Trust in independent community pharmacies: Do employee-related factors matter?
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ABSTRACT:
SUBMITTER: Theron E
PROVIDER: S-EPMC7433283 | biostudies-literature | 2020 Jan
REPOSITORIES: biostudies-literature
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Project description:BACKGROUND:Community and patient engagement in the healthcare system and biomedical research are prerequisites for eliminating health disparities. We conducted a "listening tour" to enhance our understanding of multilevel factors associated with community trust. METHODS:Using community-based participatory research (CBPR) methods, we conducted a phenomenological qualitative study. "Town-hall" style discussions were held at nine sites across an urban, Midwestern city. We recruited adults (N = 130) via community networks, social media, flyers, and word-of-mouth. Demographic assessments were self-administered and listening tour sessions were conducted by trained moderators. Themes were framed within the social ecological model (SEM; intrapersonal, interpersonal, institutional, community, and policy levels). RESULTS:Participants were mostly female (68%), African American (80%), had health coverage (97%) and were diagnosed with a chronic health condition (71%). The overarching theme was sociodemographic differences in distrust, such that African Americans and deaf/hearing impaired participants perceived disparities in healthcare, a lower quality of care, and skepticism about biomedical research, relative to Whites. CONCLUSIONS:The depth of distrust for healthcare providers, systems, and researchers in underserved communities remains strong and complex. Findings highlight the need to understand the lived experiences of community members, and how distrust is maintained. Multilevel interventions to increase trust and the accrual of underrepresented populations into clinical trials are needed.
| S-EPMC6765868 | biostudies-other
Project description:Prior research on trust repair has focused primarily on investigating verbal responses to breaches of trust. Although consistently implicated in violations, the role of affect in the repair process has been mostly ignored. Using a scenario-based paradigm, we conducted an experimental study to examine the value of mistrusted party's empathy, specific responses to an integrity-based violation (apology vs. denial), and nature of consequences (personal vs. organizational), as well as their interactive effects, on trust repair. Consequently, we sought to merge work on verbal responses with affect. Major findings indicated that presence of mistrusted party's empathy functioned to repair trust better than its absence and, when coupled with a denial of culpability, produced markedly increased perceptions of violator's integrity. These findings contribute to our understanding of how leaders influence followers through affect, informing both emotion and trust theory.
| S-EPMC6349725 | biostudies-literature
Project description:The pharmacist prescribing service was legally permitted in 2019 in Switzerland to face challenges in the health system; however, there has been a lack of implementation. The aims of this study were to identify implementation factors and to evaluate pharmacy association interventions that aim to support implementation. A qualitative study with two methods was carried out: (1) twelve semi-structured interviews with community pharmacists were recorded, transcribed, and a thematic analysis was carried out using the Consolidated Framework of Implementation Research (CFIR); (2) questionnaires were submitted to the six pharmacy associations of French-speaking Switzerland. The main barriers found were non-reimbursement by health insurance companies, medications' lack of clinical relevance, a negative perception of GPs, and a lack of time. The main facilitators were the availability of service information, pharmacies belonging to chains/groups, a reduction in the medical consultation burden, and the accessibility of pharmacies. Five associations answered, revealing different initiatives supporting implementation, but none of them had strategies at the political level nor communication strategies aimed at patients or GPs. Based on the CFIR, the most frequent implementation factors were highlighted, and this classification facilitates the transposition of the results to other contexts. The results will allow the development of targeted strategies and add the role of the pharmacy associations, which should be considered in future studies.
| S-EPMC10661259 | biostudies-literature
Project description:BackgroundOnly 60% of adults nationwide and just 36.8% of adults in Alabama have immunization data recorded in an Immunization Information System (IIS). The objective of this study, which took place before the coronavirus disease 2019 (COVID-19) pandemic, was to evaluate the impact of an IIS training program on pharmacists' IIS enrollment, participation, awareness, knowledge, intention, and attitudes.MethodsA randomized controlled trial was conducted in 2019 among Alabama pharmacists (N = 41) practicing in independently owned pharmacies and providing vaccination services but whose pharmacy was not enrolled in Alabama's IIS (Immunization Patient Registry with Integrated Technology [ImmPRINT]). Intervention pharmacists were offered a 2-hour IIS training program, including an online continuing pharmacy education article, demonstration videos, implementation guide, and informational flyer. Control pharmacies received the informational flyer only. Pharmacy-level outcomes, including enrollment and participation, were obtained from ImmPRINT administrative records. Pharmacist-level outcomes, including awareness, knowledge, intention, and attitudes, were self-reported using baseline, 1-month, and 3-month surveys. Two-way mixed analysis of variance, chi-square, and independent t tests were used to analyze differences in outcomes between and within groups.ResultsEnrollment in ImmPRINT was significantly greater among intervention pharmacists' pharmacies (P = 0.035). In particular, 59.1% of intervention pharmacies compared with 26.3% of control pharmacies were enrolled in ImmPRINT at 3 months. No statistically significant differences were found between groups in terms of participation in ImmPRINT. Intervention pharmacists' awareness of IIS was significantly greater than control pharmacists (P = 0.028) at 1 month (postintervention). Furthermore, the IIS training program significantly improved intervention pharmacists' knowledge (P = 0.030) and attitudes (P = 0.016) toward IIS over 3 months compared with the control group.ConclusionsThis pharmacist-centered training program focused on practical strategies to integrate IIS into pharmacy workflow. Results show that pharmacists' enrollment, awareness, knowledge, and attitudes significantly improved as a result of this training. As pharmacists become more involved in immunization efforts, particularly in response to COVID-19, awareness of and participation in responsible immunization documentation are critical.
