Class of 2010 Abstract / OBJECTIVES: The purpose of this study was to evaluate the accuracy of automated blood pressure machines located within community-based pharmacies. METHODS: A descriptive, prospective study was performed comparing blood pressure readings obtained from community-based automated blood pressure machines to readings from a mercury manometer for 2 different arm sizes. Mercury manometer readings were obtained using the standardized technique and a standard cuff recommended by the American Heart Association RESULTS: For the subject with the small arm size, the automated blood pressure machines reported systolic pressure readings that were, on average, 16.1 mmHg higher than those obtained manually by the researcher. The mean systolic and pressure readings for the subject with the medium arm size were not significantly different between the automated machine and manual manometer readings, and the diastolic pressure readings were modestly different. CONCLUSIONS: We found that automated blood pressure machines located within a sample of representative community pharmacies were neither accurate nor reliable. The accuracy of the readings are especially inaccurate for subjects with a smaller than average arm size.

Class of 2017 Abstract / Objectives: To determine if there is a correlation between both awareness and utilization of pharmacy care services and patient satisfaction at an independent community pharmacy in Benson, Arizona. Subjects: Patients who visited the pharmacy within a 45-day period in 2016 and who have filled at least one prescription at that location. Methods: A self-reported questionnaire was administered by pharmacy staff to assess patients’ satisfaction ratings on the pharmacy’s performance. The questionnaire also inquired about patients’ awareness and use of pharmacy services as well as demographic information including a history of specific disease states. Data were evaluated using analytic software. Results: Questionnaires were completed by 48 men (mean age = 65.8; SD = 12.57) and 69 women (mean age 60.3; SD = 15.06), with the mean number of select health conditions being 1.63 (SD = 1.16) and 1.49 (SD = 1.24), respectively. There was no correlation between the number of services for which a patient was aware, nor the number of services utilized, and overall satisfaction (p=0.466 and p=0.384, respectively). However, there was a significant positive correlation between awareness and utilization of pharmacy services (r=0.208, p=0.019). Over 74% of respondents rated satisfaction for all measures “excellent,” with professionalism of the pharmacist (92.1%) and pharmacy staff (89.9%) ranking highest. The only category that received a “poor” rating was how well the pharmacist explains medication side effects. Conclusions There was no apparent correlation between awareness of pharmacy care services and patient satisfaction at The Medicine Shoppe in Benson, nor between utilization of pharmacy services and satisfaction. However, patient satisfaction scored high in all categories surveyed.

<p>In 1999, Saskatchewan Health sanctioned licensed pharmacists in the province to initiate Exception Drug Status (EDS), also referred to as prior approval, requests on behalf of their patients. The objectives of this study were to obtain pharmacists opinions about the benefits of the EDS program to stakeholders, and to identify factors associated with pharmacists initiating a request.</p><p>In the fall of 2004, a census of community-pharmacy managers in Saskatchewan was conducted using a postal questionnaire, consisting of an introductory letter, two survey mailings and one reminder card. The questionnaire consisted primarily of seven-point Likert scale questions, and was analyzed using descriptive statistics and frequencies, followed by non-parametric analysis using Mann-Whitney U and Kruskal-Wallis tests; post-hoc analysis was carried out using the Bonferroni test.</p><p>A response rate of 82.6% was achieved. Those living in Saskatoon or Regina made up 39% of respondents, with another 39% located in centres of less than 5,000 people.</p><p>A majority of respondents (63%) agreed or strongly agreed the EDS program benefited patients and the Drug Plan (64%). Only 15%, 37% and 39% of respondents agreed or strongly agreed EDS benefits pharmacists, physicians and the health care system respectively.</p><p>Factors that were important or very important to pharmacists in deciding whether they would initiate an EDS request on behalf of their patient were: the ability of the pharmacist to obtain the required information to initiate the EDS request (77%); their ability to contact the prescribing physician (70%); and patient centred concerns such as the ability to pay (74%) or the patient had exceeded their deductible (66%). However, time (39%) was not as important relative to other factors in whether the pharmacist would apply for EDS on behalf of their patient.</p><p>The majority of respondents agreed or strongly agreed that changing the policy in 1999 was beneficial to patient care (71%), while it also contributed substantially to their administrative workload (87%). </p><p>The results of this study indicate community pharmacy managers in Saskatchewan acknowledge that the Exception Drug Status process is beneficial for their patients. While pharmacists were supportive of the benefits of an EDS program, their apprehensions towards the program lie in the administrative processes, particularly in obtaining the required information, from physicians, to submit a claim. There is also concern with the methods pharmacists must use to apply for EDS, which can be burdensome and prolong the administrative process.</p><p>To enhance pharmacists support for the program it may be necessary to develop strategies designed to reduce the administrative workload associated with the program, and to streamline the efficient communication of required information between the prescriber and pharmacist. Alternatively, financial compensation to pharmacists for their expertise and efforts might be considered; although this would not address the workload and communication concerns of pharmacists, it does provide recognition for their professional role in securing appropriate drug therapy for their patients.

