Dataset Information

Perceptions of UK Community Pharmacists on Current Consultation Skills and Motivational Interviewing as a Consultation Approach: A Qualitative Study.

ABSTRACT:

Objectives

Community pharmacists' roles in the UK are evolving; pharmacists currently deliver a wider range of clinical services with more patient-focused care. The objectives of this study were (i) to investigate UK community pharmacists' views on their current communication skills in pharmacist-patient facing consultations, and (ii) to explore the perceptions of UK community pharmacists towards the application of motivational interviewing (MI) in a pharmacy consultation. In-depth qualitative face-to-face, semi-structured interviews with ten practicing community pharmacists were carried out, ranging from 30-60 minutes in length. The interviews were audio recorded, transcribed verbatim and thematic analysis was employed. Four themes emerged from the data: (1) the fight for time; (2) wrestling with consultation styles; (3) a personal communication evolution; and (4) unfamiliar but engaging motivational interviewing. These themes demonstrated the juxtaposition between the desire for patient-centred care and the pressures of managing broader dispensing work. Participants were critical of academic and continuous professional learning (CPD) training in communication skills and there was a strong recognition of the potential role of MI in promoting patient autonomy and outcomes. Participants recognized a few elements of MI techniques in their current consultations, but welcomed further training on behavioral change for effective consultations, expressing a desire for practical MI-specific training. Face-to-face CPD of consultation skills is needed to avoid the feeling of isolation among UK practicing pharmacists and rigidity in consultation delivery. Support for community pharmacists from other pharmacy staff could relieve current pressures and allow pharmacists time to develop and acquire effective skills for patient facing roles. Behavioural change consultation skills training for pharmacists could be an effective strategy to address these current challenges.

SUBMITTER: Jalal Z

PROVIDER: S-EPMC6630739 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Perceptions of UK Community Pharmacists on Current Consultation Skills and Motivational Interviewing as a Consultation Approach: A Qualitative Study.

Jalal Zahraa Z Akhtar Sania S Finlay Katherine K King Kathryn K Goel Neera N Ward Jonathan J

Pharmacy (Basel, Switzerland) 20190531 2

<h4>Objectives</h4>Community pharmacists' roles in the UK are evolving; pharmacists currently deliver a wider range of clinical services with more patient-focused care. The objectives of this study were (i) to investigate UK community pharmacists' views on their current communication skills in pharmacist-patient facing consultations, and (ii) to explore the perceptions of UK community pharmacists towards the application of motivational interviewing (MI) in a pharmacy consultation. In-depth quali ...[more]

PMID: 31159294

Similar Datasets

Project description:BackgroundThe technical hypothesis of Motivational Interviewing (MI) proposes that: (a) client talk favoring behavior change, or Change Talk (CT) is associated with better behavior change outcomes, whereas client talk against change, or Sustain Talk (ST) is associated with less favorable outcomes, and (b) specific therapist verbal behaviors influence whether client CT or ST occurs. MI consistent (MICO) therapist behaviors are hypothesized to be positively associated with more client CT and MI inconsistent (MIIN) behaviors with more ST. Previous studies typically examine session-level frequency counts or immediate lag sequential associations between these variables. However, research has found that the strongest determinant of CT or ST is the client's previous CT or ST statement. Therefore, the objective of this paper was to examine the association between therapist MI skills and subsequent client talk, while accounting for prior client talk.MethodsWe analyzed data from a manualized MI intervention targeting both alcohol misuse and sexual risk behavior in 132 adults seen in two hospital emergency departments. Transcripts of encounters were coded using the Motivational Interviewing Skills Code (MISC 2.5) and an additional measure, the Generalized Behavioral Intervention Analysis System (GBIAS). Using these measures, we analyzed the association between client talk following specific classifications of MICO skills, with the client's prior statement as a potential confounder or effect modifier.ResultsWith closed questions as the reference category, therapist simple reflections and paraphrasing reflections were associated with significantly greater odds of maintaining client talk as CT or ST. Open questions and complex reflections were associated with significantly greater odds of CT following ST, were not associated significantly with more ST following ST, and were associated with more ST following CT (i.e., through an association with less Follow Neutral).ConclusionsSimple and paraphrasing reflections appear to maintain client CT but are not associated with transitioning client ST to CT. By contrast, complex reflections and open questions appeared to be more strongly associated with clients moving from ST to CT than other techniques. These results suggest that counselors may differentially employ certain MICO technical skills to elicit continued CT and move participants toward ST within the MI dialogue.

