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Nazaryan L, Barseghyan A, Rayisyan M, Beglaryan M, Simonyan M. Evaluating consumer self-medication practices, pharmaceutical care services, and pharmacy selection: a quantitative study. BMC Health Serv Res 2024; 24:10. [PMID: 38172981 PMCID: PMC10765736 DOI: 10.1186/s12913-023-10471-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The primary objectives of this study were the evaluation of consumer self-medication practices, the assessment of pharmaceutical care provided by pharmacy employees, and the analysis of consumer satisfaction with such care. The research was also aimed at examining the main criteria that consumers consider important when selecting a pharmacy in Armenia. METHODS The survey was based on an anonymous questionnaire and carried out between March 2020 and November 2021. It was aimed at providing a comprehensive assessment of pharmaceutical care services and consumer pharmacy choice by investigating two distinct groups: pharmacy consumers and pharmacy employees. RESULTS The research reveals that many residents in Armenia engage in self-medication without consulting professional sources, which can lead to potential risks and result in dangerous consequences. This is partly due to a lack of trust in pharmacy employees, which is primarily due to their inability to provide adequate information and advice. This study highlights a significant need for improvement in the quality of service provided by pharmacy employees. Despite these challenges, the majority of consumers reported having a preferred pharmacy, and that employee knowledge is the most important criterion when choosing a pharmacy. CONCLUSIONS Consumer distrust, in this context, is based on the incomplete knowledge or incompetency of pharmacy employees. Collective actions should be taken to improve the role of pharmacy employees and consequently improve the public trust in them, which can ensure better control of self-medication and reduce the instances of mistreatment.
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Affiliation(s)
- Lusine Nazaryan
- Department of Pharmaceutical Management, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia.
| | - Anush Barseghyan
- Department of Pharmaceutical Management, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Maria Rayisyan
- Department of Regulatory Relations of Circulation of Medicines and Medical Devices, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation
| | - Margarit Beglaryan
- Department of Pharmaceutical Management, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
| | - Marta Simonyan
- Department of Pharmaceutical Management, Yerevan State Medical University after M. Heratsi, Yerevan, Armenia
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McLachlan AJ, Carroll PR, Hunter DJ, Wakefield TAN, Stosic R. Osteoarthritis management: Does the pharmacist play a role in bridging the gap between what patients actually know and what they ought to know? Insights from a national online survey. Health Expect 2022; 25:936-946. [PMID: 34997667 PMCID: PMC9122430 DOI: 10.1111/hex.13429] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/21/2021] [Accepted: 12/24/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Guidelines encourage engagement in self-care activities for osteoarthritis (OA), but there are gaps in consumers' knowledge about suitable choices for self-care. Community pharmacists are in an ideal position to contribute to OA management through screening and supporting evidence-based pain management choices. Prior research established an association between health literacy and advice-seeking and appropriateness of analgesics choices (both lower in participants with limited health literacy) amongst people living with OA. This article explores the implications of these data for pharmacists in OA management. METHODS A national online survey was conducted amongst 628 adults aged 45-74 years, currently residing in Australia, with self-reported symptoms of OA. All data were collected using a customized online questionnaire, which was completed only once. 'Self-reported symptoms of OA' was based on six validated screening questions to identify people with OA without a formal clinical diagnosis. RESULTS Respondents matched the typical profile of people diagnosed with OA; more than half were female (56%), knees (59%) and hips (31%) were the primary affected joints and 74% were either overweight or obese. Self-identification of OA was limited (41%). Overall, 38% self-managed their pain, and limited health literacy was associated with less advice-seeking. Efficacy and ease of use were the main reasons cited for prompting use across all classes of nonprescription analgesic, with less than 20% reporting recommendation from a pharmacist. Participants were managing their pain with an average of 1.74 (95% confidence interval: 1.60-1.88) analgesics, but 73% reported inadequate pain relief and 54% had disrupted sleep. CONCLUSION Our findings highlight three key themes: lack of self-identification of OA, suboptimal pain relief and limited use of the community pharmacist as a source of management advice. Equipping community pharmacists with tools to identify OA could bridge this gap. More research is needed to determine if it will improve consumers' ability to appropriately manage OA pain. PATIENT OR PUBLIC CONTRIBUTION Consumers living with OA contributed to the study outcomes, reviewed the survey questionnaire for face validity and advised on plain language terminology.
