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Watkins K, Bennell KL, Slater H, Hinman RS, Sim TF, Darlow B, McLachlan AJ, Chua J, Briggs AM. Capabilities, opportunities and motivations within Australian community pharmacy to deliver Clinical Care Standard-aligned care for knee osteoarthritis: A mixed-methods evaluation. Osteoarthritis Cartilage 2025:S1063-4584(25)01004-0. [PMID: 40345611 DOI: 10.1016/j.joca.2025.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2024] [Revised: 03/29/2025] [Accepted: 04/14/2025] [Indexed: 05/11/2025]
Abstract
OBJECTIVE To evaluate the capabilities, opportunities, and motivations of community pharmacists and pharmacy assistants to deliver osteoarthritis (OA) care, aligned with the Australian Osteoarthritis of the Knee Clinical Care Standard. METHOD Quantitative data from pharmacists and pharmacy assistants working in Australian community pharmacies were collected via e-surveys. Behaviour-change theory-informed items measured pharmacists' capabilities, opportunities, and motivations to provide Standard-aligned care. Pharmacy assistants reflected on their perceived role in OA care through focus groups. RESULTS 407 pharmacists and 148 pharmacy assistants responded. Most pharmacists (>80%) reported high motivations to engage in OA care, with >80% agreeing that five of the seven quality statements were within their scope of practice. Across quality statements, median feasibility to deliver Standard-aligned care (measured on 9-point numeric rating scale; 1 = not at all feasible; 9 = highly feasible) ranged from 6-7 within knowledge, 5-7 within workload, 6-7 within workflow, 8 within pharmacy layout/infrastructure, and 1-5 in absence of additional remuneration. More time-consuming care (e.g., self-management support, patient review) was rated less feasible. Adjusted linear regression models identified that perceived workload and workflow feasibility increased when more pharmacists were on duty (R2: 0.02-0.11). Three themes (with sub-themes) emerged from pharmacy assistants' qualitative data (n = 13): 1) professional activities related to OA care; 2) capabilities and scope of practice; and 3) managing workflow and alleviating workload pressures. CONCLUSION While pharmacists self-reported high motivation and capabilities to deliver Standard-aligned OA care, implementation feasibility will likely depend on addressing workload, workflow, and, particularly, remuneration barriers. Role delineation and training for pharmacy assistants may support better OA care within community pharmacies.
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Affiliation(s)
- Kim Watkins
- Curtin School of Allied Health, Curtin University, Perth, Australia; Curtin Medical School, Curtin University, Perth, Australia.
| | - Kim L Bennell
- Centre for Health, Exercise and Sports Medicine (CHESM), Department of Physiotherapy, University of Melbourne, Melbourne, Australia.
| | - Helen Slater
- Curtin School of Allied Health, Curtin University, Perth, Australia.
| | - Rana S Hinman
- Centre for Health, Exercise and Sports Medicine (CHESM), Department of Physiotherapy, University of Melbourne, Melbourne, Australia.
| | - Tin Fei Sim
- Curtin Medical School, Curtin University, Perth, Australia.
| | - Ben Darlow
- Department of Primary Health Care and General Practice, University of Otago, Wellington, New Zealand.
| | | | - Jason Chua
- Curtin School of Allied Health, Curtin University, Perth, Australia; Traumatic Brain Injury Network (TBIN), Auckland University of Technology, Auckland, New Zealand.
| | - Andrew M Briggs
- Curtin School of Allied Health, Curtin University, Perth, Australia.
