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PubMed2005

Migraine therapy: a survey of pharmacists' knowledge, attitudes, and practice patterns.

OBJECTIVE: Study pharmacists' knowledge, attitudes, and practice patterns with regard to migraine therapy. BACKGROUND: Pharmacists interact with headache sufferers at least 53,000 times daily, thus are well positioned to improve the less than optimal medication management of these disorders. Methods.-Two hundred self-administered surveys, distributed at a migraine symposium, assessing pharmacists' demographic characteristics and level of agreement or disagreement with treatment approaches were conducted. RESULTS: A total of 171 useable surveys (86%) were received. Of the sample, 35% were community pharmacists, 29% were hospital pharmacists, and the remainder were from other work environments. Exclusively among community pharmacists, 80% feel that headache is an important part of their practice, 85% make between one and five over-the-counter (OTC) headache product suggestions per day, and 12% make six or more daily OTC recommendations. Among all the sample's pharmacists, more than half feel migraine patients should try OTC drugs prior to prescription medications, only half ask patients about headache-related morbidity, and one-third feel migraine-specific medications should be reserved only for patients who initially fail nonspecific drugs. Few pharmacists utilize published migraine treatment guidelines. Approximately two-thirds of pharmacists do not feel migraine is a neurobiological illness. The majority is comfortable with their ability to identify people needing a physician referral. CONCLUSIONS: Our results show pharmacists, particularly those in community pharmacies, interact with headache sufferers multiple times daily. Most pharmacists were neither familiar with nor practice migraine therapies endorsed by evidence-based guidelines. Further training of pharmacists is warranted.

Drug Prescriptions↗
PubMed1990

Evaluation of pharmacists' practice in patient education when dispensing a metered-dose inhaler.

Improper inhalation technique with beta-agonist metered-dose inhalers (MDIs) decreases efficacy of the bronchodilator. The success of demonstrating the correct technique and the pharmacist's role in patient education has been reported. To obtain information regarding the routine patient education practice of pharmacists when dispensing a beta-agonist MDI (albuterol), the following study was performed. Fifty-two prescriptions for an albuterol MDI were presented to 52 randomly chosen community pharmacists in three Tennessee cities. Twenty-six independent and 26 chain pharmacies wer evaluated. Pharmacists' practice with regard to patient education, instruction, and demonstration of the correct usage of the MDI was observed and recorded. Overall, 13 percent of the pharmacists initially offered to educate the patient-investigator (PI) regarding the correct usage of the MDI without being asked for information. Fifty-three percent of pharmacists offered information only upon being asked specifically how to use the MDI. Of the pharmacists who offered to educate the PI, 71 percent discussed less than half of the eight steps correctly. Only 1 of the 52 pharmacists actually demonstrated MDI inhalation technique, and this in response to a request. No pharmacist asked the PI to perform the technique while he/she observed. No pharmacist offered information on delivery enhancement devices. Our results demonstrate that few pharmacists educate patients on the correct usage of an MDI, and that many pharmacists are not aware of the correct technique.

Evaluation Studies as Topic↗
PubMed2006

U.S. and Canadian pharmacists' attitudes, knowledge, and professional practice behaviors toward dietary supplements: a systematic review.