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Affiliation(s)
- Andrew J McLachlan
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia
| | - Peter R Carroll
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, New South Wales, Australia.,Department of Clinical Pharmacology, Royal North Shore Hospital, St. Leonards, New South Wales, Australia
| | - David J Hunter
- Department of Rheumatology, Royal North Shore Hospital, The University of Sydney, St. Leonards, New South Wales, Australia
| | | | - Rodney Stosic
- Bayer Australia Pty., Ltd., Pymble, New South Wales, Australia
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Saleem A, Woodruff G, Steadman K, La Caze A. Investigating the impact of patient-centred labels on comprehension of medication dosing: a randomised controlled trial. BMJ Open 2021; 11:e053969. [PMID: 34794998 PMCID: PMC8603299 DOI: 10.1136/bmjopen-2021-053969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE This study aims to implement a version of patient-centred labels (PCL) consistent with current labelling practice in Australia; assess the effectiveness of PCL in relation to the proportion of participants that correctly comprehend dosing instructions, and explore the proportion of correct comprehension of PCL in participants with both low and high health literacy. DESIGN Randomised controlled trial. SETTING A large tertiary care hospital in Brisbane, Queensland, Australia. PARTICIPANTS 121 participants with a majority born in Australia (65.3%), New Zealand (14.0%), the UK (6.6%) and Ireland (2.5%). INTERVENTION Participants were randomly assigned to either a panel of three PCL (n=61) or three standard labels (n=60) and asked to comprehend their assigned panel of labels. OUTCOME MEASURES Difference in the proportion of participants that correctly comprehend dosing instructions provided on PCL compared with standard labels. The two-proportion test was used to measure the impact of PCL on the proportion of participants correctly comprehending dosing instructions. RESULTS A greater proportion of participants were able to accurately comprehend PCL compared with standard labels. The proportion of participants who were able to correctly comprehend dose instructions provided on all three labels was significantly higher in the group that received PCL; 23.3% standard vs 83.6% PCL, p<0.001. The effect was observed in both low and high health literacy participants. The proportion of participants with accurate label comprehension was higher in participants with low Newest Vital Signs scores (8.3% standard vs 85.7% PCL, p<0.001) and low Rapid Estimate of Adult Literacy in Medicine scores (10.5% standard vs 96.0% PCL, p<0.001) who received PCL. CONCLUSION This study supports the use of PCL in Australian pharmacy practice. PCL provide simple, clear and explicit dosing instructions to patients. Implementing PCL may reduce the risk of misinterpreting dosing instructions by patients and improve quality use of medicines. TRIAL REGISTRATION NUMBER ACTRN12621000083897; Results.
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Affiliation(s)
- Ahsan Saleem
- School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Gemma Woodruff
- Pharmacy Department, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Kathryn Steadman
- School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia
| | - Adam La Caze
- School of Pharmacy, The University of Queensland, Woolloongabba, Queensland, Australia
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Mafruhah OR, Huang YM, Shiyanbola OO, Shen GL, Lin HW. Ideal instruments used to measure health literacy related to medication use: A systematic review. Res Social Adm Pharm 2021; 17:1663-1672. [PMID: 33674228 DOI: 10.1016/j.sapharm.2021.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 01/28/2021] [Accepted: 01/31/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prior studies showed the association between inadequate health literacy (HL) and poor medication-related skills, while none of the published studies have reviewed and compared the existing instruments used to measure medication-related HL. This systematic review comprehensively summarizes the existing instruments that assess medication-related HL. OBJECTIVES To identify appropriate HL instruments related to medication use as screening tools for enhancing patients' ability to use medications correctly. METHODS This review retrieved medication-related HL instruments that were published between 2000 and 2019 from three databases (i.e., PubMed, Scopus, EMBASE) and by hand-searching. The PRISMA procedure was followed as well as the SURGE guideline to assess the quality of studies. Psychometric properties, HL dimensions, and types of medication information gleaned from the items in three types of HL instruments (i.e., general, disease-specific, medication-specific) were compared to identify appropriate medication-related HL instruments. RESULT Forty-eight instruments were identified from 44 studies, whereas 70.8% instruments were either disease- or medication-specific HL instruments. Most instruments with different sample sizes showed certain an extent of reliability and validity. The distributions of HL dimensions and types of medication information among the relevant items were varied across different types of instruments. The five instruments (named as the 16SQ, AKQ-CQ, DHLKI, AKT, and ChMLM) were identified as the most appropriate instruments for three types of medication-related HL, respectively. These appropriate instruments consistently covered items related to HL dimensions of literacy and comprehension and medication-related information regarding dosing, treatment indication, and side effects/precautions. CONCLUSION Of 48 identified instruments mainly derived from disease- or medication-specific studies, the five most appropriate medication-related HL instruments were identified to support clinicians in facilitating patients' correct medication use. Further confirmation to explore the usefulness among these instruments are needed.
