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Margaret C. Watson - One of the best experts on this subject based on the ideXlab platform.
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lightening the load a systematic review of Community Pharmacy based weight management interventions
Obesity Reviews, 2011Co-Authors: J Gordon, Margaret C. Watson, Alison AvenellAbstract:The extent to which Community pharmacies can increase capacity for weight management is unknown. Thus, the objective of the present paper was to evaluate the effectiveness and cost-effectiveness of Community Pharmacy weight management interventions. This paper used a design of systematic review and narrative synthesis. Electronic databases (1999-2009) were searched, including Medline, EMBASE, CINAHL and Pharm-line. Weight management studies in Community pharmacies were eligible for the inclusion criteria. All languages and study designs were considered. Outcome measures included body weight or anthropometry (at baseline and at least one follow-up time point). Data were extracted through independent, duplicate data extraction and quality assessment. As a result, 10 studies were included, totalling 2,583 service users and 582 pharmacies from the USA, the UK, Switzerland, Spain and Denmark. One was a randomized controlled trial of a meal-replacement versus a reduced calorie diet. A non-randomized controlled before and after study compared Community pharmacist treatment using Orlistat with usual care. Eight studies were uncontrolled. Five studies described behaviour change techniques. Long-term (12 months) mean weight loss measured in three studies ranged from 1.1 to 4.1 kg. Four uncontrolled studies reported statistically significant weight loss. No study reported economic evaluations. Currently, there is insufficient evidence for the effectiveness and cost-effectiveness of Community Pharmacy-based weight management initiatives to support investment in their provision.
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The feasibility of providing Community Pharmacy-based services for alcohol misuse
International Journal of Pharmacy Practice, 2009Co-Authors: Margaret C. Watson, Alison BlenkinsoppAbstract:Objectives Excessive consumption of alcohol is a major public health concern. The use of Community pharmacies and pharmacists as sources of public health information and services is gaining greater recognition. The objective of this review was to provide an overview of the evidence on the feasibility, effectiveness and acceptability of providing Community Pharmacy-based services to address the excessive consumption of alcohol. Methods Electronic databases were searched for the period 1996–2007 to identify relevant evidence. Searches were also conducted of relevant Pharmacy and addiction journals. Information was sought from key contacts in Pharmacy and alcohol research. Studies were included if they were conducted in a Community Pharmacy setting. Key findings The review comprised three feasibility studies which included 14 pharmacies and 500 customers. Non-significant reductions in alcohol consumption were reported with two studies following brief interventions by pharmacists. Between 30% and 53% of Pharmacy customers were identified as having hazardous or harmful drinking behaviour. Customer opinion of the Pharmacy-based alcohol services was not reported. Conclusions There has been little empirical evaluation of the effectiveness of Community Pharmacy-based services for alcohol misuse. The evidence presented in this review suggests that Community Pharmacy-based screening is feasible. Organisations and individuals involved with tackling excessive alcohol consumption should consider the inclusion of Community pharmacies and pharmacists as part of their strategies to address this problem. Large-scale studies are needed to evaluate the short- and long-term effects and cost-effectiveness of Community Pharmacy-based interventions to reduce excessive alcohol consumption, as well as to explore the acceptability of the service to users.
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Simulated patients in the Community Pharmacy setting. Using simulated patients to measure practice in the Community Pharmacy setting.
Pharmacy World & Science, 2004Co-Authors: Margaret C. Watson, John Skelton, Christine Bond, Phil Croft, Connie Wiskin, Jeremy M. Grimshaw, Jill MollisonAbstract:Background: Performance measurement and quality of care in Community Pharmacy settings is problematic because of the lack of formal patient registration and the resultant risk of selection bias. Although simulated patients have been used for teaching and education purposes, particularly in medical settings, their use as a research tool requires exploration in other health settings. The purpose of this paper is to describe how we used simulated patients to measure professional performance of Community Pharmacy staff. Method: Sixty pharmacies participated in a randomised controlled trial (RCT) to evaluate the effectiveness and efficiency of two guideline implementation strategies in the Community Pharmacy setting. The primary outcome measure for the study was derived from assessment forms completed by simulated patients following covert visits to participating pharmacies. Results: Of the 420 simulated patient visits scheduled, 384 (91%) were completed. Nine visits were reported by Pharmacy staff using reply-paid postcards, four of which concurred with known SP visits. Each detected visit was made by a different SP. In a post-intervention survey, 26 (52%) pharmacists stated they had been apprehensive about the use of simulated patients as part of the study, however, 41 (82%) pharmacists agreed that SP visits were an acceptable research method to use in a Community Pharmacy setting. Discussion: Simulated patients are a feasible method of assessing professional performance in Community Pharmacy settings and overcome the methodological problems of other measurement methods. Further research is needed to assess the reliability and validity of simulated patients.