<p>Cardiovascular disease is a leading cause of death and hospitalizations in Canada. Most risk factors for cardiovascular disease are known, and many are modifiable. One such risk factor that often goes unrecognized is non-adherence. Pharmacists are ideally positioned to have an influence on cardiovascular risk reduction, including supporting medication adherence; however it is still unknown whether typical (non-specialist) pharmacists can provide strategies that are effective and sustainable in todays health care system. Thus, the overall objective of this research project was to determine what interventions typical pharmacists can adopt to effectively facilitate cardiovascular risk reduction within the constraints of the current practice environment. This objective was accomplished through 4 related studies: 1) a randomized controlled trial involving a pharmacist-directed cardiovascular risk reduction collaboration within a family physician practice; 2) a systematic review identifying and evaluating published interventions by community pharmacists for cardiovascular disease or diabetes; 3) the design of a pilot study evaluating a novel community pharmacy intervention aimed at cardiovascular risk reduction and; 4) the examination of adherence patterns among antihypertensive medication users to identify associated factors and high-risk periods for non-adherence.</p> <p>Although the randomized controlled trial did not show a statistically significant benefit of the pharmacist intervention on cardiovascular risk, it did demonstrate the feasibility of incorporating a pharmacist into a collaborative role, without the need for an advanced or specialized degree. Results from the systematic review yielded several studies involving community pharmacists and cardiovascular disease or diabetes. However, the majority of these studies were of poor quality, evaluated complex and intensive interventions, and provided questionable clinical benefits. The design of the pilot study demonstrated the feasibility of developing high quality, robust research involving community pharmacists. Finally, the observational study examining adherence patterns to antihypertensive agents revealed two important findings that can guide the development of future strategies to support adherence: the first year of therapy, and particularly the first dispensation, is a critical time for the development of non-adherence and, contrary to previously published studies, adherence is similar between all classes of antihypertensive medications.</p> <p>This program of research did not identify one particular pharmacist intervention as being superior for cardiovascular risk reduction in todays practice environment. However, it did highlight the need for improved study quality and the development of interventions that are practical and can be realistically implemented by pharmacists in todays practice environment.</p>

