Canadian Pharmacists Journal / Revue des Pharmaciens du Canada

Recognizing pharmacists’ increasing roles as primary care providers, programs offering remuneration for patient care services and the administration of injections by pharmacists continue to be implemented. The objective of this article is to provide an update on remuneration programs available to pharmacists internationally for nondispensing services.

Systematic searches for relevant articles published from January 2013 to February 2018 across PubMed (MEDLINE), Embase, International Pharmaceutical Abstracts, Cochrane Library, Econlit, Scopus and Web of Science. Gray literature searches, including targeted searches of websites of payers and pharmacy associations, were also performed.

Programs were included if they were newly introduced or had changes to patient eligibility criteria and fees since previously published reviews and if they were established programs offered by third-party payers for activities separate from dispensing.

Descriptive information on each program was extracted, including the program’s jurisdiction (country and state, provincial or regional level, as applicable), payer, service description, patient eligibility criteria and fee structure.

Over the 5-year period studied, 95 new programs for noninjection patient care services and 37 programs for pharmacist-administered injections were introduced. Large ranges in fees offered for similar programs were observed across programs, even within the same country or region, at an average of $US 71 for an initial medication review, $19 for follow-ups to these reviews, $18 for prescription adaptations and $13 for injection administration. Apart from some smoking cessation programs in England, which offered incentive payments for successful quits, all services were remunerated on a fee-for-service basis, often in the form of a flat fee regardless of the time spent providing the service.

Although funding for pharmacists’ activities continues to show growth, concerns identified in previous reviews persist, including the great variability in remunerated activities, patient eligibility and fees. These issues may limit opportunities for multijurisdictional program and service outcome evaluation. Can Pharm J (Ott) 2019;152:xx-xx.

To prevent diabetic foot disease, proper foot care is essential for early detection and treatment. Pharmacists are well suited to provide accessible foot care to adults with type 2 diabetes. Limited research has examined this role.

We conducted a systematic review of community pharmacy–based and pharmacist-led foot care interventions for adults with type 2 diabetes compared to usual care. Data sources included MEDLINE, EMBASE, the Cochrane Library, CINAHL, Academic Search Complete and Health Source: Nursing/Academic Edition and Google Scholar, plus Google and hand-searching. Original research studies reported in English, focused on community pharmacy–based or pharmacist-led foot care interventions were eligible for review. Participants were adults with type 2 diabetes. Studies were summarized narratively; pooled data were not possible.

Seven studies were included in this review, 3 focusing on improving foot self-care behaviours and 4 on promoting foot examinations by the health care provider. Only 2 studies were randomized and were assessed as high quality. Six out of 7 studies reported significantly positive findings related to foot care practices.

An opportunity to influence foot care exists at each clinical encounter. Pharmacists are accessible health care practitioners and appropriate to provide a range of diabetes foot care interventions.

Seven studies examined community pharmacy–based and pharmacist-led foot care interventions for people with type 2 diabetes. Community pharmacies and pharmacists are capable of providing a variety of foot care interventions to patients with diabetes, helping detect problems early and leading to prompt intervention.

Identifying the skills and educational needs of community pharmacists concerning addiction is critical to improving the services provided for people who suffer from addiction disease (PWSAD).

Eleven one-to-one semi-structured interviews were conducted with community pharmacists practising in the Saskatoon Health Region, Canada. The interviews were recorded and transcribed verbatim and verified with the participants. Thematic analysis was employed to analyze the transcripts.

Four major themes were identified: 1) effect of the work setting on pharmacists’ encounters with PWSAD, 2) pharmacists’ knowledge of key aspects of addiction, 3) level of support within the health care system, and 4) educational and training needs.

Participants indicated that a lack of knowledge and training were major hindrances to improving the quality of the services provided to people who suffer from addiction disease. Additional practicum experience at the undergraduate level and interprofessional interactive educational sessions at the continuing educational level were key recommendations emerging from the study.