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educational strategies to promote evidence based Community Pharmacy practice a cluster randomized controlled trial rct
Family Practice, 2002Co-Authors: Margaret C. Watson, Jeremy M. Grimshaw, Jill Mollison, Christine M Bond, Anne Ludbrook, Anne WalkerAbstract:Background Community pharmacists have increasing involvement in the self-management of minor illness as a result of the availability of a wider range of over-the-counter (OTC) medicines. We undertook a randomized controlled trial (RCT) to assess the effectiveness and efficiency of educational strategies to implement evidence-based guidelines for the sale of OTC anti-fungals in the Community Pharmacy setting. Objective The aim of the study was to compare the effectiveness and efficiency of two guideline dissemination strategies in Community Pharmacy settings. Methods A 2 x 2 factorial, cluster RCT was conducted with 60 Community pharmacies in the Grampian region of Scotland. The interventions included dissemination of an evidence-based guideline for OTC management of vulvovaginal candidiasis (thrush) by postal dissemination (control), educational outreach visit or attendance at a continuing professional education session. Pre- and post-intervention simulated patient visits were made to participating pharmacies. The simulated patients completed assessment forms following each visit. The primary outcome was the appropriateness (based upon the guidelines) of sale or no sale of OTC anti-fungals. Results There were no significant differences in the proportion of appropriate outcomes following educational outreach [odds ratio (OR) = 1.1; 95% confidence interval (CI) 0.52 to 2.45] or continuing professional education (OR = 0.88; 95% CI 0.41 to 1.91). Conclusions Neither strategy was effective in improving the appropriateness of OTC management of vulvovaginal candidiasis by Community Pharmacy staff. Further research is needed to identify barriers to guideline implementation and evidence-based practice in this setting.
Marcel L. Bouvy - One of the best experts on this subject based on the ideXlab platform.
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moral dilemmas reflect professional core values of pharmacists in Community Pharmacy
International Journal of Pharmacy Practice, 2019Co-Authors: Martine Kruijtbosch, Wilma Gottgensjansen, Annemieke Floorschreudering, Evert Van Leeuwen, Marcel L. BouvyAbstract:OBJECTIVES: The aim was to recognise the professional core values in the moral dilemmas of pharmacists in Community Pharmacy and to customise the descriptions of these values for Community Pharmacy practice. METHODS: The narratives of 128 moral dilemmas, collected from Dutch PharmD students and early career pharmacists who experienced these dilemmas in practice, were qualitatively analysed. An expert panel deductively coded relevant portions of these narratives with the core values as formulated by the Royal Dutch Pharmacists Association. Other values that emerged were inductively coded and if possible used to further customise the respective core values. KEY FINDINGS: The expert panel identified all four professional core values, that is, commitment to the patient's well-being (117, 91.4%), reliable and caring (116, 90.6%), pharmaceutical expertise (72, 56.2%) and responsibility to society (30, 23.4%) in the 128 moral dilemma narratives. Thirteen other values that emerged in the analysis could all be used for the customisation of the professional core values in descriptions that better reflect Community Pharmacy practice. CONCLUSIONS: Professional core values were identified in moral dilemma narratives of pharmacists in Community Pharmacy and customised for their practice. These customised core values can enable pharmacists to better recognise moral dilemmas in practice. This can add to the advancement of the profession as a pharmaceutical care practice.
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The development of quality indicators for Community Pharmacy care
BMJ Quality & Safety, 2011Co-Authors: J De Bie, N B Kijlstra, B J G Daemen, Marcel L. BouvyAbstract:Aims To develop a national system of quality indicators for Community Pharmacy care, reported by Community pharmacies. Methods After preliminary validation, an online consensus study was conducted. Pharmacy practice experts (round 1) and practising pharmacists (round 2) were approached. Face-validity scores for risk of harm and quality of care were obtained, as well as data on feasibility and clarity. To field test the data collection a random sample of 30 Community pharmacies reported on the indicators, and were visited by a healthcare inspector to discuss practical and interpretation issues. Results After preliminary validation of 159 topics, 53 indicators were rated in round 1 by 14 of the 16 experts who were approached. The resulting 48 indicators were rated by 76 pharmacists of the 150 pharmacists who were approached (response 50%). Of the 48 indicators in the second round, 33 (69%) were rated face valid (median relevance score ≥7) for risk of harm to patients, while 43 (90%) were rated face valid for quality of care. In the field test the participating pharmacies reported on the resulting set of 44 indicators. This resulted in an adjusted set of 42 indicators. The set contains indicators on patient counselling (6), clinical risk management (10), compounding (7), dispensing (3), monitoring of medication use (11) and quality management (5). Conclusions A set of 42 quality indicators was developed for Community Pharmacy care. It is expected that this will have a positive impact on quality and safety of Community Pharmacy care in the Netherlands.
