Shalom (charlie) Isaac Benrimoj

Objectives To explore the opinions and perceptions of key stakeholders on the integration between community pharmacy and primary care, within the Valencian Autonomous Community. Specific objectives include identifying strategic interventions to facilitate this integration. Additionally, the manuscript discusses the formulation of a novel model for...

Background Collaborative practice between physicians and pharmacists is particularly important in the provision of pharmacy services, such as Comprehensive Medication Reviews (CMR), which often require a close coordination between these professionals. Understanding the level and nature of this collaboration can assist in the development of strategi...

Background: There has been a growing interest in granting prescribing rights to pharmacists as a strategy to improve healthcare access. Researchers continue to explore the impact and implementation of pharmacist prescribing. Given the recent international changes in this field, an overview of current territories allowing pharmacist independent pres...

Objective Communities' use of technology and the internet for online health information (OHI) is increasing exponentially. An understanding of how and why individuals access OHI, and how this information influences decisions on health, medicines and self-care practices is critical. This review aims to: (1) identify the factors influencing OHI-seeki...

Background Health systems worldwide are under pressure. Integration seems a possible solution to improve healthcare systems efficiency. This research aims to gather stakeholders’ opinions on integrating community pharmacy and the primary healthcare system and secondly to explore and prioritise interventions for an initial integration plan. Method...

Background Pharmacist-led management of urinary tract infections has been introduced as a service in the United Kingdom, Canada, United States of America, New Zealand, and Australia. The management of acute uncomplicated urinary tract infections by community pharmacists has gained increasing attention as a potential avenue to alleviate the burden o...

Xabier Aizpurua-Arruti,1,2 Shalom Charlie I Benrimoj,3 Estibaliz Goyenechea,1 Arantxa Isla,2,4 Ainhoa Oñatibia-Astibia,1 Amaia Malet-Larrea,1 Miguel Ángel Gastelurrutia,1,3 Olatz Cuevas,1 Julen Rodríguez-Castejón,2,4 Saioa Domingo-Echaburu,5 María Ángeles Solinís,2,4 Montserrat García,6 Ana del Pozo-Rodríguez2,4 1Official Pharmacist Association of...

Abstract Background In Australia, medications can be prescribed by medical practitioners, dentists, nurses, and dispensed by pharmacists. Until recently, pharmacists have been limited to prescribing Schedule 2 and 3 medications, and optometrists, podiatrists, and nurse practitioners can prescribe medications under their scope of practice in some ar...

Background: Health system integration is being utilized by policy makers, and health managers to increase quality and efficiency in healthcare delivery. Yet, there is limited mapping of theories, models, or frameworks. Objective: This review maps theories, models and frameworks used in health systems integration, and identifies their components....

Many countries are experiencing an increased demand for health care and a shortage of health professionals in rural areas, impacting an individual’s ability to receive timely treatment. The management of uncomplicated urinary tract infections by community pharmacists is usual practice in some regions of the United Kingdom and Canada, and Queensland...

The evolving landscape of self-care in Australia underscores the imperative of recognizing and integrating the crucial role of pharmacists in promoting greater levels of self-care. Although the social and economic justifications for self-care are acknowledged internationally and in the literature, there is very little policy recognition in relation...

Background: Data analysis techniques such as machine learning have been used for assisting in triage and the diagnosis of health problems. Nevertheless, it has not been used yet to assist community pharmacists with services such as the Minor Ailment Services These services have been implemented to reduce the burden of primary care consultations in...

Background: The Ascertaining Barriers to Compliance (ABC) taxonomy was developed aiming at systematizing definitions and operationalizations of medication adherence. Its translation is crucial to improve the generalizability, application and comparison of study findings. Objective: To provide a consensus translation of the ABC taxonomy from Engl...

Aims Cardiovascular diseases (CVD) are the primary cause of death in Chile. Pharmacist‐led medication review with follow‐up (MRF) has improved CVD risk factors control in Europe and North America. However, their healthcare systems differ from Chile's, precluding generalizability. This trial aimed to determine the effect of MRF on CVD risk factor co...