BACKGROUND: Although dietary supplements (DS) are widely sold in pharmacies, the legal, ethical, and practice responsibilities of pharmacists with respect to these products have not been well defined. This systematic review of pharmacists' attitudes, knowledge, and professional practice behaviours toward DS is intended to inform pharmacy regulators' and educators' decision making around this topic. METHODS: Eligible studies were identified through a systematic database search for all available years through to March 2006. Articles were analyzed for this review if they included survey data on U.S. or Canadian pharmacists' attitudes, knowledge, or professional practice behaviors toward DS published in 1990 or later. RESULTS: Due to the heterogeneity of the data, it was not possible to draw a conclusion with respect to pharmacists' general attitudes toward DS. Approximately equal numbers of pharmacists report positive as well as negative attitudes about the safety and efficacy of DS. There is strong agreement among pharmacists for the need to have additional training on DS, increased regulation of DS, and quality information on DS. In addition, survey data indicate that pharmacists do not perceive their knowledge of DS to be adequate and that pharmacists do not routinely document, monitor, or inquire about patients' use of DS. Despite this, a large proportion of pharmacists reported receiving questions about DS from patients and other health care practitioners. CONCLUSION: Further research is needed to explore the factors that influence pharmacists' beliefs and attitudes about DS, to accurately evaluate pharmacists' knowledge of DS, and to uncover the reasons why pharmacists do not routinely document, monitor, or inquire about patients' use of DS.

Canada↗
PubMedDate not supplied

Pharmacy placement of nonprescription nicotine replacement therapy products and community pharmacists' counseling for product use.

OBJECTIVE: To investigate the relationship between nonprescription nicotine replacement therapy (NRT) product placement within community pharmacies and the number of patients whom pharmacists report counseling for use of these products. DESIGN: Cross-sectional study. SETTING: Four Northern California counties. PARTICIPANTS: 327 community pharmacists. INTERVENTIONS: Survey mailed in 1999-2000. MAIN OUTCOME MEASURES: Estimated number of NRT purchasers who received counseling in their pharmacy and pharmacists' level of control over NRT purchases and counseling as functions of the location of the NRT products within the pharmacy setting. RESULTS: Of 327 community pharmacists surveyed, 26 (8.0%) reported that all nonprescription NRT products were stocked behind the pharmacy counter (full control over NRT purchases and counseling), 46 (14.1%) reported that all NRT products were stocked outside of the pharmacy department in an area that could not be seen easily by the pharmacist (no control), and the remainder (n = 255; 78.0%) indicated that all NRT products were located within their visual field but not behind the counter and/or that NRT products were located in more than one of the three previously described store locations (i.e., behind counter, not behind counter but within visual field, and outside visual field) (partial control). While adjusting for known confounders (pharmacists' self-efficacy for counseling, practice setting, and perceived pros of counseling), NRT product location was significantly associated with counseling of four or more patients a month for use of these products (P = .005). Specifically, compared with pharmacists with no control over NRT purchases and counseling, pharmacists with full control were 4.73 (95% CI, 1.46-15.37) times as likely to counsel four or more patients per month, and pharmacists with partial control were 2.95 (95% CI, 1.47-5.94) times as likely. Compared with pharmacists with partial control, pharmacists with full control were 1.60 (95% CI, 0.58-4.41) times as likely to counsel at least four patients monthly (P = .361). CONCLUSION: The location of nonprescription NRT products within the community pharmacy setting is associated with the number of patients whom pharmacists report counseling for use of these products.

Administration, Cutaneous↗
PubMedDate not supplied

Importation of prescription medications: experiences, opinions, and intended behaviors of U.S. community pharmacists.

OBJECTIVE: To describe community pharmacists' experiences with consumer demand for imported pharmaceuticals and their opinions about economic, policy, and patient care issues surrounding importation of medications and their willingness to procure these products from international sources, if legally permitted. DESIGN: Cross-sectional study. SETTING: Four states in the United States (Michigan, Minnesota, Illinois, and Florida). PARTICIPANTS: Community/outpatient pharmacists. INTERVENTIONS: Telephone-based survey conducted in March 2004. MAIN OUTCOME MEASURES: Self-reported opinions of pharmacists on importation of prescription drugs. RESULTS: Of 401 respondents, approximately 90% agreed that the Medicare prescription drug benefit would not diminish consumer interest in importation of medications, and a similar proportion agreed that interest was not limited to the elderly. A majority of pharmacists (69%) agreed that their primary concern about importation was the quality (i.e., purity) of the drugs. However, 57% of pharmacists agreed that drugs purchased through Canada would not pose a greater risk of medication-related problems if U.S. pharmacists oversaw the process and were available to provide patient monitoring and education. Pharmacists strongly favored regulatory actions that might decrease counterfeiting. Nearly one third (32%) of pharmacists believed that consumers should be allowed to purchase medications from Canada legally, while 44% of pharmacists believed that pharmacies should be able to procure prescription drugs from Canada legally. Almost 70% of pharmacists said that they would consider ordering medications from Canada, if legally permitted. Approximately one half of the pharmacists surveyed were concerned about job security as a result of the trend toward importation. This concern was significantly higher among pharmacy owners (chi-square [df= 1] = 9.82; P < .01). CONCLUSION: Pharmacists expressed concern about safety, liability, and the economic ramifications of prescription drug importation. More favorable opinions were expressed for situations in which imported drugs would be channeled through U.S. pharmacies.

