are in monitoring pharmacotherapy, assisting physicians in coordinating pharmacotherapy, and providing patients with medication information. Physician resistance is more likely in areas where community pharmacists assume a more autonomous role in patient care.

Attitude of Health Personnel↗
PubMed2000

Community pharmacists' views and beliefs about the treatment of symptoms suggestive of vaginal thrush in community pharmacies.

OBJECTIVE: To investigate the views and beliefs of community pharmacists about the benefits and disadvantages to the customer, pharmacy and pharmacist of treating women with symptoms suggestive of vaginal thrush. DESIGN: Semi-structured interviews. SETTING: Community pharmacists from within Grampian Primary Care NHS Trust. OUTCOME MEASURES: Pharmacists' views and beliefs analysed using content analysis. RESULTS: Of the 26 pharmacists contacted, 19 (73%) pharmacists from 16 pharmacies completed interviews. The pharmacists were generally positive towards the treatment of women with vaginal symptoms and perceived few disadvantages. Immediate access to treatment and rapid symptom relief were perceived to be the greatest advantages to the customer. The main problems were customer embarrassment, cost and the risk of masking a serious condition. Customer embarrassment was perceived to be influenced by lack of privacy and the gender of the member of staff involved in the consultation. Five pharmacists perceived vaginal thrush to be an infection that could be spread by sexual transmission. DISCUSSION: There is a need to make pharmacists aware of the current evidence regarding the treatment of vaginal thrush, particularly the sexual partners of women with acute, uncomplicated thrush do not require treatment with an antifungal. The main difficulties that community pharmacists reported with the treatment of this condition were obtaining an accurate history and this was influenced by customer embarrassment. The gender of pharmacy staff and lack of private consultation facilities were suggested as factors that are associated with customer embarrassment and hence, the ability to obtain an accurate history.

Adult↗
PubMed1991

Management of childhood diarrhoea by pharmacists and parents: is Britain lagging behind the Third World?

OBJECTIVE: To investigate the role of community pharmacists in providing advice and treatment for children with diarrhoea; to investigate mothers' responses to diarrhoea in their children. DESIGN: Cross sectional questionnaire study of a random selection of community pharmacists and of mothers attending child health clinics. Pharmacists were interviewed and given a questionnaire and a separate group was visited by a researcher posing as a parent; mothers were interviewed at the clinic. SETTING: Newcastle upon Tyne. SUBJECTS: 20 pharmacists were interviewed and visits by a researcher posing as a parent were carried out to 10 different pharmacists; 58 mothers were interviewed. MAIN OUTCOME MEASURES: Advice given by pharmacists was contrasted with standard advice on management of diarrhoea in children. RESULTS: Half of the pharmacists interviewed and 70% of pharmacists visited by a researcher posing as a parent recommended inappropriate treatment of childhood diarrhoea (such as antidiarrhoeal drugs and withholding breast milk), and only 30% at interview stated that they would ask for the age of the child. Mothers' knowledge of home treatment was inadequate. All pharmacists in the posed visits recommended a purchased treatment. CONCLUSION: Pharmacists are widely used by parents for consultation for children's ailments but their advice is not always appropriate; hence they should be given more consistent training in recognising and managing clinical problems. Medical advice on management of diarrhoea is also inconsistent and should be modified to conform to the guidelines of the World Health Organisation.

Child, Preschool↗
PubMedDate not supplied

Do community pharmacists influence prescribing?

OBJECTIVES: To evaluate whether community pharmacists have the ability to influence prescribing decisions and to determine the extent to which they do so. DATA SOURCES: International Pharmaceutical Abstracts was searched for articles published between January 1970 and September 2002 and MEDLINE was searched for articles published between January 1966 and September 2002 that contain the terms pharmaceutical care or pharmacist and intervention. STUDY SELECTION: Selected studies documented pharmacist interventions that resulted in a change in prescribing that required influencing the prescriber, included a complete description of methods and results, and were conducted in community pharmacies in the United States. DATA EXTRACTION: Selected studies were examined to determine whether, in what ways, and to what extent community pharmacists influenced prescribing. DATA SYNTHESIS: Community pharmacists in traditional practices regularly, but infrequently, recommend to prescribers that they initiate, discontinue, or change drug therapy. Prescribers usually accept and implement pharmacists' suggestions. Pharmacists are more likely to intervene to correct drug therapy problems when they have been trained to provide pharmaceutical care and have modified their practices to accommodate a more patient-centered style of practice. In the larger reviewed studies, pharmacists intervened to change therapy for the majority of their patients. CONCLUSION: Community pharmacists routinely intervene to influence prescribing. They do so, for the most part, to correct clinical problems or to provide their patients with more affordable therapy. In the majority of interventions, physicians accept and implement pharmacists' suggestions.