<p>In 1999, Saskatchewan Health sanctioned licensed pharmacists in the province to initiate Exception Drug Status (EDS), also referred to as prior approval, requests on behalf of their patients. The objectives of this study were to obtain pharmacists opinions about the benefits of the EDS program to stakeholders, and to identify factors associated with pharmacists initiating a request.</p><p>In the fall of 2004, a census of community-pharmacy managers in Saskatchewan was conducted using a postal questionnaire, consisting of an introductory letter, two survey mailings and one reminder card. The questionnaire consisted primarily of seven-point Likert scale questions, and was analyzed using descriptive statistics and frequencies, followed by non-parametric analysis using Mann-Whitney U and Kruskal-Wallis tests; post-hoc analysis was carried out using the Bonferroni test.</p><p>A response rate of 82.6% was achieved. Those living in Saskatoon or Regina made up 39% of respondents, with another 39% located in centres of less than 5,000 people.</p><p>A majority of respondents (63%) agreed or strongly agreed the EDS program benefited patients and the Drug Plan (64%). Only 15%, 37% and 39% of respondents agreed or strongly agreed EDS benefits pharmacists, physicians and the health care system respectively.</p><p>Factors that were important or very important to pharmacists in deciding whether they would initiate an EDS request on behalf of their patient were: the ability of the pharmacist to obtain the required information to initiate the EDS request (77%); their ability to contact the prescribing physician (70%); and patient centred concerns such as the ability to pay (74%) or the patient had exceeded their deductible (66%). However, time (39%) was not as important relative to other factors in whether the pharmacist would apply for EDS on behalf of their patient.</p><p>The majority of respondents agreed or strongly agreed that changing the policy in 1999 was beneficial to patient care (71%), while it also contributed substantially to their administrative workload (87%). </p><p>The results of this study indicate community pharmacy managers in Saskatchewan acknowledge that the Exception Drug Status process is beneficial for their patients. While pharmacists were supportive of the benefits of an EDS program, their apprehensions towards the program lie in the administrative processes, particularly in obtaining the required information, from physicians, to submit a claim. There is also concern with the methods pharmacists must use to apply for EDS, which can be burdensome and prolong the administrative process.</p><p>To enhance pharmacists support for the program it may be necessary to develop strategies designed to reduce the administrative workload associated with the program, and to streamline the efficient communication of required information between the prescriber and pharmacist. Alternatively, financial compensation to pharmacists for their expertise and efforts might be considered; although this would not address the workload and communication concerns of pharmacists, it does provide recognition for their professional role in securing appropriate drug therapy for their patients.

<p>Cardiovascular disease is a leading cause of death and hospitalizations in Canada. Most risk factors for cardiovascular disease are known, and many are modifiable. One such risk factor that often goes unrecognized is non-adherence. Pharmacists are ideally positioned to have an influence on cardiovascular risk reduction, including supporting medication adherence; however it is still unknown whether typical (non-specialist) pharmacists can provide strategies that are effective and sustainable in todays health care system. Thus, the overall objective of this research project was to determine what interventions typical pharmacists can adopt to effectively facilitate cardiovascular risk reduction within the constraints of the current practice environment. This objective was accomplished through 4 related studies: 1) a randomized controlled trial involving a pharmacist-directed cardiovascular risk reduction collaboration within a family physician practice; 2) a systematic review identifying and evaluating published interventions by community pharmacists for cardiovascular disease or diabetes; 3) the design of a pilot study evaluating a novel community pharmacy intervention aimed at cardiovascular risk reduction and; 4) the examination of adherence patterns among antihypertensive medication users to identify associated factors and high-risk periods for non-adherence.</p> <p>Although the randomized controlled trial did not show a statistically significant benefit of the pharmacist intervention on cardiovascular risk, it did demonstrate the feasibility of incorporating a pharmacist into a collaborative role, without the need for an advanced or specialized degree. Results from the systematic review yielded several studies involving community pharmacists and cardiovascular disease or diabetes. However, the majority of these studies were of poor quality, evaluated complex and intensive interventions, and provided questionable clinical benefits. The design of the pilot study demonstrated the feasibility of developing high quality, robust research involving community pharmacists. Finally, the observational study examining adherence patterns to antihypertensive agents revealed two important findings that can guide the development of future strategies to support adherence: the first year of therapy, and particularly the first dispensation, is a critical time for the development of non-adherence and, contrary to previously published studies, adherence is similar between all classes of antihypertensive medications.</p> <p>This program of research did not identify one particular pharmacist intervention as being superior for cardiovascular risk reduction in todays practice environment. However, it did highlight the need for improved study quality and the development of interventions that are practical and can be realistically implemented by pharmacists in todays practice environment.</p>