Attitude of Health Personnel↗
PubMedDate not supplied

Future of emergency contraception lies in pharmacists' hands.

OBJECTIVE: To increase community pharmacists' awareness about issues related to the provision of emergency contraception (EC) to women by describing pharmacist outreach and training programs and discussing pharmacy access and stocking issues, California's EC Pharmacy Program, methods for raising pharmacists' awareness, and professional development opportunities. SUMMARY: EC is both safe and effective in reducing the risk of unintended pregnancy after unprotected intercourse, yet awareness of and demand for the medication has not been high, and it often is not stocked in pharmacies. Various advocacy organizations have engaged in educating the public and physicians about EC, but relatively little attention and few resources have been targeted to ensure that the pharmacy community is aware of and educated about EC. Increased visibility and access to EC in the several states that allow pharmacists to provide EC directly to women have resulted from the active participation and leadership of pharmacists. In these states, women are showing interest in and receptivity to reproductive health services provided by pharmacists. In California, some 3000 pharmacists statewide have completed training, and in 2004 they provided EC directly to approximately 175,000 women. Pharmacists who provide EC overwhelmingly (91%) report that they do so because they see it as an important community service, and many (57%) recognize the opportunity for professional development. CONCLUSION: Pharmacists are uniquely positioned to improve access to EC, and leadership within the pharmacy community can facilitate efforts to improve access. Increased education and training of pharmacists about EC--such as continuing education programs available online at www.pharmacyaccess. learnsomething.com--are critical to ensure not only that EC is available in pharmacies but also that pharmacists are engaged in meeting the reproductive health needs of women. Increased access to EC can expand pharmacists' role in health care provision. State-specific information about EC pharmacy access initiatives is available on the Web at www.GO2EC.org.

California↗
PubMed2006

Drug-related problems in the community setting: pharmacists' findings and recommendations for people with mental illnesses.

