Since 2010, the incidence of acute Hepatitis C Virus (HCV) infections in the U.S. has nearly quadrupled. Re-use and sharing of syringes among people who inject drugs (PWID) is a significant contributor to increased rates of HCV transmission and a risk factor for HIV infection. Community pharmacists are uniquely positioned to offer harm reduction services that lower the transmission of HCV/HIV by providing sterile syringes to PWID. However, legislation on non-prescription syringe dispensing varies by state and differences in individual pharmacists’ interpretation and attitudes regarding these laws may impact their willingness to participate in harm reduction services. Little is known about the impact of these factors on pharmacist engagement with harm reduction services in central Appalachia, a region particularly hard-hit by the opioid epidemic. The objective of this project is to qualitatively evaluate open-ended responses collected as part of a survey administered to community pharmacists in three central Appalachian states in order to determine: 1) pharmacists’ knowledge and attitudes regarding their state’s non-prescription syringe dispensing laws; and 2) the correlation of attitudes about state legislation to pharmacists’ intent to sell syringes to PWID. A telephonic community pharmacist survey on non-prescription syringe attitudes and behaviors was conducted between April and June 2018 in Northeast Tennessee, Western North Carolina, and Southwest Virginia. Survey responses were obtained from pharmacists practicing in 391 community pharmacies (51% response rate) in the study region. Transcribed responses to open-ended survey questions were extracted from the dataset and a qualitative analysis was completed using a generalized inductive approach. A single investigator coded all qualitative data and a second investigator coded data from a random selection of 10% of the respondents in order to develop themes through consensus. Descriptive analysis was conducted using SPSS version 25 to compare syringe law attitude thematic categories to respondents’ intent to sell syringes to PWID. Preliminary analysis identified discrepancies in pharmacists’ non-prescription syringe law knowledge, state-specific differences in pharmacists’ non-prescription syringe law attitudes, and underlying differences in willingness to sell syringes to PWID based on attitudes. The findings may encourage pharmacists to reflect on personal attitudes and interpretation of state-specific legislation as factors that may influence participation in an evidence-based harm reduction strategy for prevention of HCV/HIV transmission. This study offers preliminary results that will serve as a basis for larger studies and interventions aimed at reducing ambiguity in pharmacists’ interpretation of non-prescription syringe dispensing laws and encouraging pharmacists to counter the spread of HCV/HIV in an evidence-based manner.

No description available.

Harm reduction is a concept that has gained momentum as it relates to prevention of negative consequences of drug use. Some harm reduction approaches, such as naloxone provision, have garnered significant support, whereas others, such as providing access to clean syringes, are the exception as opposed the rule. Evidence suggests there is significant variation in harm reduction behaviors among providers, including community pharmacists. Community pharmacies are one of the most accessible points for healthcare; approximately 90% of U.S. residents live within five miles of a pharmacy. Therefore, pharmacies have a great opportunity to promote and engage their communities in harm reduction approaches. This session will examine evidence-based harm reduction approaches that can be employed in community pharmacies. The presenters will use their syringe dispensing research conducted across three states to describe the current harm reduction climate in community pharmacies. During this interactive session, participants will discuss scenarios in which they are encouraged to evaluate their own attitudes and beliefs toward non-Rx syringe sales, naloxone dispensing and other harm reduction strategies while taking a look at the impact of state level policies on these approaches. The session will be targeted to practicing pharmacists, coalition leaders and harm reduction stakeholders.

The Canadian health care system is primarily public funded. With constant rise in health care costs, there is debate on how to best fund Canadian health care. <p>Public, private and mixed funding options are being discussed. The funding options people support will depend on how they view the health care system. Is health care a commodity or a public right? Pharmacists interact with patients daily and are involved in the delivery of health services. Their views on whether health care should be a public right or a commodity can add meaningful input to the debate.<p>The primary objective of this study was to develop a scale to measure pharmacists perceptions of health care as a commodity or a public right. In turn, this scale was used to see if a relationship exists between pharmacists orientation to health care (commodity vs. public right) and their support for different health care funding options.<p> A mail-in survey of community pharmacists in Saskatchewan was conducted based on the Dillman approach. The questionnaire consisted primarily of six-point Likert scale questions. Data analysis was performed using non-parametric tests such as Mann-Whitney U and Kruskal Wallis tests. One-way ANOVA was used for parametric data and post-hoc analysis was performed using Bonferroni test. Correlation of the scales was tested using Spearmans and Pearsons correlation coefficients. The response rate achieved was 64.2%.<p>The study results indicate that pharmacists are not willing to provide cognitive services free of charge. However, they are willing to continue providing OTC drug counseling free of charge. They will not restrict provision of cognitive services only to patients able pay. They prefer being reimbursed through other sources. They are unwilling to make time and income adjustments to improve patient health outcomes. They do not want to link the financial rewards they receive to the amount of benefit the patient receives.<p>Pharmacists favour the current system of funding health care in Canada but would prefer more choice in the delivery and funding methods. The results do not indicate any relationship between pharmacists orientation to health care (commodity vs. public right) and their level of support for different health care funding strategies. <p>The study conclusions suggest that pharmacists value and appreciate the direct impact of their work on patients. However they consider themselves to be professionals first and expect to be compensated financially for their services. Their willingness to spend time and effort towards provision of services as a public right seems to be predicated to a certain extent by the financial rewards they receive.

