Understanding pharmacist success in practice: A scoping review

Knowledge of Vulvovaginal Candidiasis Characteristics, Signs, Symptoms, and Appropriate Treatment Among Portuguese Pharmacy Professionals

BACKGROUND/OBJECTIVES

Vulvovaginal candidiasis (VVC) is a common cause of vaginitis. Over-the-counter drugs are usually dispensed by pharmacy professionals to treat this condition without prior medical consultation. This study aimed at assessing the knowledge of Portuguese pharmacy professionals regarding VVC.

METHODS

An online questionnaire including questions about the symptoms and treatment of VVC was distributed between March and April of 2024.

RESULTS

A total of 376 professionals participated in this study. There was a significantly lower proportion of men (p = 0.007) and pharmacy technicians (p = 0.005) who correctly identified the main causative agent of VVC when compared to women and pharmacists. Only 30% of women correctly identified the number of VVC episodes in the same year they classified as complicated, but this was significantly higher (p = 0.038) than the proportion of men who identified complicated VVC (20%). Topical clotrimazole preparations were the more frequently identified medicines for the treatment of uncomplicated VVC, and fluconazole-containing medicines were the preferred choice for the treatment of complicated VVC.

CONCLUSIONS

This study highlights the need to improve education and training for pharmacy professionals. By addressing these knowledge gaps, pharmacists and pharmacy technicians can provide more accurate and effective advice to patients.

Community pharmacists' comfort levels with and barriers to application of an expanded scope of practice in Québec

Background

In recent years, community pharmacists have seen their profession transition from a dispensing-focused role to a rapidly evolving clinically oriented practice. In Québec, Bill 31, adopted in 2020, increased the clinical opportunities for pharmacists with independent prescribing privileges in various defined clinical situations. As this expanded role can lead to different barriers, it is crucial to explore pharmacists' comfort levels with implementing such changes in their practice.

Methods

A web-based survey was conducted from March 25 to May 28, 2021, among community pharmacists in Québec. We collected data with a questionnaire developed for this study. Questions were grouped into 4 domains: (1) characteristics of the respondents; (2) workload and work setting; (3) comfort level with, and barriers to, adjusting medications and following up pharmacologic treatments (86 clinical situations evaluated); and (4) general barriers and facilitators to implementation.

Results

A total of 146 community pharmacists completed the questionnaire. Most were women (71.9%), younger than 50 years of age (86.2%), had a bachelor's degree (64.4%) as their highest academic level and had more than 10 years of experience as pharmacists (56.8%). Most of them worked exclusively in a community pharmacy (86.3%). Among the 86 clinical situations evaluated, there were 16 in which at least 80% of respondents felt comfortable. The main barriers identified were a lack of knowledge, experience and dedicated time and difficulties integrating these activities into the workflow; facilitators were having an adequate environment and resources.

Conclusion

This study shows community pharmacists can confidently adjust pharmacotherapy for several conditions. However, they must have adequate time and resources. Also, the more complex the clinical situations were, the less comfortable community pharmacists felt adjusting pharmacotherapy. This study identified several areas where continuing education, training and mentoring could be offered and where the work environment and organization could be improved.

Pharmacist roles in the medication use process: Perceptions of patients, physicians, and pharmacists

OBJECTIVES

It is uncertain whether stakeholder perceptions of pharmacist roles in the medication use process (MUP) have evolved alongside pharmacist advanced scope of practice. This study aimed to examine patient, pharmacist, and physician perceptions of pharmacist roles in the MUP.

DESIGN

This IRB-approved study used a cross-sectional design with online panels of patients, pharmacists, and physicians.

SETTING AND PARTICIPANTS

A Qualtrics panel of 1,004 patients, 205 pharmacists, and 200 physicians completed the surveys between August-November 2021.

OUTCOME MEASURES

Using role theory as framework, 12-item surveys were developed to examine perceptions regarding effectiveness of and best choice for improving each MUP step. Data analysis included descriptive statistics, correlations, and comparisons.

RESULTS

Majority of the physician, pharmacist, and patient samples believed that physicians prescribe the best possible medications (93.5%, 83.4%, 89.0% respectively), prescriptions are filled accurately (59.0%, 61.4%, 92.6% respectively) and timely (86.0%, 68.8, 90.2% respectively). Majority of physicians (78.5%) opined prescriptions are generally error free and patients are monitored (71%); fewer pharmacists agreed (42.9%, 51%; p<0.05). Most patients (92.4%) reported taking medications as directed; only 60% professionals agreed (p<0.05). Physicians selected 'pharmacists' as top choice for reducing dispensing errors, providing counseling, and helping patients take medications as directed. Patients wanted pharmacists to help manage their medications (87.0%) and 'someone' to periodically check on their health (100%). All 3 groups agreed physician-pharmacist collaboration was important to improve patient care and outcomes (90.0%-97.1%); however, 24% of physicians were uninterested in collaboration. Both professionals reported lack of time, appropriate setup, and interprofessional communication as challenges to collaboration.

CONCLUSION

Pharmacists believe their roles have evolved to align with expanded opportunities. Patients perceived pharmacists play comprehensive roles in medication management through counseling and monitoring. Physicians recognized pharmacist roles in dispensing and counseling, but not in prescribing or monitoring. Clarity in role expectations amongst these stakeholders is critical to optimizing pharmacist roles and patient outcomes.

