Intervention research to enhance community pharmacists' cognitive services: A systematic review

Patwardhan, Pallavi; Amin, Mohamed Ezzat Khamis; Chewning, Betty

doi:10.1016/j.sapharm.2013.07.005

Cited by 60 publications

(51 citation statements)

References 41 publications

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“…Our findings substantiate some key recommendations of previous systematic reviews: that pharmacists and their staff, when properly trained and supported, are capable of delivering the non-dispensing elements of a smoking cessation service as well as providing nicotine replacement products [4, 15–18, 20, 74, 75, 76]; that training improves their confidence and performance in this area [74, 75]; that there may be role ambiguity and/or issues of professional identity when pharmacists are invited to take on non-dispensing roles [13]; that primary studies have, to date, produced a very limited evidence base on the real-world implementation of smoking cessation services (for example, the active components of interventions have been poorly described and rarely theorised) [4, 13, 17, 20, 74]; that pharmacies may be run according to different business models but the evidence base on how these different models support non-dispensing pharmacy services is limited [4, 76]; and that there are policy implications of a major change in the professional jurisdiction of pharmacists [4, 17]. …”

Section: Discussionsupporting

confidence: 86%

“…Training has been shown to be positively received by pharmacists (strong direct evidence [54, 74]); it increases their knowledge (strong direct evidence: [49, 53, 54, 74, 75]), self-efficacy or confidence (strong direct evidence: [53, 54, 74, 75]) and intention to provide such support to their own clients (strong direct evidence: [53, 55]). These changes appear to be sustained over the medium term (moderate direct evidence [53, 56]).…”

Section: Resultsmentioning

confidence: 99%

“…A systematic review covering smoking cessation training and other behavioural interventions by pharmacists noted the near-absence of evidence on what is actually delivered to pharmacy customers following a training course (moderate direct and strong indirect evidence [74]).…”

Section: Resultsmentioning

confidence: 99%

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What works for whom in pharmacist-led smoking cessation support: realist review

Greenhalgh

Macfarlane

Steed

2016

BMC Med

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BackgroundNew models of primary care are needed to address funding and staffing pressures. We addressed the research question “what works for whom in what circumstances in relation to the role of community pharmacies in providing lifestyle interventions to support smoking cessation?”MethodsThis is a realist review conducted according to RAMESES standards. We began with a sample of 103 papers included in a quantitative review of community pharmacy intervention trials identified through systematic searching of seven databases. We supplemented this with additional papers: studies that had been excluded from the quantitative review but which provided rigorous and relevant additional data for realist theorising; citation chaining (pursuing reference lists and Google Scholar forward tracking of key papers); the ‘search similar citations’ function on PubMed. After mapping what research questions had been addressed by these studies and how, we undertook a realist analysis to identify and refine candidate theories about context-mechanism-outcome configurations.ResultsOur final sample consisted of 66 papers describing 74 studies (12 systematic reviews, 6 narrative reviews, 18 RCTs, 1 process detail of a RCT, 1 cost-effectiveness study, 12 evaluations of training, 10 surveys, 8 qualitative studies, 2 case studies, 2 business models, 1 development of complex intervention). Most studies had been undertaken in the field of pharmacy practice (pharmacists studying what pharmacists do) and demonstrated the success of pharmacist training in improving confidence, knowledge and (in many but not all studies) patient outcomes. Whilst a few empirical studies had applied psychological theories to account for behaviour change in pharmacists or people attempting to quit, we found no studies that had either developed or tested specific theoretical models to explore how pharmacists’ behaviour may be affected by organisational context. Because of the nature of the empirical data, only a provisional realist analysis was possible, consisting of five mechanisms (pharmacist identity, pharmacist capability, pharmacist motivation and clinician confidence and public trust). We offer hypotheses about how these mechanisms might play out differently in different contexts to account for the success, failure or partial success of pharmacy-based smoking cessation efforts.ConclusionSmoking cessation support from community pharmacists and their staff has been extensively studied, but few policy-relevant conclusions are possible. We recommend that further research should avoid duplicating existing literature on individual behaviour change; seek to study the organisational and system context and how this may shape, enable and constrain pharmacists’ extended role; and develop and test theory.

