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      Patient Preference and Adherence (submit here)

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      Comparison of pharmacist and public views and experiences of community pharmacy medicines-related services in England

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          Abstract

          Background

          Services provided by community pharmacists designed to support people using medicines are increasing. In England, two national services exist: Medicine Use Reviews (MUR) and New Medicines Service (NMS). Very few studies have been conducted seeking views of the public, rather than service users, on willingness to use these services or expectations of these services, or determined whether views align with pharmacist perceptions.

          Objective

          To compare the perceptions of pharmacists and the general public on medicines-related services, particularly MUR and NMS services.

          Methods

          Two parallel surveys were conducted in one area of England: one involved the general public and was administered using a street survey, and the other was a postal survey of community pharmacists. Similar questionnaires were used, seeking views of services, awareness, reasons for using services, and perceived benefits.

          Results

          Response rates were 47.2% (1,000/2,012 approached) for the public and 40.8% (341/836) for pharmacists. Few people had experienced a discussion in a private consultation room or were aware of the two formal services, although their willingness to use them was high. Pharmacists estimated time spent on service provision as 10 minutes for MUR and 12 minutes for NMS, which aligned with acceptability to both pharmacists and the public. Pharmacists underestimated the willingness of the public to wait for an informal discussion or to make appointments for formal services. Both pharmacists and the public had high expectations that services would be beneficial in terms of increasing knowledge and understanding, but public expectations and experiences of services helping to sort out problems fell well below pharmacists’ perceptions. People who had experienced a pharmacy service had different perceptions of pharmacists.

          Conclusion

          Views differed regarding why people use services and key aspects of service delivery. For services to improve, the pharmacy profession needs a better awareness of what the public, especially those with potential to benefit from services, view as acceptable and desirable.

          Most cited references25

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          Community pharmacists' attitudes towards medicines use reviews and factors affecting the numbers performed.

          Medicines use review and prescription intervention ('MUR services') is the first advanced service within the NHS community pharmacy contract and is a structured review that is undertaken by a pharmacists with patients on multiple medicines. The objective of this study was to investigate factors that influence the number of Medicines use reviews (MURs) performed by community pharmacists and to explore community pharmacists' attitudes towards the service. Setting This study was conducted with pharmacists who were employed by one UK community pharmacy chain. A questionnaire was developed to investigate factors that influence the number of MURs performed and pharmacists' attitudes towards MURs. It consisted of a series of attitudinal statements together with brief demographic data. Questionnaires were distributed to a sample of 280 pharmacists accredited to provide the service during April and May 2006. Factors affecting the number of MURs performed and community pharmacists' attitudes towards MURs. Sixty per cent (167/280) of pharmacists returned a completed questionnaire. Twenty-seven per cent of respondents had not performed any MURs, 43% had conducted one to 14 reviews and 31% had conducted 15 or more. Job title affected the number of reviews performed; respondents categorised as 'Store based' pharmacists performed significantly more MURs than those working as 'Locums' but not significantly more than 'Managing' pharmacists. Pharmacists reporting access to an accredited consultation area performed significantly more MURs than those who did not. Those working more than 20 h per week performed significantly more MURs than those working less. Gender, time since qualification, the pharmacy size and those having or currently undertaking a clinical diploma were not found to be associated with the number of MURs performed. Most respondents reported that MURs were an opportunity for pharmacist to use their professional skills in an extended role and patients would benefit from the service. However they reported concerns about GPs opinion of the service, lack of time and support staff to conduct MURs and were unhappy about consultation areas. This study demonstrates that pharmacists perceive MURs to be an opportunity for an extended role and of value to patients. However, this study has identified perceived barriers, including the availability of a consultation area suitable for performing MURs, time to perform MURs and support staff. The number of MURs performed by pharmacists appears to be affected by the pharmacists' job title, their working hours and the presence of a consultation area. Additional support for 'locum' pharmacists was also highlighted and may be needed.
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            Patient evaluation of a community pharmacy medications management service.

