This study aimed to identify the roles of community pharmacists (CPs) during the coronavirus disease 2019 (COVID-19) pandemic, the differences in their role performance compared with their perceived importance, and limiting factors.

A cross-sectional online survey of CPs was conducted. The CPs self-measured the importance and performance of each role during the pandemic using a 5-point Likert scale. A paired t-test was used to compare each role’s importance and performance scores. A logistic regression analysis of the roles with low performance scores, despite their level of importance, was conducted to determine the factors affecting performance. The limiting factors were also surveyed.

The 436 responses to the questionnaire were analyzed. The performance scores were significantly lower than the perceived importance scores for 15 of the 17 roles. The source and update frequency of COVID-19 information and participation in outreach pharmaceutical services were associated with low performance scores. Insufficient economic compensation, the lack of communication channels, and legal limitations were the limiting factors in performing the CPs’ roles.

The participation in outreach pharmaceutical services, economic compensation, and communication channel should be improved to motivate the CPs in performing their roles.

Washington State established a Memorandum of Understanding (MOU) and operational plan in 2012 to coordinate pharmacy infrastructure and workforce during a public health emergency. The objectives of this study were to adapt the MOU operational plan to the context of the coronavirus disease 2019 (COVID-19) pandemic and assess community pharmacies’ organizational readiness to implement COVID-19 testing and vaccination.

This mixed methods study was conducted June-August 2020. Three facilitated discussions were conducted with community pharmacists and local health jurisdiction (LHJ) representatives to test the MOU operational plan. Facilitated discussions were thematically analyzed to inform adaptations to the operational plan. Pharmacists were surveyed to assess their organization’s readiness for COVID-19 testing and vaccination before and after the facilitated discussions using the Organizational Readiness for Implementing Change (ORIC) measure. Survey responses were analyzed using descriptive statistics.

Six pharmacists from 5 community pharmacy organizations and 4 representatives from 2 LHJs participated in at least 1 facilitated discussion. Facilitated discussions resulted in 3 themes and 16 adaptations to the operational plan. Five of 6 community pharmacists (83% response rate) completed both surveys. Mean organizational readiness decreased from baseline to follow-up for COVID-19 testing and vaccination.

Operational plan adaptations highlight opportunities to strengthen MOUs between local and state health departments and community pharmacies to support future emergency preparedness and readiness efforts.

International guidelines on diabetes control strongly encourage the setting-up of therapeutic educational programs (TEP). However, more than half of the patients fail to control their diabetes a few months post-TEP because of a lack of regular follow-up by medical professionals. The DIAB-CH is a TEP associated with the follow-up of diabetic patients by the community pharmacist.

To compare the glycated hemoglobin (HbA1c) and body mass index (BMI) in diabetic patients of Control (neither TEP-H nor community pharmacist intervention), TEP-H (TEP in hospital only) and DIAB-CH (TEP-H plus community pharmacist follow-up) groups.

A comparative cohort study design was applied. Patients included in the TEP-H from July 2017 to December 2017 were enrolled in the DIAB-CH group. The TEP-H session was conducted by a multidisciplinary team composed of two diabetologists, two dieticians and seven nurses. The HbA1c level and the BMI (when over 30 kg/m2 at M0) of patients in Control (n = 20), TEP-H (n = 20) and DIAB-CH (n = 20) groups were collected at M0, M0 + 6 and M0 + 12 months. First, HbA1c and BMI were compared between M0, M6 and M12 in the three groups with the Friedman test, followed by the Benjamini-Hochberg post-test. Secondly, the HbA1c and BMI of the three groups were compared at M0, M6 and M12 using the Kruskal-Wallis test.

While no difference in HbA1c was measured between M0, M6 and M12 in the Control group, Hb1Ac was significantly reduced in both TEP-H and DIAB-CH groups between M0 and M6 (P = 0.0072 and P = 0.0034, respectively), and between M0 and M12 only in the DIAB-CH group (P = 0.0027). In addition, a significant decrease in the difference between the measured HbA1c and the target assigned by diabetologists was observed between M0 and M6 in both TEP-H and DIAB-CH groups (P = 0.0072 and P = 0.0044, respectively) but only for the patients of the DIAB-CH group between M0 and M12 (P = 0.0044). No significant difference (P > 0.05) in BMI between the groups was observed.