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Owoyemi T, Alonge I, Adetunji O, Ogbu E, Ogunbanjo A, White S, Adebajo A, Mallen C, Babatunde OO, Dziedzic K. Everyday living with osteoarthritis in the global South: A qualitative focus group inquiry in Nigeria. OSTEOARTHRITIS AND CARTILAGE OPEN 2025; 7:100555. [PMID: 39717526 PMCID: PMC11665529 DOI: 10.1016/j.ocarto.2024.100555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Accepted: 11/23/2024] [Indexed: 12/25/2024] Open
Abstract
Objective Africa contributes significantly to the increasing global prevalence (>37 %), unmet need and treatment burden for people with osteoarthritis. Despite this, little research has examined the expressed needs of patients with osteoarthritis (OA) and joint pain in West-Africa. This study aimed to explore lived experiences, expressed needs and current care gaps for people living with osteoarthritis in low-health resource contexts using Nigeria as a case study. Design Qualitative study using Focus Groups. People aged 45 years and over living with osteoarthritis and joint pain were recruited at local health services or via wide advertisements in the community. Discussions were recorded and transcribed verbatim. Data were analyzed using thematic analysis (inductive approach). Results Three focus groups were conducted with people living with osteoarthritis (n = 30, age range 45-90 years) across socio-demographic strata. Participants described their experiences of living with osteoarthritis as emotionally, physically, and socio-economically challenging. Four main themes (and 14 sub-themes) were identified. Participants expressed the need for an information and health education campaign and access to appropriate health professionals (especially physiotherapists) for providing support, guidance, and assistance with self-management. Conclusions The provision of an accessible, and contextually appropriate patient education package, in line with evidence-based recommendations is a critical need for people living with osteoarthritis in Nigeria. This will promote evidence-based care for OA in low-resource settings, empowering patients to self-manage and reducing confusion related to inconsistent advice and mixed messages about cause, healthcare access and OA care.
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Affiliation(s)
- Tolulope Owoyemi
- University of Ibadan, Ibadan, Nigeria
- West African Institute for Applied Health Research, Ibadan, Nigeria
| | - Ibidunni Alonge
- University of Ibadan, Ibadan, Nigeria
- West African Institute for Applied Health Research, Ibadan, Nigeria
| | | | | | - Adebimpe Ogunbanjo
- West African Institute for Applied Health Research, Ibadan, Nigeria
- Pharmacy Division, Lagos State Health Service, Lagos, Nigeria
| | - Simon White
- Keele University, School of Pharmacy and Bioengineering, Keele, Staffordshire, UK
| | - Adewale Adebajo
- West African Institute for Applied Health Research, Ibadan, Nigeria
- Musculoskeletal Health Service Research, Sheffield University, UK
| | - Christian Mallen
- School of Medicine, Primary Care Centre Versus Arthritis, Keele, Staffordshire, UK
| | - Opeyemi O. Babatunde
- West African Institute for Applied Health Research, Ibadan, Nigeria
- School of Medicine, Primary Care Centre Versus Arthritis, Keele, Staffordshire, UK
- Impact Accelerator Unit, Keele University, Keele, Staffordshire, UK
| | - Krysia Dziedzic
- Impact Accelerator Unit, Keele University, Keele, Staffordshire, UK
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Barat E, Soubieux A, Brevet P, Gerard B, Vittecoq O, Lequerre T, Chenailler C, Varin R, Lattard C. Impact of the Clinical Pharmacist in Rheumatology Practice: A Systematic Review. Healthcare (Basel) 2024; 12:1463. [PMID: 39120166 PMCID: PMC11312274 DOI: 10.3390/healthcare12151463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 07/12/2024] [Accepted: 07/18/2024] [Indexed: 08/10/2024] Open
Abstract
This is a systematic literature review on the impact of pharmacists in rheumatology, conducted using the PubMed®, CINAHL®, Cochrane Library®, and Web of science® databases and using the PRISMA 2020 checklist. This review was conducted from 2000 to June 2024. A quality analysis was performed. The selection of articles, as well as all analyses, including quality analyses, were conducted by a pair of pharmacists with experience in rheumatology, and included 24 articles. This study highlights the growth of clinical pharmacy activities in rheumatology and the positive influence of clinical pharmacists on patient care. The implementation of such initiatives has the potential to improve medication adherence, reduce medication-related risks, and optimize associated healthcare costs. All these pharmaceutical interventions aim to make the patient care journey smoother and safer. Additionally, the diversity of available pharmaceutical services caters to the varied needs of rheumatology. Furthermore, outpatient clinical pharmacy is also explored in this field and garners interest from patients. The vast majority of studies demonstrate significant improvement in patient care with promising performance outcomes when pharmacists are involved. This review highlights the diverse range of interventions by clinical pharmacists in rheumatology, which is very promising. However, to better assess the benefits of clinical pharmacists, this activity needs further development and evaluation through controlled and randomized clinical research programs.
