Skip to main content
Top
Published in: International Journal of Clinical Pharmacy 6/2013

01-12-2013 | Research Article

Australian community pharmacists’ awareness and practice in supporting secondary prevention of cardiovascular disease

Authors: Hanni Prihhastuti Puspitasari, Parisa Aslani, Ines Krass

Published in: International Journal of Clinical Pharmacy | Issue 6/2013

Login to get access

Abstract

Background: Pharmacists are well placed to identify, prevent and resolve medicine related problems as well as monitor the effectiveness of treatments in cardiovascular disease (CVD). Pharmacists’ interventions in CVD secondary prevention have been shown to improve outcomes for clients with established CVD. Objective: To explore the scope of pharmacists’ activities in supporting CVD secondary prevention. Setting: Community pharmacies in New South Wales, Australia. Methods: Twenty-one in-depth, semi-structured interviews with a range of community pharmacists were conducted. All interviews were audio-recorded and transcribed ad verbatim. Data were analyzed using a ‘grounded-theory’ approach by applying methods of constant comparison. Main outcome measure: Community pharmacists’ awareness and current practice in supporting secondary prevention of CVD. Results: Four key themes identified included ‘awareness’, ‘patient counselling’, ‘patient monitoring’, and ‘perceptions of the role of pharmacists in CVD secondary prevention’. The pharmacists demonstrated a moderate understanding of CVD secondary prevention. There was considerable variability in the scope of practice among the participants, ranging from counselling only about medicines to providing continuity of care. A minority of pharmacists who had negative beliefs about their roles in CVD secondary prevention offered limited support to their clients. The majority of pharmacists, however, believed that they have an important role to play in supporting clients with established CVD. Conclusion: Community pharmacists in Australia make a contribution to the care of clients with established CVD despite the gap in their knowledge and understanding of CVD secondary prevention. The scope of practice in CVD secondary prevention ranged from only counselling about medicines to offering continuity of care. The extent of pharmacists’ involvement in offering disease management appears to be influenced by their beliefs regarding what is required within their scope of practice.
Literature
1.
go back to reference Australian Institute of Health and Welfare. Cardiovascular disease: Australian facts 2011. Cardiovascular disease series. Cat. no. CVD 53. Canberra: AIHW; 2011. ISBN 978-1-74249-130-1. Australian Institute of Health and Welfare. Cardiovascular disease: Australian facts 2011. Cardiovascular disease series. Cat. no. CVD 53. Canberra: AIHW; 2011. ISBN 978-1-74249-130-1.
3.
go back to reference National Health Priority Action Council. National chronic disease strategy. Canberra: Australian Government Department of Health and Ageing; 2006. ISBN 0-642-82869-5. National Health Priority Action Council. National chronic disease strategy. Canberra: Australian Government Department of Health and Ageing; 2006. ISBN 0-642-82869-5.
4.
go back to reference World Health Organization. Prevention of cardiovascular disease: pocket guidelines for assessment and management of cardiovascular risk. Geneva: WHO Press; 2007. ISBN 978-92-4-154726-µ0. World Health Organization. Prevention of cardiovascular disease: pocket guidelines for assessment and management of cardiovascular risk. Geneva: WHO Press; 2007. ISBN 978-92-4-154726-µ0.
5.
go back to reference Ponniah A, Anderson B, Shakib S, Doecke CJ, Angley M. Pharmacists’ role in the post-discharge management of patients with heart failure: a literature review. J Clin Pharm Ther. 2007;32(4):343–52.PubMedCrossRef Ponniah A, Anderson B, Shakib S, Doecke CJ, Angley M. Pharmacists’ role in the post-discharge management of patients with heart failure: a literature review. J Clin Pharm Ther. 2007;32(4):343–52.PubMedCrossRef
