Patient Counseling in Community Pharmacy and its Relationship with Prescription Payment Methods and Practice Settings

1993 ◽  
Vol 27 (10) ◽  
pp. 1173-1179 ◽  
Author(s):  
Dennis W. Raisch
Keyword(s):  
Observational Data ◽  
Financial Incentives ◽  
Participation Rate ◽  
Community Pharmacies ◽  
Practice Setting ◽  
Payment Method ◽  
Patient Counseling ◽  
Payment Methods ◽  
Reported Data ◽  
Trained Observers

OBJECTIVE: To determine whether patient counseling activities in community pharmacies are related to payment method and practice setting. DESIGN: Randomly selected pharmacists voluntarily performed self-data collection (39 percent participation rate) of counseling activities for 40 hours. Observational data were also collected by trained observers. SETTING: Community pharmacies. RESULTS: Forty-seven pharmacists in national chain pharmacies and 26 in independent pharmacies collected data on 3766 counseling events. Patient counseling rates, defined as percentage of patients counseled per prescription per pharmacist, were significantly higher (p<0.05) for self-pay (median 12.9 percent) and Medicaid (median 13.0 percent) than for capitation patients (median 7.9 percent). Rates were somewhat higher (p=0.06) for chain (median 17.7 percent) than for independent pharmacists (10.7 percent). Although there was no difference in terms of pharmacist-initiated counseling, chain pharmacists had higher rates of patient-initiated counseling per prescription (median 4.3 percent) than independent pharmacists (median 2.7 percent) (p<0.01). Counseling information was related to payment method and practice setting. A significantly higher percentage (p<0.01) of counseling events for capitation patients pertained to chronic therapies (33.6 percent) compared with counseling events involving patients using other payment methods (21.8–24.8 percent). A strong correlation between observational data and self-reported data was found (Pearson r=0.696, p<0.001). CONCLUSIONS: The finding that pharmacists counsel capitation patients less frequently may be attributable to financial incentives or to pharmacists' perception that these patients do not need to be counseled. Independent pharmacists' higher number of capitation patients and increased workloads may have affected their counseling activities. These findings have implications for pharmacy service reimbursement programs, practice conditions, and continuing education programs.

Effect of Therapeutic Class on Counseling in Community Pharmacies

2002 ◽  
Vol 36 (5) ◽  
pp. 781-786 ◽  
Author(s):  
Kirsti K Vainio ◽  
Marja SA Airaksinen ◽  
Tarja T Hyykky ◽  
K Hannes Enlund
Keyword(s):  
Multiple Logistic Regression Analysis ◽  
Community Pharmacists ◽  
Important Variable ◽  
Community Pharmacies ◽  
Patient Counseling ◽  
Question Asking ◽  
Factors Associated ◽  
Independent Variables ◽  
Therapeutic Class ◽  
Trained Observers

OBJECTIVE: To assess the effect and importance of the therapeutic class of a drug as a determinant for verbal counseling by community pharmacists. METHODS: Direct external observations (n = 1431) of pharmacist—customer interactions at the point of delivery of prescription medicines were conducted in 7 community pharmacies in Finland. Trained observers noted whether the pharmacist provided information on directions for use, mode of action, and adverse effects. To examine factors associated with counseling, a multiple logistic regression analysis was constructed, with the dependent variable being counseling of any of the 3 observed topics. In addition to therapeutic class, other independent variables were the pharmacy; pharmacist's age, gender, and degree; and the customer's age, gender, previous use of medicine, and question asking. RESULTS: Provision of counseling differed significantly according to therapeutic classes. Counseling on any of the 3 observed topics was most likely to be provided for customers with antibiotics (80%) and least likely for customers with gynecologic preparations (18%). Differences between therapeutic classes remained statistically significant when the effects of the other variables were controlled for. Other significant predictors for any verbal counseling were the pharmacy, customer's previous use of the medicine, and question asking. CONCLUSIONS: Therapeutic class is an important variable that should be included in further studies and considered when comparing studies on patient counseling in community pharmacies.

