bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking cessation advice provided in 53 Norwegian pharmacies
Authors: Granas Anne G , Haugli Arild , Horn Anne M 
Published: December 2005

Abstract

Objective
To investigate the quality of the smoking cessation advice on over-the-counter (OTC) nicotine replacement treatment (NRT) provided by community and hospital pharmacies in Norway and to assess any change in customer services and pharmaceutical smoking cessation advice after a change in legislation deregulating NRT from pharmacy-only to general sale.

Method
A mystery shopper made 106 visits to 53 pharmacies in Oslo, Norway. The first visit was when NRT was a pharmacy-only medicine and the second when it had become available from any outlet as a general sales product. The pharmacies were scored on 12 observation parameters regarding customer service and pharmaceutical advice (score 0–4, total possible score was 48).

Key findings
There was considerable inter- and intra-pharmacy variation in scores. The pharmacies' total score ranged from 3 to 45. On only 14.2% of the visits was the service categorised as ‘Good’. There was no statistically significant difference in total score between the two test periods (P = 0.56), and hence no measurable difference in customer services and pharmaceutical advice as a result of increased competition after the switch to general sale. A scatter plot showed no relationship between the individual pharmacies' total score at the two visits.

Conclusions
Pharmacies' scores for the quality of their smoking cessation advice were generally low. There was no measurable change in pharmacies' customer service and pharmaceutical advice following the deregulation of NRT. There was little consistency in the total score between the first and the second visit to the same pharmacy. Improvement is needed in the smoking cessation advice provided by Norwegian pharmacies.
Consumer use of the internet for medicines information
Authors: Peterson-Clark Geraldine , Aslani Parisa , Williams Kylie A 
Published: December 2005

AbstractObjectiveTo explore consumer opinion of the internet as a source of medicines information, the reasons consumers use this information, and the impact of this information on their use of medicines.MethodFocus groups (n=6) were conducted in metropolitan Sydney, Australia during March to May 2003 with consumers (n=46) who had used the internet for medicines information.Key findingsAlthough participants expressed some concerns about the quality of internet-based medicines information (IBMI), the convenience of access to this information outweighed these reservations. Attitudes were thus positive overall. Participants used IBMI when preparing for doctors' visits, for second opinions and additional information, for information on current issues, when deciding whether to use a medicine, for comparative information on brands and generics, and when written information was not supplied by health professionals. Most participants felt empowered by the information they found and used it to play a more active role in decision making about their therapy.ConclusionThis study describes various issues associated with consumer use of IBMI and highlights the possible role of pharmacists to support their patients' efforts to access and interpret medicines information.
The training needs, attitudes and experience of pharmacy support staff in Northern Scotland
Authors: Smith Sarah M , Watson Margaret C 
Published: December 2005

Abstract

Objective
The purpose of this survey was to explore: attitudes towards training; experience of training; and training needs of support staff in hospital and community pharmacies in Northern Scotland.

Method
A postal questionnaire was sent to hospital and community pharmacies in the five regions of Northern Scotland. The intended respondents were community pharmacists, community pharmacy support staff, hospital pharmacists, and hospital pharmacy support staff.

Key findings
Data were collected from 105 (62.9%) community pharmacists, 463 (57.0%) community pharmacy support staff, 19 (90.5%) hospital pharmacists, and 88 (83.8%) hospital pharmacy support staff. Pharmacists and support staff in both settings: agreed that support staff currently receive insufficient training; were in favour of support staff receiving training; and agreed that training enhances both the confidence that support staff have in themselves and the confidence that pharmacists have in their staff. Barriers to training for support staff included: lack of availability of local relevant courses; lack of time in the working day; distance to training events; insufficient staff levels to enable staff to participate in training; and the financial cost of training. There was considerable variation in respondents' preferences for format and frequency of training.

Conclusions
Pharmacists and support staff in hospital and community sectors have positive attitudes towards training for support staff. Future training initiatives need to address barriers to training and accommodate different preferences for training format and frequency where possible.
Pictographic instructions for medications: do different cultures interpret them accurately?
Authors: Kassam Rosemin , Vaillancourt Régis , Collins John B 
Published: December 2005

Abstract

Objective
(1) To determine whether a range of linguistically diverse individuals of non-European descent could understand the meaning of predeveloped pictograms without any additional aids such as verbal explanations; (2) to identify appropriate modifications to the pictograms to diminish errors of interpretation; and (3) to test the notion that central pictogram elements have the same meaning irrespective of language or culture.

Setting
The study was conducted in Vancouver, Canada.