Background Self-perceived minor ailments might conceal other health conditions if patients are not appropriately assisted by health care professionals. The aim of the study was to evaluate the patient-related outcomes of a community pharmacy Minor Ailment Service (MAS) compared to usual pharmacist care (UC). Methods A cluster randomised controlled...

Background There is an urgent need for health care systems to be more efficient and efficacious. An approach to integrate public and private provider organizations such as community pharmacies and public primary health care (PHC) merits consideration. The objective of this review was to identify the types of integration in health care settings and...

Background: The implementation of evidence-based practices is complex, with multiple implementation factors (IFs) that can impede (barriers) or reinforce (facilitators) this process. Change Agents (CAs) can design and apply targeted implementation strategies (TIS) with the intention of optimising the implementation process. However, there is a meth...

Introduction Consultation of minor ailments and direct product request are frequent in community pharmacy in Spain although every pharmacy offers the service following their own criteria. Following Standard Operational Procedures (SOP) and referral criteria agreed between community pharmacists (CP) and general practitioners (GP) is needed to deliv...

Background Collaborative practice between community pharmacists and physicians is becoming increasingly common. Although tools and models to explore collaborative practice between both health care professionals have been developed, very few have been validated for their use in clinical practice. The objective of this study was to develop and valida...

Community pharmacies and pharmacists predominantly operate in a retail environment independently of other health care providers, and they are not often viewed as an integral member of the healthcare team. Thus, they remain overlooked or excluded during integration processes of health care systems. At the same time, there are calls by the profession...

Background Minor ailments are “self-limiting conditions which may be diagnosed and managed without a medical intervention”. A cluster randomised controlled trial (cRCT) was designed to evaluate the clinical, humanistic and economic outcomes of a Minor Ailment Service (MAS) in community pharmacy (CP) compared with usual care (UC). Methods The cRCT...

INTRODUCCIÓN INDICA+PRO es un programa desarrollado para estandarizar y protocolizar el Servicio de Indicación Farmacéutica (SIF) en la práctica habitual de las farmacias comunitarias (FC). Pretende optimizar el asesoramiento y la valoración del riesgo de pacientes con síntomas menores (SM) a través de protocolos consensuados incrementando la segu...

Background It is necessary to determine the cost utility of adherence interventions in chronic diseases due to humanistic and economic burden of non-adherence. Purpose To evaluate, alongside a cluster-randomized controlled trial, the cost-utility of a pharmacist-led medication adherence management service (MAMS) compared with usual care in communi...

Background: Cardiovascular diseases are the leading cause of death. Pharmacist-led medication review with follow-up might be cost-effective preventing cardiovascular diseases. Objective: To undertake a cost-utility analysis of the addition of pharmacist-led medication review with follow-up to usual care compared to usual care alone for cardiovas...

Background Implementation research has delved into barriers to implementing change and interventions for the implementation of innovation in practice. There remains a gap, however, that fails to connect implementation barriers to the most effective implementation strategies and provide a more tailored approach during implementation. This study aime...

Background Collaborative practice between community pharmacists and physicians is becoming increasingly common. Although tools and models to explore collaborative practice between both health care professionals have been developed, very few have been validated for their use in clinical practice. The objective of this study was to develop and valida...

Introduction The implementation of evidence-based healthcare innovations is complex with multiple implementation factors, that can either prevent (i.e., barriers) or enhance (i.e., facilitators) the implementation of evidence-based practice. These barriers may interact with each other and have multiple causes. A “Practice Change Facilitator” (PCF),...

Introduction Dealing with minor ailments and direct non-prescription product requests (DPR) account for approximately 25% of usual practice of community pharmacies (CPs). However, there is much variability in service provision. In most countries the service is not remunerated or part of health policy. Following a positive impact study, a roll out w...

