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PubMed1987

Effect of innovation characteristics on pharmacists' use of written patient medication information.

There is increasing pressure on pharmacists to provide written medication information in patients. Unfortunately, recent evidence indicates that this practice has not yet been extensively adopted. Pharmacists' reluctance can be explained partially by Diffusion of Innovations Theory which states that the characteristics of an innovation (i.e. relative advantage, compatibility with needs, experience and values, complexity and trialability) can affect its rate of adoption within a community. This theory was tested in a group of Michigan community pharmacists who recently purchased medication information sheets developed by the Michigan Pharmacists Association. Results were compared with a randomly selected sample of similar pharmacists who had not yet purchased the kit. Study findings support the theory that the adoption of an innovation (i.e. use of written information) is affected by the adopters' perception of certain innovation characteristics. The most influential factor in the adoption of the written information sheets was the extent that they were compatible with the pharmacists' business needs, professional values, and past experiences with providing written information to patients. The most important deterrent to adoption of the sheets appeared to be the perceived complexity in implementation at the practice site.

Communication↗
PubMed2004

The National Lipid Association surveys of consumers, physicians, and pharmacists regarding an over-the-counter statin in the United States: is this a good idea?

Surveys commissioned by the National Lipid Association (NLA) were conducted to determine the current attitudes and perceptions of physicians, consumers, and pharmacists regarding the impact of an over-the-counter (OTC) statin. Individuals from preexisting independent databases were randomly invited to participate in the online surveys that were open from January 26 to 30, 2004 for physicians and consumers and from March 1 to 12, 2004 for pharmacists. The results of these surveys indicate that consumers and pharmacists are more positive regarding the idea of an OTC statin, whereas physicians are more guarded. Concerns of both physicians and pharmacists included the discontinuation by patients of their prescription cholesterol-lowering therapy without consulting their physician, safety issues such as potential drug interactions and side effects, and patient ability to self-manage OTC statins. Consumers interested in purchasing an OTC statin reported that they would consult their physician before doing so, and pharmacists were interested in supporting consumers who use OTC statins. Although such support would require further training and time, pharmacists believed that they could facilitate consumer self-care programs and follow-up with physicians.

Anticholesteremic Agents↗
PubMed2005

A qualitative study of pharmacists' perspectives on the supply of emergency hormonal contraception via patient group direction in the UK.

AIM: To investigate pharmacists' views and experiences of supplying emergency hormonal contraception (EHC) via a group prescribing protocol in community pharmacies in the UK. DESIGN: Qualitative study using depth interviews. SETTING: Community pharmacists in Manchester, Salford and Trafford (Greater Manchester), and Lambeth, Southwark and Lewisham (London) Health Action Zones in the UK. PARTICIPANTS: Forty-four community pharmacists supplying EHC in Manchester, Salford and Trafford, and Lambeth, Southwark and Lewisham (London). RESULTS: Pharmacists were broadly very positive about their experiences supplying EHC via the group prescribing protocol. Pharmacists identified many benefits of the EHC schemes for clients, in particular, improved access to EHC at no cost to clients. The confidential nature of the scheme was also seen as an advantage as was the scope for referral to other service providers. Pharmacists also believed that the scheme had benefits for the profession in terms of enhanced professional standing. However, their concerns included the extent of repeated use of EHC, the possible impact on contraceptive behaviors and sexually transmitted infections and its impact on male coercive sexual behavior. CONCLUSIONS: Although pharmacy supply of EHC may improve access for some clients and is perceived as a popular service, research into the implications of the schemes as identified in this study need to be conducted.

Anecdotes as Topic↗
PubMed2026

A systematic literature review of cultural concepts taught by pharmacist preceptors during pharmacy student experiential placements.

BACKGROUND: Cultural concepts such as cultural intelligence, awareness, competency and safety are essential in guiding culturally responsive care in health professional practice. Pharmacist preceptors play a pivotal role in sharing both clinical and cultural safe practice with pharmacy students. Culturally responsive care can contribute to achieving health equity, which is especially important for Indigenous communities. AIM: To review literature on cultural concepts in pharmacist preceptorship practices, and how these concepts are taught and communicated to pharmacy students during experiential learning. METHOD: The systematic review followed the PRISMA 2020 guideline. Scopus, PubMed, and Google Scholar were used to identify articles specific to pharmacist preceptors and pharmacy students published between 2015 and 2025, and available in English. RESULTS: Three full-text articles met the inclusion criteria. Major themes and subthemes were identified; pharmacist preceptors lacked preparedness to teach cultural concepts, resulting in variability in preceptors' understanding of cultural concepts and confidence in fulfilling preceptor responsibilities, underutilised structured frameworks to guide students' learning, challenges with preceptorship due to limited resources and support, and the influence of preceptorship on student learning, which impacted students' learning and competency. CONCLUSION: Pharmacy students had minimal exposure to culturally informed pharmacist preceptorship. It is likely that pharmacist preceptors require country-specific educational resources to support culturally safe preceptorship. Future research is required to substantiate these findings, and to guide culturally responsive practice and promote equitable health outcomes in diverse populations.

