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Article ; Online: Pharmacists' Satisfaction with Work and Working Conditions in New Zealand-An Updated Survey and a Comparison to Canada.

Lam, Sharon Jessie / Lynd, Larry D / Marra, Carlo A

2023 Volume 11, Issue 1

Abstract: Background: As roles have evolved over time, changes in workplace environments have created higher patient expectations creating stressful conditions for pharmacists.: Aim: To evaluate pharmacists' perceptions of their working conditions, work ... ...

Abstract	Background: As roles have evolved over time, changes in workplace environments have created higher patient expectations creating stressful conditions for pharmacists. Aim: To evaluate pharmacists' perceptions of their working conditions, work dissatisfaction, and psychological distress; determine their predictors in New Zealand (NZ); and compare results with Canadian studies and historic NZ data. Methods: A cross-sectional online survey was distributed to registered pharmacists in NZ. The survey included demographics, work satisfaction, psychological distress, and perceptions of their working conditions (six statements with agreement rated on a 5-point Likert scale). Comparisons were made with surveys from Canada and NZ. Chi-square, t-tests, and non-parametric statistics were used to make comparisons. Results: The response rate was 24.7% (694/2815) with 73.1% practicing in a community pharmacy (45.8% independent, 27.3% chains). Pharmacists disagreed on having adequate time for breaks and tasks, while the majority contemplated leaving the profession and/or not repeating their careers again if given the choice. Working longer hours and processing more prescriptions per day were predictive factors for poorer job satisfaction. More NZ pharmacists perceived their work environment to be conducive to safe and effective primary care (57% vs. 47%, Conclusions: NZ pharmacists perceive working conditions to be sub-optimal yet had higher satisfaction than their Canadian counterparts. Work dissatisfaction and psychological distress are high and have not improved over the last two decades.
Language	English
Publishing date	2023-01-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2737194-3
ISSN	2226-4787 ; 2226-4787
ISSN (online)	2226-4787
ISSN	2226-4787
DOI	10.3390/pharmacy11010021
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Impact of Promotional Videos on Public Perception of Pharmacy Services.

Rangi, Paige / Marra, Carlo / Scahill, Shane / Anwar, Mudassir

Journal of pharmacy practice

2023 Volume 37, Issue 3, Page(s) 712–721

Abstract: Background: ...

Abstract	Background:
Language	English
Publishing date	2023-05-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1027474-1
ISSN	1531-1937 ; 0897-1900
ISSN (online)	1531-1937
ISSN	0897-1900
DOI	10.1177/08971900231177201
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Article ; Online: Do entry year pharmacy students have similar personal characteristics? Comparing personalities, professional goals, and role perceptions.

Nair, Dhanya / Green, James A / Houle, Sherilyn K D / Marra, Carlo A

Research in social & administrative pharmacy : RSAP

2023 Volume 19, Issue 4, Page(s) 634–642

Abstract: Background: Schools and faculties of pharmacy are responsible for selecting students to admit into the profession. Despite many similarities, admission processes, pharmacists' training, and scope of practice are different across jurisdictions. Students ... ...

