[show abstract][hide abstract] ABSTRACT: Objective To assess the education and training needs of community pharmacists to support the delivery of an expanded public health
role. Setting Community pharmacy in Scotland. Method Two focus groups of community pharmacists (n=4 in each) in geographically distinct regions of Scotland explored issues of public health function, competencies and education
and training. Findings from thematic analysis were used to develop a draft postal questionnaire. Following piloting, pharmacist
managers from a random sample of 500 community pharmacies in Scotland were contacted by telephone to ascertain the number
of pharmacists working in each pharmacy in the following 14-day period. A survey pack containing questionnaires for each identified
pharmacist working in the study period was sent by post to the pharmacist manager in each pharmacy. The questionnaire contained
items on: demographics; views and attitudes towards: public health; competencies for public health practitioners; and education
and training needs. One postal reminder was sent 2weeks later. Main Outcome Measures Main themes identified from focus group discussions; questionnaire response rate; views and attitudes towards public health
competencies and education and training. Results Four hundred and fifteen managers agreed to participate, providing 904 potential participants. The response rate was 25%
(223/904). Most (n=179, 80%) were aware of the term ‘pharmaceutical public health’. While a majority saw the importance of public health to
their practice (n=177, 79%) agreeing/strongly agreeing, they were less comfortable with the term ‘specialist’. Respondents viewed competencies
relating to health promotion (n=192, 86%) more relevant than surveillance (n=70, 31%), risk management (n=29, 13%) and strategic developments (n=12, 5%). Responses indicated a desire for education and training with more than half (n=121, 54%) agreeing/strongly agreeing that they had a need now, with 69% (n=153) expressing a future need. Conclusion Results should be interpreted with caution due to the response rate. However, this research highlights the self assessed
gap in competence related to pharmaceutical public health for community pharmacists in Scotland.
International Journal of Clinical Pharmacy 04/2012; 30(6):801-809. · 1.27 Impact Factor
[show abstract][hide abstract] ABSTRACT: Nonmedical (ie, nonphysician) prescribing is a key development in the UK that has brought about many changes in prescribing policy and practice. Systematic research into the views of the general public toward such developments is limited.
To determine the awareness of, views on, and attitudes of members of the Scottish general public toward nonmedical prescribing, with an emphasis on pharmacist prescribing.
A questionnaire was mailed in November 2006 to a random sample of 5000 members of the general public in Scotland aged 18 and over, obtained from the UK electoral roll. The questionnaire contained items on awareness of nonmedical prescribing, levels of comfort with specific health professionals, and attitudes toward pharmacist prescribing.
Response rate was 37.1%. More than half of the individuals who responded were taking prescribed drugs. Nine hundred and seventy-eight (56.6%) were aware that trained health professionals could write prescriptions for medicines previously only prescribed by physicians. Awareness was associated with: increasing age (p < 0.001), having a health professional in their immediate family (p < 0.001), self-rated general health (p < 0.005), and a higher education level (p < 0.01). In logistic regression, all factors were retained as independent predictors of awareness (p < 0.001). Comfort levels for nonmedical prescribing were highest for pharmacists (median 4, IQR 3-5 [1 = low, 5 = high]), closely followed by nurses, and lowest for radiographers (median 2, IQR 1-4) (p < 0.001). While more than half of the respondents supported pharmacists having a prescribing role, fewer felt that pharmacists should prescribe the same range of drugs as physicians. There were concerns about lack of privacy in a pharmacy, despite acknowledging its enhanced convenience.
Our results indicate that more than half of the respondents were aware of nonmedical prescribing. A higher proportion was more comfortable with prescribing by pharmacists and nurses than with other healthcare professionals. Several issues relating to aspects of clinical governance were highlighted, specifically education and data handling.
Annals of Pharmacotherapy 05/2009; 43(6):1115-21. · 2.57 Impact Factor
[show abstract][hide abstract] ABSTRACT: The new community pharmacy contract in Scotland will formalise the role of pharmacists in delivering public health services. To facilitate assessment of education and training needs it is necessary to define the relevant public health competencies for community pharmacists. The objective of this research was to define and develop consensus around such competencies.
The "Skills for Health National Occupational Standards for Public Health Practitioners" was used to define an initial set of competencies. A two stage Delphi technique was undertaken to develop consensus. An expert panel, representing public health and pharmacy stakeholders, rated their agreement with the importance of each competency, with the agreement level set at 90%.
Level of agreement (%) with each public health competency; those competencies achieving more than 90% agreement with importance for community pharmacy practice.
Ten organisations (83% of those invited) and a total of 30 members (88%) agreed to take part in the process. In round 1 of the Delphi, responses were received from 25 (83%) individuals and 22 (73%) in round 2, with consensus being achieved for 25/68 (37%) competencies in round 1 and a further 8/68 (12%) in round 2.
