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Baas G, Crutzen S, Smits S, Denig P, Taxis K, Heringa M. Process evaluation of a pharmacist-led intervention aimed at deprescribing and appropriate use of cardiometabolic medication among adult people with type 2 diabetes. Basic Clin Pharmacol Toxicol 2024; 134:83-96. [PMID: 37563775 DOI: 10.1111/bcpt.13931] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/13/2023] [Accepted: 08/01/2023] [Indexed: 08/12/2023]
Abstract
BACKGROUND A quasi-experimental study investigated a pharmacist-led intervention aimed at deprescribing and medication management among adult patients with type 2 diabetes at risk of hypoglycaemia. OBJECTIVE This study aimed to evaluate the process of implementing the intervention consisting of a tailored clinical medication review (CMR) supported by a training and a toolbox. METHODS Mixed-methods study based on the Grant framework, including the domains "recruitment," "delivery of intervention" and "response" of pharmacists and patients. Data collected were administrative logs, semi-structured observations of patient consultations (n = 8), interviews with pharmacists (n = 16) and patient-reported experience measure (PREM) questionnaires (n = 66). RESULTS Tailored CMRs were conducted largely as intended for 90 patients from 14 pharmacies. Although patient selection based on a medication-derived hypoglycaemia risk score was considered useful, pharmacists experienced barriers to proposing deprescribing in patients with recent medication changes, without current hypoglycaemic events, or treated by medical specialists. The training and toolbox were evaluated positively by the pharmacists. Overall, patients were satisfied with the CMR. CONCLUSION Pharmacists and patients valued the CMR focusing on deprescribing and medication management. To optimize implementation and effectiveness of the intervention, improvements can be made to the patient selection, pharmacist training and the collaboration between healthcare professionals.
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Affiliation(s)
- Gert Baas
- SIR Institute for Pharmacy Practice and Policy, Leiden, The Netherlands
- Department of Pharmaceutical Sciences, Utrecht University, Utrecht, The Netherlands
| | - Stijn Crutzen
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Sanne Smits
- Unit of PharmacoTherapy, -Epidemiology, and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Petra Denig
- Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, The Netherlands
| | - Katja Taxis
- Unit of PharmacoTherapy, -Epidemiology, and -Economics, Groningen Research Institute of Pharmacy, University of Groningen, Groningen, The Netherlands
| | - Mette Heringa
- SIR Institute for Pharmacy Practice and Policy, Leiden, The Netherlands
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Haldane C, Neukom J, Lailo JM, Hero K, Vetter B. Diabetes and blood glucose monitoring knowledge and practices among pharmacy professionals in Cambodia and Viet Nam: digital survey and education. BMC MEDICAL EDUCATION 2023; 23:483. [PMID: 37386440 DOI: 10.1186/s12909-023-04449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 06/14/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND In Southeast Asia, pharmacies are critical sources of healthcare advice for under-served communities, including those with/at risk of diabetes. AIM Explore knowledge/practices relating to diabetes and blood glucose monitoring (BGM) among pharmacy professionals in Cambodia and Viet Nam, using digital professional education to address gaps. METHODS An online survey was distributed to pharmacy professionals in Cambodia and Viet Nam registered on SwipeRx mobile application. Eligible participants dispensed medicines and/or were involved in purchasing products, and worked at retail pharmacies stocking ≥ 1 BGM product. An accredited continuing professional development module was then made available to pharmacy professionals and students on SwipeRx in both countries. After completing the 1-2 h module, users were required to correctly answer ≥ 60% (Cambodia) or ≥ 70% (Viet Nam) of knowledge assessment questions to achieve accreditation units from local partners. RESULTS Whereas 33% of survey respondents in Cambodia (N = 386) and 63% in Viet Nam (N = 375) reported performing blood glucose testing at the pharmacy, only 19% and 14% were aware that clients taking multiple daily doses of insulin should check blood glucose levels several times a day. Of 1,137 and 399 pharmacy professionals/students who completed the module and passed the assessment in Cambodia and Viet Nam, 1,124 (99%) and 376 (94%) received accreditation. Knowledge levels improved substantially in 10 of 14 learning areas in Cambodia and 6 of 10 in Viet Nam. CONCLUSIONS Digital education can strengthen pharmacy professional capacity to provide comprehensive and accurate information on diabetes management and the awareness of quality BGM products in Southeast Asia.