Alison Avenell - One of the best experts on this subject based on the ideXlab platform.
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lightening the load a systematic review of Community Pharmacy based weight management interventions
Obesity Reviews, 2011Co-Authors: J Gordon, Margaret C. Watson, Alison AvenellAbstract:The extent to which Community pharmacies can increase capacity for weight management is unknown. Thus, the objective of the present paper was to evaluate the effectiveness and cost-effectiveness of Community Pharmacy weight management interventions. This paper used a design of systematic review and narrative synthesis. Electronic databases (1999-2009) were searched, including Medline, EMBASE, CINAHL and Pharm-line. Weight management studies in Community pharmacies were eligible for the inclusion criteria. All languages and study designs were considered. Outcome measures included body weight or anthropometry (at baseline and at least one follow-up time point). Data were extracted through independent, duplicate data extraction and quality assessment. As a result, 10 studies were included, totalling 2,583 service users and 582 pharmacies from the USA, the UK, Switzerland, Spain and Denmark. One was a randomized controlled trial of a meal-replacement versus a reduced calorie diet. A non-randomized controlled before and after study compared Community pharmacist treatment using Orlistat with usual care. Eight studies were uncontrolled. Five studies described behaviour change techniques. Long-term (12 months) mean weight loss measured in three studies ranged from 1.1 to 4.1 kg. Four uncontrolled studies reported statistically significant weight loss. No study reported economic evaluations. Currently, there is insufficient evidence for the effectiveness and cost-effectiveness of Community Pharmacy-based weight management initiatives to support investment in their provision.
Derek Stewart - One of the best experts on this subject based on the ideXlab platform.
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Views and experiences of Community Pharmacy team members on antimicrobial stewardship activities in Scotland: a qualitative study
International Journal of Clinical Pharmacy, 2020Co-Authors: Antonella Pia Tonna, Anita Elaine Weidmann, Jacqueline Sneddon, Derek StewartAbstract:Background It has been acknowledged and recognised internationally that the Community Pharmacy team has a major role to play in antimicrobial stewardship programmes, particularly regarding patient engagement. However, there is a paucity of published research on Community Pharmacy-based activities in antimicrobial stewardship, and views and perceptions of the Community Pharmacy team on their role in antimicrobial stewardship. Objective To explore views and experiences of Community Pharmacy teams across Scotland on antimicrobial stewardship, activities related to European Antibiotic Awareness Day, and a self-help guide to treating infection. Setting Community Pharmacy, Scotland. Methods Qualitative, semi-structured in-depth telephone interviews were undertaken with a purposive sample of Community Pharmacy team members over a six week period between November and December in 2016. Interviews were audio-recorded, transcribed verbatim and data analysed thematically using the framework approach. Main outcome measure Views and perceptions of antimicrobial stewardship and European Antibiotic Awareness Day activities and role of the Pharmacy team. Results Twenty-seven participants were interviewed—20 pharmacists, five Pharmacy graduates completing their pre-registration year, and members of the Pharmacy support team including two Pharmacy technicians and one medicines counter assistant. They were working mainly in urban areas and across five regions of Scotland. Most were aware of antimicrobial stewardship but some were not familiar with the term. Participants identified roles for the Community Pharmacy team in antimicrobial stewardship including the importance of the Pharmacy as a first port of call for self-care advice. Some participants, including pharmacists, showed lack of awareness of European Antibiotic Awareness Day; those who were aware thought it may not have the desired impact on educating the public. Most participants, irrespective of role within the team, were not familiar with the self-help guide but they perceived this as a useful resource for the Pharmacy team. Conclusion The participants recognised and identified roles for the Community pharmacist within antimicrobial stewardship. However, the lack of awareness of European Antibiotic Awareness Day shows a need for European Antibiotic Awareness Day tools and other materials to be more effectively disseminated and for more training to be provided.