BACKGROUND AND OBJECTIVE: Adverse drug events are a leading cause of morbidity in Australia and internationally. People taking psychotropic drugs for mental illnesses may be particularly susceptible. This study aimed to classify and describe pharmacists' Home Medicines Review (HMR) findings and recommendations for people with mental illnesses. METHODS: This was a descriptive study conducted from March to November 2003. General practitioners and community pharmacists practising in two regions of metropolitan Sydney were invited to participate. General practitioners recruited and referred community-dwelling people with mental illnesses to receive HMRs conducted by accredited pharmacists. Reviewing pharmacists interviewed 49 people in their homes. During the interviews the pharmacists provided drug information, assessed drug knowledge and beliefs, and assessed drug adherence. Pharmacists then produced written referenced reports that outlined drug-, patient- and prescriber-related findings and recommendations. These findings and recommendations were presented to the referring general practitioners at follow-up case conferences. MAIN OUTCOME MEASURES: Drugs were classified using the Anatomical Therapeutic Chemical Classification System. Pharmacists' findings and recommendations were classified using the Clinical Pharmacy Activity Classification System. RESULTS: The most common types of nervous system drugs taken by people who received a HMR were antidepressants (n = 39.33%), analgesics (n = 29.24%) and antipsychotics (n = 17.14%). Pharmacists reported 403 findings and made 360 recommendations for 49 people, with 90% of recommendations being accepted by the referring general practitioners. The most common findings related to potential adverse drug reactions (n = 53, for 47% of people), suspected adverse drug reactions (n = 48, for 55% of people), potential interactions (n = 30, for 37% of people), and people taking additional drugs unbeknown to their referring general practitioner (n = 26, for 25% of people). The most common recommendations were to switch a drug (n = 37, for 49% of people), suggest a non-drug treatment (n = 29, for 41% of people) and to suggest a new drug (n = 27, for 49% of people). At the time of referral, general practitioners documented people to be taking 7.8 +/- 4.4 (mean +/- SD) drugs each (range 1-18). Following home interviews, pharmacists determined people to be taking 9.1 +/- 4.8 drugs (range 1-20). This difference was statistically significant (p < 0.001). CONCLUSIONS: Pharmacists identified a high incidence of drug-related problems among people receiving treatment for mental illnesses. Pharmacists also identified a higher incidence of overall drug use than documented by the referring general practitioners. HMRs and case conferences, undertaken collaboratively by general practitioners and pharmacists, may be a useful strategy to identify drug-related problems among people with mental illnesses.

Adult↗
PubMed2004

What do mothers of young children think of community pharmacists? A descriptive survey.

AIM: To discover the attitudes of mothers of young children towards community pharmacists, and mothers' use of community pharmacies for childhood illnesses OBJECTIVES: To discover how frequently mothers visit pharmacies; for which childhood complaints they tend to consult a pharmacist first, rather than other health professionals; to identify how helpful mothers feel their pharmacists are; and to identify whether mothers prefer pharmacists with particular demographic characteristics, eg having children of their own. METHODS: A questionnaire survey based on the results of four focus groups conducted with mothers of children aged under five years. 117 questionnaires were distributed by five pharmacies in Northern England to a convenience sample between July and September 2000, with one written reminder to non-respondents one month later. A total of 85 (73%) were returned and the anonymised data were entered into SPSS for Windows for analysis. RESULTS: 61% of mothers claimed to visit the pharmacy once a month or more but only 22% of mothers claimed to have had advice from the pharmacist once a month or more. 57% of the mothers are loyal customers to one pharmacy. 87% of the mothers reported that pharmacist's advice was helpful or very helpful. Mothers sought advice from pharmacists for minor childhood ailments but not always in the first instance. Mothers did not feel that the demographic characteristics of the pharmacists affected the advice given but they expressed a personal preference for receiving advice from female pharmacists with children. LIMITATIONS AND RECOMMENDATIONS: This was an exploratory study with a small sample so the results cannot be generalised. Also, convenience sampling is prone to bias. However, this qualitative study presents some preliminary indications about mothers' use of pharmacies for advice on young children's ailments, and suggests aspects that warrant further investigation. CONCLUSION: In this study, mothers of children under five years of age rated pharmacist's advice as helpful. They did not consider that the demographics of the pharmacist would affect the advice they received, but preferred to consult a pharmacist with children.

Adult↗
PubMedDate not supplied

Pharmaceutical care in chain pharmacies: beliefs and attitudes of pharmacists and patients.

