Top

BMC Health Services Research

Published in:

Open Access 01-12-2016 | Research article

A qualitative study of community pharmacists’ opinions on the provision of osteoporosis disease state management services in Malaysia

Authors: Jah Nik, Pauline Siew Mei Lai, Chirk Jenn Ng, Lynne Emmerton

Published in: BMC Health Services Research | Issue 1/2016

Abstract

Background

Osteoporosis has significant impact on healthcare costs and quality of life. Amongst the models for collaborative disease state management services published internationally, there is sparse evidence regarding the role of community pharmacists in the provision of osteoporosis care. Hence, the aim of our study was to explore community pharmacists’ opinions (including the barriers and facilitators) and scope of osteoporosis disease state management services by community pharmacists in Malaysia, informing a vision for developing these services.

Methods

Semi-structured individual interviews and focus groups discussions were conducted with community pharmacists from October 2013 to July 2014. Three trained researchers interviewed the participants. Interviews were recorded and transcribed verbatim. Data were analyzed thematically using an interpretative description approach.

Results

Nineteen community pharmacists with 1–23 years of experience were recruited (in depth interviews: n = 9; focus group discussions: n = 10). These participants reflected on their experience with osteoporosis-related enquiries, which included medication counseling, bone density screening and referral of at-risk patients. Key barriers were the lack of numerous factors: public awareness of osteoporosis, accurate osteoporosis screening tools for community pharmacists, pharmacists’ knowledge on osteoporosis disease and medications, time to counsel patients about bone health, collaboration between pharmacists and doctors, and support from the government and professional body. The pharmacists wanted more continuing education on osteoporosis, osteoporosis awareness campaigns, a simple, unbiased osteoporosis education material, and inter-professional collaboration practices with doctors, and pharmacists’ reimbursement for osteoporosis care.

Conclusions

The involvement of community pharmacists in the provision of osteoporosis disease state management was minimal. Only ad-hoc counseling on osteoporosis prevention was performed by community pharmacists. Development and trial of collaborative osteoporosis disease state management services in community pharmacy could be facilitated by training, support and remuneration.

Available only for authorised users

Cauley JA. Public health impact of osteoporosis. The Journals of Gerontology Series A, Biological sciences and medical sciences 2013 doi:10.1093/gerona/glt093.

Cooper C, Campion G, Melton 3rd LJ. Hip fractures in the elderly: A world-wide projection. Osteoporos Int. 1992;2(6):285–9. doi:10.1007/BF01623184.CrossRefPubMed

Department Of Statistics M. Population Projections In Malaysia: 2010–2040. 2012. Retrieved (24/11/2015): http://www.statistics.gov.my.

Majumdar SR, Johnson JA, McAlister FA, Bellerose D, Russell AS, Hanley DA et al. Multifaceted intervention to improve diagnosis and treatment of osteoporosis in patients with recent wrist fracture: a randomized controlled trial. Canadian Medical Association Journal 2008 doi:10.1503/cmaj.070981.

Nayak S, Roberts MS, Greenspan SL. Factors associated with diagnosis and treatment of osteoporosis in older adults. Osteoporosis International 2009 doi:10.1007/s00198-008-0831-8.

Khan YH, Mallhi TH, Sarriff A, Khan AH. Osteoporosis: are healthcare professionals missing an opportunity? Springerplus 2013 doi:10.1186/2193-1801-2-463.

Khan YH, Khan AH, Sarriff A. A Review Of Knowledge, Attitude And Practices (KAP) Of Community Population Towards Osteoporosis. J App Pharm. 2012;3(4):628–38.

Harvey N, Dennison E, Cooper C. Osteoporosis: impact on health and economics. Nature Reviews Rheumatology 2010 doi:10.1038/nrrheum.2009.260.

Burge R, Dawson-Hughes B, Solomon DH, Wong JB, King A, Tosteson A. Incidence and economic burden of osteoporosis-related fractures in the United States, 2005–2025. Journal of Bone and Mineral Research 2007 doi:10.1359/jbmr.061113.

10.