Community Pharmacy Services↗
PubMedDate not supplied

Pharmacist care plans and documentation of follow-up before the Iowa Pharmaceutical Case Management program.

OBJECTIVES: To document drug therapy problems and their causes and assess pharmacist follow-up of patients with identified drug therapy problems. DESIGN: Cross-sectional analysis. SETTING: Iowa. PARTICIPANTS: 160 pharmacists who submitted 754 pharmaceutical care plans in an effort to qualify for participation in the Iowa Pharmaceutical Case Management program. INTERVENTIONS AND MAIN OUTCOME MEASURES: Care plans were assessed for drug therapy problems and causes and for documentation of pharmacist follow-up (actual, none, or intent to follow up). RESULTS: Pharmacists documented a wide variety of drug therapy problems and causes, including adverse drug reactions (20.1% of care plans), need for additional drug therapy (18.9%), lack of patient adherence to therapy (16.3%), incorrect medication being prescribed (14.1%), and drug dose too high (10.0%). Pharmacist follow-up with patients was not optimal, with 31% of care plans providing documentation of actual follow-up. Another 42.2% of plans indicated that the pharmacist intended to contact the patient for follow-up but either did not do so or did not record the intervention. No actual follow-up or intent to follow up was recorded in 26.8% of care plans. Pharmacists practicing in independent pharmacies followed up with patients more frequently than those in other settings (36.4% of care plans, compared with 22.7%, 23.2%, and 28.4% for chain, clinic, and franchise pharmacies). Pharmacists were more likely to follow up when the identified problem involved drug safety rather than effectiveness (36.2% versus 28.3% of care plans). CONCLUSION: Documentation of pharmacist follow-up with patients was less than optimal. In addition to identifying drug therapy problems and causes, pharmacists must complete the care continuum through documentation of patient monitoring and follow-up to transform the philosophy and vision of the pharmaceutical care concept into a practice of pharmacy recognized and rewarded by patients and payers.

Case Management↗
PubMedDate not supplied

Developing a mobile pharmacist-conducted wellness clinic for rural Montana communities.

OBJECTIVE: To describe pharmacist-conducted disease screening services in remote communities. SETTING: Frontier, rural, and nonrural counties throughout western Montana. PRACTICE DESCRIPTION: Using federal telehealth funds, a motor home was converted into a mobile office and equipped with a satellite transmitting/receiving dish to provide wireless Internet access. The pharmacist uses an ultrasound unit to test heel bone density, a spirometer to test lung function, and appropriate analyzers to measure A1C and serum lipid levels. Screening clinics are held in conjunction with county health departments, tribal health authorities, community pharmacies, county agricultural extension agents, and Federally Qualified Health Centers. Employee wellness clinics are also conducted. Student pharmacists assist with screenings. PRACTICE INNOVATION: Mobile pharmacist-conducted disease screening clinics in remote communities. MAIN OUTCOME MEASURES: Number of communities served, number of patients screened, percentage of test results out-of-range/patients referred to their primary health care providers for follow-up, number of student pharmacists participating, and total revenues generated. RESULTS: During the first 2 years of the project, IPHARM pharmacists traveled approximately 14,000 miles, conducted 72 clinics in 17 counties and performed 5,100 screening tests for more than 3,100 people. Approximately 36% of all screening test results were outside of expected range. More than 80 student pharmacists, most of whom were on clinical rotations, participated in the clinics and 11 community pharmacists have been trained to conduct screenings. In excess of dollar 70,000 was generated by the project in operating revenue and donations. At the conclusion of IPHARM's first year of operations, the motor home was taken out of service because of the cost of gasoline, difficulties of winter travel with such a large vehicle, and the realization that virtually all host organizations were able to provide space in which the screening clinics could be conducted. CONCLUSION: Pharmacists and student pharmacists are capable of providing disease screening services in remote frontier and rural communities. Obtaining sufficient payment for these services in rural communities to cover costs remains a challenge.

