Implementing oral chemotherapy services in community pharmacies: a qualitative study of chemotherapy nurses' and pharmacists' views

Abstract

The study suggests there are significant concerns and challenges associated with community pharmacies implementing any of the proposed levels of oral chemotherapy services. Educational and training opportunities for community pharmacists and the careful development of safe infrastructures will be essential in the future planning and implementation of any community pharmacy oral chemotherapy service.

Perceived barriers to the implementation of clinical pharmacy services in a metropolis in Northeast Brazil

“…A collaborative relationship between pharmacists and healthcare professionals, with the aim of improving patient and health system outcomes, has become an important goal to be achieved since pharmacists changed their original focus from drug supply towards a focus on patient care [ 45 – 47 ]. Studies indicate that barriers related to pharmacist-healthcare team interaction may hinder the CPS implementation process [ 32 , 48 ]. Accordingly, inter-professional collaborative relationships should be encouraged to help decrease resistance and increase understanding and awareness among the healthcare team regarding the implementation of CPS.…”

Solidarity or dissonance? A systematic review of pharmacist and GP views on community pharmacy services in the UK

“…Pharmacists voiced enthusiasm towards the concept of extended services, commonly referring to the accessibility/convenience of pharmacy services to patients and providing an alternative healthcare destination to GPs. Pharmacists in two studies mentioned potential financial benefits to patients (Butt & Ream, 2016;Pumtong et al, 2008) with one of these studies highlighting the importance of minor ailments to those in highly deprived areas who may not be able to afford over-the-counter medications (Pumtong et al, 2008). Other patient benefits discussed were reassurance (Lucas & Blenkinsopp, 2015;Morecroft et al, 2015;Thomas et al, 2010;Urwin, Wright, Twigg, & McGough, 2016), increased patient confidence (Urban, Rivers, & Morgan, 2008) and improved clinical outcomes (Campion, Hilton, & Irving, 2007;Latif & Boardman, 2008;Lucas & Blenkinsopp, 2015;Morecroft et al, 2015;Ogunbayo, Schafheutle, Cutts, & Noyce, 2015;Paudyal, Hansford, Scott Cunningham, & Stewart, 2010;Wells, Thornley, Boyd, & Boardman, 2014).…”

“…They perceived the main benefit to GPs of extended pharmacy services was to reduce workload pressures (Agomo, Ogunleye, & Portlock, 2016a;Atkins et al, 2016;Morecroft et al, 2015;Pumtong et al, 2008), freeing up GPs time to deal with more urgent matters (Heller, Johnstone, & Cameron, 2017;Morecroft et al, 2015). In terms of their own benefit, most pharmacists viewed these services as an opportunity for role expansion/professional development, improving their relationships with patients (Butt & Ream, 2016;Campion et al, 2007;Latif et al, 2016;Paudyal et al, 2010;Pumtong et al, 2008;Urwin et al, 2016) and GPs (Agomo et al, 2016a;Pumtong et al, 2008). However, this optimism was not entirely shared by all pharmacists as some were less enthusiastic about extended services and roles (Butterworth et al, 2017;Ogunbayo et al, 2015;Pfleger, McHattie, Diack, McCaig, & Stewart, 2008;Pumtong et al, 2008;Saramunee et al, 2014;Savage et al, 2013;Sohanpal et al, 2016;Wells et al, 2014).…”

“…This commonly stemmed from a perceived lack of confidence among pharmacists to provide extended services. In two studies, pharmacists highlighted the need to train locum pharmacists to provide the services on offer as many pharmacies hired them (Akram et al, 2012;Butt & Ream, 2016). GPs also often doubted pharmacists' competence to provide extended services (Atkins et al, 2016;Blenkinsopp et al, 2008;Bradley et al, 2012;Saramunee et al, 2014), expressing concerns with their ability to provide services beyond medicines management (Atkins et al, 2016;Blenkinsopp et al, 2008;Bradley et al, 2012;Saramunee et al, 2014).…”

The Position of Clinical Pharmacists in Delivering Advanced Pharmacy Practice Education and Services: Short Communication

“…Oral chemotherapy services, wellness services, cognitive memory screening, psychotherapy, pharmacogenetic testing, health education, concordance, counselling, medication therapy management (MTM), follow-up and referral services Determine educational and training opportunities for community pharmacists, thereby improve patient-centred experiences that supplement their confidence, knowledge, and skill in providing advanced pharmacy services [35][36][37][38][39][40][41][42][43][44][45][46] Surgical department Cardiopulmonary resuscitation (CPR) Determine pharmacist participation on CPR teams in health care delivery organizations [47,48] Regulatory scrutiny Drug Pricing Evaluate and monitor drug pricing through the use key metrics on cost savings achieved, maintenance costs, and other aspects of program involvement [49] In-patient Pharmaceutical care Provision of pharmaceutical care, identification of drug therapy problems, prevention of adverse drug reactions and monitoring of drug therapy management [48,50,51] Out-patient department Ambulatory care, patient education Assertively advancing ambulatory care practice, to achieve the national priorities of improving patient care, adherence, patient health, and affordability of care [48,52,53] Pediatric department Pediatric care Provision of advanced pediatric care [48,54] Intensive care units and oncology department Palliative care services Introducing the concept of 'advanced practice roles' in pharmacy within the new integrated regionalized palliative care service [48,55,56] …”