OBJECTIVE: To develop, validate and apply a scale to measure patient satisfaction in a randomised controlled trial of community pharmacy service. METHODS: Published scales were reviewed to inform development of the patient satisfaction scale. Questionnaires were sent to patients in the control (n=500) and intervention (n=941) groups of a randomised controlled trial of community pharmacy-led management of coronary heart disease at baseline and 12-month follow-up. Any underlying main factors were assessed with exploratory factor analysis. Reliability and construct validity were tested. The 15-item scale was used to compare patient satisfaction across arms with their most recent pharmacy visit. RESULTS: Response rates were 92% (461/500) for control and 96% (903/941) for intervention groups at baseline and 85% control (399/472) and intervention (810/941) at follow-up. At baseline satisfaction was very similar in the intervention and control groups (median scores of 42). At follow-up mean satisfaction had significantly improved for the intervention compared with the control (median scores of 46 compared with 43; P<0.01); intervention females were more likely to be satisfied with the service than males (49 compared with 44; P<0.01). Three main factors explained the majority of the data variance. Cronbach's alpha was 0.7-0.9 for both groups over time for all factors and total scale. An increase in the overall satisfaction corresponding to a decrease in subjects wanting that particular service to be provided during their next visit indicated construct validity of the scale. CONCLUSION: A new scale of patient satisfaction with community pharmacy services was developed and shown to be reliable and valid. Its application showed increased satisfaction in the intervention group receiving a new pharmacy service.

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.

No description available.

Background: The Alliance for Patient Medication Safety (APMS) helps community pharmacies comply with continuous quality improvement requirements of many states and third party payment contracts through use of their Pharmacy Quality Commitment (PQC) program. Aims: To assess changes in the incidence of prescription Quality Related Events (QREs) and adoption of patient safety culture attitudes after guided PQC implementation. Methods: Twenty-one pharmacies were randomized to standard PQC practices (control) or guided PQC implementation (treatment). Pharmacy staff completed retrospective pre and post safety culture questionnaires. Negative binomial mixed and linear regression analyses were employed to examine changes in QREs rates and attitudes, respectively. Rasch analysis was used to assess questionnaire validity and reliability. Results: During the 2-month study period 3,343 QREs were reported to the online PQC system. At baseline, no difference in the average QRE reporting rate was identified between groups. Treatment group QRE reporting rates differed in one category post treatment (more incorrect safety caps QREs reported in treatment group, p<0.034). Seventy-one employees completed the questionnaire (70% response). Attitude improvement in the treatment group was 36% greater than in control (p<0.0001). The questionnaire demonstrated acceptable reliability and validity evidence. Conclusions: Guided PQC implementation increased reporting of certain QREs and increased the adoption of patient safety culture attitudes among staff pharmacy.

Diss. (sammanfattning) Stockholm : Karol inst., 2003. / Härtill 6 uppsatser.