Adult↗
PubMed1994

Nutritional support: pharmacists' influence on the prescribing process.

A commitment was made at a 1,025-bed county teaching facility to increase staff pharmacists' involvement in nutritional support and physician prescribing. The plan was to utilize the Nutritional Support Clinical Pharmacy Specialist (NSCPS) to train the staff pharmacists to provide direct patient care for patients receiving parenteral nutrition. The implementation included specialized training for staff pharmacists, staff pharmacists monitoring all parenteral nutrition patients, pharmacists' attendance at nutritional support rounds, documentation of all pharmacist interventions, and pharmacists' involvement in the drug-usage evaluation (DUE) process. The results of the increased influence of pharmacists on the prescribing process included more appropriate parenteral nutrition therapy, earlier transitioning from parenteral to enteral nutrition, recognition of staff pharmacists as resources by the physicians, and increased job satisfaction for pharmacists.

Drug Utilization↗
PubMed2003

[The directions of the activity of the Society of Lithuanian Pharmacists in 1922-1940].

The aim of this work is to examine the directions of the activity of the Society of Lithuanian Pharmacists in 1922-1940. When preparing this work archive documents, the publications of the magazine "Pharmaceutical News" and other periodical press was investigated. In the independent Republic of Lithuania (1918-1940) four professional pharmaceutical organizations were active. The most influential one was the Society of Lithuanian Pharmacists, established on September 18, 1922, where only owners of pharmacies could become its real members. This organization united about 80% of owners of pharmacies in all the country. The main directions of the activity of the Society were the following: active participation in the creation of a legitimate basis of pharmacy, concern for the interests and ethics of its members, publication, participation in an international activity. The Society of Lithuanian Pharmacists belonged to the International Pharmaceutical Federation (IPF), and established the Society of Baltic Pharmacists together with societies of Latvian and Estonian pharmacists in 1938. The Society of Lithuanian Pharmacists paid great attention to the problems of professional ethics and it used to fight with the so called "soiled competition". The Court of Honour was established for this purpose which tried the violations of ethics by the members of the society. The magazine "Pharmaceutical News" was being published in common with the Union of Lithuanian Pharmacists in 1923-1940. It was the main professional pharmaceutical magazine in Lithuania which reflected pharmaceutical problems of that time, was concerned with the ways to solve them and the activity of organizations. The Society of Lithuanian Pharmacists became stronger and stronger gradually, gained bigger and bigger authority and extended the directions of its activity. Moreover, it started to take care of the heritage of pharmaceutical history and charity as well. In particular, the Society of Lithuanian Pharmacists established the museum of an ancient Lithuanian pharmacy, financially supported the Society of Lithuanian Pharmacy Students and other organizations. When Lithuanian was occupied by the Soviet Union, the activity of all societies was ceased, societies of Lithuanian pharmacists stopped functioning on September 13, 1940 as well.

History of Pharmacy↗
PubMed1978

Community, hospital and clinical pharmacists and drug information centers as physician drug information sources.

The use of drug information centers and clinical, hospital and community pharmacists by university and community practice physicians in North Carolina was examined. Questionnaires were sent to 674 nonfederal physicians with a response rate of 203 (35.5%). Approximately half of the sample were staff members of a university hospital. The questionnaire covered eight types of drug information. Significant results were reported at the p = 0.05 level. Physicians sought specific drug information approximately one to four times a month. University hospital-affiliated physicians rated clinical and hospital pharmacists significantly higher than community pharmacists for six subject areas, and they also ranked clinical pharmacists over hospital pharmacists on four subject areas and considered them more reliable than other pharmacy drug information sources. Physicians associated with community hospitals ranked hospital pharmacists over community pharmacists as sources of information for four areas and rated them more reliable than other pharmacy drug information sources; this group preferred to use community pharmacists for information on product availability. It appears that clinical pharmacists are used by university-associated physicians as drug information sources. Use in community hospitals of the hospital pharmacist as a drug information source is better than the literature might suggest.

Attitude of Health Personnel↗
PubMed2026

Factors associated with successful integration of pharmacists into residential aged care teams: A qualitative study.

