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PubMed2006

Physicians' perceptions and expectations of pharmacists' professional duties in government hospitals in Kuwait.

OBJECTIVE: The objectives of this study were to evaluate the perceptions, expectations and experience of physicians with hospital-based pharmacists in Kuwait. MATERIALS AND METHODS: A piloted self-administered questionnaire was hand delivered to 200 physicians practicing in four government hospitals in Kuwait. Main sections of the questionnaire comprised a series of statements pertaining to physicians' perceptions, expectations and experiences with pharmacists. RESULTS: One hundred and twenty (60%) questionnaires were returned. At least 57% of physicians in Kuwait appear comfortable with pharmacists carrying out patient-directed roles. In addition, they appeared to have high expectations of pharmacists, with 79% of them regarding pharmacists as knowledgeable drug therapy experts. Less than 60% considered pharmacists as applying their drug knowledge in practice and only 29% agreed that pharmacists routinely counselled their patients. There was no correlation between physician variables such as number of years since graduation from medical school, age, area of practice and their perceptions of pharmacists. CONCLUSION: Physicians in Kuwait appear comfortable with pharmacists providing a broad range of services but appear somewhat less comfortable with pharmacists' provision of direct patient care. Physicians considered pharmacists knowledgeable drug therapy experts, but regarded them as not routinely providing a broad range of higher-level pharmacy services.

Adult↗
PubMed1987

Drug information services in Quebec: determination of community and hospital pharmacists' needs.

A survey of Quebec pharmacists was conducted to determine drug information resources currently available, obtain information on pharmacists' involvement as drug information providers, and determine their perceived drug information needs. Responses were obtained from 665 of 3283 registered pharmacists for a response rate of 20.3 percent. Hospital and community pharmacists represented more than 90 percent of the respondents. The two reference texts most frequently found in community pharmacists' libraries were Compendium of Pharmaceutical Specialties and Goodman and Gilman's The Pharmacological Basis of Therapeutics, the latter being available to only 49 percent of the pharmacists. More than 60 percent of the hospital pharmacists had at least 10 of the reference texts listed on our survey instrument. The majority of pharmacists were actively involved in a variety of clinical pharmacy services. Providing drug information to consumers or health professionals was one of the most common activities. Several pharmacists expressed their needs for drug information center (DIC) support in different drug information categories. Information on drug interactions and adverse drug reactions was rated as an important need by 68 and 59.9 percent of the community pharmacists, respectively. The institution of a regional DIC may provide the support system needed by the pharmacists of Quebec.

Drug Information Services↗
PubMed1994

Pharmacists as members of the healthcare team in Israel: sectoral differences.

OBJECTIVE: To examine the sectoral differences among Israeli pharmacists regarding their perception of actual versus desired contact with other members of the healthcare team, and measures necessary to achieve a closer working relationship among members. DESIGN, SETTING, AND PARTICIPANTS: Pharmacists from private, community, and hospital sectors (n = 145) completed a survey that assessed their respective views of the current and future roles of the pharmacist as a member of the healthcare team. MAIN OUTCOME MEASURES: Common to pharmacists in all three sectors is their aspiration for greater cooperation among members of the healthcare team, especially with physicians. Intersectoral differences were found in their attitude toward their role in the healthcare team: hospital pharmacists would like a better relationship with patients, private pharmacists would like closer ties with physicians, and community pharmacists would like better teamwork with the nurse. No sectoral differences were seen in how pharmacists see themselves as members of the clinical healthcare team. Only 12 percent believe they have adequate knowledge to advise on clinical pharmacotherapy. To perform this function, they indicated that more training in pharmacotherapy would be needed (98.6 percent of respondents), as well as joint courses with medical students (84.2 percent), and a modification of their internship period requiring them to work in each of the different practice sectors (73.4 percent). No sectoral differences were observed regarding the benefits of a more active role of the pharmacist in the healthcare team. CONCLUSIONS: One possible explanation for Israeli pharmacists' low professional self-image, despite the rewards of the profession, is that they lack the necessary clinical knowledge that would enable them to take a more active role in the healthcare team. Pharmacists' job satisfaction may improve if a more active advisory role in the healthcare team can be achieved.