Humans↗
PubMed1992

The role of pharmacists in patients' education on medication.

The pharmacist, as the last health professional to come into contact with the patient, plays a vital role in patient education on drug use. The objective of this study was to assess the extent of pharmacists' involvement in the education of patients on drug use. Five hundred patients were interviewed. The findings indicated that both physicians and pharmacists explained the use of medication; however, pharmacists (20%) were much clearer in their instructions than physicians (11%). Ninety percent of patients who needed more information on their medicines, besides its frequency of use, did not receive it. Patients were not told about drug adverse reactions (100%), storage conditions (93%), important precautions (91%), drug-food interaction (90%) and preparation of suspensions (64%). Fifty-one respondents had in the past made mistakes in the use of their medications, and in 16% this resulted in serious consequences. Ninety-three prescriptions contained drug-drug interactions, and 97% of these were dispensed unnoticed. Of the patients interviewed, 72% were satisfied with the role of pharmacists in disseminating drug information, 67% would get a refill from them without going to their physicians, and 52% had consulted them for OTC medications. It is concluded that, although there are some deficiencies, pharmacists are providing information on drug usage and patients have confidence in them. They should, therefore, acquire the proper training and communication skills to enable them to provide this service more effectively.

Adolescent↗
PubMed1989

Georgia pharmacists' attitudes toward cigarettes and smokeless tobacco.

To determine the degree to which pharmacists might cooperate with other health-care providers in reducing tobacco use, the authors surveyed 500 Georgia pharmacists on their knowledge, attitudes, and sales practices regarding cigarettes and smokeless tobacco (ST). Analysis of the 152 questionnaires (30.3%) returned showed that respondents' knowledge of the effects of tobacco use, especially cigarettes, was high. Overall, pharmacists believe that pharmacies should not sell cigarettes and ST; sales to minors and radio and television advertising of tobacco should be prohibited; and ST is not a safe alternative to cigarettes. More employee pharmacists than managers sold cigarettes when they did not believe they should, citing the reason that higher management makes the decision. Managers who didn't believe they should sell tobacco products said they did so because they felt the public should be free to choose. These findings may reflect a tendency of pharmacists to accept employment without control over conditions, and suggest that encouraging pharmacists to use their influence to discourage tobacco use might be acceptable to practitioners.

Adult↗
PubMed1998

Pharmacists as vaccine advocates: roles in community pharmacies, nursing homes, and hospitals.

Pharmacists increasingly take on immunization roles for their communities: advocates, facilitators and immunizers. Between 50 and 94% of people who receive a pharmacist's recommendation to be immunized accept that recommendation. Over 5 million doses of influenza vaccine per year are administered in pharmacies. In 25 states, pharmacists are authorized to administer immunizations. More than 1000 pharmacists were trained to immunize in 1997. Consultant pharmacists can recommend vaccines in nursing facilities in the course of monthly drug regimen reviews. People have exceptional access to pharmacist at a wide variety of hours. Pharmacy-based immunization training incorporates safeguards that mimic or exceed quality standards in public-health clinics.

Health Knowledge, Attitudes, Practice↗
PubMedDate not supplied

Pharmacists' attitudes regarding quality of worklife.

OBJECTIVE: To examine the quality of worklife of pharmacists across practice environments. DESIGN: Written survey mailed to a stratified random sample of pharmacists. PARTICIPANTS: 2,014 pharmacist-members of the American Pharmaceutical Association (APhA) residing in the United States. MAIN OUTCOME MEASURES: Work-related attitudes including job satisfaction, career satisfaction, organizational commitment, turnover intention, likelihood of voting for a union, and patient care issues. RESULTS: Usable surveys were returned by 1,199 practicing APhA members (60% response rate). Overall, work-related attitudes were generally positive. However, clear differences were identified in quality-of-worklife perceptions associated with practice setting, area of primary responsibility, and several demographic variables. Some quality-of-worklife concerns were found in all practice settings. While a majority of respondents indicated that they would not vote for a union at their place of employment if given the opportunity, 43% of staff employee pharmacists (who would likely be targeted in any union campaign) indicated that they would definitely or probably vote for a union. CONCLUSION: From the pharmacist's perspective, important quality-of-worklife issues include job and career satisfaction, turnover intention, and patient care concerns. The data provide a point of departure for future dialogue, action, and research aimed at understanding and enhancing the quality of pharmacists' worklife.

