Mentoring pharmacy staff to implement a medication support service: An evaluation of process and outcomes

Drivers of engagement in virtual communities of practice: a qualitative study of Australian pharmacists' perceptions and experiences

BACKGROUND

In today's digital age, virtual Communities of Practice allow pharmacists to connect and collaborate across geographical and professional boundaries. These platforms create opportunities for shared learning and knowledge exchange, fostering innovation and helping pharmacists stay informed about evolving practices.

AIM

This study aimed to explore the factors that drive engagement in virtual Communities of Practice among Australian pharmacists.

METHOD

A qualitative study was conducted with 24 Australian pharmacists recruited via social media, professional networks, and conferences. Five online focus groups (each with 3-4 participants) were conducted, lasting 45-60 min. Discussions were transcribed verbatim, and data were analysed thematically using the Framework Method. Rigor was ensured through convenience sampling, maintenance of an audit trail, and the use of independent coding and thematic analysis to enhance credibility and confirmability.

RESULTS

Four major themes emerged from the analysis: 'access to information', 'sense of community', 'active facilitation', and 'platform usability'. Participants appreciated peer-shared knowledge and staying informed about current practices. A strong sense of community was cultivated as participants supported by others within the virtual community of practice. Active facilitation, such as moderators filtering content and engaging participants, was essential for maintaining a constructive environment. Additionally, platform usability, characterised by user-friendly features, the ability to keep personal and professional boundaries, and flexibility in accessing activities, significantly enhanced participant engagement.

CONCLUSION

The study identified four key drivers of engagement in virtual Communities of Practice including accessible information, community support, active facilitation, and platform usability. These findings inform the design of virtual Communities of Practice to enhance professional collaboration and practice. Addressing these factors can enhance virtual Communities of Practice effectiveness in supporting professional collaboration, reducing isolation, and fostering continuous learning, particularly in evolving pharmacy roles.

Evaluation of a training program to support the implementation of a community pharmacist-led support service for people living with severe and persistent mental illness

BACKGROUND

With appropriate training, community pharmacists can support people living with severe and persistent mental illness (SPMI) by identifying and managing medication-related issues and physical health concerns. The Bridging the Gap between Physical and Mental Illness in Community Pharmacy (PharMIbridge) randomized controlled trial (RCT) tested the impact of an individualized, pharmacist-led support service for people living with SPMI.

OBJECTIVE(S)

To evaluate the impact of the PharMIbridge training program on pharmacy participants' knowledge and confidence, as well as stigma and attitudes, in relation to supporting, and providing services to, people living with SPMI; compared to Mental Health First Aid (MHFA) training alone.

METHODS

Pharmacy staff (n = 140) from 55 community pharmacies across four RCT regions attended face-to-face training. Both intervention group (IG) and comparator group (CG) participants received MHFA training while IG participants received additional PharMIbridge training, involving role-plays and mental health consumer educators (MHCEs). A questionnaire including validated instruments was administered at baseline, after training and after 12 months. Comparative analyses included paired t tests and mixed between/within analysis of variance (ANOVA).

RESULTS

Pre and post-training surveys were completed by 136 participants, most of which were pharmacists. Both IG and CG participants had significant reductions in stigma (P < 0.001) post-training. IG participants' confidence and knowledge regarding metabolic monitoring significantly improved compared to CG (P < 0.001). IG participants were significantly more confident and comfortable in providing medication counseling, compared to CG participants (P < 0.05).

CONCLUSION

MHFA training reduced participants' stigma toward mental health. However, the purpose-designed PharMIbridge training program provided pharmacists with additional knowledge and skills to confidently support the physical health care needs of people living with SPMI. The inclusion of role-plays and MHCEs allowed pharmacists to self-reflect and practice skills in safe, supportive environments. Future studies should continue to involve MHCEs in pharmacy training and explore whether these improvements are sustainable.

The development of a taxonomy to support goal setting between mental health consumers and community pharmacists

BACKGROUND

Goal setting is widely used in mental healthcare, yet there is limited information about goal development between community pharmacists and people experiencing mental health conditions.

OBJECTIVES

i) To review goals developed in partnership between Australian community pharmacists and people experiencing depression/anxiety, and ii) categorize goals and develop a taxonomy.

METHODS

Community pharmacists (n = 142) who had completed a mental health training program provided an individualized medication support service and documented goal planning for 350 people experiencing anxiety and/or depression. Goals were reviewed using a general inductive content analysis to develop themes which were then grouped, categorized, and coded. This involved three researchers in different phases of the coding, repeated review and redrafting of the taxonomy, and inter-rater reliability consistency checks.

RESULTS

The goals (n = 749) represented a diverse range of health behaviors and outcomes (e.g., medication adherence, relationships, leisure activities). The resulting taxonomy involved five overarching domains: improved health; satisfaction with life; manage physical illnesses; manage mental health; and use of medicines.