Adult↗
PubMed2002

Evaluation of the effectiveness of UK community pharmacists' interventions in community palliative care.

INTRODUCTION: In 1997, the Royal Pharmaceutical Society of Great Britain Working Party reported that UK community pharmacists had a crucial role in effective medicines management and effective symptom control for those receiving palliative care in the community. However, prior to the integration of community pharmacists into the community palliative team, it is necessary to evaluate the effectiveness of their pharmaceutical interventions. AIM: To assess the effectiveness of community pharmacists' clinical interventions in supporting palliative care patients in primary care using an independent multidisciplinary panel review. METHODS: Patients with a life expectancy of less than 12 months were each registered with a single pharmacy and their consent was obtained for the community pharmacists to access their general practitioner (GP) case records. The community pharmacists received training in palliative pharmaceutical care and documenting interventions. The trained community pharmacists provided palliative pharmaceutical care to the recruited patients. At the end of a 10-month period, the clinical interventions were reviewed by an independent multidisciplinary expert panel consisting of a palliative care consultant, a Macmillan nurse (community palliative care nurse) and a hospital pharmacist with special interest in palliative care. RESULTS: Fourteen community palliative care teams (including community pharmacists, GPs and community nurses) took part in the study and 25 patients were recruited over the 10-month recording period. All but one patient had a diagnosis of cancer; the other patient had chronic obstructive pulmonary disease. By the end of the project, 14 patients had died. Community pharmacists recorded a total of 130 clinical interventions. Thirty interventions were excluded as insufficient information had been documented to allow review by the panel. Eighty-one per cent of the interventions were judged by the expert panel likely to be beneficial. However, 3% were judged likely to be detrimental to the patients' well-being. CONCLUSIONS: Most of the clinical interventions made by the community pharmacists for palliative pharmaceutical care were judged by the expert panel as being likely to be beneficial. The result supports the view that when community pharmacists are appropriately trained and included as integrated members of the team, they can intervene effectively to improve pharmaceutical care for palliative care patients.

Adult↗
PubMedDate not supplied

Pharmacists' attitudes and concerns regarding syringe sales to injection drug users in Denver, Colorado.

OBJECTIVE: To identify factors influencing pharmacists' decisions about selling syringes to injection drug users (IDUs). DESIGN: Audiotaped interviews. SETTING: Denver, Colorado. PARTICIPANTS: Thirty-two pharmacists at 24 pharmacies. INTERVENTION: One-hour semistructured interviews. MAIN OUTCOME MEASURES: Practices regarding syringe sales to IDUs and factors influencing the practices. RESULTS: Of the 32 pharmacists interviewed, 16 indicated that they sold syringes to all customers ("pro-sell"), 11 refused to sell unless shown proof of diabetic status ("no-sell"), and 5 were "undecided." Several factors influenced the decision to sell. A perceived conflict between prevention of disease and prevention of drug abuse most clearly distinguished the three categories, with pro-sell pharmacists more likely than others to prioritize disease prevention and believe that syringe sales would not increase drug abuse. Business concerns, such as the effect of the presence of IDUs on other customers and the possibility of discarded syringes around the store, were especially prevalent among no-sell and undecided pharmacists. Seventeen pharmacists did not know about Colorado laws governing syringe sales. Four no-sell pharmacists used the laws to justify their decision not to sell, and two undecided pharmacists said they used the law when they did not want to sell syringes to IDU. All pharmacists supported syringe exchange programs. CONCLUSION: One-half of the pharmacists sold syringes to IDUs, and several more indicated that they would do so if certain concerns were addressed. These data suggest that improved syringe disposal options, continuing education programs, and clarification of existing laws and regulations would encourage more pharmacists in Denver to sell syringes to IDUs.

Attitude of Health Personnel↗
PubMedDate not supplied

Identifying caring behaviors of pharmacists through observations and interviews.