Background: Organisational culture refers to the way employees perceive, think and feel about their work and organisation, guiding their behaviours. The way community pharmacists perceive their work pressures, as well as organisational outcomes such as job satisfaction and commitment, turnover and performance may be influenced by organisational culture. However, there is little evidence of the link between organisational culture and community pharmacists’ perceptions of their workplace. Moreover, it is not possible to establish which outcomes can be linked to organisational culture, due to the lack of validated instruments capable of measuring aspects that are unique to community pharmacy. The aim of this study was to design and validate a questionnaire to measure organisational culture in community pharmacy in Great Britain. Methods of questionnaire design and testing: Qualitative interviews with 12 community pharmacists working in Greater Manchester and relevant literature were analysed to identify variables describing organisational culture in community pharmacy, informing the design of a new conceptual model. Survey items were drafted based on the conceptual model, and response categories for the questionnaire were chosen. Cognitive interviews established the content validity of the conceptual model and questionnaire. The questionnaire was then administered to a sample of community pharmacists in Great Britain (n=1000) obtained from the GPhC register of pharmacies. Factor analysis was conducted to validate the questionnaire and investigate its component structure. Inferential analysis was conducted to investigate differences in how community pharmacists perceived organisational culture. Results: Two-hundred-and-nine usable questionnaires were returned. Factor analysis revealed five dimensions comprising of 60 items. These dimensions are: Business and work configuration; Social relationships; Personal and professional development; Skills utilisation; and Environment and structures. The conceptual model was adjusted based on these dimensions and the items retained, describing how different variables interact to produce different cultures. The questionnaire demonstrated good psychometric properties, with high levels of validity and reliability. Findings from the questionnaire revealed differences in how community pharmacists perceived their cultures, suggesting different cultures: more positive ratings were associated with owners, pharmacists from ethnic backgrounds, and those working in independent pharmacies; more negative ratings were associated with relief pharmacists, white pharmacists, and pharmacists working in supermarket pharmacies. Discussion: Organisational culture influences the way individuals think and behave. Supportive cultures that facilitate workflow are paramount in shaping organisations’ professional image and determining its success. However, findings from the questionnaire indicate that the way community pharmacists perceive organisational culture varies, suggesting different organisational cultures. It is important for leaders to consider these differences and their impact on organisational outcomes. The validated conceptual model will be useful in future research by describing how different configurations produce different cultures. The questionnaire will allow the investigation of differences in how organisational culture is perceived in community pharmacy and their link to job outcomes, and identification of organisational variables which may be perceived as infrequent triggering change and guiding interventions to maximise positive outcomes, for both pharmacists and pharmacies.

Class of 2005 Abstract / Objectives: To determine the level of patient satisfaction regarding counseling services provided at a local community pharmacy. Methods: 100 questionnaires were handed out randomly to pharmacy customers who received counseling services on new prescription medication(s). The questionnaires contained multiple criteria/statements regarding the provision of counseling services. Customers were also asked to select from a list of potential additional categories of information that they would like to receive during counseling. Results: 48 of 100 questionnaires were received at the time this report was written. Customers strongly agreed that the criteria regarding the content of the counseling services were met: (name/strength/dose, and with all of the statements regarding the pharmacist's professional attributes and the counseling environment except one regarding privacy involved with counseling). Suprisingly, only 20% of customers would feel more comfortable being counseled in a more private area such as a separate room or walled off area. Implications: This study provided important feedback to the community pharmacy as well as the pharmacists working there in regards to the evaluation of counseling services provided to their valued customers. Customers have the opportunity to provide their input in regard to their satisfaction level of the quality of counseling services they receive at this community pharmacy (in the form of a questionnaire). Customers, through the completion of the questionnaire, may realize the value of this questionnaire and its use as a tool to improve the areas of the counseling services that customers agree need improvement as well as the opportunity to realize that this community pharmacy does care and value it’s customers and their level of satisfaction in the counseling services provided. This questionnaire may be used as a tool by the community pharmacy in the future to re-assess these criteria of counseling services in the overall purpose of improving the quality of counseling services provided by this community pharmacy.