CONCLUSIONS

Pharmacists have a role in providing person-centered care and addressing social determinants of health by considering factors that contribute to a person's overall wellbeing. While further testing is necessary, the taxonomy is valuable for pharmacists unfamiliar with supporting goal development with people experiencing anxiety and/or depression.

Reflections of mentors and mentees on a national mentoring programme for pharmacists in the United Kingdom: An examination into organisational culture and systems

BACKGROUND

There is no accepted or consistent model for delivering mentoring programmes, manifesting in some debate surrounding the ideal conducive system. Mentorship structures and culture within pharmacy can be advanced by researching experiences of mentors and mentees.

OBJECTIVE

To explore lived experiences of participants in a nationwide mentoring programme in relation to motivations and barriers associated with engaging with mentoring, and what system changes and organisational culture shift could further support mentoring for pharmacy professionals.

METHODS

This study adopted a constructivist research paradigm, with a qualitative design to focus on how participants interpreted the world and their experiences. Verbatim transcripts of recordings were examined using deductive and inductive thematic analysis.

RESULTS

Participants in twenty one-to-one interviews appreciated the programme's allowance for organic relationships to occur, its contribution towards advancing the profession forward, its flexibility, and available resources. They discussed training needs and a more formal onboarding process into the programme that facilitated greater awareness of resources, as well as the need to evaluate and tweak it. System changes were highlighted so that mentoring can be part of the organisational culture, such as incorporating mentoring in job descriptions to increase capacity, senior members of the profession acting as role models, and linking mentoring to existing education and development structures.

CONCLUSION

Data demonstrated the need for formal structure but that which allowed for informal and organic relationships to develop. It is paramount for sponsoring organisations to provide resources and continuously monitor the program. The rich information gathered on administrative support and structure of a mentoring programme, along with its organisational facets, should help organisations when implementing similar initiatives. An organisation sponsoring or administering a mentoring programme must take actions that help codify its mentoring culture and its advocacy of mentoring as key to advancement for its profession's members.

Health needs assessment in a regional community pharmacy using the PRECEDE-PROCEED model

BACKGROUND

Community pharmacies have capacity to provide a variety of professional pharmacy services. However, planning models are underutilised when guiding pharmacists in assessing local health and social needs for providing tailored services to meet community needs and priorities.

OBJECTIVE

The objective of this was to utilize the PRECEDE-PROCEED model to perform a health needs assessment to identify health concerns in a regional Australian community for guiding professional pharmacy service development.

METHODS

A health needs assessment using the PRECEDE-PROCEED model was conducted in November 2019 using a convergent mixed-methods design through: (1) convenience sampling of pharmacy customers with a survey, (2) purposive sampling of a sole community pharmacist with a semi-structured interview, and (3) collection of regional health and social data from online databases.

RESULTS

The community survey response rate was 44.8%. Of 113 participants, the majority were female (71.7%) and town dwellers (89.4%), representing 6.4% of the town's population. Mental illness was cited by 35.3% of community survey participants to be impacting local health and wellbeing, with depression/anxiety the most prevalent self-reported condition (44.2%), predominantly affecting women (72%). The community pharmacist and regional secondary data provided additional support for the prioritization of mental illness. Depression/anxiety was associated with delays/avoidance of prescription medicine due to cost (p = .002), poor self-rated health (p = .012), worsening health over the past year (p < .001), seeking advice from a pharmacist about health or medicines (p = .03), and receipt of emergency care in the past year (p = .001). The lack of a local general practitioner, social isolation, and environmental issues also impacted health and wellbeing.

CONCLUSIONS

The PRECEDE-PROCEED model identified mental health as the greatest health priority in the community, using multiple data sources and participatory methods. Using this model provides insight into the development of tailored community pharmacy interventions that address health priorities such as mental health needs in a community.

Bridging the gap between physical and mental illness in community pharmacy (PharMIbridge): protocol for an Australian cluster randomised controlled trial

INTRODUCTION

There is a significant life expectancy gap attributable to physical comorbidities for people living with severe and persistent mental illness (SPMI) compared with the general population. Medications are a major treatment for SPMI management and physical illnesses, hence pharmacists are well positioned to support mental healthcare and comorbidities. The randomised controlled trial (RCT) aim is to evaluate effectiveness of an individualised, pharmacist led, support service for people experiencing SPMI focusing on medication adherence and physical comorbidity management, compared with standard care (a medication-management service; MedsCheck). METHODS AND ANALYSIS: PharMIbridge is a cluster RCT, whereby community pharmacies in four Australian regions will be randomised (1:1 ratio), to either Intervention Group (IG) or Comparator Group (CG). All IG and CG pharmacy staff will receive Blended-Mental Health First Aid training. Additionally, IG pharmacists will receive further training on medication adherence, goal setting, motivational interviewing, managing physical health concerns and complex issues relating to psychotropic medication. CG pharmacists will not receive additional training, and will provide standard care (MedsCheck). The primary outcome will be change in participants medication adherence for psychotropic medication over 6-months. Using mixed-effects logistic regression model and a cluster size of 48 pharmacies, a total of 190 participants will need to be recruited to each arm to find a statistically significant difference in medication adherence. Secondary outcomes will be changes in factors associated with cardiometabolic risk and quality of life, emphasising physical and psychological well-being; medication-related problems; adherence to other prescribed medication; pharmacists knowledge, confidence and ability to support people experiencing SPMI; and effects on healthcare utilisation. A within RCT-based economic evaluation comparing the intervention with standard care will be undertaken.

