{"id":6731,"date":"2021-01-24T17:48:58","date_gmt":"2021-01-24T22:48:58","guid":{"rendered":"https:\/\/desis.osu.edu\/seniorthesis\/?p=6731"},"modified":"2021-01-24T17:48:59","modified_gmt":"2021-01-24T22:48:59","slug":"patient-and-public-perspectives-of-community-pharmacies-in-the-united-kingdom-a-systematic-review","status":"publish","type":"post","link":"https:\/\/desis.osu.edu\/seniorthesis\/index.php\/2021\/01\/24\/patient-and-public-perspectives-of-community-pharmacies-in-the-united-kingdom-a-systematic-review\/","title":{"rendered":"Patient and public perspectives of community pharmacies in the United Kingdom: A systematic review"},"content":{"rendered":"\n<p>By: <a href=\"https:\/\/onlinelibrary.wiley.com\/action\/doSearch?ContribAuthorStored=Hindi%2C+Ali+M+K\">Ali M. K. Hindi BPharm, MSc<\/a><a href=\"https:\/\/onlinelibrary.wiley.com\/action\/doSearch?ContribAuthorStored=Schafheutle%2C+Ellen+I\">Ellen I. Schafheutle PhD, MRes, MSc, FFRPS<\/a><a href=\"https:\/\/onlinelibrary.wiley.com\/action\/doSearch?ContribAuthorStored=Jacobs%2C+Sally\">Sally Jacobs BSc, PhD<\/a><br>Published in Health Expectations, An Internation Journal of Public Participation in Health Care and Health Policy<br>08 November 2017<br><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"d33845415\">Abstract<\/h2>\n\n\n\n<p><strong>Background<\/strong><br>The United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. However, patient and public awareness of community pharmacy services has been limited.<\/p>\n\n\n\n<p><strong>Objective<\/strong><br>To identify and synthesize the research literature pertaining to patient and public perspectives on: existing community pharmacy services, extended pharmacist roles and strategies to raise awareness of community pharmacy services.<\/p>\n\n\n\n<p><strong>Search strategy &amp; inclusion criteria<br><\/strong>Systematic search of 8 electronic databases; hand searching of relevant journals, reference lists and conference proceedings. UK studies investigating patient or public views on community pharmacy services or pharmacist roles from 2005 to 2016.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Introduction<\/h2>\n\n\n\n<p>In recent decades, the advancement of the pharmacy profession has seen a movement away from a traditional supply function towards more clinically orientated activities. Community pharmacies are the most frequently visited health\u2010care destinations<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0011\"> <\/a>leading policymakers to recognize the importance of extending community pharmacists\u2019 roles to meet growing public demands.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0011\"> <\/a>This has led to novel reimbursement structures being implemented across many health\u2010care systems, including Australia, Canada, New Zealand and the United States,<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0015\"> <\/a>which fund cognitive services as well as medicines supply.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\" id=\"hex12639-sec-0007-title\">Findings<\/h3>\n\n\n\n<ul class=\"wp-block-list\"><li>Public cognizance<ul><li>The theme of public cognizance concerned how community pharmacies are held within the mindset of patients and the public.<br><\/li><\/ul><\/li><li>Awareness and use of pharmacy services<ul><li>Low public or patient awareness of extended pharmacy services was a common finding. The pharmacy setting appeared to be portrayed as a dispensary (medicines supply) and place for medicines purchase as well as advice on minor ailments. Nearly half (48.3%) of participants in one study chose &#8220;to dispense&#8221; as the most common reason for using pharmacies followed by the purchase of medicinal (22%) and non\u2010medicinal products.<br><\/li><\/ul><\/li><li>Perceptions of pharmacists<ul><li>Patient and public perceptions of pharmacists seemed to influence their preferences for pharmacy\u2010led services. There appeared to be resistance to acknowledge the pharmacist as an essential member of the health\u2010care team.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0046\"> <\/a>Members of the public rated the importance of pharmacist roles with regard to certain public health issues relatively low in a questionnaire study, whilst activities linked to their traditional roles such as advice on medication usage, side\u2010effects and disposal were rated highest. Only 1% of patients in a survey chose \u201ctrust in the pharmacist\u201d as a reason to visit the pharmacy, yet in another survey, trust in pharmacists was high.<br><\/li><\/ul><\/li><li>Barriers<ul><li>Studies repeatedly raised a perceived lack of privacy and confidentiality as a barrier to using extended pharmacy services,\u00a0with the pharmacy environment not considered an appropriate venue for private discussions. Particular concerns were about busyness and conversations being overheard, particularly regarding private matters. In addition, 2 studies revealed the specific dissatisfaction of service users with supermarket pharmacies in terms of privacy.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0056\"> <\/a>It was apparent that patients and members of the public were unfamiliar with consultation rooms offered at UK pharmacies since the introduction of the new community pharmacy contracts. One survey demonstrated low utilization of consultation rooms, with only 28.8% and 19.4% of respondents experiencing advice or services in private rooms, respectively. <\/li><\/ul><\/li><\/ul>\n\n\n\n<h3 class=\"wp-block-heading\">Discussion<\/h3>\n\n\n\n<p>International literature addressing the first theme, \u201cpublic cognizance,\u201d confirms that low public awareness is not exclusive to the United Kingdom.\u00a0The considerable lack of awareness of extended pharmacy services and pharmacist roles suggests that more could be done to promote the pharmacy setting as an attractive venue for health\u2010care delivery. Nevertheless, little has been done in the way of promoting pharmacy services or enhancing public understanding of pharmacists\u2019 knowledge and skills.