Abstract	Background: Schools and faculties of pharmacy are responsible for selecting students to admit into the profession. Despite many similarities, admission processes, pharmacists' training, and scope of practice are different across jurisdictions. Students that are selected for admission may then differ in a number of ways, including by personality traits and other individual difference measures. Objective: To compare the trait characteristics between students entering a New Zealand (NZ-University of Otago) and Canadian ((University of Waterloo) pharmacy programme and to compare their professional goals and role perceptions. Methods: Incoming first year students at each university were invited to take an online questionnaire that included personality characteristics and potential predictors of involvement in pharmacists' roles: (1) the Big Five Inventory (openness, conscientiousness, extraversion, agreeableness, neuroticism); (2) the Achievement Goals Questionnaire-Revised; (3) the Rational Experiential Inventory; and (4) Counsellor Role Orientation. Statistical tests were conducted to determine if there were differences between entry level pharmacy students from NZ and Canada. Results: 184 students (97/150 Otago, 87/118 Waterloo) completed the survey. On average, Waterloo students scored higher on agreeableness (M = 80 vs. 76, p = 0.06), conscientiousness (M = 70 vs. 68, p = 0.30), mastery-approach (M = 93 vs.90, p = 0.06), and faith-in-intuition (M = 67 vs. 61, p = 0.03) compared to Otago pharmacy students who were higher for openness M = 70 vs. 66, p = 0.09). An item measuring reliance on physicians for medicine advice was endorsed more by Otago pharmacy students (M = 35 vs. M = 15, p < 0.001). Items on time pressure (e.g., "It takes too much time to for a pharmacist to talk with a patient about the medication they receive") were higher for Otago students (M = 41 vs. M = 38, p = 0.26). Higher scores for pharmacist restriction ("There should be legal restrictions on what pharmacists can tell patients") were also seen among Otago students (M = 26 vs. M = 12, p < 0.001). There were important differences between entry level pharmacy students and practicing pharmacists in both jurisdictions. Discussion: While entry-level pharmacy students had similar personality profiles, differences were observed in role expectations and in experiential learning orientation. This highlights differing societal views on the role of pharmacists in each respective country. Pharmacy schools should study their student bodies when designing their curricula and electives, helping ensure graduates feel like they have the training to do what they need to do. Future work will determine if these personality and learning goals influence students' preparation for practice.
MeSH term(s)	Humans ; Students, Pharmacy ; Goals ; Canada ; Personality ; Pharmaceutical Services ; Surveys and Questionnaires ; Education, Pharmacy ; Pharmacists ; Professional Role
Language	English
Publishing date	2023-01-13
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2192059-X
ISSN	1934-8150 ; 1551-7411
ISSN (online)	1934-8150
ISSN	1551-7411
DOI	10.1016/j.sapharm.2023.01.001
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Article ; Online: Describing the consumer profile of different types of community pharmacy in Aotearoa New Zealand.

Nind, James / Marra, Carlo A / Scahill, Shane / Smith, Alesha

Journal of primary health care

2023 Volume 15, Issue 4, Page(s) 376–381

Abstract: Introduction Aotearoa New Zealand has a range of community pharmacies; independent, corporate, hybrid, and mail-order, each with differing service delivery models. Corporate and hybrid pharmacies do not charge the NZ$5.00 co-payment on standard ... ...

Abstract	Introduction Aotearoa New Zealand has a range of community pharmacies; independent, corporate, hybrid, and mail-order, each with differing service delivery models. Corporate and hybrid pharmacies do not charge the NZ$5.00 co-payment on standard prescriptions; however, prescription co-payments were universally removed from 1July 2023. Aim This research aims to describe the consumer profiles of Aotearoa New Zealand's different types of community pharmacies prior to the removal of the prescription co-payment. Methods A nationwide retrospective observational study linked 1-year of dispensing data (1 March 2022-28 February 2023) from the Pharmaceutical Collection to patient enrolment data using a National Health Index (NHI) number to identify the demographic details of people who use the different pharmacy types. People were assigned to a particular type of pharmacy if they collected at least 70% of their prescriptions from there; if they did not meet this threshold, they were defined as mixed users. Results Independent pharmacies had an older customer base and fewer Asian users compared to other pharmacy types. Hybrid pharmacies served a greater proportion of Pacific peoples and those from areas of high deprivation. Māori made up relatively equal proportions of users across all pharmacy types. Areas without major cities had fewer corporate pharmacies and only four hybrid pharmacies were identified outside of Auckland. Discussion There appears to be differences in the consumer profiles of the different pharmacy types. These results will serve as a comparison to how removing prescription co-payments shifts patients' behaviour.
MeSH term(s)	Humans ; Community Pharmacy Services ; New Zealand ; Pharmacies ; Retrospective Studies
Language	English
Publishing date	2023-10-12
Publishing country	Australia
Document type	Observational Study ; Journal Article
ZDB-ID	2572943-3
ISSN	1172-6156 ; 1172-6156
ISSN (online)	1172-6156
ISSN	1172-6156
DOI	10.1071/HC23083
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Article ; Online: What do pharmacy users think of free pharmacy services? Investigating pharmacy users' perceptions, attitudes and willingness to pay for free healthcare from pharmacies.