OBJECTIVE: To discuss with pharmacists and patients with reactive airways disease their beliefs about pharmaceutical care and the pharmacist's role in health care, obstacles to providing pharmaceutical care in community pharmacies, and strategies to overcome these obstacles. DESIGN: Two focus groups of patients, two focus groups of pharmacists. PARTICIPANTS: Thirteen patients with reactive airways disease and 11 chain pharmacists. MAIN OUTCOME MEASURES: Qualitative reports on the pharmacist's role in health care delivery and obstacles to implementing pharmaceutical care programs. RESULTS: Pharmacists wished to provide pharmaceutical care, and patients were supportive of pharmacists' involvement in their health care. Both viewed counseling as an important role for pharmacists and believed that pharmacists should work with patients' physicians. Reported obstacles included lack of time, inadequate privacy, and pharmacists' lack of direct access to patients' physicians. Pharmacists and patients believed pharmacists should have access to patient-specific clinical data. CONCLUSION: Focus groups provided valuable information for designing pragmatic pharmaceutical care. The obstacles and possible solutions identified through the discussions represent fertile ground for designing innovative pharmaceutical care programs.

Asthma↗
PubMed1999

Pharmacist-operated drug information centres in Singapore.

OBJECTIVE: Relatively little is known about the organized drug information centres (DICs) in Asia. Here we evaluate the four pharmacist-operated DICs in Singapore and compare them with published information on DICs located in Australia, the U.K. and the U.S., and with established guidelines for quality assurance of DICs. METHODS: A prospective survey was conducted in 1996 in which two sets of questionnaires were developed and distributed to the DIC pharmacists to elicit information on the DIC as well as the DIC pharmacists. In addition, the enquiry records received by the DICs over the period 1 April to 31 July 1996 were collated for evaluation. RESULTS: All the pharmacist-operated DICs in Singapore were well equipped with facilities for information retrieval, storage and dissemination, and they had adequate literature resources comparable with DICs in Australia, the U.K. and the U.S. They also complied with many of the DIC guidelines compiled by The Society of Hospital Pharmacists of Australia, except for the institution of formal quality assurance programmes, which was lacking in all centres. The professional activities of the local DIC pharmacists were also similar to their counterparts in Australia, the U.K. and U.S., but the job scope could be expanded to include other activities that are gaining impetus among other DIC pharmacists. Postgraduate professional training of pharmacists was inadequate compared with the specialist training received by DIC pharmacists in the U.S. A total of 2517 enquiries were collated for evaluation. Physicians were the major class (47-57%) of enquirers in the local hospitals. The classes of questions received by the DICs were not different from those received by DICs elsewhere, although the DICs in the hospitals received a preponderance of questions on dose (20-25%) and product availability (13-16%). More than 60% of enquiries received by the DICs in the hospitals were answered within 5 min, while about 80% of the enquiries required reference to not more than one literature resource. CONCLUSIONS: The pharmacist-operated DICs in Singapore have comparable standards to established DICs in Australia, the U.K. and U.S., while the workload and activities of the local DIC pharmacists are similar to their counterparts in these countries. It is recommended that the DICs institute formal quality assurance programmes and expand the training and job scope of the DIC pharmacists.

Australia↗
PubMed2000

New York City pharmacists' attitudes toward sale of needles/syringes to injection drug users before implementation of law expanding syringe access.

In May 2000, New York State passed legislation permitting the sale, purchase, and possession of up to 10 needles and syringes (hereafter "syringes") without a prescription, intended to reduce blood-borne pathogen transmission among injection drug users (IDUs). To obtain baseline data on pharmacists' attitudes and practices related to human immunodeficiency virus (HIV) prevention and IDUs, a telephone survey was administered to 130 pharmacists systematically selected in New York City. Less than half of pharmacists were aware of the new law; 49.6% were willing to or supported providing nonprescription sales of syringes to IDUs. Pharmacists in support tended to be less likely to consider customer appearance "very important." Managing and supervising pharmacists were more likely than staff pharmacists to support syringe sales to IDUs. Managing and supervising pharmacists who stocked packs of 10 syringes and personal sharps disposal containers, pharmacists who supported syringe exchange in the pharmacy, and pharmacists who were willing to sell syringes to diabetics without a prescription were more likely to support syringe sales to IDUs. Syringe disposal was a prominent concern among all pharmacists. Those not in support of syringe sales to IDUs tended to be more likely to believe the practice would increase drug use. These data suggest the need for initiatives to address concerns about syringe disposal and tailored continuing education classes for pharmacists on HIV and viral hepatitis prevention among IDUs.

