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An evaluation of community pharmacy-based services for type 2 diabetes in an Indonesian setting: patient survey.

ABSTRACT: Background. Diabetes is an emerging chronic disease in developing countries. Its management in developing countries is mainly hospital/clinic based. The increasing diabetes burden in developing countries provides opportunities for community pharmacists to deliver a range of services. Since the management of diabetes requires the patient's own involvement, it is important to gain their views in order to develop pharmacy-based diabetes services. Studies on diabetes patients' views have been limited to developed countries. Objectives. To investigate, within a developing country setting (Indonesia), current use of pharmacy services by type 2 diabetes patients, and to evaluate their views regarding community pharmacists' roles, and the characteristics that influence their views. Methods. A questionnaire survey was conducted within 10 purposefully selected community pharmacies in Surabaya, Indonesia. Each pharmacy recruited approximately 20 patients seeking antidiabetic medications. Usage of pharmacy services was identified using binary responses ('yes'/'no') and views on pharmacists' roles were rated using Likert scales; an open-ended question was used to identify patient perceived priority roles. Logistic regression models were used to determine characteristics associated with patients' views. Results. A total of 196 pharmacy patients with type 2 diabetes responded (58.3% response rate). Most patients used community pharmacies for dispensing (100%) and education on how to use medications (79.6%). There were mixed views towards pharmacists providing services beyond dispensing. The highest priorities identified were from the 'patient education' domain: education on medications (i.e., directions for use (64.5%), storage (26.6%), common/important adverse effects (25.5%)); and the 'monitoring' domain: monitoring medication compliance (37.3%). Patients with higher incomes or who were working were less supportive of these expanded services, whereas patients who previously used a service, those with risk factors for complications or having poor/unknown glycaemic control were more supportive. Conclusions. Community pharmacies in Surabaya, Indonesia in this study were mainly utilised for dispensing. However, many type 2 diabetes patients using these pharmacies report limited monitoring of blood glucose levels and poor glycaemic control, which indicates an opportunity for greater pharmacist involvement. Yet for this to occur, patients' limited expectations of pharmacists roles will need to be broadened. Characteristics influencing these views should inform the development of pharmacy-based diabetes services in the environment of the burgeoning burden of diabetes.

SUBMITTER: Wibowo Y

PROVIDER: S-EPMC4690368 | biostudies-literature | 2015

REPOSITORIES: biostudies-literature

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An evaluation of community pharmacy-based services for type 2 diabetes in an Indonesian setting: patient survey.

Wibowo Yosi Y Parsons Richard R Sunderland Bruce B Hughes Jeffery J

PeerJ 20151210

Background. Diabetes is an emerging chronic disease in developing countries. Its management in developing countries is mainly hospital/clinic based. The increasing diabetes burden in developing countries provides opportunities for community pharmacists to deliver a range of services. Since the management of diabetes requires the patient's own involvement, it is important to gain their views in order to develop pharmacy-based diabetes services. Studies on diabetes patients' views have been limite ...[more]

PMID: 26713231

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Project description:OBJECTIVES:The primary objective was to assess the accuracy (calibration and validation status) of digital blood pressure (BP) monitors used within community pharmacy in England and the secondary objectives were to assess the overall quality of the BP service by assessing service prevalence, service utilisation and other in-service considerations. DESIGN:A cross-sectional survey. SETTING:Primary-care retail-pharmacies. PARTICIPANTS:500 pharmacies that contribute to government dispensing-data were invited by post to complete the survey. Private contractors were excluded. INTERVENTIONS:We conducted a questionnaire survey with a follow-up (September 2018 to December 2018). RESULTS:109 responses were received. 61% (n=66) of responding pharmacies provided a free BP check to their patients. 40 (61%) pharmacies used recommended validated clinical metres, 6 (9%) had failed validation and 20 (30%) provided too little information to enable us to determine their monitor's status. CONCLUSIONS:Responding pharmacies were able to provide useful BP monitoring services to their patients, though quality enhancements need to be implemented. Majority of pharmacies use validated BP monitors, however, there was a lack of range of cuff sizes, variation in replacement and calibration of monitors and apparent absence of such practice in a minority of pharmacies alongside variation in training standards. We noted higher frequency of BP screening in the most deprived postcodes.We recommend in-service redesign and delivery improvements, and suggest professional bodies and researchers work together to create clearer frameworks for front-line practitioners, creating appropriate incentives to facilitate this service redesign.Funders and policy setters should consider the value added to the National Health Service and other healthcare agencies of such screening by pharmacy providers both nationally and internationally. It has the potential to reduce complications of undiagnosed hypertension and the medicines burden that it creates. Future work should examine the impact of pharmacist-led BP screening on patients.

