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Receiving a pharmaceutical care service compared to receiving standard pharmacy service: How do patients in Sweden differ with regard to perceptions of medicine use and the pharmacy encounter?
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. (The Pharmaceutical Outcomes Research Group)
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences. (The Pharmaceutical Outcomes Research Group)
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Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy.
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2010 (English)In: Research in Social and Administrative Pharmacy, ISSN 1551-7411, E-ISSN 1934-8150, Vol. 6, no 3, 185-195 p.Article in journal (Refereed) Published
Abstract [en]

Background: Qualitative research has shown that gaining control of medicine treatment, increased feelings of safety and empowerment are central concepts in patients’ perceptions of a pharmaceutical care (PC) service provided in Sweden. However, little is known about the relationship between patient-perceived outcomes and the level of community pharmacy services that they receive. Objective: To describe and compare patients who had previously received a PC service and patients who had received a standard pharmacy service (SS) with regard to their perceptions of medicine use and the pharmacy encounter. Methods: Cross-sectional survey design comparing matched groups of patients who were previously selected to receive a PC service or who had received a standard service. Patients who were 60 years or older and used 5 or more prescription medicines concomitantly were included in the survey. Questionnaires included questions about feelings of safety in drug therapy, general health, drug-related problems (DRPs), medication beliefs, adherence and experiences of pharmacy encounters. Results: Patients receiving the PC service used more prescription medicines, had poorer self-reported health, and felt less safety in their medicine therapy, than did patients in SS. PC patients reported that they felt safer with medications, felt a genuine interest from the pharmacist, received important information, and felt more prepared to see the doctor after having spoken to the pharmacist, than did patients in SS. DRPs reported to a greater extent by patients receiving the PC service included difficulties opening containers, worries about side effects, experiences of side effects, worries about drug-drug interaction and inadequate treatment effects. Adherence and medication beliefs showed no statistical difference between groups. Conclusion: Patients receiving a PC service are a worried, vulnerable and information seeking group. In comparison to patients receiving SS, the PC patients are more insecure about their medicine therapy, although talking to a pharmacist increased their self-reported feelings of safety and provided better preparation for visits to the doctor.

Place, publisher, year, edition, pages
Pittsburgh: ELSEVIER , 2010. Vol. 6, no 3, 185-195 p.
Keyword [en]
Community pharmacy, Pharmaceutical care
National Category
Social and Clinical Pharmacy
Research subject
Social Pharmacy
Identifiers
URN: urn:nbn:se:uu:diva-108971DOI: 10.1016/j.sapharm.2009.09.002ISI: 000208738900003PubMedID: 20813332OAI: oai:DiVA.org:uu-108971DiVA: diva2:241914
Available from: 2009-10-06 Created: 2009-10-06 Last updated: 2017-12-13Bibliographically approved
In thesis
1. Counselling in Swedish Community Pharmacies: Understanding the Process of a Pharmaceutical Care Service
Open this publication in new window or tab >>Counselling in Swedish Community Pharmacies: Understanding the Process of a Pharmaceutical Care Service
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Community pharmacy practice is moving towards patient care and away from the mere dispensing of medicines. In this movement, which is guided by the philosophy of Pharmaceutical care (PC), new counselling services emerge.

The purpose of the thesis was to add knowledge about the real-world provision of PC services by studying a defined PC service in Swedish pharmacies.

Specific aims of this thesis were to investigate the experiences of professionals working with or close to the service and to describe the content of consultations, counselling behaviour and patterns of follow-up. Further aims were to characterise patients receiving the service and describe their perceived outcomes, in relation to standard service.

Data were collected via focus groups, telephone interviews, observations, a patient medication record database and a cross-sectional survey.

The practitioners reported greater use of their pharmaceutical knowledge and provision of more thorough patient support. Perceived barriers in delivering the service included difficulties in documenting and getting commitment from colleagues, managers and prescribers. Doctors working close to PC pharmacies held varying opinions about the service.

Consultations dealt with issues potentially improving the outcomes of medical treatment, but the level of patient centredness varied and was limited by the practitioners’ focus on the computer screen. The rate of follow-up evaluations was modest, but was higher at pharmacies with a high volume of patients receiving the service.

PC patients were mostly elderly and female, using about 10 prescription drugs. In comparison to patients receiving standard service, they were more worried, vulnerable and information-seeking. At the same time, their feelings of safety following the pharmacy visit were more pronounced than those of patients receiving standard service. They also felt better prepared for doctor visits.

In order for community pharmacy to better meet patients’ needs and optimise PC services, increased attention should be given to implementation strategies, interprofessional collaboration and educational efforts focusing on patient centredness.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 71 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Pharmacy, ISSN 1651-6192 ; 107
Keyword
Community pharmacy, Counselling, Pharmaceutical care, Sweden
National Category
Social and Clinical Pharmacy
Research subject
Social Pharmacy
Identifiers
urn:nbn:se:uu:diva-108973 (URN)978-91-554-7622-9 (ISBN)
Public defence
2009-11-16, Auditorium Minus, Museum Gustavianum, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2009-10-26 Created: 2009-10-06 Last updated: 2009-10-26Bibliographically approved

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