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Affiliation(s)
- Eric Barat
- Department of Pharmacy, Rouen University Hospital, F-76000 Rouen, France
- Department of Public Health, Normandie University, UNICAEN, Inserm U1086, F-14000 Caen, France
| | - Annaelle Soubieux
- Department of Pharmacy, Rouen University Hospital, F-76000 Rouen, France
| | - Pauline Brevet
- Department of Rheumatology & CIC-CRB 1404, CHU Rouen, University Rouen Normandie, UNIROUEN, F-76000 Rouen, France
| | - Baptiste Gerard
- Department of Rheumatology, Rouen University Hospital, F-76000 Rouen, France
| | - Olivier Vittecoq
- Department of Rheumatology & CIC-CRB 1404, CHU Rouen, University Rouen Normandie, UNIROUEN, F-76000 Rouen, France
| | - Thierry Lequerre
- Department of Rheumatology & CIC-CRB 1404, CHU Rouen, University Rouen Normandie, UNIROUEN, F-76000 Rouen, France
| | | | - Rémi Varin
- Department of Pharmacy, Rouen University Hospital, F-76000 Rouen, France
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Thapa P, Kc B, Gyawali S, Leong SL, Mohamed Ibrahim MI, Lee SWH. Effectiveness of community pharmacist-led interventions in osteoarthritis pain management: A cluster-randomized trial. Res Social Adm Pharm 2024; 20:149-156. [PMID: 37945419 DOI: 10.1016/j.sapharm.2023.10.012] [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: 06/30/2023] [Revised: 09/04/2023] [Accepted: 10/26/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Community pharmacists contribute in osteoarthritis management via evidence-based pain management services. However, their roles and impacts on osteoarthritis management in low- and middle-income countries have yet to be explored. OBJECTIVE This study aims to evaluate the effectiveness of community pharmacist-led educational intervention and medication review among osteoarthritis patients. METHODS A 6-month cluster-randomized controlled study was conducted in 22 community pharmacies of Nepal. Patients clinically diagnosed with osteoarthritis, aged 18 years and above, with a poor knowledge level of osteoarthritis and pain management were enrolled in the study. The intervention groups were educated on osteoarthritis and pain management, and had their medications reviewed while control group received usual care. Primary outcomes evaluated for the study were the change in pain levels, knowledge, and physical functional scores at 3 and 6 months. Repeated analyses of covariance were performed to examine the outcomes. RESULTS A total of 158 participants were recruited for the study. The intervention group reported improvements in pain score (mean difference 0.473, 95 % CI 0.047 to 0.900) at 3 months and the end of the study (mean difference 0.469, 95 % CI 0.047 to 0.891) as compared to control. Similarly, improvement in knowledge scores were observed in the intervention group at 3 months (mean difference 5.320, 95 % CI 4.982 to 5.658) and 6 months (mean difference 5.411, 95 % CI 5.086 to 5.735). No differences were observed in other outcomes, including physical functional score, depression, and quality of life. CONCLUSION Community pharmacist-led intervention improved patients' knowledge of osteoarthritis and pain management. While pain scores improved, physical functional score, depression, and quality of life score remained unchanged. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05337709.
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Affiliation(s)
- Parbati Thapa
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Bhuvan Kc
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia; College of Public Health, Medical, and Veterinary Sciences, James Cook University, Townsville, Queensland, Australia
| | - Sudesh Gyawali
- Department of Pharmacology, Manipal College of Medical Sciences, Pokhara, Nepal
| | - Siew Lian Leong
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | | | - Shaun Wen Huey Lee
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia; School of Pharmacy, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Selangor, Malaysia; Asian Centre for Evidence Synthesis in Population, Implementation and Clinical Outcomes (PICO), Health and Well Being Cluster, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia; Global Asia in the 21st Century (GA21) Platform, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia.