Abdul Aziz, Yasmin H / Heydon, Susan J / Duffull, Stephen B / Marra, Carlo A

Exploratory research in clinical and social pharmacy

2023 Volume 11, Page(s) 100288

Abstract: Background: Evidence exists of pharmacists providing free or partially subsidised clinical services in order to meet patient healthcare needs. Little is known about how patients perceive the quality and importance of such unfunded services to their ... ...

Abstract	Background: Evidence exists of pharmacists providing free or partially subsidised clinical services in order to meet patient healthcare needs. Little is known about how patients perceive the quality and importance of such unfunded services to their healthcare. Objectives: To explore pharmacy user perspectives about unfunded services such as their valuation, why they chose to access these services from the pharmacy as well as their willingness to pay should pharmacies need to start charging for the provision of such services owing to budgetary constraints. Methods: This study was nested in a larger nationwide study where 51 pharmacies were recruited across fourteen locations across New Zealand . Semi-structured interviews were conducted with patients who had accessed unfunded services in community pharmacies. Patients were followed up to identify their percieved health outcomes resulting from accessing the unfunded service. Results: A total of 253 patient interviews were conducted on-site across 51 pharmacies in New Zealand. Two main themes were identified pertaining to (1) patient-provider relationship and (2) Willingness to pay. A total of fifteen different considerations were found to influence pharmacy users' decisions to access health services from the pharmacy. It was found that 62.8% of patients were willing to pay for unfunded services and the majority paying NZD$10. Conclusion: Patients positively rate these services and largely deem them important for their healthcare. Willingness to pay for services were also variable between patients and were dependant on the type of service accessed.
Language	English
Publishing date	2023-06-16
Publishing country	United States
Document type	Journal Article
ISSN	2667-2766
ISSN (online)	2667-2766
DOI	10.1016/j.rcsop.2023.100288
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Article ; Online: A Systematic Review of Independent and Chain Pharmacies Effects on Medication Adherence.

Nind, James / Smith, Alesha / Scahill, Shane / Marra, Carlo A

Pharmacy (Basel, Switzerland)

2022 Volume 10, Issue 5

Abstract: As the last step in the care pathway, pharmacies can significantly impact a patient's medication adherence and the success of treatment. The potential impact of patient's pharmacy choice on their medication adherence has yet to be established. This study ...

Abstract	As the last step in the care pathway, pharmacies can significantly impact a patient's medication adherence and the success of treatment. The potential impact of patient's pharmacy choice on their medication adherence has yet to be established. This study aims to review the impact a pharmacies ownership model, either independent or chain, has on its users' medication adherence. As a generalisation, independent pharmacies offer a more personal service and chain pharmacies offer medications at lower prices. A keyword search of EMBASE and MEDLINE databases in March 2022 identified 410 studies, of which 5 were deemed to meet our inclusion criteria. The studies mostly took place in North America, measured medication adherence using pharmacy records over a 12-month period. This review was unable to substantiate a difference in the rate of medication adherence between the users of independent and chain pharmacies. However, those with a lower income, greater medication burden, and increased age appeared to use an independent pharmacy more than a chain pharmacy and to have greater medication adherence when doing so. Establishing the differences in service provision between types of pharmacies and why people choose a pharmacy to frequent should be a focus of future research.
Language	English
Publishing date	2022-09-29
Publishing country	Switzerland
Document type	Journal Article ; Review
ZDB-ID	2737194-3
ISSN	2226-4787 ; 2226-4787
ISSN (online)	2226-4787
ISSN	2226-4787
DOI	10.3390/pharmacy10050124
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Article ; Online: Cost-Effectiveness of Pharmacist Prescribing for Managing Hypertension in the United States.