Adult↗
PubMedDate not supplied

On-line DUR messages: pharmacists' attitudes and actions in response.

Community pharmacists are encountering on-line drug utilization review (DUR) messages with increasing frequency. DUR messages are sent by third party claims processors and generated by pharmacies' in-house computer systems. The purpose of this study was to ascertain community pharmacists' attitudes toward on-line DUR messages and the actions most often taken by pharmacists after receiving these messages. A 28-item questionnaire was mailed to a random sample of 1,500 community pharmacies throughout the United States. Four hundred twenty-seven questionnaires were returned and analyzed (a 28.5% response rate). The majority of respondents were male pharmacists practicing in independent community pharmacies in cities with populations of less than 50,000. The low response rate from chain pharmacies was an important limitation of this study. The results indicate that pharmacists find DUR messages related to medication overuse and drug interactions to be the most useful. Interventions are not performed for all DUR messages received, and interventions usually consist of telephoning physicians and talking to patients. This study demonstrates that many types of DUR messages are useful to pharmacists; however, additional research and further refinement of DUR messages appear necessary.

Attitude↗
PubMedDate not supplied

Impact of OBRA '90 on pharmacists' patient counseling practices.

OBJECTIVE: To assess the impact of OBRA '90 regulations on the counseling practices of community pharmacists in Nebraska. METHODS: A telephone survey was conducted of 80 randomly selected community pharmacies throughout Nebraska. A modified written survey was mailed to the 34 telephone nonrespondents and to another 86 randomly selected community pharmacists. A composite response rate (combining both survey methods) of 67.5% (112 of 166) was obtained, and responses were sorted into an independent community pharmacy group (n = 80) and a chain pharmacy group (n = 32). RESULTS: Only 44.6% of respondents reported that time devoted to patient counseling had increased as a result of OBRA '90. Chain pharmacists generally devoted more time to counseling after OBRA '90 became effective than did independent community pharmacists. CONCLUSION: While more than three out of four pharmacists felt adequately prepared for mandated patient counseling, fewer than half reported that time devoted to counseling had increased. Although the profession is moving toward the standard of pharmaceutical care, many pharmacists are not yet counseling as the law requires.

Community Pharmacy Services↗
PubMedDate not supplied

Pharmacists' knowledge of and attitudes toward opioid pain medications in relation to federal and state policies.

OBJECTIVE: To assess Wisconsin pharmacists' knowledge of and attitudes toward the use of opioid analgesics in the management of chronic cancer and noncancer pain, and to explore the potential for these beliefs to interfere with pharmacist dispensing, the last link of the distribution chain of controlled substances to patients. DESIGN: Mail survey. SETTING: Urban and rural pharmacies, long-term care facilities, hospitals, and outpatient clinics in Wisconsin in 1998. PATIENTS OR OTHER PARTICIPANTS: Representative sample of Wisconsin pharmacists. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Responses to self-administered questionnaires. RESULTS: Although most respondents were knowledgeable about the issues addressed in this study, there were important exceptions. Not all pharmacists knew what constitutes legitimate dispensing practices for controlled substances under federal or state policy in emergencies or for patients with terminal illnesses, and many were unaware of the important distinctions among addiction, physical dependence, and tolerance. Many respondents did not view the chronic prescribing/dispensing of opioids for more than several months to patients with chronic pain of malignant or nonmalignant origin as a lawful and acceptable medical practice; this was especially true when the patient had a history of opioid abuse. CONCLUSION: Pharmacists play a pivotal role in ensuring patient access to medications. Viewed in the context of federal and state controlled substances policies, our findings suggest that the incorrect knowledge and inappropriate attitudes of some pharmacists could contribute to a failure to dispense valid prescriptions for opioid analgesics to patients in pain.

Adult↗
PubMed1995

Pharmacists as agents of change for rational drug therapy.