The Canadian health care system is primarily public funded. With constant rise in health care costs, there is debate on how to best fund Canadian health care. <p>Public, private and mixed funding options are being discussed. The funding options people support will depend on how they view the health care system. Is health care a commodity or a public right? Pharmacists interact with patients daily and are involved in the delivery of health services. Their views on whether health care should be a public right or a commodity can add meaningful input to the debate.<p>The primary objective of this study was to develop a scale to measure pharmacists perceptions of health care as a commodity or a public right. In turn, this scale was used to see if a relationship exists between pharmacists orientation to health care (commodity vs. public right) and their support for different health care funding options.<p> A mail-in survey of community pharmacists in Saskatchewan was conducted based on the Dillman approach. The questionnaire consisted primarily of six-point Likert scale questions. Data analysis was performed using non-parametric tests such as Mann-Whitney U and Kruskal Wallis tests. One-way ANOVA was used for parametric data and post-hoc analysis was performed using Bonferroni test. Correlation of the scales was tested using Spearmans and Pearsons correlation coefficients. The response rate achieved was 64.2%.<p>The study results indicate that pharmacists are not willing to provide cognitive services free of charge. However, they are willing to continue providing OTC drug counseling free of charge. They will not restrict provision of cognitive services only to patients able pay. They prefer being reimbursed through other sources. They are unwilling to make time and income adjustments to improve patient health outcomes. They do not want to link the financial rewards they receive to the amount of benefit the patient receives.<p>Pharmacists favour the current system of funding health care in Canada but would prefer more choice in the delivery and funding methods. The results do not indicate any relationship between pharmacists orientation to health care (commodity vs. public right) and their level of support for different health care funding strategies. <p>The study conclusions suggest that pharmacists value and appreciate the direct impact of their work on patients. However they consider themselves to be professionals first and expect to be compensated financially for their services. Their willingness to spend time and effort towards provision of services as a public right seems to be predicated to a certain extent by the financial rewards they receive.

Despite national guidelines, the management of difficult asthma remains suboptimal, and there may be opportunities for pharmacists to improve asthma outcomes. This six-month prospective, randomised, open study investigated the effects of pharmaceutical care across primary and secondary care on difficult asthma. Fifty-two patients attending a hospital difficult asthma clinic were randomised (1:1) to receive usual medical care (UC), or pharmacist interventions (PI) comprising asthma review, education, and medicines optimisation from a hospital advanced clinical pharmacist, plus follow-up targeted Medicines Use Review (t-MUR) from community pharmacists. Forty-seven patients completed the study. More interventions were performed in the PI group at baseline (total 79 vs. 34, p<0.001), but only six patients received a t-MUR. At six-months, PI were non-inferior to UC for all outcomes. The primary outcome measure was Juniper’s Asthma Control Questionnaire score and reduced (improved) from a median (IQ) score of 2.86 (2.25, 3.25) and 3.00 (1.96, 3.71) in the PI and UC groups respectively to 2.57 (1.75, 3.67) and 2.29 (1.50, 3.50). At baseline, 58.8%, 46.9% and 17.6% of patients had optimal inhaler technique using Accuhalers, Turbohalers or pMDIs; education improved technique but this was not maintained at six-months. Adherence rates < 80% were observed in 57.5% of patients at baseline, and was improved in the PI group at six-months (10/20 PI vs. 3/21 UC had adherence rates of 80-120%, p=0.020). This study demonstrates that the management of difficult asthma by specialist pharmacists is as effective as usual medical care. Future research should investigate whether pharmacist-led follow-up produces further improvements.