Work Profile Factors Identified From the Career Pathway Evaluation Program, 2018 Pharmacist Profile Survey

Objective. To identify work profile factors from the Career Pathway Evaluation Program, 2018 Pharmacist Profile Survey. Methods. Exploratory factor analysis was used to describe the underlying structures (factors) that best represented respondents' work profiles. Descriptive statistics and Analysis of Variance were used to describe the 17 different work categories listed in the survey. Results. Eleven underlying factors were identified for the respondents' work setting profiles. A description of these factors among the 17 different respondent career categories revealed variation that can be useful in describing the career categories in the APhA Career Pathway Evaluation Program for Pharmacy Professionals. Conclusion. The results revealed variation among pharmacist career types. The profiles constructed in this study describe the characteristics of various career paths and can be helpful for decisions regarding educational, experiential, residency, and certification training in pharmacist careers.

Weight management counselling among community pharmacists: a scoping review

OBJECTIVES

To complete a scoping review of studies of community pharmacy-delivered weight and obesity management services from January 2010 to March 2017.

METHODS

A scoping review was conducted to obtain an overview of research related to the study objective. The PubMed, EBSCO and CINAHL databases were searched from January 2010 to March 2017 for articles examining obesity/weight management in community pharmacies. Included studies had to contain an obesity/weight management programme delivered primarily by community pharmacies. All non-interventional studies were excluded.

KEY FINDINGS

Nine articles were eligible for data extraction. Across the nine included studies, 2141 patients were enrolled. The overwhelming majority of patients enrolled in the studies were female, approximately 50 years of age, had a mean weight of 92.8 kg and mean BMI of 33.8 kg/m2 at baseline. Patients in these various programmes lost a mean of 3.8 kg, however, two studies demonstrated that long-term (>6 months) weight loss maintenance was not achieved. The average dropout rate for each study ranged from 8.3% to 79%.

CONCLUSIONS

Obesity has a significant impact on the health and wellness of adults globally. Recent research has shown that community pharmacies have the potential to positively impact patient weight loss. However, additional research is needed into the specific interventions that bring the most value to patients and can be sustained and spread across community pharmacy practice.

Admissions processes in North American pharmacy schools: To what extent are characteristics of practice success measured?

INTRODUCTION

The goal of preparing competent pharmacy practitioners starts with the admissions process, whereby skills and abilities can be screened to identify those individuals with a strong potential for success. This study sought to describe the admissions processes of top pharmacy schools in North America and identify the extent to which characteristics associated with professional success are measured.

METHODS

An observational survey design was used to collect information to help characterize the admissions processes of 60 pharmacy schools. Online and centralized Pharmacy College Application Service data of admissions requirements were confirmed and further details were collected through a telephone or email cross-sectional survey. Data were analyzed using descriptive statistics.

RESULTS

Online data indicate that every school (n = 60) requires prerequisite courses; 53 (88%) consider grade point average (GPA) and 45 (75%) consider the Pharmacy College Admission Test (PCAT). Most schools utilize interviews during admissions (94%), with 67% using a personal interview, 20% the Multiple Mini Interview (MMI), and 7% a combination of both. Of 60 schools contacted, 42% completed the survey. Most schools (92%) assess critical thinking and professional motivation; the personality traits of agreeableness and conscientiousness were considered by 83%. Personal interview was the most frequently cited method for assessing applicant characteristics.

CONCLUSION

Current admissions practices in the top North American pharmacy schools are varied and continue to rely on traditional components including GPA, PCAT, and interviews. However, there is also a movement toward using standardized and validated measures of non-cognitive aspects potentially more predictive of success in pharmacy school and subsequent practice.

What makes pharmacists successful? An investigation of personal characteristics

OBJECTIVES

The primary objective of this study was to identify characteristics of pharmacists that contribute to their success.

DESIGN

A working definition of success in pharmacy practice was derived from a scoping literature review and is based on the premise that successful pharmacists practice to full scope within the context of their practice setting. Semistructured individual interviews were conducted with selected pharmacists. Potential candidates were nominated by leading pharmacists in the field with the use of our prespecified definition of success. Lists from the nominators were compared, and pharmacists who appeared on more than 1 list were invited to participate. The interview tool was developed with the use of previous research on success in health care professions.

SETTING AND PARTICIPANTS

Participants were 10 practicing pharmacists in a variety of locations (5 urban/5 rural) and practice settings (5 hospital/4 community/1 ambulatory care).

OUTCOME MEASURES

Themes related to successful pharmacists practicing to full scope.

RESULTS

Pharmacists meeting our definition of success were engaged in assessment and care planning, other expanded scope activities, and interpersonal activities and collaboration. The 10 interviewed pharmacists described motivation, critical thinking, emotional intelligence, core competencies, and work-life balance as significant contributors to their success.

CONCLUSION

Several characteristics were identified as potentially related to success. These characteristics may be useful in pharmacists identifying areas for personal growth and development.

Reflections on the Pharmacist-Patient Covenant

The first tenet of the Code of Ethics for Pharmacists of the American Pharmacists Association describes the relationship between the pharmacist and the patient as a covenant. The central argument of this commentary is that the symbolic language of covenant, the metaphor used to describe the pharmacist-patient relationship, should be formally acknowledged as an ideal theory or concept. However, before committing to this ideal, there should be resonance with the realities of pharmacy practice. This commentary argues that the intimate nature of a covenantal relationship is not a good fit with most contexts in which pharmacists practice. The disconnection between the ideal of the covenantal relationship and context is important because codes of ethics apply regardless of context. By acknowledging the ideal of a covenantal relationship, transitional structures could then be developed to move the pharmacy profession toward this ideal.

Differences and similarities in clinical pharmacy practice in China and the United States: a narrative review

The clinical pharmacy practice provided by pharmacists aims to improve the rational use of medication and enhance the quality of life of patients. Although clinical pharmacy in the USA has been developing for almost 60 years, it began in China only in 2005. Despite this, rapid development in clinical pharmacy has been achieved under the support of China's Ministry of Health. This article aims to compare the differences between, and similarities of, clinical pharmacy practice in China and the USA.