We analyze what is known and unknown about the contribution of the pharmacist as patient educator, physician consultant, and agent to affect patient outcomes in ambulatory settings. The need for pharmacist services is discussed, as are the theoretical underpinnings and quality of the scientific evidence to support their efficacy. The analysis is conducted in the context of a shift in pharmacists' roles from product to patient orientation as well as recent U.S. legislation mandating enhanced pharmacists' roles via drug utilization review for all Medicaid patients. We conclude with a research and action agenda, calling for stronger research designs in evaluating pharmacists' interventions. The shifting paradigm in the pharmacy profession, coupled with the implementation of the Omnibus Budget Reconciliation Act of 1990, provide unique opportunities for rigorous evaluations of pharmacists as agents of change for rational drug therapy.

Ambulatory Care↗
PubMed2001

A randomized trial to measure the optimal role of the pharmacist in promoting evidence-based antibiotic use in acute care hospitals.

BACKGROUND: There is a considerable gap between randomized clinical trials and implementing the results into practice. This is particularly relevant in the use of broad-spectrum antibiotics in hospitals. Hospital pharmacists can be effective vehicles for bridging this gap and promoting evidence-based medicine. To determine the most effective way of using the pharmacist in this role, a prospective cefotaxime intervention study was conducted with randomization incorporated into the design as well as patient-related therapeutic outcomes. METHODS: A total of 323 patients who were prescribed cefotaxime were randomized into an intervention or nonintervention group where only the former was challenged by pharmacists for inappropriate cefotaxime usage relative to hospital guidelines. The primary outcome was the appropriateness of cefotaxime prescribing between groups. Logistic regression analysis was then used to identify factors that were associated with successful clinical response. RESULTS: Overall, 94% of orders in the intervention group met cefotaxime dosage criteria compared with 86% in the control group (p = .018). However, there was no impact with respect to promoting cefotaxime use for an appropriate indication (81% vs. 80%; p = .67). There was a trend for improved clinical outcomes in patients who received cefotaxime within hospital guidelines (OR = 1.73; p = .31). CONCLUSIONS: The pharmacist as a vehicle for promoting the appropriate use of broad-spectrum antibiotics in the acute care hospital setting can improve the dosing of such agents. However, several barriers to optimizing the impact of the pharmacist were implied by the data. Removing these barriers could increase the pharmacists' utility as an agent for improved patient care.

Anti-Bacterial Agents↗
PubMed2000

The benefits of a hospital based community services liaison pharmacist.

OBJECTIVE: To investigate the benefits of a community services liaison pharmacist in addressing medication misuse in elderly patients, which occur on both admission and discharge. DESIGN: Completion of a medication history for each patient on admission by the community liaison pharmacist. On discharge updated medication record sheets were faxed to the patient's GP and community pharmacy; a survey of GPs' and community pharmacists' opinions who were involved in the study was carried out. SUBJECTS AND SETTING: 109 patients over the age of 60 on 4 or more medications admitted by the medical admissions unit of Antrim Area Hospital. MAIN OUTCOME MEASURES: Medication related problems; GP and community pharmacist opinions of the service. RESULTS: Of the 109 patients, 61% had an incomplete medication history on admission, 21% of patients who brought their own drugs were not dealt with appropriately in hospital and 33% of discharged patients had medication-related problems. The service was felt to be very useful by GPs (80%) and community pharmacists (100%). A reduction in readmission rate of 2.4% was seen in these patients compared to the average for this age group. CONCLUSION: The community services liaison pharmacist produced benefits in terms of patient medication management, reduced readmission rates and wastage of patients' own drugs. A more detailed one-year study will now be carried out.

Aged↗
PubMed2001

Pharmacist involvement with warfarin dosing for inpatients.

This study audits the quality of medical inpatient maintenance anticoagulation control by junior doctors and evaluates the impact of the implementation of warfarin guidelines on the anticoagulation control achieved by doctors compared with that by a pharmacist. Introduction of warfarin guidelines made no significant difference to the anticoagulation control achieved by junior doctors. The pharmacist demonstrated significantly better (p < 0.001) therapeutic control than the doctors in the areas of anticoagulation control measured, namely international Normalised Ratios (INRs) less than two and greater than six and INRs within the therapeutic range. The pharmacist overall, maintained 58% of INRs within range compared to 15% by junior doctors, over a twelve week period. In addition, there was a major reduction in the number of INRs requested by the pharmacist. Extrapolated over a year, this would amount to approximately 3,500 fewer INR requests on the medical wards. The effect of pharmacist dosing was also demonstrated in the difference in timing of warfarin administration by nursing staff. A much larger percentage of doses (90%) was administered within one hour of the prescribed time, compared to junior doctors (15%). This study has demonstrated that there is a role for the clinical pharmacist dosing warfarin for inpatients, by offering improved anticoagulation control, in addition to the accepted role in outpatients. It also shows that such involvement provides improved quality of patient care, reduced number of INR requests and improvement in the coordination of patient discharge between primary and secondary care.