Project description:Insomnia is one of the most common minor ailments to which patients seek advice in a community pharmacy setting. Due to the availability of a wide variety of over-the-counter (OTC) products, community pharmacists are in the front line to safe-guard patients looking for self-medication or advice for treatment of insomnia. The purpose of this study was to assess the content of community pharmacists' interactions with patients seeking advice for insomnia in Jordan. A cross-sectional study using a simulated patient methodology was conducted across a stratified convenience sample of community pharmacies in three major cities in Jordan. The visits were evaluated using pre-defined criteria adapted from published literature relating to content and counseling skills. Visits were audio-recorded using a hidden microphone and the simulated patient completed a data collection form immediately after each visit. A total of 67 community pharmacies (response rate = 93.0%) agreed to participate and were all visited once by the simulated patient. The median duration of the visit was 2 minutes (range: 0.2-4 minutes). The majority (86.6%) of visits resulted in the sale of a drug, most commonly a combination product (paracetamol and diphenhydramine) for 30 recommendations (44.8%). This was followed by a natural plant extract combination product, namely valerian and lemon balm (Melissa officinalis L.) for 23 (34.3%). Pharmacists often did not question medical history or other symptoms prior to product sale. Frequently, the recommended dose (49.3%) and administration time (38.8%) were the only information provided to the patient. No information was provided in relation to potential drug interactions or contraindications. No advice was offered on lifestyle or good sleeping hygiene. This study provided evidence that community pharmacists in Jordan in general did not offer adequate counseling for patients seeking advice for insomnia. Exploration of the reasons and factors contributing to this practice and highlighting professional opportunity and responsibility is recommended.

Project description:BackgroundPets, pet owners (referred to as clients in veterinary medicine and throughout this article), veterinarians, and community pharmacies may all benefit from veterinary compounding services provided in community pharmacies, but the benefits of this service are not well-documented in the literature.ObjectivesThis study identified perceived benefits and barriers and evaluated the need for veterinary compounding services in community pharmacies; it also evaluated current business practices related to veterinary compounding services.MethodsA cross-sectional survey was administered to three groups: 1) clients who filled a pet prescription at a study pharmacy, 2) clients who had not filled pet prescriptions, and 3) local veterinarians. Eligible participants were 18 or older; clients must have owned a pet in the past five years. The surveys collected demographic information and assessed benefits, barriers, need, and business practices regarding veterinary compounding services. Demographics were evaluated through descriptive statistics. Responses to Likert-scale items were compared between groups using the Mann-Whitney U test. Qualitative responses were assessed for emerging themes.ResultsOne hundred eighteen clients and 15 veterinarians participated in the study. Seventy-two of 116 clients (62%) and eight of 10 veterinarians (80%) agreed that clients would benefit from veterinary compounds provided in community pharmacies. Only 40% of veterinarians agreed that community pharmacists have the knowledge to compound pet medications, compared to 67% of clients (P=0.010). Similarly, 47% of veterinarians agreed that community pharmacists have the skills to compound pet medications, compared to 72% of clients (P=0.016). Forty-eight of 118 clients (41%) would travel 10 miles or more out of their way for veterinary compounding services at community pharmacies.ConclusionsThis study assessed client and veterinarian perceptions of veterinary compounding service benefits, barriers, and need in community pharmacies. Clients identified more opportunities for veterinary compounding services in community pharmacies when compared to veterinarians. Both groups identified a need for veterinary compounding services and agreed community pharmacies providing these services would benefit pets and clients.

Project description:UnlabelledRisk factors for cardiovascular disease including diabetes have seen a large rise in prevalence in recent years. This has prompted interest in prevention through the identifying individuals at risk of both diabetes and cardiovascular disease and has seen increased investment in screening interventions taking place in primary care. Community pharmacies have become increasingly involved in the provision of such interventions and this systematic review and meta-analysis aims to gather and analyse the existing literature assessing community pharmacy based screening for risk factors for diabetes and those with a high cardiovascular disease risk.MethodsWe conducted systematic searches of electronic databases using MeSH and free text terms from 1950 to March 2012. For our analysis two outcomes were assessed. They were the percentage of those screened who were referred for further assessment by primary care and the uptake of this referral.ResultsSixteen studies fulfilled our inclusion criteria comprising 108,414 participants screened. There was significant heterogeneity for all included outcomes. Consequently we have not presented summary statistics and present forest plots with I2 and p values to describe heterogeneity. We found that all included studies suffered from high rates of attrition between pharmacy screening and follow up. We have also identified a strong trend towards higher rates for referral in more recent studies.ConclusionsOur results show that pharmacies are feasible sites for screening for diabetes and those at risk of cardiovascular disease. A significant number of previously unknown cases of cardiovascular disease risk factors such as hypertension, hypercholesterolemia and diabetes are identified, however a significant number of referred participants at high risk do not attend their practitioner for follow up. Research priorities should include methods of increasing uptake to follow up testing and early intervention, to maximise the efficacy of screening interventions based in community pharmacies.

Dataset Information

An evaluation of community pharmacy-based services for type 2 diabetes in an Indonesian setting: patient survey.

Publications

An evaluation of community pharmacy-based services for type 2 diabetes in an Indonesian setting: patient survey.

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