| S-EPMC8917836 | biostudies-literature
Project description:AimTo characterize the usage profile and the factors associated with the prolonged use of proton pump inhibitor drugs in a community pharmacy.MethodologyThis is a cross-sectional, prospective and observational study involving interviews with 410 patients who acquired PPI for their own use from community pharmacies. To characterize the factors associated with the prolonged use of PPI, a multivariate logistic regression model was used.ResultsPantoprazole (42.7%) and omeprazole (31%) were the most acquired PPIs, prescribed mainly by gastroenterologists (49.5%). They are used in the morning, especially for gastrointestinal symptoms, however, they had been consumed for more than 5 years in 30% of cases. The factors associated with prolonged use are old age (OR 1.03 CI95% 1.01-1.05), body mass index (OR 1.07 CI95% 1.01-1.12), use of non-steroidal anti-inflammatories (OR 3.18 CI95% 1.20-8.43) and selective serotonin reuptake inhibitors (OR 3.5 95% CI 1.39-8.88).ConclusionPPIs are adequate in terms of indication and form of use, however, prolonged use associated with old age, being overweight and use of anti-inflammatories and antidepressants is frequent.
| S-EPMC8191994 | biostudies-literature
Project description:BackgroundTrust is a forward-looking covenant between the patient and the doctor where the patient optimistically accepts his/her vulnerability. Trust is known to improve the clinical outcomes.ObjectivesTo explore the factors that determine patients' trust in doctors and to segment the community based on factors which drive their trust.SettingResource-poor urban and rural settings in Tamil Nadu, a state in southern India.ParticipantsA questionnaire was administered to a sample of 625 adult community-dwelling respondents from four districts of Tamil Nadu, India, chosen by multistage sampling strategy.Outcome measuresThe outcomes were to understand the main domains of factors influencing trust in doctors and to segment the community based on which of these domains predominantly influenced their trust.ResultsFactor analysis revealed five main categories, namely, comfort with the doctor, doctor with personal involvement with the patient, behaviourally competent doctor, doctor with a simple appearance and culturally competent doctor, which explained 49.3% of the total variance. Using k-means cluster analysis the respondents were segmented into four groups, namely, those who have 'comfort-based trust', 'emotionally assessed trust', who were predominantly older and belonging to lower socioeconomic status, those who had 'personal trust', who were younger people from higher socioeconomic strata of the community and the group who had 'objectively assessed trust', who were younger women.ConclusionsTrust in doctors seems to be influenced by the doctor's behaviuor, perceived comfort levels, personal involvement with the patient, and to a lesser extent by cultural competence and doctor's physical appearance. On the basis of these dimensions, the community can be segmented into distinct groups, and trust building can happen in a strategic manner which may lead to improvement in perceived quality of care.
| S-EPMC3855707 | biostudies-literature
Project description:IntroductionAutomated dose dispensing (ADD) is being introduced in several countries and the use of this technology is expected to increase as a growing number of elderly people need to manage their medication at home. ADD aims to improve medication safety and treatment adherence, but it may introduce new safety issues. This descriptive study provides insight into the nature and consequences of medication incidents related to ADD, as reported by healthcare professionals in community pharmacies and hospitals.MethodsThe medication incidents that were submitted to the Dutch Central Medication incidents Registration (CMR) reporting system were selected and characterized independently by two researchers.Main outcome measuresPerson discovering the incident, phase of the medication process in which the incident occurred, immediate cause of the incident, nature of incident from the healthcare provider's perspective, nature of incident from the patient's perspective, and consequent harm to the patient caused by the incident.ResultsFrom January 2012 to February 2013 the CMR received 15,113 incidents: 3,685 (24.4%) incidents from community pharmacies and 11,428 (75.6%) incidents from hospitals. Eventually 1 of 50 reported incidents (268/15,113 = 1.8%) were related to ADD; in community pharmacies more incidents (227/3,685 = 6.2%) were related to ADD than in hospitals (41/11,428 = 0.4%). The immediate cause of an incident was often a change in the patient's medicine regimen or relocation. Most reported incidents occurred in two phases: entering the prescription into the pharmacy information system and filling the ADD bag.ConclusionA proportion of incidents was related to ADD and is reported regularly, especially by community pharmacies. In two phases, entering the prescription into the pharmacy information system and filling the ADD bag, most incidents occurred. A change in the patient's medicine regimen or relocation was the immediate causes of an incident.