Gowan J, Roller L. Disease state management: Osteoporosis: Prevention and management in older people. Aust J Pharm. 2012;41:110–8.

11.

Summers KM, Brock TP. Impact of pharmacist-led community bone mineral density screenings. The Annals of pharmacotherapy 2005 doi:10.1345/aph.1E321.

12.

Liu Y, Nevins JC, Carruthers KM, Doucette WR, McDonough RP, Pan X. Osteoporosis risk screening for women in a community pharmacy. Journal of the American Pharmacists Association: JAPhA 2007 doi:10.1331/JAPhA.2007.05107.

13.

Yuksel N, Majumdar SR, Biggs C, Tsuyuki RT. Community pharmacist-initiated screening program for osteoporosis: randomized controlled trial. Osteoporosis International 2010 doi:10.1007/s00198-009-0977-z.

14.

Yood RA, Emani S, Reed JI, Lewis BE, Charpentier M, Lydick E. Compliance with pharmacologic therapy for osteoporosis. Osteoporosis International 2003 doi:10.1007/s00198-003-1502-4.

15.

Goode JV, Swiger K, Bluml BM. Regional osteoporosis screening, referral, and monitoring program in community pharmacies: findings from Project ImPACT: Osteoporosis. Journal of the American Pharmacists Association : JAPhA 2004 doi:10.1331/154434504773062609.

16.

Li WW, Kendler DL. Pharmaceutical care and community pharmacists’ understanding of bisphosphonate dosing information. Journal of clinical pharmacy and therapeutics 2004 doi:10.1111/j.1365-2710.2004.00597.

17.

MacLaughlin EJ, MacLaughlin AA, Snella KA, Winston TS, Fike DS, Raehl CR. Osteoporosis screening and education in community pharmacies using a team approach. Pharmacotherapy 2005 doi:10.1592/phco.25.3.379.61604.

18.

Laliberte MC, Perreault S, Damestoy N, Lalonde L. The role of community pharmacists in the prevention and management of osteoporosis and the risk of falls: results of a cross-sectional study and qualitative interviews. Osteoporos Int. 2013;24(6):1803–15. doi:10.1007/s00198-012-2171-y.CrossRefPubMed

19.

Klop C, De Vries F, Vinks T, Kooij MJ, Van Staa TP, Bijlsma JW, et al. Increase in prophylaxis of glucocorticoid-induced osteoporosis by pharmacist feedback: a randomised controlled trial. Osteoporos Int. 2014;25(1):385–92. doi:10.1007/s00198-013-2562-8.CrossRefPubMed

20.

Stuurman-Bieze AG, Hiddink EG, van Boven JF, Vegter S. Proactive pharmaceutical care interventions decrease patients’ nonadherence to osteoporosis medication. Osteoporosis International 2014 doi:10.1007/s00198-014-2659-8.

21.

Crockett JA, Taylor SJ, McLeod LJ. Patient responses to an integrated service, initiated by community pharmacists, for the prevention of osteoporosis. International Journal of Pharmacy Practice 2008 doi:10.1211/ijpp.16.2.0003.

22.

Chaiyakunapruk N, Laowakul A, Karnchanarat S, Pikulthong N, Ongphiphadhanakul B. Community pharmacy-based implementation and evaluation of an osteoporosis self-assessment tool for Asians. J Am Pharm Assoc. 2006;46:391–6.CrossRef

23.

Shafie AA, Hassali MA, Azhar S, See OG. Separation of prescribing and dispensing in Malaysia: a summary of arguments. Research in social & administrative pharmacy : RSAP 2012 doi:10.1016/j.sapharm.2011.06.002.

24.

Chua SS, Lim KP, Lee HG. Utilisation of community pharmacists by the general public in Malaysia. The International journal of pharmacy practice 2013 doi:10.1111/j.2042-7174.2012.00219.x.

25.

Steed L. Community pharmacy interventions for health promotion: effects on professional practice and health outcomes. Cochrane Database of Systematic Reviews 2014 doi:10.1002/14651858.CD011207.

26.

Thorne S, Reimer Kirkham S, O’Flynn-Magee K. The Analytic Challenge in Interpretive Description. Int J Qualitative Methods. 2004;3:1.