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Affiliation(s)
| | | | | | - Kol Hero
- Department of Preventive Medicine, Ministry of Health, Phnom Penh, Cambodia
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Nathan AD, Shankar PR, Sreeramareddy CT. Topical corticosteroid counselling among Malaysian community pharmacists: a qualitative interview study. BMC PRIMARY CARE 2023; 24:119. [PMID: 37231354 DOI: 10.1186/s12875-023-02071-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 05/17/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Topical corticosteroids (TCS) are commonly available in community pharmacies and are used in skin conditions like atopic dermatitis and psoriasis among others. Problems such as overuse, use of potent steroids and steroid phobia have been identified in the use of TCS in the literature. The aim of the study was to obtain community pharmacists (CPs) views regarding factors influencing their counselling of patients about TCS; challenges associated, important problems, the counselling process, shared care with other healthcare professionals, and explore further the findings from the questionnaire-based study. METHODS Seven licensed practicing community pharmacists (from the Klang Valley, Malaysia) were interviewed between 23rd September to 14th November 2021. These were CPs participating in the questionnaire study who agreed to be interviewed. NVIVO 11 software was used for data analysis. Codes and themes were generated and agreed on by the researchers. RESULTS The major themes identified related to the process mentioned of providing information to patients, the issues addressed by CPs during the counselling (including steroid phobia, overuse of TCS, patients asking for a specific preparation by name), less counselling support material, language barriers, lesser knowledge about certain conditions, information sources used by CPs (material provided by Ministry of Health and Malaysian Pharmacists Association, MIMS) and suggestions to strengthen the quality of counselling (specialization in skin diseases, webinars, shared care models). For patients requesting a particular preparation by name, the pharmacist will decide whether the preparation requested is suitable or suggest an alternative. Steroid phobia was seen more commonly among parents of young children and young patients. MIMS was available as a smartphone application making it easier to use. Advanced training for CPs in the management of skin conditions like that provided for diabetes mellitus can be considered. CONCLUSIONS Counselling was conducted while dispensing TCS in the open area of the pharmacy. Challenges to counselling were lack of time, limited counselling materials, and language barriers. Steroid phobia requires attention. Initiatives to strengthen counselling were mentioned by respondents and appear feasible. Further research covering the entire country is required.
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Affiliation(s)
- Abigail Dayang Nathan
- Public Health student, School of Postgraduate Studies, International Medical University, Kuala Lumpur, Malaysia
| | - Pathiyil Ravi Shankar
- IMU Centre for Education, International Medical University, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
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Alqudah A, Oqal M, Al-Samdi A, Qnais E, Wedyan M, Abu Gneam M, Alnajjar R, Alajarmeh M, Yousef E, Gammoh O. Knowledge and practice of community pharmacists towards SGLT2 inhibitors. F1000Res 2022; 11:659. [PMID: 35811806 PMCID: PMC9237554 DOI: 10.12688/f1000research.122170.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/24/2022] [Indexed: 09/05/2024] Open
Abstract
Background: Sodium/glucose cotransporter 2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs which improve glycaemic control in type 2 diabetes mellitus (T2DM) by preventing the kidney from reabsorbing glucose back to blood. Community pharmacists have long-term relationships with most of their chronic patients, so they play a key role in care for people with diabetes. Therefore, the objective of this study was to assess pharmacists' knowledge and practice towards SGLT2 inhibitors. Methods: A cross-sectional study was conducted to meet the study objectives. A convenience sample of 348 community pharmacists in Jordan was recruited. knowledge and practice were assessed using a self-administered questionnaire created for the purpose of this study. Results: A total of 400 community pharmacists were reached, of whom 348 answered the survey (response rate 87%). The results indicated that SGLT2 inhibitors knowledge score among community pharmacists in Jordan was 6.61 (out of 12). Factors like age, gender, location of the pharmacy, years of pharmacists' experience had no effect on knowledge score; however, pharmacists who attended training courses on diabetes had higher knowledge scores. Additionally, pharmacists' dispensing practice toward SGLT2 inhibitors had insufficient knowledge, such as lack of knowledge about the superiority of SGLT2 inhibitors over other anti-diabetics and inability to give the best advice to patients. Conclusions: Our findings reflect a moderate knowledge among community pharmacists about SGLT2 inhibitors which may negatively affect the patients' outcome; thus, continuous education for the pharmacists is essential.
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Affiliation(s)
- Abdelrahim Alqudah
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Muna Oqal
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, 13133, Jordan
| | - Ahmad Al-Samdi
- Department of Adult Health Nursing, Princess Salma Faculty of Nursing, Al al-Bayt University, Al-Mafraq, Zarqa, 13133, Jordan
| | - Esam Qnais
- Department of Biology and Biotechnology, Faculty of Science, Hashemite University, Zarqa, Zarqa, 13133, Jordan
| | - Mohammed Wedyan
- Department of Biology and Biotechnology, Faculty of Science, Hashemite University, Zarqa, Zarqa, 13133, Jordan
| | - Majd Abu Gneam
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Roaa Alnajjar
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Manar Alajarmeh
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Elaf Yousef
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Omar Gammoh
- Department of Clinical Pharmacy and Pharmacy Practice, Yarmouk University, Irbid, Zarqa, 13133, Jordan
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Alqudah A, Oqal M, Al-Samdi A, Qnais E, Wedyan M, Abu Gneam M, Alnajjar R, Alajarmeh M, Yousef E, Gammoh O. Knowledge and practice of community pharmacists towards SGLT2 inhibitors. F1000Res 2022; 11:659. [PMID: 35811806 PMCID: PMC9237554 DOI: 10.12688/f1000research.122170.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/28/2022] [Indexed: 11/20/2022] Open
Abstract
Background: Sodium/glucose cotransporter 2 (SGLT2) inhibitors are a new class of oral anti-diabetic drugs which improve glycaemic control in type 2 diabetes mellitus (T2DM) by preventing the kidney from reabsorbing glucose back to blood. Community pharmacists have long-term relationships with most of their chronic patients, so they play a key role in care for people with diabetes. Therefore, the objective of this study was to assess pharmacists' knowledge and practice towards SGLT2 inhibitors. Thus, improving pharmacists' knowledge about this group of medications could improve the treatment outcome of people with diabetes. Methods: A cross-sectional study was conducted to meet the study objectives. A convenience sample of 348 community pharmacists in Jordan was recruited. knowledge and practice were assessed using a self-administered questionnaire created for the purpose of this study. Results: A total of 400 community pharmacists were reached, of whom 348 answered the survey (response rate 87%). The results indicated that SGLT2 inhibitors knowledge score among community pharmacists in Jordan was 6.61 (out of 12). Factors like age, gender, location of the pharmacy, years of pharmacists' experience had no effect on knowledge score; however, pharmacists who attended training courses on diabetes had higher knowledge scores. Additionally, pharmacists' dispensing practice toward SGLT2 inhibitors had insufficient knowledge, such as lack of knowledge about the superiority of SGLT2 inhibitors over other anti-diabetics and inability to give the best advice to patients. Conclusions: Our findings reflect a moderate knowledge among community pharmacists about SGLT2 inhibitors which may negatively affect the patients' outcome; thus, continuous education for the pharmacists is essential.