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An exploration of key stakeholders' perspectives on the implementation of ehealth policy in Community Pharmacy in Scotland.
2015Co-Authors: Katie Maclure, Brian Addison, Vibhu Paudyal, Derek StewartAbstract:Scotland's eHealth strategy promotes the use of information technology to 'improve communications across the healthcare team', which aligns with the quality strategy in placing the 'focus on outcomes and real benefits delivered rather than technologies.' The more recently published 2020 Workforce Vision envisages 'making more and better use of technology and facilities to increase access to services and improve efficiency', which was reinforced by the Prescription for Excellence and the Review of NHS Pharmaceutical Care of Patients in the Community in Scotland. Policies are supportive of ehealth in facilitating collaborative health and social care in providing integrated, person-centred, patient care enabling Community Pharmacy to offer extended and accessible services. This research aimed to explore and describe key stakeholders' perspectives on the implementation of ehealth policy in Community Pharmacy in Scotland.
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Views of the Scottish general public on Community Pharmacy weight management services: international implications
International Journal of Clinical Pharmacy, 2012Co-Authors: Anita Elaine Weidmann, Scott Cunningham, Gwen Gray, Denise Hansford, Giovanna Bermano, Derek StewartAbstract:Background Obesity has reached pandemic levels, with more than 1.5 billion adults being affected worldwide. In Scotland two-thirds of men and more than half of women are either overweight or obese, placing Scotland overall third behind the United States of America and Mexico. All Community pharmacies in Scotland are contracted to provide public health services such as smoking cessation and there is increasing interest in their contribution to weight management. Researching this area in Scotland may provide valuable information to facilitate the development of Community Pharmacy services in other parts of the UK and internationally. Objectives To describe the views of the Scottish general public on the provision of weight management services via Community pharmacies. Setting General public in Scotland. Methods A cross-sectional postal questionnaire survey of 6,000 randomly selected members of the Scottish general public aged 18 years and over. Main outcome measures Views on Community Pharmacy led weight management services. Results Questionnaires were returned by 20.6% (n = 1,236). Over half 60.1% (n = 751) agreed or strongly agreed that they had easy access to Pharmacy services in general and around one-third agreed (35%; n = 438) that it was more convenient to obtain weight management advice from a pharmacist than it is to make an appointment with a GP. Most respondents however lacked awareness of the types of health services available through Community Pharmacy (13.2%; n = 162) and would not feel comfortable speaking to a pharmacist or medicines counter assistant about weight related issues (25%; n = 320). Concerns over privacy (47.3%; n = 592) and perceived lack of pharmacists’ specialist knowledge (open comments) were identified as potential barriers to service uptake by the general public. Conclusion Overall, respondents appear to be receptive to the idea of accessing weight management services through Community Pharmacy but a perceived lack of privacy, poor knowledge of pharmacists’ skill level and of public health services available to them may explain the reluctance in the uptake of such services to date. The general public’s views expressed in this study may help to shape future Community Pharmacy led weight management service provision.
Christine Bond - One of the best experts on this subject based on the ideXlab platform.
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development validation and application of a patient satisfaction scale for a Community Pharmacy medicines management service
International Journal of Pharmacy Practice, 2011Co-Authors: Michela Tinelli, Alison Blenkinsopp, Christine BondAbstract:Objective To develop, validate and apply a scale to measure patient satisfaction in a randomised controlled trial of Community Pharmacy service. Methods Published scales were reviewed to inform development of the patient satisfaction scale. Questionnaires were sent to patients in the control (n = 500) and intervention (n = 941) groups of a randomised controlled trial of Community Pharmacy-led management of coronary heart disease at baseline and 12-month follow-up. Any underlying main factors were assessed with exploratory factor analysis. Reliability and construct validity were tested. The 15-item scale was used to compare patient satisfaction across arms with their most recent Pharmacy visit. Results Response rates were 92% (461/500) for control and 96% (903/941) for intervention groups at baseline and 85% control (399/472) and intervention (810/941) at follow-up. At baseline satisfaction was very similar in the intervention and control groups (median scores of 42). At follow-up mean satisfaction had significantly improved for the intervention compared with the control (median scores of 46 compared with 43; P < 0.01); intervention females were more likely to be satisfied with the service than males (49 compared with 44; P < 0.01). Three main factors explained the majority of the data variance. Cronbach's alpha was 0.7–0.9 for both groups over time for all factors and total scale. An increase in the overall satisfaction corresponding to a decrease in subjects wanting that particular service to be provided during their next visit indicated construct validity of the scale. Conclusion A new scale of patient satisfaction with Community Pharmacy services was developed and shown to be reliable and valid. Its application showed increased satisfaction in the intervention group receiving a new Pharmacy service.