OBJECTIVE: To identify caring behaviors of community pharmacists demonstrated in the pharmacist-patient interaction. DESIGN: Qualitative research. SETTING: Five community pharmacies in the Greater Chicago area. PARTICIPANTS: 8 pharmacists identified as "caring pharmacists" by corporate managers and 13 pharmacy technicians. INTERVENTIONS: Observations of pharmacy personnel interacting with patients and interviews of 2 pharmacists. MAIN OUTCOME MEASURES: Caring behaviors. RESULTS: Four categories of caring behaviors emerged from the observation field notes: physical behaviors (leaning toward patient, smiling, looking patient in eye), relationship behaviors (greeting patients, knowing name, making small talk), task behaviors-nonpharmacy (explaining receipt and money transaction), and task behaviors-pharmacy (providing information, calling physician, asking about allergies and explaining interactions). In interviews, pharmacists said that a caring pharmacist was about "being for the patient," and both noted that caring pharmacists greet the patient, inquire about the patient's health and family, and are sincerely interested in the patient. Mentors and family members are important in developing caring pharmacists, the pharmacists said. CONCLUSION: Specific caring behaviors identifiable among pharmacists and pharmacy technicians. These behaviors can be modeled by pharmacy managers and should be taught in pharmacy schools.

Adult↗
PubMedDate not supplied

Pharmacists' personal use, professional practice behaviors, and perceptions regarding herbal and other natural products.

OBJECTIVES: To characterize pharmacists' personal and family use of, professional practice behaviors regarding, and perceptions of herbal and other natural products (H/NPs), and to ascertain whether these characteristics differ by pharmacists' education, practice setting, and other demographic characteristics. DESIGN: Descriptive study. SETTING: Minnesota. INTERVENTION: Cross-sectional questionnaire mailed in June 2000. PARTICIPANTS: A random sample of 1,017 pharmacists with active Minnesota licenses. RESULTS: Of the 533 respondents, 282 (53%) reported personal use of H/NPs, and 240 (45%) reported having recommended H/NPs to a family member. Pharmacists working in community/outpatient settings and pharmacists living in nonurban areas were more likely to report H/NP use. Patients' requests, consumer demand, manufacturer's reputation, and manufacturer's ability to provide product quality data were key factors influencing respondents' decisions to purchase and stock H/NPs in the pharmacy. Trade journals/professional newsletters, continuing education coursework, reference texts, and reports of randomized clinical trials were considered very important sources of information about H/NPs. However, almost all respondents (95%) felt available information on H/NPs was "not adequate" or only "somewhat adequate." Half the pharmacists (51%) believed that H/NPs were safe, but only 19% believed they were effective. Slightly more than half of the respondents (56%) reported suggesting to a patient that he or she try an H/NP. The amount of government oversight of H/NPs was considered "not adequate" by 78% of pharmacists. On average, pharmacists reported that patients ask them questions regarding H/NPs 7 times per 40-hour workweek; other health care practitioners ask an average of 1.3 times per week. CONCLUSION: Pharmacists' personal use of H/NPs is as high or higher than that of other groups of Americans, and they use similar products. Decisions to stock H/NPs in a pharmacy are influenced by consumer demand and concern for product quality. Pharmacists desire more information on H/NPs and more government oversight of these products, and pharmacists are increasingly being sought out as sources of information regarding H/NPs.

Adult↗
PubMedDate not supplied

Prevalence of substance use by pharmacists and other health professionals.

OBJECTIVES: To assess substance use, misuse, and abuse rates across a representative sample of dentists, nurses, pharmacists, and physicians; compare these rates to available general population data; and determine whether pharmacists report disproportionate unauthorized or illicit substance use. DESIGN: Cross-sectional, descriptive self-report survey. SETTING: A small northeastern state. PARTICIPANTS: Stratified random sample of dentists, nurses, pharmacists, and physicians. INTERVENTIONS: Mailed 7-page survey. MAIN OUTCOME MEASURES: Demographic characteristics; lifetime, past-year, and month prevalence of substance use; frequency of use; drug-related dysfunctions; drug misuse; and abuse potential. RESULTS: Six contacts with participants in the summer 2002 resulted in a 68.7% response rate. More than one half (58.7%) of pharmacists reported using a nonprescribed drug at least once in their lifetime. Though total illicit drug use rates by pharmacists were not noticeably different from those of other health professional (HP) groups, a greater proportion of pharmacists reported lifetime use of minor opiates, anxiolytics, and stimulants. Past-year prevalence of drug use was highest among pharmacists (12.8%). Except for anxiolytics, past-year prevalence of use of most other medications by pharmacists was slightly greater than prevalence of use rates reported by physicians and more prevalent than use rates reported in the general population. As with the other HP groups, pharmacists reported low levels of substance-associated dysfunctions and potential abuse. CONCLUSION: The findings suggest that lifetime nonprescribed drug use by pharmacists does not appear to be disproportionate when compared with other groups of HPs. Specific drug use rates varied across HP groups, possibly suggesting medication access facilitates drug-associated experiences by HPs. Consequently, unauthorized or illicit substance use by HPs, including pharmacists, suggests the need for more intensive educational programs on practitioner impairment.

