The Pharmaceutical Journal
Vol 270 No 7252 p796
7 June 2003

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Australian emphasis in latest IJPP

In this article, research published in the latest issue of the International Journal of Pharmacy Practice is highlighted by Joanna Lumb, managing editor, IJPP

The June issue of the International Journal of Pharmacy Practice has an Australian feel to it. Three of the original papers report studies from Australia and another paper, reporting a trial carried out in India, is from researchers based in Australia. The international mix continues with a paper from the Netherlands and two papers from the United Kingdom.

Clinical interventions

Researchers from Sydney evaluated the effect of targeted education, a professional fee or both on the rate of clinical interventions made by community pharmacists. They studied four groups of pharmacists:

• No education or remuneration

• "Basic" education and remuneration

• "Advanced" education and remuneration

• Remuneration only

Remuneration alone did not lead to an increase in clinical interventions and increases in the groups receiving both education and remuneration were short lived, leading the authors to suggest a need to investigate whether or not longer-term education strategies would have more sustainable effects.

The clinical significance of "proactive" pharmacy interventions was evaluated by an expert panel and showed no difference between the four groups. However, pharmacists who had undertaken the education programme were more likely to intervene in complex areas, such as drug interactions and adverse events. This, the authors say, might be related to increased knowledge and confidence. Overall, about half of the proactive interventions were classed as "clinically significant" and 2 per cent as "clinically very significant" or "potentially life saving". Extrapolating nationally, the authors estimate that over 3,700 potentially life-saving community pharmacist interventions can be expected each year in Australia.

Patients with schizophrenia

Another paper reports that patients with schizophrenia have unmet needs that might be addressed by more active involvement of community pharmacists. Researchers in the Netherlands found that patients and their relatives were unaware of the support available from community pharmacists. In turn, pharmacists seemed unaware of the needs and expectations of these patients.

The majority of patients said they would like more information about their antipsychotic medicines. The research also indicates that patients and relatives would value inquiries from community pharmacists about how treatment is progressing and discussion of any medication-related problems. In addition, they liked the idea of reminders from the pharmacist when a medication refill is due.

Pharmacists tended to assume that patients and relatives had probably received sufficient information from other health care providers. Some were anxious not to frighten first-time antipsychotic users by providing too much information.

Pharmacists and public health

UK researchers conducted a systematic review of community pharmacists' attitudes towards and perceptions of their role in improving public health. An evaluation of 12 studies showed that pharmacists attach high importance to health promotion activities but concerns about being intrusive meant that interventions were more likely to be reactive than proactive. Activities tend to centre on the supply and use of medicines. Training was found to have a positive effect on shaping attitudes and behaviour. As expected, current remuneration systems had a constraining effect and the authors suggest that service and remuneration models that encompass health improvement activity, together with appropriate training, are needed for pharmacists to extend their activity to wider public health topics.

Other studies

Also published in the June issue of the IJPP:

Discharge prescriptions A survey of the extent of pharmacist transcribing of discharge prescriptions in UK hospitals. In 2001, around one-third of hospital pharmacies were providing this service, but most schemes were not run extensively throughout the hospitals. Few hospitals had formal training programmes for this service.

Paediatric dosing A study shows how an educational intervention from a pharmacist helped to improve the dosing accuracy of paediatric liquid medicines in a hospital in India. Errors in physician prescribing and parental administration were reduced by the intervention, which included promotion of the use of oral dose syringes.

Students' views on health professions Pharmacy students perceive health care professions along three major dimensions relating to "empathy", "potency" and "expertise", an Australian study shows. It also indicates that as pharmacy students progress through training their views on their own profession change, with signs of possible decline in the "potency" dimension.

Influence of social environment on health In addition to the research papers, the IJPP has a report of work presented at the recent Health Services Research and Pharmacy Practice conference, which includes discussion of the influence of social environment on health.

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