Pharmacists views on participating in New Zealand’s community pharmacy anticoagulation management service: a mixed-methods study

Beyene, Kebede; Chan, Amy Hai Yan; Barton, Emma; Yan, Shuyue; Singh, Sheryl; Basani, Apoorva; Voong, Johny; Harrison, Jeff

doi:10.1007/s11096-020-01148-4

Cited by 4 publications

(26 citation statements)

References 22 publications

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“…Whether conducted by a pharmacist through a service like CPAMS or done by one's self, point-of-care testing of INR levels was generally appreciated both by people taking OACs and their providers. [6][7][8][9][10] For example, CPAMS and self-testing were described as improving the convenience of INR testing by increasing the number of sites available to conduct testing while decreasing the wait time associated with queues for blood draws and receiving the results of these blood draws. [6][7][8]10 With this similarity in mind, we have nevertheless chosen to separate out the 2 forms of point-of-care testing in our presentation of the analysis below.…”

Section: Resultsmentioning

confidence: 99%

“…Two publications, derived from 1 study, described using a mixed-methods study design. 6,7 The remaining publications did not describe a study design, but all were qualitative and used 1 of the following for data analysis: thematic analysis, 8 framework analysis, 9 or content analysis. 10 Four publications (including the qualitative portions of both mixed-methods publications) used interviews to collect data [6][7][8][9] and 1 publication used text mining from blog posts.…”

Section: Methodsmentioning

confidence: 99%

“…Of the 5 publications, 3 were from the UK 8-10 and 2 were from Aotearoa New Zealand. 6,7 Participant Population…”

Section: Country Of Originmentioning

confidence: 99%

“…Across 5 publications there were a total of 43 people taking OACs engaged in self-testing, 8,9 7 people taking OACs engaged in CPAMS, 7 42 health care professionals providing CPAMS, 6,7 and 6 health care professionals wishing to provide CPAMS. 6 One study was not able to report participant characteristics given its design as a content analysis of blogs. 10…”

Section: Country Of Originmentioning

confidence: 99%

“…Of the 5 included publications, 3 were identified as being of a moderate degree of credibility and confirmability. 6,7,10 One of these publications 6 separated their presentation of data from their analysis by placing "data" (i.e., participant quotes) in tables cordoned off from the narrative text. While this may be a practical exercise for disciplines oriented toward the statistical representations of analysis (e.g., clinical epidemiology) or result from pressures to meet journal word limits that prevent authors from fully elaborating the connections between data and analysis in the text, their confirmability (i.e., whether an analysis makes sense in light of the presented data) was difficult to assess as a result.…”

Section: Summary Of Critical Appraisalmentioning

confidence: 99%

See 4 more Smart Citations

Point-of-Care Testing of International Normalized Ratios for People on Oral Anticoagulants: A Rapid Qualitative Review

Herington¹,

MacDougall²

2021

cjht

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The opportunity to engage in self-testing can be experienced as simultaneously liberating and constraining. While self-testing may be appreciated as a form of point-of-care testing for international normalized ratio (INR) levels, some people engaged in self-testing were concerned with the limited amount of personalized care they received. People using oral anticoagulants described community pharmacist-led anticoagulation management services (CPAMS) as a convenient way of testing INR levels and learning about their health needs. Community pharmacists felt they were well-situated to provide care through CPAMS, but acknowledged the importance of ongoing training, oversight, and appropriate levels of resourcing.

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Section: Resultsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

“…Of the 5 publications, 3 were from the UK 8-10 and 2 were from Aotearoa New Zealand. 6,7 Participant Population…”

Section: Country Of Originmentioning

confidence: 99%

Section: Country Of Originmentioning

confidence: 99%

Section: Summary Of Critical Appraisalmentioning

confidence: 99%

See 3 more Smart Citations

Point-of-Care Testing of International Normalized Ratios for People on Oral Anticoagulants: A Rapid Qualitative Review

Herington¹,

MacDougall²

2021

cjht

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A Qualitative Systematic Review of Facilitators of and Barriers to Community Pharmacists–Led Anticoagulation Management Service