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Affiliation(s)
- Okti Ratna Mafruhah
- School of Pharmacy and Graduate Institute, China Medical University, Taichung City, 404333, Taiwan; Department of Pharmacy, Universitas Islam Indonesia, Daerah Istimewa Yogyakarta, 55584, Indonesia
| | - Yen-Ming Huang
- College of Pharmacy and Allied Health Professions, South Dakota State University, Brookings, SD, 57007, USA; Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei City, 100025, Taiwan
| | - Olayinka O Shiyanbola
- Division of Social and Administrative Sciences, School of Pharmacy, University of Wisconsin-Madison, WI, 53705, USA
| | - Guan-Lin Shen
- School of Pharmacy and Graduate Institute, China Medical University, Taichung City, 404333, Taiwan
| | - Hsiang-Wen Lin
- School of Pharmacy and Graduate Institute, China Medical University, Taichung City, 404333, Taiwan; Department of Pharmacy, China Medical University Hospital, Taichung City, 404332, Taiwan; Department of Pharmacy System, Outcomes and Policy, College of Pharmacy, University of Illinois at Chicago, IL, 60607, USA.
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Alzayer R, Svedin E, Rizvi SA, Basheti I, Chaar B, Saini B. Pharmacists' experience of asthma management in culturally and linguistically diverse (CALD) patients. Res Social Adm Pharm 2020; 17:315-325. [PMID: 32354642 DOI: 10.1016/j.sapharm.2020.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND In Australia, one of the world's significantly multicultural nations, asthma is one of the most common chronic conditions. A significant level of health disparities have been observed in many countries with a culturally and linguistically diverse demography. Previous studies have identified that language and culture affect health care provision, this is why culturally competent care is crucial when managing chronic conditions in diverse populations. OBJECTIVE The purpose of this study was to explore Australian community pharmacists' experience and perspective about providing care for CALD people with asthma. METHODS Qualitative semi-structured interviews were used as the method of choice to fulfil the study objective. Participants were recruited purposively from suburbs of relative diversity in two Australian cities: Melbourne and Sydney. Interviews with consenting pharmacist were conducted using an interview guide. Verbatim transcripts of interviews were then thematically analysed. RESULTS Thirty-two interviews resulted in five emergent themes 1) Pharmacists' attitudes towards CALD patients and Cultural Competence; 2) Barriers and facilitators; 3) Clinical issues; 4) Cultural barriers; 5) Workarounds. It was evident that language and to a smaller extent, cultural barriers were experienced regularly by pharmacists managing CALD patients; pharmacists had mostly adapted with a range of methods to work around these barriers. Although pharmacists had a positive attitude, there seemed to be a need for enhanced cultural competence skills; reflections from pharmacists supported the need for further training and pharmacy specific resources. CONCLUSIONS There is a significant gap in cultural awareness among Australian pharmacists. Future direction suggests obligatory training in cultural competence for health professionals in order to be able to provide cultural proficient care.
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Affiliation(s)
- Reem Alzayer
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
| | - Elin Svedin
- Faculty of Pharmacy, Uppsala University, Sweden.
| | | | - Iman Basheti
- Faculty of Pharmacy, Applied Science Private University, Amman, Jordan.
| | - Betty Chaar
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
| | - Bandana Saini
- School of Pharmacy, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
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Chen H, Ung COL, Chi P, Wu J, Tang D, Hu H. Consumers' Perceptions About Pharmaceutical Care Provided by Community Pharmacists in China in Relation to Over-the-Counter Drugs: A Qualitative Study. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2019; 55:46958018793292. [PMID: 30095016 PMCID: PMC6088464 DOI: 10.1177/0046958018793292] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
While patient-centered care is highly anticipated nowadays, investigation of consumers’ perceptions and expectations about pharmacist’s pharmaceutical care when providing over-the-counter (OTC) drugs is sparse. This article aimed to explore consumers’ perceptions regarding the pharmaceutical care that community pharmacists provide in relation to OTC drugs. Semistructured interviews were conducted with consumers recruited (N = 97) in Yinchuan City, China. The 4 main themes that emerged were expectations on pharmaceutical care, attitude toward pharmacist’s competence, experience of self-medication, and suggestions for improving pharmaceutical care. Most participants had high expectations on community pharmacists to recommend the right medicines, to advise them about the effective use of drug, to advise them about the safe use of drug, and to recommend economic drugs. However, their previous experiences at community pharmacy were far from satisfaction reportedly, leading to a general distrust in pharmacist’s certification and qualification, knowledge, communication skills, and attitude. As a result, the participants turned to self-medication based on their personal experiences, their relatives’ experiences, the information on drug label, and the information distributed in the mass media. Realizing the need to improve pharmaceutical care, the participants also made improvement suggestions specific to community pharmacist, community pharmacy, and the government.
