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      Pharmacists’ and pharmacy technicians’ scopes of practice in the management of minor ailments at community pharmacies in Indonesia: a cross-sectional study

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          Abstract

          Background:

          Managing minor ailments in community pharmacy is an evolving pharmacy service in developing countries. Defined scopes of practice for pharmacy staff are essential for the safe management of minor ailments. Limited research exists regarding the perceptions of Indonesian pharmacists’ and pharmacy technicians’ scopes of practice in providing minor ailments management services.

          Objective:

          To evaluate pharmacists’ and pharmacy technicians’ understanding of their scopes of practice, perceived competency and factors influencing the delivery of minor ailments services in Indonesian community pharmacies.

          Methods:

          Cross-sectional surveys were conducted during January-February 2020 of pharmacists and pharmacy technicians attending seminars conducted by relevant Indonesian Associations in Central Java, Indonesia. Percentage of common responses (PCR) described similarity of perceived scopes of practice for pharmacists and pharmacy technicians. Univariate and multivariate analyses identified associations of scopes of practice with pharmacy characteristics.

          Results:

          A total of 185 pharmacists and 142 pharmacy technicians participated. Pharmacy technicians performed minor ailment consultations, however, if considered beyond their scope of practice, they referred the patient to the pharmacist (T=120/142, 84.5%). Vaginal thrush, bacterial conjunctivitis, gastro-oesophageal reflux disease, and acute pain were minor ailments perceived only within a pharmacist’s scope (PCR above 60%). Of 34 minor ailments, 11 showed PCR values between 40-60% overlapping pharmacists and pharmacy technicians perceived scopes of practice (allergy/rash, back pain, cold sores, dermatitis, diarrhoea, eczema, hayfever, haemorrhoids, rheumatism, sore throat, and superficial wounds). Back pain, cold sores, dermatitis, and sore throat associated pharmacists’ scope of practice with years of practice experience (p-value<0.05). Pharmacy technicians perceived their scopes of practice to be wider than perceived by pharmacists.

          Conclusions:

          Discordance between pharmacists’ and pharmacy technicians’ perceived scopes of minor ailments management highlights the need for clearly defined scopes of practice for each professional group. Each professional group must practise within their competence to ensure safe pharmacy practices.

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          Most cited references40

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          Interrater reliability: the kappa statistic

          The kappa statistic is frequently used to test interrater reliability. The importance of rater reliability lies in the fact that it represents the extent to which the data collected in the study are correct representations of the variables measured. Measurement of the extent to which data collectors (raters) assign the same score to the same variable is called interrater reliability. While there have been a variety of methods to measure interrater reliability, traditionally it was measured as percent agreement, calculated as the number of agreement scores divided by the total number of scores. In 1960, Jacob Cohen critiqued use of percent agreement due to its inability to account for chance agreement. He introduced the Cohen’s kappa, developed to account for the possibility that raters actually guess on at least some variables due to uncertainty. Like most correlation statistics, the kappa can range from −1 to +1. While the kappa is one of the most commonly used statistics to test interrater reliability, it has limitations. Judgments about what level of kappa should be acceptable for health research are questioned. Cohen’s suggested interpretation may be too lenient for health related studies because it implies that a score as low as 0.41 might be acceptable. Kappa and percent agreement are compared, and levels for both kappa and percent agreement that should be demanded in healthcare studies are suggested.
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            The adequacy of response rates to online and paper surveys: what can be done?

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              A comparison of two time intervals for test-retest reliability of health status instruments.

              Studies of test-retest reliability for health-related quality of life instruments have used varying intervals between test administrations. There is no evidence available to aid in the selection of the time interval between questionnaire administrations for a study of test-retest reliability for health status instruments. We compared the test-retest reliability at 2 days and 2 weeks for four knee-rating scales and the eight domains of the SF-36. Seventy patients with disorders of the knee who were in a stable state were randomly allocated to repeat the questionnaires at either 2 days or 2 weeks. There were no statistically significant differences in the test-retest reliability (intraclass correlation coefficient and limits of agreement statistics) for the two time intervals.
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                Author and article information

                Contributors
                Journal
                Pharm Pract (Granada)
                Pharm Pract (Granada)
                Pharmacy Practice
                Centro de Investigaciones y Publicaciones Farmaceuticas
                1885-642X
                1886-3655
                Apr-Jun 2021
                26 May 2021
                : 19
                : 2
                : 2295
                Affiliations
                MPharm. Pharmacy, Curtin Medical School, Curtin University . Perth, WA (Australia). vinci.mizranita@ 123456postgrad.curtin.edu.au
                PhD. Senior Lecturer. Pharmacy, Curtin Medical School, Curtin University . Perth, WA (Australia). T.Sim@ 123456curtin.edu.au
                PhD. Emeritus Professor. Pharmacy, Curtin Medical School, Curtin University . Perth, WA (Australia). B.Sunderland@ 123456curtin.edu.au
                PhD. Adjunct Research Fellow. Curtin School of Allied Health, Curtin University . Perth, WA (Australia). R.Parsons@ 123456curtin.edu.au
                PhD. Adjunct Professor. Pharmacy, Curtin Medical School, Curtin University . Perth, WA (Australia). J.D.Hughes@ 123456curtin.edu.au
                Author notes

                Conceptualization: VM, TFS, BS, JDH. Data curation: VM. Formal analysis: VM, RP. Investigation: VM. Methodology: VM, TFS, BS, RP, JDH. Supervision: TFS, BS, JDH. Validation: TFS, BS, JDH. Writing – original draft: VM. Writing – review & editing: VM, TFS, BS, RP, JDH.

                Author information
                https://orcid.org/0000-0003-4147-5638
                https://orcid.org/0000-0003-0068-5006
                https://orcid.org/0000-0001-6214-995X
                https://orcid.org/0000-0002-5691-0084
                https://orcid.org/0000-0003-0040-4753
                Article
                pharmpract-19-2295
                10.18549/PharmPract.2021.2.2295
                8216711
                34221196
                a9f8085d-c6bd-473e-a3a8-1b5be5add25d
                Copyright: © The Authors

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY-NC-ND 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 23 January 2021
                : 02 May 2021
                Categories
                Original Research

                nonprescription drugs,self care,professional practice,professional role,scope of practice,community pharmacy services,pharmacies,pharmacists,pharmacy technicians,multivariate analysis,cross-sectional studies,indonesia

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