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Needs assessment study for Community Pharmacy travel medicine services.
Journal of Travel Medicine, 2008Co-Authors: Caroline Hind, Christine Bond, Amanda J. Lee, Edwin Van TeijlingenAbstract:Background Community pharmacists in the UK currently provide limited travel medicine services. An enhanced service could offer the traveling public general advice, provision of immunizations, and malaria prophylaxis. The assessment of need for a travel vaccine service from Community pharmacies is key to the decision to develop the service. Method The needs assessment used a questionnaire survey of potential travelers recruited from Community pharmacies and the regional travel clinic. Results In total, 151 completed questionnaires were received (response rate 40%); nearly three times as many replies were from females (74%) than males (26%). Details for 230 different proposed visits abroad and 174 different past visits were analyzed. General medical practice (54.3%) and Community pharmacies (36.4%) were rated as providing the most useful advice. Most respondents (76.4%) required advice on vaccines, 53.9% on malaria prophylaxis, and 54.9% on bite prevention. Many (58.9%) agreed, or strongly agreed, that they would use the Community Pharmacy to provide travel immunizations, while 43% (strongly) agreed that they would be prepared to pay to obtain travel medicine services including immunizations. The median amount that participants were prepared to pay for a full travel assessment was £10, £13 for the administration of typhoid vaccine, £70 for a course of rabies vaccine, and £25 for malaria tablets for Kenya. Nearly three quarters (74.8%) agreed, or strongly agreed, that the Community Pharmacy would provide a convenient location from which to obtain travel services and 70.2% that the Pharmacy could provide a one-stop shop for travel medicine services. Conclusions Members of the traveling public do visit Community pharmacies, and most people are traveling for holiday purposes. The results suggest that travelers would be prepared to use the Community Pharmacy to provide travel advice and immunizations.
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Simulated patients in the Community Pharmacy setting. Using simulated patients to measure practice in the Community Pharmacy setting.
Pharmacy World & Science, 2004Co-Authors: Margaret C. Watson, John Skelton, Christine Bond, Phil Croft, Connie Wiskin, Jeremy M. Grimshaw, Jill MollisonAbstract:Background: Performance measurement and quality of care in Community Pharmacy settings is problematic because of the lack of formal patient registration and the resultant risk of selection bias. Although simulated patients have been used for teaching and education purposes, particularly in medical settings, their use as a research tool requires exploration in other health settings. The purpose of this paper is to describe how we used simulated patients to measure professional performance of Community Pharmacy staff. Method: Sixty pharmacies participated in a randomised controlled trial (RCT) to evaluate the effectiveness and efficiency of two guideline implementation strategies in the Community Pharmacy setting. The primary outcome measure for the study was derived from assessment forms completed by simulated patients following covert visits to participating pharmacies. Results: Of the 420 simulated patient visits scheduled, 384 (91%) were completed. Nine visits were reported by Pharmacy staff using reply-paid postcards, four of which concurred with known SP visits. Each detected visit was made by a different SP. In a post-intervention survey, 26 (52%) pharmacists stated they had been apprehensive about the use of simulated patients as part of the study, however, 41 (82%) pharmacists agreed that SP visits were an acceptable research method to use in a Community Pharmacy setting. Discussion: Simulated patients are a feasible method of assessing professional performance in Community Pharmacy settings and overcome the methodological problems of other measurement methods. Further research is needed to assess the reliability and validity of simulated patients.
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Exploiting IT: benefits for Community Pharmacy and consumers
International Journal of Pharmacy Practice, 2002Co-Authors: Jacqueline Mary Inch, Christine Bond, Aileen M. Grant, A. W. LaingAbstract:Focal points Information technology (IT) is an underused resource within Community Pharmacy with huge potential to introduce new models of service delivery The Pharmacy sector can learn from the experiences of banking and legal sectors Work presented here is part of a large systematic review exploring change and innovation in Community Pharmacy Main themes emerging from this systematic review are changing interaction with consumers and auto-dispensing and information technology The majority of identified papers (to date) are discursive/opinion pieces, with little hard evidence