| S-EPMC4109935 | biostudies-literature
Project description:The provision of professional pharmacy services by community pharmacists continues to be limited, particularly in low and middle income countries. It was postulated that multiple management challenges faced by community pharmacists contribute to this situation.The primary aim of the research was to determine the challenges faced in the management of community pharmacies in Sarawak (the largest state in Malaysia), and practical strategies to cope and overcome the challenges.Semi-structured interviews were carried out with community pharmacists practising in Sarawak. Purposive and snowball sampling were employed to ensure a diverse group of informants. The interviews were audio-recorded and transcribed verbatim, with the resultant data analysed using thematic analysis. Data collection, coding, interpretation were carried out iteratively until theoretical saturation.Twenty respondents from different demographic characteristics were recruited. Six major themes were identified. Management challenges faced by community pharmacists traverse five major domains: market competition, legislative issues, customers' knowledge and expectations, macroeconomic impacts and operational challenges. Most of these challenges require government intervention to be resolved. In the meantime, improving customer service and expanding the range of professional services were seen as the most viable strategies to cope with existing challenges. The main concern is that current legislative and economic landscape may hinder these strategies. Enactment of dispensing separation and more protective measures against market competition were suggested to alleviate the challenges faced.Numerous management challenges faced by community pharmacists that distract them from delivering professional pharmacy services have been highlighted. Urgent affirmative actions by the government are warranted in supporting community pharmacists to realise and maximise their potentials.
| S-EPMC5499352 | biostudies-other
Project description:BackgroundThe environment in which a patient lives influences their health outcomes. However, the degree to which community factors are associated with readmissions is uncertain.ObjectiveTo estimate the influence of community factors on the Centers for Medicare & Medicaid Services risk-standardized hospital-wide readmission measure (HWR)-a quality performance measure in the U.S.Research designWe assessed 71 community variables in 6 domains related to health outcomes: clinical care; health behaviors; social and economic factors; the physical environment; demographics; and social capital.SubjectsMedicare fee-for-service patients eligible for the HWR measure between July 2014-June 2015 (n = 6,790,723). Patients were linked to community variables using their 5-digit zip code of residence.MethodsWe used a random forest algorithm to rank variables for their importance in predicting HWR scores. Variables were entered into 6 domain-specific multivariable regression models in order of decreasing importance. Variables with P-values <0.10 were retained for a final model, after eliminating any that were collinear.ResultsAmong 71 community variables, 19 were retained in the 6 domain models and in the final model. Domains which explained the most to least variance in HWR were: physical environment (R2 = 15%); clinical care (R2 = 12%); demographics (R2 = 11%); social and economic environment (R2 = 7%); health behaviors (R2 = 9%); and social capital (R2 = 8%). In the final model, the 19 variables explained more than a quarter of the variance in readmission rates (R2 = 27%).ConclusionsReadmissions for a wide range of clinical conditions are influenced by factors relating to the communities in which patients reside. These findings can be used to target efforts to keep patients out of the hospital.
| S-EPMC7584172 | biostudies-literature
Project description:BACKGROUND:Community pharmacies provide an important healthcare service, which is broadly established, and constitutes the preferred and initial contact for members of the community. The significant value of community pharmacies was further highlighted during the COVID-19 pandemic crisis. OBJECTIVE:The assessment of community pharmacies preparedness for the COVID-19 pandemic. METHODS:A cross-sectional interview survey of 1018 community pharmacies working in four regions of Egypt (South, East, Centre, and North). Data collection was conducted from 8-19 April 2020. RESULTS:Availability of personal protective equipment (PPE) and medication was better than alcohol (70% conc.). Home delivery services were available in 49.1% of pharmacies. Infection control measures covering interactions between staff were in place in up to 99.5% of pharmacies. Conversely, there was less frequent availability of contactless payment (29.1%), hand sanitizers (62.1%) or masks (86.5%) for customer use, or a separate area for patients with suspected COVID-19 (64%). Verbal customer education (90.4%) was used preferably to written (81.3%). Despite high clinical knowledge and awareness (97.6%-99.2%), only 8.8% of pharmacists had reported suspected COVID-19 cases, however this varied significantly with pharmacist demographics (geographic region P < 0.001; pandemic training p < 0.001; position p = 0.019; age p = 0.046). CONCLUSIONS:Government and policymakers strive to mitigate the shortage of PPE and medication. More attention should be given to infection control measures around interactions between staff and customers to ensure community pharmacists are fit and able to provide continuity in their important role. Educating customers using regularly-updated posters, banners or signs will contribute to decreasing contact with patients, and reducing the number and duration of visits to the pharmacy. Pandemic preparedness of community pharmacists must also extend to reporting procedures. By avoiding under-reporting or over-reporting, community pharmacists will contribute to accurate monitoring of the national spread of infection.
| S-EPMC7211678 | biostudies-literature