Adult↗
PubMedDate not supplied

The pharmacist as physician extender in family medicine office practice.

OBJECTIVE: To describe the role of the pharmacist as a salaried physician extender in a private practice diabetes management clinic. SETTING: Columbus, Ohio. PRACTICE DESCRIPTION: Private suburban family medicine office practice. PRACTICE INNOVATION: Clinical pharmacy physician-extender practice in a private medical office and direct compensation to pharmacist. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Financial reimbursement for providing pharmaceutical care; improvement in disease outcomes; pharmacist and student pharmacist satisfaction. RESULTS: Family medicine physicians hired a pharmacist to extend their diabetes care for complex metabolic syndrome patients and other patients with diabetes who had therapy management problems. The pharmacist, working with student pharmacists, develops treatment plans for drug therapy, nutrition, exercise, and foot care that are reviewed and approved by the managing physician and implemented by the pharmacist and other office staff. More than 260 patients have been referred and managed by the practice with favorable results. The pharmacist is reimbursed as an employee and the practice receives revenue for the pharmacist's practice. CONCLUSION: Working in a private physician office practice provides a unique means of providing pharmaceutical care with reimbursement for the pharmacist.

Adolescent↗
PubMed2000

Pharmacists' knowledge and attitudes toward herbal medicine.

OBJECTIVE: The use and sales of herbal medications have increased dramatically over the past several years. Pharmacists are in an ideal position to educate patients about herbal medicines. This study was intended to determine the knowledge and attitudes of pharmacists regarding herbal medications. METHODS: A survey was distributed to pharmacists at several state and regional meetings in Virginia and North Carolina between August and October 1998. The survey evaluated demographic data, attitudinal scales, and a 15-item herbal medicine knowledge test. Pharmacists immediately returned the surveys to the distributor on completion. RESULTS: Of the 217 surveys distributed, 164 met the inclusion criteria for further evaluation. Of the pharmacists surveyed, 68.0% practiced in a community pharmacy, 45.1% had previous continuing education on herbal medications, and 73.6% sold herbal medications in their practice settings. The average score on the herbal knowledge test was 6.3 (maximum score of 15). Pharmacists with previous continuing education scored significantly higher than those without prior continuing education (p < 0.001). Of the 15 questions, the five that pharmacists were most likely to answer correctly assessed the uses of herbal medications. Additionally, pharmacists with prior continuing education or with access to herbal medication information at their practice site were more likely to agree that providing information about herbal medication is a pharmacist's professional responsibility (p = 0.02 and p = 0.01, respectively). CONCLUSIONS: The findings from this study demonstrate that pharmacists were more likely to answer correctly about the uses of herbal medications than about drug interactions, adverse drug effects, and precautions of herbal medications. Additionally, pharmacists with previous continuing education on herbal medications were more knowledgeable about these products. With the increasing use of herbal medications, there is a greater need for pharmacy training programs in this area.

Adult↗
PubMed2005

Evidence-based practice by pharmacists: utilization and barriers.