Preparing pharmacists to increase naloxone dispensing within community pharmacies under the Pennsylvania standing order

2020 ◽  
Author(s):  
Heather M Santa ◽  
Samira G Amirova ◽  
Daniel J Ventricelli ◽  
George E Downs ◽  
Alexandra A Nowalk ◽  
...  
Keyword(s):  
Community Pharmacists ◽  
The United States ◽  
Health Concern ◽  
Community Pharmacies ◽  
Opioid Overdose ◽  
Patient Counseling ◽  
Opioid Use ◽  
Overdose Prevention ◽  
Standing Order ◽  
Overdose Deaths

Abstract Purpose Opioid misuse and overdose deaths remain a public health concern in the United States. Pennsylvania has one of the highest rates of opioid overdose deaths in the country, with Philadelphia County’s being 3 times higher than the national average. Despite several multimodal interventions, including use of SBIRT (screening, brief intervention, and referral to treatment) methods and naloxone distribution, the rate of overdose deaths remains high. Methods To gain insights on strategies for improving access to naloxone and naloxone distribution by pharmacists in Philadelphia County, a study was conducted in 11 community pharmacies (chain and independent) in Philadelphia. Twenty-four pharmacists were recruited and completed SBIRT and naloxone trainings. Each pharmacy elected to have at least 1 pharmacy champion who received additional training on and helped develop pharmacy site–specific naloxone dispensing protocols. Results Pre-post survey results showed a reduction in stigmatizing attitudes regarding naloxone dispensing and an increase in pharmacists’ understanding of the standing order and appropriate naloxone use. There was an increase in pharmacists’ self-reported confidence in their ability to appropriately identify, discuss, and dispense naloxone to patients. All pharmacies increased their average monthly dispensing rate following protocol implementation. Conclusion Pharmacists who received both trainings were more likely to change naloxone dispensing practices, leading to an overall increase in naloxone dispensing by community pharmacists. The study addressed overall gaps in pharmacists’ knowledge, reduced stigma, and prepared pharmacists to address opioid use and overdose prevention with their patients. The described pharmacist-led patient counseling and intervention service for overdose prevention may be explored as a model for other community pharmacies to adopt to improve naloxone dispensing and similar interventions to reduce overdose deaths.

Applying Patient Counseling to the Practice Setting (Scenarios)

2020 ◽  
pp. 63-89
Author(s):  
Harvey M. Rappaport ◽  
Kelly S. Straker ◽  
Tracy S. Hunter ◽  
Joseph F. Roy
Keyword(s):  
Practice Setting ◽  
Patient Counseling

scholarly journals Influence of Mobile Payment on Bus Boarding Service Time

2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Guojun Chen ◽  
Weilun Chen ◽  
Shuyang Zhang ◽  
Dong Zhang ◽  
Haode Liu
Keyword(s):  
Service Time ◽  
Regression Models ◽  
Mobile Payment ◽  
Qr Code ◽  
Payment Method ◽  
Ic Card ◽  
Payment Methods ◽  
First Choice ◽  
Service Efficiency ◽  
Bus Service

A new form of mobile payment, Quick Response (QR) code, has been a popular way of paying bus fares in China since 2017. Compared with conventional payment methods, cash or IC card, QR code shows a lot of differences in response time, recognition accuracy, and payment procedure, which significantly influences the boarding service time (BST) for passengers. However, no research has considered its efficiency. This study, therefore, tries to fill this gap and investigate its influence on BST. Sufficient ride-check data were collected, and the influence of the QR code payment method on BST was examined through a set of regression models. Passengers pay the bus fare with different payment methods as their first choice; nevertheless, when the payment fails, they may transfer among them. According to the payment choice, result, and process, we introduce the first-choice-based, the last-choice-based, and the choice-transfer-based models, respectively. The scenario with delays in calling out the QR code was considered in the choice-transfer-based model. The onboard crowdedness was regarded as a categorical variable to determine the regime of the boarding process in all models. We conduct empirical analysis in Wuhan, and this study can help to identify the influence of the QR code payment method on BST, consequently, improving bus service efficiency.

scholarly journals Emergency Contraception Access and Counseling in Urban Pharmacies: A Comparison between States with and without Pharmacist Prescribing

Pharmacy ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 105 ◽  
Author(s):  
Rebecca H. Stone ◽  
Sally Rafie ◽  
Dennia Ernest ◽  
Brielle Scutt
Keyword(s):  
Continuing Education ◽  
San Francisco ◽  
Emergency Contraception ◽  
Primary Source ◽  
Community Pharmacies ◽  
Patient Access ◽  
Patient Counseling ◽  
The Public ◽  
Adult Females ◽  
Primary Endpoints