The long-lasting benefit on glycemic control of multidisciplinary group sessions associated with community pharmacist-led educational interventions on self-care for diabetic patients was demonstrated in the present study. There is thus evidence pointing to the effectiveness of a community/hospital care collaboration of professionals on diabetes control in primary care.

Community pharmacies are recognised as an under-utilised, accessible resource that could support the urgent care agenda. This study aimed to provide a snapshot of the number and nature of urgent care requests presented to a sample of community pharmacies in three counties in southern England, to determine how requests are managed, whether management is appropriate, as assessed by a group of experts, and whether customers receiving the care are satisfied with pharmacists’ interventions.

A representative sample of pharmacists across the region was invited to keep a log-book documenting all urgent care requests over a two-week period. Data were analysed to estimate frequency and type of requests and to compare consultations in core and non-core hours. Log-book entries were scrutinised blind by an expert panel to determine appropriateness of pharmacist’s responses. Customers receiving pharmacists’ interventions were surveyed to assess satisfaction.

Seventeen pharmacies kept log-books detailing 432 urgent care consultations, equating to 13 consultations per pharmacy per week. Of these, 70% (n = 302) were dealt with by the pharmacist in-house with 30% (n = 130) resulting in referrals. Locum pharmacists were significantly more likely to refer to other NHS services than regular pharmacists. Over half the requests were for symptom management, skin problems presenting most commonly (38% of all symptoms presented). Forty-seven percent of consultations were considered to have ‘averted the need for other NHS services’. Pharmacists’ referral (but not assessment of urgency) was deemed appropriate by the expert panel in 90% of consultations. Ninety-five percent of customers surveyed were satisfied with the service and would use the pharmacy again.

Extrapolating findings across the study population (approximately 4.4 million) suggests that community pharmacists manage over 11 500 urgent care consultations per week, with 8050 managed independently. These prevent approximately 5400 other NHS encounters, while also meeting customer expectations and expert panel endorsement.

The aim of this study was to investigate the basic preparedness of rural community pharmacies to continue operations during and immediately following a disaster.

In 2014, we conducted a telephone survey (N = 990) of community pharmacies in 3 rural areas: North Dakota/South Dakota, West Virginia, Southern Oregon/Northern California regarding whether they had a formal disaster/continuity plan, offsite data backup, emergency power generation, and/or had a certified pharmacy immunizer on staff. Logistic regression and chi square were performed using Stata 11.1.

Community pharmacies in rural areas (≤50.0 persons/mile2) were less likely to have emergency power (odds ratio [OR] = 0.59; 95% confidence interval [CI]: 0.32-1.07) or certified pharmacy immunizer on staff (OR = 0.47; 95% CI: 0.34-0.64). Pharmacies in lower income areas were less likely to have emergency power and offsite data backup or a formal disaster plan (OR = 0.70; 95% CI: 0.49-0.99) compared with pharmacies in higher income areas. Community pharmacies in areas of higher percent elderly population were less likely to have emergency power (OR = 0.54; 95% CI: 0.39-0.73), or certified pharmacy immunizer on staff (OR = 0.65; 95% CI: 0.47-0.91) compared with chain pharmacies in areas with lower percent elderly population.

Being in a rural, low-income, or high-elderly area was associated with lower likelihood of basic preparedness of community pharmacies.

This study aimed to assess the consistency and replicability of these process measures during provision of the Italian Medicines Use Review (I-MUR).

Medication review is a common intervention provided by community pharmacists in many countries, but with little evidence of consistency and replicability. The I-MUR utilised a standardised question template in two separate large-scale studies. The template facilitated pharmacists in recording medicines and problems reported by patients, the pharmaceutical care issues (PCIs) they found and actions they took to improve medicines use.

Community pharmacists from four cities and across 15 regions were involved in the two studies. Patients included were adults with asthma. Medicines use, adherence, asthma problems, PCIs and actions taken by pharmacists were compared across studies to assess consistency and replicability of I-MUR.