BACKGROUND: Evidence-based medicine (EBM) is the use of the current best evidence from research to make practice and policy decisions. Little is known regarding the attitudes of pharmacists toward EBM. OBJECTIVE: To determine the attitudes of pharmacists toward EBM, the extent that pharmacists use evidence to make decisions, and identify barriers to the use of evidence. METHODS: A self-administered questionnaire was mailed to 2000 randomly selected Illinois licensed pharmacists. The questionnaire assessed the pharmacists' attitudes toward EBM, the extent to which recommendations are based on primary and tertiary literature, and perceived barriers to the use of EBM. RESULTS: Completed responses were received from 323 pharmacists (17.2% response rate). Overall, respondents had positive attitudes toward EBM (58% positive, 32% somewhat positive). Respondents thought research findings were useful (42%) or very useful (42%) to daily practice. Nearly one-half (49.8%) of respondents had conducted a primary literature search within the past year. Hospital pharmacists and pharmacists in other practice settings were more likely than community pharmacists to conduct a literature search in the past year (75%, 61%, and 30%, respectively; p < 0.001). Although 86% of respondents reported having Internet access at home, only 42% of all respondents identified that they had PubMed access at home. Common barriers to the use of EBM include lack of time (45%), physician attitudes toward pharmacist recommendations (19%), and access to resources (11%). CONCLUSIONS: Pharmacist respondents have positive attitudes toward EBM and the application of research findings to practice.

Adult↗
PubMed2006

Which pharmacists contribute to high-level pharmacotherapy audit meetings with general practitioners?

BACKGROUND: In the Netherlands, community pharmacists and general practitioners (GPs) collaborate in pharmacotherapy audit meetings (PTAMs) to optimize pharmacotherapy. OBJECTIVE: To identify associations between the quality level of PTAMs and characteristics of pharmacists. METHODS: We used a cross-sectional questionnaire design in a Dutch general practice and community pharmacy setting to estimate the contribution of pharmacists to the quality level of PTAMs. The questionnaire was sent to 123 community pharmacies working closely with 104 GP practices. The outcome variable was the quality level of PTAMs. The questionnaire provided information on 4 topics that were used as independent variables: characteristics of the PTAMs, provision of pharmacotherapy activities, characteristics of the pharmacists, and characteristics of the pharmacies. RESULTS: In total, 109 (88.6%) pharmacists completed the questionnaire, with 103 participating in 62 different PTAMs. Seventeen pharmacists participated in level 1 PTAMs (lowest level), 57 in level 2, 21 in level 3, and 8 in PTAMs at the highest level. The multinomial logistic regression identified only one significant association: pharmacists who participated in the highest quality level reported that they undertake initiatives in PTAMs (OR 2.98; 95% CI 1.07 to 8.26) more frequently compared with pharmacists participating on the lowest level. CONCLUSIONS: In light of existing evidence, the role of pharmacists in PTAMs seems to be important. Pharmacists should create a distinct profile of their expertise, allowing them to professionalize PTAMs by undertaking more initiatives. PTAMs offer pharmacists a great opportunity to become integral members of the prescribing process.

Community Pharmacy Services↗
PubMed2003

Perceptions of pharmacists as providers of immunizations for adult patients.

Pharmacists have been involved with patient care at the Family Medicine Center, affiliated with the Medical University of South Carolina, for over 20 years. In 1999, to add to existing clinical services, pharmacists administered immunizations (influenza and pneumonia) to over 400 adult patients during clinic visits in designated patient care rooms. A few months after the immunization period, both health care providers and immunized patients were asked to respond to a survey regarding their opinions of pharmacist-administered immunizations. Response rates were 71% for health care providers and 16% for all immunized patients. Most (90%) of the health care respondents felt comfortable with pharmacists providing immunizations and thought it was appropriate for pharmacists to provide this service. However, 35% of the providers did not agree that pharmacists should provide immunizations in local pharmacies. Most (97%) of the immunized patients felt comfortable with their provider but did not recall that a pharmacist had administered the immunization. In addition, 64% questioned the qualifications of a pharmacist to administer immunizations, and only 43% felt comfortable having a community pharmacist administer a vaccine. By extrapolation of these data, one can determine that patients do not regard pharmacists as qualified providers of immunizations. Further study of patient perception of pharmacists in this role is being conducted.

Adult↗
PubMed2006

Pharmacist-acquired medication histories in a university hospital emergency department.