6.
go back to reference Machado M, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part I: systematic review and meta-analysis in diabetes management. Ann Pharmacother. 2007;41(10):1569–82.PubMedCrossRef Machado M, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part I: systematic review and meta-analysis in diabetes management. Ann Pharmacother. 2007;41(10):1569–82.PubMedCrossRef
7.
go back to reference Machado M, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part II: systematic review and meta-analysis in hypertension management. Ann Pharmacother. 2007;41(11):1770–81.PubMedCrossRef Machado M, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part II: systematic review and meta-analysis in hypertension management. Ann Pharmacother. 2007;41(11):1770–81.PubMedCrossRef
8.
go back to reference Machado M, Nassor N, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part III: systematic review and meta-analysis in hyperlipidemia management. Ann Pharmacother. 2008;42(9):1195–207.PubMedCrossRef Machado M, Nassor N, Bajcar J, Guzzo GC, Einarson TR. Sensitivity of patient outcomes to pharmacist interventions. Part III: systematic review and meta-analysis in hyperlipidemia management. Ann Pharmacother. 2008;42(9):1195–207.PubMedCrossRef
9.
go back to reference McConnell KJ, Denham AM, Olson KL. Pharmacist-led interventions for the management of cardiovascular disease: opportunities and obstacles. Dis Manag Health Outcomes. 2008;16(3):131–44.CrossRef McConnell KJ, Denham AM, Olson KL. Pharmacist-led interventions for the management of cardiovascular disease: opportunities and obstacles. Dis Manag Health Outcomes. 2008;16(3):131–44.CrossRef
10.
go back to reference Evans CD, Watson E, Eurich DT, Taylor JG, Yakiwchuk EM, Shevchuk YM, et al. Diabetes and cardiovascular disease interventions by community pharmacists: a systematic review. Ann Pharmacother. 2011;45(5):615–28.PubMedCrossRef Evans CD, Watson E, Eurich DT, Taylor JG, Yakiwchuk EM, Shevchuk YM, et al. Diabetes and cardiovascular disease interventions by community pharmacists: a systematic review. Ann Pharmacother. 2011;45(5):615–28.PubMedCrossRef
11.
go back to reference Amariles P, Sabater-Hernandez D, Garcia-Jlmenez E, Rodriguez-Chamorro MA, Prats-Mas R, Marin-Magan F, et al. Effectiveness of dader method for pharmaceutical care on control of blood pressure and total cholesterol in outpatients with cardiovascular disease or cardiovascular risk: EMDADER-CV randomized controlled trial. J Manag Care Pharm. 2012;18(4):311–23.PubMed Amariles P, Sabater-Hernandez D, Garcia-Jlmenez E, Rodriguez-Chamorro MA, Prats-Mas R, Marin-Magan F, et al. Effectiveness of dader method for pharmaceutical care on control of blood pressure and total cholesterol in outpatients with cardiovascular disease or cardiovascular risk: EMDADER-CV randomized controlled trial. J Manag Care Pharm. 2012;18(4):311–23.PubMed
12.
go back to reference George J, McNamara K, Stewart K. The roles of community pharmacists in cardiovascular disease prevention and management. Australas Med J. 2011;4(5):266–72.PubMedCrossRef George J, McNamara K, Stewart K. The roles of community pharmacists in cardiovascular disease prevention and management. Australas Med J. 2011;4(5):266–72.PubMedCrossRef
14.
go back to reference Sweeny K. The pharmaceutical industry in Australia: working paper no. 34. Pharmaceutical industry project working paper series. Melbourne: Centre for Strategic Economic Studies Victoria University of Technology; 2007 [cited 2013 Feb 1]. Available from: http://www.cfses.com. Sweeny K. The pharmaceutical industry in Australia: working paper no. 34. Pharmaceutical industry project working paper series. Melbourne: Centre for Strategic Economic Studies Victoria University of Technology; 2007 [cited 2013 Feb 1]. Available from: http://​www.​cfses.​com.
15.