Pharmacists are often the primary source of emergency contraception (EC) access and patient information. This study aims to identify differences in pharmacist-reported EC access and counseling between states which do or do not permit pharmacist-prescribed EC. This prospective, mystery caller study was completed in California (CA), which permits pharmacist-prescribed EC after completion of continuing education, and Georgia (GA), which does not. All community pharmacies that were open to the public in San Diego and San Francisco, CA, and Atlanta, GA were called by researchers who posed as adult females inquiring about EC via a structured script. Primary endpoints were EC availability and counseling. Statistical analyses completed with SPSS. Researchers called 395 pharmacies, 98.2% were reached and included. Regarding levonorgestrel (LNG), CA pharmacists more frequently discussed (CA 90.4% vs. GA 81.2%, p = 0.02), stocked (CA 89.5% vs. GA 67.8%, p < 0.01), and correctly indicated it “will work” or “will work but may be less effective” 4 days after intercourse (CA 67.5% vs. GA 17.5%, p < 0.01). Ulipristal was infrequently discussed (CA 22.6% vs. GA 3.4%, p < 0.01) and rarely stocked (CA 9.6% vs. GA 0.7%, p < 0.01). Pharmacists practicing in states which permit pharmacist-prescribed EC with completion of required continuing education may be associated with improved patient access to oral EC and more accurate patient counseling.

Criteria for Assessing the Appropriateness of Patient Counseling in Community Pharmacies

2000 ◽  
Vol 34 (2) ◽  
pp. 170-175 ◽  
Author(s):  
Paul R Ward ◽  
Paul Bissell ◽  
Peter R Noyce
Keyword(s):  
Random Sample ◽  
Nominal Group Technique ◽  
Nominal Group ◽  
Assessment Criteria ◽  
Community Pharmacies ◽  
Reliability Testing ◽  
Validity And Reliability ◽  
Patient Counseling ◽  
General Applicability ◽  
The Uk

OBJECTIVE: To develop valid, reliable criteria for assessing the appropriateness of the management of common ailments and nonprescription drug therapy in community pharmacies in the UK. METHODS: The criteria were developed by an expert panel using the nominal group technique. The validity of the criteria was tested by surveying a random sample of pharmacists who were asked to rate the importance of each criterion on a semantic differential scale from 1 (low) to 7 (high). Subsequently, the reliability of the criteria was assessed: a random sample of pharmacists were each asked to apply the criteria to four vignettes of patient counseling on two separate occasions. RESULTS: All assessment criteria exceeded our predefined level of face, content, and consensual validity. In reliability testing, the overall assessment of appropriateness, along with five component assessment criteria, surpassed our predefined level of reliability. Three criteria, however, did not meet our predefined standard. These criteria were rational content of advice, rational product choice, and referral to another health professional. CONCLUSIONS: This represents the first systematic attempt to develop an instrument of general applicability for assessing the appropriateness of patient counseling and to subject it to rigorous validity and reliability testing. We suggest that further work is required to refine the criteria that did not meet reliability standards and to understand the decision-making processes underlying the assessment of vignettes of patient counseling.

scholarly journals Community Pharmacies, Drug Stores, and Antibiotic Dispensing in Indonesia: A Qualitative Study

2021 ◽  
Author(s):  
Astri Ferdiana ◽  
Marco Liverani ◽  
Mishal Khan ◽  
Luh Putu Lila Wulandari ◽  
Yusuf Ari Mashuri ◽  
...  
Keyword(s):  
Qualitative Study ◽  
Financial Incentives ◽  
Access To Medicines ◽  
Careful Examination ◽  
Community Pharmacies ◽  
Unintended Effects ◽  
Policy Reforms ◽  
Self Medication ◽  
Middle Income ◽  
Dispensing Practices

Abstract Background Inappropriate dispensing of antibiotics at community pharmacies is an important driver of antimicrobial resistance (AMR), particularly in low- and middle-income countries. Thus, a better understanding of dispensing practices is crucial to inform national, regional, and global responses to AMR. This requires careful examination of the interactions between vendors and clients, sensitive to the context in which these interactions take place. Methods In 2019, we conducted a qualitative study to examine antibiotic dispensing practices and associated drivers in Indonesia, where self-medication with antibiotics purchased at community pharmacies and drug stores is widespread. Data collection involved 60 in-depth interviews with staff at pharmacies and drug stores (n = 31) and their clients (n = 29), conducted in an urban (Bekasi) and a semi-rural location (Tabalong) to capture different markets and different contexts of access to medicines. Interview transcripts were analysed using thematic content analysis. Results A common dispensing pattern was the direct request of antibiotics by clients, who walked into pharmacies or drug stores and asked for antibiotics without prescription, either by their generic/brand name or by showing an empty package or sample. A less common pattern was recommendation to use antibiotics by the vendor after the patient presented with symptoms. Drivers of inappropriate antibiotic dispensing included poor knowledge of antibiotics and AMR driving patient demand, financial incentives to maximise medicine sales in an increasingly competitive market, the unintended effects of health policy reforms, and weak regulatory enforcement. Conclusions Inappropriate dispensing of antibiotics in community pharmacies is the outcome of complex interactions between vendors and clients, shaped by wider and changing socio-economic processes. Concerted action should be taken to address this complexity and involve such providers in the development and implementation of AMR national action plans.

