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      The patient experience in a community pharmacy mental illness and addictions program

      1 , 2 , 3 , 1 , 2 , 3 , 1 , 2 , 3
      Canadian Pharmacists Journal / Revue des Pharmaciens du Canada
      SAGE Publications

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          Abstract

          <div class="section"> <a class="named-anchor" id="section1-1715163519839424"> <!-- named anchor --> </a> <h5 class="section-title" id="d4275789e123">Background:</h5> <p id="d4275789e125">The Bloom Program was designed to enhance pharmacists’ care of people with lived experience of mental illness and addictions in Nova Scotia. The Program’s demonstration period was from September 2014 to December 2016 and included a qualitative evaluation of the patient experience. </p> </div><div class="section"> <a class="named-anchor" id="section2-1715163519839424"> <!-- named anchor --> </a> <h5 class="section-title" id="d4275789e128">Methods:</h5> <p id="d4275789e130">Patients were recruited for individual interviews through Bloom Program pharmacies. Interviews were transcribed verbatim and analyzed following Braun and Clarke’s 6-step approach for thematic analysis. </p> </div><div class="section"> <a class="named-anchor" id="section3-1715163519839424"> <!-- named anchor --> </a> <h5 class="section-title" id="d4275789e133">Results:</h5> <p id="d4275789e135">Ten patients were interviewed between May and June 2016. Ten themes were determined through data analysis and included medication management, accessing pharmacists in a new way, providing social support, bridging service gaps, providing interim care, reducing financial barriers, navigation and advocacy, holistic approaches, empowerment through knowledge and awareness and collaboration. </p> </div><div class="section"> <a class="named-anchor" id="section4-1715163519839424"> <!-- named anchor --> </a> <h5 class="section-title" id="d4275789e138">Discussion:</h5> <p id="d4275789e140">Pharmacists expectedly provided medication management activities to patients for both physical and mental health concerns in the Bloom Program. Many activities conducted with Bloom Program patients fell outside of dispensing roles and medication management. These activities, such as social support, triage, navigation and increasing access, which were highly valued by patients, are poorly measured and assessed in pharmacy practice research. </p> </div><div class="section"> <a class="named-anchor" id="section5-1715163519839424"> <!-- named anchor --> </a> <h5 class="section-title" id="d4275789e143">Conclusion:</h5> <p id="d4275789e145">Participants in the Bloom Program reported the significant contributions of pharmacists and pharmacy teams in their overall health and wellness. Future evaluations of interventions like the Bloom Program should include measurement of constructs valued by patients and also consider impacts on inequalities and inequities. Pharmacy practice researchers can benefit from other research and evaluation being conducted for primary care interventions. </p> </div>

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          Equity of access to primary healthcare for vulnerable populations: the IMPACT international online survey of innovations

          Background Improving access to primary healthcare (PHC) for vulnerable populations is important for achieving health equity, yet this remains challenging. Evidence of effective interventions is rather limited and fragmented. We need to identify innovative ways to improve access to PHC for vulnerable populations, and to clarify which elements of health systems, organisations or services (supply-side dimensions of access) and abilities of patients or populations (demand-side dimensions of access) need to be strengthened to achieve transformative change. The work reported here was conducted as part of IMPACT (Innovative Models Promoting Access-to-Care Transformation), a 5-year Canadian-Australian research program aiming to identify, implement and trial best practice interventions to improve access to PHC for vulnerable populations. We undertook an environmental scan as a broad screening approach to identify the breadth of current innovations from the field. Methods We distributed a brief online survey to an international audience of PHC researchers, practitioners, policy makers and stakeholders using a combined email and social media approach. Respondents were invited to describe a program, service, approach or model of care that they considered innovative in helping vulnerable populations to get access to PHC. We used descriptive statistics to characterise the innovations and conducted a qualitative framework analysis to further examine the text describing each innovation. Results Seven hundred forty-four responses were recorded over a 6-week period. 240 unique examples of innovations originating from 14 countries were described, the majority from Canada and Australia. Most interventions targeted a diversity of population groups, were government funded and delivered in a community health, General Practice or outreach clinic setting. Interventions were mainly focused on the health sector and directed at organisational and/or system level determinants of access (supply-side). Few innovations were developed to enhance patients’ or populations’ abilities to access services (demand-side), and rarely did initiatives target both supply- and demand-side determinants of access. Conclusions A wide range of innovations improving access to PHC were identified. The access framework was useful in uncovering the disparity between supply- and demand-side dimensions and pinpointing areas which could benefit from further attention to close the equity gap for vulnerable populations in accessing PHC services that correspond to their needs. Electronic supplementary material The online version of this article (doi:10.1186/s12939-016-0351-7) contains supplementary material, which is available to authorized users.
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            Feedback from community pharmacy users on the contribution of community pharmacy to improving the public's health: a systematic review of the peer reviewed and non-peer reviewed literature 1990-2002.