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Affiliation(s)
- Abdelrahim Alqudah
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Muna Oqal
- Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, 13133, Jordan
| | - Ahmad Al-Samdi
- Department of Adult Health Nursing, Princess Salma Faculty of Nursing, Al al-Bayt University, Al-Mafraq, Zarqa, 13133, Jordan
| | - Esam Qnais
- Department of Biology and Biotechnology, Faculty of Science, Hashemite University, Zarqa, Zarqa, 13133, Jordan
| | - Mohammed Wedyan
- Department of Biology and Biotechnology, Faculty of Science, Hashemite University, Zarqa, Zarqa, 13133, Jordan
| | - Majd Abu Gneam
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Roaa Alnajjar
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Manar Alajarmeh
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Elaf Yousef
- Department of clinical pharmacy and pharmacy practice, Faculty of pharmaceutical sciences, The Hashemite University, Zarqa, Zarqa, P.O box 330127, Zarqa 13133, Jordan, Jordan
| | - Omar Gammoh
- Department of Clinical Pharmacy and Pharmacy Practice, Yarmouk University, Irbid, Zarqa, 13133, Jordan
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Gargya D, Mirkazemi C, Curtain C. Qualitative exploration of the experiences of community pharmacists delivering the Diabetes MedsCheck service. J Clin Pharm Ther 2022; 47:1194-1200. [PMID: 35322454 PMCID: PMC9543553 DOI: 10.1111/jcpt.13654] [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: 11/10/2021] [Revised: 02/20/2022] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE The Diabetes MedsCheck (DMC) pharmacist service improves patient medication use and provides education on diabetes self-management. The original 2012 program evaluation identified barriers and facilitators in implementation. There are no recent studies exploring pharmacists' experiences with the DMC service. This pilot study may contribute to achieving an optimal diabetes management service in Australia. To explore the experiences of community pharmacists in providing the DMC service. METHODS A purposive sampling approach was used to recruit practising Australian community pharmacists from July to December 2019. Inclusion criteria included provision of DMC service for more than 1 year and having delivered the service within 3 months of recruitment. Semi-structured interviews elicited pharmacists' experience with the DMC service. RESULTS AND DISCUSSION Twelve interviews of community pharmacist owners, managers and employees (including three who had additional medication review and diabetes qualifications), resulted in four primary themes: benefit of and need for training in diabetes management, challenges of service delivery and implementation, the challenge of patients' diabetes management and the positive effect of DMC on pharmacists' professional satisfaction from the positive impact on patient interactions and diabetes management. Pharmacists highlighted the need for continuous training on diabetes management and patient communication, and a dedicated time and space for service provision for optimal implementation and delivery of DMC. DMC helped to fulfil pharmacists' desires to provide health care. Pharmacists perceived through patient engagement and patient feedback that DMC benefits patient health care. WHAT IS NEW AND CONCLUSION Positively, the implementation of the DMC service has promoted engagement with other health professionals while also contributing to pharmacists' professional satisfaction. Patient satisfaction and awareness of the health knowledge that pharmacists provide promotes pharmacist capabilities to the public. To ensure that accessible diabetes care in community pharmacy is optimized for greatest patient care, pharmacists delivering DMC should be supported by provision of contemporary diabetes management training and communication skills. Additional investment in community pharmacy operational set-up, such as dedicated pharmacist time, dedicated consulting space, upskilling of staff and investment in technology is also required to support optimal delivery of DMC.
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Affiliation(s)
- Diane Gargya
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia
| | - Corinne Mirkazemi
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia
| | - Colin Curtain
- School of Pharmacy and Pharmacology, University of Tasmania, Hobart, Tasmania, Australia
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