27.

Sandelowski M. Focus on Research Methods: Whatever Happened to Qualitative Description? Research in Nursing & Health. 2000.

28.

Babar ZUD, Ibrahim MIM, Singh H, Bukahri NI, Creese A. Evaluating drug prices, availability, affordability, and price components: implications for access to drugs in Malaysia. PLoS Med. 2007;4(3), e82. doi:10.1371/journal.pmed.0040082.CrossRefPubMedPubMedCentral

29.

Huston SA, Hobson EH. Using focus groups to inform pharmacy research. Research in social & administrative pharmacy : RSAP 2008 doi:10.1016/j.sapharm.2007.09.001.

30.

Reid AE, Aiken LS. Integration of five health behaviour models: common strengths and unique contributions to understanding condom use. Psychol Health. 2011;26(11):1499–520. doi:10.1080/08870446.2011.572259.CrossRefPubMedPubMedCentral

31.

Godin G, Belanger-Gravel A, Eccles M, Grimshaw J. Healthcare professionals’ intentions and behaviours: a systematic review of studies based on social cognitive theories. Implementation science : IS 2008 doi:10.1186/1748-5908-3-36.

32.

Pope C, Ziebland S, Mays N. Qualitative research in health care. Analysing qualitative data. BMJ. 2000;320:114–6.CrossRefPubMedPubMedCentral

33.

Kvale S, Brinkmann S. InterViews: Learning the Craft of Qualitative Research Interviewing. Los Angeles: SAGE Publications; 2009.

34.

Malterud K. Qualitative research: standards, challenges, and guidelines. Lancet 2001 doi:10.1016/S0140-6736(01)05627-6.

35.

Sarriff A, Gillani WS, M. Babiker GAR. Pharmacist perception to importance and self-competence in pharmacy practice. Int J Pharm Stud Res. 2010;30:264e–73e.

36.

Khan YH, Sarrif A, Khan AH. Facing bitter truth of bones—Assessment of osteoporosis knowledge and beliefs in community settings. Int J Pharm Bio Sci. 2013;4:1.

37.

Kempen TGH, van de Steeg-van Gompel C, Hoogland P, Liu YQ, Bouvy ML. Large scale implementation of clinical medication reviews in Dutch community pharmacies: drug-related problems and interventions. Int J Clin Pharm. 2014;36(3):630–5. doi:10.1007/s11096-014-9947-4.CrossRefPubMed

38.

Chan V, Cave AJ, Banh HL. Self-reported osteoporosis prevention in inhaled corticosteroid users in community pharmacy setting. SAGE Open Medicine. 2015;3:2050312115586912. doi:10.1177/2050312115586912.

39.

International Osteoporosis Foundation. The Asian Audit Epidemiology, costs and burden of osteoporosis in Asia 2013. 2013. Retrieved (24/11/2015) from: http://www.iofbonehealth.org/asian-audit.

40.

Deo P, Nayak R, Rajpura J. Women’s Attitudes and Health Beliefs toward Osteoporosis Screening in a Community Pharmacy. Journal of osteoporosis 2013 doi:10.1155/2013/650136.

41.

Thomsen K, Jepsen DB, Matzen L, Hermann AP, Masud T, Ryg J. Is calcaneal quantitative ultrasound useful as a prescreen stratification tool for osteoporosis? Osteoporos Int. 2015;26(5):1459–75. doi:10.1007/s00198-014-3012-y.CrossRefPubMed

42.

Kanis JA, Johnell O, Oden A, Johansson H, McCloskey E. FRAX and the assessment of fracture probability in men and women from the UK. Osteoporos International 2008 doi:10.1007/s00198-007-0543-5.

43.

Malaysian Osteoporosis Society. Clinical Guidance on Management of Osteoporosis 2012. 2012. Retrieved (20/5/2013) from: http://www.msr.org.my/file_dir/340413148504d91ebcb85b.pdf.

44.

