Health Inequality and Pharmacy

A special issue of Pharmacy (ISSN 2226-4787).

Deadline for manuscript submissions: closed (31 October 2019) | Viewed by 12766

Special Issue Editors


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Guest Editor
University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
Interests: cardiovascular disease; adherence to medication; service developments
Special Issues, Collections and Topics in MDPI journals

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Guest Editor
Robert Gordon University, Aberdeen AB10 7QB, UK
Interests: technology enabled care; equality of access to health care services; health literacy; digital literacy; pharmacy practice

Special Issue Information

Dear Colleagues,

We are pleased to announce a Special Issue of the journal Pharmacy, guest edited by Dr Vibhu Paudyal, University of Birmingham and Dr Katie MacLure, Robert Gordon University, Aberdeen.

Health inequality is one of the key public health and healthcare challenges in the 21st century. Disparities around access to healthcare, medicines, health literacy, and resources to manage medicines requires multi-disciplinary and multi-sector action. In this context, pharmacy as a healthcare set up and a profession has a key role to play. Pharmacists’ expertise, interests, contribution and skills are beginning to be well recognised internationally. It is imperative that best practices in research, service development and evaluation that aim to address health inequality through pharmacy are published, allowing best practices, key challenges and lessons to be shared widely.

Dr. Vibhu Paudyal
Dr. Katie MacLure
Guest Editors

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Keywords

  • Health inequality
  • Disparity
  • Pharmacy
  • Public health pharmacy
  • Prevention

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Published Papers (3 papers)