Method
This study tested a set of 16 predeveloped pictograms to determine whether they accurately communicated the intended medication administration directions to participants who neither speak nor read English, French or Spanish. Both qualitative and quantitative methods evaluated the pictograms' interpretability among 39 participants from three language groups, Cantonese, Somali and Punjabi. Standard analysis of variance tested for differences due to language groups and other demographics.

Key findings
Only four of the 16 initial pictograms tested were interpreted correctly by 70% of participants. Relaxing the criterion from 70% to 50% included seven more. Modifications of problem elements within the pictograms further improved interpretation accuracy levels by 22%, to a final accuracy of 67.15%. Quantity errors were twice as common as timing, administration route or auxiliary instruction errors.

Conclusions
Participants could identify particular pictographic symbols they found confusing or ambiguous. Basic education and time since immigration predicted interpretation accuracy better than first language or any other demographic characteristic.
Community pharmacists' attitudes to medicines management: a qualitative study
Authors: Dinnie Elizabeth , Bond Christine , Watson Margaret 
Published: December 2005

Abstract

Objective
To explore community pharmacists' knowledge of, and attitudes toward, medicines management, including concerns or barriers to offering medicines management services from community pharmacy premises.

Method
Focus groups held with purposively sampled pharmacists from community, practice and research sectors in Scotland. Participants were invited to discuss community pharmacists' knowledge and experience of medicines management, concerns about providing medicines management services from community pharmacy premises, and possible effects of such services on relationships with general practitioners (GPs).

Key findings
Ten pharmacists attended two focus groups. Characteristics of participants varied according to sex and employment status as well as the type and setting of the pharmacy in which they worked. Participants were familiar with the term ‘medicines management’ but understanding varied between and within groups and differences from and similarities to the term ‘pharmaceutical care’ were less clear. Concerns about the delivery of extended services included practical issues and the effect on the ‘traditional’ role of the community pharmacist. Views were mixed on whether medicines management could become a routine part of all community pharmacists' practice or whether it required specialisation. Pharmacists distinguish between ‘patients’ and ‘customers’ in relation to their differing needs. The relationship between pharmacists and GPs was influenced by the post held by the pharmacist and the setting of the pharmacy.

Conclusions
The pharmacists in this small, regional sample expressed a wide range of attitudes and opinions about the delivery of medicines management services from community pharmacies. Useful insights were given into the practicalities of providing such services on a daily basis in the current working environment, and how pharmacists might be able to provide medicines management services in other ways. Medicines management can be seen as a reprofessionalising strategy for pharmacy, making use of the pharmacist's status as an ‘expert’ to enhance the natural object, the ‘drug’ into the object of social significance, the ‘medicine’. Further research with pharmacists from other regions is needed to confirm this explanation.
The clinical autonomy of community pharmacists in England. 1. Designing and testing a survey instrument
Authors: Magirr Peter , Grimsley Mike , Ottewill Roger , Noyce Peter 
Published: December 2005

Abstract

Objective
To design and test an instrument for measuring variations in the extent to which community pharmacists perceive they can exercise autonomy in clinical settings.

Method
To assist with the design of the instrument a focus group comprising practising community pharmacists from a variety of backgrounds was used. The group contributed ideas for 12 scenarios, based on critical incidents in community pharmacy, which comprise the core of the instrument, and a range of responses that reflect varying degrees of autonomy. Testing involved two pilot surveys in different areas of the UK and rigorous appraisal by the research team and focus group. Various refinements were subsequently made including simplification of the scale of responses and the addition of ‘reality checks’.

Key findings
Data from the two pilots provided evidence of variations in perceived autonomy between contractors, employees and locums.

Conclusions
The instrument was deemed to meet the criteria of credibility; reliability, in terms of consistency; and criterion and construct validity and therefore was suitable for a full-scale survey which is reported in a second paper.
The clinical autonomy of community pharmacists in England. 2. Key findings
Authors: Magirr Peter , Grimsley Mike , Ottewill Roger , Noyce Peter 
Published: December 2005

Abstract

Objective
To investigate the perceived autonomy of community pharmacists in clinical settings and any differences between subgroups of pharmacists.

Method
A specially designed instrument, a central feature of which was 12 scenarios, was distributed by post to a systematic random sample of 2000 community pharmacists in England selected from the Royal Pharmaceutical Society of Great Britain database. Data were analysed using techniques including contingency tables, main effects binary logistic modelling and Cronbach's alpha scores.