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Section: Discussionsupporting

confidence: 86%

Section: Resultsmentioning

confidence: 99%

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What works for whom in pharmacist-led smoking cessation support: realist review

Greenhalgh

Macfarlane

Steed

2016

BMC Med

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“…Based on the cognitive perspective, a role is formulated from different societal expectations on an individual occupying a specific position 26,27. The literature suggests ten standards that patients and customers use to evaluate services: (1) reliability, (2) responsiveness, (3) assurance, (4) empathy, (5) tangibles, (6) friendliness, (7) fairness, (8) control, (9) options, and (10) alternatives 26,27,28,29,30,31,32,33.…”

Section: Introductionmentioning

confidence: 99%

Community pharmacy in Lebanon: A societal perspective

Iskandar

Hallit

Raad

et al. 2017

Pharm Pract (Granada)

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Objective:To assess patients’ attitudes towards the community pharmacist’s role and determine their negative and positive reactions towards community pharmacists in Lebanon.Methods:A cross-sectional study, conducted between January and April 2016, was designed to assess the general public satisfaction with the services provided by the community pharmacies. It was carried out, using a proportionate random sampling of Lebanese community pharmacies from each district. Two sided statistical tests were used to compare between group percentages, Wilcoxon test for quantitative variables with non-homogeneous variances or non-normal distribution, and Student’s t-test for quantitative variables of normal distribution and homogeneous variances. The ANOVA test was used to compare between three groups or more, and Pearson correlation coefficient were used to correlate between quantitative variables.Results:a total of 565 participants completely answered the survey questions with a response rate of 94%. The bivariate analysis showed that the patient perception index was positively and significantly correlated with the patient level of expectation index, the overall pharmacy experience and the patient’s reason for visiting the pharmacy (p<0.001 for all 3 variables) but was negatively correlated with the barriers for asking questions significantly (p=0.032). On the other hand, this perception index was significantly and positively associated with the number of pharmacy visits, the age categories, the level of education and the family monthly income (p<0.05 for all variables).Conclusion:Public perception and attitude toward community pharmacist in Lebanon is poor despite highly qualified pharmacists. Aspects of pharmacy services most relevant to patients were respect, empathy, a friendly staff, listening carefully, giving quality time, responding quickly to their needs and respecting their privacy. The ministry of Health in Lebanon, along with the Lebanese Order of Pharmacists should educate the pharmacist about working on the different issues patients are complaining about in order to play a more important role in the society and become the number one trusted health care professional.

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“…Implementation research is evolving, but studies using implementation theory and investigation of the implementation influences, over the course of implementation during each implementation stage, is scarce in both pharmacy and other disciplines [1, 2]. Knowledge of pharmacy’s implementation process, combined with the use of a suitable implementation framework(s), could aid widespread adoption, implementation, sustainability and eventual scale-up of professional pharmacy services.…”

Section: Introductionmentioning

confidence: 99%

Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis

Moullin

Sabater‐Hernández

Benrimoj

2016

BMC Health Serv Res

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BackgroundMultiple studies have explored the implementation process and influences, however it appears there is no study investigating these influences across the stages of implementation. Community pharmacy is attempting to implement professional services (pharmaceutical care and other health services). The use of implementation theory may assist the achievement of widespread provision, support and integration. The objective was to investigate professional service implementation in community pharmacy to contextualise and advance the concepts of a generic implementation framework previously published.MethodsPurposeful sampling was used to investigate implementation across a range of levels of implementation in community pharmacies in Australia. Twenty-five semi-structured interviews were conducted and analysed using a framework methodology. Data was charted using implementation stages as overarching themes and each stage was thematically analysed, to investigate the implementation process, the influences and their relationships. Secondary analyses were performed of the factors (barriers and facilitators) using an adapted version of the Consolidated Framework for Implementation Research (CFIR), and implementation strategies and interventions, using the Expert Recommendations for Implementing Change (ERIC) discrete implementation strategy compilation.ResultsSix stages emerged, labelled as development or discovery, exploration, preparation, testing, operation and sustainability. Within the stages, a range of implementation activities/steps and five overarching influences (pharmacys' direction and impetus, internal communication, staffing, community fit and support) were identified. The stages and activities were not applied strictly in a linear fashion. There was a trend towards the greater the number of activities considered, the greater the apparent integration into the pharmacy organization. Implementation factors varied over the implementation stages, and additional factors were added to the CFIR list and definitions modified/contextualised for pharmacy. Implementation strategies employed by pharmacies varied widely. Evaluations were lacking.ConclusionsThe process of implementation and five overarching influences of professional services implementation in community pharmacy have been outlined. Framework analysis revealed, outside of the five overarching influences, factors influencing implementation varied across the implementation stages. It is proposed at each stage, for each domain, the factors, strategies and evaluations should be considered. The Framework for the Implementation of Services in Pharmacy incorporates the contextualisation of implementation science for pharmacy.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1689-7) contains supplementary material, which is available to authorized users.

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Intervention research to enhance community pharmacists' cognitive services: A systematic review

Cited by 60 publications

References 41 publications

What works for whom in pharmacist-led smoking cessation support: realist review

What works for whom in pharmacist-led smoking cessation support: realist review

Community pharmacy in Lebanon: A societal perspective

Qualitative study on the implementation of professional pharmacy services in Australian community pharmacies using framework analysis

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