Adolescent↗
PubMed2001

Nursing and residential care for the elderly in Northern Ireland: the contribution of the pharmacist.

AIM OF THE STUDY: To gain more detailed information on the current pharmaceutical service provision in nursing and residential homes in Northern Ireland and to assess the views of care staff on future pharmacy services. METHOD: A structured questionnaire was developed and mailed to all nursing and residential homes (n = 586) in Northern Ireland on two occasions. RESULTS: A response rate of 68% (n = 396) was obtained. The most frequent services currently provided by community pharmacists were the supply of medication and the collection of unwanted, discontinued or out-of-date medicines. The majority of respondents also reported receiving advice on safe-keeping, correct administration of medicines, advice on more appropriate formulations and advice on patient medication records from the community pharmacist. Over a third of all the respondents received advice on compliance devices. A similar proportion stated that their care staff were trained by the pharmacist on broad medication management issues. Over 90% of all homes strongly supported staff training by pharmacists on the recognition of medication-related problems as a future service. Over 70% of all respondents thought additional guidelines and advice for missed dosages and the use of home remedies would be beneficial. A review of patient medication records to assess drug-drug interactions and possible adverse drug reactions by pharmacists was supported by over 65% of all respondents. CONCLUSIONS: This work has demonstrated that those responsible for care in nursing and residential facilities strongly support further involvement by the pharmacist in these care facilities; pharmacy policy makers must ensure that such services are developed to meet the needs of these vulnerable elderly residents.

Aged↗
PubMed1998

Pharmacists' concerns and suggestions related to the sale of tobacco and alcohol in pharmacies.

A random sample of Pharmacists in Indiana was selected and surveyed regarding their thoughts and comments on the sale of tobacco and alcoholic products by pharmacies. A total of 212 pharmacists provided written responses to an open-ended question. The replies were then synthesized into major themes. The majority of comments categorized revealed strong opposition to pharmacies selling tobacco and alcohol products. The most frequently occurring message regarding the sale of these products by pharmacies was that it goes against the pharmacist's role as a professional health care provider and may harm their image. For some pharmacists, this issue posed a moral dilemma between caring for patient safety and the economic incentives provided by the sale of tobacco and alcohol. Based on these findings, a follow-up phone survey was conducted to solicit suggestions from pharmacists on how to advocate against the sale of tobacco and alcohol by pharmacies. The majority of pharmacists strongly recommended that they need to do more among themselves and within their store environment, rather than have regulations imposed on pharmacies when it comes to limiting the sale of these products.

Adult↗
PubMed2002

Community pharmacists' perspectives on pharmaceutical care implementation in New Zealand.

OBJECTIVE: There were three objectives to this study: to establish New Zealand community pharmacists' level of understanding of the pharmaceutical care process, to determine their attitudes to the concept of pharmaceutical care; and to determine the barriers to commencing pharmaceutical care practice. Comparisons were made between proprietors (pharmacy owners) and employees, males and females, and younger and older pharmacists. METHOD: The research tool was a questionnaire instrument, encompassing a total of 67 questions designed to determine community pharmacists' understanding, attitudes and appreciation of the opportunities and barriers inherent in the pharmaceutical care process. A total of 490 pharmacists representing 286 proprietors and 204 employees randomly selected from the Pharmaceutical Society register were sent a questionnaire. RESULTS: The total responses numbered 377, which was a 76.9% overall response rate. Over 60% of the pharmacists surveyed had a correct understanding of pharmaceutical care. Approximately the same percentage felt the future of pharmacy would depend on the provision of services other than dispensing. Insufficient time, as a barrier to implementation, was identified by 87% of respondents, and an absence of a reimbursement system by a further 82%. Lack of: therapeutic knowledge; clinical problem solving skills; finance; appropriate space, patient demand; access to patient medical records, and data on the value of PC were identified as major barriers by over 50% of all respondents. There were significant differences in response to a number of issues recorded by males and females, proprietors and employees, and pharmacists above and below the mean sample age of 45 years. CONCLUSION: This study found that the community pharmacy environment in New Zealand had a high level of understanding of the pharmaceutical care process, but identified some significant barriers to implementation.

Adult↗