A qualitative study exploring community pharmacists' awareness of, and contribution to, self-care support in the management of long-term conditions in the United Kingdom.

Self-care support refers to activities aimed at educating, training and empowering patients with skills and ability to manage [and monitor] their long-term conditions (LTCs). While self-care support by health care professionals has emerged as a distinct concept in the management of LTCs, evidence of community pharmacy's contribution is sparse. The aim was to explore community pharmacy's contribution to self-care support of LTCs. The objectives were to explore how community pharmacists conceptualize self-care support of LTCs and how they operationalize the core elements of this in their practice. Semi-structured interviews were conducted with community pharmacists in England (n = 12) and Scotland (n = 12). A framework consisting of the core elements of self-care support (information and advice; skills training and support; technology; support networks; and collaborative care planning) was developed from the literature and was used to structure the interviews and analysis. Analysis was done thematically using the interpretative phenomenological analysis technique. The three main themes that emerged were conceptualization; operationalization of the core elements; and barriers to providing self-care support. Participants conceptualized self-care of LTCs as patients taking responsibility for their own health, performing activities that improved their LTCs and that enabled them to become more independent in managing their LTCs. Their views on self-care support did not reflect this conceptual understanding but was described primarily as providing patients with information and advice rather than actively supporting them. Participants' views of operationalizing the core elements of self-care support was found to be medicines focused, opportunistic and dependent on the services they provided, rather than being patient-centered and proactive. The barriers to providing self-care support of LTCs in community pharmacy were described as priority accorded to dispensing activities, the structure of the community pharmacy contract, lack of incentives to provide self-care support and patients' expectations and lack of awareness of community pharmacy's role in LTCs management. Community pharmacists' theoretical understanding of self-care was not reflected in the ways that they portrayed their contributions to self-care support. The current ways in which community pharmacy delivers its services for patient care may need to be re-configured in order to fit into the holistic self-care support paradigm.

Ogunbayo OJ ，Schafheutle EI ，Cutts C ，Noyce PR ... -  《-》

How do community pharmacists conceptualise and operationalise self-care support of long-term conditions (LTCs)? An English cross-sectional survey.

To explore community pharmacists' contributions to self-care support of long-term conditions by; investigating their conceptual understanding of self-care principles; identifying self-care support activities they considered important and their engagement in them; and examining barriers and enablers. A questionnaire was developed using existing literature and qualitative interviews, piloted and distributed online to a random sample of 10 000 community pharmacists in England between August and November 2014. The questionnaire contained sections addressing the above objectives. Data were analysed using descriptive statistics; free text comments were analysed using content analysis. A total of 609 responses were received; 334 completed all sections of the survey. Responses to statements exploring conceptual understanding showed that respondents were more likely to agree with self-care principles about patients taking responsibility and being more actively involved in their health and care; they agreed less with self-care principles promoting patient autonomy and independence. Respondents considered medicines-related self-care support activities as a lead role for community pharmacy, which they said they engaged in regularly. Whilst many agreed that other self-care support activities such as supporting self-monitoring and collaborative care planning were important, they indicated only limited engagement. Respondents identified access to patient records and availability of private consultation rooms as their main barriers and enablers, respectively; working relationship with GPs and skill-mix in community pharmacy were viewed as both barriers and enablers. Community pharmacists in this study conceptualised and operationalised self-care support of long-term conditions (LTCs) from a narrow, medicines-focussed perspective, rather than from a multifaceted, patient-focussed perspective. A concerted and coherent strategy that builds on the strengths, and tackles the identified barriers is needed if community pharmacy is to improve contributions to self-care support of LTCs.

Ogunbayo OJ ，Schafheutle EI ，Cutts C ，Noyce PR ... -  《-》

Self-care of long-term conditions: patients' perspectives and their (limited) use of community pharmacies.

Ogunbayo OJ ，Schafheutle EI ，Cutts C ，Noyce PR ... -  《-》

Exploring opportunities for providing pharmacists with feedback on their practice and performance around the electronic Minor Ailments Service in Scotland.

The electronic Minor Ailments Service (e-MAS), implemented in all community pharmacies in Scotland since 2006, allows pharmacists to manage minor ailments at no charge to patients including provision of medication, advice or referral. E-MAS is supported through an electronic network, 'E-pharmacy', which is managed by National Health Service Scotland. E-pharmacy has the capacity to remotely record e-MAS activities, such as details of medicines supply and patient registration allowing provision of feedback to community pharmacies. The aim of this research was to explore community pharmacists' views on potential utility of e-MAS performance data as a source of feedback on the quality of their own practice. Focus groups and telephone interviews with community pharmacists from four geographical Health Board areas in Scotland were utilised. Twenty community pharmacists took part in the study. Pharmacists highlighted potential for feedback to support practice in areas related to medicines supply (for example, formulary adherence and reimbursements to pharmacies from the Health Boards), patient registration and the impact of the new guidelines on their practice. Participants deemed individualised feedback to be potentially more useful than local or national aggregated data sets. Issues of confidentiality and participants' disinterest in feedback were potential barriers to the use of the data. This qualitative study has identified potential benefits of performance feedback data to pharmacists' practice. Key barriers to the use of the feedback, such as the issues of privacy and confidentiality need to be addressed by National Health Service information providers. Findings warrant further large scale evaluation of their application to practice.

Paudyal V ，Hansford D ，Cunningham S ，Stewart D ... -  《-》

Views and experiences of community pharmacy team members on antimicrobial stewardship activities in Scotland: a qualitative study.

Tonna AP ，Weidmann AE ，Sneddon J ，Stewart D ... -  《-》