            A patient-centered approach is increasingly recognized as an important component in the evaluation of healthcare services. To assess patient satisfaction with, attitudes toward, and expectations of or experience with community pharmacy in general, and to evaluate the effect of the community pharmacy-led medications management service on these factors. Postal questionnaire surveys were completed at baseline and after 12 months (follow-up) as part of a randomized controlled trial of the service. The setting was 9 primary care organizations in England. Patients with coronary heart disease were recruited from general practice registers and randomly allocated to the intervention (pharmacy-led medications management service) or control group. Survey response rates at baseline and follow-up were 88.4% (1232/1394) and 80.1% (1085/1355), respectively. The respondents indicated that they wanted pharmacists to provide dispensing, medications review, advice on medications and health, private consultation areas, and short visit times. At follow-up, intervention patients were more likely than control patients (p < 0.01) to rate the service provided by their pharmacist with a higher level of satisfaction, and most intervention patients stated a preference for seeing their physician to discuss their medications, although this was less marked than in control patients (76% vs 85%; p < 0.01). Intervention patients were also more willing than control patients to ask the pharmacist questions that they would be unable to ask a physician (20% vs 11%, respectively; p < 0.01), to ask the pharmacist questions about their medications (32% vs 18%, respectively; p < 0.01), and to recommend this practice to others (51% vs 40%, respectively; p < 0.01). Pharmacist intervention was associated with significant and positive changes in patient satisfaction. While patients probably continue to prefer a physician-led service, they value aspects of a pharmacy service. Patients generally preferred discussing medications with the family physician, but experiencing the community pharmacy-led service resulted in an attitudinal shift toward the pharmacist. These findings suggest a benefit in developing the community pharmacist's role as a reviewer of, and adviser on, patients' medications.
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              Pharmacists' and consumers' viewpoints on counselling on prescription medicines in Australian community pharmacies.

              The aim was to investigate and compare counselling on prescription medicine provided by Australian community pharmacists based on pharmacist and consumer self-reports, and to explore consumers' interest in receiving prescription medicine information. Mail and face-to-face surveys containing comparable questions for both study groups. The setting was Sydney metropolitan community pharmacies, Australia (22 pharmacists and 157 consumers). No statistically significant differences were found between pharmacists and consumers in reporting provision of verbal information for new (Z = -0.57, P = 0.57) and repeat prescriptions (Z = -1.71, P = 0.09). However, there were statistically significant differences between the two cohorts in reporting dissemination of written information (Z = -2.6, P = 0.009 and Z = -2.68, P = 0.007 for new and repeat prescriptions, respectively). Both groups reported that the most common type of verbal information provided by pharmacists was in relation to medicine administration rather than safety aspects of medicines. Approximately 59% of consumers expressed an interest in receiving counselling for new prescriptions only. Pharmacists regularly provided verbal counselling on new prescription medicines, but infrequently provided written medicine information or any type of information for regular medicines. Lack of consumers' interest in receiving prescription medicine information may have contributed to the low counselling rates. Thus, there is a need to develop strategies to improve pharmacist counselling practice and to enhance consumer involvement in the counselling process.
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                Author and article information

                Journal
                Patient Prefer Adherence
                Patient Prefer Adherence
                Patient Preference and Adherence
                Patient preference and adherence
                Dove Medical Press
                1177-889X
                2016
                09 September 2016
                : 10
                : 1749-1758
                Affiliations
                Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, UK
                Author notes
                Correspondence: Janet Krska, Medway School of Pharmacy, The Universities of Greenwich and Kent, Chatham Maritime, Kent ME4 4TB, UK, Tel +44 1634 202950, Fax +44 01634 883827, Email j.krska@ 123456kent.ac.uk
                Article
                ppa-10-1749
                10.2147/PPA.S112931
                5026175
                27672313
                33c4aa80-6be5-4045-937b-563d2f14ab87
                © 2016 Rodgers et al. This work is published and licensed by Dove Medical Press Limited

                The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.

                History
                Categories
                Original Research

                Medicine
                community pharmacy,public opinion,pharmacist perceptions,medicines-related services
                Medicine
                community pharmacy, public opinion, pharmacist perceptions, medicines-related services

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