go back to reference Creswell JW. Qualitative inquiry and research design: choosing among five approaches. 3rd ed. Thousand Oaks: Sage Publications; 2013. ISBN 978-1-4129-9530-6. Creswell JW. Qualitative inquiry and research design: choosing among five approaches. 3rd ed. Thousand Oaks: Sage Publications; 2013. ISBN 978-1-4129-9530-6.
16.
go back to reference Birk M, Mills J. Grounded theory: a practical guide. London: Sage Publications; 2010. ISBN 9781848609938. Birk M, Mills J. Grounded theory: a practical guide. London: Sage Publications; 2010. ISBN 9781848609938.
18.
go back to reference National Health and Medical Research Council. Strengthening cardiac rehabilitation and secondary prevention for Aboriginal and Torres Strait Islander people: a guide for health professionals. Canberra: Australian Government NHMRC; 2005. ISBN 1864962720. National Health and Medical Research Council. Strengthening cardiac rehabilitation and secondary prevention for Aboriginal and Torres Strait Islander people: a guide for health professionals. Canberra: Australian Government NHMRC; 2005. ISBN 1864962720.
19.
go back to reference National Stroke Foundation. Clinical guidelines for stroke management 2010. Melbourne: National Stroke Foundation of Australia; 2010. ISSBN0-978-0-9805933-3-4. National Stroke Foundation. Clinical guidelines for stroke management 2010. Melbourne: National Stroke Foundation of Australia; 2010. ISSBN0-978-0-9805933-3-4.
20.
go back to reference National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand. Reducing risk in heart disease: an expert guide to clinical practice for secondary prevention of coronary heart disease. Melbourne: National Heart Foundation of Australia; 2012. ISBN 978-1-74345-016-1. National Heart Foundation of Australia and the Cardiac Society of Australia and New Zealand. Reducing risk in heart disease: an expert guide to clinical practice for secondary prevention of coronary heart disease. Melbourne: National Heart Foundation of Australia; 2012. ISBN 978-1-74345-016-1.
21.
go back to reference Fei G, Jiang X, Gui-lian W, Jia-hong W, Jin-song W, Jin-ming Y, et al. Community-wide survey of physicians’ knowledge of cholesterol management. Chin Med J. 2010;123(7):884–9. Fei G, Jiang X, Gui-lian W, Jia-hong W, Jin-song W, Jin-ming Y, et al. Community-wide survey of physicians’ knowledge of cholesterol management. Chin Med J. 2010;123(7):884–9.
22.
go back to reference Adams OP, Carter AO. Diabetes and hypertension guidelines and the primary health care practitioner in Barbados: knowledge, attitudes, practices and barriers—a focus group study. BMC Fam Pract. 2010;11(96):1. Adams OP, Carter AO. Diabetes and hypertension guidelines and the primary health care practitioner in Barbados: knowledge, attitudes, practices and barriers—a focus group study. BMC Fam Pract. 2010;11(96):1.
23.
go back to reference Sacco RL, Adams R, Albers GW, Alberts MJ, Benavente O, Furie K, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention. Stroke. 2006;37(2):577–617.PubMedCrossRef Sacco RL, Adams R, Albers GW, Alberts MJ, Benavente O, Furie K, et al. Guidelines for prevention of stroke in patients with ischemic stroke or transient ischemic attack: a statement for healthcare professionals from the American Heart Association/American Stroke Association Council on Stroke: co-sponsored by the Council on Cardiovascular Radiology and Intervention. Stroke. 2006;37(2):577–617.PubMedCrossRef
24.
go back to reference Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011;124:00–00 (cited 2011 Nov 30). Available from: http://circ.ahajournals.org. Smith SC, Benjamin EJ, Bonow RO, Braun LT, Creager MA, Franklin BA, et al. AHA/ACCF secondary prevention and risk reduction therapy for patients with coronary and other atherosclerotic vascular disease: 2011 update: a guideline from the American Heart Association and American College of Cardiology Foundation. Circulation. 2011;124:00–00 (cited 2011 Nov 30). Available from: http://​circ.​ahajournals.​org.
25.