Attitude of Health Personnel↗
PubMedDate not supplied

How pharmacists respond to on-line, real-time DUR alerts.

OBJECTIVE: To quantify the type and frequency of drug utilization review (DUR) alerts sent by one claims processor to pharmacists; identify how pharmacists respond to these on-line, real-time DUR messages; and quantify the interventions taken by these pharmacists as a result of these alerts. DESIGN: Retrospective analysis of Medicaid claims from July 1, 1995, through June 30, 1996. SETTING: State of Delaware. PARTICIPANTS: 55,000 Medicaid recipients served by 170 participating pharmacies and 2,000 physicians. INTERVENTIONS: All on-line DUR alerts sent to pharmacists and the pharmacists' responses were categorized by alert type and analyzed by drug class. MAIN OUTCOME MEASURES: Pharmacists' response (dispensed prescription, contacted prescriber, talked with patient, consulted own reference sources) and drug classes. RESULTS: During the study period, 807,017 claims generated 83,260 DUR alerts involving 73,554 (9.1%) prescriptions. Prescriptions were not dispensed in 20.9% of cases because of the DUR message. Prescriptions were dispensed 17.7% of the time after the pharmacist contacted the prescriber, in 20.6% of cases after the pharmacist talked with the patient, and 37.2% of the time after reviewing internal resources. Action taken by pharmacists varied among and within DUR criteria categories. Specific examples of alerts generated in high-frequency and high-profile areas are reviewed, some of which generated inconsistent responses. CONCLUSION: Among Delaware Medicaid providers, drug alerts resulted in pharmacists not dispensing prescriptions in a surprising percentage of situations. Pharmacists' responses varied according to the drug class involved and the type of alert received.

Drug Interactions↗
PubMed2002

A survey of pharmacists' opinions and practices related to the sale of cigarettes in pharmacies-revisited.

The objective of the study was to follow-up on important findings from a 1996 statewide survey of Indiana pharmacists regarding their opinions and practices related to the sale of cigarettes in pharmacies. More specifically, this study was designed to (1) collect 2001 state-wide data concerning the percentage of Indiana pharmacies selling cigarettes and to learn what pharmacists think about the sale of cigarettes in their stores; (2) compare these findings with results from a 1996 study; and collect new information on (3) whether a cigarette selling policy in pharmacies in which pharmacists are employed differs from their professional and personal values; (4) pharmacists' opinions related to state-wide initiatives on tobacco control in Indiana; and (5) the level of involvement with smoking cessation activities by community pharmacists. A 1996 survey instrument of Indiana pharmacists opinions and practices related to the sale of cigarettes in pharmacies served as the basis for questionnaire design. In addition, 11 new items were added to assess the three new objectives of the study. This questionnaire was administered to half of the 1,280 pharmacies in Indiana. Collected data were analyzed by using descriptive and inferential statistical methods. Findings reveal that independent pharmacies had significantly reduced their sale of cigarettes from 1996 while there was no significant change among retail chain pharmacies. Additionally, significantly more pharmacists in 2001 believed that pharmacies should not sell cigarettes compared to five years ago. Also, more than three-fourths of pharmacists who worked in pharmacies that sold cigarettes felt it differed from their professional values. When it came to pharmacists involvement in tobacco control activities, results were mixed. This study found that the majority of pharmacists do not ask their patients about their smoking habits. In addition, an overwhelming majority of Indiana pharmacists were unfamiliar with a number of state public health programs/resources on smoking preven- tion and cessation. Nevertheless, it was very encouraging that nearly three-fourths of the pharmacies offer counseling programs for smokers who want to quit and more than one-half believed that increasing the state excise tax on cigarettes would be effective on tobacco control in Indiana.