Despite national guidelines, the management of difficult asthma remains suboptimal, and there may be opportunities for pharmacists to improve asthma outcomes. This six-month prospective, randomised, open study investigated the effects of pharmaceutical care across primary and secondary care on difficult asthma. Fifty-two patients attending a hospital difficult asthma clinic were randomised (1:1) to receive usual medical care (UC), or pharmacist interventions (PI) comprising asthma review, education, and medicines optimisation from a hospital advanced clinical pharmacist, plus follow-up targeted Medicines Use Review (t-MUR) from community pharmacists. Forty-seven patients completed the study. More interventions were performed in the PI group at baseline (total 79 vs. 34, p<0.001), but only six patients received a t-MUR. At six-months, PI were non-inferior to UC for all outcomes. The primary outcome measure was Juniper’s Asthma Control Questionnaire score and reduced (improved) from a median (IQ) score of 2.86 (2.25, 3.25) and 3.00 (1.96, 3.71) in the PI and UC groups respectively to 2.57 (1.75, 3.67) and 2.29 (1.50, 3.50). At baseline, 58.8%, 46.9% and 17.6% of patients had optimal inhaler technique using Accuhalers, Turbohalers or pMDIs; education improved technique but this was not maintained at six-months. Adherence rates <80% were observed in 57.5% of patients at baseline, and was improved in the PI group at six-months (10/20 PI vs. 3/21 UC had adherence rates of 80-120%, p=0.020). This study demonstrates that the management of difficult asthma by specialist pharmacists is as effective as usual medical care. Future research should investigate whether pharmacist-led follow-up produces further improvements. / The Pharmaceutical Trust for Educational and Charitable Objects (PTECO) (now known as Pharmacy Research UK).

Yes / Aims and Objectives The vision for the future Great Britain pharmacy workforce development has been proposed as of August 2015 and this starts/reignites discussions as to how pharmacists continue to operate as a body whilst maintaining and extending their professional acumen and experience [1]. The pharmacy sector has grown substantially and qualified pharmacists are often assumed to be managers, without having completed management modules during their degree [2]. The aim of this study was to determine how CPD supports management skills development (MSD) of pharmacists in these sectors. / The full text will be available on permission from the publisher.

Yes / Objectives The New Medicines Service (NMS) is provided by community pharmacists in England to support patient adherence after the initiation of a new treatment. It is provided as part of the National Health Service (NHS) pharmacy contractual framework and involves a three-stage process: patient engagement, intervention and follow-up. The study aims to explore community pharmacists’ experiences and perceptions of NMS within one area of the United Kingdom. Methods In-depth semi-structured telephone interviews were conducted with 14 community pharmacists. Interviews were audio-recorded, independently transcribed and thematically analysed. Key findings Pharmacists gave a mixed response to the operationalisation, ranging from positive opportunities for improving adherence and enhancement of practice to difficulties in terms of its administration. Pharmacists generallywelcomed opportunities to utilise their professional expertise to achieve better patient engagement and for pharmacy practice to develop as a patient resource. There was a perceived need for better publicity about the service. Different levels of collaborative working were reported. Some pharmacists were working closely with local general practices most were not. Collaboration with nurses in the management of long-term conditions was rarely reported but desired by pharmacists. Where relationships with general practitioners (GPs) and nurses were established, NMS was an opportunity for further collaboration; however, others reported a lack of feedback and recognition of their role. Conclusions Community pharmacists perceived the NMS service as beneficial to patients by providing additional advice and reassurance, but perceptions of its operationalisation were mixed.Overall, our findings indicate that NMS provides an opportunity for patient benefit and the development of contemporary pharmacy practice, but better collaboration with GPs and practice nurses could enhance the service.

Yes / Background: The NHS in the UK supports pharmacists’ deployment into general practices. This article reports on the implementation and impact of the Primary Care Pharmacy Programme (PCPP). The programme is a care delivery model that was undertaken at scale across a city in which community pharmacists (CPs) were matched with general practices and performed clinical duties for one half-day per week. Aim: To investigate (a) challenges of integration of CPs in general practices, and (b) the perceived impact on care delivery and community pharmacy practice. Design & setting: This mixed-methods study was conducted with CPs, community pharmacy employers (CPEs), scheme commissioners (SCs), and patients in Sheffield. Method: Semi-structured interviews (n = 22) took place with CPs (n = 12), CPEs (n = 2), SCs (n = 3), and patients (n = 5). A cross-sectional survey of PCPP pharmacists (n = 47, 66%) was also used. A descriptive analysis of patient feedback forms was undertaken and a database of pharmacist activities was created. Results: Eighty-six of 88 practices deployed a pharmacist. Although community pharmacy contracting and backfill arrangements were sometimes complicated, timely deployment was achieved. Development of closer relationships appeared to facilitate extension of initially agreed roles, including transition from ‘backroom’ to patient-facing clinical work. CPs gained understanding of GP processes and patients’ primary care pathway, allowing them to follow up work at the community pharmacy in a more timely way, positively impacting on patients’ and healthcare professionals’ perceived delivery of care. Conclusion: The PCPP scheme was the first of its kind to achieve almost universal uptake by GPs throughout a large city. The study findings reveal the potential for CP–GP joint-working in increasing perceived positive care delivery and reducing fragmented care, and can inform future implementation at scale and at practice level.