The Impact of the Internet on Community Pharmacy Practice

Opportunities for extended community pharmacy services in United Arab Emirates: perception, practice, perceived barriers and willingness among community pharmacists

Background

Community pharmacies are widely distributed in the United Arab Emirates where community pharmacists’ (CPs’) perspectives on provision of extended community pharmacy services (ECPS) is not known. This study assessed CPs perception, practices, perceived barriers and willingness to provide ECPS.

Methods

A descriptive cross-sectional survey using a self-administered Likert-type questionnaire (Cronbach alpha = 0.976) was conducted among 195 community CPs in Northern emirates, selected through multistage sampling technique. The filled questionnaires were assessed for CPs’ perception, practice, perceived barriers and willingness to perform ECPS. Mann–Whitney and Kruskal–Wallis tests examined the association between demography and outcome variables (alpha value of 0.05) with further analysis using Dunn’ post hoc test.

Results

Of the respondents, 71.8% (n = 140) ‘strongly agreed’ that every CP must provide ECPs and 39% (n = 76) ‘strongly agreed’ in supporting ECPS with another 44.1% (n = 86) ‘agreed’ on the same. The major barriers felt by CPs in practicing ECPS were lack of incentive for employee pharmacists [3 (2–3)], lack of documentation [3 (2–3)], insufficient time [3 (2–3)] and lack of patients’ demand [(2–3)]; maximum score (5–5). CPs also responded ‘completely’ willing to provide services such as blood pressure measurement, pregnancy testing and BMI measurement. Pharmacy location influenced practice score (p = 0.008) and access to the internet had a significant effect on barriers score (p = 0.000). Availability of drug information sources impacted perception (p = 0.038), practice (p = 0.000) and willingness scores (p = 0.011).

Conclusions

CPs’ perception on providing ECPS was positive and they are currently offering ECPS within their available resources and facilities. Less demand from patients and lack of time were reportedly the major barriers in offering ECPS. Proper utilization of CPs in providing ECPS can complement the healthcare system with additional cost and time savings for the patients.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40545-022-00418-y.

'More of an art than a science'? The development, design and mechanics of the Delphi Technique

The Delphi Technique is a group judgement method which is typically used to reach agreement from a group of people with expertise in a particular area. It is an iterative process where panel members complete questionnaires over several rounds, often rating their agreement/disagreement against a statement, with changes made in later rounds based on the feedback received. It has been used widely in pharmacy-related studies relevant to education, research and practice. This paper provides a critical analysis of the various design choices which researchers may consider when planning a Delphi namely the panel of participants, the use of the Likert scale, the effect of feedback, what constitutes consensus and the number of rounds. It also gives an overview of the development and origins of the Delphi, and discusses the advantages and disadvantages of the technique. Advantages include that the Delphi can be conducted with panel members in different geographical locations in their own time, however the technique can therefore take longer to conduct and lacks face-to-face discussion. Patient experts may be less comfortable participating in a relatively complex survey, however the anonymous nature of the process can be more inclusive in allowing participants to feedback candidly. This paper shows the importance of careful planning of the design choices to ensure the reliability and validity of the Delphi.

Looking Back at US Pharmacy’s Past to Help Discern Its Future

Objective: To review specific literature that aimed to predict the future of US pharmacy, beginning in the late 1980s. Data Sources: Articles were identified from searching MEDLINE, CINAHL, Google Scholar, and references of relevant articles. The following combinations of search terms were used: future, pharmacy, prediction, and forecast. Study Selection and Data Extraction: The following inclusion criteria were applied: (1) full-text commentary, review, or original research and (2) focused predominantly on the pharmacy in the United States. Data on predictions for the future of pharmacy were extracted. Data Synthesis: We selected 3 articles published between 1988 and 2006, with each aiming to project the future for the following decade. We examined each prediction in light of the current knowledge. Relevance to Patient Care and Clinical Practice: Educators, practitioners, and other stakeholders should consider reflecting on the changes in pharmacy for the past 3 decades and applying both historical and emerging trends to improve patient care and sustain practice in the third decade of the 21st century and beyond. Conclusion: Most of the predictions for the future of pharmacy from the past 3 decades materialized, with some still in progress (reimbursement for pharmacy services), whereas others manifested in unexpected ways (transition from shortage to excess of pharmacists). Current forces shaping pharmacy include, but are not limited to, growing spending and use of specialty drugs, automation of pharmacy operations, growth of pharmacy in the digital health enterprise, and growing consumer interest in the use of analytical pharmacy that tests drugs before dispensing.

Ratings of journals for the dissemination of pharmacy-related social and administrative science

BACKGROUND

It has been over a decade since a journal quality rating study has been conducted in the social and administrative sciences (SAdS). This study sought to reevaluate perceptions of journal quality.

OBJECTIVES

To develop a list of journals that are suitable publication venues for SAdS scholars and compare the quality of these journals as rated by school of pharmacy deans, SAdS department/division chairs, and SAdS faculty.

METHODS

A list of journals was assembled and presented to a Delphi panel of 15 SAdS scholars. Using a modified Delphi technique, the panel refined the list by judging the suitability of each journal as a publication venue for scholars. This list was used in a survey administered via the Internet. Journal quality was rated on a 7-point Likert-type scale with the option of indicating unfamiliarity with each journal. Differences in quality ratings between faculty, chairs, and deans were explored. Adjusted rating scores were calculated based on familiarity with journals. Ratings from the current study were compared to previous studies.

RESULTS

One hundred and twelve journals emerged from the modified Delphi technique. Kruskal-Wallis analysis of variance found no significant difference in perceived journal quality across all journals evaluated by the 3 groups (KW=3.91). Groups did differ in their familiarity (KW=11.71, P<.01), with faculty being the most familiar with the journals and deans being the least familiar. Journal rankings were highly correlated with journal rankings from previously published studies.

CONCLUSIONS

Results of this study have implications for scholars choosing publication venues and those who make decisions contingent on scholars' publication records. These differences may represent a positive or negative bias that affects hiring as well as tenure and promotion decisions. This study provides guidance for decisions reliant on publication records, but should not be used exclusively as such an indicator.

Dysfunctional Tear Syndrome

PURPOSE

To develop current treatment recommendations for dry eye disease from consensus of expert advice.

METHODS

Of 25 preselected international specialists on dry eye, 17 agreed to participate in a modified, 2-round Delphi panel approach. Based on available literature and standards of care, a survey was presented to each panelist. A two-thirds majority was used for consensus building from responses obtained. Treatment algorithms were created. Treatment recommendations for different types and severity levels of dry eye disease were the main outcome.

RESULTS

A new term for dry eye disease was proposed: dysfunctional tear syndrome (DTS). Treatment recommendations were based primarily on patient symptoms and signs. Available diagnostic tests were considered of secondary importance in guiding therapy. Development of algorithms was based on the presence or absence of lid margin disease and disturbances of tear distribution and clearance. Disease severity was considered the most important factor for treatment decision-making and was categorized into 4 levels. Severity was assessed on the basis of tear substitute requirements, symptoms of ocular discomfort, and visual disturbance. Clinical signs present in lids, tear film, conjunctiva, and cornea were also used for categorization of severity. Consensus was reached on treatment algorithms for DTS with and without concurrent lid disease.

CONCLUSION

Panelist opinion relied on symptoms and signs (not tests) for selection of treatment strategies. Therapy is chosen to match disease severity and presence versus absence of lid margin disease or tear distribution and clearance disturbances.