Submitted by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2015-04-20T13:48:43Z No. of bitstreams: 1 Dissertação Fernanda de Farias Rodrigues. 2014.pdf: 1910857 bytes, checksum: c70535b5be734bc92cd97daf06f970a5 (MD5) / Approved for entry into archive by Maria Creuza Silva (mariakreuza@yahoo.com.br) on 2015-04-20T14:25:55Z (GMT) No. of bitstreams: 1 Dissertação Fernanda de Farias Rodrigues. 2014.pdf: 1910857 bytes, checksum: c70535b5be734bc92cd97daf06f970a5 (MD5) / Made available in DSpace on 2015-04-20T14:25:55Z (GMT). No. of bitstreams: 1 Dissertação Fernanda de Farias Rodrigues. 2014.pdf: 1910857 bytes, checksum: c70535b5be734bc92cd97daf06f970a5 (MD5) / Os desafios para o controle da tuberculose, no SUS, vêm sendo cada dia maiores, e as ações de controle da doença no Brasil, coordenadas pelo Programa Nacional de Controle da Tuberculose (PNCT), priorizam o cuidado ao paciente nos serviços de atenção primária à saúde (APS). Neste nível do sistema de saúde, os serviços da Assistência Farmacêutica mostram-se fundamentais, os quais podem interferir no alcance das metas previstas para o controle da doença. Esse estudo teve como objetivo geral avaliar o funcionamento dos serviços de Assistência Farmacêutica no cuidado ao paciente com tuberculose em unidades de atenção primária à saúde no município de Salvador – Bahia. Foi realizado um estudo de avaliação de estrutura e processo de trabalho dos serviços de Assistência Farmacêutica em duas unidades de saúde do município, unidade A e unidade B, que disponibilizavam medicamentos para o tratamento da tuberculose e contavam com a presença do profissional farmacêutico. Para avaliação da estrutura foram definidos três critérios: instalações prediais, recursos materiais e recursos humanos. Para avaliação de processo de trabalho, os critérios foram agrupados em duas dimensões; serviços farmacêuticos técnico-gerenciais e serviços farmacêuticos técnico-assistenciais. A coleta dos dados foi realizada através de entrevistas semi-estruturadas e de observação sistemática guiada por roteiro nas duas unidades. Foram entrevistados os farmacêuticos responsáveis pela gestão do componente estratégico na Subcoordenadoria de Assistência Farmacêutica da Secretaria Municipal de Saúde, e nas duas unidades foram entrevistados os farmacêuticos atuantes, seus respectivos gerentes e uma amostra de pacientes atendidos nas mesmas. O estudo demonstrou que não há disponibilidade de cuidado ao paciente com tuberculose em 100% das unidades de atenção primária à saúde, o que contraria as diretrizes do PNCT. Em relação às unidades selecionadas, verificaram-se dois cenários distintos no que diz respeito à estrutura e ao processo de trabalho dos profissionais para assegurar o cuidado ao paciente com tuberculose. A unidade A apresentou deficiências na estrutura quando comparada com a unidade B, a qual contou com melhor estrutura para o serviço. Em relação ao processo de trabalho, verificou-se que, no que dizia respeito ao desenvolvimento dos serviços farmacêuticos técnico-gerenciais, as duas unidades apresentaram semelhanças, embora algumas dessas atividades ocorressem com maior dificuldade na unidade A. Os serviços técnico-assistenciais eram plenamente realizados na unidade B, sendo pouco executado na unidade A. A farmácia da unidade A alcançou 65% dos critérios utilizados para avaliação, e a farmácia da unidade B, 97%. Recomenda-se a ampliação e melhor organização dos serviços farmacêuticos na atenção primária do município de Salvador e a unidade B pode servir como referência para as demais unidades da rede para o cuidado ao paciente com tuberculose.

Acknowledgement: "My sincere thanks to my supervisors Julie, Alison and Christina" - Identified Julie and Alison from the Department staff webpages - sm 26/02/2019 / There is little research investigating factors that facilitate or inhibit timely access to palliative care medicines from community pharmacies. Though palliative care is recognised within the UK government’s strategy and community pharmacists are considered to have a role it is uncertain to what extent this aim is incorporated into local practice. This thesis uses mixed methods to investigate the time taken to access palliative care medication from five community pharmacies in one area of England. The effect of prescription errors, stock availability and other factors is examined. Furthermore, semi-structured interviews with five community pharmacists and eleven other healthcare professionals explore medication access and the community pharmacist’s role in palliative care using the Framework method. Stock availability led to delays with one in five customers going to more than one pharmacy to get urgently required palliative care medications. Legal prescription errors were more common on computer generated prescriptions but did not lead to delays. Three subthemes were identified in accessing palliative care medicines: environment and resources; communication and collaboration; skills and knowledge. The community pharmacist’s role in palliative care was limited due to reluctance from other healthcare professionals to share information, poor access to patient records and lack of integration into the primary healthcare team. This study highlights implications for professionals, commissioners and providers to improve services for those trying to access palliative medication. Community pharmacies remain a largely untapped resource for supporting patients, relatives and carers towards the end of life in both cancer and other advanced life-limiting diseases.