BACKGROUND: Australia's Aged Care Onsite Pharmacist program aims to support quality use of medicines in residential aged care homes. This is a novel role introduced into existing teams in a complex environment. Factors associated with successful integration since implementation are currently unknown. AIM: This study aims to explore the perspectives of pharmacists and other stakeholders within aged care homes regarding successful integration of the novel aged care pharmacist service into healthcare teams. METHODS: A qualitative approach, using interpretive descriptive methodology, was used to explore perspectives. Semi-structured focus groups and interviews with pharmacists, nursing and care staff, allied health professionals, general practitioners, residents, and family members were undertaken. Data were collected via Zoom™, audio- and video-recorded, and transcribed verbatim. Two researchers undertook inductive thematic analysis to identify key themes. RESULTS: 30 participants across focus groups, focus-group interviews, interviews, and member-checking processes contributed. An overarching theme of proactivity and showing a genuine interest in others underpinned three key themes. Theme 1: Pharmacists needed to be seen, through physical presence and availability, as well as developing a distinct identity. Theme 2: Pharmacists needed to build trust, through collaboration in real time and demonstrating value. Theme 3: Pharmacists needed to develop an understanding of the aged care home environment, including social and contextual norms, as well as procedures, routines and roles. DISCUSSION: This research complements existing understandings of interprofessional collaboration and teamwork amongst healthcare professionals. Themes were interlinked; we used a sensitising framework, social cognitive theory, to present and explain the findings and interactions that can support pharmacist integration into existing teams. Aged care services should structure onboarding to prioritise early visibility, clarify roles and organisational needs, and foster in-person collaboration. Pharmacists should demonstrate proactivity and an authentic interest in all staff, residents and families.

Humans↗
PubMed1999

Pharmacist participation on physician rounds and adverse drug events in the intensive care unit.

CONTEXT: Pharmacist review of medication orders in the intensive care unit (ICU) has been shown to prevent errors, and pharmacist consultation has reduced drug costs. However, whether pharmacist participation in the ICU at the time of drug prescribing reduces adverse events has not been studied. OBJECTIVE: To measure the effect of pharmacist participation on medical rounds in the ICU on the rate of preventable adverse drug events (ADEs) caused by ordering errors. DESIGN: Before-after comparison between phase 1 (baseline) and phase 2 (after intervention implemented) and phase 2 comparison with a control unit that did not receive the intervention. SETTING: A medical ICU (study unit) and a coronary care unit (control unit) in a large urban teaching hospital. PATIENTS: Seventy-five patients randomly selected from each of 3 groups: all admissions to the study unit from February 1, 1993, through July 31, 1993 (baseline) and all admissions to the study unit (postintervention) and control unit from October 1, 1994, through July 7, 1995. In addition, 50 patients were selected at random from the control unit during the baseline period. INTERVENTION: A senior pharmacist made rounds with the ICU team and remained in the ICU for consultation in the morning, and was available on call throughout the day. MAIN OUTCOME MEASURES: Preventable ADEs due to ordering (prescribing) errors and the number, type, and acceptance of interventions made by the pharmacist. Preventable ADEs were identified by review of medical records of the randomly selected patients during both preintervention and postintervention phases. Pharmacists recorded all recommendations, which were then analyzed by type and acceptance. RESULTS: The rate of preventable ordering ADEs decreased by 66% from 10.4 per 1000 patient-days (95% confidence interval [CI], 7-14) before the intervention to 3.5 (95% CI, 1-5; P<.001) after the intervention. In the control unit, the rate was essentially unchanged during the same time periods: 10.9 (95% CI, 6-16) and 12.4 (95% CI, 8-17) per 1000 patient-days. The pharmacist made 366 recommendations related to drug ordering, of which 362 (99%) were accepted by physicians. CONCLUSIONS: The presence of a pharmacist on rounds as a full member of the patient care team in a medical ICU was associated with a substantially lower rate of ADEs caused by prescribing errors. Nearly all the changes were readily accepted by physicians.

Boston↗
PubMed2004

Pharmacists' role in reporting adverse drug reactions in an international perspective.