The total number of pharmacists and patients completing the studies was 275 and 1711, respectively. No statistically significant differences were found between the studies in the following domains: patients’ demographic, patients’ perceived problems, adherence, asthma medicines used and healthy living advice provided by pharmacists. The proportion of patients in which pharmacists identified PCIs was similar across both studies. There were differences only in the incidence of non-steroidal anti-inflammatory drug use, the frequency of potential drug-disease interactions and in the types of advice given to patients and GPs.

The use of a standardised template for the I-MUR may have contributed to a degree of consistency in the issues found, which suggests this intervention could have good replicability.

This service aimed to improve patient access to treatment for urinary tract infections (UTI), impetigo and exacerbation of chronic obstructive pulmonary disease (COPD) and relieve pressure on general practice and out of hours services.

In 2016, a service (Pharmacy First) was introduced in Forth Valley for the management of UTI, impetigo and exacerbation of COPD using patient group directions in community pharmacies. Trained pharmacists supplied a limited range of prescription medicines. Pathways for GP referral were defined. After 5 months of implementation, the service was evaluated.

A quantitative evaluation was undertaken. Feedback was sought from patients, GPs, pharmacists and GP reception staff, using structured questionnaires. Pharmacy records were used to assess referrals and pharmacy data summarised the number and type of consultations. Basic cost data was obtained from the Health Board.

In all, 75 pharmacies (of 76), and all 55 GP practices in the area, participated in the service. Over a 5-month period, 1189 cases were managed, the majority being for UTI (75.4%) followed by impetigo (15.2%), then COPD (9.3%). Of all cases, 77.9% were prescribed medication by the pharmacist, 9.1% were given advice only and 16.7% were referred to the GP. Independent clinical assessment of a random sample of 30 GP referrals considered all to be ‘appropriate’. Feedback was received from 69 pharmacists, 34 GPs, 54 reception staff and 73 patients. Patients were very satisfied with the service, most frequently citing the ‘quick and efficient’ access to treatment, and a ‘professional service’. Two thirds of GPs (67%) and 59% of reception staff found the service useful, mainly because it reduced pressure on GP appointments. A further cost benefit evaluation would allow objective assessment of the value of this service.

This study was to perform unit cost analysis of managing common illnesses comparing between a primary care unit (PCU) and a community pharmacy.

PCU is a key point of access for primary care in Thailand. Although a community pharmacy is an ideal setting, it has not been successfully incorporated in Thailand's health service. Common illnesses are encountered everyday by community pharmacists, an appropriate compensation for this service has not been established.

A primary care service of one educational institution was a study site. Eight common illnesses were emphasised. Patient visits were observed, prospectively at community pharmacy and retrospectively at PCU, during August to October 2013. Labour and material costs related to management of common illnesses were recorded. Total cost divided by total patient visits determined the unit cost. For the community pharmacy, patients were followed up after 3–14 days of visit to evaluate the effectiveness. Sensitivity analysis was performed by varying direct medical cost at ±10–30%.

At the community pharmacy, community pharmacists performed multiple tasks including interviewing and assessing patients, choosing an appropriate treatment and dispensing. Of 9141 visits, 775 (8.5%) with common illnesses were included. Upper respiratory disorder was found the highest 41.9% (325/755). Unit cost of treatment ranged from 54.16 baht (£1.18) for pain to 82.71 baht (£1.80) for skin disorder. Two-thirds of pharmacy visits (77.9%, 539/692) reported complete recovery. Managing common illnesses at the PCU was performed by nurse assistants, nurses, doctors and pharmacists. Of 6701 patient visits to the PCU, 1545 (23.1%) visits were at least one of the eight illnesses. Upper respiratory disorder was the majority, 53.0% (771/1454). Unit cost of treatment ranged from 85.39 baht (£1.86) for eye/ear to 245.93 baht (£5.36) for sexual health. Managing common illness at a community pharmacy shows satisfactory effectiveness with lower unit cost.

This research sought (a) to investigate the similarities and differences in how pharmaceutical services are provided by community pharmacies (CPs) and dispensing doctor practices (DPs) and (b) to identify the issues relevant to determining the quality of pharmaceutical services in these settings.

UK pharmaceutical services, including dispensing prescriptions and public health advice, can be provided from both (CP) and, in rural areas, (DP). While there is much similarity between CPs and DPs in the types of services provided, there is also the potential for variation in service quality across settings.