Emergency Contraception Access and Counseling in Metropolitan and Nonmetropolitan Pharmacies in Georgia

2021 ◽  
pp. 089719002110528
Author(s):  
Rebecca H. Stone ◽  
Savannah Gross ◽  
Brielle Reardon ◽  
Henry N. Young
Keyword(s):  
Emergency Contraception ◽  
Geographic Location ◽  
Community Pharmacies ◽  
Patient Counseling ◽  
Chi Square ◽  
Ulipristal Acetate ◽  
Timely Access ◽  
Mystery Shopper ◽  
Stock Information ◽  
Work Up

Background: Emergency contraception (EC) efficacy is dependent on timing of administration. Adequate pharmacy stock information and accurate patient counseling are important to ensure timely access. Objective: This study evaluates pharmacist reported availability and counseling for levonorgestrel (LNG) and ulipristal acetate (UPA), and identifies differences between caller type and pharmacies in metropolitan vs nonmetropolitan areas of Georgia. Methods: This prospective, randomized, telephone-based study included 25% of Georgia community pharmacies, stratified by geographic location. Calls were made by investigators, first posing as a mystery shopper inquiring about EC stock and efficacy, then 3–6 weeks later as a researcher inquiring about EC stock. Analysis utilized descriptive statistics, chi Square, and logistic regression. Results: Of 600 pharmacies, the mystery shopper caller reached 86%: 74% of pharmacists initially discussed LNG, 57.1% had it stocked, more often in metropolitan areas (OR 1.7, 95% CI 1.08–2.6). Ulipristal acetate was discussed by 1.9% and reported in-stock < 1%. Of those who discussed window of efficacy, 79% indicated LNG would either not work 4 days after intercourse or they were unsure. The research caller successfully completed a second call for 64% of pharmacies: 57% stocked LNG, 3% stocked UPA, and UPA was more likely to be stocked in metropolitan pharmacies. Conclusion: In Georgia, UPA availability is poor, and nonmetropolitan pharmacies were less likely to stock LNG and UPA. A minority of pharmacists correctly indicated that LNG may work up to 120 hours after intercourse. Strategies are needed to overcome barriers to EC availability in community pharmacies and support pharmacists’ EC counseling.

Relationships among Prescription Payment Methods and Interactions between Community Pharmacists and Prescribers

1992 ◽  
Vol 26 (7-8) ◽  
pp. 902-906 ◽  
Author(s):  
Dennis W. Raisch
Keyword(s):  
Community Pharmacists ◽  
Third Party ◽  
Fee For Service ◽  
Payment Method ◽  
Prescribing Errors ◽  
Payment Methods ◽  
Service Mode ◽  
Types Of Information

OBJECTIVE: This research was performed to examine community pharmacists' interactions with prescribers and to determine if these interactions are related to payment method. DESIGN: Randomly selected pharmacists (47 in chain pharmacies and 26 in independent pharmacies) collected data concerning prescriber interactions for a 40-hour period. These interactions were analyzed in terms of payment methods, prescriber acceptance, and types of information discussed. RESULTS: Information concerning 730 interactions by 72 pharmacists was obtained. Payment methods were related to the frequency of interactions per pharmacist (p<0.01). There were higher percentages of interactions for self-pay (median 2.2 percent) and Medicaid (median 1.8 percent) prescriptions than for third-party fee-for-service (mode 0 percent) or capitation prescriptions (mode 0 percent). Type of information discussed was related to payment method. The vast majority of information provided by pharmacists (91 percent) was accepted by prescribers. The rate of acceptance was 97 percent for prescriber-initiated interactions versus 88 percent for pharmacist- or patient-initiated interactions (p<0.01). CONCLUSIONS: Relationships between payment method and interactions were identified. These findings may be attributable to prescribing policies and reimbursement policies. Prescribing policies that restrict prescribers to a formulary may help make them become more adept at using those products; thus, they will make fewer prescribing errors. Reimbursement policies that require patients to consistently use a specific pharmacy (i.e., capitation) may help pharmacists become more familiar with the patient's prescription history. Therefore, interactions with prescribers are needed less frequently for these patients' prescriptions.

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