INTRODUCTION: The participation of the pharmacist in national spontaneous reporting systems for adverse drug reactions (ADRs) has not always been a matter of course. Even today, there are a number of countries, in particular the Scandinavian countries, where pharmacists are not authorised to report ADRs. In those countries in which they are allowed to report, they do not always use this opportunity. METHODS: We have conducted a review of the literature to investigate the involvement of pharmacists in ADR reporting. In addition, we evaluated the pharmacists' actual contributions in 2001 by means of an international questionnaire-based survey among the countries participating in the WHO Drug Monitoring Programme in September 2002. Apart from the numbers of pharmacists' reports, respondents were asked to indicate their assessment of both the quality and the significance of the contribution. Of the 68 participating countries, 41 responded by returning the questionnaire. RESULTS AND CONCLUSIONS: The appreciation of pharmacists' ADR reports is high in those countries that have more experience with greater numbers of pharmacists' reports. The countries that received fewer reports from pharmacists gave lower scores to their contribution. If the specific contribution pharmacists can make to the quantity and quality of ADR reports were to be exploited to a greater extent, this could lead to a substantial improvement of the international adverse drug reactions reporting system.

Adverse Drug Reaction Reporting Systems↗
PubMed2005

Development of the specialist menopause pharmacist (SMP) role within a research framework.

OBJECTIVE: To determine the potential contribution of a new healthcare practice model, the specialist menopause pharmacist (SMP) role. METHOD: Post pilot, the SMP's remit was proposed as combining clinical practice (service delivery) and research studies, with emphasis on strengthening liaison between the secondary and primary care sectors. Action research, a qualitative research technique, was selected to document role development in the first year. Here the pharmacist-researcher's focus was a local situation where the effects of a particular change, involving people who were part of the situation, were assessed. The change factor was the introduction of the pharmacist to the multi-disciplinary specialist team. The pharmacist-researcher did not attempt to hold anything constant but observed the changes occurring in a systematic manner. Analysis of on-going collaborative professional activity generated the hypothesis that the role was of use in enhancing patient care. Using triangulation and focusing on the descriptive phrase 'of use', it was then possible to study SMP implemented 'actions' that would be accepted as being 'useful' SMP functions. The aim was to test for reliability and obtain data with greater range and accuracy. The three studies undertaken included a controlled, questionnaire study asking for patients' views on the pharmacist service, auditing health professionals usage of the pharmacist operated telephone help-line, and assessing the impact of structured on-site training on community pharmacists. MAIN OUTCOME MEASURE: Overall impact and achievements over 3 years, against a background where the SMP role continued to develop during the study. RESULTS: Action research methodology engendered reflective practice, enabling the SMP to be both the service delivery provider (the intervention) and the researcher. This pharmacist practice model is accepted both by patients and health professional colleagues. The remit combines clinical practice with on-going research studies. In the UK setting, the SMP can undertake numerous liaison activities between secondary and primary care sectors to facilitate enhanced delivery of menopause patient care. CONCLUSION: Using an action research approach, and combining qualitative and quantitative methods to complement data collection, it was possible to assess the specialist pharmacist role in depth.

Education, Pharmacy, Continuing↗
PubMed2006

Community pharmacists in Australia: barriers to information provision on complementary and alternative medicines.

OBJECTIVE: To determine, by surveying Australian community pharmacists, the perceived barriers to the provision of information about complementary and alternative medicines (CAMs) and suggestions for overcoming them. METHOD: Anonymous, self-administered survey sent to a random sample of 701 pharmacists registered in three states of Australia in 2004. MAIN OUTCOME MEASURE: Pharmacists' perceived barriers to the provision of information about CAMs. RESULTS: A total of 344 questionnaires were returned by pharmacists (49% response) of which 211 (30%) were currently practising in community pharmacy. Ninety-five percent of surveyed community pharmacists indicated that they personally received enquires about CAMs, with fewer than 15% reporting they were "very confident" in answering queries about safety, interactions or benefits of CAMs. Frequently used CAM information sources were those from manufacturers and distributors, professional newsletters and journals and textbooks. Pharmacists' perceived barriers to the provision of CAM information included a lack of suitable training (most training was informal), deficiencies in available information sources, a lack of managerial support, the need for regulatory changes, consumer beliefs about CAM safety and time constraints due to competing demands in daily practice. Pharmacists proposed improvements to overcome these barriers including improvements to training. CONCLUSION: There is scope for pharmacy professional organisations and educational institutions to further support pharmacists in their practice through providing information on the best information sources available and training that meets the needs of undergraduate students, pharmacists and other pharmacy staff. There is a need to examine regulatory requirements concerning the provision of product information with CAMs in Australia and to implement mechanisms for increasing consumer awareness of regulatory procedures for these medicines.

Adolescent↗