Introducción Los farmacéuticos comunitarios juegan un papel importante en el manejo de síntomas menores, tanto en pacientes que consultan por un síntoma menor como aquellos que demandan un medicamento para el mismo (automedicación). El objetivo de un Servicio de Indicación Farmacéutica (SIF) en la Farmacia Comunitaria (FC) es llevar a cabo un aseso...

Introducción INDICA+PRO es un estudio desarrollado en dos fases. La primera fase tiene como objetivo la evaluación del impacto de un Servicio de Indicación Farmacéutica (SIF), y la segunda evaluar un programa para la implantación del SIF en la práctica habitual de las farmacias comunitarias (FC) españolas. En el SIF, el farmacéutico lleva a cabo un...

INTRODUCCIÓNUno de los objetivos de un programa de implantación es asegurar que los beneficios de las intervenciones analizadas en estudios de impacto se transfieren a la práctica habitual. Para ello, los indicadores de proceso y resultado a la práctica requieren de marcos teóricos. El servicio de indicación farmacéutica (SIF) permite realizar una...

INTRODUCCIÓN La implantación de innovaciones sanitarias requiere marcos teóricos y herramientas para la implantación y sostenibilidad de servicios. El facilitador farmacéutico (FaFa) realiza formación y ofrece apoyo continuo a las farmacias comunitarias (FC) in situ para proponer soluciones a las barreras identificadas durante la implantación del s...

Background Non-adherence to medications continues to be a burden worldwide, with significant negative consequences. Community pharmacist interventions seem to be effective at improving medication adherence. However, more evidence is needed regarding their impact on disease-specific outcomes. The aim was to evaluate the impact of a community pharmac...

Background Implementation of Professional Pharmacy Services (PPSs) requires a demonstration of the service’s impact (efficacy) and its effectiveness. Several systematic reviews and randomised controlled trials (RCT) have shown the efficacy of PPSs in patient’s outcomes in community pharmacy. There is, however, a need to determine the level of evide...

Aim: To assess the trial-based cost–effectiveness of medication review with follow-up compared with usual care in primary care. Materials & methods: A cluster randomized controlled trial included patients if they were independent older adults, receiving five or more prescriptions, with moderate or high cardiovascular risk. Costs were estimated from...

Background Community pharmacies provide an appropriate setting to deliver minor ailment services (MASs). Many community pharmacy services have been developed previously without stakeholder involvement. As a result, implementation of services may fail to produce the expected impact. The aim of this research was to co-design and test the feasibility...

Background Implementation factors are hypothesised to moderate the implementation of innovations. Although individual barriers and facilitators have been identified for the implementation of different evidence-based services in pharmacy, relationships between implementation factors are usually not considered. Objectives To examine how a network of...

Objective: Pharmacists have been increasing patient-focused care through the implementation and provision of professional services. However, there is a lack of evidence on how to achieve long-term sustainability of the service once it is implemented. A framework identifying the factors affecting the sustainability of professional pharmacy services...

Background: Medication review with follow-up (MRF) is a service where community pharmacists undertake a medication review with monthly follow-up to provide continuing care. The ConSIGUE Program assessed the impact and implementation of MRF for aged polypharmacy patients in Spanish Community Pharmacies. The present paper reports on the clinical impa...

Background Minor ailments are “self-limiting conditions which may be diagnosed and managed without a medical intervention”. A cluster randomised controlled trial (cRCT) was designed to evaluate the clinical, humanistic and economic outcomes of a Minor Ailment Service (MAS) in community pharmacy (CP) compared with usual care (UC). Methods The cRCT w...

ABSTRACT Objectives: To evaluate an implementation programme of a community pharmacy medication review with follow- up (MRF) service using a hybrid effectiveness- implementation study design, and to compare the clinical and humanistic outcomes with those in a previously conducted cluster randomised controlled trial (cRCT). Setting: Community phar...

Background: Implementation research has delved into barriers to implementing change and interventions for the implementation of innovation in practice. There remains a gap, however, that fails to connect implementation barriers to the most effective strategies and provide more tailored interventions during implementation. This study aimed to link i...

Pharmacists have a societal duty of care. How to best provide that type of care requires scientific study. Pharmacy practice is a scientific discipline that studies the different aspects of the practice of pharmacy, and its impact on health care systems, medicine use, and patient care. Its scope has expanded globally to encompass clinical, behaviou...

Background: A cluster randomised controlled trial (cRCT) performed from July 2018 to March 2019 demonstrated the clinical impact of a community pharmacist delivered minor ailment service (MAS) compared with usual pharmacist care (UC). MAS consisted of a technology-based face-to-face consultation delivered by trained community pharmacists. The cons...

Integrating health innovations into the health system is a complex endeavour that requires a well-designed planning process engaging key stakeholders. Stakeholder analyses lay the foundations to inform appropriate planning processes and undertake strategic actions. A systematic scoping review was performed to explore how stakeholder analyses are ap...

There is evidence that the Australian Government is embracing a more integrated approach to health, with implementation of initiatives like primary health networks (PHNs) and the Government’s Health Care Homes program. However, integration of community pharmacy into primary health care faces challenges, including the lack of realistic integration i...

The interrelationship between governmental policies and objectives in primary health care and community pharmacy/pharmacists' strategic plans are of the outmost importance, having significant professional, economic and practical consequences for the future of the pharmacy profession, research, education and health care. Sharing information of the p...

Background Community pharmacists are well positioned to support patients’ minor ailments. The objective was to evaluate the clinical and humanistic impact of a minor ailment service (MAS) in community pharmacy compared with usual pharmacist care (UC). Methods A cluster randomised controlled trial was conducted. Intervention patients received MAS,...

Background: Implementation science emerged to address the challenges associated with the incorporation of evidence-based innovations into practice. Once the challenge is overcome, the ultimate goal is to achieve the sustainability of innovations to promote their continuity and long-term integration. Assessment tools and measures have been designed...

BACKGROUND Strategies to improve medication adherence have been widespread and effective in the literature, yet their impact is limited in real practice with patient adherence levels staying consistently low at 50%. Few patients persistently engage long-term to improve health outcomes, even when aware of the consequences of poor adherence. With an...

Background: Strategies to improve medication adherence are widespread in the literature; however, their impact is limited in real practice. Few patients persistently engage long-term to improve health outcomes, even when they are aware of the consequences of poor adherence. Despite the potential of mobile phone apps as a tool to manage medication...

Background: To increase the collaboration between community pharmacists and medical practitioners working in primary care it is critical to have collaborative protocols in place. Minor ailments could be a good example where this collaboration would benefit patient care as patients are seeking treatment in both settings. These collaborative protocol...

Introduction Containment of healthcare expenditure is a growing concern of many governments, providers and administrators. Reducing waste and improving cost effectiveness in the delivery of patient care remain at the forefront of policy and decision making. Pharmacist led medication adherence interventions represent an opportunity for future cost c...

Background Pharmacists‐led medication reviews ( MRs ) are claimed to be effective for the control of cardiovascular diseases; however, the evidence in the literature is conflicting. The main objective of this meta‐analysis was to analyze the impact of pharmacist‐led MRs on cardiovascular disease risk factors overall and in different ambulatory sett...

Implementation of pharmaceutical care through professional pharmacy services is a complex process, in which multilevel implementation factors interact and affect implementation processes and outcomes. This process has traditionally been approached in an ad hoc manner, and assuming that positive benefits and diffusion of information through key stak...

Pharmaceutical care services in primary care have been an area of research from the initial definitions in the early 1990s. The research has resulted in a range of evidence-based services delivered in primary care setting, from the community pharmacies and by the pharmacy workforce. Research has also been focusing on the implementation in community...

The use of a machine learning approach to determine the most effective facilitation strategies to overcome barriers during the implementation of Professional Pharmacy Services in community pharmacy.

Objectives To evaluate the health economics evidence based on randomized controlled trials of pharmacist-led medication review in pharmacotherapy managed cardiovascular disease risk factors, specifically, hypertension, type-2 diabetes mellitus and dyslipidaemia in ambulatory settings and to provide recommendations for future evaluations. Methods A...

Background: Internationally, governments have been investing in supporting pharmacists to take on an expanded role to support self-care for health system efficiency. There is consistent evidence that minor ailment schemes (MASs) promote efficiencies within the health care system. The cost savings and health outcomes demonstrated in the United Kingd...

Background Primary health professionals are well positioned to support the delivery of patient self-management in an evidence-based, structured capacity. A need exists to better understand the active components required for effective self-management support, how these might be delivered within primary care, and the training and system changes that...

To improve patient outcomes, healthcare practices undergo constant implementation of innovations. An implementation intervention that considers organizational and behavioural aspects is facilitation. Change Facilitators help individuals and groups realize what they need to change and how to make change happen. However, behavioural change trials req...

Background: Scarcity of prospective medication non-adherence cost measurements for the Australian population with no directly measured estimates makes determining the burden medication non-adherence places on the Australian health care system difficult. This study aims to indirectly estimate the national cost of medication non-adherence in Australi...

Aim: To develop a standardized framework determining the economic impact of medication nonadherence. Materials & methods: Secondary analysis of existing literature reported cost data, aggregating cost outcome indicators. Weighted-average cost analysis performed, determining the proportional contribution to total cost. Results: Direct costs were rep...

Many community pharmacists ideologically support recent changes to their roles in primary healthcare. However, their antithetical resistance towards practice change could have systemic causes (i.e. role stresses), which may account for increased job dissatisfaction, burnout, and job turnover in the profession. Deeper comprehension was sought using...

Background: Stakeholder participation optimizes health planning, fostering the acceptability and integration of new health services. Collaborative approaches may help overcome existing challenges in the development, implementation and evaluation of community pharmacy services (CPSs). Stakeholder analyses lay the foundation for building collaborati...

Background Pharmacists are increasingly being included as members of general practice primary care teams. To date, there have been few published studies describing the competencies of general practice (GP) pharmacists and establishing their subsequent educational needs. Aim of the review The aim of this literature review is to establish the activit...

Introduction Adherence-enhancing interventions have been assessed in the literature, however heterogeneity and conflicting findings have prohibited a consensus on the most effective approach to maintain adherence over time. With the ageing population and growth of chronic conditions, evaluation of sustainable strategies to improve and maintain medi...

Risk of bias summary. (PDF)

Category definitions. (DOCX)

Heterogeneity between trials comparisons for the composite measure. (DOCX)

Sensitivity and sub-group analyses. (DOCX)

Complete search strategy. (DOCX)

Final rank orders from SUCRA analyses. (DOCX)

PRISMA NMA checklist. (DOCX)

Node-splitting analyses. (DOCX)

Complete references. a. Included meta-analyses b. Included primary studies c. Excluded primary studies d. Studies included in the network meta-analysis (DOCX)

Risk of bias graph. (PDF)

BACKGROUND Internationally, governments have been investing in supporting pharmacists to take on an expanded role to support self-care for health system efficiency. There is consistent evidence that minor ailment schemes (MAS) promote efficiencies within the healthcare system. The cost savings and health outcomes demonstrated in the UK and Canada o...

The general objective of the study was to evaluate the clinical, humanistic and economic impact of a protocolized pharmaceutical indication service in patients who come to the Community Pharmacy for a consultation on minor symptoms included (heartburn, headache, nasal congestion, acute diarrhea, sore throat , menstrual pain, cold sores, meteorism o...

Background: Medication non-adherence remains a significant problem for the health care system with clinical, humanistic and economic impact. Dispensing data is a valuable and commonly utilized measure due accessibility in electronic health data. The purpose of this study was to analyze the changes on adherence implementation rates before and after...

Background: Medication non-adherence has a dynamic, temporal and multifactorial nature with a significant impact on economic and clinical outcomes. Interventions to improve adherence are complex and require adaptation to patients' needs, which may include patient's medical conditions. The aim of this study was to assess the comparative effectivenes...