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Affiliation(s)
| | | | | | - Jihong Wu
- 2 University of Electronic Science and Technology of China, Chengdu, China
| | | | - Hao Hu
- 1 University of Macau, China
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Mullan J, Weston KM, Bonney A, Burns P, Mullan J, Rudd R. Consumer knowledge about over-the-counter NSAIDs: they don't know what they don't know. Aust N Z J Public Health 2016; 41:210-214. [PMID: 27774735 DOI: 10.1111/1753-6405.12589] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2016] [Revised: 05/01/2016] [Accepted: 06/01/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To investigate consumers' knowledge about commonly purchased over-the-counter (OTC) products containing ibuprofen. METHODS Customers buying two popular OTC ibuprofen-containing products (Nurofen™ or Nurofen Plus™ ) were asked to complete a short survey assessing their knowledge about the products. RESULTS The survey was completed by 262 respondents, most of whom were older than 50 years of age; female; well-educated; with adequate functional health literacy. The majority correctly identified ibuprofen as an active ingredient and knew the correct intervals between doses. However, almost a third couldn't correctly identify the maximum daily dose and were unaware of some contraindications. Furthermore, fewer than half recognised potential side effects. Those who hadn't completed high school were significantly less likely to seek medical advice (when required) and significantly less likely to know when it was safe to take these products. CONCLUSIONS The gaps in consumer knowledge, especially about the maximum daily dose, contraindications and potential side effects may be placing consumers at risk of experiencing ibuprofen-related adverse events. Implications for public health: Improving consumer knowledge to address these gaps in their understanding about the safe use of popular OTC ibuprofen-containing products is an important public health concern.
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Affiliation(s)
- Judy Mullan
- School of Medicine, University of Wollongong, New South Wales
| | | | - Andrew Bonney
- School of Medicine, University of Wollongong, New South Wales
| | - Pippa Burns
- School of Medicine, University of Wollongong, New South Wales
| | | | - Rima Rudd
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Harvard University, US
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Koster ES, Philbert D, Blom L, Bouvy ML. “These patients look lost” – Community pharmacy staff’s identification and support of patients with limited health literacy. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2016; 24:403-410. [DOI: 10.1111/ijpp.12272] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2015] [Revised: 04/12/2016] [Accepted: 04/13/2016] [Indexed: 11/28/2022]
Abstract
Abstract
Objective
To date, routine use of health literacy assessment in clinical settings is limited. The objective of this study was to explore if community pharmacy staff can identify patients with limited health literacy, how they identify patients and how they support patients to improve medication use. In addition, perceived barriers in providing care for patients with limited health literacy were assessed.
Methods
Structured face-to-face interviews with pharmacy staff were performed in 27 community pharmacies. Questions concerned pharmacy staff’s experiences with limited health literacy during their work, e.g. recognition of patients, communication strategies and possible interventions for this patient group to improve medication use.
Key findings
Results from 74 interviews were included for analysis. Sixty-eight interviewees (92%) mentioned to identify patients with limited health literacy during their work, mostly based on intuition. Suggested strategies to improve medication use included tailored education and information, intensive support or use of aids such as a multidose drug dispensing system. Pharmacy staff indicated lack of time as a barrier to provide tailored pharmaceutical care.
Conclusions
Most participants mentioned to recognize patients with limited health literacy merely on intuition or based on certain patient characteristics. Thus, an unknown number of patients with limited health literacy might be missed. This underlines the need to create more awareness of health literacy among pharmacy professionals. Moreover, training of pharmacy staff and use of aids to identify limited health literacy may help to identify more patients who need additional counselling.
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Affiliation(s)
- Ellen S Koster
- Utrecht Pharmacy Practice network for Education and Research, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Daphne Philbert
- Utrecht Pharmacy Practice network for Education and Research, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Lyda Blom
- Utrecht Pharmacy Practice network for Education and Research, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Marcel L Bouvy
- Utrecht Pharmacy Practice network for Education and Research, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
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