Public Health in Community Pharmacy

1
Public Health in Community Pharmacy

• Fiona Macfarlane BSc MPH
• Health Promotion Officer
• NHS Forth Valley

2
Background

• Scottish Executive Dental Action Plan (2005)1
• NHS Forth Valley Dental Health Strategy (2005)2
• 1 Year Pilot - Oral Health Initiative in
  Community Pharmacy (2007- 2008)
• Pilot Service Evaluation and Client Experiences
• The Scottish Executive. An Action Plan for
  Improving Oral Health and Modernising the NHS
  Dental Services in Scotland. Edinburgh The
  Scottish Executive 2005
• NHS Forth Valley. Multi-agency and Dental Health
  Strategy for NHS Forth Valley. Stirling NHS
  Forth Valley 2005

3
Background

• Scottish Executive Dental Action Plan (2005)1
• NHS Forth Valley Dental Health Strategy (2005)2
• 1 Year Pilot - Oral Health Initiative in
  Community Pharmacy (2007- 2008)
• Pilot Service Evaluation and Client Experiences

4
Background

• Scottish Executive Dental Action Plan (2005)1
• NHS Forth Valley Dental Health Strategy (2005)2
• 1 Year Pilot - Oral Health Initiative in
  Community Pharmacy (2007- 2008)
• Pilot Service Evaluation and Client Experiences

5
The experiences and perceptions of Community
Pharmacists in NHS Forth Valley involved in
delivering an innovative oral health intervention
with clients accessing substance misuse services.
6
Objectives

• To explore the community pharmacists perceptions
  of their public health role in contributing to
  health improvement amongst substance misuse
  clients
• To identify factors that influence community
  pharmacists participation in public health
  interventions
• To explore the experiences of community
  pharmacists who delivered oral health
  interventions to substance misuse clients

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Objectives

• To investigate the perceptions and attitudes
  towards oral health improvement with substance
  misuse clients
• To determine if community pharmacists believe
  they can engage effectively with substance misuse
  clients to affect health behaviour and behaviour
  change related to oral health improvement
• To investigate if community pharmacists are
  appropriately placed to deliver oral health
  improvement with substance misuse

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Method / Data Collection

• Qualitative Methodology
• Non random sampling
• Semi- structured interview schedule
• Face to face interviews
• Analysis and Interpretation
• Data transcription
• Thematic analysis and coding
• Ethical Approval
• University of Glasgow Faculty of Medicine Ethics

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Experiences and Perceptions

• Good Idea, Beneficial, Raised Awareness
• A lot of them with regards to the oral health,
  you know, have mentioned about their teeth and
  theyve had problems with, you know dental work
  and stuff so obviously the oral hygiene
  initiative is a good idea Pharmacist 12

10

• I thinkit may be of benefit to one of two
  cases out of the 6 in our particular case
• Pharmacist 13
• I think it just reminds them. I think they are
  all becoming a lot more aware of their oral
  health
• Pharmacist 16

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Intervention / Service Delivery

• Easy to deliver and well organised
• It is quite an easy way that its been set out.
  Its quite easy to give the information simple
  and straight forward and not time consuming
  thats the kind of things we need
• Pharmacist 4

12

• Its been, I think, very well organised its
  been very straightforward and very easy to do I
  think its been made very easy for me to do
• Pharmacist 13

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Engagement / Attitude

• Three quarters of pharmacists involved other
  staff in the delivery of the intervention
• Staff engagement was viewed positively by the
  pharmacists
• Mixed perceptions of client engagement
• Its just a freebie?

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Effectiveness

• Over half reported that the model was effective
  or very effective
• They are guaranteed to come in for their
  methadone utilising the pharmacists is the most
  effective way of doing it
• Pharmacist 7

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Impact on Client Attitudes and Behaviours

• Some perceived impact on client attitudes and
  behaviours
• I think its had a good impact, I think it just
  remind them they are more aware of their health
  and oral health especially I think its had a
  positive impact definitely
• Pharmacist 16

16

• It did have an impact, I wouldnt say it was
  enormous, probably I would say significant
• Pharmacist 1
• Hopefully weve maybe changed some of their
  attitudes sort of dispelled their theories on
  oral health and methadone I think we must have
  made an impact
• Pharmacist 10

17

• theyve been coming here for while so theyre
  like oh yes, I dont wet the toothbrush and you
  know it seems that theyre remembering what
  youve told them
• Pharmacist 12

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Appropriateness

• All of the pharmacists believed they were
  appropriately placed to engage and deliver the
  oral health intervention
• Recurring themes
• Regular / frequent contact
• Existing relationship
• Accessibility of the pharmacy

19

• Were best placed really, if we are seeing them
  everyday. Thats really the only healthcare
  professional theyre going to be seeing on a
  regular basis
• Pharmacist 4
• I think that this is more than appropriate
  were a bit of continuity for them and we do see
  them most regularly
• Pharmacist 16

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Summary

• Good idea, beneficial, raised awareness and
  influenced the behaviours and attitudes of some
  clients
• Simple and straightforward to deliver, well
  organised and not time consuming
• Largely positive experiences of the intervention
• Community pharmacists feel appropriately placed
  to deliver the intervention
• Could be adopted to address other health issues
  with this client group

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Contact Details

• Fiona Macfarlane
• Health Promotion Officer
• NHS Forth Valley
• Tel. [phone]
• Email. Fiona.macfarlane2_at_nhs.net