Class of 2011 Abstract / OBJECTIVES: To compare pharmacists’ perceptions of patients’ health literacy levels to their measured health literacy levels. METHODS: This was descriptive study that included thirty patients from two independent pharmacies where they were administered a health literacy survey at random during their routine visit to the pharmacy. Each participant’s health literacy assessment was scored and assigned to a corresponding literacy level. Pharmacists from each store were then surveyed as to what they perceived each patient’s health literacy level to be. RESULTS: Twenty-eight of the thirty participants (93%) obtained the highest literacy score possible in the assessment. Two participants scored lower literacy levels and were both non-whites who were currently taking six or more medications and over the age of 50. No significant differences with respect to age, gender, education level, number of previous conversations with the pharmacist, or number of current medications were found as compared to measured literacy level. Actual literacy scores as well as perceived literacy levels between sites were also found to be insignificant (p=0.17 and p=0.58 respectively). With respect to race, there was a significant difference between whites vs. non-whites relative to REALM scores (p<0.001). Analysis of the difference between actual literacy scores and perceived scores were unable to be determined.       CONCLUSION: Based on the two participants who had lower literacy levels, this may suggest a disparity in health literacy with respect to race, age, and number of concurrent medications. However, due to lack of study variability, the significance of the difference was unable to be determined and conducting a larger study with more diverse settings, demographics, and larger sample size is suggested.

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 create, deliver, and evaluate a malignant melanoma continuing education (CE) seminar for pharmacists. Methods: A CE program was developed and presented to educate pharmacists about skin cancer prevention, specifically malignant melanoma, and their role in prevention through patient counseling. All practicing pharmacists who attended the CE program were asked to fill out a knowledge indicator and assess their comfort level in counseling patients about sun safety before and after the program. The participants also answered questions addressing how often they counsel patients on sunscreen use, their personal experience with skin cancer, preferred CE format, previous CE attendance, sex, age, practice site, hours worked per week, and years since graduation from pharmacy school. Results: The survey instrument was completed by 84 pharmacists. The average score on the pre-test knowledge indicator was 4.95 ± 0.39 and the average score on the post-test knowledge indicator was 7.81 ± 0.39. This was a significant improvement (p < 0.01). There was a significant increase in participant comfort level when counseling patients about sun safety after attending the CE program (p < 0.01). Personal experience with skin cancer did not have a significant effect on the pre-test knowledge indicator scores, however it was associated with the knowledge indicator change score (p < 0.01). Completion of previous skin cancer CE programs did not have a significant effect on the pre-test knowledge indicator score or the change score. Conclusions: Pharmacists who attended the CE program improved their knowledge indicator scores when tested about malignant melanoma and sun safety. Many participants felt more comfortable counseling patients about sun safety and felt their counseling on sun safety would change as a result of attending this CE program.

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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 / 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.