Project description:Background Despite increasing interest in antimicrobial stewardship (AMS), little is known about the related practices and perceptions of community pharmacists. Objective To develop and validate a questionnaire to measure the current practices of, and barriers to community pharmacists' participation in AMS. Setting Community pharmacists in Tasmania, Australia. Method A questionnaire to explore AMS knowledge, current practices and perceptions of community pharmacists was developed. It was designed after rigorous literature review, expert opinion, and feedback from a group of community pharmacists. A convenience sample of 140 Tasmanian community pharmacists was used for this study. Cronbach's alpha and exploratory factor analysis (EFA) were used for reliability and validity. The questionnaire was hosted online, a link to which was sent by invitation e-mails, fax and post to community pharmacists in Tasmania, Australia. Main outcome measure Current AMS practices, perceived importance, barriers and facilitators of AMS. Results Eighty-five pharmacists responded to the survey yielding a response rate of 61%. EFA identified one factor solution for each of three perceptions scales and showed acceptable reliability. The Cronbach's alpha of perceived importance-understanding was 0.699, perceived importance-motivating was 0.734, perceived support from GPs was 0.890, operational barriers was 0.585, general facilitators was 0.615. Most pharmacists reported that they counselled patients on adverse effects (86%), drug interactions (94%), and allergies (96%). In contrast, less than half (43%) intervened with prescribers regarding antibiotic selection. Lack of training, lack of access to patients' records, limited interactions with general practitioners and absence of a reimbursement model were major barriers limiting community pharmacists' participation in AMS. Conclusion The questionnaire was of acceptable reliability and validity; a larger study will further contribute in its reliability and validity. Future studies utilising the questionnaire at national and international level may provide further insights into the determinants of community pharmacist's involvement in AMS.

Project description:BackgroundHeart failure (HF) is an important health problem and guidelines recommend multidisciplinary management. The pharmacist is an important member of the multidisciplinary heart failure team, both in the hospital and community setting. This study aims to explore the perceptions of community pharmacists on their role in HF care.MethodsWe conducted a qualitative study based on face-to-face semi-structured interviews with 13 Belgian community pharmacists between September 2020 and December 2020. We used the Qualitative Analysis Guide of Leuven (QUAGOL) method as guidance for data analysis until data saturation was reached. We structured interview content into a thematic matrix.ResultsWe identified two major themes: heart failure management and multidisciplinary management. Pharmacists feel responsible for the pharmacological and non-pharmacological management of heart failure, citing easy access and pharmacological expertise as important assets. Diagnostic uncertainty, lack of knowledge and time, disease complexity and difficulties in communication with patients and informal care providers are barriers to optimal management. General practitioners are the most important partners in multidisciplinary community heart failure management, although pharmacists perceive a lack of appreciation and cooperation and deplore communication difficulties. They feel intrinsically motivated to provide extended pharmaceutical care in HF but cite the lack of financial viability and information sharing structures as important barriers.ConclusionThe importance of pharmacist involvement in multidisciplinary heart failure teams is undisputed by Belgian pharmacists, who cite easy access and pharmacological expertise as important assets. They point out several barriers impeding evidence-based pharmacist care for outpatients with heart failure: diagnostic uncertainty and disease complexity, lack of multidisciplinary information technology and insufficient resources. We recommend that future policy should focus on improved medical data exchanges between primary and secondary care electronic health records as well as the reinforcement of interprofessional relationships between locally affiliated pharmacists and general practitioners.