<\/p>\n\n\n\n<p>Perceptions of physicians being at the top of the health\u2010care hierarchy were also common in other countries, including Australasia,\u00a0North America, Europe\u00a0and Middle East. This is borne out in evidence where physician\u2010pharmacist collaboration in clinical settings has been shown to significantly improve patient outcomes.\u00a0However, physicians have shown a reluctance to support pharmacist integration due to their unawareness of extended services.\u00a0Moreover, physicians believe that clinical roles are better suited for themselves,<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0098\"> <\/a>that pharmacists lack the training or ability to carry out extended roles,<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0006\"> <\/a>and have suspicion of pharmacists\u2019 financial motives. Physicians have also been concerned that extending pharmacist roles and granting them more access to patient information would compromise patient confidentiality and threaten physicians\u2019 health\u2010care authority.<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0008\"> <\/a>In order to achieve better recognition and integration of physician and pharmacy services, it will be crucial to develop a better understanding of each other&#8217;s knowledge, skills and potential contribution to patient care.<\/p>\n\n\n\n<p>Regarding patient and public attitudes towards pharmacy services, international literature confirms findings from this review that the convenience of community pharmacies and having well\u2010established patient\u2010pharmacist relationships<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0077\"> <\/a>are key facilitators for the usage of pharmacy services. So if it is indeed important that patients experience services in order to build rapport with their pharmacists, fully acknowledge their worth\u00a0and consider recommending them to peers,<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0104\"> <\/a>then pubic promotion campaigns can only go so far. Furthermore, when designing effective community pharmacy services, it will be important to take patients\u2019 preferences into account, where access to and convenience of pharmacy services is particularly valued.<\/p>\n\n\n\n<p>Privacy and confidentially of the pharmacy environment, or rather the lack thereof, was considered a major barrier for using advanced pharmacy services. Moreover, patient and public awareness of private consultation rooms remains low, despite their existence being a requirement of the new community pharmacy contract. Furthermore, patients\/the public perceived pharmacists\u2019 limited authority to be a barrier for broadening roles. Whilst the introduction of pharmacist independent prescribing in 2006\u00a0has gone some way to overcoming this, integration within the wider primary care team remains crucial. The introduction of \u201csummary care records,\u201d a scheme introduced in 2016,<a href=\"https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639#hex12639-bib-0106\"> <\/a>which permits a range of health\u2010care professionals, including pharmacists and pharmacy technicians, to access core clinical and medication information, with the patient&#8217;s consent, may prove to be another important step towards integration and autonomy.<\/p>\n\n\n\n<h3 class=\"wp-block-heading\">Conclusions<\/h3>\n\n\n\n<p>This systematic review provides an update of the patient and public perceptions of community pharmacy services since the introduction of a revised contractual framework for community pharmacy in the United Kingdom, which introduced funding for cognitive services. Whilst the majority of the literature suggests that patient and public opinions about community pharmacy services are positive, awareness of pharmacy services beyond medicines supply remains low. Patients still look to their physicians, so successful integration of pharmacy services into the primary care pathway will be essential. For this to be achieved, pharmacists\u2019 clinical skills beyond medicines supply need to be recognized and embraced by patients and physicians alike. Furthermore, potential barriers within pharmacy, such as low pharmacist confidence, reorganization of workload to accommodate high\u2010quality services effectively and the potential conflict a commercial environment poses, also need to be addressed. Ease of access and convenience of pharmacies present a major advantage for their usage. Future research should explore different approaches to increasing awareness, evaluate the effectiveness of different methods of promotion and understand what the public as well as other stakeholders consider to be effective.<\/p>\n\n\n\n<p>Source: https:\/\/onlinelibrary.wiley.com\/doi\/full\/10.1111\/hex.12639<br>Image Source: Unsplash.com<\/p>\n\n\n\n<p><strong>Analysis:<br><\/strong>I chose this article because it was rich in information on my focus topic. This article is an analysis of many studies conducted about the public&#8217;s perception of pharmacists all over the world, and it points out a lot of key issues. First, there is a lack of public awareness of what pharmacists really do, and for that, they are undervalued and seen as pill clerks. Second, there is a perception of physician supremacy in the health field, in which the physician is seen as the expert and the pharmacist is seen as the assistant who simply gives you the thing the physician told you that you needed. Thereafter, there is a lack of connection between pharmacists and physicians, which creates this confusion and could be a reason why pharmacists are undervalued. Lastly, the environment of the pharmacy itself creates barriers for why patients don&#8217;t consult pharmacists more often.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>By: Ali M. K. Hindi BPharm, MScEllen I. Schafheutle PhD, MRes, MSc, FFRPSSally Jacobs BSc, PhDPublished in Health Expectations, An Internation Journal of Public Participation in Health Care and Health Policy08 November 2017 Abstract BackgroundThe United Kingdom has been at the forefront of enhancing pharmacist roles and community pharmacy services, particularly over the past decade. 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