Key findings
The response rate was 31% (626 community pharmacists). Comparison with a regional survey confirmed that the respondents were representative of the community pharmacy workforce. ‘Reality checks’ indicated that, notwithstanding variations, the scenarios were perceived as being within the experience of many respondents and of importance for clinical autonomy. Community pharmacists' perceptions of their autonomy were mainly affected by occupational status and work pattern. Contractor pharmacists were much more likely to opt for high autonomy responses than employees and locums. Similarly pharmacists who worked full-time were more likely to opt for these responses than those working part-time. Little association was found between high autonomy and gender, size of employing organisation and length of time qualified.

Conclusions
Differences in perceived autonomy may be due, in part, to the extent to which organisational and managerial constraints operate. With the moves towards an enhanced role for community pharmacists in a primary care-led NHS, these differences should be taken into account in safeguarding pharmacists' professional standing, policy making and managing service delivery.
Coping with prescription charges in the UK
Authors: Schafheutle Ellen I , Hassell Karen , Noyce Peter R 
Published: December 2005

Abstract

Objective
To explore cost-related behaviour in patients subject to prescription charges.

Method
A questionnaire was designed and employed to survey 244 patients with either dyspepsia or hypertension who paid for their medication, either through prescription charges or over-the-counter medication. Respondents were identified through 21 community pharmacies in the North of England. Analysis was descriptive.

Key findings
The NHS prescription charge caused over two-thirds of respondents to have to make key decisions about whether and how they could afford to have their prescriptions dispensed. The strategies used by the respondents to cope with this cost, such as (i) ones initiated by patients, (ii) those involving self-medication and (iii) ones involving the general practitioner (GP), are presented. Respondents' views about medication cost issues and the GP's involvement are also discussed.

Conclusions
This study provides further evidence that prescription charges may act as a barrier to the use of prescribed medicines, and that patients who have problems affording their medication use a number of strategies to reduce cost. These strategies suggest that such patients do not take their medication as intended, or even have them dispensed, with potentially negative impacts on health outcome. However, patients do not generally raise the challenge that prescription charges present to them, or strategies they use to cope with cost, with their GPs. This has implications for improving concordance through the Medicines Partnership programme. Awareness about patients' affordability problems needs to be raised and incorporated into concordant consultations.
Factors related to medication adherence among homeless women and children
Authors: Sleath Betsy , Calloway Michael , Selz-Campbell Laurie , Beard Ashley 
Published: December 2005

Abstract

Objective
The primary objective of this study was to examine factors related to medication adherence among homeless women and children. A secondary purpose was to describe the medication informational needs of homeless women.

Method
Fifty-seven women at six different shelters for homeless women in Wake County, North Carolina were interviewed during the summer of 2001.

Key findings
Fifty-eight per cent of women reported having at least one medical condition and 84% of the women had taken at least one medication during the past week. Twenty-six per cent of women said that during the last week they had not taken a medication on purpose and 30% purposively cut back on a medication. A woman with a substance abuse problem was five times more likely to purposively not take a medication. Almost half of the women who had children living with them had a child that had taken medication during the past week. The primary reasons cited for not using medications as directed were access issues. Fifty-eight per cent of the women wanted to learn more about their or their children's medications. The majority of women preferred to receive more verbal and written drug information.

Conclusions
Pharmacists need to work with local homeless shelters and the women in these shelters to help make sure that they receive needed medications and information for themselves and their children.
Using discrete choice experiments to value preferences for pharmacy services
Authors: Payne Katherine , Elliott Rachel 
Published: December 2005

Abstract

Objective
This paper describes the application of discrete choice experiments (DCEs), in the measurement of consumers' preferences for pharmacy services.

Summary
Patients' preferences for healthcare influence strongly their use of services. Quantifying revealed preferences for services (what services people use) is not always possible because either the service does not yet exist or the consumer has no experience of it. There is a need for tools that measure stated preference (what people say they will do) for healthcare, to allow development of new services. DCEs have been used in the valuation of preferences for healthcare services and interventions and can be applied usefully to the valuation of preferences for pharmacy services. DCEs assume that preferences are based on preferences for different attributes of a service, and that consumers are prepared to trade off one attribute against another, such as effectiveness versus side-effects. In a DCE study, respondents make hypothetical choices between scenarios of services with fixed attributes, but varying levels, revealing their strength of preference for attributes of that service. These data are analysed using regression, which generates coefficients that quantify the direction and magnitude of preferences. Marginal rates of substitution and willingness to pay for each attribute can be estimated, which provide powerful information for future service provision. For this approach to be applied in practice, key methodological issues must be handled explicitly, principally scenario design, attribute and level selection, orthogonality, level balance, minimal overlap and utility balance. A hypothetical example of a DCE designed for valuing consumers' preferences for a medication review service for the elderly is described.
Implementation of cognitive pharmaceutical services (CPS) in professionally active pharmacies
Authors: Hopp Trine R , Sørensen Ellen W , Herborg Hanne , Roberts Alison S 
Published: December 2005

Abstract

Objective
To investigate the implementation process of cognitive pharmaceutical services (CPS) in ‘professionally active’ pharmacies in Denmark; to describe the factors that influence the implementation process in the context of organisational theory.

