Pharmacists' training, experiences and behaviours in managing homeless patients.

Paudyal, Vibhu; Gibson-Smith, Kathrine; MacLure, Katie; Forbes-McKay, Katrina; Buchanan, Carol; Wilson, Liz; Radley, Andrew; Stewart, Derek

Abstract

Community pharmacists are well-situated to offer proactive and opportunistic support and advice to the homeless. The aim of this research was to investigate pharmacists' training, experiences and behaviours in managing homeless patients. A questionnaire using both open and closed questions was developed, based on existing literature, researcher expertise and the Theoretical Domains Framework (TDF) - a synthesis of behaviour change theory. The TDF outlines fourteen individual domains perceived to influence behaviour, including knowledge, skills, beliefs about capabilities and social influences. The questionnaire was reviewed and piloted with fifty pharmacists, and NHS R&D approval was obtained. The questionnaire was then sent to a random sample of 1,951 community pharmacies in England and Scotland, with two follow-up reminders. Results were analysed using descriptive statistics. 321 responses (response rate 16.5%) were received. The mean (SD) age of respondents was 39 (plus or minus 12) years with a third (n=94, 29.3%) having been qualified as a pharmacist for fewer than five years. Many respondents (n = 187) reported having managed a homeless patient in their pharmacy, with approximately 17% (n=53) saying that this was a daily activity. The majority (n=242, 75.4%) of participants said that homelessness was not included in their undergraduate, postgraduate or continuous professional development (CPD) pharmacy training (n=225, 70.1%). Only a third (n=100, 31.1%) agreed or strongly agreed that they knew to whom they should refer a homeless patient for social support. Approximately 42% (n=137) indicated they would discuss homelessness only if raised by the patient. Only one fifth (n=71, 22.1%) felt comfortable advising homeless patients on how to minimise the impact of homelessness on their medication use, and the vast majority of respondents reported a lack of clear guidelines (n=294, 94.2%). The results of this study suggest lack of appropriate opportunities - at undergraduate, postgraduate and CPD level - for training on how to manage homeless patients. There is a need to develop guidelines that will enable community pharmacists to better support homeless patients in alleviating the impact of homelessness; these guidelines should include advice on the pharmacist's role in supporting homeless medicine management and providing signposting to appropriate social services.

Citation

PAUDYAL, V., GIBSON-SMITH, K., MACLURE, K., FORBES-MCKAY, K., BUCHANAN, C., WILSON, L., RADLEY, A. and STEWART, D. 2017. Pharmacists' training, experiences and behaviours in managing homeless patients. Presented at the 46th European symposium on clinical pharmacy: science meets practice: towards evidence-based clinical pharmacy services, 9-11 October 2017, Heidelberg, Germany.

• Presentation Conference Type: Poster
• Conference Name: 46th European symposium on clinical pharmacy
• Conference Location: Heidelberg, Germany
• Start Date: Oct 9, 2017
• End Date: Oct 11, 2017
• Deposit Date: Apr 2, 2018
• Publicly Available Date: Apr 2, 2018
• Keywords: Community pharmacists; Homeless patients; Medication; Training opportunities
• Public URL: http://hdl.handle.net/10059/2852