Nayak S, Edwards DL, Saleh AA, Greenspan SL. Systematic review and meta-analysis of the performance of clinical risk assessment instruments for screening for osteoporosis or low bone density. Osteoporos Int. 2015;26(5):1543–54. doi:10.1007/s00198-015-3025-1.CrossRefPubMedPubMedCentral

45.

Koh LKH, Sedrine WB, Torralba TP, Kung A, Fujiwara S, Chan SP et al. A simple tool to identify Asian women at increased risk of osteoporosis. Osteoporosis International 2001 doi:10.1007/s001980170070.

46.

Laliberte MC, Perreault S, Damestoy N, Lalonde L. Ideal and actual involvement of community pharmacists in health promotion and prevention: a cross-sectional study in Quebec, Canada. BMC public health 2012 doi:10.1186/1471-2458-12-192.

47.

Wibowo Y, Berbatis C, Joyce A, Sunderland VB. Analysis of enhanced pharmacy services in rural community pharmacies in Western Australia. Rural Remote Health. 2010.

48.

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? The International journal of pharmacy practice 2012 doi:10.1111/j.2042-174.2011.00164.x.

49.

Rosenthal MM, Breault RR, Austin Z, Tsuyuki RT. Pharmacists’ self-perception of their professional role: Insights into community pharmacy culture. Journal of the American Pharmacists Association 2011 doi:10.1331/Japha.2011.10034.

50.

Kreling DH, Doucette WR, Mott DA, Gaither CA, Pedersen CA, Schommer JC. Community pharmacists’ work environments: evidence from the 2004 National Pharmacist Workforce Study. J Am Pharm Asso. 2006;46:331–9.CrossRef

51.

Chui MA, Look KA, Mott DA. The association of subjective workload dimensions on quality of care and pharmacist quality of work life. Research in Social & Administrative Pharmacy 2014 doi:10.1016/j.sapharm.2013.05.007.

52.

Farris KB, Schopflocher DP. Between intention and behavior: an application of community pharmacists’ assessment of pharmaceutical care. Social Science & Medicine 1999 doi:10.1016/S0277-9536(99)00078-7.

53.

Elayeh E, Akour A, Yousef AM, Farah D, Hamaly M, Basheti I. Osteoporosis amongst Jordanians: Effect of pharmacist-directed brochure education on peoplenulls knowledge. Tropical Journal of Pharmaceutical Research 2014 doi:10.4314/tjpr.v13i12.22.

54.

Bardet J-D, Vo T-H, Bedouch P, Allenet B. Physicians and community pharmacists collaboration in primary care: A review of specific models. Research in Social and Administrative Pharmacy 2015 doi:10.1016/j.sapharm.2014.12.003.

55.

Montgomery AT, Kalvemark-Sporrong S, Henning M, Tully MP, Kettis-Lindblad A. Implementation of a pharmaceutical care service: prescriptionists’, pharmacists’ and doctors’ views. Pharm World Science 2007 doi:10.1007/s11096-006-9072-0.

56.

Kitzinger J. Qualitative research. Introducing focus groups. BMJ. 1995;311(7000):299–302. doi:10.1136/bmj.311.7000.299.CrossRefPubMedPubMedCentral

Title: A qualitative study of community pharmacists’ opinions on the provision of osteoporosis disease state management services in Malaysia
Authors: Jah Nik
Pauline Siew Mei Lai
Chirk Jenn Ng
Lynne Emmerton
Publication date: 01-12-2016
Publisher: BioMed Central
Published in: BMC Health Services Research / Issue 1/2016
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-016-1686-x

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

A qualitative study of community pharmacists’ opinions on the provision of osteoporosis disease state management services in Malaysia

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2016

Shortened first-line TB treatment in Brazil: potential cost savings for patients and health services

A qualitative synthesis of the positive and negative impacts related to delivery of peer-based health interventions in prison settings

Effect of a patient decision aid (PDA) for type 2 diabetes on knowledge, decisional self-efficacy, and decisional conflict

The effectiveness of clinical networks in improving quality of care and patient outcomes: a systematic review of quantitative and qualitative studies

Factors associated with No-Shows and rescheduling MRI appointments

Why hospital physicians attend work while ill? The spiralling effect of positive and negative factors