Method
Twenty semi-structured interviews were conducted with pharmacy staff and owners in ‘professionally active’ pharmacies from 16 community pharmacies in Denmark.

Key findings
Fifty-one factors that influence the implementation process were identified. Based on their content and relationships, the factors were categorised into nine ‘common sense’ dimensions: network and relations with the environment; the environment's expectations and pressure for change; barriers to implementation of CPS; competence in relation to CPS; organising the pharmacy for provision of CPS; culture of the pharmacy; resources within the pharmacy; management within the pharmacy; the role of the pharmacy. Subsequently the 51 factors were categorised and described in relation to Leavitt's model of an organisation.

Conclusion
Implementation of CPS in the pharmacy is a very complex process, which is unique to the individual pharmacy. The model formed a relevant basis for describing the factors, and the theoretical analysis showed a complex interdependence of the factors identified in the study. Many interdependent factors influence the process and this has to be taken into account in designing future models for implementation of CPS. Such models should support comprehensive and flexible strategies that can be adapted to the dynamics of the individual organisation.
A cost-effectiveness analysis of a community pharmacist-initiated disease state management service for type 2 diabetes mellitus
Authors: Taylor Susan J , Milanova Tsveta , Hourihan Fleur , Krass Ines , Coleman Clare , Armour Carol L 
Published: December 2005

AbstractObjectiveTo conduct an economic evaluation of a community pharmacy-delivered disease state management (DSM) service for type 2 diabetes mellitus.SettingThe study was a parallel groups design, with control and intervention groups matched on demographic and diabetes-related characteristics, and was conducted in New South Wales, Australia. Three different settings were included — rural and metropolitan community pharmacy settings and hospital diabetes clinics.MethodA cost-effectiveness analysis of the specialised service was conducted. The economic perspective adopted in the present analysis is that of the healthcare sector in general, taking into account the viewpoint of both the Commonwealth Government of Australia and the New South Wales State Government.Key findingsGlycosylated haemoglobin (HbA1c) levels decreased by 0.46% (P = 0.02) in the intervention group compared with a change of 0.03% (P = 0.81) in the control group after 9 months. To obtain the 0.43% (95% confidence interval (CI) 0.34-0.52) reduction in HbA1c achieved by the specialised service, the cost to the healthcare sector was $A383 (Australian dollars; 95% CI $A46.16–717.46) per patient per 9 months.ConclusionThis service has resulted in a significant reduction in HbA1c which should translate into improved health outcomes long term, since each 1% reduction in HbA1c has been associated with reductions in risk of 21% from any endpoint related to diabetes. Given the annual costs for the management of each patient with diabetes in Australia, the additional $A383 invested in the first 9 months of this service is likely to result in a saving to the healthcare system long term.
Evaluation of a pharmacist-managed repeat dispensing system: the GP perspective
Authors: Porteous Terry , Bond Christine 
Published: December 2005

Abstract

Objective
To evaluate a new pharmacist-managed repeat dispensing system from the perspective of participating general practitioners (GPs).

Setting
Fifteen general practices in four English health authorities, from which 36 eligible GPs received questionnaires.

Method
A new repeat dispensing system was implemented in which GPs gave patients three copies of their repeat prescription on a specially designed form. Each copy ordered a one-month supply of medication. At each monthly dispensing of the prescription, pharmacists asked patients a series of questions relating to use of their medication including information that would establish the need for continued supply. A postal questionnaire comprising closed and open questions was used to collect data on GPs' experiences of the new repeat dispensing system.

Key findings
Twenty-seven GPs (75%) completed and returned questionnaires. The system was liked by GPs and most said they would prefer to provide this system or a modified version of it for their patients. Most GPs said that medication control had either improved or remained the same for their patients. Existing communications between community pharmacists and GPs were reported to be good and in many cases improved as a result of the new system. GPs did not like having to sign all three copies of the prescription.

Conclusion
The repeat dispensing system was well received by GPs. The findings of this study have been used to inform the repeat dispensing system to be implemented by the UK government at national level.