ETHICS AND DISSEMINATION

The protocol and pharmacist training programme received Griffith University Human Research Ethics Committee approval (HREC/2019/473 and HREC/2019/493 respectively). Results will be published in peer-reviewed journals and available at the Sixth Community Pharmacy Agreement website (http://6cpa.com.au/about-6cpa/).

TRIAL REGISTRATION NUMBER

ANZCTR12620000577910.

Successful implementation and provision of enhanced and extended pharmacy services

BACKGROUND

Careful planning is important for successful implementation and ongoing provision of enhanced and extended pharmacy services.

OBJECTIVE

To explore the factors that contributed to the successful implementation and ongoing provision of enhanced and extended services in Western Australian community pharmacies.

METHODS

In-depth semi-structured telephone interviews were conducted with purposively selected pharmacists from various practice settings. Interviews explored experiences and perspectives on the provision of enhanced and extended professional services and continued until saturation was achieved. Analysis focused on prior investigation before implementation of services, perceptions of the impact of the services and factors to be considered. The COM-B (Capability, Opportunity, Motivation and Behaviour) model was applied post hoc to the thematic analysis to explore whether there was an overlap between themes and the model.

RESULTS

In total 26 pharmacists (16 males, 10 females) participated in semi-structured interviews during October 2017 and February 2018. They classified as 20 community, 13 accredited and 7 specialist pharmacists and 11 pharmacist immunisers (some classified as more than one). Interview duration was 55 min (minimum 22, maximum 91 min). Responses regarding prior investigation/research conducted varied in approach followed and level of enquiry. Opinions about services were overall positive such as enhanced collaboration with other healthcare professionals, positive patient outcomes, increased staff satisfaction and acceptance of pharmacists as primary care providers. New services did not always provide direct financial benefit. Three major themes emerged as factors that impacted on provision of services: 1) pharmacist characteristics, 2) local needs, structures and support, and 3) an enabling practice framework.

CONCLUSIONS

Pharmacists who were successful in the implementation and maintenance of new professional services were familiar with local needs. Both pharmacy and pharmacist aspects should be considered during implementation and maintenance of new professional services. An enabling practice framework is crucial in facilitating new pharmacy services.

Protocol for a feasibility study of an Indigenous Medication Review Service (IMeRSe) in Australia

INTRODUCTION

The age-adjusted rate of potentially preventable hospitalisations for Aboriginal and Torres Strait Islander people is almost five times the rate of other Australians. Quality use of medicines has an important role in alleviating these differences. This requires strengthening existing medication reviewing services through collaboration between community pharmacists and health workers, and ensuring services are culturally appropriate. This Indigenous Medication Review Service (IMeRSe) study aims to develop and evaluate the feasibility of a culturally appropriate medication management service delivered by community pharmacists in collaboration with Aboriginal health workers.

METHODS AND ANALYSIS

This study will be conducted in nine Aboriginal health services (AHSs) and their associated community pharmacies in three Australian states over 12 months. Community pharmacists will be trained to improve their awareness and understanding of Indigenous health and cultural issues, to communicate the quality use of medicines effectively, and to strengthen interprofessional relationships with AHSs and their staff. Sixty consumers (with a chronic condition/pregnant/within 2 years post partum and at risk of medication-related problems (MRPs) per site will be recruited, with data collection at baseline and 6 months. The primary outcome is the difference in cumulative incidence of serious MRPs in the 6 months after IMeRSe introduction compared with the 6 months prior. Secondary outcomes include potentially preventable medication-related hospitalisations, medication adherence, total MRPs, psychological and social empowerment, beliefs about medication, treatment satisfaction and health expenditure.

ETHICS AND DISSEMINATION

The protocol received approval from Griffith University (HREC/2018/251), Queensland Health Metro South (HREC/18/QPAH/109), Aboriginal Health and Medical Research Council of New South Wales (1381/18), Far North Queensland (HREC/18/QCH/86-1256) and the Central Australian HREC (CA-18-3090). Dissemination to Indigenous people and communities will be a priority. Results will be available on the Australian Sixth Community Pharmacy Agreement website and published in peer-reviewed journals.

TRIAL REGISTRATION NUMBER

ACTRN12618000188235; Pre-results.