The results from past studies about the effects of second-generation e-prescribing systems on community pharmacists' outcomes and practices are inconclusive, and the claims of effectiveness and efficiency of such systems have not been supported in all studies. There is a strong need to study the factors that lead to positive outcomes for the users of these systems.
It is important to share information about other countries' pharmacists to optimize cross-border medical cooperation. This paper examines the dispensing systems and the work done by pharmacists in the United Kingdom, Germany, France, Thailand, and Malaysia so as to compare these countries' medical practices and develop a cohesive vision for the future of Japanese pharmacists. All five of the countries have dispensing assistants. Pharmacists in Japan have duties of inventory control, drug dispensing, and providing medication advice. In contrast, assistants working in other countries are responsible for some aspects of dispensing and inventory control, allowing the pharmacists to spend their time and competency in instructing patients on how to take their medication. Because of this, pharmacists were actively involved with health promotion intervention in the United Kingdom, Germany, and France. It is hoped that work done by Japanese pharmacists would transition from primarily dispensing drugs to patient care, advice, and counseling to enrich overall health promotion and health/nutrition counseling.
The role of pharmacists has transformed significantly because of changes in pharmacists' training and population health demands. Within this context, community pharmacists are recognized as important health personnel for the provision of extended health services. Similarly, in Malaysia, the need to transform community pharmacy practice has been discussed by all interested parties; however, the transition has been slow due in part to the nonexistence of a dispensing separation policy between pharmacists and medical doctors in private community practices. For decades, medical doctors in private community practices have had the right to prescribe and dispense, thus diluting the role of community pharmacists because of overlapping roles. This article explores dispensing separation in Malaysia and, by taking into account the needs of health professionals and health care consumers, suggests a mechanism for how dispensing separation practice can be implemented.
BACKGROUND: Effective communication between community pharmacists and patients, particularly with a patient-centered approach, is important to address patients' concerns relating to antidepressant medication use. However, few studies have investigated community pharmacists' communication behaviors in depression care.
OBJECTIVE: To characterize community pharmacist-patient interactions during consultations involving use of antidepressants.
METHODS: Twenty community pharmacists received 3 simulated patient visits involving issues related to the use of antidepressants: 1) patient receiving a first-time antidepressant prescription; 2) patient perceiving lack of efficacy of antidepressants after 2 weeks of treatment, and 3) patient intending to discontinue treatment prematurely. All 60 encounters were audio-recorded and analyzed using the Roter Interaction Analysis System (RIAS), a quantitative coding system that characterizes communication behaviors through discrete categories. A patient-centeredness score was calculated for each encounter.
RESULTS: The majority of pharmacist communication was biomedical in nature (50.7%), and focused on providing therapeutic information and advice on the antidepressant regimen. In contrast, only 5.4% of pharmacist communication was related to lifestyle/psychosocial exchanges. There were also few instances of emotional rapport-building behaviors (8.6%) or information gathering (6.6%). Patient-centered scores were highest in the scenario involving a first-time antidepressant user, as compared to other scenarios involving issues with continued therapy.
CONCLUSIONS: Community pharmacists appeared to adopt a "medication-centered" approach when counseling on antidepressant issues. There is scope for improvement in patient-centered communication behaviors, particularly lifestyle/psychosocial discussions, facilitating patient participation, and emotional rapport-building. The RIAS appears suited to characterize brief consultations in community pharmacies and can provide a framework in guiding communication training efforts. Further research is needed to assess the impact of pharmacist communication behaviors on patient care outcomes.
KEYWORDS: Antidepressant adherence; Patient-centeredness; Pharmacist–patient communication; Roter Interaction Analysis System
In New Zealand, pharmacists are funded to provide adherence support to their patients via a service called "Medicines Use Review" (MUR). The service is based on the assumption that the medication regimen is clinically appropriate and therefore does not include a clinical review. However, whether or not pharmacists make clinical recommendations to patients during MUR is unclear.
BACKGROUND: The use of generic medicines has been increasing steadily internationally, primarily because of cost concerns. Knowledge and use patterns of generic medicines in Iraq have not yet been measured.
OBJECTIVE: This study aimed to explore consumers' perception and knowledge on issues relating to generic medicine use in Basrah, Iraq.
METHODS: A qualitative approach was used to gather information from consumers in Basrah, Iraq. A purposive sample of 14 consumers in Basrah was interviewed face-to-face using a semistructured interview guide.
RESULTS: Thematic analysis of the interviews identified 5 major themes: understanding of the term "generic medicine," preference for generic medicine, refusal of generic medicine, generic substitution, and education on the use of generic medicines. Not all the consumers were familiar with the term "generic medicine;" they were familiar with the term "commercial medicine." Most of the participants understood that generics cost less compared with their branded counterparts. Most of the consumers said that their physicians and pharmacists had given them information on generics.
CONCLUSION: Knowledge of generic medicines may be lacking among consumers in Iraq. Development of consumer education on generics by health care providers is required to support the implementation of the policy on generic medicines in Iraq.
The practice of pharmacy and, consequently, pharmacy curricula have undergone significant changes over the past years in response to a rapidly changing economic, political, and social environment. Within this context, the pharmacist's role had expanded to include more direct interaction with the public in terms of the provision of health information and advice on the safe and rational use of medications. To carry out these roles effectively, pharmacists need to be well prepared on how to deal with patients' behavior and psychology. The understanding of patient sociobehavioral aspects in the medication use process is paramount to achieving optimal clinical and humanistic outcomes from therapy. The concept of behavioral sciences and health psychology are embedded as the fundamental concepts in the field of social pharmacy, and thus it is imperative that this should be taught and nurtured to future pharmacy practitioners. Based on the growing needs for future pharmacists to be exposed to issues in social pharmacy, many pharmacy schools around the world have adopted this subject to be part of their standard curriculum. In this commentary, a discussion of the needs of social pharmacy courses in pharmacy curriculum will be addressed in the context of both developed and developing countries.
BACKGROUND: Diabetic patients' experience and knowledge about their medication play an important role in determining the success of long-term adherence in their disease management.
OBJECTIVE: This study aimed to explore diabetic patients' experience and knowledge about diabetes and its medication and to understand the factors contributing to medication adherence in Malaysian population.
METHODS: A qualitative research approach was adopted to gain a better understanding of the current perceptions and knowledge held by diabetic patients. Twelve patients were interviewed using a semi-structured interview guide. Saturation point of the interview was reached after the 10th interview, and no more new themes emerged from the subsequent 2 interviews. All interviews were transcribed verbatim and analyzed by means of a standard content analysis framework.
RESULTS: A total of 4 themes were identified from the interview analysis: knowledge about diabetes and its medication, experiences of adverse effects of medication, issues related to adherence, and the impact of medical and family relationships on well-being. Most of the patients were aware of the disease known as diabetes but unaware which type of diabetes they were suffering from. None of the participants knew the adverse effects of their medication, and most of them considered it to be safe. Financial barriers, forgetfulness, self-medication, and quality of relationships with doctor and family members seem to be the factors that challenge adherence in our sample of diabetic patients.
CONCLUSION: This study identified a number of key themes that might be useful in enhancing the awareness of experiences, knowledge, adherence, and attitudes of Malaysian patients with diabetes. More efforts should be taken to estimate how diabetic patients take their medication, and a well-planned educational program is also required to educate and encourage patients to practice a healthy lifestyle.