Dixon, Dave L / Johnston, Karissa / Patterson, Julie / Marra, Carlo A / Tsuyuki, Ross T

JAMA network open

2023 Volume 6, Issue 11, Page(s) e2341408

Abstract: Importance: Pharmacist-led interventions can significantly improve blood pressure (BP) control. The long-term cost-effectiveness of pharmacist-prescribing interventions implemented on a large scale in the US remains unclear.: Objective: To estimate ... ...

Abstract	Importance: Pharmacist-led interventions can significantly improve blood pressure (BP) control. The long-term cost-effectiveness of pharmacist-prescribing interventions implemented on a large scale in the US remains unclear. Objective: To estimate the cost-effectiveness of implementing a pharmacist-prescribing intervention to improve BP control in the US. Design, setting, and participants: This economic evaluation included a 5-state Markov model based on the pharmacist-prescribing intervention used in The Alberta Clinical Trial in Optimizing Hypertension (or RxACTION) (2009 to 2013). In the trial, control group patients received an active intervention, including a BP wallet card, education, and usual care. Data were analyzed from January to June 2023. Main outcomes and measures: Cardiovascular (CV) events, end-stage kidney disease events, life years, quality-adjusted life years (QALYs), lifetime costs, and lifetime incremental cost-effectiveness ratio (ICER). CV risk was calculated using Framingham risk equations. Costs were based on the reimbursement rate for level 1 encounters, medication costs from published literature, and event costs from national surveys and pricing data sets. Quality of life was determined using a published catalog of EQ-5D utility values. One-way sensitivity analyses were used to assess alternative reimbursement values, a reduced time horizon of 5 years, alternative assumptions for BP reduction, and the assumption of no benefit to the intervention after 10 years. The model was expanded to the US population to estimate population-level cost and health impacts. Results: Assumed demographics were mean (SD) age, 64 (12.5) years, 121 (49%) male, and a mean (SD) baseline BP of 150/84 (13.9/11.5) mm Hg. Over a 30-year time horizon, the pharmacist-prescribing intervention yielded 2100 fewer cases of CV disease and 8 fewer cases of kidney disease per 10 000 patients. The intervention was also associated with 0.34 (2.5th-97.5th percentiles, 0.23-0.45) additional life years and 0.62 (2.5th-97.5th percentiles, 0.53-0.73) additional QALYs. The cost savings were $10 162 (2.5th-97.5th percentiles, $6636-$13 581) per person due to fewer CV events with the pharmacist-prescribing intervention, even after the cost of the visits and medication adjustments. The intervention continued to produce benefits in more conservative analyses despite increased costs as the ICER ranged from $2093 to $24 076. At the population level, a 50% intervention uptake was associated with a $1.137 trillion in cost savings and would save an estimated 30.2 million life years over 30 years. Conclusion and relevance: These findings suggest that a pharmacist-prescribing intervention to improve BP control may provide high economic value. The necessary tools and resources are readily available to implement pharmacist-prescribing interventions across the US; however, reimbursement limitations remain a barrier.
MeSH term(s)	Female ; Humans ; Male ; Middle Aged ; Cardiovascular Diseases/complications ; Cost-Benefit Analysis ; Hypertension/drug therapy ; Hypertension/complications ; Pharmacists ; Quality of Life ; United States ; Aged
Language	English
Publishing date	2023-11-01
Publishing country	United States
Document type	Journal Article
ISSN	2574-3805
ISSN (online)	2574-3805
DOI	10.1001/jamanetworkopen.2023.41408
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Article ; Online: A systematic review of economic evaluations of pharmacist services.