Adult↗
PubMed2000

Comparative effectiveness of general practitioner versus pharmacist dosing of patients requiring anticoagulation in the community.

OBJECTIVE: To compare pharmacist- with general practitioner-managed anticoagulation in the community. DESIGN: Included in the study were all patients who had been managed by general practitioners (GPs) and subsequently referred to the pharmacist-led outreach service within Gateshead & South Tyneside Health Authority. A retrospective analysis was carried out recording individual international normalized ratio (INR) estimations, the time interval between successive tests and whether the result resided within the prescribed therapeutic range. These values were derived for both the GP- and pharmacist-managed elements of care. SUBJECTS: Fifty-one patients who met the inclusion criteria identified from eight practices had been successively treated by GPs and then by pharmacists. Eighteen patients (35.3%) had a diagnosis of non-rheumatic atrial fibrillation, 10 (19.6%) had thromboembolic disease and 13 (25.5%) had valvular disease. RESULTS: In total, 1782 INR results were analysed. GPs were responsible for 1075 (60.3%) of these estimations and pharmacists for the remaining 707 (39.7%). Of the GP-monitored results the patient-mean proportion of estimates that resided within the prescribed therapeutic range was 0.6 (SD = 0. 21, n = 51) compared with pharmacist management where patients showed a mean in range proportion of 0.7 (SD = 0.18, n = 51, P = 0. 03). The mean inter-test interval was 28.6 days (SD = 8.65, n = 51) for GPs compared with 34.1 days (SD = 12.3, n = 51, P = 0.01) for pharmacists. The weighted INR index for GPs was 17.2 (SD = 7.93, n = 51) compared with 24.7 (SD = 13.15, n = 51, P < 0.001) for pharmacists. CONCLUSION: There is no apparent detriment to INR control when pharmacist management is compared with that of GPs. The overall proportion of INR estimations within the prescribed range is greater for pharmacists than for GPs and the interval between tests is longer for pharmacists compared with GPs.

Aged↗
PubMed1998

Downsizing of health-system pharmacist positions.

The effects of downsizing on institutional pharmacists were studied. A national mail survey was sent to a random sample of 533 members of ASHP in January 1997. The questionnaire was designed to determine (1) the influence of selected factors on the downsizing of pharmacist positions and (2) pharmacists' attitudes about downsizing. A total of 256 usable questionnaires were received, for a net response rate of 48%. Forty-four pharmacists, or 17%, had personally been affected by downsizing. Sixty-one percent of the pharmacists affected by downsizing had had administrative positions. After downsizing, only 32% of the pharmacists had an administrative position. Most of the pharmacists were currently employed. Thirty-five (79%) described their current job responsibilities as substantially changed. Two thirds made the same salaries or higher salaries. Pharmacists who had been downsized rated mergers, the impact of managed care, and the profit motive as the most influential causes of downsizing of pharmacist positions. The three most common negative comments about the impact of downsizing cited reduction in the quality of patient care, increased stress, and lowered morale. Most of the pharmacists believed that communication skills, education, cross-training, and clinical skills are keys to surviving downsizing. Most pharmacists whose positions were downsized said they went on to jobs with similar or higher salaries and substantially different responsibilities.

Adult↗
PubMed1999

Pharmacists' job satisfaction and perceived utilization of skills.