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Research

10 pages, 218 KiB  
Article
Designing a Clinical Pharmacy Primary Care Intervention for Myocardial Infarction Patients Using a Patient and Public Involvement Discussion
by Zahraa Jalal, Vibhu Paudyal, Shahad Al-Arkee, Gillian Dyson and John Marriott
Pharmacy 2020, 8(1), 13; https://doi.org/10.3390/pharmacy8010013 - 24 Jan 2020
Cited by 2 | Viewed by 2396
Abstract
Objective: to conduct a Patient and Public Involvement (PPI) focus group session. To help inform the design of a clinical pharmacy intervention in primary care for patients after a coronary event. Methods: this study followed a public involvement method. Community members [...] Read more.
Objective: to conduct a Patient and Public Involvement (PPI) focus group session. To help inform the design of a clinical pharmacy intervention in primary care for patients after a coronary event. Methods: this study followed a public involvement method. Community members of the public and community engaged research patients who had experienced myocardial infarction where invited to actively take part in a focus group discussion. This is to share past experiences and provide input and advice into the design of a potential research proposal. The session took place at a cardiac rehabilitation centre. Results: four key themes were identified from the focus group these included: experiences with pharmacy and primary care services, medicines knowledge, the pharmacist role and building rapport with healthcare professionals. Nine participants and three researchers attended the PPI discussion session. Seven of the participants were patients who had experienced a cardiac event in the last three months and two were carers. Primary care pharmacy services both clinical and public health were not very familiar to the participants. Different experiences with clinical pharmacy services were reported by participants, while one experience was reported to be helpful others perceived community pharmacists to be to be busy and isolated behind a counter. A general practice GP based specialist nurse was a familiar model of care unlike a specialist clinical pharmacist GP based care role. Participants reported limited time in GP consultations and the need to book double appointments. Participants stressed the need to receive consistent information about their disease and medication from different professionals involved in their care. Different views were expressed regarding the ability to build rapport with a clinical pharmacist when compared to a GP. Input on study outcomes and design was provided by participants. Conclusion: participants in this session mentioned that a clinical pharmacy intervention after hospital discharge would be useful for their continuity of care. Plans are in place to continue to involve patients and the public in the write up, ethics and dissemination of the potential clinical pharmacy proposal. Full article
(This article belongs to the Special Issue Health Inequality and Pharmacy)
10 pages, 216 KiB  
Article
Clinical Pharmacy Intervention for Persons Experiencing Homelessness: Evaluation of Patient Perspectives in Service Design and Development
by Parbir Jagpal, Nigel Barnes, Richard Lowrie, Amitava Banerjee and Vibhu Paudyal
Pharmacy 2019, 7(4), 153; https://doi.org/10.3390/pharmacy7040153 - 13 Nov 2019
Cited by 16 | Viewed by 4406
Abstract
Persons experiencing homelessness have a high prevalence of severe mental health problems, alcohol dependence, substance misuse and infectious hepatitis C, and face up to twelve times higher mortality rates compared to the general population. They also face barriers to accessing healthcare. However, clinical [...] Read more.
Persons experiencing homelessness have a high prevalence of severe mental health problems, alcohol dependence, substance misuse and infectious hepatitis C, and face up to twelve times higher mortality rates compared to the general population. They also face barriers to accessing healthcare. However, clinical pharmacy services are currently not available to homeless populations in England. The aim of this study was to conduct public involvement sessions with persons experiencing homelessness with a view to inform the design of patient-centred clinical pharmacy healthcare services. Qualitative methodology was used, using a focus group with homeless persons from emergency shelters and one to one engagement with those sleeping rough, using a topic guide. A total of nine homeless persons took part—seven males and two females. The participants of the sessions said that patient-centred clinical pharmacy services delivered for homeless persons would address many of their unmet needs around access to medicines, their understanding of prescribed medicines and holistic management of their health. The service would be able to make a positive impact on their health outcomes by screening for health conditions, facilitating better integration across services, referral and liaison with other services, and minimising misuse of prescribed medicines. The findings of this study will be used to inform the development, implementation and evaluation of a patient-centred clinical pharmacy service tailored to meet the specific needs of the homeless population. Full article
(This article belongs to the Special Issue Health Inequality and Pharmacy)
13 pages, 301 KiB  
Article
Race/Ethnicity, Socioeconomic Status, and Polypharmacy among Older Americans
by Shervin Assari and Mohsen Bazargan
Pharmacy 2019, 7(2), 41; https://doi.org/10.3390/pharmacy7020041 - 25 Apr 2019
Cited by 30 | Viewed by 4906
Abstract
Background: Very few studies with nationally representative samples have investigated the combined effects of race/ethnicity and socioeconomic position (SEP) on polypharmacy (PP) among older Americans. For instance, we do not know if prevalence of PP differs between African Americans (AA) and white older [...] Read more.
Background: Very few studies with nationally representative samples have investigated the combined effects of race/ethnicity and socioeconomic position (SEP) on polypharmacy (PP) among older Americans. For instance, we do not know if prevalence of PP differs between African Americans (AA) and white older adults, whether this difference is due to a racial gap in SEP, or whether racial and ethnic differences exist in the effects of SEP indicators on PP. Aims: We investigated joint effects of race/ethnicity and SEP on PP in a national household sample of American older adults. Methods: The first wave of the University of Michigan National Poll on Healthy Aging included a total of 906 older adults who were 65 years or older (80 AA and 826 white). Race/ethnicity, SEP (income, education attainment, marital status, and employment), age, gender, and PP (using 5+ medications) were measured. Logistic regression was applied for data analysis. Results: Race/ethnicity, age, marital status, and employment did not correlate with PP; however, female gender, low education attainment, and low income were associated with higher odds of PP among participants. Race/ethnicity interacted with low income on odds of PP, suggesting that low income might be more strongly associated with PP in AA than white older adults. Conclusions: While SEP indicators influence the risk of PP, such effects may not be identical across diverse racial and ethnic groups. That is, race/ethnicity and SEP have combined/interdependent rather than separate/independent effects on PP. Low-income AA older adults particularly need to be evaluated for PP. Given that race and SEP have intertwined effects on PP, racially and ethnically tailored interventions that address PP among low-income AA older adults may be superior to universal interventions and programs that ignore the specific needs of diverse populations. The results are preliminary and require replication in larger sample sizes, with PP measured directly without relying on individuals’ self-reports, and with joint data collected on chronic disease. Full article
(This article belongs to the Special Issue Health Inequality and Pharmacy)
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