Consumer perspectives of expanded practice in rural community pharmacy

Australian J Rural Health

Cairns²,

Glass

2021

Self Cite

Objective To explore pharmacist and stakeholder perspectives of pharmacists providing expanded services in rural community pharmacies. Design A descriptive qualitative study with an ethnographic lens of rural culture collected data via in‐depth semi‐structured interviews with stakeholder representatives and rural and remote pharmacists. Setting Regional, rural and remote practice settings as defined by the Modified Monash Model MM3‐MM7. Participants Twelve rural or remote pharmacists and eight stakeholder representatives from various government and professional organisations participated in the study. Main outcome measure Macro‐, meso‐ and micro‐level perspectives of pharmacists providing expanded pharmacy services in rural community pharmacies. Result At the macro‐level, both pharmacists and stakeholders agreed that governance is needed to clarify the terms used to describe expanded practice as a first step to developing an expanded practice framework. The meso‐level revealed that pharmacist participants expected expanded practice to improve rural pharmacist recruitment and retention through improved professional satisfaction. The importance of effective collaboration and coordination with other health care providers in a community was described by pharmacists and stakeholders to ensure success of expanded services. All participants agreed that sustainability of these services relied on appropriate remuneration. At the micro‐level, expanded pharmacy services are expected to save consumers’ time and money as patients are redirected into appropriate health care settings. Conclusion Enablers and barriers across policy, health professional, consumer and community levels need to be addressed in order to design and develop sustainable expanded pharmacy services to improve health service provision in rural and remote communities.

Section: Discussionmentioning

confidence: 99%

“…This demonstrates that although understandably some consumers currently would not be willing or able to pay, a greater percentage of consumers are willing to pay for services that they value. This in addition to government funding options needs to be considered when developing a framework 21 …”

Section: Discussionmentioning

confidence: 99%

Rural pharmacists and stakeholders perspectives of expanded pharmacy practice: A descriptive study

Australian J Rural Health

Cairns²,

Glass

2021

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“…This is a longitudinal pre- and post-design study of a community-pharmacy-based intervention piloted in two rural community pharmacies in Queensland, Australia. Co-design has been applied to this study with stakeholder, health professional, pharmacist and consumer perspectives from previous research utilised in conjunction with community consultation to inform the design of this study [ 8 – 10 ]. Prior to the intervention, participating pharmacies will collect usual care data for 8 weeks beginning November 2020.…”

Section: Methods and Designmentioning

confidence: 99%

“…Internationally, rural pharmacists are providing innovative models of care and working at expanded scopes of practice to better meet health needs [ 7 ]. Pharmacists, consumers and health professionals living in rural and remote locations in Australia are supportive of pharmacists expanding their service delivery to improve patient outcomes [ 8 – 10 ]. Rural pharmacists in Australia work in a unique setting with complex patients and limited access to health services and the potential for them to improve ear health care is unknown.…”

Section: Introductionmentioning

confidence: 99%

LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Programme): a feasibility study protocol for a community pharmacy-based ear health intervention

Cairns

Mantzourani

et al. 2021

Pilot Feasibility Stud

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Background Ear disease is a major cause of preventable hearing loss and is very common in rural communities, estimated to affect 1.3 million Australians. Rural community pharmacists are well placed to provide improved ear health care to people who are unable to easily access a general practitioner (GP). The purpose of this study is to apply an ear health intervention to the rural community-pharmacy setting in Queensland, Australia, to improve the management of ear disease. The aims are the following: (1) to evaluate the feasibility, potential effectiveness and acceptability of a community pharmacy-based intervention for ear health, (2) to evaluate the use of otoscopy and tympanometry by pharmacists in managing ear complaints in community pharmacy and (3) to evaluate the extended role of rural pharmacists in managing ear complaints, with the potential to expand nationally to improve minor ailment management in rural communities. Methods/design This is a longitudinal pre- and post-test study of a community-pharmacy-based intervention with a single cohort of up to 200 patients from two rural community pharmacies. Usual care practices pertaining to the management of ear complaints will be recorded prior to the intervention for 8 weeks. The intervention will then be piloted for 6 weeks, followed by a 12 month impact study. Patients aged > 13 years presenting to the pharmacies with an ear complaint will be invited to participate. Trained pharmacists will conduct an examination including a brief history, hearing screening, otoscopy and tympanometry assessments. Patients will be referred to a general practitioner (GP) if required, according to the study protocol. Patients will complete a satisfaction survey and receive a follow-up phone call at 7 days to explore outcomes including prescribed medications and referrals. Pharmacists and GPs will complete pre- and post- intervention interviews. Patient, pharmacist and GP data will be analysed using descriptive statistics and thematic analysis for the qualitative data. Discussion This study will demonstrate the implementation of a screening and referring ear health intervention in rural community pharmacy. Feasibility, potential effectiveness and acceptability of the intervention will be assessed. Trial registration Australian and New Zealand Clinical Trial Registry Number: ACTRN12620001297910.

“…Scoping and systematic reviews and studies including both qualitative and quantitative methods, involving community consultation with the public and health professionals, who work in rural and remote locations in Australia were undertaken in this component of the application [ 8 , 15 , 16 , 17 , 18 , 19 , 20 , 21 ], Table 1 provides the components of the PRECEDE-PROCEED model in the context of LISTEN UP.…”

Section: Methodsmentioning

confidence: 99%

Developing an Ear Health Intervention for Rural Community Pharmacy: Application of the PRECEDE-PROCEED Model

Cairns

Glass

2021

IJERPH

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Unaddressed hearing loss affects an estimated 466 million people worldwide, costing over $750 billion globally, with rural communities being particularly disadvantaged, due to the greater inequity in access to healthcare services. This mixed-methods study aimed to use the PRECEDE-PROCEED model to develop and pilot a rural community pharmacy-based ear health service, LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Program). The PRECEDE process involved an assessment of the predisposing, reinforcing and enabling constructs to support practice change through a scoping review, stakeholder surveys and interviews and consultation with governing bodies and regulatory authorities. The PROCEED segment structured the evaluation of the service pilot and informed planned implementation, process, impact and outcome evaluation. The pilot study conducted in February 2021 included 20 participants, with the most common ear complaints presented being pain, pressure or blockage. All these participants reported high levels of satisfaction with the service, would recommend the service to others and would attend the pharmacy first before seeing a GP for future ear complaints. The PRECEDE-PROCEED model provides a comprehensive model to guide the design of the LISTEN UP program, an innovative model, expanding services offered by rural community pharmacies, with preliminary results demonstrating high consumer satisfaction.