            To systematically review feedback from pharmacy users on their perceptions and experiences of health-related advice and services provided from community pharmacies. The focus of the review was community pharmacy activities in relation to promoting health and well-being, preventing ill-health and maintaining health. Searches were conducted for peer-reviewed (international) and non-peer-reviewed (UK) research. Electronic databases searched included MEDLINE, EMBASE, Cochrane Library and International Pharmaceutical Abstracts; hand searches of key journals and conference abstracts, key informants. Key informants in the UK were contacted to identify unpublished studies. The inclusion period was 1990 onwards. Data extraction and synthesis Data were abstracted into a matrix by one author with a sample checked by a second. The Health Development Agency's Evidence Base 2000 standards and the evidence categories used by the Department of Health in the National Service Frameworks were applied to each item. Seven peer reviewed papers and 13 non-peer reviewed reports were identified for inclusion in the review. Consumer usage of pharmacies is almost universal with prescription supplies and purchase of over the counter medicines predominating. Evidence shows that not only is usage low for general health advice, but that pharmacists are perceived as 'drugs experts' rather than experts on health and illness. Emergency hormonal contraception and head lice management schemes have been well received. There is a need to consider privacy and confidentiality surrounding advice giving. Users of community pharmacy-based health development initiatives express a high level of satisfaction. If community pharmacies are to be used to their full extent, then actions to extending the public's awareness and acceptance of the pharmacist's role in giving advice will be crucial. Further research will be needed to measure any change in premises development on the public's perception of the level of privacy in pharmacies.
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              Defining professional pharmacy services in community pharmacy.

              Multiple terms and definitions exist to describe specific aspects of pharmacy practice and service provision, yet none encompass the full range of professional services delivered by community pharmacy. The majority of current pharmacy service definitions and nomenclature refer to either the professional philosophy of pharmaceutical care or to specific professional pharmacy services; particularly pharmaceutical services provided by pharmacists with a focus on drug safety, effectiveness and health outcomes. The objective of this paper is therefore to define a professional pharmacy service within the context of the community pharmacy model of service provision. A professional pharmacy service is defined as "an action or set of actions undertaken in or organised by a pharmacy, delivered by a pharmacist or other health practitioner, who applies their specialised health knowledge personally or via an intermediary, with a patient/client, population or other health professional, to optimise the process of care, with the aim to improve health outcomes and the value of healthcare." Based on Donabedian's framework, the professional pharmacy service definition incorporates the concepts of organizational structure, process indicators and outcome measures. The definition will assist in many areas including recognition of the full range of services provided by community pharmacy and facilitating the identification of indicators of professional pharmacy service implementation and sustainable provision. A simple conceptual model for incorporating all services provided by community pharmacy is proposed. Copyright © 2013 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                Canadian Pharmacists Journal / Revue des Pharmaciens du Canada
                Can Pharm J
                SAGE Publications
                1715-1635
                1913-701X
                April 02 2019
                May 2019
                April 09 2019
                May 2019
                : 152
                : 3
                : 186-192
                Affiliations
                [1 ]College of Pharmacy (Murphy, Gardner), Dalhousie University, Halifax
                [2 ]Department of Psychiatry (Murphy, Gardner), Dalhousie University, Halifax
                [3 ]Contact Consulting (Jacobs), Halifax, Nova Scotia
                Article
                10.1177/1715163519839424
                6512187
                31156732
                de99de6a-0633-468f-9061-f92133f77814
                © 2019

                http://journals.sagepub.com/page/policies/text-and-data-mining-license

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