The relationship between job satisfaction and perceived utilization of skills among pharmacists practicing in institutional and ambulatory care settings in Arizona was studied, and factors thought to influence pharmacists' perceived utilization of skills were evaluated. Questionnaires on job satisfaction and perceived utilization of skills were mailed to a random sample of 600 pharmacists. Information on workplace factors such as hours worked, practice setting, and job title was collected. A 4-item measure of general job satisfaction and a 10-item measure of perceived utilization of skills were used. Responses were measured on a five-point Likert scale ranging from "strongly disagree" to "strongly agree." The response rate was 35%. There was a significant positive relationship between job satisfaction and perceived utilization of skills and between job satisfaction and adequate staffing, where "staffing" referred to factors such as competence of coworkers and workload. Pharmacists with training beyond a B.S. degree in pharmacy were more satisfied with their job than those whose highest degree was a B.S. in pharmacy. Pharmacists practicing in institutional settings, pharmacists with management titles, and older pharmacists perceived that they were utilizing their skills to a greater extent than did pharmacists practicing in ambulatory care settings, pharmacists with a general staff title, and younger pharmacists. Among a sample of Arizona pharmacists in institutional and ambulatory care settings, job satisfaction was influenced by perceived utilization of skills, staffing, and education; practice setting, job title, and age were significantly related to perceived utilization of skills.

Adult↗
PubMed2005

Advice-giving on self-medication: perspectives of community pharmacists and consumers in Singapore.

BACKGROUND: In Singapore, community pharmacists provide an advice-giving service to consumers who seek self-medication for minor ailments management. This service has not been studied formally from the perspectives of pharmacists and consumers. OBJECTIVES: The study aimed to identify (i) the approach taken by pharmacists in providing advice for self-medication and (ii) consumers' behaviour in self-treatment and their perception of the advice-giving role of the community pharmacist. METHOD: The pharmacists and consumers were surveyed independently using two structured questionnaires. RESULTS AND DISCUSSION: All community pharmacists who participated in the survey were confident in providing advice on self-medication. However, none of them recorded the consultations and only 17.5% of them had documented their general physician referrals. Most consumers (66.3%) would self-medicate and only consult a professional when the desired outcome was not achieved. Less than 10% of consumers would approach the pharmacists as the first option for advice. More than half of the pharmacists felt that the advice they rendered deserved a fee whereas only 28.4% of the consumers were willing to pay. Both parties thought the fee should not be more than S5 dollars (US3 dollars). CONCLUSION: Generally, there is congruence in the perspectives on self-medication between the advice-giving pharmacist and the consumer. The consumers still lack awareness that pharmacists can help them to self-medicate more safely and effectively. Therefore, more effort in public education is warranted. The current state of poor documentation of the advisory function of community pharmacists should be improved.

Adult↗
PubMedDate not supplied

Influence of pharmacists' opinions on their dispensing medicines without requirement of a doctor's prescription.

OBJECTIVE: To assess the influence of pharmacists' opinions on their dispensing medicines with a "medical prescription only" label without requiring a doctor's prescription. METHODS: We performed a cross-sectional study of 166 community pharmacies in northwest Spain. The opinions of pharmacists on the following were collected as independent variables through personal interview: a) physicians' prescribing practices; b) the pharmacist's qualifications to prescribe; c) the responsibility of the pharmacist regarding the dispensed drugs; d) the customer' qualifications for self-medication; and e) the pharmacist's perception of his or her own work. The dependent variable was the pharmacist's demand for a medical prescription for 5 drugs, which in Spain require a prescription. Multiple linear regression models were constructed. RESULTS: The response rate was 98.8%. A total of 65.9% of pharmacists reported dispensing antibiotics without a prescription. This percentage was 83.5% for nonsteroidal anti-inflammatory drugs, 46.3% for angiotensin-converting enzyme inhibitors, 13.4% for benzodiazepines, and 84.8% for oral contraceptives. Further results showed that pharmacists with a heavier workload and those who underestimated the physicians' qualifications to prescribe but overestimated their own qualifications to prescribe less frequently demanded medical prescriptions. In contrast, pharmacists who stressed the importance of their duty in rationalizing the consumption of drugs more frequently demanded medical prescriptions. CONCLUSION: Our results suggest that to increase the quality of dispensing: a) the importance of the pharmacist's duty in controlling drug consumption should be stressed; b) pharmacies' workload should be optimized; and c) perceptions of physicians' prescribing practices among pharmacists should be improved.

Adult↗