There is little research investigating factors that facilitate or inhibit timely access to palliative care medicines from community pharmacies. Though palliative care is recognised within the UK government’s strategy and community pharmacists are considered to have a role it is uncertain to what extent this aim is incorporated into local practice. This thesis uses mixed methods to investigate the time taken to access palliative care medication from five community pharmacies in one area of England. The effect of prescription errors, stock availability and other factors is examined. Furthermore, semi-structured interviews with five community pharmacists and eleven other healthcare professionals explore medication access and the community pharmacist’s role in palliative care using the Framework method. Stock availability led to delays with one in five customers going to more than one pharmacy to get urgently required palliative care medications. Legal prescription errors were more common on computer generated prescriptions but did not lead to delays. Three subthemes were identified in accessing palliative care medicines: environment and resources; communication and collaboration; skills and knowledge. The community pharmacist’s role in palliative care was limited due to reluctance from other healthcare professionals to share information, poor access to patient records and lack of integration into the primary healthcare team. This study highlights implications for professionals, commissioners and providers to improve services for those trying to access palliative medication. Community pharmacies remain a largely untapped resource for supporting patients, relatives and carers towards the end of life in both cancer and other advanced life-limiting diseases.

There are widespread concerns about the increasing use of multiple medicines. The aims of this thesis were to identify older patients' and general practitioners' (GPs) attitudes to and experiences of multiple medicine use, as well as to describe patterns of multiple medicine use in different age groups in association with patient-related factors. An additional aim was to contribute to scientific methodological development by providing an empirical example of the application of the Lehoux, Poland, &amp; Daudelin template for the analysis of interaction in focus groups. Data were collected via qualitative focus group discussions and from a cross-sectional community-based population survey conducted during 2001-2005. The patients revealed co-existing accounts of both immediate gratitude that medicines exist and problems with using multiple medicines such as worrying whether multiple medicine use is 'good' for the body. The patient-doctor relationship coloured their attitudes towards their treatment and care. The GPs at times felt insecure, though surrounded by treatment guidelines. Lack of communication with hospital specialists was perceived to reduce treatment quality, while influence of patient pressure was thought to contribute to the development of multiple medicine use. An interaction analysis helped in appreciating and clarifying the contexts in which results from the content analysis were created. Further discussion is needed on how to best report these results. Different cut-offs are useful in defining multiple medicine use in different age groups. Vast majorities of users of multiple medicines were found to have unique medicine combinations. Multiple medicine use was found to be associated with morbidity and poor self-rated health across all age groups.

The aim of this thesis was to explore Swedish pharmacist students’ learning during pharmacy internship. Internships are meant to introduce students to professional practice. Education programs have to reflect changes in the professional role, and take into account that learning in a professional practice setting differs from organized formal education. This thesis includes both quantitative and qualitative research approaches and applies workplace learning theories. A scheme for measuring pharmacy students’ reflective ability was developed and shown to be feasible and reliable. Factors important for reflection were found to be primarily social and contextual, especially trained tutor and small pharmacy size. Notably, learning style or critical thinking did not correlate to students’ reflective ability. Tutors and students perceived that students used a wide variety of activities supporting learning of a broad repertoire of knowledge and skills, preparing them for coming professional working life. Tutors are most important to support learning. However, the current curriculum and formal activities do not address all these outcomes and learning activities used, e.g. workplace learning. The first overall conclusion is that internship plays an essential part in the pharmacist education program. The integration of formal and informal learning activities during internship, including raising awareness of incidental learning, is important to support students in learning the professional practice of pharmacy. This integration could possibly be strengthened by introducing further tutor training, different assignments, and by using portfolios. The second conclusion is that the community of practice is essential for students’ learning during internship, especially the student-tutor interaction. Hence, the entire social context has to be considered and it is important to ensure a good learning environment at pharmacies during internship. In summary, this thesis contributes to the understanding of students’ learning during pharmacy internship and introduces educational research on the Swedish undergraduate pharmacy education programs.