PURPOSE: A study was conducted to identify discrepancies between medication histories taken by emergency department (ED) providers (physicians, nurses, and medical students) and medication histories taken by clinical pharmacists. METHODS: During a three-month period, a clinical pharmacist was assigned to the ED in a 475-bed, tertiary care teaching facility that serves as a level I trauma center. On the arrival of a patient, ED providers completed a standard assessment that included the patient's medication history. Patients to be admitted through the ED were interviewed by the clinical pharmacist. In addition to a medication history, the pharmacist collected the patient's height, weight, immunization history, and allergy information. The medication history obtained by the ED provider was compared with the history obtained by the clinical pharmacist, and discrepancies were documented. RESULTS: The clinical pharmacists in the ED performed 286 medication histories; 34 were excluded. The remaining 252 histories taken were used in the study. The pharmacists identified 1096 home medications versus 817 home medications documented by ED providers. Of the 817 home medications documented by the ED, the regimens of 637 (78%) were incomplete and were supplemented with dosing information by the pharmacists. Pharmacists reported 375 medication allergies versus 350 reported by ED providers. Immunization histories were obtained in 252 of the 252 (100%) pharmacist-acquired medication histories versus 45 of the 252 (18%) acquired by ED personnel. CONCLUSION: Pharmacist-acquired medication histories in the ED were more complete than those acquired by other health professionals.

Adolescent↗
PubMed2000

A survey on factors that could affect adverse drug reaction reporting according to hospital pharmacists in Great Britain.

INTRODUCTION: Since April 1997, UK hospital pharmacists have been invited to submit reports of suspected adverse drug reactions (ADRs) to the Committee on Safety of Medicines (CSM) and Medicines Control Agency. Three studies have investigated the involvement of hospital pharmacists in ADR reporting; however, they did not investigate the possible factors that could affect ADR reporting. OBJECTIVES: (i) To analyse the extent to which hospital pharmacists think that specified factors could affect reporting ADRs; (ii) to identify any additional factors that could hinder reporting; and (iii) to recommend possible methods to improve reporting. METHODS: Piloted questionnaires were sent to 548 hospital pharmacists in Great Britain randomly selected by the Royal Pharmaceutical Society of Great Britain (RPSGB) from their computer database. 346 questionnaires were returned and 280 were included in this study. RESULTS: 46% of the pharmacists had identified ADRs that were considered to be reportable according to the CSM criteria in the 6 months prior to the survey. 39% did not report these ADRs either to the CSM or the manufacturers. Only 8.2% reported that their hospitals had a written policy; conversely, 73.7% agreed that such a policy could enhance ADR reporting. Although not statistically significant, the result showed an increasing tendency to report ADRs by pharmacists who had received training. Furthermore, there was an increasing tendency to report ADRs with increasing seniority. DISCUSSION: The results show that hospital pharmacists say they are more likely to report serious and rare ADRs and ADRs associated with newly marketed drugs. Factors that could reduce ADR reporting included being busy at work, lack of confidence in recognising ADRs and the fear of breaching patient confidentiality. Most common suggestions on methods to improve ADR reporting were to provide ADR training and meetings (34%) and a hospital written policy (24%). RECOMMENDATIONS: ADR training and meetings would be a useful step in improving hospital pharmacist ADR reporting. Therefore, we recommend that the CSM and the RPSGB liaise with regional drug information centres and schools of pharmacy to provide more study days and training programmes for hospital pharmacists. Furthermore, the CSM should write to the 'Drugs and Therapeutics Committee' of each hospital and encourage them to develop a written local policy for pharmacist ADR reporting. Further studies should be conducted to test the recommendations noted here, assessing the response of the pharmacists in terms of absolute numbers of reports made. It would be particularly interesting to study the need for a written hospital policy and education.

Adverse Drug Reaction Reporting Systems↗
PubMed1999

Pharmaceutical care and health outcomes in community settings: a matched pair analysis of perceptions of hypertensive patients versus pharmacists.