go back to reference El Hajj MS, Al Nakeeb RR, Al-Qudah RA. Smoking cessation counseling in Qatar: community pharmacists’ attitudes, role perceptions and practices. Int J Clin Pharm. 2012;34(4):667–76.PubMedCrossRef El Hajj MS, Al Nakeeb RR, Al-Qudah RA. Smoking cessation counseling in Qatar: community pharmacists’ attitudes, role perceptions and practices. Int J Clin Pharm. 2012;34(4):667–76.PubMedCrossRef
26.
go back to reference McCaig D, Fitzgerald N, Stewart D. Provision of advice on alcohol use in community pharmacy: a cross-sectional survey of pharmacists’ practice, knowledge, views and confidence. Int J Pharm Pract. 2011;19(3):171–8.PubMedCrossRef McCaig D, Fitzgerald N, Stewart D. Provision of advice on alcohol use in community pharmacy: a cross-sectional survey of pharmacists’ practice, knowledge, views and confidence. Int J Pharm Pract. 2011;19(3):171–8.PubMedCrossRef
27.
go back to reference Grimes T, Duggan C, Gallagher P, Strawbridge J. Care of the stroke patient—communication between the community pharmacist and prescribers in the Republic of Ireland. Pharm World Sci. 2009;31(6):648–55.PubMedCrossRef Grimes T, Duggan C, Gallagher P, Strawbridge J. Care of the stroke patient—communication between the community pharmacist and prescribers in the Republic of Ireland. Pharm World Sci. 2009;31(6):648–55.PubMedCrossRef
28.
go back to reference Puspitasari HP, Aslani P, Krass I. A review of counseling practices on prescription medicines in community pharmacies. Res Soc Adm Pharm. 2009;5(3):197–210.CrossRef Puspitasari HP, Aslani P, Krass I. A review of counseling practices on prescription medicines in community pharmacies. Res Soc Adm Pharm. 2009;5(3):197–210.CrossRef
29.
go back to reference Guirguis LM. Mixed methods evaluation: pharmacists’ experiences and beliefs toward an interactive communication approach to patient interactions. Patient Educ Couns. 2011;83(3):432–42.PubMedCrossRef Guirguis LM. Mixed methods evaluation: pharmacists’ experiences and beliefs toward an interactive communication approach to patient interactions. Patient Educ Couns. 2011;83(3):432–42.PubMedCrossRef
30.
go back to reference Lenz TL, Stading JA. Lifestyle modification counseling of patients with dyslipidemias by pharmacists and other health professionals. J Am Pharm Assoc. 2005;45(6):709–13. Lenz TL, Stading JA. Lifestyle modification counseling of patients with dyslipidemias by pharmacists and other health professionals. J Am Pharm Assoc. 2005;45(6):709–13.
31.
go back to reference Hunt LM, Kreiner M, Brody H. The changing face of chronic illness management in primary care: a qualitative study of underlying influences and unintended outcomes. Ann Fam Med. 2012;10(5):452–60.PubMedCrossRef Hunt LM, Kreiner M, Brody H. The changing face of chronic illness management in primary care: a qualitative study of underlying influences and unintended outcomes. Ann Fam Med. 2012;10(5):452–60.PubMedCrossRef
33.
go back to reference Oladapo AO, Rascati KL. Review of survey articles regarding medication therapy management (MTM) services/programs in the United States. J Pharm Pract. 2012;25(4):457–70.PubMedCrossRef Oladapo AO, Rascati KL. Review of survey articles regarding medication therapy management (MTM) services/programs in the United States. J Pharm Pract. 2012;25(4):457–70.PubMedCrossRef
34.
go back to reference Mak VS, Clark A, Poulsen JH, Udengaard KU, Gilbert AL. Pharmacists’ awareness of Australia’s health care reforms and their beliefs and attitudes about their current and future roles. Int J Pharm Pract. 2012;20(1):33–40.PubMedCrossRef Mak VS, Clark A, Poulsen JH, Udengaard KU, Gilbert AL. Pharmacists’ awareness of Australia’s health care reforms and their beliefs and attitudes about their current and future roles. Int J Pharm Pract. 2012;20(1):33–40.PubMedCrossRef
35.
