Patient and pharmacist perceptions of a pharmacist-led educational intervention for people with psoriasis.

摘要

BACKGROUND: Chronic plaque psoriasis is an inflammatory skin condition that affects up to 3% of the UK population and most patients have mild to moderate disease that can be effectively managed with topical therapies in primary care. In recent years, community pharmacists in the UK have been encouraged to adopt a more clinically focused role, particularly around supporting those with longterm conditions. However, little is known about how pharmacists might help support those with longterm skin conditions. OBJECTIVES: To determine patient and participating pharmacists' views of an educational intervention delivered in community pharmacy to those with mild to moderate chronic plaque psoriasis. METHODS: Pharmacists recruited patients either opportunistically when they presented at the pharmacy with a prescription for psoriasis treatment, or via a letter of invitation to those identified from their pharmacy medication records as using prescribed topical treatment for psoriasis. The intervention consisted of one face-to-face consultation and a follow-up appointment after approximately 6 weeks. Structured telephone interviews were conducted with 38 of the patients who participated in the intervention after completion of the follow-up visit. The interviews sought information on patients' reasons for joining the study, measures of satisfaction with the pharmacy consultation and perceptions on whether the pharmacist's advice improved their skin condition. The data generated were analysed quantitatively with open responses coded for subsequent analysis. In addition, semi-structured telephone interviews conducted with all seven participating pharmacists, explored their perceptions on the value of the intervention for both themselves and patients and the potential for wider adoption of such a service. All interviews were audio-recorded, transcribed verbatim and analysed thematically. RESULTS: Nearly three-quarters of patients (74%) joined the study to learn more about their condition and its management and half, (51%) reported improvements in knowledge after the intervention. The majority (84%) of patients believed that their psoriasis had improved as a result of the advice they received during the intervention. Pharmacists also improved their knowledge of psoriasis and its management and welcomed the opportunity for greater patient interaction, believing that patients benefited from the intervention and saw pharmacists as members of the healthcare team managing their condition. However, ensuring patients returned for the second appointment and juggling the demands of the study with other work was sometimes problematic. There were mixed views on the wider adoption of the intervention. CONCLUSION: In the present study, patients felt that their psoriasis improved as a result of the advice from pharmacists and this view was shared by pharmacists. Further work with a larger patient cohort is necessary to explore the extent to which these findings are generalisable to the wider population of pharmacists and patients with mild to moderate psoriasis.