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Babatunde OO, Cottrell E, White S, Chudyk A, Healey EL, Edwards J, Nicholls E, O'Brien N, Todd A, Walker C, Stanford C, Cork T, Long A, Simkins J, Mallen CD, Dziedzic K, Holden MA. Co-development and testing of an extended community pharmacy model of service delivery for managing osteoarthritis: protocol for a sequential, multi-methods study (PharmOA). BMC Musculoskelet Disord 2024; 25:54. [PMID: 38216895 PMCID: PMC10785546 DOI: 10.1186/s12891-023-07105-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 12/08/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Osteoarthritis is a common, painful and disabling long-term condition. Delivery of high-quality guideline-informed osteoarthritis care that successfully promotes and maintains supported self-management is imperative. However, osteoarthritis care remains inconsistent, including under use of core non-pharmacological approaches of education, exercise and weight loss. Community pharmacies are an accessible healthcare provider. United Kingdom government initiatives are promoting their involvement in a range of long-term conditions, including musculoskeletal conditions. It is not known what an enhanced community pharmacy role for osteoarthritis care should include, what support is needed to deliver such a role, and whether it would be feasible and acceptable to community pharmacy teams. In this (PharmOA) study, we aim to address these gaps, and co-design and test an evidence-based extended community pharmacy model of service delivery for managing osteoarthritis. METHODS Informed by the Theoretical Domains Framework, Normalisation Process Theory, and the Medical Research Council (MRC) framework for developing complex interventions, we will undertake a multi-methods study involving five phases: 1. Systematic review to summarise currently available evidence on community pharmacy roles in supporting adults with osteoarthritis and other chronic (non-cancer) pain. 2. Cross-sectional surveys and one-to-one qualitative interviews with patients, healthcare professionals and pharmacy staff to explore experiences of current, and potential extended community pharmacy roles, in delivering osteoarthritis care. 3. Stakeholder co-design to: a) agree on the extended role of community pharmacies in osteoarthritis care; b) develop a model of osteoarthritis care within which the extended roles could be delivered (PharmOA model of service delivery); and c) refine existing tools to support community pharmacies to deliver extended osteoarthritis care roles (PharmOA tools). 4. Feasibility study to explore the acceptability and feasibility of the PharmOA model of service delivery and PharmOA tools to community pharmacy teams. 5. Final stakeholder workshop to: a) finalise the PharmOA model of service delivery and PharmOA tools, and b) if applicable, prioritise recommendations for its wider future implementation. DISCUSSION This novel study paves the way to improving access to and availability of high-quality guideline-informed, consistent care for people with osteoarthritis from within community pharmacies.
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Affiliation(s)
- Opeyemi O Babatunde
- Keele University, Primary Care Centre Versus Arthritis, School of Medicine, Keele, Staffordshire, ST5 5BG, UK.
- Impact Accelerator Unit, Keele University, Keele, Staffordshire, ST5 5BG, UK.
| | - Elizabeth Cottrell
- Wolstanton Medical Centre Newcastle-Under-Lyme, Newcastle-under-Lyme, ST5 8BN, UK
| | - Simon White
- Keele University, School of Pharmacy and Bioengineering, Keele, Staffordshire, UK
| | - Adrian Chudyk
- Keele University, Primary Care Centre Versus Arthritis, School of Medicine, Keele, Staffordshire, ST5 5BG, UK
- Impact Accelerator Unit, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Emma L Healey
- Keele University, Primary Care Centre Versus Arthritis, School of Medicine, Keele, Staffordshire, ST5 5BG, UK
| | - John Edwards
- Wolstanton Medical Centre Newcastle-Under-Lyme, Newcastle-under-Lyme, ST5 8BN, UK
| | - Elaine Nicholls
- Keele University, Primary Care Centre Versus Arthritis, School of Medicine, Keele, Staffordshire, ST5 5BG, UK
- Keele Clinical Trials Unit, Keele University, Keele, Staffordshire, UK
| | - Nicola O'Brien
- Department of Psychology, Northumbria University, Newcastle-Upon-Tyne, Tyne and Wear, UK
| | - Adam Todd
- Newcastle University, School of Pharmacy, Newcastle-Upon-Tyne, Tyne and Wear, UK
| | - Christine Walker
- Impact Accelerator Unit, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Colin Stanford
- NHS Shropshire Clinical Commissioning Group, Shrewsbury, Shropshire, UK
| | - Tania Cork
- North Staffs and Stoke Local Pharmaceutical Committee, Stoke-On-Trent, Staffordshire, UK
| | - Angela Long
- Department of Psychology, Northumbria University, Newcastle-Upon-Tyne, Tyne and Wear, UK
| | - Joanna Simkins
- Keele University, Primary Care Centre Versus Arthritis, School of Medicine, Keele, Staffordshire, ST5 5BG, UK
| | - Christian D Mallen
- Keele University, Primary Care Centre Versus Arthritis, School of Medicine, Keele, Staffordshire, ST5 5BG, UK
| | - Krysia Dziedzic
- Keele University, Primary Care Centre Versus Arthritis, School of Medicine, Keele, Staffordshire, ST5 5BG, UK
- Impact Accelerator Unit, Keele University, Keele, Staffordshire, ST5 5BG, UK
| | - Melanie A Holden
- Keele University, Primary Care Centre Versus Arthritis, School of Medicine, Keele, Staffordshire, ST5 5BG, UK
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