go back to reference Rosenthal MM, Breault RR, Austin Z, Tsuyuki RT. Pharmacists’ self-perception of their professional role: insights into community pharmacy culture. J Am Pharm Assoc. 2011;51(3):363–7. Rosenthal MM, Breault RR, Austin Z, Tsuyuki RT. Pharmacists’ self-perception of their professional role: insights into community pharmacy culture. J Am Pharm Assoc. 2011;51(3):363–7.
36.
go back to reference Al Hamarneh YN, Rosenthal M, McElnay JC, Tsuyuki RT. Pharmacists’ perceptions of their practice: a comparison between Alberta and Northern Ireland. Int J Pharm Pract. 2012;20:57–64.PubMedCrossRef Al Hamarneh YN, Rosenthal M, McElnay JC, Tsuyuki RT. Pharmacists’ perceptions of their practice: a comparison between Alberta and Northern Ireland. Int J Pharm Pract. 2012;20:57–64.PubMedCrossRef
37.
go back to reference AbuRuz S, Al-Ghazawi M, Snyder A. Pharmaceutical care in a community-based practice setting in Jordan: where are we now with our attitudes and perceived barriers? Int J Pharm Pract. 2012;20(2):71–9.PubMedCrossRef AbuRuz S, Al-Ghazawi M, Snyder A. Pharmaceutical care in a community-based practice setting in Jordan: where are we now with our attitudes and perceived barriers? Int J Pharm Pract. 2012;20(2):71–9.PubMedCrossRef
38.
go back to reference Ibrahim A, Scott J. Community pharmacists in Khartoum State, Sudan: their current roles and perspectives on pharmaceutical care implementation. Int J Clin Pharm. 2012;35(2):236–43.PubMedCrossRef Ibrahim A, Scott J. Community pharmacists in Khartoum State, Sudan: their current roles and perspectives on pharmaceutical care implementation. Int J Clin Pharm. 2012;35(2):236–43.PubMedCrossRef
39.
go back to reference Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533–43.PubMed Hepler CD, Strand LM. Opportunities and responsibilities in pharmaceutical care. Am J Hosp Pharm. 1990;47(3):533–43.PubMed
40.
go back to reference Pellegrino AN, Martin MT, Tilton JJ, Touchette DR. Medication therapy management services: definitions and outcomes. Drugs. 2009;69(4):393–406.PubMedCrossRef Pellegrino AN, Martin MT, Tilton JJ, Touchette DR. Medication therapy management services: definitions and outcomes. Drugs. 2009;69(4):393–406.PubMedCrossRef
42.
go back to reference Cipolle RJ, Strand LM, Morley PC, eds. Pharmaceutical care practice: the patient-centered approach to medication management services. New York: McGraw-Hill; 2012. ISBN 978-0-07-175638-9. Cipolle RJ, Strand LM, Morley PC, eds. Pharmaceutical care practice: the patient-centered approach to medication management services. New York: McGraw-Hill; 2012. ISBN 978-0-07-175638-9.
43.
go back to reference Gadkari AS, Mott DA, Kreling DH, Bonnarens JK. Pharmacy characteristics associated with the provision of drug therapy services in nonmetropolitan community pharmacies. J Rural Health. 2009;25(3):290–5.PubMedCrossRef Gadkari AS, Mott DA, Kreling DH, Bonnarens JK. Pharmacy characteristics associated with the provision of drug therapy services in nonmetropolitan community pharmacies. J Rural Health. 2009;25(3):290–5.PubMedCrossRef
44.
go back to reference Haag JD, Stratton TP. Patient care services in rural Minnesota community pharmacies. J Am Pharm Assoc. 2010;50(4):508–16. Haag JD, Stratton TP. Patient care services in rural Minnesota community pharmacies. J Am Pharm Assoc. 2010;50(4):508–16.
45.
go back to reference Xu KT, Borders TF. Characteristics of rural elderly people who bypass local pharmacies. J Rural Health. 2003;19(2):156–64.PubMedCrossRef Xu KT, Borders TF. Characteristics of rural elderly people who bypass local pharmacies. J Rural Health. 2003;19(2):156–64.PubMedCrossRef
Metadata
Title
Australian community pharmacists’ awareness and practice in supporting secondary prevention of cardiovascular disease
Authors
Hanni Prihhastuti Puspitasari
Parisa Aslani
Ines Krass
Publication date
01-12-2013
Publisher
Springer Netherlands
Published in
International Journal of Clinical Pharmacy / Issue 6/2013
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI
https://doi.org/10.1007/s11096-013-9854-0

Other articles of this Issue 6/2013

International Journal of Clinical Pharmacy 6/2013 Go to the issue