UNLABELLED: This study aimed to: (1) assess the level of pharmaceutical care delivered by pharmacists, and (2) compare patients' and pharmacists' health related quality of life (HRQOL) assessments for patients receiving antihypertensive therapy as an indicator of the delivery of pharmaceutical care. DESIGN: An exploratory, cross-sectional study using matched pair survey instruments. SETTING: Columbus, Ohio. PARTICIPANTS: Patients in a community setting prescribed antihypertensive medication and their pharmacists were selected for study participation. INTERVENTIONS: Parallel surveys distributed to patients and their pharmacists. MAIN OUTCOME MEASURES: Level of pharmaceutical care delivered by pharmacists, and perceived patient viewpoints on: clinical outcomes (blood pressure control, and side effects due to antihypertensive medication) and humanistic outcomes (overall, emotional and physical HRQOL) by patients and pharmacists. RESULTS: Analysis of 52 useable matching surveys of pharmacists and patients indicated that nearly all pharmacists counsel patients and two thirds of pharmacists counsel and monitor drug therapy. This is consistent with providing the minimal OBRA 90 requirements. When comparing patient and pharmacist perceived patient clinical as well as humanistic outcomes, a high level of association was reported between the two groups. CONCLUSIONS: The results of this study suggest that pharmacists are cognizant of patient clinical and humanistic outcomes and hence, they are in an excellent position to improve patient outcomes by making appropriate drug therapy changes.

Antihypertensive Agents↗
PubMed2001

Community pharmacist knowledge and behavior in collecting drug copayments from Medicaid recipients.

Community pharmacists' knowledge and behavior regarding the collection of copayments for prescription drugs from Medicaid recipients were studied. In fall 1998 a questionnaire was mailed to a random sample of 1465 community pharmacists (one pharmacist per drugstore) in Maryland, Pennsylvania, and West Virginia. The objectives were to determine the extent to which these pharmacists waived copayments for prescription drugs for Medicaid recipients, to document the pharmacists' knowledge of federal policies on Medicaid copayments, and to evaluate the factors associated with pharmacist copayment collection and knowledge of federal copayment policies. A total of 543 pharmacists (37%) responded. Most respondents indicated that they collected copayments for over 90% of drugs dispensed to Medicaid patients subject to copayment policies. Pharmacists most likely to waive Medicaid copayments practiced in drugstores with a high volume of Medicaid-related prescriptions and a large percentage of customers who were elderly Medicaid recipients. Pharmacists least likely to waive copayments believed that doing so would have a negative financial impact on the pharmacy. Nearly three fourths of the pharmacists exhibited fair or good knowledge of federal Medicaid copayment policies, but this varied widely by state. Many said that they would collect copayments in at least some situations even if this opposed federal policy. Pharmacists in Maryland, Pennsylvania and West Virginia had highly variable behavior patterns and knowledge with respect to the collection of drug copayments from Medicaid recipients.

Fees, Pharmaceutical↗
PubMed2003

Perceived interprofessional barriers between community pharmacists and general practitioners: a qualitative assessment.

BACKGROUND: There have been calls for greater collaboration between general practitioners (GPs) and community pharmacists in primary care. AIM: To explore barriers between the two professions in relation to closer interprofessional working and the extension of prescribing rights to pharmacists. DESIGN OF STUDY: Qualitative study. SETTING: Three locality areas of a health and social services board in Northern Ireland. METHOD: GPs and community pharmacists participated in uniprofessional focus groups; data were analysed using interpretative phenomenology. RESULTS: Twenty-two GPs (distributed over five focus groups) and 31 pharmacists (distributed over six focus groups) participated in the study. The 'shopkeeper' image of community pharmacy emerged as the superordinate theme, with subthemes of access, hierarchy and awareness. The shopkeeper image and conflict between business and health care permeated the GPs' discussions and accounted for their concerns regarding the extension of prescribing rights to community pharmacists and involvement inextended services. Community pharmacists felt such views influenced their position in the hierarchy of healthcare professionals. Although GPs had little problem in accessing pharmacists, they considered that patients experienced difficulties owing to the limited opening hours of pharmacies. Conversely, pharmacists reported great difficulty in accessing GPs, largely owing to the gatekeeper role of receptionists. GPs reported being unaware of the training and activities of community pharmacists and participating pharmacists also felt that GPs had no appreciation of their role in health care. CONCLUSION: A number of important barriers between GPs and community pharmacists have been identified, which must be overcome if interprofessional liaison between the two professions is to be fully realised.

Attitude of Health Personnel↗