Egunsola

Mastikhina

et al. 2021

Ann Pharmacother

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Objective: To identify the facilitators of and barriers to the implementation of Community Pharmacists–Led Anticoagulation Management Services (CPAMS). Data Sources: MEDLINE, EMBASE, CINAHL, Cochrane Database of Systematic Reviews, and Cochrane CENTRAL Register of Controlled Trials were searched from inception until August 20, 2021. Study Selection and Data Extraction: All abstracts proceeded to full-text review, which was completed by 2 reviewers. Data extraction was completed by a single reviewer and verified. Analysis was completed using best-fit framework synthesis. Data Synthesis: A total of 17 articles reporting on CPAMS from 6 jurisdictions were included: 2 Canadian provincial programs (Nova Scotia, Alberta), a national program (New Zealand), and 3 cities in the United Kingdom (Whittington and Brighton and Hove) and Australia (Sydney). Facilitators of CPAMS included convenience for patients, accessibility for patients, professional satisfaction for pharmacists, increased efficiency in anticoagulation management, improved outcomes, enhanced collaboration, and scalability. Barriers included perceived poor quality of care by patients, resistance by general practitioners, organizational limits, capping of the number of eligible patients, and cost. Relevance to Patient Care and Clinical Practice: The barriers and facilitators identified in this review will inform health policy makers on the implementation and improvement of CPAMS for patients and health care practitioners. Conclusion and Relevance: CPAMS has been implemented in 6 jurisdictions across 4 countries, with reported benefits and challenges. The programs were structurally similar in most jurisdictions, with minor variations in implementation. New anticoagulation management programs should consider adapting existing frameworks to local needs.

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A national survey of pharmacists and interns in Aotearoa New Zealand: provision and views of extended services in community pharmacies

McDonald

Morris

Pledger

et al. 2021

BMC Health Serv Res

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Background Changes in pharmacy models of care, services and funding have been occurring internationally, moving away from the traditional dispensing role to more extended patient-facing roles utilising pharmacists’ clinical skills. This study aimed to identify the extended services offered by community pharmacy in Aotearoa New Zealand and the barriers and facilitators to extended services provision. The study is unique in that it includes intern (pre-registration) pharmacists. Methods An online survey, conducted in 2018, of all pharmacists and intern (pre-registration) pharmacists working in a community pharmacy. Data were analysed using descriptive statistics and regression analyses. Results The results are based on replies from 553 community pharmacists and 59 intern pharmacists (response rate: 19 and 26% respectively). Both pharmacists (83%) and interns (85%) want to work at the top of their scope of practice. Wide variation exists in the specific services individual pharmacists offer. Most pharmacists were accredited to supply the emergency contraceptive pill (95%), sildenafil for erectile dysfunction (86%) and trimethoprim for uncomplicated urinary tract infection (85%). Fewer were able to immunise (34%) or to supply selected oral contraceptives (44%). Just under a quarter could provide a Medicines Use Review (MUR) or Community Pharmacy Anticoagulation Management Service (CPAMS). Of the pharmacists not already accredited, 85% intended to gain accreditation to supply selected oral contraceptives, 40% to become vaccinators, 37% to offer CPAMS and 30% MUR. Interns expressed strong interest in becoming accredited for all extended services. Poisson regression analyses showed key factors supporting the likelihood of providing extended services were owner and management support and appropriate space and equipment. Being excited about the opportunities in community pharmacy, having employer funding and time for training and sufficient support staff were also statistically significant. Conclusions Pharmacists need time and a supportive management structure to enable them to deliver extended services. Health policy with a greater strategic emphasis on funding services and pharmacist training, and developing technician support roles, will help to minimise or eliminate some of the barriers to role expansion both in Aotearoa New Zealand and internationally.

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Pharmacists views on participating in New Zealand’s community pharmacy anticoagulation management service: a mixed-methods study

Cited by 4 publications

References 22 publications

Point-of-Care Testing of International Normalized Ratios for People on Oral Anticoagulants: A Rapid Qualitative Review

Point-of-Care Testing of International Normalized Ratios for People on Oral Anticoagulants: A Rapid Qualitative Review

A Qualitative Systematic Review of Facilitators of and Barriers to Community Pharmacists–Led Anticoagulation Management Service

A national survey of pharmacists and interns in Aotearoa New Zealand: provision and views of extended services in community pharmacies

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