A postal questionnaire of DPs and CPs in South West England was conducted to provide a descriptive overview of pharmaceutical services across the settings. A subsection of questionnaire respondent sites were selected to take part in case studies, which involved documentary analyses, observation and staff interviews.

Survey response was 39% for CPs (52/134) and 48% (31/64) for DPs. There were three CP and four DP case study sites, with 17 staff interviews. More pharmacies than practices were open at the weekend and they had more staff trained above NVQ level 2. Both doctors and pharmacists saw themselves as medicines experts, as being accessible and having good relationships with patients. Workplace practices and organisational ethos varied both within and across settings, with good practice observed in both. Overall, CPs and DPs have much in common. Workplace culture and an evidence-based approach to checking prescriptions and error reporting need to be considered in future assessments of service quality.

To explore public health nutritionists’ perceptions of nutrition and its place in community pharmacy (CP) presently and into the future; and to explore perceived opportunities, feasibility and scope of public health nutrition (PHN) interventions in CP, with a focus on maternal and infant nutrition.

Qualitative data were gathered through semi-structured interviews and drew on hermeneutics as the theoretical framework for analysis and interpretation.

Queensland, Australia.

Public health nutritionists, identified through purposive, criterion sampling, were chosen due to (i) their role as potential stakeholders, (ii) their knowledge and emphasis on nutrition and (iii) their practice experience.

Opportunities for PHN action focused primarily on actions relating to early nutrient supplementation in pregnancy and breast-feeding protection and promotion. Opportunities in CP were constrained by practitioners’ perception of (i) conflict between health care and commercial interests in CP, (ii) problematic practices in CP and (iii) values and motivations of practitioners and other stakeholders in the CP sector. Strategies were suggested to improve practices and enhance the setting from a PHN perspective. Participants suggested both collaborative and regulatory approaches to achieve settings-based changes, identifying the need for these to coexist for effective outcomes.

Public health nutritionists suggest that opportunities for PHN action are constrained by perceived conflicted interests and that consumers need to be adequately protected from the influence of commercial interests. PHN action in this setting needs adequate reflection on evidence as well as ethics ensuring that practices are ‘for the good’ of mothers and infants.

The RESPECT (Randomised Evaluation of Shared Prescribing for the Elderly in the Community, randomised over Time) trial was a multi-centre pragmatic trial of pharmaceutical care in the community, which took place in five areas of East and North Yorkshire.

This paper reports a qualitative study designed to explore attitudes of community pharmacists towards the process of ‘pharmaceutical care’ as tested in the trial.

We recruited 21 pharmacists from the trial into four focus groups, moderated by an independent researcher, and analysed using a thematic qualitative approach.

Four themes emerged from the data: the pharmacist–patient relationship; the pharmacist–general practitioner (GP) relationship; the pharmacists’ continuing professional development; and the role of peer support. Pharmacists welcomed this opportunity for more collaborative working with patients, GPs and peers.

There is evidence of sub-optimal teamwork between community pharmacists and GP prescribers, which could be improved by more joint training and by new extended roles for pharmacists.

To assess perceptions related to facets of community pharmacy usage within the Portuguese general population.

An ONSA (The Governmental Public Health Observatory) instrument was used, the ECOS (EmCasaObservamosSaúde) sample. This consisted of a national representative sample of household units with atelephone. General demographics and pharmacy users’ perceptions related to five facets of community pharmacy usage were collected by telephone interviews.

Almost one-third (31.9%) of the participants were probable chronic drug users, hence in regular contact with the community pharmacy. Thirty-four percent preferred not to talk with the person who dispenses their prescribed drugs. Most users (47.6%) expressed opinions of pharmacists as being health care rather than business oriented, although one quarter of the sample was not sure. A large majority (73.7%) would like pharmacists to participate in their treatment decisions, but 55.1% did not seem able to distinguish between pharmacists and non-pharmacist technical staff working at the pharmacy counter. Most significant predictors of users’ dichotomous perceptions related to the usage facets surveyed were age, education and occupation. Being older, less literate and economically inactive increased the odds of inappropriate users’ perceptions of the pharmacists.

Results showed that erroneous concepts and behaviours exist within the Portuguese population in relation to the community pharmacists’ role. This is a matter for pharmacy professional and educational bodies to take into account when developing intervention strategies, in particular when communicating with the general public.