Price, Emilia / Shirtcliffe, Andi / Fisher, Thelma / Chadwick, Martin / Marra, Carlo A

The International journal of pharmacy practice

2023 Volume 31, Issue 5, Page(s) 459–471

Abstract: Background: Challenges to the provision of health care are occurring internationally and are expected to increase in the future, further increasing health spending. As pharmacist roles are evolving and expanding internationally to provide individualised ...

Abstract	Background: Challenges to the provision of health care are occurring internationally and are expected to increase in the future, further increasing health spending. As pharmacist roles are evolving and expanding internationally to provide individualised pharmaceutical care it is important to assess the cost-effectiveness of these services. Objectives: To systematically synthesise the international literature regarding published economic evaluations of pharmacy services to assess their cost-effectiveness and clinical outcomes. Methods: A systematic review of economic evaluations of pharmacy services was conducted in MEDLINE, EMBASE, PubMed, Scopus, Web of Science, CINAHL, IPA and online journals with search functions likely to publish economic evaluations of pharmacy services. Data were extracted regarding the interventions, the time horizon, the outcomes and the incremental cost-effectiveness ratio. Studies' quality of reporting was assessed using the Consolidated Health Economic Evaluation Reporting Standard (CHEERS) statement. Results: Seventy-five studies were included in the systematic review, including 67 cost-effectiveness analyses, 6 cost-benefit analyses and 2 cost-consequence analyses. Of these, 57 were either dominant or cost-effective using a willingness-to-pay threshold of NZ$46 645 per QALY. A further 11 studies' cost-effectiveness were unable to be evaluated. Interventions considered to be most cost-effective included pharmacist medication reviews, pharmacist adherence strategies and pharmacist management of type 2 diabetes mellitus, hypertension and warfarin/INR monitoring. The quality of reporting of studies differed with no studies reporting all 28 items of the CHEERS statement. Conclusions: There is strong economic evidence to support investment in extended pharmacist services, particularly those focussed on long-term chronic health conditions.
MeSH term(s)	Humans ; Cost-Benefit Analysis ; Diabetes Mellitus, Type 2/drug therapy ; Pharmacists ; Pharmaceutical Services ; Cost-Effectiveness Analysis
Language	English
Publishing date	2023-08-04
Publishing country	England
Document type	Systematic Review ; Journal Article
ZDB-ID	1087040-4
ISSN	2042-7174 ; 0961-7671
ISSN (online)	2042-7174
ISSN	0961-7671
DOI	10.1093/ijpp/riad052
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Article ; Online: Pharmacists of the future: What determines graduates' desire to engage in patient-centred services?

Nair, Dhanya / Green, James A / Marra, Carlo A

Research in social & administrative pharmacy : RSAP

2020 Volume 17, Issue 3, Page(s) 545–552

Abstract: Background: Pharmacists increasingly need to provide patient centred activities like medicine management (e.g., medicine use review/home medicine review), screening for chronic illness (e.g., point of care testing for cardiovascular diseases including ... ...