Project description:Veterinarians often give advice in a persuasive form, a style that has been shown to evoke resistance to change in clients experiencing psychological ambivalence (i.e. those who see both advantages and disadvantages to changing). With this style of communication, veterinarians run the risk of counteracting their purpose to encourage clients to follow recommendations. Motivational interviewing (MI) is a client-centered communication methodology that aims to facilitate clients' internal motivation to change. In MI, Change Talk represents clients' own statements expressing consideration of, motivation for or commitment to behavior change and has been shown to be strongly correlated with behavior change. Sustain Talk is corresponding statements related to maintaining the status quo. The aim of this exploratory study was to evaluate the potential of MI to facilitate behavior change in veterinary herd health management (VHHM) by investigating the effect of dairy cattle veterinarians' MI skills on client Change and Sustain Talk. We recorded VHHM consultancies on 170 Swedish cattle farms performed by 36 veterinarians, randomly distributed into 2 groups: MI veterinarians (n = 18) had received 6-month training in MI and control veterinarians (n = 18) had not received any training. Veterinarians' MI skills were assessed using the Motivational Interviewing Treatment Integrity coding system 4.2.1 and categorized as poor_untrained, poor_trained, near moderate and moderate. Client communication was coded using the Client Language Easy Rating coding system. The effect of MI skills on Change Talk, Sustain Talk and Proportion of Change Talk(Change Talk divided by the sum of Sustain Talk plus Change Talk) was investigated using cross-classified regression models with random intercepts for veterinarian and client (farm). The models also included additional explanatory variables (e.g. type of veterinarian and client's satisfaction with the consultation). The veterinarian's MI skills were associated with the client's Change Talk, but results regarding Sustain Talk or Proportion of Change Talk were inconclusive. Clients of veterinarians reaching the highest (i.e. moderate) MI skills expressed 1.5 times more Change Talk than clients of untrained veterinarians. Clients of general large animal practitioners expressed less Sustain Talk than clients of animal health veterinarians and had higher Proportion of Change Talk. Results indicate that learning to practice MI may be one means to improve adherence to veterinary recommendations and to improve efficiency in VHHM services.

Project description:BackgroundLifestyle is one of the main determinants of people's health. It is essential to find the most effective prevention strategies to be used to encourage behavioral changes in their patients. Many theories are available that explain change or adherence to specific health behaviors in subjects. In this sense the named Motivational Interviewing has increasingly gained relevance. Few well-validated instruments are available for measuring doctors' communication skills, and more specifically the Motivational Interviewing.Methods/designThe hypothesis of this study is that the Scale for Measuring Motivational Interviewing Skills (EVEM questionnaire) is a valid and reliable instrument for measuring the primary care professionals skills to get behavior change in patients. To test the hypothesis we have designed a prospective, observational, multi-center study to validate a measuring instrument. -ScopeThirty-two primary care centers in Spain. -Sampling and Size: a) face and consensual validity: A group composed of 15 experts in Motivational Interviewing. b) Assessment of the psychometric properties of the scale; 50 physician- patient encounters will be videoed; a total of 162 interviews will be conducted with six standardized patients, and another 200 interviews will be conducted with 50 real patients (n=362). Four physicians will be specially trained to assess 30 interviews randomly selected to test the scale reproducibility. -Measurements for to test the hypothesis: a) Face validity: development of a draft questionnaire based on a theoretical model, by using Delphi-type methodology with experts. b) Scale psychometric properties: intraobservers will evaluate video recorded interviews: content-scalability validity (Exploratory Factor Analysis), internal consistency (Cronbach alpha), intra-/inter-observer reliability (Kappa index, intraclass correlation coefficient, Bland & Altman methodology), generalizability, construct validity and sensitivity to change (Pearson product-moment correlation coefficient).DiscussionThe verification of the hypothesis that EVEM is a valid and reliable tool for assessing motivational interviewing would be a major breakthrough in the current theoretical and practical knowledge, as it could be used to assess if the providers put into practice a patient centered communication style and can be used both for training or researching purposes. TRIALS REGISTRATION Dislip-EM study: NCT01282190 (ClinicalTrials.gov).

Dataset Information

Perceptions of UK Community Pharmacists on Current Consultation Skills and Motivational Interviewing as a Consultation Approach: A Qualitative Study.

Objectives

Publications

Perceptions of UK Community Pharmacists on Current Consultation Skills and Motivational Interviewing as a Consultation Approach: A Qualitative Study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets