Jasmina Fejzic

Mental health consumer and caregiver perceptions of stigma in Australian community pharmacies

Background: The stigma of mental illness can be a barrier to effective medication management in the community pharmacy setting. This article explored mental health consumers’ or caregivers’ experiences of stigma in Australian community pharmacies. Materials: Semi-structured interviews and focus groups were conducted with a purposive sample of consumers or caregivers (n = 74). Interview transcripts were analysed using a general inductive approach. Discussion: Stigma presented a barrier to effective mental health management. Self-stigma impeded consumers’ community pharmacy engagement. Positive relationships with knowledgeable staff are fundamental to reducing stigma. Conclusions: Findings provide insight into the stigma of mental illness in community pharmacies.

Review of community pharmacy staff educational needs for supporting mental health consumers and carers

Development of a mental health education package for community pharmacy staff should be informed by mental health consumers/carers’ needs, expectations and experiences, and staff knowledge, skills and attitudes. This review (1) explored research on community pharmacy practice and service provision for mental health consumers/carers, and (2) identified validated methods for assessing staff knowledge, skills and attitudes about mental illness to inform the development of a training questionnaire. A literature scan using key words knowledge, skills, attitudes, and beliefs combined with community pharmacy, pharmacist, and pharmacy support staff, and mental illness, depression, anxiety was conducted. A small number of studies were found that used reliable methods to assess pharmacists’ training needs regarding mental illness and treatment options. There was little published specifically in relation to depression and anxiety in community pharmacy practice. No studies assessed the training needs of pharmacy support staff. A systematic analysis of pharmacy staff learning needs is warranted.

Privacy and confidentiality: perspectives of mental health consumers and carers in pharmacy settings

The study aims to explore within the community pharmacy practice context the views of mental health stakeholders on: (1) current and past experiences of privacy, confidentiality and support; and (2) expectations and needs in relation to privacy and confidentiality.

Trust and Safe Spaces: Mental Health Consumers’ and Carers’ Relationships with Community Pharmacy Staff

BackgroundTrusting relationships between mental health consumers and health care providers are critical in the management and recovery process. Although community pharmacy staff are well placed to form relationships with mental health consumers and carers, little is known about the existence, nature or significance of consumer–staff relationships.ObjectivesThe aim of this study was to explore mental health consumers’ and carers’ perceptions of community pharmacy services, and describe the nature of their relationships with pharmacy staff.MethodsFocus groups and semi-structured interviews were conducted with a convenience sample of 74 mental health consumers or carers who self-selected into the study. Thematic analysis was undertaken to explore participants’ perspectives.ResultsPositive experiences of pharmacy services were perceived to encourage consumers’ and carers’ trust in pharmacists and promote relationship development. This was enhanced when participants felt that elements of patient-centred care were part of the pharmacy services provided. Although some participants perceived community pharmacy to have a limited role in mental health, those who had established relationships highlighted the current role of pharmacists in their care, and appeared to welcome further extensions of pharmacists’ role in mental health.ConclusionsTrusting relationships between consumers and carers and community pharmacy staff were deemed to be important in mental health care and contributed to consumers’ and carers’ views of pharmacy as a safe health care space. Community pharmacy services that included core elements of patient-centred care appeared to facilitate relationship formation and associated benefits. Education and training is needed for community pharmacy staff to improve mental health knowledge and promote positive engagement with consumers and carers.

Medication management reviews for people from the former Yugoslavia now resident in Australia

Aim: The objective of this prospective study was to conduct medication management reviews (MMR) in people from a non-English speaking background (NESB) (Bosnian/Serbian/ Croatian, from former Yugoslavia, currently residing in Australia) in their native language in order to identify medication-related problems (needs analysis) and implement appropriate therapeutic interventions, in collaboration with their general practitioners (GPs).Methods: Twenty-five participants entered the study. Each was interviewed and medication-related issues were identified by the health care team.Results: Various interventions (over 150 for the whole group, an average of 6 per participant), based on actual and potential medication-related problems, were designed to improve the use of medicines. The MMRs introduced effective changes into the participants’ health care. Psychological (e.g., feeling depressed) and sociological factors (e.g., costs of medicines, not understanding labels written in English) were identified as having significant impacts on medication management.Conclusions: These data confirmed there are avoidable medication-related problems in people from a NESB. GPs and pharmacists working in health care teams with a trained interpreter could greatly improve medication use through regular review and a team approach to problem identification and solving.

Communication capacity building through pharmacy practice simulation

Objective. To examine the effectiveness of simulated learning modules (SLMs) encompassing EXcellence in Cultural Experiential Learning and Leadership (EXCELL) core competencies in enhancing pharmacy students’ professional communication skills. Methods. Students completed three hours of preparatory lectures and eight hours of workshops comprising six SLMs themed around pharmacy practice and pharmacy placements. Each SLM comprised role-plays with actors, facilitation using EXCELL Social Interaction Maps (SIMs), and debriefing. Evaluations of SLMs included quantitative and qualitative survey responses collected before, during and after workshops, and after placements. Facilitators reflected on SLMs as a pedagogic modality. Results. Student feedback was positive about SLMs as an effective learning tool. The majority indicated areas of new learning and found SLMs enhanced their professional skills and confidence. Facilitator feedback was positive, and suggested SLM optimization strategies. Conclusion. Student and teaching team recommendations will inform future curriculum development including the optimization of SLMs in pharmacy education.

Implementing simulated learning modules to improve students’ pharmacy practice skills and professionalism

Background: Effective communication enables healthcare professionals and students to practise their disciplines in a professional and competent manner. Simulated-based education (SBE) has been increasingly used to improve students’ communication and practice skills in Health Education. Objective: Simulated learning modules (SLMs) were developed using practice-based scenarios grounded in effective communication competencies. The effect of the SLMs on Pharmacy students’ (i) Practice skills and (ii) Professionalism were evaluated. Methods: SLMs integrating EXCELL competencies were applied in the classroom to study their effect on a number of learning outcomes. EXcellence in Cultural Experiential Learning and Leadership (EXCELL) Program is a schematic, evidence-based professional development resource centred around developing participants’ self-efficacy and generic communication competencies. Students (N=95) completed three hours of preliminary lectures and eight hours of SLM workshops including six scenarios focused on Pharmacy Practice and Experiential Placements. Each SLM included briefing, role-plays with actors, facilitation, and debriefing on EXCELL social interaction maps (SIMs). Evaluations comprised quantitative and qualitative survey responsed by students before and post-workshops, and post-placements, and teachers’ reflections. Surveys examine specific learning outcomes by using pharmacy professionalism and pharmacy practice effectiveness scales. Responses were measured prior to the commencement of SLMs, after completion of the two workshops and after students completed their block placement. Self-report measures enabled students to self-assess whether any improvements occurred. Results: Student responses were overwhelmingly positive and indicated significant improvements in their Pharmacy practice and professionalism skills, and commitment to professional ethics. Qualitative feedback strongly supported students’ improved communication skills and confidence. Teacher reflections observed ecological validity of SLMs as a method to enhance professionalism and communication skills, and suggested ways to improve this teaching modality. Conclusion: Inclusion of SLMs centred on practice and professionalism was evaluated as an effective, teaching strategy by students and staff. The integration of SIMs in SLMs has potential for wider application in clinical teaching.

Towards concordance in healthcare: Perspectives of general practitioners, complementary and alternative medicine practitioners and pharmacists in Australia

Summary Partnerships and concordance are desirable concepts for optimal healthcare. The concept of concordance is based on negotiation between equals in a therapeutic relationship, forming a therapeutic alliance between all partners. One field of healthcare in which concordant relationships may be particularly desirable is complementary and alternative medicine (CAM). CAM is increasingly used by consumers worldwide, and provider–patient relationships are important across the spectrum of CAM-to-conventional medicine; thus, it was considered useful to research CAM and concordance in parallel. The objective of this problem-detection study (PDS) was to investigate practitioners’ (general practitioners’, pharmacists’ and CAM practitioners’) views on their relationships and reaching concordant partnerships with consumers in the areas of both conventional medicine and CAM. Focus groups and semi-structured interviews guided the development of the PDS instrument. The questionnaire consisted of 36 items corresponding to seven thematic units deduced from the preliminary data. The differences in perceptions between the surveyed groups indicated that achieving concordance relies on mutual respect and communication and understanding of roles, responsibilities and limitations, and differences in opinion may be compromising the formation of partnerships. Potentially problematic issues identified by this research could be addressed by educational interventions and enhancement of communication between all parties involved, as information loses value when not shared, and may be prone to contradiction and confusion. Further research is warranted in order to facilitate positive changes in the health system.Partnerships and concordance are desirable concepts for optimal healthcare. The concept of concordance is based on negotiation between equals in a therapeutic relationship, forming a therapeutic alliance between all partners. One field of healthcare in which concordant relationships may be particularly desirable is complementary and alternative medicine (CAM). CAM is increasingly used by consumers worldwide, and provider–patient relationships are important across the spectrum of CAM‐to‐conventional medicine; thus, it was considered useful to research CAM and concordance in parallel. The objective of this problem‐detection study (PDS) was to investigate practitioners’ (general practitioners’, pharmacists’ and CAM practitioners’) views on their relationships and reaching concordant partnerships with consumers in the areas of both conventional medicine and CAM. Focus groups and semi‐structured interviews guided the development of the PDS instrument. The questionnaire consisted of 36 items corresponding to seven thematic units deduced from the preliminary data. The differences in perceptions between the surveyed groups indicated that achieving concordance relies on mutual respect and communication and understanding of roles, responsibilities and limitations, and differences in opinion may be compromising the formation of partnerships. Potentially problematic issues identified by this research could be addressed by educational interventions and enhancement of communication between all parties involved, as information loses value when not shared, and may be prone to contradiction and confusion. Further research is warranted in order to facilitate positive changes in the health system.

An underutilised resource for Antimicrobial Stewardship: a ‘snapshot’ of the community pharmacists’ role in delayed or ‘wait and see’ antibiotic prescribing

Various strategies have been implemented in primary care to address the inappropriate use of antibiotics, with varying degrees of success. One such intervention is delayed or ‘wait and see’ prescribing, where the prescriber indicates to wait a few days before dispensing the antibiotic. The aim of this study was to explore community pharmacists’ perceptions and practice experiences with delayed antibiotic prescribing.

Simulated learning for generic communication competency development: a case study of Australian post-graduate pharmacy students

ABSTRACT Authentic workplace experience is becoming increasingly challenging to provide for students. Simulation represents an effective pedagogical strategy for communication competency development in preparation for, or in lieu of clinical placements/practicums. The case study represents an innovative approach to simulating aspects of a pharmacy practice when insufficient placements were available. Prior to undertaking a three-week placement, a cohort of Master of Pharmacy (MPharm) students (N = 95) completed two four-hour simulated learning modules (SLMs). Each of the six SLMs addressed interpersonally challenging, commonly experienced pharmacy practice scenarios generated by pharmacists/pharmacy educators. Scenarios, underpinned by the Excellence in Cultural Experiential Learning and Leadership (EXCELL) model, included schemas called Social Interaction Maps (SIMs), and involved interacting with trained actors. EXCELL is an evidence-based, professional development resource centred on learning generic social competencies including participating in a team, refusing a request and giving feedback. Evaluations comprised students’ survey responses collected before, during and after SLM workshops and pharmacy placements, and reflections from workshop facilitators. Students reported significant improvements in their overall communication competencies post-workshops and post-placement. Facilitators rated SLMs as a useful strategy to improve students’ communication competence and workplace readiness. Future curriculum development could benefit from including discipline-specific, interpersonally challenging SLMs using SIMs and actors (where possible) to simulate workplace interactions.