Abstract	Background: Pharmacists increasingly need to provide patient centred activities like medicine management (e.g., medicine use review/home medicine review), screening for chronic illness (e.g., point of care testing for cardiovascular diseases including hypertension and hypercholesterolemia), treatment for chronic conditions (e.g., warfarin for thrombotic prophylaxis), and primary care treatment (trimethoprim, emergency contraceptive pill, and sildenafil). However, the adoption of patient-centred services into practice is still low, and it not known which pharmacist characteristics are associated with the adoption of these services. Objective: The primary objective of this study was to investigate whether personality and other characteristics of pharmacy graduates are associated with their intention to provide patient-centred services in the future. Methods: The study design was a cross-sectional survey of pharmacy graduates from the University of Otago at the end of 2017. The web-based survey involved several potential determinants: (1) the Achievement Goals Questionnaire (Revised), (2) five-factor ('Big Five') model of personality, (3) decision-making style using the Rational Experiential inventory, (4) general self-efficacy, (5) sense of belonging to the pharmacy profession. Additionally, interest in provision of services was assessed. Results: A total of 83 graduates completed the survey (response rate 63%, female 64%, age 22.5 years, SD: 1.7). Intention to provide patient-centred services was associated with higher: conscientiousness, agreeableness, and extraversion; mastery-approach; self-efficacy; and sense of belonging to the profession. Relative to the New Zealand population norms, these students were higher in conscientiousness and lower in neuroticism. Graduates were more interested in providing new patient-centred roles than more traditional services. Conclusion: Overall, pharmacy graduates were very positive regarding their future involvement in patient-centred services. Pharmacy graduates' sense of self-efficacy and a sense of belonging in the profession were associated with interest in patient-centred roles. Increasing their self-efficacy and sense of belonging to the profession and building on their enthusiasm as new graduates are key to greater provision of patient-centred activities.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Female ; Humans ; Male ; New Zealand ; Pharmaceutical Services ; Pharmacies ; Pharmacists ; Surveys and Questionnaires ; Young Adult
Language	English
Publishing date	2020-05-05
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2192059-X
ISSN	1934-8150 ; 1551-7411
ISSN (online)	1934-8150
ISSN	1551-7411
DOI	10.1016/j.sapharm.2020.04.030
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Article ; Online: Examining non-medical prescribing trends in New Zealand: 2016-2020.

Raghunandan, Rakhee / Marra, Carlo A / Tordoff, June / Smith, Alesha

BMC health services research

2021 Volume 21, Issue 1, Page(s) 418

Abstract: Background: Population growth and general practitioner workforce constraints are creating increasing demand for health services in New Zealand (NZ) and internationally. Non-medical prescribing (NMP) is one strategy that has been introduced to help ... ...

Abstract	Background: Population growth and general practitioner workforce constraints are creating increasing demand for health services in New Zealand (NZ) and internationally. Non-medical prescribing (NMP) is one strategy that has been introduced to help manage this. Little is known about the NMP practice trends in NZ. The aim of this study was to provide a current overview of the scale, scope, and trends of NMP practice in NZ. Methods: All claims for community dispensed medicines prescribed by a non-medical prescriber were extracted from the NZ Pharmaceutical Collection for the period 2016-2020. Patient demographics were retrieved from the Primary Health Organisation enrolment collection. These national databases contain prescription information for all subsidised community pharmacy medicines dispensed and healthcare enrolment data for 96% of New Zealanders. Results: The proportion of prescriptions written by all NMP providers and patients receiving NMP prescriptions increased each year from 1.8% (2016) to 3.6% (2019) and 8.4% (2016) to 14.4% (2019) respectively. From 2016 to 2019, the proportion of NMP patients who had at least one NMP prescription increased from 26% to 39% for nurse prescribers, from 1% to 9% for pharmacist prescribers, from 2% to 3% for dietitian prescribers, and decreased from 47% to 22% for dentists, and from 20% to 12% for midwives. The most commonly prescribed medicines were antibiotics (amoxicillin, amoxicillin with clavulanic acid, and metronidazole), and analgesics (paracetamol, and codeine phosphate). While some NMP providers were prescribing for patients with greater health needs, all NMP providers could be better utilised to reach more of these patients. Conclusions: This study highlights that although the NMP service has been implemented in NZ, it has yet to become mainstream healthcare practice. This work provides a baseline to evaluate the NMP service moving forward and enable policy development. Improved implementation and integration of primary care NMP services can ensure continued access to prescribing services and medicines for our communities.
MeSH term(s)	Drug Prescriptions ; Humans ; New Zealand ; Pharmacists ; Primary Health Care
Language	English
Publishing date	2021-05-03
Publishing country	England
Document type	Journal Article
ISSN	1472-6963
ISSN (online)	1472-6963
DOI	10.1186/s12913-021-06435-y
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