Class of 2005 Abstract / Objectives: The objectives of this study were to 1) describe Japanese pharmacists’ perceptions about community pharmacy on a variety of issues and 2) compare the perceptions between different groups. Methods: A questionnaire was administered to a convenience sample of community pharmacists in the Tokyo metropolitan area and Hiroshima prefecture. Pharmacists were surveyed on various issues such as job satisfaction, the separation of prescribing and dispensing, their relationship with patients and physicians, and pharmacy education. A five-point Likert scale was used to measure responses. Results: One hundred forty-four questionnaires were completed. Eighty-four percent of respondents were female, 37.5% had more than ten years of practice experience, and 81.9% worked in Tokyo. Japanese community pharmacists are neutral or satisfied with their jobs. However, respondents were not satisfied with the current state of community pharmacy in Japan (2.81 + 0.83), did not feel respected by patients (2.74 + 0.99) and physicians (1.99 + 0.95), felt that four years of education was not enough to provide adequate patient care (1.96 + 1.01), and would like to do more clinical oriented activities (3.77 + 0.84). Significant differences were found in some responses between groups such as males versus females and pharmacists with more versus less than ten years of practice experience. Conclusions: Respondents were not satisfied with the current state of community pharmacy in Japan. Areas that could use improvement are respect from patients and physicians, involvement in clinical activities, and assistance at work. Significant differences were found in the perceptions of the groups studied.

Class of 2006 Abstract / Objectives: To evaluate the public’s awareness regarding the professional role pharmacists have in a community pharmacy setting. Methods: The study design was a small-scale, cross-sectional survey conducted in two community pharmacy sites. Subjects included patients picking up prescription medications requiring pharmacist consultation. Volunteer participation and completion of the PQ, constituted eligible enrollment into the study. The pharmacy questionnaire (PQ) consisted of 11 statements. Subjects were to read and signify along an ordinal scale whether they strongly disagreed to strongly agree with each statement. A total of 134 surveys were completed and returned for analysis from the two pharmacy sites. Analysis of the PQ looked at responses within and between group demographics, such as gender, age, frequency and reason for visitation to pharmacy. The impact of the independent variables on patient responses to the questionnaire and the differences in patient responses between the two collection periods was analyzed using independent t-tests or a one-way ANOVA. Results: The average response scores were positive for all Statements, ranging from ‘Somewhat Agree’ to ‘Agree.’ The two lowest rated statements were concerning the refusal to fill an unsafe prescription, and checking for prescription 3x for accuracy. The three highest rated Statements were ensuring patient understanding of proper medication use, answering questions about side effects, and pharmacist knowledge and expertise. Women answering questions more positively than men, particularly with ensuring patient understanding of proper medication use (p <0.01) and answering questions about side effects (p <0.05). The pharmacists’ knowledge and expertise was significantly higher rated in women than in men (p <0.01) and older women answered more positively than younger women (p <0.05). The statement about Refusing to fill an unsafe prescriptions had subjects 26 to 35 years old answering more negatively when compared to the 46 to 55 and >65 year old groups (p <0.05). As age increased, subjects responded more positively to the pharmacist verifying dosages, and men disagreed to a greater degree than women (p <0.01). Increases in the frequency of pharmacy visits had a visual trend of more positive responses, but only the verification of dosages was nearly significant (p <0.05). By whom the questionnaire was completed by (self or non-self) had no bearing on the response. Conclusions: Regardless of age, gender, or setting, patients tended to be reasonably familiar with the role community pharmacists take part in as a member of the health care profession.