Public health competencies for community pharmacists achieving consensus predominantly focused on health improvement activities at individual and local community levels and ethical management of self rather than those relating to surveillance and assessment and strategic development. There is a need to research community pharmacists' views of these competencies and to systematically assess their education and training needs.
International Journal of Clinical Pharmacy 02/2008; 30(1):111-9. · 1.27 Impact Factor
[show abstract][hide abstract] ABSTRACT: To investigate community pharmacists' awareness, views and attitudes relating to independent prescribing by community pharmacists and their perceptions of competence and training needs for the management of some common conditions.
Community pharmacies in Scotland.
A pre-piloted postal questionnaire was mailed to 500 randomly selected community pharmacies in Scotland for completion by the 'main pharmacist'.
Scottish community pharmacists' awareness, views and attitudes towards independent prescribing by community pharmacists; perceived competence and training needs in relation to diagnosis and treatment of conditions in four therapeutic areas; perceptions about patient accessibility to medicines and safety of independent prescribing by community pharmacists; and attitudes towards becoming an independent prescriber. The items regarding perceptions and attitudes were subjected to Principal Components Analysis (PCA) to identify the domains. Univariate analysis was performed on individual items in the questionnaire against total scores on the identified domains; significant variables in univariate analysis were further analysed in linear regression models.
A response rate of 43.4% (217/500) was achieved. Despite expressing confidence in their abilities to become independent prescribers and feeling competent in diagnosing and treating those conditions listed in the questionnaire, clinical training prior to implementation of independent prescribing was regarded important by 211 (97.7%) respondents, while 191 (88.4%) regarded clinical training in drugs used for treating the conditions to be important. Gaining improved patient consultation skills and ability to communicate prescribing actions to GP practices were regarded to be important by 125 (57.9%) and 172 (80.0%), respectively. In PCA, three domains--confidence in independent prescribing, satisfaction with the current methods of supply, and requirements for the process of independent prescribing were identified. Practising more hours per week as a pharmacist (p = 0.01), supplementary prescribing training (p = 0.02), and involvement in Scottish Executive pharmaceutical care model schemes (p = 0.02), were found to be associated with greater 'confidence in independent prescribing'.
High awareness of independent prescribing and perceived competence in diagnosing and selecting appropriate drugs for treating many common conditions were identified. Prescribing training with emphasis on evidence-based medicine, generic issues of prescribing and diagnostic and consultation skills is warranted before independent prescribing is undertaken by community pharmacists.
International Journal of Clinical Pharmacy 05/2006; 28(2):45-53. · 1.27 Impact Factor
[show abstract][hide abstract] ABSTRACT: Pharmacists’ interpretation of public health competencies for practice
To investigate community pharmacists’ interpretation of Public Health Practice national occupational standards (Skills for Health and Public Health Research Unit 2009) in relation to workplace practices
Community Pharmacy Champions in Lothian and Grampian (n= 6-8 in each) were invited to take part in a vignette focus group in each geographical area. Recruitment was through the Health Boards.
A researcher facilitated the vignette (Barter and Renold 1999, Hughes 1998) using trigger questions, based on The Standards. Another researcher took notes of the discussion. The session was spilt into three:
1. Participants were asked to describe their handling of an outbreak of head-lice in their locality. Notes were taken during the session.
Notes of session one were typed up during a break when the participants were offered food.
2. Participants reconvened and were asked to verify that the typed notes were a true reflection of their previous discussion, freely making amendments, by group consensus. The group then matched the vignette notes (session one) to The Standards. During this time, the facilitator (a qualified SVQ assessor) matched the notes to The Standards in another room.
3. Participants discussed the process of interpreting the Public Health national occupational standards, gaps and mis-matches with the assessor’s interpretation.
The sessions were digitally recorded. Consent and copyright clearance forms were provided.
Community pharmacists should be operating at level 5 in terms of public health practice. They appear to be operating at level 4 in some areas and level 3 for others.
1. Do not consider themselves to be: leaders; involved in research or policy development
2. Are 'doing' surveillance, although according to our previous research they claimed not to be.
3. Report working largely in a vacuum, with little partnership working within the community.
This has implications for rolling out public health policy.
BARTER, C. and RENOLD, E., 1999. The Use of Vignettes in Qualitative Research. Social Research Update, (25)
HUGHES, R., 1998. Considering the Vignette Technique and its Application to a Study of Drug Injecting and HIV Risk and Safer behaviour. Sociology of Health and Illness, 20(3), pp. 381-400
SKILLS FOR HEALTH AND PUBLIC HEALTH RESEARCH UNIT, 2009. Public health skills and career framework. [online] Available from: http://www.phru.nhs.uk/Doc_Links/PHSkills&CareerFramework_Launchdoc_April08.pdf [Accessed 15 th June 2009]